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Apr 30

Postpartum Depression


Pospartum depression (postnatal depression), is a type of clinical depression, affecting women, after childbirth. Normally this of nervous tension occurs in women in the first new months of pregnancy, but in some women, it can last after child birth. The rate of occurrence is between 5 -25%, depending to the uniqueness of each women. In men the occurrence of postpartum depression are uncleared with the range between 1% and 25%. Normally the symptoms will go away on its own in a short period of time (Baby blue symptoms). In some women, the symptoms get more serve everyday and does not go away that can leading to the onset of postpartum depression
Symptoms As a result of rapid hormone change after birth 1. Sadness 2. Lack of interest in your baby and negative feelings towards your baby 3. Changes in eating appetite 4. Reduced sexual desire 5. Feelings of worthlessness and guilt 6. Trouble focusing, remembering, or making decisions 7. Mood swing 8. Insomnia 8. irritability 9. Loss of pleasure 10. Suicidal 11. Withdrawal from friends and family 12. Etc.
Causes and risk factors 1. The body can not adjust quickly enough to the rapid hormone change after birth, such as suddenly drop of estrogen and progesterone. thyroid hormone, etc. 2. Sudden change physically and emotionally, such as premature baby, losing the baby weight, insecurity, etc. 3. Over whelming for the responsibility to look after the newborn. 4. Emotional stress during labor and delivery 5. Previous incidence of depression can increases the risk of the diseases. 6. previous incidence of pospartum depression can increases the risk of the diseases. 7. Unplanned pregnancy 8. Serve menstrual cramps and pain 9. Family history Increased risk of the incidence if one or more direct family has the previous the diseases. 10. Etc.
How postpartum depression affects the baby Since postpartum depression is a serious mental illness, it can interfere with your ability to look after yourself, your child and daily activities performance,etc., if left untreated, it can badly effect your newborn such as loving one minute and withdrawn the next, do not response to the needs of the baby, leading to the insecurity attachment(a negative feeling when they are baby), lack of emotional bond between the mother and the baby, etc. 1. Insecurity attachment is negative feeling when they are baby a. Children with insecurity attachment have difficulty connecting to others and managing their own emotions. 2. Children with insecurity attachment have a lack of trust to others and self-worth, a fear of getting close to other and feel unsafe when alone. 3. May be delayed in their development, due to withdrawal him self out of learning 4. Sleep disorder, may be caused the feeling of unsafe 5. Quiet and passive due to no response from the depressive mother. 6. Behavior problem 7. Aggression 8. Lower self esteem 9. Increased risk of depression in the later of the baby’s life 10. Etc.
Treatments Although there is no specific treatment for postpartum depression, researchers suggest the below treatment depending to the situation of each woman. 1. Interpersonal therapy (IPT) Interpersonal therapy (IPT), which is a time-limited, annualized psychotherapy, focuses on remit depression, alleviate interpersonal distress, and assist patients to build or better utilize social supports is believed to be very effective in treating women with postpartum depression.
2. Marriage Some women with postpartum depression may feet that their marriage is in danger of breaking off, such as feeling unsupport of the partner,… then marriage counseling could be very beneficial.
3. Hormone therapy Certain types of anti-depression medicine used combination with estrogen therapy can be beneficial
4. Medicine Antidepressants may be necessary in some case, depending to the severity of the diseases and breast feeding.
5. Support from the family, friends, support group can be helpful.
6. In some case, a women with postpartum depression may be put in the hospital if the treatments do not help or her action may be in danger to herself and the baby.
In the 18-month study followed 157 women who were recruited from middle-class communities across the Iowa City region. researcher found that even though all depressed mothers received treatment and most were symptom-free, postpartum mothers reported their toddlers as less securely attached,… Fortunately, most women will find that the condition improves in a few months of treatment and most of them recovery from the diseases.
Postpartum Depression Learn How To Get Rid Of Your Postpartum Depression Naturally And Safely.

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ByRyan Jaslow      For the largest imaging study of human brains ever conducted, researchers from the University of Vermont studied the brains of 1,896 14-year-olds with functional magnetic resonance imaging (fMRI) scans. During the scans, teens were asked to perform a task that involved them pressing a button on a keyboard.  Then the researchers would unpredictably provide a cue during the task that would signal when a participant should not press the button. That task would require the brain to inhibit the act of pushing the button, which could be used to measure how impulsive a teen is.

The researchers found differences in these brain networks caused some teens to act more impulsively than others: teens who were able to stop the signal had the certain networks “light up” on the fMRI scan. Acting more impulsively raises a teen’s risk for drug and alcohol experimentation, the researchers said.

“These networks are not working as well for some kids as for others,” leading them to become more impulsive, Robert Whelan, a post-doctoral researcher at the University of Vermont, said in a university written statement.  When given the opportunity to smoke, drink or do drugs, a 14-year-old with a less functional impulse-regulating network will be more likely to say, “yeah, gimme, gimme, gimme!” study author Dr. Hugh Garavan, an associate professor of psychiatry at the University of Vermont, told LiveScience.

The researchers said this study solves a “chicken-or-egg” question of whether brain changes come before drug use or are caused from it. Their findings are published in the April 29 issue of Nature Neuroscience.  Differences in a different set of brain networks were also connected to symptoms were tied to another impulsivity-related condition, attention-deficit hyperactivity disorder (ADHD). ADHD is a disorder that causes problems with over-activity, inattention, impulsivity or a combination of all those factors beyond what’s typical for a child’s development.

In recent years research has suggested a link between ADHD and likelihood for substance abuse, but the new study suggests ADHD is not a full-blown risk for drug use since the problems are regulated by different networks.  “The take-home message is that impulsivity can be decomposed, broken down into different brain regions, and the functioning of one region is related to ADHD symptoms, while the functioning of other regions is related to drug use,” said Garavan.

So what does it all mean?  The researchers said in the statement that a better understanding of brain networks that put some teens at high risk for drug abuse can aid public health by reducing the number of deaths among teens – which are often caused by preventable accidents caused by impulsive risky behaviors.

Apr 30

Bullied Children at Greater Risk for Self-Harm


By Mary Elizabeth Dallas    FRIDAY, April 27 (HealthDay News) — Children who are bullied are three times more likely than others to self-harm by the time they are 12 years old, according to a new study.

A team of researchers from the United States and the United Kingdom said its findings, published online April 27 in the BMJ, could help identify those at greatest risk for this type of behavior.

Examples of self-harming behaviors included cutting and biting arms, pulling out clumps of hair, head-banging and attempted suicide by strangulation, the study said.

The researchers examined sets of twins born between 1994 and 1995 in England and Wales. Six months before their 12th birthday, the twins’ risk for self-harm was assessed. This information was available for 2,141 participants.

The investigators found that 237 of the children were the victims of bullies. Of these kids, 8 percent engaged in self-harm. In contrast, of the 1,904 children who had not been bullied, only 2 percent had self-harmed.

Among the bullied children, the study authors pointed out several factors that further increased their risk for self-harm, including:

  • A family history of self-harming behavior
  • Maltreatment
  • Behavioral and emotional problems.

The researchers also noted in a journal news release that girls were more likely to self-harm than boys.

Lead study author Helen Fisher, of the Institute of Psychiatry at King’s College London, and colleagues concluded that schools and health care professionals should intervene and protect bullied children by working to “reduce bullying and introduce self-harm risk-reduction programs.” They added that systems should be in place to help children cope with the emotional distress of bullying.

Apr 30

Alternative ADHD Treatment: Fish Oil


by Tina Adler      Could a daily fish oil capsule help curb the symptoms of attention deficit hyperactivity disorder (ADD ADHD) in children and adults? alternative ADHD treatment really help?

Quite possibly, suggests the latest research – including a study published in the May 5, 2005, issue of Pediatrics. “A lack of certain polyunsaturated fatty acids may contribute to dyslexia and attention-deficit/hyperactivity disorder,” reports one of the study’s authors, Paul Montgomery, D.Phil., a researcher in the psychiatry department at the University of Oxford in England.

For the study, schoolchildren were given fish oil supplements rich in omega-3 essential fatty acids (EFAs) for a period of three months. The children showed significant improvements in behavior, reading, and spelling.

Given this finding, Montgomery has become a proponent of fish-oil supplements for children with ADD. “People would be lucky if they could get their kids’ EFA levels up sufficiently by diet alone,” says Montgomery. “I think supplementation with omega 3’s is the only sensible way forward. One gram per day seems right for most children.”

Montgomery recommends choosing a fish oil supplement that contains a high ratio of omega-3 fatty acids (EPA) to omega-6 fatty acids (DHA). “The right ratio of 3’s to 6’s seems to be about four to one,” he says.

Apr 29

What Parents Can Do About CyberBullying


Bully Prevention & Online Safety for Kids

Published on April 29, 2012 by Signe Whitson, L.S.W. in Passive Aggressive Diaries

I remember with clarity the day my daughter “discovered” the internet. She was just three years old and playing hostess to the son of one of my college friends, visiting from out of town. As the two toddlers were breezing through the kitchen, my friend’s son, Jack, stopped short and suggested enthusiastically, “Let’s play computer!”

I laughed, thinking how cute it was going to be to watch the little ones sit and pretend to type on my laptop. Then, before my amazed eyes, Jack navigated successfully to and introduced my daughter to the wonders of the world wide web.

Now, at not-quite-nine, I am still amazed everyday at how natural and intuitive technology usage is to my daughter and to all of her peers who have grown up with computers, cell phones, tablets, and texting as part of their everyday lives. I am also aware, however, that things like Internet Safety, Cyberbullying and “Netiquette” may not register on her radar the same way they do on mine.

When she was very young, I worried about the unknown: online predators who could try to trick her into revealing personal information so that they could cause her physical harm. Now, in her tween years, I know that “stranger danger” is still a threat, but I spend more of my time worrying about the known: frenemies from her daily life who may use taunting texts, humiliating social media posts, and viral videos to cause her emotional harm. It’s no wonder that when she begs me (at least once daily) for a cell phone, I feel chills run up and down my spine.

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No matter how tech-savvy my daughter becomes, I am constantly aware that she is young and that it is up to me to monitor her safety and well-being with technology in the same consistent, diligent way that I ensure her well-being on a playground. These basic rules are our first line of defense in minimizing (I’m too wise to think that “preventing” is realistic) cyberbullying and using technology in safe, respectful ways:

Talk About Safe Sites

In her pre-literate days, I could rely on the fact that the only way my daughter could get from one website to another was by me typing in the correct website address for her. Likewise, I knew that she would be content staying on PBS Kids, Disney, or Nick Jr. Websites. Those days are long gone. Flashing icons, interesting links, viral videos–there are so many ways that children and tweens are tempted into visiting and viewing less-than-innocent content online.

Without wanting to scare my daughter out of ever going near a computer again, I do talk frankly with her about the fact that predators exist in cyberspace (I have explained this in terms appropriate for each stage of her development, but have never sidestepped the subject) and that it is important for her to safeguard her personal information while online.

Define “Safe Sharing”

I’m so glad we had the talk about safe sites when we she was young, because it has helped us make a seamless transition in her tween years to talking about what is—and what is never, ever, ever, never—safe to share online. First and foremost, our rule is to go photo-free. The network news is chock-full of stories about kids who have gotten themselves into friendship-destroying, reputation-shattering, college admission-sacrificing, future career-jeopardizing, family-humiliating situations because of photos they have posted online or via text. For parents who don’t want to take as hard of a line on photos, at minimum, I recommend making sure that the photos their kids share are never suggestive or sexual in any way.

