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Jun 30

When the Voice Inside Your Head Turns Bad


Empowering yourself to challenge your inner critic.
Published on April 18, 2012 by Melanie A. Greenberg, Ph.D. in The Mindful Self-Express

The Committees in Our Heads
all have voices inside our heads commenting on our moment-to-moment experiences, the quality of our past decisions, mistakes we could have avoided, and what we should have done differently. For some people, these voices are really mean and make a bad situation infinitely worse. Rather than empathize with our suffering, they criticize, disparage, and beat us down at every opportunity! The voices are often very salient, have a familiar ring to them and convey an emotional urgency that demands our attention. These voices are automatic, fear-based “rules for living” that act like inner bullies, keeping us stuck in the same old cycles and hampering our spontaneous enjoyment of life and our abilities to live and love freely.

Where Do the Voices Come From?
Psychologists believe these voices are residues of childhood experiences—automatic patterns of neural firing stored in our brains and dissociated from the memory of the events they are trying to protect us from. While having fear-based self-protective and self-disciplining rules probably made sense and helped us to survive when we were helpless kids, at the mercy of our parents’ moods, whims, and psychological conflicts, they may no longer be appropriate to our lives as adults. As adults, we have more ability to walk away from unhealthy situations and make conscious choices about our lives and relationships based on our own feelings, needs and interests. Yet, in many cases, we’re so used to living by these unwritten internal rules that we don’t even notice or question them. And we unconsciously distort our view of things so they seem to be necessary and true. Like prisoners with “Stockholm Syndrome,” we have bonded with our captors!

What Happens When the Committee Takes Charge of Our Lives?
If left unchecked, the committees in our heads will take charge of our lives and keep us stuck in mental and behavioral prisons of our own making. Like typical abusers, they scare us into believing that the outside world is dangerous, and that we need to obey their rules for living in order to survive and avoid pain. By following (or rigidly disobeying) these rules, we don’t allow ourselves to adapt our responses to experiences as they naturally unfold. Our behaviors and emotional responses become more a reflection of yesterday’s reality than what is happening today. And we never seem to escape our dysfunctional childhoods.

The Schema Therapy Approach
Psychologist Jeffrey Young and his colleagues call these rigid rules of living and views of the world “schemas.” Based on our earliest experiences with caregivers, schemas contain information about our own abilities to survive independently, how others will treat us, what outcomes we deserve in life, and how safe or dangerous the world is. They can also get in the way of our having healthy relationships in life, work, and love.

How Negative Schemas Affect Our Lives & Relationships

Young suggests that negative schemas limit our lives and relationships in several ways:

(1) We behave in ways that maintain them.

(2) We interpret our experiences in ways that make them seem true, even if they really aren’t.

(3) In efforts to avoid pain, we restrict our lives so we never get to test them out

(4) We sometimes overcompensate and act in just as rigid, oppositional ways that interfere with our relationships.

The Abandonment Schema – Diana’s Story
A woman who we will call Diana has a schema of “Abandonment.” When she was five years old, her father ran off with his secretary and disappeared from her life, not returning until she was a teenager. The pain of being abandoned was so devastating for young Diana that some part of her brain determined that she would never again allow herself to experience this amount of pain. Also, as many children do, she felt deep down that she was to blame; she wasn’t lovable enough, or else her father would have stuck around; a type of ‘Defectiveness” schema.

Once Diana developed this schema, she became very sensitive to rejection, seeing the normal ups and downs of children’s friendships and teenage dating as further proof that she was unlovable and destined to be abandoned. She also tried desperately to cover up for her perceived inadequacies by focusing on pleasing her romantic partners, and making them need her so much that they would never leave her. She felt a special chemistry for distant, commitment-phobic men. When she attracted a partner who was open and authentic, she became so controlling, insecure and needy that, tired of not being believed or trusted, he eventually gave up on the relationship.

Diana’s unspoken rule is that it is not safe to trust people and let relationships naturally unfold; if she relaxes her vigilance for even a moment, the other person may leave. In an effort to rebel against her schema, she also acted in ways that were opposite to how she felt; encouraging her partner to stay after work to hang out with his friends, in an attempt to convince herself (and him) that she was ultra-independent. This led to chronic anger and feelings of dissatisfaction with her partner’s lack of understanding of her needs; she neither understood nor acknowledged her own role in the cycle.

What Can We Do?
Schema Therapy can help Diana (and her partner) understand how their schemas result in ways of relating to self and others that are repetitive, automatic, rigid, and dysfunctional. By acknowledging and empathically connecting with her unresolved fears and unmet needs, Diana can become more flexible and free. These new theories and therapies can help to heal couples conflict and individual problems such as anxiety, depression, personality disorders, grief, and childhood trauma. The schema concept helps us understand how early childhood events continue to influence adult relationships and mental health issues. We need to recognize their influence, pay attention to what our automatic inner voices are saying, and (with professional help, if necessary), begin to free ourselves from their grip.

Schema Therapy Website:
About The Author

Melanie Greenberg, Ph.D. is a clinical psychologist, life coach, and expert on life change, health psychology, integrative & behavioral medicine, chronic stress and pain, who has published her own research in academic journals. Previously a Professor, she is now an influential practicing psychologist, speaker, and media consultant.

Jun 30

Does Cheating Automatically Mean Divorce?


By Sari Eckler Cooper Is it possible to move on after a spouse has had an affair?

As a certified sex and licensed couples therapist, I have worked with many couples in the aftermath of an affair. Those first few weeks and months seem crazy to the hurt partner as they try to piece together their life, which is usually in shambles.

Surprisingly, many couples that face infidelity do end up remaining together. However, it is not obvious in the early stage of discovery. For some unfaithful partners, the endless questioning by their spouse frustrates them and makes them feel ashamed constantly. They may truly feel sorry for their actions or they may feel like their admission and apologies have entitled them to move forward without going over the details. I try to balance the information I think the hurt partner has a right to know and what I think may be hurtful to know in the long run. I ask hurt partners to save their questions to ask in a couples’ session so I can slowly unwrap the meaning of the question and give my expertise on whether I think the answer to the question will be helpful or hurtful in the long run.

The couples with whom I’ve worked that ended up staying together worked hard to go over the story of the affair and what new boundaries or guidelines needed to be put into place to prevent it from happening again. They also remained in therapy long enough to explore the aspects of the relationship itself that may have contributed to the partner straying, in addition to deeper feelings related to their childhood (at times there was a parent that abandoned the family either emotionally and/or physically) that were begin replayed in the marriage.

My clients who transformed their relationships after an affair also explored the timing of the affair(s) in their lifecycle. One husband felt abandoned by his wife when she became so involved with child-rearing that she left little time for their relationship. It reminded him of his experience as a child in a large family who was left to himself most of the time because his mother was too busy taking care of younger children and cooking meals. Another woman felt overwhelmed by depression after her mother died of cancer and she thought, “Is that all there is?” Many times a person will use an affair to escape a painful experience because they don’t have the words or trust that their partner or anyone else could understand what they’re going through. The work in therapy allowed these feelings to come to the surface and allowed the hurt partner to feel empathy for their spouse, thus making them feel closer and more open to sharing in the future.

My clients who didn’t remain together after an affair had a cheating partner who already had decided to end the marriage before coming into therapy. Other couples who split had a hurt spouse that couldn’t move past the anger phase into the more curious or inquisitive phase of healing. Another couple that had trouble healing was one whose marriage had been in a state of apathy for years. An affair is terribly painful for a couple but with the right steps, divorce can be avoided.

Here are some tips if you find yourself in the aftermath of an affair:

1. Commit to a certain period of time in couples therapy to work on the relationship.

2. Write down questions you have regarding the affair that you would like to understand better and bring them to therapy.

3. Find out why the affair happened when it did.

4. Don’t act out by having an affair of your own in retaliation.

5. Establish specific actions which the partner who strayed can do to begin to repair the trust, including showing up when they say they will, giving names of hotels and names of colleagues on business trips (if the affairs took place out of town) and letting your partner know if the person with whom you had the affair has contacted you.

6. Refrain from making a decision about the marriage or threatening divorce while you’re working on healing for the agreed upon time in therapy.

7. Make sure there are no more secrets regarding this affair or others that may emerge and thus ruin the trust you are trying to rebuild.

8. Make time to spend outside of therapy alone as a couple without talking about the affair to reestablish some good feeling and bonding.

9. Don’t overshare details of what is going on with children. Children need stability to feel safe and secure, and while they can be told you’re having troubles, they can also be told you’re working on it without going into details. If a decision to divorce ensues, there are steps involved to prepare them for the change.

10. If you can, work with a certified sex therapist who is also an experienced couples therapist. You’ll have a better chance of exploring ways to restore and improve the sexual life following an affair.

Jun 30

CBT Psychotherapy Best For Anxiety Disorders


By Janice Wood Associate News Editor
A University of Houston researcher has found that patients suffering from anxiety disorders showed the most improvement when treated with cognitive-behavioral therapy (CBT) — in conjunction with a “transdiagnostic” approach, which allows therapists to use one kind of treatment no matter what the anxiety.

The problem up to now, according to Peter Norton, Ph.D., an associate professor in clinical psychology and director of the Anxiety Disorder Clinic at the University of Houston, has been that each anxiety disorder — such as panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder, and phobias — has had a targeted treatment.

The transdiagnostic approach recognizes that many overlapping dimensions exist among these anxiety disorders. It suggests that thinking about anxiety disorders as a whole from a behavioral dimension and/or psychological dimension perspective may yield important insights into these disorders.

Norton, who says the specific treatments aren’t all that different from each other, has shown that a combination of CBT with the transdiagnostic approach has proven more effective than CBT combined with other types of anxiety disorder treatments, such as relaxation training.

“The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been an important breakthrough in understanding mental health, but people are dissatisfied with its fine level of differentiation,” he said. The DSM uses a categorical approach to classifying mental disorders, including anxiety concerns.

“Panic disorders are considered something different from social phobia, which is considered something different from PTSD. The hope was that by getting refined in the diagnosis we could target interventions for each of these diagnoses, but in reality that just hasn’t played out.”

Norton’s research began 10 years ago when he was a graduate student in Nebraska and found he couldn’t get enough people together on the same night to run a group session for social phobia.

“What I realized is that I could open a group to people with anxiety disorders in general and develop a treatment program regardless of the artificial distinctions between social phobia and panic disorder, or obsessive-compulsive disorder, and focus on the core underlying things that are going wrong,” said Norton.

He says cognitive-behavioral therapy, which has a specific time frame and goals, is the most effective treatment as it helps patients understand the thoughts and feelings that influence their behaviors. The twist for him was using CBT in conjunction with the transdiagnostic approach.

The patients receiving the transdiagnostic treatment showed considerable improvement, especially with treating comorbid diagnoses, a disease or condition that co-exists with a primary disease and can stand on its own as a specific disease, like depression. Anxiety disorders often occur with a secondary illness, such as depression or substance and alcohol abuse, he noted.

“What I have learned from my past research is that if you treat your principal diagnosis, such as social phobia, you are going to show improvement on some of your secondary diagnosis,” he said. “Your mood is going to get a little better, your fear of heights might dissipate. So there is some effect there, but when we approach things with a transdiagnostic approach, we see a much bigger impact on comorbid diagnoses.”

