Angst. If it could be bottled up and sold as a weapon it would be valuable on the black market. A big part of what plagues PWS is the constant anxiety—the worry, frustration, isolation, shame, embarrassment, unrest, guilt, busted confidence, depression, uncertainty, hopelessness, anger, and exasperation. And then there’s the relationship problems and the feeling that nobody understands all that’s in that bottle. Yeah, there are the blocks, the repetitions or the prolongations, the tics or grimaces. People can a least see or hear that part… but what’s in that bottle they can’t see or hear. Maybe that’s the worst part. Medical doctors don’t seem to get it. The best advice that I can offer is to get in front of a good speech-language pathologist who works with PWS—one who works with adults. There are lots of kid therapists but look for one who works with adults. At a minimum look for the CCC-SLP designation. A good therapist can quell the above and is super helpful.