Next on my list of words of wisdom to my technology worshipper: What you post is permanent. Once you share something online, it is out of your hands where it goes, who will forward it, who will see it, and how it can potentially be used. When Queen Bees and Wannabeees author, Rosalind Wiseman called technology a weapon of mass social destruction, she was not exaggerating; according to the CDC, 97% of middle schoolers are bullied while online. So, as much as my daughter might think she can trust her BFF with her deepest, darkest secrets, I remind her of the importance of never posting personal information that a BFF-with-a-grudge could at some point distort and use against her.

Set Clear Guidelines on Etiquette

When the internet first became a powerful force in the lives of kids, the term “netiquette” was coined to describe ethical ways to interact while online. Though no equivalent phrase has yet emerged for cell phone use (cell-iquette??), it is important to talk to kids about how to treat others while texting. For example, I pose these questions to my daughter (only to an occasional groan, surprisingly)

• Would you say the words you are texting to a person’s face?

• What would your parents think if they read this text?

• Could this message you are sending cause hurt or embarrassment to me, my friends, my family, or anyone else?

• Can your text be taken out of context and used to hurt you or someone else?

• If you received a threatening or rumor-spreading text message, what would you do?

• How does technology make it easier for you to say something unkind to someone?

Cell phones and social networking sites are prime tools of bullying among young people, so being clear that texts, phone calls, and social media sites are never to be used as tools of gossip, exclusion, embarrassment, etc. is essential. Likewise, parents are wise to encourage their kids to tell them about any incidents of cyberbullying that they are aware of, even if they are not directly involved. By keeping a dialogue going, parents can position themselves to help a child who may be being bullied online and can establish a set of standards for how their own kids must behave online.

Know the Lingo

Are you familiar with these text-friendly acronyms?


• JK



Texting has a language all of its own. Laugh out Loud (LOL), Just Kidding (JK), and Be Right Back (BRB) are common enough, but while most adults that are parents today take for granted that ATM stands for a bank’s Automatic Teller Machine, kids can tell you that it is more likely to refer to their being “at the mall.” Online lingo is cryptic, clever, and intentionally elusive. The over-30 crowd may never know all of the acronyms, but the more parents educate themselves about the lingo their kids are using, the better able they are to monitor technology use and abuse.

Know Your Child’s Passwords

Am I a helicopter parent? I don’t really think so, though I will own the accusation if necessary, for my firm belief is that kids need clear guidance, limits, and expectations when it comes to using technology. In my own home and in the workshops I do, I always advise parents that when the time comes to allow their child access to a cell phone, Facebook, YouTube, or any other piece of today’s technology, they would not be overstepping their bounds to let their kids know that they maintain the right to access their child’s accounts at any time. The relative freedom of cell phones and social media sites tempt even the most trustworthy and responsible kids to engage in risky behavior, so it is important for parents to let their kids know upfront that they will be reading texts, reviewing MMS messages, scrutinizing Facebook posts, viewing YouTube uploads and providing any other kind of oversight that underscores the importance of safe technology usage by kids.

While I advise parents to know their kids’ passwords, it is equally important that parents tell their kids not to give their passwords to friends—like, ever. Trusted BFF one day, sworn enemy the next; when kids give up their passwords, they are giving up control of their personal accounts, their online identity, and potentially their good reputation.

Lastly, if your child is using a social networking site such as Facebook, ask to “friend” them or, at minimum, ask another trusted adult to do so. While kids may initially resist this as “spying,” when parents present this guideline as coming from a place of love and concern for their child’s well-being, the young person’s sense of paranoia often melts away.

Parental Controls

And one final note to wrap up my thoughts on the topic of keeping kids as safe as possible when it comes to using today’s social technology. In response to a conversation about cyberbullying recently, I heard someone bluster, “I don’t know what the big deal is–all of those sites and gadgets have parental controls on them. Parents should just use them and be done with it.”

If only it were that simple. I agree with his basic advice about activating parental controls: adults should use them. However, I caution all parents not to rely on them as a sole means of safety for kids. Parental controls are limited…and we all know how good kids can be at testing limits! Automated safety features are a great first line of defense—best fortified by discussion, guidelines, standards, knowledge, interest, and a whole lot of support for kids.

Apr 29

I. What is dementia ?

About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability that is severe enough to interfere with people’s every life and Alzheimer’s disease is the most common type of dementia in aging people.

II. Types of dementia

1. Alzheimer’s disease Alzheimer’s disease is a brain disorder named for German physician Alois Alzheimer. Alzheimer’s destroys brain cells, causing problems with memory, thinking and behavior severe enough to affect language communication, memory, lifelong hobbies or social life. Alzheimer’s gets worse over time, and it is fatal. Over 1 million people in US alone are currently afflicted by Alzheimer’s disease because of degeneration of hippocampus and cerebral cortex of the brain where memory, language and cognition are located. With this mental disorder, brain cells gradually die and generate fewer and fewer chemical signals day by day resulting in diminished of functions. Overtime memory thinking as well as behavior deteriorates. Today, there is no known cure.

2. Absence of acetylcholine If the nerves located in front of the brain perish, causing diminished quality of acetylcholine resulting in language difficulty, memory loss, concentration problem and reduced moblile skills because of lacking reaction in muscular activity and refection.

3. Dementia due to long-term alcohol abuse. Dementia is common in patients with alcoholism. Most classic is the Korsakoff’s dementia resulting in extremely poor short term memory and often associated with the memory losses are confabulations.

4. Multi-infarct dementia Also known asvascular dementia , is the second most common form of dementia after Alzheimer’s disease in older adults. It is caused by different mechanisms all resulting in vascular lesions in the brain.

5. Dementia associated with Parkinson’s disease Parkinson disease (PD) is a disabling, progressive condition. It is a cognitive deficits due to the interruption of frontal-subcortical loops that facilitate cognition and that parallel the motor loop.

6. Creutzfeldt-Jakob disease (CJD) People who have eaten contaminated beef many years may be infected without even knowing it. Creutzfeldt-Jakob disease is a quickly progressing and fatal disease that consists of dementia, muscle twitching and spasm.

7. Subdural hematoma It is the accumulation of blood beneath the outer covering of the brain that result from the rupture of blood vessel. Subdural hemorrhages may cause an increase in tracranial pressure, which can cause compression of and damage to delicate brain tissue. Acute subdural hematoma has a high mortality rate.

There are many types of dementia such as metabolic disorders, dementia due to long-term substance abuse, hypothyroidism, and hyperethyroidism.

Alzheimer’s Disease – My Story This Is A Real Case Study, Written By An Alzheimer’s Sufferer Sharing His Hurts, Frustration And Desperation.

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Apr 29

Spanking’s long-term effect on intelligence


Spanking lowers IQ

Disciplining your child can be a challenge, but new research suggests that parents may wish to adopt methods other than spanking to manage their child’s behaviour. A recent study by University of New Hampshire professor Murray Straus shows that children who are spanked have lower IQs than children who are not spanked. 

Straus and colleagues measured spanking and IQ level in 806 children aged two to four and 704 children aged five to nine. Four years later, children aged two to four who were spanked had IQ scores on average five points lower than children who were not spanked in the same age group. Similarly, children aged five to nine who were spanked had IQ scores 2.8 points lower than children who were not spanked in the same age group. The researchers also found that the greater the number of times a child was spanked, the slower the development of the child’s mental ability.

Chicken or egg?

Other research by Straus may help to explain his latest findings; previous studies suggest that if spanking becomes a chronic stressor in a child’s life, the child may show an increase in post-traumatic stress symptoms, such as being fearful or easily startled. These types of anxious feelings can have a negative impact on cognitive ability.

Although this explanation appears logical, the relationship between spanking and IQ level needs to be examined more carefully. While Straus’ study shows an association between spanking and IQ level, it does not show cause and effect. It is not clear if spanking causes lower cognitive ability or if lower cognitive ability might lead to more spanking. For example, children with low cognitive ability may have associated behavior problems that are frustrating for parents to deal with. Low cognitive ability would be the cause, and parents spanking more often would be the effect. In this scenario, there is still the same relationship between IQ level and spanking as that found in Straus’ study, however we are able to identify the direction of the relationship. 

Undecidedly, there could be other factors influencing the relationship between IQ level and spanking. Parents who are spanking are using other forms of discipline less. The parent who explains to their child why what they are doing is wrong is increasing verbal interaction and stimulating cognitive development for their child. This could mean that a lack of verbal discipline combined with the spanking behavior itself, causes a low IQ level.

When spanking gets out of hand

There is a difference between giving your child the belt and spanking, at least according to Straus. He defines corporal punishment as the use of physical force with the intention of causing a child to experience pain but not injury for the purpose of correction or control of the child’s behavior.

These criteria, physical force, intent to cause pain, and the goal of managing behavior, must all be present at the same moment for corporal punishment to be identified. Think about removing a splinter from your child’s hand. You are using physical force and causing pain, but only to get that pesky splinter out. There is no effort to influence behavior. Furthermore, it is important to make a distinction between pain and injury. Giving your child the belt poses a significant risk of injury and is considered physical abuse instead of corporal punishment.

However, the line between corporal punishment and physical abuse can become blurred. According to the American Academy of Pediatrics, “although spanking may immediately reduce or stop an undesirable behavior, its effectiveness decreases with subsequent use. The only way to maintain the initial effect of spanking is to increase systematically the intensity with which it is delivered.” This means that if a certain behavior is not corrected after the first spank, the parent will hit the child again, but harder, perpetuating a cycle of punishment that can easily escalate into physical injury or physical abuse.

Theory vs. practice

Straus discriminates between spanking and more severe forms of assault in theory, but in practice these behaviors are more closely related. Data reported as corporal punishment by parents can be easily confounded with more severe forms of assault, making it difficult to discern the level of severity that leads to negative effects on child development.

Along with severity, there are problems with collecting data about the frequency of spanking found in Straus’ study. Mothers of the children in the two age groups were asked how many times they spanked their children during a two week period. This means that any spanking behavior that occurred outside of the time interval was not recorded. The behavior of fathers or other caregivers was not taken into consideration within or outside of the time interval.

Mothers reported the number of instances the child was spanked, which does not accurately reflect severity or frequency of spanking behavior. Whether the child was spanked hard five times on one occasion, or lightly just once, the act was reported as one instance of spanking. Also, we cannot forget that pain is a subjective experience. What is considered a hard painful slap on the behind to one child, may feel like a light touch to another.

Spanking affects emotions and mental health as well as intelligence

Looking beyond its effect on IQ, it is perhaps not a surprise that young children also experience stressful and negative emotions when faced with corporal punishment. Negative reactions to threatening stimuli, like those that affect behavior and development in humans, are parallel in the animal kingdom. Researchers observed two rats in a cage with an electric grid floor. As soon as the researchers administered a stressful shock through the floor the rats became violent, attacked each other, and fought to the point of drawing blood.

Corporal punishment contains an element of shock to a child. Children who are spanked or hit experience a range of emotional or behavioral probems through to adulthood, including aggression and anxiety, leading to violence in the home, depression, and substance abuse or dependence. 

The effects of spanking transcend culture and age

Straus’ findings appeared universal: around the world, a strong link exists between corporal punishment and IQ for adults who received corporal punishment as teenagers. Using data from 32 nations, Straus found the higher the percent of university students who received corporal punishment as teenagers, the lower the national average IQ. Most likely, adults who received corporal punishment as teenagers, also received it as children.

International organizations are beginning to take notice. Both the European Union and the United Nations have advised all member nations to prohibit corporal punishment by parents. In response, 24 nations have committed to legally banning corporal punishment by this year.

Tawnya Pancharovski  Medical Writer  AboutKidsHealth

Apr 29

ADD/ADHD Children: Effective Discipline Techniques


Children with attention deficit hyperactivity disorder (ADHD)/attention deficit disorder (ADD) are notoriously difficult to discipline. Because of the effects of the disorder, it’s hard to get some children to even listen to the reasons why they’re being punished. And consequences can be very hard to enforce with children who are easily distracted.