“In my research study, over two-thirds of [co-existing] diagnoses went away, versus what we typically find when I’m treating a specific diagnosis such as a panic disorder, where only about 40 percent of people will show that sort of remission in their secondary diagnosis,” he continued.

“The transdiagnostic treatment approach [appears to be] more effiient in treating the whole person rather than just treating the diagnosis… then treating the next diagnoses.”

Norton notes the larger contributions of the studies are to guide further development and interventions for how clinical psychologists, therapists and social workers treat people with anxiety disorders. The data collected will be useful for people out on the front lines to effectively treat people to reduce anxiety disorders, he said.

Jun 30

Emotional Vulnerability


Emotional Vulnerability: A Stepping Stone to Deeper Intimacy
“Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it.” ~Rumi

We all have barriers—psychological defenses that shield us from the emotional pain and discomfort that is experienced as too overwhelming. In these instances, our barriers work to keep certain memories and feelings at bay (a type of internal emotional housekeeping), making life just a bit more livable.

Sometimes our barriers act as an external shield, keeping us at what feels like a safe distance from others. The message here is, “If I allow you in, if we get too close, something bad will happen.” Said differently, these barriers continuously regulate emotional intimacy, creating a distance that feels comfortable (and safe) to you. Intimacy regulation can be a conscious decision, but often we are unaware of the barriers we’ve erected throughout our lives (they function on a type of auto-pilot). We can even be unaware that we’re creating distance between us and our spouse or partner.

Emotional Vulnerability: Love’s Platform

Our barriers to love are in many ways barriers against vulnerability (emotional distance = emotional safety)—to love fully is to open yourself and allow another a front row seat (and back stage pass) to your inner sanctum.

To be seen by another (unencumbered by expectation, pretense, bravado and the comfort/security of the roles we inhabit throughout our lives) is certainly a risky undertaking. When emotionally vulnerable in this way, we yearn for self-affirming contact—our deepest desires to be acknowledged and accepted (in spite of our fear-based perceptions of inadequacy) are fully on display when we’re standing on the center stage of vulnerability.

Vulnerability is (or should be) a two-way process. Non-reciprocated vulnerability can leave us emotionally exposed, stranded without the security of mutual contact and connection. Whenever our hearts are truly open to another’s vulnerability, a shared vulnerability is created, a mutuality that allows for a deeper level of relatedness and intimacy. This “dance of intimacy” (to borrow Harriet Lerner’s phrase) is always in motion and co-created by couples—both you and your partner are responsible for this relational dance.

Shared vulnerability is the greatest (and often most unrecognized) gift couples can give one another.

Vulnerability Is Fragile and in Need of Ongoing Care

Vulnerability is delicate and finicky, requiring certain relational conditions in order to remain a presence in your marriage or relationship. When pro-vulnerability conditions are violated (by one or both partners), vulnerability is likely to recoil and, depending on the intensity of the violation, may refuse to re-emerge for quite some time. For this reason, it’s important for couples to learn about and be mindful of each other’s bids for greater vulnerability.

Rule of thumb: Don’t assume your partner’s vulnerability will look like your vulnerability—I see this type of pattern in my work with couples:

Partner A makes a bid toward greater intimacy by taking the risk to be more emotionally vulnerable (for instance, sharing something important to him/her or apologizing for something);
Partner B is either unaware of the bid or too angry-defensive to acknowledge the bid;
Partner A is quickly wounded, shamed and retracts emotionally. The open-receptive way of relating (a way of relating that is an essential part of the vulnerability landscape) gives way to a closed-off, hurt-angry-defensive way of relating.
Partner B counters with his/her own version of defensiveness. A defensive-to-defensive way of relating starts to pick up steam and overwhelms the couple.
At this point, neither partner is willing to risk moving back into an open-receptive way of relating—to do so would involve exposing oneself to further hurt and humiliation.

In order to avoid these painful cycles of relating, I often suggest to couples that they preface their bids for deeper vulnerability and intimacy by saying something like, “I just want to make sure I have your attention, because this is really hard for me…” This lets the other partner know that you are stepping out of your typical/casual way of relating into a more fragile/vulnerable way of relating.

Relationship Help: Why Risk Vulnerability in the First Place?

As alluded to above, in order to relate from our deepest, most authentic self (stripped of pretense and showmanship), we must become emotionally open and, therefore, vulnerable to another. From the playing field of vulnerability, relationship magic is possible, but for this possibility to be realized, we must be met with loving acceptance.

Emotional fulfillment, wholeness and healing are possible when this occurs.

Are you ready to move toward greater emotional vulnerability with your spouse/partner? If so, set the ground work by having discussions about what you each need for this to occur. What would allow you to feel more emotionally secure in order to move toward greater emotional openness?

Remember, emotional security, vulnerability and intimacy arise from a foundation of effective communication in your marriage/relationship.

Until next time!

Dr. Rich Nicastro

by Susan Newman, Ph.D. I listened to her parents beg, “Talk to your Uncle Steve.” From the time she was able to talk, with the exception being her father, Annie refused to speak to her uncle and most adult males. She spoke to her mother and her aunt at full tilt and somewhat to a few female grown-ups. At five-years-old, she would play games with me when we were together once or twice a year, but spoke as little as possible. “Your turn,” she said, or pulling another game off the shelf, “Can we play this one?” Not the chatter you would expect from a bright, young lady starting school.

Annie resisted monumental bribes including a trip to Disney World bankrolled by Uncle Steve if she would just acknowledge him. Her parents worried: Would Annie outgrow her shyness? Or would it be a lifelong affliction? Was her shyness a form of mental illness? Did she need medication? Was her shyness related to being an only child?

Shyness, like so many other labels, is one people hastily attached to only children in spite of the fact that years ago researchers discovered no link. In 1998 Jerome Kagan, Harvard researcher, reported that shyness had a biological base and that only children were the same in this respect as their peers who had siblings. A commenter to my post, Is One Child the New Traditional Family, like many parents I’ve talked with, feels the same way. She wrote:

“…People/children are born with inborn traits such as outgoing or shy. Having a sibling does not change that for the most part. I have one daughter and let me tell you she is a very social outgoing child…it seems to be almost natural for her. I think some people have great social skills while for others it is not the strongest aspect of their personality. Sometimes an overly shy child will cling/hide behind the sibling which is not so healthy either.”

Researcher Judith Blake found that “only children may actually be more outgoing and have more friends than kids from larger families.” Based on evidence, it’s safe to strike “shy” from the only child stereotypical label list. But is shyness is a mental health condition that should be treated? And if so, when and how?

In March of this year Murray B Stein, Professor of Psychiatry and Family & Preventive Medicine at the University of California, San Diego discussed the origins of shyness, when it can be classified as a mental illness and treatments available. He noted that 5 percent of the population has social anxiety disorder at a level that interferes with their functioning. But, he adds, “a range of effective cognitive behavioral and pharmacological treatments for children and adults exists.”

When not engaging with others including family members severely limits activities, shyness can be a huge problem. An article in the BBC News Magazine reports that “acute shyness is one of the most under-recognized mental health problems of the modern age say some.” In the same article, Harvard Medical School Professor Ronald Kessler is quoted as saying, “social phobia is tragic and the tragedy is that it’s relatively easily treated but most people don’t get treatment.”

Drug companies push their anti-depressant offerings as a cure. One camp believes oxytocin hormone (released from the brain) delivered in a form like Pitocin used to induce labor may be the answer when served up as a nasal spray. The Spanish National Institute of Toxicology (NIT) warns that the language used to describe the antide-pressant Seroxat (paroxetine) known as the “anti-shyness pill” may lead to its overuse or incorrect use with children, teens, and young adults.

Others advocate for counseling as the answer for extreme shyness that results in social phobia. Are these wise approaches for the shy child? In spite of her unwillingness to talk to her Uncle Steve, as a child Annie related well to her girlfriends, and by junior high to males and family members without any intervention. New situations and making new friends were a bit more problematic for Annie, but once over the initial hump and engaged, she added new peers to her friend list readily.

Being slow to warm up and needing some degree of familiarization with a situation before feeling “safe” may be shyness on the mid to low end of the spectrum, but it’s not a label parents want to attach to their child. Saying “Oh, she’s just shy” only reinforces the hesitancy you’re trying to reduce. And, labels endure. He or she could very well outgrow it or learn to overcome it without drugs and/or therapy. If you have a shy child, be patient and offer words or ideas she can use to ease into new situations that seem difficult. Recognize where your child is on the spectrum and understand that the reluctance will probably work itself out. If it doesn’t, respect your child’s non-aggressive temperament and tentativeness; feel grateful that you don’t have an aggressive, loud-mouth offspring from whom others try to escape.

Do you recall being painfully shy as a child? Did you outgrow it? Or, would you classify yourself as a social phobic. Would you, like some experts in the field, define your aversion to social situations a mental illness?
•Follow Susan Newman on Twitter.
•Sign up for Dr. Newman’s periodic Family Life Alert Newsletter
•Visit Susan’s website:
•Check out Susan’s new book, The Case for the Only Child

Jun 28

Treating Depression in the Elderly


By Chris Iliades, MD
Depression in healthy older people is actually less common than it is in healthy younger people, but depression and aging can be a dangerous mix for seniors dealing with chronic illness, loneliness, or loss of independence. Depression is the most important risk factor for suicide in the elderly, and older white men commit suicide more often than any other group.

Although 80 percent of depression in the elderly can be successfully treated, there are special concerns that the combination of depression and aging present. Here’s what you need to know:

Chronic illness. Diseases of aging like dementia, Alzheimer’s, Parkinson’s, heart disease, stroke, and others may have symptoms that mimic, mask, or make depression worse. These conditions often make the diagnosis and treatment of depression in the elderly more challenging.
Denial. Many elderly people, and even some caregivers, may assume that a certain amount of depression is a normal part of aging. Some elderly people may also think of depression as a weakness and be ashamed to ask for help.
Different response to treatment. Elderly people may be more sensitive to some types of antidepressant medications and may be more likely to experience side effects. On the other hand, they may respond better to simple group therapies that include exercise, and they are more likely to have depression relief through better treatment of their underlying medical conditions.

Treatment of Mild Depression in the Elderly

Depression treatment may begin with an evaluation of the elderly person’s medications. Often, adjusting or stopping certain medications may be helpful. If further treatment is needed, referral to a psychiatrist, psychologist, or other mental health professional is usually the next step:

Psychosocial treatment. Therapy that addresses social interaction is very important for many elderly people. Often, a type of intervention that relieves loneliness goes a long way — a group aerobic exercise session, like walking or swimming, can be very effective.
Talk therapy. Psychotherapy, or talk therapy, may be tried before resorting to medications. Studies show that this type of intervention works as well as medication for mild depression in the elderly. Cognitive behavioral therapy is a type of talk therapy that replaces negative thought patterns and behaviors with positive ones.
Social support. In addition to treatment, establishing a support system is particularly important for seniors. This may include group meals or meals on wheels, arranging for visiting nurses, and encouraging activities like volunteer work that reestablish a sense of purpose and encourage social engagement in elderly people who are able.