But these challenges don’t mean that you should give up — there are effective ways to discipline a child with ADD/ADHD. First, be aware of these common mistakes:

  • Not communicating to the child what he or she did wrong. “Punishment tells you what not to do, but it doesn’t tell you what to do,” says Sharon K. Weiss, a behavioral consultant and co-author of From Chaos to Calm: Effective Parenting of Challenging Children With ADHD and Other Behavioral Problems. If you just tell your child, “Don’t do that,” she won’t learn what she should do instead.
  • Flying off the handle. Do you have a habit of losing your temper and screaming, or worse? If theatrics are the only thing your child with ADHD responds to, it’s because you’ve taught him that it’s only when “Mount Mom” erupts that he really has to listen.
  • Failing to follow through. Do you threaten punishments and then never follow through on them? “I see parents who complain, ‘My kid never listens to me,'” says Adam Winsler, Ph.D., professor of developmental psychology at George Mason University in Fairfax, Virginia. “But they have contributed to that situation. Children learn they don’t have to listen to their parents, because whatever their parents say they are going to do doesn’t happen.”

Further, parents of children with ADD/ADHD shouldn’t over-rely on drugs to solve problems. While medication is very helpful in getting children with ADHD to calm down and focus, it is not a magic pill — nor is it a one-size-fits-all treatment. New guidelines from the American Academy of Pediatrics suggest that preschoolers, in particular, should undergo behavioral therapy even before trying medication. Teens and school-age children may also benefit from a combination of ADHD drugs and therapy. “We know that nothing works better than medication but that people who also undergo behavioral therapy are happier campers,” says Ann Childress, MD, a child and adolescent psychiatrist and an ADHD researcher in Las Vegas. “The combination works better than either one alone.”

So how do you effectively discipline your ADD/ADHD child? Here are some pointers:

Get your child’s attention. Children with ADD/ADHD are very good at tuning out the world — and that includes you. You can’t correct bad behavior if the child doesn’t listen to what you have to say. So turn off the TV and take away the video games. Send other children out of the room. Get down to your child’s level and make eye contact. Then explain what he or she did wrong and dole out a punishment that matches the severity of the offense.

Institute a warning system. Children with ADD/ADHD are very routine-oriented. Establish a schedule for the day that includes times when homework will be done, rooms cleaned, and TV watched. If they have clear expectations for how the day will proceed, children with ADHD will better understand why they are being reprimanded if, for example, they are not getting ready for school by a certain time.

Treat discipline as a teaching tool. Before you speak to your child about a behavior you want stopped, says Weiss, “ask yourself, ‘What do I want him or her to do instead?'” If hitting is the problem, for example, explain that “in our family we keep our hands and feet to ourselves.” Then reward your child with ADD/ADHD for not striking a sibling during an argument.

The bottom line: Good discipline requires good communication. Connect with your child, set reasonable expectations, and reward good behavior, and soon you’ll spend less time yelling and more time praising your child’s accomplishments.

Apr 29

Pain Intensity Greater for Women Than Men


MONDAY, Jan. 23, 2012 (HealthDay News) — According to the results of a study in which researchers examined pain scores from tens of thousands of patients in the United States, women experience more intense pain than men.

The findings, published in the Jan. 23 issue of the Journal of Pain, suggest that greater effort is needed to recruit women into studies in order to determine the reasons for this gender difference, the Stanford University School of Medicine investigators said.  For the study, the researchers analyzed electronic medical records to examine more than 160,000 pain scores reported for more than 72,000 adult patients. The results showed higher pain scores for women in virtually every disease category. The differences were both statistically and clinically significant, the authors noted in a Stanford news release.

“In many cases, the reported difference approached a full point on the 1-to-10 scale. How big is that? A pain-score improvement of one point is what clinical researchers view as indicating that a pain medication is working,” study senior author Dr. Atul Butte, a professor of systems medicine in pediatrics, said in the news release.

The overall results tended to confirm previous findings, such as the fact that women with fibromyalgia or migraine report more pain than men with those conditions. But the study also identified previously undocumented gender differences. For example, pain intensity among patients with acute sinusitis or neck pain is greater in women than in men.  Butte noted that there are numerous studies showing that women report more pain than men for a number of diseases.

“We’re certainly not the first to find differences in pain among men and women. But we focused on pain intensity, whereas most previous studies have looked at prevalence: the percentage of men versus women with a particular clinical problem who are in pain,” he said.  “To the best of our knowledge, this is the first-ever systematic use of data from electronic medical records to examine pain on this large a scale, or across such a broad range of diseases,” Butte added.

Apr 27

By: ELIZABETH MECHCATIE, Clinical Psychiatry News Digital Network  ARLINGTON, VA. – Widespread long-term use of benzodiazepines for anxiety remains a reality, despite guidelines that recommend against the practice, according to speakers participating in a roundtable discussion at the annual conference of the Anxiety Disorders Association of America..

Benzodiazepines alleviate anxiety symptoms, but they do not help to resolve anxiety disorders in the long term, with posttreatment relapse rates reported as high as 63%. Learning impairment associated with benzodiazepines is the side effect that “significantly diminishes the effects” of cognitive-behavioral therapy (CBT), said Dominic A. Candido, Ph.D., a psychologist in the department of psychiatry at the Dartmouth Geisel School of Medicine, Hanover, N.H.

He cited a 2010 study that found benzodiazepine usage rates in the general population ranged from about 2% to almost 18%. In the study, about one-third of people who received an initial prescription stayed on the drug long term – despite the recommendation in treatment guidelines that suggests limited short-term use. Recently, the departments of Veterans Affairs and Defense guidelines recommended against the use of benzodiazepines for posttraumatic stress disorder – partly because benzodiazepines increase the likelihood of stress symptoms.

“When practitioners do not have alternatives, they tend to go to these agents that will give them short-term relief but often at long-term detriment to the patient,” he said.

Shanna Treworgy, Psy.D., also of Geisel medical school, said the impact on procedural memory “perhaps is the worst side effect” of benzodiazepines in the treatment of anxiety. “Research that has successfully pulled apart explicit and implicit memory has demonstrated significant effects on procedural learning and memory” during treatment with benzodiazepines, she said. “This happens through impairing acquisition of new memories through reduced arousal or sedative effects.”

The studies include a 1997 investigation of exposure therapy in women with flying phobia, which evaluated the acute and long-term effects of alprazolam. Women on alprazolam had significantly reduced levels of anxiety compared with those on placebo during the first flight. But during a second flight a week later, when the former group of women was not medicated, they had significantly increased feelings of anxiety, an increased heart rate, a desire to leave the plane, and panic, while those who had been on the placebo during both flights showed decreases in multiple measures of anxiety. “We’re wondering if this perhaps was preventing new learning,” Dr. Treworgy said, adding that the authors suggested that exposure therapy to flying phobia was incompatible with benzodiazepine treatment.

Summing up the evidence, she said, “What seems to be happening is that the result is reduced anxiety in the moment but worse long-term anxiety reactions documented in both animal and human studies.”

A psychiatrist at Geisel School of Medicine, Dr. Matthew S. Duncan said that in clinical practice, benzodiazepine prescribing can be tailored to CBT to help patients stop taking the medications and become more functional. He added that he has experienced a paradigm shift in the prescribing of benzodiazepines, which also entails explaining this approach to patients. “I have to be able to convince them and articulate that prescribing benzodiazepines for your anxiety may have short-term gains but keep you sicker longer,” said Dr. Duncan.

Dr. Candido said he and his colleagues have developed a CBT protocol to treat patients with anxiety that involves starting patients with 3 days of a benzodiazepine administered at three doses a day (preferably one with a short half-life, such as lorazepam) and no beta-blockers, followed by 3 days with no benzodiazepine treatment, gradually increasing the drug-free period. Single as-needed doses are never taken, and the drug is never used before a coping skill session, he said.

An audience member pointed out that as CBT becomes less available, the use of benzodiazepines for anxiety increases, and another member of the audience commented that he would use this approach all the time if more CBT therapists were available.

Apr 27

‘Use It Or Lose It’ – Protecting Your Brain


The findings of a new study suggest that the protective effects of an active cognitive lifestyle arise through multiple biological pathways.
For some time researchers have been aware of a link between what we do with our brains and the long term risk for dementia. In general, those who are more mentally active or maintain an active cognitive lifestyle throughout their lives are at lower risk.
“The ideas of a ‘brain reserve’ or ‘cognitive reserve’ have been suggested to explain this, but were basically a black box. This research throws some light on what may be happening at the biological level,” said Associate Professor Michael J. Valenzuela, a brain aging expert at the Brain and Mind Research Institute, University of Sydney, Australia, who led this new study.
Researchers used data from the Cognitive Function and Ageing Study, a large population-based study in the United Kingdom that has been following over 13,000 elderly individuals prospectively since 1991.
At the time of this study, 329 brains had been donated and were available for analysis. Brains were compared based on the individual’s dementia status at death (yes or no) and cognitive lifestyle score, or CLS (low, middle, or high).
The three CLS groups did not differ among multiple Alzheimer’s disease (AD) neuropathology measures, including plaques, neurofibrillary tangles, and atrophy. This means that cognitive lifestyle seems to have no effect on the brain changes typically seen in those with Alzheimer’s disease.
However, an active cognitive lifestyle in men was associated with less cerebrovascular disease, in particular disease of the brain’s microscopic blood vessels. An active cognitive lifestyle in women was associated with greater brain weight. In both men and women, high CLS was associated with greater neuronal density and cortical thickness in the frontal lobe.
“These findings suggest that increased engagement in stimulating activities are part of a lifestyle that is, overall, more healthy,” commented Dr. John Krystal, Editor of Biological Psychiatry. “Rather than specifically protecting the health of activated circuits, it seems that a more active lifestyle has general effects on brain health reflected in greater neuronal density and preservation of the blood supply to the brain.”   “Overall, our research suggests that multiple complex brain changes may be responsible for the ‘use it or lose it’ effect,” Valenzuela added.
With a globally aging society and the risk of dementia increasing significantly with age, dementia-prevention strategies are of rising importance. Understanding the mechanisms of cognitive enhancement through research such as this can help support and inform the development of effective strategies to enrich cognitive lifestyle and potentially reduce dementia risk.

by Thomas Vander Ven, Ph.D.     The college drinking scene is a matrix of fun and looming crisis. Students share laughter, adventure, and emergent affection when they drink together. And they also face a variety of risks, including injury, sexual victimization, acute toxicity, and death. Based on a large body of scholarly research, we know that heavy drinking in college is linked to a host of negative outcomes. If so many negative consequences can and do occur in the drinking scene, then why do some college students continue to chase dangerous levels of intoxication? This question inspired my eight-year study of college drinking. I surveyed 469 students, conducted 25 intensive interviews, and spent countless hours observing the college drinking scene in student bars, house parties, and at street festivals. My study was sociological in that I sought to see intoxication—and the troubles it produced—as a collective effort. I wanted to see how students worked together to accomplish collective intoxication and how they worked together to manage its effects.

My student informants were usually eager to talk to me about the drinking scene and graciously shared their insights. As a result, I was able to see college partying in a brand new way. Past researchers have tended to focus on the negative effects of college drinking, giving only scant attention to the variety of social and emotional payoffs that draw the College Drinker to the scene. My respondents felt that there were many social benefits associated with collective intoxication (e.g., it reduced shyness, it gave them the temporary confidence to “hook up” with love interests, and it created a world of adventure where “anything can happen”). These findings should not be surprising to anyone who ever partied with friends in college. But what about the negative effects of heavy drinking? Why do they persist in an activity that carries such potential for injury, sickness, and emotional distress? According to my analysis, part of the answer to this question is the use of “drunk support.”

Drunk support refers to the delivery of emotional and/or instrumental provisions delivered from one person to an intoxicated other. This includes: attending to a drunksick friend while they are vomiting, consoling an emotionally distraught co-drinker who is upset about a relationship or feeling aggrieved by the actions of other drinkers, and providing physical reinforcement when one’s friend gets into a fistfight. Drunk support turns negative events into mutually beneficial, bonding experiences. Social support feels rewarding to both the giver and to the receiver. When negative events occur in the college drinking culture, then, co-drinkers mobilize to help one another in ways that turn the negative experience into a positive one. Thus, my data suggest that heavy drinkers continue to drink in spite of these noxious outcomes and they continue to drink, in part, because these negative events bring them closer together, because the experiences allow them to demonstrate the depth and quality of their character, and because these events become “war stories” that will become an important part of their friendship narratives. Even severe hangovers are recast by college drinkers as mutually supportive bonding experiences that are “part of the fun.” And when college drinkers are feeling shameful about embarrassing drunken performances, their friends and codrinkers bail them out by saying, “Don’t worry about it, you were hilarious last night!”

Drunk support may actually perpetuate risky drinking because it gives drinkers a sense that they will be taken care of when the party train goes off the rails. On the other hand, drunk support can be positive if it prevents tragedy or reduces victimization. My respondents reported that they were vigilant, for example, about looking out for their friends if they felt that they were vulnerable to sexual victimization. Students escort their intoxicated friends home from bars and intervene when they see their inebriated female friends leaving a bar or house party with an unknown male. The informal support located within the drinking scene suggests policy implications.

College administrators could find ways to encourage and facilitate drunk support to reduce the potential harms in the college drinking scene. First, college drinkers are already looking out for one another when they drink together. Let’s use programming to make them more confident, more effective bystanders. Bystander intervention training could include encouraging students to intervene before their cohorts get dangerously intoxicated and could teach them to recognize the signs of acute toxicity. Moreover, universities could enact amnesty policies that allow students to call for help without worrying that they or their endangered drinking partner would be sanctioned for underage drinking or for violating other university policies. At the same time, schools could require students to be conscientious bystanders as part of a mandatory code of conduct. Students who do not help those in need, that is, should be held accountable for their negligence. Finally, universities can create and train student support teams that patrol the drinking scene looking for signs of disorder and distress. These support units—like the “Green Team” at Dartmouth College—would provide an extra institutionalized layer of support and harm reduction to the drinking scene. After decades of education and prevention programming at American universities, rates of risky drinking have not changed much. It is time that we involve our students more directly in harm reduction strategies and that we encourage students to develop new ideas to make the drinking scene a safer place.

Apr 27

Talking to Kids About ADHD


Once your child’s doctor has made an ADHD diagnosis, it’s time to take a deep breath and talk about what the diagnosis means. Many kids with ADHD already suspect that they are different in some way, so this conversation could be an opportunity to reassure them that their ADHD symptoms have a cause — and some solutions.

Parenting ADHD kids can be challenging, but you can make it a more positive experience, starting with this first conversation. The most important thing is to remember that even though your child has ADHD, he or she is an individual — and so are you.

“I hesitate to distill parent/child/provider communication into simple dos and don’ts,” says Bonnie Zima, MD, MPH, associate director of the Jane and Terry Semel Institute’s Health Services Research Center and professor-in-residence in the UCLA department of psychiatry and behavioral sciences at the David Geffen School of Medicine. The conversation will be different in every family, but your role as parent, stresses Dr. Zima, is to actively guide the way in which information about ADHD is shared, respecting your family’s values even as you talk about ADHD symptoms.

Honesty in Parenting Kids With ADHD

Here are some ideas for starting the parent-child ADHD conversation:

  • Include your child’s doctor or therapist in the discussion. This affords you the benefit of having an experienced professional on hand to help focus the conversation and provide age-appropriate answers to your child’s questions.
  • Stay positive. Don’t overwhelm your child with technical information, and don’t appear sad or resigned. Remember that there are benefits to having a diagnosis — namely that you and your child can now better explain and learn to manage any symptoms that may have been causing frustration previously. You can also start to proactively work on a plan for discipline and academic success if your child is of school age.
  • Emphasize that you’re all part of a team. Let your child know that he or she is not alone in managing ADHD. You, your child, and your medical team should aim for shared decision-making at every stage of the treatment process, says Zima. Knowing that you, too, will be making changes to help your family life run more smoothly may make your child feel more optimistic about the changes he has to make. Kids with ADHD should know that they play an active role in their success — with mom’s and dad’s support, of course.
  • Emphasize the upside of ADHD. It’s easy to get distracted by the frustrations of ADHD, but it’s important to also tell your kids that ADHD makes them different in some positive ways as well. For example, kids with ADHD are very energetic and creative, can contribute new ideas to projects and groups, and have a natural magnetism that draws people to them.
  • Discuss practical changes. Once you have an ADHD diagnosis for your child, your medical team might suggest changes in the way that schedules, homework, and discipline are handled. Be matter-of-fact in explaining what will change and how your child can succeed in the new system. Don’t blame your child or the ADHD for the work involved.
  • Let them know you love them. Kids with ADHD can lose sight of your love because the focus is often on problems with their behavior. Emphasize that even though there will be bad days for both of you, you still love them — and that love has no bearing on whether or not they have ADHD.

Age-Appropriate Parenting Strategies

Your parenting style and the ADHD conversation will also depend on the age of your child:

  • Preschoolers. Use very simple language and focus on ADHD symptoms or behaviors that your child probably knows have been problems. You might talk about the difficulty your child has staying still, for example. Then explain how you and your child’s doctors and caregivers will be helping them to do better.
  • Elementary-school children. At this age, children are more concerned about pleasing you by succeeding at school, both socially and academically. Talk to them about the ADHD symptoms that could pose challenges on these fronts. Encourage them to ask questions or ask for solutions to specific problems they encounter each day. Address how to be a good friend, and discuss specific discipline issues so that they understand their boundaries.
  • Middle-school and high-school kids. You can have a more adult conversation with children in these age groups, so explain the diagnosis in more depth. Stress that having ADHD is not an excuse for bad behavior, and point out that many people are very creative and successful with ADHD. Teens can have more responsibility over their schedules, taking their medications, and determining the rewards and consequences that are part of their behavior plans. This is also an important time to start talking about the temptation and danger of risky behaviors and how kids with ADHD can handle peer pressure to try alcohol or drive too fast. Continue to encourage your teen to ask questions and talk directly with a doctor or therapist about issues they are facing. Zima points out that understanding and coping with ADHD means that teens need to be even more engaged in the shared decision-making process, unless there are serious safety concerns that require you to be more involved.

Talking to kids with ADHD about their diagnosis and what it means may seem like your greatest parenting challenge thus far. But chances are, you’ll have many such conversations as they grow up and face more complicated situations at school and with their peers. Keep talking and learning about ADHD, and you will be better equipped to help your child succeed.

Apr 27

Is Taking a Break From ADHD Drugs Safe?


Everyone needs a break at some point, and people taking medication for ADHD might feel exactly that way. It’s a hassle to take ADHD drugs every day, particularly if you experience some of the common side effects. If you’ve ever wondered if temporarily stopping ADHD drugs is okay or if there are any potential side effects to stopping, it’s time to get some answers.

Taking a Vacation From ADHD Drugs: Is It Safe?

If you’re considering stopping your ADHD drugs, even for a brief time, it’s important to start by asking yourself some questions.

“Understand why [you] want to stop it and what is the purpose,” suggests F. Allen Walker, MD, a psychiatrist with ADHD and his own practice specializing in ADHD in Louisville, Ky. “There’s not really much of a risk involved in stopping medications periodically. It’s not something that I necessarily promote and encourage patients to do unless they’ve already been on the medication for a period of time, and they understand the benefits of the medication.”  Studies show that there’s no real reason to stop and no harm from long-term treatment with ADHD drugs. One study, reviewing children who had been treated with stimulant drugs for as long as two years, showed no risks or side effects from treatment, but rather benefits in symptoms and improved social skills from continued treatment with medication. The study also found that those children treated long-term with ADHD drugs had better self-esteem.

If you want to try stopping ADHD drugs for a time, such as a weekend, vacation, or holiday break from school, Dr. Walker says it’s important to talk to your doctor first about the right way and the right time to do it — not in the middle of the school year or during a busy time at work.  Taking a break from ADHD drugs could have its advantages under the right circumstances. “I think sometimes it can be good for [patients] to stop their medicine so they understand what it’s like being on it and off it,” says Walker. The break can be a reminder about what the medication really achieves and give you useful perspective.

Stopping ADHD Drugs: Potential Risks

While in general it’s not considered particularly dangerous to take a break from ADHD drugs on occasion and with your doctor’s okay, Walker says that there are some potential risks to be considered, including:

  • Side effects from restarting medications too quickly without a doctor’s supervision
  • Problems at work or school
  • Problems with relationships, friends, family, or even a spouse
  • Social alienation
  • Reckless or impulsive behavior

Even if the risks are minimal, consider that the patient might be losing out on the benefits of ADHD drugs. Just because a child isn’t in school doesn’t mean that the medication isn’t still needed or isn’t beneficial. A study found that children attending a summer treatment camp for ADHD who took ADHD medications performed better socially than children who didn’t take medication.  And, Walker notes, the impairment to social skills shouldn’t be disregarded as unimportant. “Often what happens to kids is they become alienated socially. It erodes their self-esteem and they start to feel bad about who they are,” he says. This can lead to poor academic performance or more serious problems like promiscuity, antisocial behavior, drug abuse, and alcohol abuse. “The consequences of not having kids properly treated for ADHD in social settings can lead to things that are far worse than maybe making a bad grade.”

Whether it’s a good idea to temporarily stop ADHD drugs really depends on the individual, Walker adds. There are many factors to take into account, like age, gender, and the reason why you think you need a break. Though the risk is fairly minimal, so are the benefits. One thing is certain —you can’t know what’s right for you, or your child, unless you discuss it with your doctor. And that’s a step you should always take before changing anything about yourADHD treatment.

Apr 27

Mental Decline Can Start at age 45


THURSDAY, Jan. 5, 2012 (HealthDay News)  By Steven Reinberg

Sorry, Boomers, but a new study suggests that memory, reasoning and comprehension can start to slip as early as age 45.  This finding runs counter to conventional wisdom that mental decline doesn’t begin before 60, the researchers added.  “Cognitive function in normal, healthy adults begins to decline earlier than previously thought,” said study author Archana Singh-Manoux.

“It is widely believed that cognitive ability does not decline before the age of 60. We were able to show robust cognitive decline even in individuals aged 45 to 49 years,” added Singh-Manoux, research director at INSERM’s Center for Research in Epidemiology & Population Health at the Paul-Brousse Hospital in Paris.  These findings should be put in context of the link between cognitive function and the dementia, Singh-Manoux said.  “Previous research shows small differences in cognitive performance in earlier life to predict larger differences in risk of dementia in later life,” she said.

Understanding cognitive aging might enable early identification of those at risk for dementia, Singh-Manoux said.  The report was published in the Jan. 5 issue of BMJ.  For the study, Singh-Manoux and colleagues collected data on nearly 5,200 men and 2,200 women who took part in the Whitehall II cohort study. The study, which began in 1985, followed British civil servants from the age of 45 to 70.  Over 10 years, starting in 1997, the participants’ cognitive function was tested three times. The researchers assessed memory, vocabulary, hearing and vision.

Singh-Manoux’s group found that over time, test scores for memory, reasoning and vocabulary skills all dropped. The decline was faster among the older participants, they added.  Among men aged 45 to 49, reasoning skills declined by nearly 4 percent, and for those aged 65 to 70 those skills dropped by about nearly 10 percent.  For women, the decline in reasoning approached 5 percent for those aged 45 to 49 and about 7 percent for those 65 to 70, the researchers found.