Treatment for Moderate or Severe Depression in the Elderly

When social support and talk therapy are not enough, other types of depression treatments that may be effective for depression in the elderly include antidepressant medications and electroconvulsive therapy (ECT). These therapies are almost always used in addition to psychotherapy and support:
Antidepressants. The first antidepressant medications used for depression in the elderly are usually selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing brain chemicals that fight depression, but they may also cause thinning of bones and put elderly people at risk for hip fractures. Doctors may need to start these medications at lower doses and increase them more slowly for the elderly.
ECT. Sometimes called shock therapy, this treatment has been shown to be very helpful for severe depression in the elderly when other depression treatments are not enough.. Side effects may include loss of memory. Duration of treatment. For a first episode of depression in the elderly, treatment should continue for six months to one year after symptoms have been relieved. For an elderly person who has had more than one episode of depression, depression treatment may need to be continued for several years.

It is important for elderly persons and their caregivers to understand that symptoms of depression are not a normal part of aging. The combination of depression and aging can make diagnosis and treatment more challenging, but depression in the elderly is just as treatable as depression in other age groups.
Last Updated: 06/07/2012

Steven Reinberg, HealthDay Reporter WEDNESDAY, March 21, 2012 (HealthDay News) — Aspirin, a popular weapon in the war against heart attacks, may also play a role in cancer prevention and treatment, three new British studies suggest.

“We have now found that after taking aspirin for three or four years there starts to be a reduction in the number of people with the spread of cancers, so it seems as well as preventing the long-term development of cancers, there is good evidence now that it is preventing the spread of cancers,” said lead researcher Dr. Peter M. Rothwell, a professor of neurology at the University of Oxford and John Radcliffe Hospital in Oxford. “Because aspirin prevents the spread of cancers, it could potentially be used as a treatment,” he added.

But the research is not conclusive, and did not prove that aspirin combats cancer. So, people should not start popping aspirin in the hopes of thwarting cancer, experts said. Previously, these investigators showed that a daily dose of aspirin taken over 10 years appeared to prevent some cancers, but the short-term benefits and the benefits for women weren’t clear.

Currently, a daily low-dose aspirin is recommended for people who have had a heart attack or stroke to prevent another. “It may well be that taking aspirin to prevent cancer becomes the main reason for taking it,” Rothwell said. Aspirin may work against cancer by inhibiting platelets, which promote clotting and also help cancer cells spread, he said.

The papers were published March 21 in The Lancet and The Lancet Oncology. In one study, Rothwell’s team analyzed data from 51 clinical trials comparing aspirin with no aspirin in preventing heart attacks.

Overall, daily low-dose aspirin reduced the risk of dying from cancer 15 percent. Taking aspirin five years or more reduced the risk 37 percent, and over three years, the risk reduction was about 25 percent for both men and women, the researchers noted. In addition, aspirin was associated with a 12 percent reduction in deaths from non-cardiovascular causes, they found.

In another study, Rothwell’s team looked at the effect of aspirin on slowing the spread of cancer, or metastasis. Their data came from five clinical trials that also looked at daily low-dose aspirin (75 milligrams or more) and heart attack and stroke prevention. The researchers zeroed in on patients who developed cancer.

Over more than six years of follow-up, low-dose aspirin reduced the risk of distant metastasis by 36 percent, compared with cancer patients receiving a placebo, they found. Moreover, aspirin reduced the risk of metastasis in solid tumors, such as colon, lung and prostate cancer, by 46 percent and by 18 percent for cancers of the bladder and kidney.

It also reduced the risk of diagnosing a cancer that had already spread by 31 percent. For those who continued to take aspirin after a cancer diagnosis, the risk of metastasis was cut by 69 percent, the researchers calculated. Aspirin also reduced the risk of dying from cancer by about half. These risk reductions remained after taking into account age and sex, the researchers said.

In a third study, Rothwell’s group looked at the effect of aspirin on metastases by analyzing observational studies rather than clinical trials. These studies revealed a 38 percent reduction in colon cancer, which matched well with the risk reduction seen in clinical trials, they said. There were similar findings for esophageal, gastric, biliary and breast cancer, they added.

While the study is attention-getting, not everyone agrees with the overall conclusions. Among them is Nancy R. Cook, an associate biostatistician at Brigham and Women’s Hospital and Harvard Medical School in Boston and co-author of an accompanying journal editorial. She pointed out that these studies only dealt with trials where aspirin was given daily, whereas two large trials in which aspirin was given every other day found no connection with cancer prevention.

“Aspirin seems to work for people who have had cardiovascular disease. Perhaps in the long-term it will turn out to be protective for cancer, but we need to verify that and get more information,” Cook said. And, aspirin is not benign, Cook said, pointing out risks for bleeding and other gastrointestinal problems.

People should not start taking aspirin hoping to preventing cancer, Cook said. “Most of the studies show that the effect doesn’t accrue until after 10 years,” she noted. Eric Jacobs, strategic director of pharmacoepidemiology for the American Cancer Society, said that “this study provides important new evidence that long-term daily aspirin, even at low doses, may lower risk of developing cancer.”

However, any decision about treatment should be made on an individual basis in consultation with a doctor, he said.
“Because these results are new,” Jacobs added, “it will take time for the broader scientific community to evaluate the data in the context of existing knowledge and to consider whether the clinical guidelines should be changed.”

Jun 28

How ADHD Stimulant Medications Work


By Laurie Dupar, PMHNP, RN, PCC, Certified ADHD Coach and Nurse Practitioner, Coaching for ADHD

ADHD is a medical condition where the brain is not producing enough of the neurotransmitter Dopamine. The brain is no different than other organs in our body, such as our heart, lungs, kidneys or pancreas. In fact a good analogy to help understand how ADHD medications work is similar to how insulin helps someone with diabetes. In diabetes, the pancreas does not produce enough insulin. Sometime this occurs in childhood…sometimes it happens with aging. Either way, management of diabetes includes learning about the condition of diabetes, making changes in lifestyle habits, such as eating certain foods, and increasing exercise. However, one of the most important ways to re-balance the body’s insulin is with a pill or an injection of insulin.

ADHD is similar. With ADHD, the brain is simply not producing or utilizing enough Dopamine. You see, most of the Dopamine in our brain is made in the middle part of the brain. Without a sufficient amount of Dopamine, there is not enough of it to get to the frontal lobe so it can do all those “executive functions” such as paying attention to things that are less interesting, or filtering out environmental stimuli or pausing to think before we act or say something.

So, when a person takes a stimulant medication such as Ritalin or Adderall, those medicines work directly on the brain to help those Dopamine neurotransmitters either produce more Dopamine or utilize it more effectively. What they are “stimulating” and only simulating is the Dopamine! Voilà! Stimulating the Dopamine receptors increases the Dopamine available in the brain. With an increased Dopamine level the brain is now better balanced and ready to complete the tasks of the day!

Laurie Dupar, Senior Certified ADHD Coach and trained Psychiatric Nurse Practitioner, specializes in working with clients who have been diagnosed with ADD/ADHD

Jun 28

Exercise Can Reduce Hot Flashes


By Rick Nauert PhD Senior News Editor Although it is not a panacea for everything that ails, exercise comes close, and new research suggests physical activity may reduce hot flashes in menopausal women.

Penn State researchers discovered exercise has the capacity to reduce hot flashes in the 24 hours following physical activity. Women who are relatively inactive, overweight or obese tend to have a risk of increased symptoms of perceived hot flashes, noted Steriani Elavsky, Ph.D., assistant professor of kinesiology at Penn State.

Experts say that perceived hot flashes do not always correspond to actual hot flashes. This factor has limited extrapolation of prior research findings as earlier studies typically analyzed only self-reported hot flashes. Researchers say the current study is the first to look at objective versus subjective hot flashes. Elavsky and colleagues studied 92 menopausal women for 15 days. Participants were recruited for a study of activity and consisted of women with mild to moderate symptoms.

This sample, while reflective of the real world, is in stark contrast to earlier menopausal studies that used women experiencing severe symptoms and seeking help. “Our sample included women with mild to moderate symptoms and they were recruited for a study of physical activity, not for a study of menopause,” said Elavsky. “We recruited women residing in the community. We used recruitment sources that included a variety of outlets in the community frequented by women, like libraries, fairs, gyms, advertisements in local newspapers, etc.”

Women ranged in age from 40 to 59 years old, had two children on average, and were not on hormone therapy. During analysis the researchers separated the women into normal weight and overweight/obese categories and higher fit and lower fit categories. These categories were not necessarily mutually exclusive.

The participants wore accelerometers to monitor their physical activity and also wore monitors that measured skin conductance, which varies with the moisture level of the skin. Each participant recorded the individual hot flashes she had throughout the 15-day period on a personal digital assistant. Using two methods of recording hot flashes allowed researchers to analyze the frequency of objective and subjective hot flashes. Objective hot flashes occurred when the monitor recorded them; subjective hot flashes occurred when the woman reported them.

When an objective and a subjective hot flash were recorded within five minutes of each other, it was considered a “true positive” hot flash. “Some physiological explanations would suggest that performing physical activity could increase hot flashes because it acutely increases body core temperature,” said Elavsky.

However, researcher discovered that on average, the women in the study experienced fewer hot flash symptoms after exercising. That said, women who were classified as overweight, having a lower level of fitness or those experiencing more frequent or more intense hot flashes, noticed the smallest reduction in symptoms.

Researchers say that they do not know if a diet and exercise regime could help a woman lose weight and become more fit and therefore experience fewer hot flashes, but it is a possibility worthy of future investigation. “For women with mild to moderate hot flashes, there is no reason to avoid physical activity for the fear of making symptoms worse,” said Elavsky.

“In fact, physical activity may be helpful, and is certainly the best way to maximize health as women age. Becoming and staying active on a regular basis as part of your lifestyle is the best way to ensure healthy aging and well-being, regardless of whether you experience hot flashes or not.”

The study is reported in the journal Menopause.

Jun 25

By Genevra Pittman New research from Iceland suggests kids who get early treatment for their attention-deficit/hyperactivity disorder don’t have as much trouble on national standardized tests as those who aren’t prescribed medication until age 11 or 12. Common medications used to treat ADHD include stimulants such as Vyvanse, Ritalin and Concerta.

“Their short-term efficacy in treating the core symptoms of ADHD — the symptoms of hyperactivity and attention and impulsivity — that has been established,” said Helga Zoega, the lead author on the new study from the Mount Sinai School of Medicine in New York. “With regard to more functional outcomes, for example academic performance or progress, there’s not as much evidence there as to whether these drugs really help the kids academically in the long term,” she told Reuters Health.

To try to answer that question, Zoega and colleagues from the United States and Iceland consulted prescription drug records and test scores from Icelandic elementary and middle school students between 2003 and 2008. Out of more than 13,000 kids registered in the national school system, just over 1,000 were treated with ADHD drugs at some point between fourth and seventh grade – 317 of whom began their treatment during that span.

Kids with no record of an ADHD diagnosis tended to score similarly on the standardized math and language arts tests given in fourth and seventh grade. Those who were medicated for the condition were more likely to have their scores decline over the years – especially when stimulants weren’t started until later on.

For math exams in particular, students who started on stimulants within one year of their fourth grade tests had an average score decline of less than one percent between that and their seventh-grade exam – compared to a more than nine percent drop for those who didn’t get treated until sixth or seventh grade. The difference was especially clear for girls, Zoega and her colleagues reported Monday in Pediatrics.

According to the Centers for Disease Control and Prevention, parent reports suggest close to one in 10 kids and teens in the U.S. have ever been diagnosed with ADHD, and two-thirds of those with a current diagnosis are treated with medication such as stimulants. J. Russell Ramsay, who studies ADHD at the University of Pennsylvania’s Perelman School of Medicine in Philadelphia, said kids’ trouble in school is usually one of the top reasons parents seek help for their ADHD.

When it comes to school performance, “There are obvious benefits of getting started sooner rather than later,” he told Reuters Health. “Especially if students are struggling later on, this study would suggest it may be at the very least useful to explore and consider certain treatment options.”

Families can see a mental health professional and discuss the pros and cons of medication and other treatments, he added. The researchers noted they didn’t have information on kids’ exact underlying ADHD diagnosis or its severity, and they also couldn’t tell whether youngsters were getting behavioral treatment or extra school help along with stimulants.

“Not all kids need medication,” Zoega said. “It’s important to think about whether alternative treatment options, whether earlier intervention with those could have a beneficial effect.” ADHD drugs can come with side effects, including appetite loss, sleep problems and stomach aches.

One of the other researchers on the study has received funding from pharmaceutical companies, including those that make stimulant drugs for ADHD. “Medications are probably still the reflex response, with a good evidence base,” said Ramsay, who wasn’t involved in the new research. “But there are other things that can be added in later or concurrently that can also provide support to the child, to the family and to the educators.”

Jun 24

Ways to Sharpen Your People Skills


By Chris IliadesMedically reviewed by Niya Jones, MD, MPH
Life would be great if everybody got along and agreed on everything. But that is not the world we live in. To get along in the real world you need people skills and more. Whether to maintain relationships at home or at work, you need to know how to listen, how to make your wishes known, and how to resolve differences without conflict.

There are several strategies you can practice to improve your people skills in dealing with different personalities and challenging situations … and boost your confidence level in the process.

1. Develop Your Emotional Intelligence

Emotional intelligence allows us to be aware of and in charge of our emotions. Sharpening your emotional intelligence can help you to keep your emotions balanced and boost your confidence.

These strategies will help you develop your emotional intelligence:

Learn to become more aware of your emotions and responses to certain situations. “Awareness is the foundational skill along the path to improved interpersonal skills,” explains Tres Roeder, founder and president of Roeder Consulting in Cleveland, Ohio. Keep your emotions in balance. “In order to be in rhythm with others, you have to be in rhythm with yourself,” notes Debbie Mandel, MA, stress-management specialist and author of Addicted to Stress. Recognize when you or others are stressed. When it comes to dealing with difficult situations, keep in mind that “proper timing can lead to a better outcome. If you or the other person is stressed, you will lose common ground,” advises Mandel. 2. Resolve Conflict in a Positive Way

Be it at work or at home, a certain amount of conflict is unavoidable in any relationship.

Try these three ways to improve your people skills and resolve conflict in a positive way:

Focus on the present. Holding onto old hurts or grudges makes it hard to move forward and build a better future. Think about respecting the other person, not controlling them. “The goal is to adapt to situations and people, not impose yourself on them. You can show respect for other people’s opinions without agreeing with them,” Mandel notes. Focus on compromise rather than on winning or losing. “In a constructive conflict the goal is to aim for an equitable compromise. There are no winners or losers,” says Mandel. 3. Learn to Listen to Others

Talking is simple; real communication requires good listening skills.
Practice these tips to become a better listener:

Pay attention to inflection. “Research shows the vast majority of communication occurs at the non-verbal level,” advises Roeder. “Pay attention to not only what people are saying, but also how they are saying it.” Take time to really listen before you respond. When others are speaking, instead of actually listening to them, many people are concentrating on what they plan to say next. Doing this can cause you to miss key elements of the other person’s point and results in a lack of true communication. Take the time to be patient and simply listen before launching into your own point of view. Don’t interrupt. “Let the other person speak without interrupting. Focusing on what another person is saying and making eye contact helps us truly understand what is meaningful,” notes Mandel.
Here are more ways to improve your interpersonal skills.

4. Ask for Feedback

When you take a moment to ask for feedback, you communicate better and you are more likely to hear and share ideas.

Understand why feedback is important:

No one likes to be preached to. People don’t want to feel like they are hearing a lecture. By asking for feedback and other people’s opinions on a matter, you show that you are willing to hear and explore other points of view. Interpretation counts. What one person says and what another person hears are often two strikingly different things. Taking time to ask for feedback such as “Do you understand what I mean?” or “How would you have handled that situation?” is a good way to see if you are communicating effectively. Maintaining a positive attitude makes understanding easier. Asking for feedback shows that you have a confident and positive attitude. “People gravitate to positive people because good moods are contagious,” says Mandel.

5. Respect and Be Aware of Cultural Differences

We learn most of our people skills from our parents and others in our community. When communicating with someone from a different culture, however, it is important to acknowledge cultural differences.

Try these approaches to ease communication:

Understand eye contact. In our culture, direct eye contact often indicates sincerity while in another culture it could be considered rude. Expect some misunderstanding. In cross-cultural communication, it is best to go slowly and step back instead of getting frustrated. In our culture we like to get to the point. In other cultures it may be important to establish rapport before discussing potentially controversial issues. Keeping these differences in mind can minimize your frustration if and when you encounter any snags in communication. Get some help. To foster improved communication, it can be helpful to rely on an intermediary who understands both cultures. 6. Seek out New People

Meeting new people can enhance your creativity, help broaden your perspective on life, and improve your emotional intelligence. Remember these people skills when meeting someone new:

Use body language. Pay attention to non-verbal communication cues such as good posture, appropriate eye contact, and friendly gestures. Listen up. Rely on good communication and listening skills. Truly get to know people by allowing them to express themselves without immediately interrupting with your own ideas. Be aware of the situation around you. “That includes awareness of yourself, awareness of others, and awareness of the situational context within which the relationship is occurring,” says Roeder. Keeping external factors in mind, such as potential stressors and distractions, can make it easier to help navigate new situations with people you don’t know very well.

7. Maintain Relationships

Healthy relationships boost your confidence and make your life more rewarding. Here are some final thoughts on people skills that promote good relationships:

Take the time to be aware of the important people and relationships in your life. “People are more intuitive when they have the time to be intuitive,” notes Roeder. “In other words, if you are constantly running from one meeting to the next you may be missing important clues in how to get along with others.” In order to respect others you must respect yourself. “Self-respect means knowing what you uniquely bring to the table. When you feel good about yourself, you will be positive and affirming to others,” says Mandel. Have the right attitude. The emotional intelligence needed to maintain relationships is more than just people skills. It also involves having the right attitude. This includes expecting challenges along the way, keeping things in perspective, having a sense of humor, and not taking yourself too seriously. Practice even some of these skills and you may be surprised by the results.

Jun 24

By Lisa Esposito, HealthDay News WEDNESDAY, Nov. 2, 2011 (HealthDay News) — Some Boston parents might be in for a rude awakening: 13 percent of area high school students say they’ve received “sext” messages and one in 10 has either forwarded, sent or posted sexually suggestive, explicit or nude photos or videos of people they know by cellphone or online.

So found a study of more than 23,000 students, with the results scheduled to be presented Wednesday at the American Public Health Association’s annual meeting in Washington, D.C. Sexting can include overtones of bullying and coercion, and teens who are involved were more likely to report being psychologically distressed, depressed or even suicidal, according to the 2010 survey of 24 (of 26) high schools in Boston’s metro-west region.

Twice as many respondents who said they had sexted in the past year reported depressive symptoms, compared to teens who did not. Moreover, 13 percent of teen involved in sexting reported a suicide attempt during that period compared with 3 percent of non-sexting teens, according to the researchers at the Education Development Center in Newton, Mass.

That doesn’t mean that sexting leads to depression or increases suicide risk. “It’s a cross-sectional study — it shows an association but not a causal relationship,” explained lead researcher Shari Kessel Schneider. However, she added, “It’s important to know there’s a link between sexting and psychological distress. It’s something to be considered if you know of a youth who is involved in sexting.”

Of the high-school students, 10 percent of boys and 11 percent of girls said they had sent one of these images in the past year, while 6 percent of males and 4 percent of females had had such an image sent of themselves. The researchers also found that youths who did not self-identify as heterosexual — that is, they described themselves as gay, lesbian, bisexual other or not sure — were more likely to be involved in sexting.

Other studies have examined sexting on a national basis, prompting parents to question how they can prevent their own children from posting — or posing for — these images. “I encourage parents to treat a kid’s cellphone as a computer: thinking of securing, protecting and limiting it,” said Marian Merritt, Internet safety advocate for Norton, part of Symantec Inc. As soon a child receives his or her first cell phone, “Set family rules. Age 12 is standard.”

“If that phone is a smartphone, password protect it,” she said. “It could prevent your child getting victimized” by someone else who picks it up and uses it. And to monitor your son’s or daughter’s use: “Check your online statement, to see if your child is sending a lot of photo messages.”

Parents need to take back control of the technology, she said, whether it’s by setting online time limits on the home wireless router or limiting access and privacy: “Charge the phone in the kitchen, some central location, so it’s not on their pillow, buzzing late at night with text messages.” Talk to your children, she said. “Don’t wait until they’re 16, that’s exactly the wrong way to do stuff. Start much earlier. Especially with boys, know how incredibly common it will be for them to receive a [sext] message. Ask them, ‘What would you do?’ What’s the right thing to do to protect the girl? Delete it?’ Try to make sure he shows empathy for the girl.”

Some adolescents will be more affected than others, Merritt said. “In general, with all the things on the Internet, it’s very hard to predict who will be impacted. Some kids are able to roll with it and there are others who can’t.” Justin Patchin, co-director of the Cyberbullying Research Center, said his first advice to teens who receive a sext message is this: “You should delete it and not tell anybody. If it’s doesn’t get disseminated and distributed, it’s ended.”

He said he’s received flak for suggesting on the center’s website that kids don’t always need to go to adults when sexting involves a friend (or girlfriend or boyfriend), but he still believes, “If you tell adults, you’re throwing that person under a bus.” Once people in authority, such as teachers and principals, are made aware of sexting, legal reporting requirements come into play.

“Adults, it seems, are forced to respond to sexting in extreme ways — ways that have long-term, irreversible consequences,” he posted in February. “Until we can develop reasonable responses that do not potentially foreclose on the futures of all involved, we are wise to advise that students do not contact adults, unless the situation is appearing to get out of control. And I think teens know when it is out of control.” Patchin doesn’t discount that sexting can have serious ramifications. “You can look at high-profile examples, of people with severe psychological problems,” he said, referring to two publicized cases of young girls committing suicide where sexting was a factor.

In his center’s dealings with sexting, he said, “We’ve talked with frustrated, embarrassed, upset kids.”

Merritt cautioned against overreacting about the findings and said she would like to see more data, for instance, on how sexting relates to teens’ gender orientation. Kessler Schneider’s group does intend to do more studies in that area. For now, she said, the Boston findings should “draw attention to the link between sexting and mental health, which should be addressed by anti-bullying and health-promotion initiatives.”