“Greater awareness of the fact that our cognitive status is not intact until deep old age might lead individuals to make changes in their lifestyle and improve [their] cardiovascular health, to reduce risk of adverse cognitive outcomes in old age,” Singh-Manoux said.  Research shows that “what is good for the heart is good for the head,” which makes living a healthy lifestyle a part of slowing cognitive decline, she said.

Targeting patients who have risk factors for heart disease such as obesity, high blood pressure and high cholesterol might not only protect their hearts but also prevent dementia in old age, the researchers said.  “Understanding cognitive aging will be one of the challenges of this century,” especially as people are living longer, they added.  In addition, knowing when cognitive decline is likely to start can help in treatment, because the earlier treatment starts the more likely it is to be effective, the researchers noted.

Francine Grodstein, an associate professor of medicine at Brigham and Women’s Hospital in Boston and author of an accompanying editorial, said more research is needed into how to prevent early cognitive decline.  “If cognitive decline may start at younger ages, then efforts to prevent cognitive decline may need to start at younger ages,” she said.  “New research should focus on understanding what factors may contribute to cognitive decline in younger persons,” Grodstein added.

“This is consistent with what we have seen in other studies and the cognitive changes that occur as we age,” said Heather M. Snyder, senior associate director of medical & scientific relations at the Alzheimer’s Association.  These changes do not mean that all these people will go on to develop Alzheimer’s diseaseor another dementia, Snyder noted. “It is important to remember that the cognitive changes associated with aging are very different from the cognitive changes that are associated with Alzheimer’s disease,” she stressed.

Although some of these people may go on to develop Alzheimer’s disease there is currently no way to tell who is at risk, Snyder said. “This is why it is so important to continue to investigate biological changes that occur in the earliest stages, because it is difficult to [determine] the cognitive changes that are associated with Alzheimer’s disease,” she said.  Snyder noted that Alzheimer’s disease can start 15 to 20 years before symptoms are apparent, which makes finding a biological marker so important. “If a therapeutic is available, we can intervene at that point,” she said.

Dysgraphia is a learning disability that sometimes accompanies ADHD and affects writing skills, handwriting and spelling. How to recognize the symptoms…

             by  Leane Somers

I knew my son had a problem with writing when I saw that his first-grade journal contained mostly drawings and only a few sentences. In second grade, Austin was still reversing the letters b and d, something most of his peers had outgrown.

His teachers called it laziness, but as he did his homework, I saw him labor to form letters correctly. He worked slowly, erased a lot, and cried. One day, after he’d struggled with a paragraph for two hours, I had him type it at the computer. He was finished in 20 minutes.  Austin has dysgraphia, a learning disability that can accompany attention deficit disorder (ADD ADHD). Dysgraphia affects handwriting, spelling, and the ability to put thoughts on paper. It makes the process of writing maddeningly slow, and the product often illegible. Forming letters requires such effort that a child may forget what he wanted to say in the first place.

The act of writing something down helps most of us to remember, organize, and process information, but children who struggle with the mechanics of writing learn less from assignments than do their peers. Work often goes unfinished, and self-esteem suffers. Fortunately, there are strategies for helping children with dysgraphia, in school and at home.

Getting help

If your child has persistent problems with writing—a tight pencil grip, unfinished words, a mixture of letter sizes—consult the school’s special education staff. If they can’t test for dysgraphia, look for an occupational therapist, pediatric neurologist, or a neuropsychologist with experience in the disorder.  Once your child is diagnosed, meet with the school’s evaluation team to see if she’s eligible for services or support. Reducing the emphasis on or amount of writing allows most dysgraphic children to work successfully in school. Helpful changes in the classroom may include extra time on tests, worksheets to reduce the amount of copying needed, removing neatness and spelling as grading criteria, and reducing the length of written assignments or the number of math problems required.

Your child may also benefit from working with an occupational therapist on letter formation, fine-motor skills, and cursive writing, which can be easier than printing for a dysgraphic child.

Tactics and tools

Learning to type can be a lifesaver: Invest in a children’s typing program, such as Jump Start Typing ($19.99), for kids ages seven to 10, or Mavis Beacon Teaches Typing ($19.99), for kids ages 11 and up. Have your child practice on the computer for 10 minutes a day. A lightweight keyboard, like those available from AlphaSmart, will allow him to type notes in class and transfer them to your home computer.  Graph paper with large squares, which provide visual guidance for spacing letters and numbers, is also useful. For big projects, use Ghostline poster board, which is lightly lined with a grid.

To ease homework woes, have your child try pencils of different thicknesses and plastic pencil grips. Encourage her to dictate sentences into a tape recorder before writing them down. Occasionally, offer to do the typing while she does the research.

Apr 26

1. Unintentional Versus Deliberate Wounding

It’s common for people to attribute motivation to other people’s behavior—to ascribe “why” the other person did what s/he did. And one dimension where this occurs has to do with intentionality: Did your partner mean to be hurtful, or was the hurt s/he caused unintentional? Not surprisingly, deliberate actions of malice are more likely to shatter trust than accidental wounding.

2. Episodic Versus Repetitive Wounding

We all argue occasionally with our loved ones (episodic arguments) and the research has shown that this isn’t necessarily a bad thing—in fact, trying to avoid conflict at all costs turns out to be detrimental to one’s marriage or relationship. But when periodic marital or relationship conflicts are replaced by repetitive arguing/wounding, couples have little chance to recover from the emotional fallout of previous fights. No mutual understanding and closure over what happened takes place. This cumulative impact of negativity can make couples feel beleaguered and, ultimately, disengage from one another.

3. Acknowledged Versus Disavowed Wounding

When you acknowledge that you have hurt your partner (even if you do not fully “get” why your actions might have been experienced as hurtful by him/her), you’ve taken a big step toward ownership of your behavior. The message is sent: “I realize my actions caused you distress, and I’m sorry that you were upset.” Such a message can go a long way toward healing the inevitable relationship wounds that occur. Disavowing responsibility creates a relationship environment that is unpredictable and emotionally unsafe, and healing cannot take hold in such an unfriendly atmosphere.

4. Validated Versus Minimized Wounding

Validating your partner’s hurt goes one step further than acknowledging that you’ve caused him/her to be upset (as discussed in number 3). Whenever you validate, you send the potentially healing message that you understand why your partner is upset, that his/her reaction makes sense to you (the message being: “Of course you’re upset, why wouldn’t you be?”). The opposite position, of minimizing or ignoring your partner’s emotional pain, is likely to keep the flames of hurt smoldering indefinitely. When you invalidate your spouse’s/partner’s emotional wounds (wounds that you might have caused), you are adding layer of hurt on top of layer of hurt. Talk about a one-two punch to the emotional gut!

5. Superficial Versus Core Wounding

For a hurtful comment or action to cause wounding, it has to have a place to land—in other words, the more your partner believes and accepts your hurtful comment as truthful, the deeper the pain will be. The most lasting effects of wounding occur when your statements/actions trigger your partner’s core emotional wounds—wounds that were created in childhood.  We all have core wounds from our pasts, and these emotional wounds reflect our deepest sensitivities and vulnerabilities, and when these are awakened and agitated during conflict, the wounding that occurs is more likely to be more intense and lasting.

When couples struggle to make sense of and shake off the mutual hurts that have occurred over time (or that may occur), it’s important to understand why certain emotional wounds rock you at your core, while others seem relatively insignificant and easy to move past. If it turns out that you (or your partner) seem stuck in the quicksand of past misunderstandings and hurts, it may be that one or more of the above is at work and needs addressing.

Apr 26

Male Anorexia


    When in history has a male ever been concerned about fitting into a pair of skinny jeans? Media has hyper-focused on the skinny male model. Today’s fashion is geared towards the emaciated male in a pair of skinny jeans. This male body image does not occur naturally unless someone is ill. We now have a whole culture of men trying to obtain an impossible body image.  There appears to be a rise in the number of males with eating disorders. According to NEDA, at least one million males in the United States have an eating disorder such as anorexia or bulimia. But these numbers are skewed due to the high prevalence of undiagnosed males with eating disorders.

Twenty years ago, very few people even knew what an eating disorder was. Today, the public awareness of eating disorders has allowed some men with anorexia to come forward. But most males will not seek treatment for eating disorders because of the shame, the fact that there are fewer male residential treatment centers and the misperception that eating disorders only occurs in females or gay men.

How can you tell if someone has anorexia nervosa? A male with anorexia nervosa is less than 85 percent of normal body weight. He avoids eating, has poor body image and may exercise obsessively. He is intensely concerned about losing flab or building muscle. He believes he is fat when others are telling him that he is too thin. It is important to note that he really does see himself as fat. It is caused by deficiencies in the brain brought on by starvation. Anorexia nervosa may actually compromise the ability to reason in its victims.  People with anorexia usually also have one or more co-occurring disorders such as anxiety, obsessive-compulsive disorder or depression.  Males and females both suffer many of the same symptoms of anorexia, such as:

  • Dehydration (fainting)
  • Performing food rituals
  • Bursts of energy followed by fatigue
  • Constantly talks about body image, weight and diets
  • Avoids eating
  • Purges (anorexia nervosa — purge type)
  • Isolates
  • Thin hair and brittle nails
  • Excessive movements even when seated to burn calories

When someone with anorexia under-eats, the brain may dispense feelings of euphoria that briefly counteract anxious or depressed feelings. In this way, food restriction is used as an anti-depressant or a way to “zone out.” A male with anorexia uses the obsessive thoughts of weight, diet, food (not eating) and body image as a way of pushing down feelings or past traumas. This is common for all types of eating disorders.

The highest number of males with eating disorders have binge eating disorder, compulsive overeating or obesity. These boys and men often do not get treatment until they have diabetes, heart attacks or other weight-related diseases.  There are many causes of eating disorders. Genetics can make a person more predisposed to acquiring an eating disorder. This usually occurs in families who have eating disorders or other addictions.

The desire for control makes a male more vulnerable to the disease. This is often the result of feeling smothered or abandoned and misunderstood by their families. Many males report that they had parents who overemphasized physical appearances. In these families, the individual learned to keep his feelings, doubts, fears, anxieties and imperfections hidden. There may be family issues that they try to avoid by focusing on their disorders and their ability to control their food intake.

Having a perfectionistic personality type can be a factor in the development of anorexia. Most males with anorexia are above average students and may have excelled at sports. Some say perfectionism is the leading cause of male anorexia. Perfectionism leads to the desire to be good, accepted, perfect and in control — all of which are prerequisites of anorexia.  Male anorexia is lethal. When the body is not fed it will take fat from the muscles and organs to sustain life. Males generally have less fat than females, so there is the added complication of losing muscle mass. The heart is an important muscle that may be affected. In addition, potassium and electrolyte imbalances may be a risk factor for cardiac problems such as heart attacks.

With the rise in male eating disorders and associated risks, it is imperative that men with eating disorders seek help!

If you or a loved one needs more information Rebecca’s House Eating Disorder Treatment Programs offers free eating disorder assessments and information, call 800-711-2062.  If you’re struggling with an eating disorder, call the National Eating Disorders helpline at 1-800-931-2237.

Apr 26

Will Antidepressants Zap Your Good Emotions?


If you’re depressed, antidepressants can help you minimize those feelings of sadness and hopelessness — but will the drugs also undermine your ability to feel joy?

Emotional blunting — an overall unfeeling or numbness — is a common complaint of depression patients prescribed to certain antidepressants. This diminished capacity to have feel-good emotions during positive moments can be a significant side effect for some people taking selective serotonin reuptake inhibitors, or SSRIs.  And when research supporting the idea was first discussed at a national conference in 2002, mental health professionals nodded in agreement over the existence of this unwanted side effect, recalls psychiatrist Heidi Combs, MD, an assistant professor of psychiatry at the University of Washington in Seattle.

However, emotional blunting is largely based on what doctors hear from their patients, as opposed to results from clinical research. So what can be done about it?

Who Experiences Emotional Blunting?

SSRIs are a class of antidepressants that affect the way the brain uses the neurotransmitter serotonin. Their effect is intended to relieve the symptoms of depression — and they’re often successful in doing so. Unfortunately, explains Dr. Combs, the drugs also act on the reward pathways in the brain — the pathways that bring us pleasure. For some people, this means that they experience emotional blunting, or the sensation that all their emotional responses are dulled.

“If something positive is going on, these patients might not have the full response,” Combs says. Though there are many case studies, the lack of large clinical studies makes it difficult to predict which people will experience this side effect — and which ones won’t.  Part of the problem is the very nature of depression. People struggling with depression often complain that they have lost some of their ability to respond emotionally to events and people around them. So for a long time, emotional blunting caused by antidepressants was written off a as symptom of hard-to-treat depression.

However, says Combs, it’s fairly easy now for physicians to tease apart the symptoms of depression itself and this antidepressant side effect. If the depression symptoms have improved, but emotional blunting persists, it’s likely due to the antidepressant. If, on the other hand, the emotional blunting continues alongside unrelieved sadness, weepiness, and other depression symptoms, then it’s more apt to be part of the original disorder, she explains.

Get Your Glee Back: What to Do About Emotional Blunting

To regain your pleasure response, Combs recommends these solutions:

  • Switch antidepressants. It may be a good idea to move to another class of antidepressants entirely because someone who responds to one SSRI drug with emotional blunting may respond the same way to another one.
  • Add a second medication. If switching to another class of drugs just leaves you with more troublesome symptoms (which can happen if you’re dealing with anxiety), ask your doctor about adding just a small amount of another antidepressant to free the reward pathways.
  • Talk it out. If you’re feeling an overall loss of emotional response, working through the problems that are causing stress and depression in the first place (including solving practical problems like those related to housing or income) may help.

If you find that your depression medication is edging out all your emotions, talk to your doctor. This is a real effect, emphasizes Combs, but the good news is that it has real solutions.

Apr 26

PTSD and Depression


by Deborah Serani, Psy.D.

Trauma is an event where an experience bears down on your physical and emotional life. It can be mild, like when someone cuts in front of you while you’re driving; moderate, as in the car careening with yours causing an accident, or severe, the accident resulting in life threatening injuries. For many, once a traumatic event ends, they can return to their regularly scheduled lives with not too much interference. But for others, trauma leaves an indelible imprint – interfering with daily life in overwhelming ways.

Post Traumatic Stress Disorder (PTSD) is a serious anxiety disorder that results after a significant traumatic event. Long ago, it was called shell-shock, combat stress and battle fatigue, and thought to only occur with soldiers or individuals who endured unspeakable trauma. What we know now is that PTSD can occur in children and adults, and can be caused by direct exposure to a horrifying experience or the witnessing of a traumatic event. Research shows that rates of depression increase after a trauma and are especially high for a child or adult with PTSD. In fact, depression is nearly 3 to 5 times more likely to occur in those with PTSD than those without PTSD.

In 1981, Michele Rosenthal was just a regular thirteen year old girl – but a medical allergy called  Toxic Epidermal Necrolysis Syndrome  ravaged her little body, turning her into a full-body burn patient almost overnight. The trauma she endured was so extreme that it stunned her doctors, terrified her parents and threatened her very life. Michele lived day to day enduring unspeakable pain, nearly dying from symptoms. With luck and grace, she pulled through, but not without physical and emotional scars. Her memoir “Before The World Intruded” details this journey and her triumph over trauma. It is an inspiring read about what it takes to make sense of trauma, how to rise above depression and despair, and how self-discovery leads to change. Now a mental health advocate and certified professional coach, she uses her personal experience to help survivors learn to cope with, manage and strategize the PTSD recovery process.

What is the one thing Psychology Today readers should know about trauma?

The absolute number one thing readers should know is that trauma imprints deeply in the brain in ways you might not even be aware of. We all spend our waking moments in the conscious brain, which is only 12% of your brain. The conscious part of the brain is responsible for short-term memory, analytical thinking and decision-making. The subconscious part of the brain, however, equals 88% of the brain. That’s the part responsible for long-term memory, beliefs, associations and feelings, to name a few of the processes that go on below the realm of your conscious awareness. The subconscious mind actually remembers everything since the day you were born, even when your conscious mind doesn’t. The reason this is important to understand is because very often you can survive a trauma and think you are fine, that you’ve let go of any connection to what you experienced. Later, however, you may begin to see behaviors that indicate otherwise. Nightmares, for example, or new fears and anxieties. It’s important to understand that this is absolutely normal and only indicates that you’ve got some things that need to be processed around the event. The effects of trauma are not always logical, predictable or expected; survivors need to be aware of differences in themselves and explore how those differences may be in response to a recent traumatic experience.

You explored and experienced many different kinds of treatment interventions and specialists during your illness and recovery. What advice would you give Psychology Today readers when it comes to seeking answers to chronic illness, trauma or emotional struggles?

The most critical element is checking in with yourself! Trauma and emotional struggles have no single prescription for resolution. Each of us has to find our own personal roadmap to relief. The key is to work with modalities and practitioners that resonate with you. That is, treatments with which you feel reasonably comfortable and professionals with whom you feel connected and safe. I did move through ten modalities before I ultimately found relief. Along the way there were some that felt good to me, and some that made me enormously uncomfortable. I learned early on to trust my instincts and eliminate those processes that compounded the normal stress of recovery work. There’s a certain amount of treatment that is going to bring up uncomfortable feelings and emotions. That unavoidable discomfort is part of facing what needs to be faced. In order to do the tough work it helps to be working with a technique and an individual that allows you to focus on the work and not your discomfort with the actual process itself.

What was one of the most meaningful things you learned about yourself through your journey?

Great question! So often we think of trauma and recovery in terms of what’s lost, destroyed or broken. While those elements may exist in certain moments, the larger picture is that trauma and recovery force us to grow in ways we never may have discovered without such challenges. In my own journey, one particular example comes to mind: My trauma occurred due to a medical mistake when I was thirteen years old. An allergy to a medication turned me into the equivalent of a third-degree burn patient almost overnight. While I made a full physical recovery, I never rebounded emotionally. For the next twenty-five years I lived in the shadow of that event. I was plagued by nightmares, sadness, depression, anxiety and fear for my safety. After several years I just accepted that that was the kind of person I was. I accepted that I was not joyful and even thought that it was impossible for me to feel joy. And then one day I decided that I really wanted to be the kind of person who could feel joy, so I set about developing that experience for myself. I was enormously successful. What I learned along the way was that I contained a natural resilience I hadn’t been aware of or tapped into, and also that I have a deep well of joy within me – all I had to do was learn how to access it. In trauma recovery we have a chance for posttraumatic growth. In engaging in that growth I learned I was stronger than I expected, more creative and life-loving than I knew, and more empowered than I ever expected in the creation of the life I desired.

You often say that “we don’t heal in isolation, we heal in community.” Tell readers what you mean by that?

In my own recovery and in that of so many of the survivors with whom I work and speak, there’s an enormous tendency toward isolation. We’re not happy with ourselves and our lives, we don’t feel safe or in control and so we hide out. As one military psychologist calls it, we ‘hunker in the bunker.’ The problem is that it’s very difficult to heal in that isolated and detached state. We need the support, knowledge and advice of others to help us navigate the ever-changing terrain of trauma recovery. So, one aspect of what I mean by the quote you mentioned is that we heal better and more quickly when we accept help. The other element of that has to do with my belief in how much survivors can teach each other. Survivors have a meta-language that allows them to understand each other on a deep and experiential level. When we connect with each other, we strengthen ourselves. When we help each other, we move ourselves forward through an exchange of energy, ideas, education and support.

Before the World Intruded, your memoir of your traumatic experiences, is a powerful story of determination in the face of despair.  What do you most want readers to learn from your personal narrative?

The most important message in the book, I think, is that we all have enormous healing potential. The goal is learning to access that potential to conquer the past and create the future. I went through twenty-five years of struggle before I found the information I needed to begin charting a path to relief. If I can overcome the built up effects of twenty-five years, there’s hope for us all! Trauma recovery is, as my mom says, ‘a long and winding road.’ There will be successes and failures, certainties and doubts. The key along the way is to maintain your hope and develop a deep belief in your ability to achieve your goals.

Is there anything else you would want Psychology Today readers to know about PTSD, depression or anxiety?

So many things I’d want them to know! Most importantly: First, if you are struggling with the effects of the past, it’s not your fault. Feeling posttraumatic stress is a reasonable response to an overwhelming, unexpected and shocking experience. Second, help exists and it’s your job to seek and engage in the therapeutic process. Third, it is possible for you to transcend trauma no matter how deeply you feel affected or how long it’s been since your experience. It will take time, but you do have the potential to feel better. Fourth, self-care is enormously important after trauma and in recovery. Find a way to take care of yourself in terms of routines and activities that soothe and restore your energy, vitality and resilience. Finally, the key to finding relief lies in finding the courage to face what needs to be faced, do what needs to be done and accept the ups and downs of the process until the job is completed

Michele Rosenthal, a certified PTSD coach, is the founder of and the host of YOUR LIFE AFTER TRAUMA, Thursdays on Seaview Radio @ 7pm EST. She welcomes your comments and questions.

Apr 25

Anxiety Increases Cancer Severity


ScienceDaily (Apr. 25, 2012) — Worrywarts, fidgety folk and the naturally nervy may have a real cause for concern: accelerated cancer. In a new study led by researchers at the Stanford University School of Medicine, anxiety-prone mice developed more severe cancer then their calm counterparts.

“Anxiety may be defined as increased sensitivity to physically existent, or non-existent but perceived or anticipated, stressors,” said stress expert and immunologist Firdaus Dhabhar, PhD, first author of the study.

Dhabhar’s previous work has investigated the balance of “good” and “bad” stress. Short-lived stressors — like being chased by a lion, or giving a weighty presentation to your boss — can actually boost your immune system by preparing your body for battle. But constant stress, such as caring for a disabled loved one, breaks down the body’s ability to fight off disease over time, he said.

The question is: How much stress is too much? Because stress responses vary between individuals, Dhabhar turned to understanding the link between base-level anxiety and actual stress.

For mice, stress comes from striking a balance between exploring to find food and mates, and protecting themselves from danger. Highly anxious mice, Dhabhar hypothesized, would err on the side of avoiding danger. He and his research team placed hairless mice on a raised, cross-shaped track, which had one walkway enclosed by walls and the other open. Then they measured how often each mouse ventured to the open arms. Likewise, he placed them in a large box, half lit and half dark, and noted those that spent the most time in the dark side.

Apr 25

Do You Love a Narcissist?


By Darlene Lancer, JD, MFT       It’s easy to fall in love with narcissists. Their charm, talent, success, beauty, and charisma cast a spell, along with scintillating conversation, compliments toward and maybe even apparent interest in you.  Once hooked, however, you have to contend with narcissists’ demands, criticisms and self-centeredness. Perhaps you were embarrassed when your mate cut in front of the line or shuddered at the dismissive way he or she treated a waitress. Interpersonal relationships revolve around them. You’re expected to meet their needs when needed, and are dismissed when not.