Because the new study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Jun 21

Life Style causes of Dementia


written by Kyle. J. Norton
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. American typical diet contains high amount of saturated and trans fat, artificial ingredients with less fruits and vegetable which can lead to dementia and other kind of diseases

I. Causes of Dementia
H. Life Style causes of Dementia
1. Unhealthy diet
Unhealthy lifestyle choices lead to an increasing incidence of obesity, dyslipidemia and hypertension–components of the metabolic syndrome. These disorders can also be linked to AD. Recent research supports the hypothesis that calorie intake, among other non-genetic factors, can influence the risk of clinical dementia.(1)

2. Psychological and Neurological effects
Researchers at the G.J. Patel Ayurved College, showed that Mind and body are inseparable entities and influences each other until death. Many factors such as stress, anxiety, depression, negative thoughts, unhealthy life style, unwholesome diet etc., disturb mental and physical wellbeing. Senile dementia is the mental deterioration, i.e, loss of intellectual ability associated with old age. It causes progressive deterioration of mental faculties, e.g., memory, intellect, attention, thinking, comprehension and personality, with preservation of normal level of consciousness.(2)

3. Excessive alcohol drinking
Moderate alcohol drinking of less than 2 cups for men and 1 cups for women are said to offers possible health benefits(3), but Binge drinking in midlife is associated with an increased risk of dementia, according to the follow-up, 103 participants had developed dementia. Binge drinking (ie, alcohol exceeding the amount of 5 bottles of beer or a bottle of wine on 1 occasion at least monthly), as reported in 1975, was associated with a relative risk of 3.2 (95% confidence interval=1.2-8.6) for dementia. Passing out at least twice as a result of excessive alcohol use during the previous year, as reported in 1981, was associated with a relative risk of 10.5 (2.4-46) for dementia in drinkers.(4)

4. Smoking
Smoking is a risk factor for several life-threatening diseases, but its long-term association with dementia is controversial and somewhat understudied.In a studyof a total of 5367 people (25.4%) were diagnosed as having dementia (including 1136 cases of AD and 416 cases of VaD) during a mean follow-up period of 23 years. Results were adjusted for age, sex, education, race, marital status, hypertension, hyperlipidemia, body mass index, diabetes, heart disease, stroke, and alcohol use, Dr. Rusanen M, and the team at the University of Eastern Finland, said ” heavy smoking in midlife was associated with a greater than 100% increase in risk of dementia, AD, and VaD more than 2 decades later. These results suggest that the brain is not immune to long-term consequences of heavy smoking”(5).

Jun 21

Bipolar Disorder and Anosognosia


One of the biggest problems in the treatment of bipolar disorder is that many people aren’t aware they are ill. This lack of awareness, termed anosognosia, can be a major barrier that keeps some people with bipolar disorder from getting the treatment they need. In their minds, they’re not sick, so why take medication?

Anosognosia in Bipolar Disorder

It is estimated that around 40 percent of people who have bipolar disorder also have anosognosia. In fact, anosognosia is the primary reason why those with this disease do not take their bipolar medications. Anosognosia is even more common in people who have delusions or hallucinations associated with their bipolar disorder. When people with anosognosia have a hallucination or delusion, they believe that what they are seeing or thinking is real, and are not convinced that an illness is causing these symptoms.

Many people with bipolar disorder have anosognosia that comes and goes, and anosognosia is often not a problem during periods of bipolar remission. But when a bipolar episode hits, they cannot grasp that they have an illness.

Anosognosia is different from denial, which is a common psychological tool people use to suppress the painful emotions associated with an illness or another stressful event. Instead, anosognosia is thought to be caused by damage to the brain, particularly the frontal and parietal lobes of the brain’s right hemisphere. The right hemisphere of the brain controls thinking skills, and damage can result in a number of problems, including difficulty with reasoning and problem solving.

Anosognosia is not unique to bipolar disorder. It is also seen in schizophrenia, stroke, brain tumor, Alzheimer’s disease, and Huntington’s disease.

Bipolar Disorder and Anosognosia: Coping Tips for Caregivers

As the caregiver for someone with bipolar disorder, you play a major role in your loved one’s life.

The patient “really need[s] to have a reliable care partner,” says Gary Sachs, MD, founder and director of the Bipolar Clinic and Research Program at Massachusetts General Hospital, and associate professor of psychiatry at Harvard Medical School in Boston.

Dr. Sachs says it is critical for someone with bipolar disorder to have somebody who can help the patient follow the treatment plan, especially when he is ill and cannot do it on his own.

Here are some ways to encourage your loved one to stick with prescribed bipolar treatment:

By Krisha McCoy When his mood is stable, tell him that studies show that people with bipolar disorder can improve with medication. Without medication, the odds of him getting sicker increase, which in turn increases the risk of hospitalization, incarceration, suicide, violent behavior, and becoming a victim of violence.
Developing a partnership with the patient is vital. And that means listening to your loved one’s fears, whether those fears revolve around the diagnosis or being hospitalized against his will.
Empathize; don’t dismiss his opinions or emotions. Get the patient to talk about what is going on, person to person.
Pay more attention to what she thinks is important, not what you think. As the caregiver, you might think that the hallucinations are a huge deal, but your loved one might think lack of sleep is the biggest problem. Discuss her problem; it will help develop trust.
Together, plan how to deal with an acute bipolar episode, especially when anosognosia is an issue.
Don’t get discouraged if you cannot convince her that she has an illness. Focus on helping her stick to her prescribed treatment. The patient might take the medications if you help her remember some of the negative experiences that occurred when she skipped medications before.

Jun 21

By Amanda MacMillan | | When people think of post-traumatic stress disorder (PTSD), they’re apt to picture combat veterans or the victims of violence and sexual assault. But new research suggests post-traumatic stress is also common following another kind of harrowing experience: heart attacks.

As many as 1 in 8 people who survive a heart attack will go on to develop symptoms of PTSD, a new analysis has found. And to make matters worse, PTSD symptoms appear to increase the risk of having a second heart attack or dying prematurely.

A heart attack, in which blood flow to the heart is suddenly interrupted, is a common — and sometimes terrifying — experience, says Donald Edmondson, the lead author of the analysis and an assistant professor of behavioral medicine at Columbia University Medical Center, in New York City.

“About 1.4 million people [in the United States] have heart attacks every year; that’s as many people as are in our entire active military,” Edmondson says. “That feeling that your life is in danger — the loss of control when your body turns on you — is something that these people have a hard time forgetting.”

( Can Ecstasy Help Ease Post-Traumatic Stress?)

Previous research has found that heart attacks can contribute to depression, and a number of small studies have suggested a similar link to PTSD, a type of anxiety disorder. To assess just how common the disorder is in this population, Edmonson and his colleagues pooled and re-analyzed the results of 24 studies comprising 2,384 heart attack survivors from around the world.

Overall, 12% of study participants developed significant PTSD symptoms after having a heart attack, and 4% met the official criteria for a PTSD diagnosis. Although the methods varied from study to study, researchers generally focused on classic symptoms of the disorder, including frequent nightmares or flashbacks, intrusive thoughts, and elevated blood pressure or heart rate.

The findings, which appear this week in the journal PLoS ONE, are important for doctors and especially cardiologists, most of whom aren’t trained to look for signs of anxiety in heart patients, says Dr. Ramin Ebrahimi, an interventional cardiologist and clinical professor of medicine at the University of California, Los Angeles.

“It has become hard for physicians to have a holistic approach and to consider the whole picture,” says Ebrahimi, who was not involved in the new analysis. “As a cardiologist, my main focus is opening the artery and making sure the medication is appropriate. Most doctors aren’t thinking about whether the person is scared or traumatized at that point.”

( Surprising Heart Attack Risks)

Traumatization may influence a patient’s prognosis, however. Three of the studies included in the analysis looked at the relationship between post-traumatic stress and subsequent hospitalizations in the years following a heart attack. Taken together, the studies suggest that heart attack survivors with PTSD symptoms are twice as likely as those without them to die or experience another heart attack or heart-related complication within three years.

The physiological changes associated with PTSD symptoms, such as elevated blood pressure, likely play a role in these patients’ increased risk of heart attack, Edmonson says. And, as with depression, the disorder may cause patients to neglect their own care.

A study that follows a large group of heart attack survivors over time will be needed to confirm these theories. In the meantime, Edmonson says, the new findings should encourage doctors and heart patients to be aware of PTSD symptoms and seek out talk therapy or medication if needed.

“Unless you know that PTSD is a possibility, it’s hard to say to your doctor, ‘I’m thinking about my heart attack a lot more than I maybe should be, and it’s making me anxious,’” he says. “Patients should know that 1 in 8 people are going to develop symptoms like these, and that there are good treatments out there for them.”

PTSD is not “a disorder of veterans,” Ebrahimi says. “It is a disorder that anybody can get after being exposed to a traumatic situation. Even if it’s something that might not seem traumatic to you or me — having a gun pointed at you, almost being in an accident, surviving a heart attack — to that person, it can cause lasting symptoms.”

Jun 21

Do Bossy Moms Mean Heavy Kids?


By Annie Hauser, Senior Editor THURSDAY, Feb. 2, 2012 — “You’ll like it. Just try it. Eat!” These phrases probably sound familiar to any parent who’s tried to cajole their kids into taking a few extra bites of food. And though they’re uttered with the best of intentions, this kind of mealtime pushiness can result in real weight gain, a new study published in the American Journal of Clinical Nutrition reports.

In the study, researchers at the University of Michigan brought 1,218 moms and their kids to a university lab for snack-time observation when the child was 15 months, 2 years, and 3 years old. Researchers found that when parents were overly intrusive during snack time, the kids were heavier — though not significantly so — by age 3. For example, the study found that a child with a pushy parent might move from the 50th percentile on the body mass index scale to the 57th — noticeable, but not an unhealthy weight gain.

Although it’s not necessarily certain that the pushiness of the parents alone led to the excess weight, experts suggest that the findings mean parents should take a relaxed approach to their child’s eating. The best course of action is to present the child with healthy options, and then back off when it comes to how much the child eats, they say. The thought is that overly encouraging parents can actually override the kid’s satiety signals — limiting the child’s brain’s ability to tell when they feel full.

Lower-income and minority children have a greater risk of obesity than white, affluent children, the study authors note, and these parents have been shown to be more likely to push toddlers to eat at meal times. Still, more research needs to be done to ascertain the link between parental behavior and childhood obesity. The same team of researchers is now starting a study where they will have participants videotape typical meals at home to see whether parent-child interactions in the home are related to weight.

For more fitness, diet, and weight loss news, follow @weightloss on Twitter from the editors of @EverydayHealth.

Jun 20

Myths About Living Single


By Katie Kerns
Google “health benefits of marriage,” and you’ll find that scientists have put a lot of time and effort into studying why getting hitched is good for you. “Marriage Is Good for Your Health,” “Marriage, the Key to a Better Life,” and “Single People May Die Younger” are just a few of the spouse-exalting headlines that pop up.

But in honor of National Singles Week — and for all of those happy, healthy uncommitted folks out there — we’ve combed the latest studies and surveys to debunk a few of the negative myths about singlehood. We’re not knocking marriage — we just think it’s time to recognize that there are plenty of benefits to living the single life too.

Myth: Married people are happier and healthier than unmarried people. Hollywood does a great job of painting singlehood as lonely, unstable, and downright dismal (think Bridget Jones crying into her ice cream, alone on New Year’s Eve). But one recent study published in the Journal of Social and Personal Relationships found that people over 40 who never settle down are just as emotionally healthy as their wedded peers. When researchers compared more than 1,500 40- to 74-year-olds — both married and never married — they found that the latter group’s “psychological resources” (factors that promote well-being and prevent depression, such as self-sufficiency and optimism) were just as strong.

And while marriage has been shown to have a protective effect against depression, heart conditions, and other health problems, other findings prove that not all marriages are good for you. One study published in the Archives of General Psychiatry found that unhappy matrimonies can be extremely harmful to both emotional and physical health (while those content, never-been-married folks are doing just fine).
Myth: All single guys are commitment-phobes. Think all of those George Clooney-esque bachelors out there will never settle down? That may be true for some, but it turns out that most unmarried men aren’t terrified of commitment. A recent study funded by (conducted by researchers at Rutgers University and Binghamton University) found that single men have just as high hopes for getting married one day as women do. Although age did play a factor — men aged 21 to 24 and those older than 50 were actually more inclined toward marriage than women of the same age, while guys in between these years were a little less commitment-friendly — this study may help refute the eternal-bachelor stereotype once and for all.

According to the study’s lead researcher, Helen Fisher, PhD, the notion that men aren’t the marrying kind has been wrong all along. “The study supports what I have long suspected: That men are just as eager to find a partner, fall in love, commit long term, and raise a family,” she wrote on’s blog. “It’s an illuminating, indeed myth-shattering, new set of scientific data.” However, Mark Regnerus, a sociologist at the University of Texas at Austin, recently told Time that he believes what’s shifting is women’s attitudes toward marriage — females are becoming more independent and less worried about securing a ring, which has evened out the playing fields.
Myth: All unmarried people are married to their jobs. There’s a misconception in the dating world that if you’re a hard worker, you have no interest or time for love. But in a recent survey of more than 4,500 single people from the dating site Zoosk, 64 percent of single guys reported that they’re actually more productive in the office when dating someone (about half of women said the same thing). That means these people are harmoniously dating and working — without wrecking the relationship or the career.

Keep in mind, however, that there’s a fine line between being a hard worker and being an obsessed, always-on-the-clock employee. According to Workaholics Anonymous, one of the tell-tale signs of workaholism is that those long hours at the office start having a negative effect on relationships. So if that new guy you’ve been dating keeps canceling plans with you for his job, perhaps it’s time to terminate the relationship.

Myth: All singletons are cynical about love. “Love stinks (yeah, yeah).” These romance-bashing lyrics by the J. Geils Band may sound like an anthem for single people everywhere, but research shows many people flying solo are just as sappy when it comes to love as committed ones. In the same study, 41 percent of singles said they believed in love at first sight — and 76 percent said they thought if they ever married, they would stay married forever.
Myth: Young bachelors and bachelorettes are promiscuous. Kids these days! Turns out, they’re waiting longer to have sex. A 2011 governmental study from the U.S. Centers for Disease Control (CDC) found that 29 percent of 15- to 24-year-olds are virgins — up from 22 percent in 2002. In addition, a recent National Campaign to Prevent Teen and Unplanned Pregnancy survey of more than 5,000 people between the ages of 15 and 24 found that there has been a decline in sexual activity in this age group over the past 10 years.

Why are young people waiting before they hop in the sack? Researchers aren’t exactly sure, but believe it could have to do with greater awareness of sexually transmitted diseases and sexual health.
Myth: Unmarried couples who cohabitate are ruining their chances of a happy marriage. Good news for the two-thirds of couples who choose to move in together before saying “I do”: Your pre-marital shack-up isn’t doomed. Research on 13,000 people from the National Center of Health Statistics found that cohabitating couples who get married later are just as likely to live happily ever after as those twosomes who wait until they’re married before living together.

So what’s with all the finger-wagging? The study’s researchers explained that the previous studies that found that cohabitating couples have higher divorce rates are decades old — and their findings may be outdated.

By Madeline Vann, MPH Just like adults, many kids — infants and toddlers included — are plagued with mental health problems. In fact, nearly one in five children has a mental illness, and for some of these youths, the disease interferes significantly with their daily lives.

But according to recent research from the American Psychological Association, young children are less likely to get mental health treatment than their grownup counterparts. Why? Too often, kids are expected to “grow out” of their emotional problems.

That means it’s up to the parents not to ignore any instinctive sense that their child’s emotional health is at risk. If you suspect any signs of mental illness such as ADHD or depression in children, it’s important to seek help from an expert in kids’ psychology.

What to Do When Something’s ‘Off’

“Most parents want to believe that their kids are doing okay,” says psychiatrist William M. Klykylo, MD, professor and director of the division of child and adolescent psychiatry at the Wright State University School of Medicine in Dayton, Ohio. “But if you feel that something is going on or if someone you trust — a teacher or counselor, a minister or other clergy person, or a coach — says ‘I’ve got a feeling about your child,’ pay attention.”

The signs of mental illness in children vary by age and type of illness, with some psychiatric disorders appearing even in preschool years. However, two warning signs tend to cross over into all categories and signal that you should consult with an emotional health professional experienced in kids’ psychology:
Extremes or peculiarity of behavior for the age and gender of the child, such as being significantly more hyper, aggressive, or withdrawn
Sudden, hard-to-explain negative changes in behavior, such as a steep drop in grades
But many children have more than one mental illness — which makes getting a diagnosis even more challenging.
Know These Signs of Kids’ Mental Illness

Here are some of the signs of mental illness during different age ranges.

Preschool/early elementary school years:
Behavior problems in preschool or daycare
Hyperactivity way beyond what the other kids are doing
Trouble sleeping
Persistent nightmares
Excessive fear, worrying, or crying
Extreme disobedience or aggression. Because it’s often within a child’s nature to disobey or intrude on a playmate’s space, an excessive degree of this behavior is what should concern you, says Dr. Klykylo, such as deliberate destructiveness or hurting peers or animals.
Lots of temper tantrums all the time
Persistent difficulty separating from a parent. Klykylo acknowledges that many children experience separation anxiety at first; there could be a problem if this goes on for months.

Klykylo adds that what you might think are signs of mental illness may in fact be symptoms of another condition entirely, such as a sleep disorder, but that you should still seek medical help.

Grade school years:

At this stage, Klykylo suggests looking at your child’s relationships as a good external barometer of well-being. A child might only have one or two friends, but it’s not the number of friends that you want to watch — it’s the type of friends and how well your child maintains those friendships. If one drops off, that’s an issue, says Klykylo.

Other possible signs of mental illness include:
Excessive fears and worries
Extreme hyperactivity
Sudden decrease in school performance
Loss of interest in friends or favorite activities
Loss of appetite
Sudden changes in weight
Excessive worry about weight gain
Sudden changes in sleep habits
Visible prolonged sadness
Substance use or abuse
Seeing or hearing things that are not there

Klykylo notes that from a parent’s perspective, it can be hard to figure out what type of mental illness could be threatening your child. For example, he says, “Depression in children does exist, but it is often accompanied by hyperactivity.” While depression can cause a loss of appetite, if your child is refusing to eat or only eats very limited selections, you might also be seeing the early signs of an eating disorder.

Tween and teen years:

The preceding signs of mental illness are still a concern, but the behaviors may be more pronounced as children get older. Look for:
Destructive behavior, such as damaging property or setting fires
Constantly threatening to run away or running away, which can be a precursor to self- harm, says Klykylo
Withdrawal from family and friends
Comments or writings that suggest a desire to harm himself or others

Once you seek help, your child will be evaluated. The Child Behavior Checklist, which contains more than 100 questions related to child behavior, may be used — or the kids’ psychology expert you choose may refer to the DSM-IV with strict medical guidelines for diagnosing mental illnesses.

Your participation in both the evaluation and the treatment of your child could be essential, says Klykylo. Younger children are often treated with the involvement of their caregivers and family, he says. Medication, therapy, behavior change, modifications in the school setting, and other tools may be needed to help you and your child, depending on the diagnosis.

Jun 17

Top ten myths about introverts


Top ten myths about introverts by Jerry Brito

Myth #1 – Introverts don’t like to talk.
This is not true. Introverts just don’t talk unless they have something to say. They hate small talk. Get an introvert talking about something they are interested in, and they won’t shut up for days.

Myth #2 – Introverts are shy.
Shyness has nothing to do with being an Introvert. Introverts are not necessarily afraid of people. What they need is a reason to interact. They don’t interact for the sake of interacting. If you want to talk to an Introvert, just start talking. Don’t worry about being polite.

Myth #3 – Introverts are rude.
Introverts often don’t see a reason for beating around the bush with social pleasantries. They want everyone to just be real and honest. Unfortunately, this is not acceptable in most settings, so Introverts can feel a lot of pressure to fit in, which they find exhausting.

Myth #4 – Introverts don’t like people.
On the contrary, Introverts intensely value the few friends they have. They can count their close friends on one hand. If you are lucky enough for an introvert to consider you a friend, you probably have a loyal ally for life. Once you have earned their respect as being a person of substance, you’re in.

Myth #5 – Introverts don’t like to go out in public.
Nonsense. Introverts just don’t like to go out in public FOR AS LONG. They also like to avoid the complications that are involved in public activities. They take in data and experiences very quickly, and as a result, don’t need to be there for long to “get it.” They’re ready to go home, recharge, and process it all. In fact, recharging is absolutely crucial for Introverts.

Myth #6 – Introverts always want to be alone.
Introverts are perfectly comfortable with their own thoughts. They think a lot. They daydream. They like to have problems to work on, puzzles to solve. But they can also get incredibly lonely if they don’t have anyone to share their discoveries with. They crave an authentic and sincere connection with ONE PERSON at a time.

Myth #7 – Introverts are weird.
Introverts are often individualists. They don’t follow the crowd. They’d prefer to be valued for their novel ways of living. They think for themselves and because of that, they often challenge the norm. They don’t make most decisions based on what is popular or trendy.

Myth #8 – Introverts are aloof nerds.
Introverts are people who primarily look inward, paying close attention to their thoughts and emotions. It’s not that they are incapable of paying attention to what is going on around them, it’s just that their inner world is much more stimulating and rewarding to them.

Myth #9 – Introverts don’t know how to relax and have fun.
Introverts typically relax at home or in nature, not in busy public places. Introverts are not thrill seekers and adrenaline junkies. If there is too much talking and noise going on, they shut down. Their brains are too sensitive to the neurotransmitter called Dopamine. Introverts and Extroverts have different dominant neuro-pathways. Just look it up.

Myth #10 – Introverts can fix themselves and become Extroverts.
Introverts cannot “fix themselves” and deserve respect for their natural temperament and contributions to the human race. In fact, one study (Silverman, 1986) showed that the percentage of Introverts increases with IQ.

Jun 14

What Is Neuroticism? What Causes Neurosis?


Neuroticism is a long-term tendency to be in a negative emotional state. People with neuroticism tend to have more depressed moods – they suffer from feelings of guilt, envy, anger and anxiety, more frequently and more severely than other individuals. Neuroticism is the state of being neurotic.