What it’s Like to Love a Narcissist

In the beginning, you were delighted to be in the narcissist’s aura. Now you’re tense and drained from unpredictable tantrums, attacks, and unjustified indignation at imaginary slights. You begin to doubt yourself, worry what he or she will think, and become as preoccupied with the narcissist as he or she is with him or herself.  After a while, you start to lose self-confidence. Your self-esteem may have been intact when you met, but your partner finds you coming up short and doesn’t fail to point it out. Most narcissists are perfectionists. Nothing you or others do is right or appreciated. Talking about your disappointment or hurt gets turned into your fault or another opportunity to put you down. They can dish it, but not take it, being highly sensitive to any perceived judgment.

Narcissists have no boundaries. They see you as an extension of themselves, requiring you to be on call to meet their needs regardless of your own. You might get caught up in trying to please them. This is like trying to fill a bottomless pit. Their needs, whether for admiration, service, love, or purchases, are endless. You might go out of your way to fill their request only to have your efforts devalued because you didn’t read their mind. They expect you to know without having to ask. You end up in a double-bind – damned if you displease them and damned when you do.  Narcissists don’t like to hear “No.” Boundary-setting threatens them. They’ll manipulate to get their way and make sure you feel guilty if you’re bold enough to risk turning them down. You become afraid that if you don’t please them, you risk an onslaught of blame and punishment, withheld love, and a ruptured relationship. This is all too possible, because the narcissist’s relationship is with him- or herself. You just have to fit in. Nevertheless, you stay in the relationship, because periodically the charm, excitement, and loving gestures that first enchanted you return.

Do Narcissists Love?

In public, narcissists switch on the charm that first drew you in. People gravitate toward them and are enlivened by their energy. You’re proud to bask in their glow.  But at home, they’re totally different. They may privately denigrate the person they were just entertaining. You begin to wonder if they have an outward “as if” personality. Maybe you’re reassured of their love when they bestow complimentary and caring words and gestures, are madly possessive, or buy you expensive gifts, then doubt their sincerity and question whether they’re being manipulative or saying what’s appropriate.  Sometimes, you might think they love only themselves. That’s a common misconception. Actually, narcissists dislike themselves immensely. Their inflated self-flattery, perfectionism, and arrogance are merely covers for the self-loathing they don’t admit – usually even to themselves. Instead, it’s projected outward in their disdain for and criticism of others. This is why they don’t want to look at themselves. They’re too afraid, because they believe that the truth would be devastating. Narcissists don’t have much of a Self at all. Emotionally, they’re dead inside. (See Self-Love.)

Early Beginnings

It’s hard to be empathic with narcissists, but they didn’t choose to be that way. Their natural development was arrested as a toddler due to faulty early parenting, usually by a mother who didn’t provide sufficient nurturing and opportunity for idealization. They’re left with an unrealistic view of themselves, and at times make you experience what it was like having had to feed the needs of a cold, invasive, or unavailable narcissistic parent. Anne Rice’s vampire Lestat had such an emotionally empty mother, who devotedly bonded with him to survive.

The deprivation of real nurturing and lack of boundaries make narcissists dependent on others to feed their insatiable need for validation. Like the mythological Narcissus, they don’t know themselves, but only can love themselves as a reflection in the eyes of others. Poor Narcissus. The gods sentenced him to a life without human love. He fell in love with his reflection by a pool, and died by the water, hungering for a response from his reflection.


All personality traits, including narcissism, exist on a continuum from mild to severe. Narcissism ranges from self-centeredness and some narcissistic traits to Narcissistic Personality Disorder (“NPD”). NPD wasn’t categorized as a disorder by the American Psychiatric Association until 1987, because it was felt that too many people shared some of the traits and it was difficult to diagnose. The summarized diagnosis is controversial and undergoing further change.  Someone with NPD is grandiose (sometimes only in fantasy), lacks empathy, and needs admiration from others, as indicated by five of these characteristics:

  1. A grandiose sense of self-importance; exaggerates achievements and talents
  2. Dreams of unlimited power, success, brilliance, beauty, or ideal love
  3. Lacks empathy for the feelings and needs of others
  4. Requires excessive admiration
  5. Believes he or she is special and unique, and can only be understood by, or should associate with other special or of high-status people (or institutions)
  6. Unreasonably expects special, favorable treatment or compliance with his or her wishes
  7. Exploits and takes advantage of others to achieve personal ends
  8. Envies others or believes they’re envious of him or her
  9. Has “an attitude” of arrogance or acts that way

Of all the narcissists, beware of malignant narcissists, who are the most pernicious, hostile, and destructive. They take traits 6 and 7 to an extreme, and are vindictive and malicious. Avoid them before they destroy you.


People with codependence lack a core Self, and define themselves based on others. This is true for all narcissists, whose Self is so weak and insecure they need constant validation. Stereotypically, they’re not interested in taking care of others – but some narcissists are caretakers. Some narcissistic men do this with money, because it boosts their self-esteem.

When two narcissists get together, they’re miserable needing each other, yet fighting over whose needs come first and pushing away. On the other hand, it can be a perfect fit, albeit painful, for ordinary codependents, because their low self-esteem is boosted by the narcissist’s attributes and aura of success. It also allows them to tolerate the narcissist’s emotional abuse. They feel needless and guilty asserting their needs and caring for a narcissist makes them feel valued. Because they feel undeserving of receiving love, they don’t expect to be loved for who they are – only for what they give or do.


Narcissists don’t usually seek help unless a major loss shatters their illusions. But both narcissism and codependency can be healed with courage, time, and a commitment to yourself. Recovery entails improving boundaries and self-acceptance based upon real self-knowledge. Psychotherapy and joining a 12-Step program are beneficial ways to start.

Apr 24

ScienceDaily (Apr. 18, 2012) — A five year study conducted with thousands of local teenagers by University of Montreal researchers reveals that those who used speed (meth/ampthetamine) or ecstasy (MDMA) at fifteen or sixteen years of age were significantly more likely to suffer elevated depressive symptoms the following year.

“Our findings are consistent with other human and animal studies that suggest long-term negative influences of synthetic drug use,” said co-author Frédéric N. Brière of the School Environment Research Group at the University of Montreal. “Our results reveal that recreational MDMA and meth/amphetamine use places typically developing secondary school students at greater risk of experiencing depressive symptoms.” Ecstasy and speed-using grade ten students were respectively 1.7 and 1.6 times more likely to be depressed by the time they reached grade eleven.

Apr 24

Seven Mistakes Couples make and Solutions to Help


by Barbara Peters

Impaired or troubled communication is definitely one of the most common reasons couples end up in a therapist’s office.

Good communication is like glue. It plays a large part keeping relationships intact and holding strong. On the other hand, poor communication leads to conflict, often acting as a solvent to cause relationships to separate or dissolve.  The happiest couples are the ones who are emotionally open and not afraid of being vulnerable with each other. It’s not always easy to talk about sensitive subjects that elicit fears and insecurities. With rejection or criticism expected or looming, certain important topics can go unspoken for years or become communicated in indirect, obtuse ways.

Couples without good communication can become disengaged and will often seek out “safe people” for discussing their concerns, rather than their partner. Or, they might opt to keep feelings bottled inside while needs remain unmet. Depression and other negative emotional states can easily take over.

The following are seven mistakes individuals often make when communicating with their significant other:

  • Not listening to what the other is saying
  • Formulating a response too quickly without getting sufficient information
  • Using words or phrases that the other does not understand
  • Displaying inappropriate vocal gestures, such as tone, pitch and facial expression
  • Unfriendly body language (arms folded over chest)
  • Poor timing for a serious discussion
  • Failure to ensure the other person understands your message

Now, here’s how to overcome communication mistakes:

  • Clearly state your point or opinion.
  • Deliver your message in a loving manner.
  • Be open to answer questions.
  • Choose an appropriate time to dialogue.
  • Use common words and phrases your partner understands or explain your meaning clearly.
  • Show open body language.
  • Allow your partner time to respond; wait patiently for an answer.

Being aware of impaired communication is the first step to better communication. When you find you’re in the throes of communicating badly, such as a screaming match with your partner, ask for help from him or her, or take a time-out rather than say things that might later cause more conflict or hurt feelings. Your words are like an e-mail – once you hit the send button, it is done.

Apr 24

Migraine Guidelines: What Works, What Doesn’t


MONDAY, April 23 (HealthDay News) — Dozens of medications are available to prevent debilitating migraine headaches, but most migraine sufferers don’t use them, a new study finds.  “Approximately 40 percent of people with migraines need preventive treatment, and only about one-third of them are actually getting it,” said Dr. Stephen D. Silberstein, co-author of new guidelines developed by the American Academy of Neurology and the American Headache Society.  The drugs include prescription, over-the-counter and herbal medications. Which will work best “depends on the patient,” said Silberstein, director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia.

The guidelines, published in the April 24 issue of Neurology, were scheduled for presentation at the academy’s annual meeting in New Orleans, April 21 to 28.  Dr. Brian M. Grosberg, director of the Montefiore Headache Center in New York City, said recent studies have shown that preventive treatment is underutilized by both patients and their physicians.  “Although there is no cure for migraine, preventive medications can decrease migraine occurrence by 50 percent or more, as well as reduce the severity and duration of headaches that do occur,” said Grosberg, who was not involved with writing the guidelines.

Most preventive treatments are taken daily day, unlike medications taken to relieve the pain and other symptoms of a migraine attack once it occurs.  According to the American Academy of Neurology, migraines were the cause of more than 3 million emergency room visits in the United States in 2008. Symptoms can include throbbing or pulsing in one area of the head, nausea, vomiting and extreme sensitivity to light and sound. Migraine attacks are more common in women, and may last for hours or days.

The new guidelines include information from 29 studies published between 1999 and 2009 that describe effective preventive treatments for migraine. They state that:

  • Among prescription drugs, strong evidence shows that anti-epileptic drugs such as Depakote (divalproex sodium), Topamax (topiramate) and sodium valproate as well as the blood pressure drugs metoprolol (Lopressor, Toprol), propranolol (Inderal) and timolol (Blocadren) — which belong to the class of medications known as beta blockers — reduce the number of migraine attacks and their severity.
  • The seizure drug lamotrigine (Lamictal) was not shown to prevent  migraine.
  • Frova (frovatriptan), one of a class of drugs originally developed to treat migraines, seems to be effective against menstrual-related migraines.
  • The antidepressant Effexor (venlafaxine) appears to have some preventive benefit.
  • Over-the-counter drugs Motrin (ibuprofen) and Aleve (naproxen) as well as riboflavin (vitamin B2) and the herb butterbur may also play a role in prevention.

Silberstein said that that if all the drugs work equally well, people should consider other diseases the drugs treat and use any side effects to your advantage.  If you’re obese, for example, Topamax might be your best bet as a side effect is weight loss, he said.  People with epilepsy should consider Depakote and those with depression an antidepressant such as Effexor, he noted.  Grosberg said patients should discuss the options with their doctor. “There are many effective preventive strategies.  It’s important that the headache sufferer and treating physician work together to find the optimal treatment approach,” said Grosberg.

“The preventive strategy should always be tailored to the individual patient, bearing in mind personal preference, co-existing medical conditions, frequency of dosing and cost, as well as other factors,” he added.    Silberstein added that even people who take over-the-counter or herbal treatments should see their doctor for follow-up because all medications can cause side effects or interact with other drugs.

SOURCES: Stephen D. Silberstein, M.D., director, Jefferson Headache Center, Thomas Jefferson University, Philadelphia; Brian M. Grosberg, M.D., associate professor, neurology, Albert Einstein College of Medicine, and director, Montefiore Headache Center, New York City; April 24, 2012, Neurology

Apr 24

Child Developmental Stages: Is My Child Normal?


by Dr. Greg Stasi

The number one reason that parents contact myself and the various therapists at North Shore Pediatric Therapy is to find out whether or not their children are developing and progressing at a normal rate. When should my child crawl? When should she start speaking? At what age should he be walking? These are all questions that we find ourselves answering on a daily basis. Parents often are not privy to this information. If only children would come with an instruction manual. Each child develops at a different rate, which is found to be dependent upon several factors including environmental influence (exposure to a variety of experiences) to genetic predisposition. That being said, there are stages of development that every child will reach in a hierarchical order. The main areas of development include a child’s motor ability and his or her language functioning. Language functioning can then be broken down into two main areas: receptive language, which is the child’s ability to listen to and follow auditory demands, and expressive language, which is the ability to provide comprehensive responses. Below is a chart for the major stages of motor and language development along with typical ages in which the child should reach the stage.