Those who score highly on neuroticism tend to be particularly sensitive to environmental stress and respond poorly to it. They may perceive every day, run-of-the-mill situations as menacing and major; trivial frustrations are problematic and may lead to despair.

An individual with neuroticism is typically self-conscious and shy. There is a tendency to internalize phobias and other neuroses, such as panic disorders, aggression, negativity, and depression. Neuroses (singular: neurosis) refers to a mental disorder involving distress, but not hallucinations nor delusions – they are not outside socially acceptable norms. The individual is still in touch with reality.

When talking about neuroticism, it is common to read about high, medium or low scores. People with low scores are more emotionally stable and manage to deal with stress more successfully than those with high scores. Individuals with low scores are usually even-tempered, calm, and less likely to become upset and tense, compared to people with high scores.
What is the difference between neurosis and neuroticism
Basically, neurosis is an actual disorder, such as obsessive thoughts or anxiety, while neuroticism is the state of having the disorder. In modern non-medical texts the two are often used with the same meaning. For psychologists and psychiatrists today, these terms are rarely used (outdated terms).
How did famous figures define neurosis?
Emotional instability – according to Hans Jürgen Eysenck (1916 – 1997), a German-British psychologist, neurosis is a term for emotional instability.

A general affection of the nervous system – neurosis was first used by Dr. William Kullen, from Scotland, in 1769 – he said the term referred to “disorders of sense and motion” caused by “a general affection of the nervous system”.

Does not interfere with rational thought or ability to function – more recently, neurosis, as well as neurotic disorder or psychoneurosis refer to mental disorders which do not interfere with rational thought or the individual’s ability to function, even though they do cause distress. Psychosis, on the other hand, does interfere with a person’s ability to function.

Caused by an unpleasant past experience – according to Sigmund Freud (1956-1939), a famous Austrian neurologist who founded the discipline of psychoanalysis, neurosis as an ineffectual coping strategy caused by emotions from past experience which overwhelm or interfere with current experience. He once gave, as an example, an overwhelming fear of dogs, which may have resulted from a dog-attack earlier in life.

Conflict between two psychic events – Carl Gustav Jung 1875 – 1961) a Swiss psychiatrist, the founder of analytical psychology, believed that neurosis is the result of a conflict between two psychic contents; a conscious and unconscious content.
Health Professionals No Longer Use The Terms Neurosis or Neuroticism
As mentioned earlier, “neurosis” is no longer a currently-used term among health care professionals. These days, neuroses type references are described under the areas of depressive disorders or anxiety.

According to Medilexicon’s medical dictionary, Neurosis is:

“1. A psychological or behavioral disorder in which anxiety is the primary characteristic; defense mechanisms or any phobias are the adjustive techniques that a person learns to cope with this underlying anxiety. In contrast to the psychoses, people with a neurosis do not exhibit gross distortion of reality or gross disorganization of personality but in severe cases, those affected may be as disabled as those with a psychosis.
2. A functional nervous disease, or one in which there is no evident lesion.

3. A peculiar state of tension or irritability of the nervous system; any form of nervousness.”

And Neuroticism is:

“The condition or psychological trait of being neurotic.”

In 1980, the American Psychiatric Association’s Diagnostic and Statitstical Manual of Mental Disorders (third publication) removed the term neurosis.
Neurosis and personality disorder are very different
A person who is neurotic is different from one with a personality disorder.

A personality disorder refers to a more severe personality pathology. A person with neurosis is still relatively well in touch with reality, has a consolidated identity, and still uses defense mechanisms like other “mentally healthy” people do.

Neurotics (people with neurosis) are believed to benefit from psychoanalysis.

Those with personality disorders require more ego-supportive techniques.

Written by Christian Nordqvist

Jun 14

ADHD Strategies • June 2, 2012
Recently, I’ve noticed a pattern in my clients that I call the “tipping point”. The “tipping point” is basically a time in people’s lives when, for various reasons, the strategies they have been using to compensate for their ADHD challenges no longer seem to be working. This “tipping point” is often experienced along with feelings of overwhelm and chaos. Up until a “tipping point,” people have been able to balance known or unknown challenges with ADHD with strategies they may not have even realized they were using. Up until the “tipping point”, they had been able to adapt and cope well with their symptoms, even going as far as being under the radar for an official diagnosis of ADHD (in other words their symptoms were not interfering with their functioning). But for some reason a life change – it could be a job promotion, relationship change, a school change, or any myriad of different things – renders the current strategies ineffective and over time there is a sense that things are no longer “going well” and in fact, life seems to be falling apart in a big way.

Here are some life situations that could be possible “tipping points”:

Warning Sign #1: New Problems at School. Often, when higher elementary or middle school hits, students begin unraveling as they experience more responsibility in juggling multiple classrooms, more homework and larger classrooms. Suddenly it seems like nothing is working anymore. They can’t get things done that they want to get done, everything sort of goes into chaos, things start to come undone. Their schoolwork starts to suffer; they may have trouble concentrating in class, forget to hand in homework or start to experience difficulties with old friendships. Often, no one recognizes these warning signs as being ADHD-related because the students previously had managed or were able to compensate for their challenges. Parents and educators start to feel helpless when a previously successful student seems to become unmotivated. Students are told they just need to try harder. Everyone is unsure how to get the child back on track and the students begin to feel stupid, lazy and incapable.

Warning Sign #2: Inability to Cope After Significant Life Changes. Some people with ADHD experience their first “tipping point” after a significant life change…even a positive life change such as getting married or moving into a new home. These major life celebrations are anticipated with great joy, but may often be a change that “tips” the balance. Perhaps you’ve been able to balance your own life and your own schedule and where you put things up until now, but then you get married and now your spouse has a different way of doing things or expectations of the way things should be organized that differ from your views, not to mention having to deal with the extra stuff in your space. Slowly you notice that things are not working as well as they had before, and because this is supposed to be the happiest time of your life, you think there must be something wrong with you…right? Wrong! Significant life changes such as getting married, having another child or moving homes can often upset an unknown balance.

Warning Sign #3: Unable to Transition Successfully Into A New Role at Work. Up until your “tipping point” you have been performing really well in your job. So well, in fact, that you are promoted. Slowly you may start to notice that you are not doing this new job as well as everyone expected, and you begin to isolate yourself, dread going to work and may eventually get fired. What happened? You reached your “tipping point”. Not because you didn’t deserve the job, but because changes in work often come with changes of staff, support, work space, etc. that throw you off.

Warning Sign #4: Change in Family Dynamics. If you find yourself with new responsibilities and changes in your family, such as taking in an elderly parent, adding members to your family, or getting a new roommate, the additional responsibilities, change in routine and stress can gradually sink in and leave you overwhelmed and unable to cope as you have previously. It is so easy to begin to think you are a terrible mom, unfit for the responsibilities of a family or may be destined to living alone. It’s not YOU, you were thrown off-balance, and your ability to compensate for your ADHD with your old routine, structures or systems is no longer working. But instead of seeing the truth, that it isn’t anything you’ve done wrong, or know that you can fix this, you’re filled with undeserved guilt and shame.

Warning Sign #5: Physical Injury. People often experience their “tipping point” when an ADHD-management strategy such as exercise decreases or activity level changes. Unbeknownst to many people with ADHD, participation in sports and/or daily exercise provides some additional Dopamine to our brain and helps to create structure and routine in our lives that help to better manage ADHD symptoms. “Tipping points” are common for high school athletes who have earned success not only in their sports but academically, only to go off to college and experience failure for the first time. Without the rigorous physical training and structure of high school, they begin to slowly fall apart. Another common “tipping point” for people with ADHD is when they have experienced an injury and have to decrease their activity or exercise level. This change in routine and absence of daily Dopamine boosts can challenge previous steadiness, energy levels and ability to focus and life begins to wobble.

As you can see, there are many reasons, often beyond your control, that might lead you to your “tipping point.” Watch for the next issue of my e-zine, which will share ways you can keep yourself from tipping over the edge. But, in the meantime if you recognize yourself in these “tipping point” warning signs and are ready to get help, click here to schedule a “Succeed With ADHD” Strategy Session. Because remember, a “tipping point” means that you are at a crossroads and you have a choice which way you will react- you can continue down that path to chaos and overwhelm, or you can get restructured and relearn ways to to cope and get back on track!

Jun 14

Music Therapy for Children With ADHD


By Beth W. Orenstein
First developed at the University of Michigan in 1944, music therapy has long been used to help people with conditions such as depression, anxiety, or post-traumatic stress disorder. Music therapy also has been shown to help children with ADHD and is being used more frequently for that very reason.

“Music is an age-old way to heal, and it works exceedingly well for children with ADHD,” says Doris Jeanette, PsyD, a psychologist in Philadelphia. “Music reduces the anxiety you have in your body, and when you’re talking about kids with ADHD symptoms, all they have is anxiety.”

Music is calming, and calmed children with ADHD are better able to focus and pay more attention to what they are doing, says Mechelle Chestnut, MA, a music therapist who works in the public schools in New Jersey and has a private practice for teens and adults in New York. Because it is familiar and not threatening, music also makes children with ADHD more open to working with a therapist, Chestnut says.

As an ADHD alternative treatment, music therapy sessions can be one-on-one or in a small group. The therapist and the children may listen to music or play an instrument or sing songs together. Music provides an excellent opportunity for children to express themselves, Chestnut says. Sessions are individualized to the participants’ needs.

Music Therapy: No Talent Needed

One of the great pluses of music therapy is that children don’t need any musical talent to benefit from it. However, sometimes children with ADHD symptoms are quite creative, and music therapy can bring out their hidden musical talents.

No particular style of music is better than another, although classical music can be calming and studies suggest that listening to classical music may increase IQ. “It’s what’s known as the ‘Mozart effect,’” Dr. Jeanette says.

Several small studies have found that rhythmic exercises improved attention, motor control, and academic skills in children with ADHD. In sessions held over three to five weeks, children wore headphones and sensors on their hands and feet and were asked to perform exercises to a rhythmic computer-beat. The researchers reported improvement in the children’s attention, language processing, behavior, and motor control afterward.

The American Music Therapy Association can help you find a music therapist in your area. You can e-mail your request to and include the location where you’re looking for a therapist. Your child’s counselor also may know of music therapists in your area.

Make Your Own Music

You can also use music at home to help your child. Children with ADHD often have attachment issues, Chestnut says. Listening to music or playing music together or even singing songs can be a way to bond, she says. “Even if it’s just 30 seconds of a song that you sing, it’s a way of connecting,” she says. Don’t worry if you’re out of tune. “It’s worth the risk of sounding bad,” she says, “and no one will notice.”

When it’s time for bed, Chestnut suggests, put on some very quiet music, perhaps classical music or any kind of music that’s simple in rhythm and harmony. “Put it on for a half-hour before bedtime,” she says. “If that’s done regularly, it can be a cue to your child that we’re getting toward bedtime and help him to relax.”

Ask children what music they like to listen to and why. Listen to what they’re saying and don’t be judgmental about their choice, Chestnut adds. Be sure you have that music on a CD or on the radio and listen to it together. “It, too, is a way to connect with your child,” she says.

Music therapy has become one of the recognized ADHD alternative treatments. If you think your child could benefit from music therapy, talk to his teachers and therapists and add some music to your child’s world.