Motor Development

Motor Skill

Expected Age of Achievement

Head erect and steady when held

Six weeks

Lifts self up by arms when prone

Two months

Rolls from side to side

Two months

Rolls from back to side

Four months

Sits alone

Seven months


Seven months

Stands alone

Eleven months

Walks without assistance

Twelve months

Walks up stairs with assistance

Sixteen months

Jumps up and down

Twenty three months

Language Development

Receptive Language (listening and responding to information) 

Age of Child

Speech/Language Behavior Observed
Zero to three months Turns head to caregiver and smiles when spoken to
Four to six months Responds to word “no” and responds to changes with tone of voice
Seven to twelve months Listens when spoken to, recognizes names of objects, first word
Two to three years Understand two part commands and understand contrasting words
Three to five years Understand most of what they hear
Expressive Language (communicating needs and wants)

Age of Child

Speech/Language Behavior Observed
Zero to three months Make sounds indicating pleasure, cry differently to express needs
Three to six months Laugh, babble, mimic sounds
Nine to twelve months First words, repeat sounds, use most consonant and vowel sounds
Twelve to fifteen months Gesture and speak ‘no’, ask for help with gestures and sounds
Fifteen to eighteen months Use 10-20 words, 20-25 percent of speech is intelligible by others
Eighteen to twenty four months Use three word sentences, 50-70 percent of speech is intelligible
Two to three years 400 word vocabulary, word for almost everything, answer “what” questions
Three to four year olds 900-1000 word vocabulary, use pronouns correctly, use three to six word sentences
Four to five years old 1,500-2,500 word vocabulary, use six to eight word sentences
The above charts are what we know to be the stages of development with regard to children’s receptive and expressive language and motor functioning. Typically, children will reach the target behaviors within the ages given. However, development is variable for many children and not every child will reach the various stages at the same time.
If your child is not demonstrating the motor or language behaviors that should be present at his or her age, there are several things you should do. First, do not panic. Ask your pediatrician about your concerns. If you continue to have concerns, have an evaluation by a psychologist, occupational therapist, or speech/language therapist in order to determine if there are possible delays and what type of therapy may be warranted. A lot of parents ask me: won’t my child develop those skills eventually? Many children may often “catch up” with their development; however, the concern would be at what cost? How did the child’s delays impact him or her socially or emotionally? What was the impact with his or her academic performance? Parents often know instinctually when there is something atypical about their child. If you are watching other children at the playground or at play-dates doing things that your child is not (that you feel they should be) and you have any concern at all, it can’t hurt to ask a professional. Be proactive! Do not wait until it is too late to get the assistance your child needs most. Research has shown that the earlier intervention is applied, the more successful it can be. The goal of the therapies would be to ensure the child reaches his or her potential with no long term consequences.
Apr 24

Video Games Good for Seniors Health


By Rick Nauert PhDSenior News Editor Reviewed by John M. Grohol, Psy.D. on April 24, 2012

Two new articles suggest that younger folks may have some competition over the video controller.

New research suggests that video game technology can be a valuable tool for helping people of all ages improve lifestyle and health habits and manage disease. Researchers have discovered that “exergames” have significant benefits for older adults by providing cognitive stimulation and a source of social interaction, exercise, and fun.  According to two articles in Games for Health Journal, the games help senior adults’ lead fuller, more independent lives for a longer time,

“The elderly often forsake their lifelong activities in exchange for the safety, security, and care of institutional living,” said Editor-in-Chief Bill Ferguson, Ph.D.  “This trade-off need not require the sacrifice of physical activity and fitness. Furthermore, video games offer an escape from routine. All of these benefits can improve the well-being of elderly adults.”

Experts say that digital games offer a home-based method to support behavior modification. The games can serve as a method to motivate individuals to take better care of themselves and to self-mange chronic conditions.  Physical, occupation and speech therapists are taking advantage of technology to develop home-based rehabilitation and training programs for older adults.

Video games also offer a good alternative to traditional forms of aerobic exercise, according to the authors, Hannah Marston, Ph.D., German Sport University Cologne, Germany, and Stuart Smith, Ph.D., Neuroscience Research, Randwick, New South Wales, Australia.  Researchers determined video games interest older adults because of the fun involved with gaming; the social aspect of the experience; the challenge it presents; the combination of cognitive and physical activity; and the ability to gain specific skills as a result of gaming.

Source: Mary Ann Liebert

Apr 23

Parenting Adolescents and the Problems of Letting Go


Published on April 23, 2012 by Carl E. Pickhardt, Ph.D. in Surviving (Your Child’s) Adolescence

Raising adolescents is one long, often agonizing, exercise in the hardest part of parenting: letting go.

At each stage of the way, parents find themselves under pressure to loosen their hold as the adolescent pushes for more individuality and independence, bent on becoming a unique person free to live on her or his own terms.  Why can letting go be so hard for parents? Letting go creates some degree loss for parents – for example, of companionship, closeness, communication, and control. Consider some problems of parental losses from letting go that come with each stage of adolescence.

During the first stage of adolescence, early adolescence (ages 9 – 13) there is letting go of childhood identity and companionship. Now parents lose their best buddy and tagalong who prized time with parents, communicating everything and sharing in whatever they liked to do. For parents who were given such a golden childhood time, this letting go can be particularly painful. They will never have their son or daughter as little child again. For these parents, this loss deserves honest mourning, appreciating the passing of a magical time they had together that they will never have again.

During the second stage of adolescence, mid adolescence (ages 13 – 15) there is letting go of  social time with family for the increased importance of hanging out with friends. Now the double life of adolescence begins in earnest: the life about which parents are told and the one about which for privacy’s and freedom’s sake they are not. Parents tend to be told less as peers matters more. To protect social independence with peers, parents are put at a social distance. This letting go can be worrisome for parents when ignorance becomes a source of anxiety. The loss can be partly moderated when their home becomes a hosting place for friends, when their son or daughter is invited to include friends in family activities, when parents can develop friendships with their adolescent’s friends.

During the third stage of adolescence, late adolescence (ages 15 – 18) there is the letting go of younger restrictions as some older freedoms (driving, dating, and part time employment, for example) are allowed by parents and others, not necessarily parent approved, that are encouraged by peers (substance use, sex, and adventurous risk taking, for example). This creates a very scary letting go for parents who must accept that they cannot keep their teenager free of more worldly dangers that are associated with the worldly experience he or she is wanting. The loss of parental protection that was provided by older restrictions may be partly supplanted by adequately preparing the high school teenager to understand and manage new risks that come with acting more grown up. Parents have a duty to inform.

During the fourth and final stage of adolescence, trial independence (ages 18 – 23) there is the letting go from home and the chance to live apart from family. It takes a lot of fortitude to watch as the young person struggles to try his wings and keep his footing at the same time, sometimes falling victim to the errors of his ways. The last stage of adolescence requires a lot of parental letting go. What can ease this hard adjustment is a role change in relationship to their son or daughter. They can give up being managing parents (asserting authority and taking charge) and become mentoring parents instead (being available for consultation and advice should the young person ask.) Now the parents respect the adolescent’s right to make and live by her own choices, while she respects the knowledge from longer life experience that parents have to offer.  What is important for parents to understand about the loss side of letting go is that simply because this progressive release allows the adolescent to live more independently doesn’t mean parents are abandoning the child. In fact this is the great challenge of parenting teenagers: how parents can still stay lovingly and meaningfully connected to their son or daughter, and remain available, as adolescence gradually grows them apart.

They hope that as they let go their responsibility for looking after the teenager’s welfare, that the teenager will be able to take the protection of that responsibility on. To this end, they are increasingly letting go and allowing the teenager to learn the value of freedom by paying freedom’s price. “Remember, more independence is not free. When we allow you more discretionary choice, we hold you accountable for the decisions made.” This, of course, is the only way responsibility is taught: by parents letting go so the teenager can take new decision-making on and learn the hard way by accepting and sometimes paying for the consequences.

There are some parents who have great difficulty with this second aspect of letting go. They confuse responsible behavior in their teenager with responsibility. I work in a large university town, and I see cases like this from time to time. Parents come in wondering: “We can’t understand it. All the way through high school our daughter was so responsible. She did everything we asked, she never got out of line. But now at college, it’s one episode of trouble after another! She’s lost all sense of responsibility!”

This is when I suggest that maybe she never had much sense of responsibility to begin with. Perhaps her responsible behavior in high school was really just social obedience to strict parents who she wanted to please, or at least feared displeasing. In high school, she let them set all the limits and make all the freedom choices for her. But now in college, she is living away from them, on her own, and for the first time must set limits and make freedom choices for herself. If they want her to learn to take responsibility at this late date, they must let go control, not interfere, and allow her to confront the consequences of her actions.  “But we can’t stand seeing her hurt herself!” they protest. So we end up talking about the parental pain that can come with letting go and letting children learn from the errors of their ways.

Finally, consider the parent who stated her loss at this last letting go in very human terms. “Is this the return I get for all I’ve invested in my teenager? Now she just puts me aside, ignores our relationship, and leaves home to focus on her own life after all I’ve done?”  “Yes,” I replied, “that’s the reward parents have been working for all these hard adolescent years. It’s called ‘independence.’ Holding on, guiding, and providing support to their growing child was a great labor of love; but at the end of adolescence, the greater loving is to let the loved one go.”

Apr 23

Nightmares and Night Terrors in Bipolar Disorder


By ,      I’ve had vivid dreams all my life – long, clear, and so detailed I could write them out as bizarre stories. These are rarely nightmares, but I have those, too, on occasion. My nightmares most commonly revolve around the fear of falling. For example, more than once I’ve dreamed I was in an elevator with a central pillar, and suddenly the floor turned to rubber and detached from the edges. The only real safety is to hang onto the pillar, but I’m never alone, so several of us are going for that pillar, while others clutch the edges of the heavy rubber sheet as it bends down into the shaft.


Apr 23

April 23, 2012 in Alzheimer’s disease & dementia

Cognitive decline is a pressing global health care issue. Worldwide, one case of dementia is detected every seven seconds. Mild cognitive impairment is a well recognized risk factor for dementia, and represents a critical window of opportunity for intervening and altering the trajectory of cognitive decline in seniors.

A new study by researchers at the Centre for Hip Health and Mobility at Vancouver Coastal Health and the University of British Columbia shows that implementing a seniors’ exercise program, specifically one using resistance-training, can alter the trajectory of decline. Perhaps most importantly, the program improved the executive cognitive process of selective attention and conflict resolution as well as associative memory, which are robust predictors of conversion from mild cognitive impairment to dementia.

Over the course of six months, the study team followed 86 senior women with probable . The is the first to compare the efficacy of both resistance and aerobic training to improve executive cognitive functions – such as attention, memory, problem solving and decision making – necessary for independent living. The trial also assessed the effect of both types of exercise on associative memory performance and corresponding functional .

Both types of exercise were performed twice weekly for six months. Participants were measured with a series of cognitive tests and brain plasticity was assessed using functional MRI. The results showed resistance-training significantly improved executive cognitive functions, associative , and functional brain plasticity. In contrast to previous studies in healthy older adults, aerobic training did not demonstrate any significant effect for cognitive and brain plasticity.

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