Jun 14

Teen Drinkers Often Feel Like Social Outcasts


By Janice Wood Associate News Editor

Teen Drinkers Often Feel Like Social OutcastsRather than gaining “liquid courage” to let loose with friends, teenage drinkers are more likely to feel like social outcasts, according to a new study.

The study shows alcohol consumption leads to increased social stress, which then leads to poor grades, especially among students in schools with tightly connected cliques and low levels of alcohol use.

Researchers analyzed data from the National Longitudinal Study of Adolescent Health (Add Health) on 8,271 adolescents from 126 schools. Begun in 1994, it is the largest survey of health-related behavior among adolescents between grades 7 and 12.

The researchers, who also drew on Add Health’s Adolescent Health and Academic Achievement transcript study, found a correlation between drinking, feelings of loneliness and not fitting in in all school environments. However, these feelings were especially significant among teenage drinkers in schools where fellow students tended to avoid alcohol and were tightly connected to each other.

The research was led by sociologist Dr. Robert Crosnoe from the University of Texas at Austin.

When not surrounded by fellow drinkers, they are more likely to feel like social outcasts, said Crosnoe, who was quick to note that this doesn’t mean teenage drinkers would be better off in a different school where cliques are focused on drinking.

“Instead, the results suggest that we need to pay attention to youth in problematic school environments in general, but also to those who may have trouble in seemingly positive school environments,” he said.

The researchers, who adjusted for factors such as ethnicity, race, gender, and socioeconomic circumstances, tracked the teens’ grade point averages and discovered a direct link between feelings of isolation and declining grades.

The difference between drinkers who felt as though they did not fit in socially and their peers could be as much as three-tenths of a point in grade point average from year to year.

“In general, adolescents who feel as though they don’t fit in at school often struggle academically, even when capable and even when peers value academic success, because they become more focused on their social circumstances than their social and academic activities,” Crosnoe said.

“Given that social development is a crucial component of schooling, it’s important to connect these social and emotional experiences of drinking to how teenagers are doing academically.”

The study, funded by the National Institute of Child Health and Human Development, was published in the Journal of Health and Social Behavior.

Jun 13

Can my child’s ADHD break my marriage?


VOXXI Blogs I met my husband when we were very young – we were high school sweethearts all the way. When we could legally do so, we made it official and then started a family. Not too long after, we had our first child, Kennedy. From my personal experience and observations, having children brings two people closer or drives them apart – either way, things definitely change.

When they’re babies, you can’t ever get enough alone time and the nighttime waking will make anyone irritable. Then toddlerhood has you in a constant state of pre-panic attack from all the falling, running off, climbing, and general ‘everywhereness’ of children that age – oh! and those are the so called “easy years!” Strong couples usually prevail, and sadly many married people barely end up nearly managing to be functional parents together- if they can. So, what happens when you add a high needs child with a disorder that spells out pure and utter chaos? Relationships are pushed to their absolute limits!

I once read a statistic that said married parents of an ADHD child were twice as likely to divorce by the time the child turned 8. My child is 8, and even though my marriage is nowhere near being close to the threat of divorce – I understand why this statistic is true.

Factors that could cause distress in relationships

When you have a child with ADHD, you can expect to have those toddler-like issues for many years past the toddler age group.
adhd2 Can my childs ADHD break my marriage? Having children is a wonderful thing, although it puts an additional strain on your relationship. But what about if your child has ADHD? Children with ADHD are very immature and self-destructive. Imagine having a child that’s in a perpetual state of the “terrible twos,” it gets to be overwhelming.

They don’t pay attention while they’re in motion and have a high tendency towards injuring themselves. My son has broken more bones just walking than anyone I know. He’s also very messy because of his lack of attention. He leaves everything scattered while playing and eating, which extends beyond the normal 8 year-old boy mess. These things alone put a lot of strain on me as an individual since my focus and attention are so monopolized by my attempts to contain the chaos.

One major factor that I feel puts a huge stress on marriages is the disagreement on how to handle a child with a learning disability. You and you’re spouse are probably not going to agree entirely on issues like discipline, how to address behavior problems at school, or medications. Some times the wrong decision can have negative implications, and then resentment and blame over a bad parenting decision become part of the martial equations.

My tips for coping

While I am proud to say that I feel like my marriage has survived the really hard parts of figuring out how to function under the added stress, it is a constant ‘practice’ to keep the wrecking ball at bay. Strong couples usually prevail the arrival of children, and sadly many married people end up just nearly managing to be functional parents together- if they can. So, what happens when you add a high needs child with a disorder that spells out pure and utter chaos? Relationships are pushed to their absolute limits!

At least once a week, we escape together. It doesn’t really matter what we do, we just do it without my son. He gets a day or two to get totally spoiled rotten by his grandparents, and we can enjoy the things other parents of children Kennedy’s age and childless couples take for granted. If you are having a hard time in a strained marriage – take regular breaks together.

My other major marriage protector is that we talk to each other about how we’re being affected by the situation, and how it makes us feel. It’s so good to know that you’re not alone in it, and your spouse knows how it feels to parent a high needs child, particularly your high needs ADHD child, better than any of your friends of family.

The hardest thing I have to force myself to do is – agree to disagree. I am a woman that wants people to follow my lead. I’m the alpha (in my mind), and I don’t like to be questioned – in other words, I’m a woman!

That attitude can bring any relationship to its knees, and when it comes to parenting, having that attitude with your spouse just makes you a bully. So, I have to accept that my husband has every right to disagree with me, and to ‘think’ he’s right, because all in all, we’re both trying to do the right thing for our son.

Positive airway pressure even helps patients who fail to use the treatment as prescribed, study finds.

TUESDAY, June 12 (HealthDay News) — Positive airway pressure, which is used to treat obstructive sleep apnea, may also help ease symptoms of depression among people with the sleep-related breathing disorder, a new study suggests.

Although depression is common among people with sleep apnea, researchers from the Cleveland Clinic Sleep Disorders Center found that patients who used positive airway pressure therapy had fewer depressive symptoms — even if they didn’t follow the treatment exactly as prescribed.

Obstructive sleep apnea occurs when the tissue in the back of the throat blocks the airway, which causes people to stop breathing while they are sleeping. The condition disrupts sleep and can increase the risk of other health problems such as heart disease and stroke. Positive airway pressure therapy helps correct this problem by keeping the airway open with a stream of air. CPAP, or continuous positive airway pressure, is the term commonly used to describe a form of the therapy that is delivered through a mask worn during sleep.

In conducting the study, researchers asked 779 sleep apnea patients to complete a questionnaire, known as PHQ-9, which assessed and scored their symptoms of depression. Following positive airway pressure treatment, the patients repeated the questionnaire. The study revealed that all of the participants reported improvements in their depression symptoms.

Patients using positive airway pressure for more than four hours each night showed more improvement than those who did not adhere to their treatment regimen as strictly.

“The score improvements remained significant even after taking into account whether a patient had a prior diagnosis of depression or was taking an antidepressant,” lead investigator Dr. Charles Bae said in a news release from the American Academy of Sleep Medicine.

“The improvements were greatest in sleepy, adherent patients but even non-adherent patients had better PHQ-9 scores. Another interesting finding was that among patients treated with [positive airway pressure], married patients had a greater decrease in PHQ-9 scores compared to single or divorced patients,” Bae added.

The study was scheduled to be presented Tuesday at the annual meeting of the Associated Professional Sleep Societies in Boston. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Heart, Lung, and Blood Institute has more about sleep apnea.

Jun 13

Top 25 Psychiatric Medications for 2011


Medications used to treat mental disorders continue to enjoy the best sales they’ve had ever. Meanwhile, psychotherapy usage continues to decline.

We started tracking the top 25 psychiatric medications prescribed in the U.S. back in 2005, with the help of IMS Health and their innovative Xponent service, which tracks the vast majority of prescriptions dispensed in the U.S.

The top 5 are below, while the rest of the list follows.

Xanax (alprazolam) – 47,792,000
Celexa (citalopram) – 37,728,000
Zoloft (sertraline) – 37,208,000
Ativan (lorazepam) – 27,172,000
Prozac (fluoxetine HCL) – 24,507,000

To put the percent changes below into perspective, the U.S. total population rose approximately 1.6 percent from 2009 to 2011. That suggests that anything above 1.6 percent change was driven by other factors — more people seeking treatment, more pharmaceutical advertising and marketing, or some other factor.

The biggest movers and shakers on the list were Celexa — moving up 15 spots to grab the second most-prescribed psychiatric drug in 2011 — and Wellbutrin XL, moving from 22 to 13.

Drugs used to treat attention deficit hyperactivity disorder (ADHD) — generic amphetamine salts and methylphenidate — enjoyed big gains as well. The rise of generics is not surprising, since once a medication goes off-patent, it becomes cheaper to purchase. Cheaper meds makes them available to more people who can now afford them.

Check out the Top 25 Psychiatric Medication Prescriptions for 2011 now.

Jun 12

By Traci PedersenAssociate News Editor
A fear of the dark may trigger some insomnia, according to researchers at Ryerson University. The findings will be presented at Sleep 2012, the annual meeting of the Associated Professional Sleep Societies, in Boston.

In the small study of 93 college-aged men and women, researchers found that more poor sleepers than good sleepers confessed a fear of the dark. “I think the most surprising part of the study is that people told us,” says researcher Colleen Carney, Ph.D., associate professor of psychology at Ryerson University, Toronto. Fear of the dark was confirmed through sleep lab experiments.

Carney and her research team decided to pursue the fear of the dark notion after she heard many people with insomnia, over the years, talk about sleeping with a light or TV on. All participants (average age 22) completed questionnaires regarding their sleep habits. One particular questionnaire is called the Insomnia Severity Index that helps classify people as good or poor sleepers. Participants were then assigned into either the poor-sleeper group or the good-sleeper group—there were 42 poor sleepers and 51 good sleepers.

Interestingly, of the 42 poor sleepers, almost half said they were afraid of the dark. Of the 51 good sleepers, only about one-quarter were afraid of the dark. In the sleep lab, Carney tried to confirm the fear of the dark. Four different times, she exposed both the good and poor sleepers to a burst of white noise. “If you are nervous, you are going to flinch,” said Carney.

Researchers observed participants’ responses, such as blinking speed and other reactions to measure the level of fear. They were measured twice in a simulated bedroom setting that was lit and twice in the same setting while dark. “We measured the blinks, the size, and how fast,” Carney said. ”The poor sleepers tended to blink fast in the dark in response to the unexpected noise.”

The poor sleepers had greater ”startle” responses only in the dark, she found, while the good sleepers tended to get used to the burst of white noise. “That’s what you do when you aren’t afraid,” she said. “The poor sleepers actually became more afraid.”

Carney believes that, for the poor sleepers, a fear of the dark may contribute to increased arousal once the lights are turned off. To lessen insomnia, Carney says those who have a fear of the dark should work directly on the fear, or phobia.

Jun 12

5 Surefire Ways to Destroy a Healthy Marriage


5 Surefire Ways to Destroy a Healthy Marriage By Dr. Rich Nicastro
In the interest of alternative forms of learning, every once in a while I like to turn relationship help advice upside down and talk about the common ways couples mess up perfectly solid marriages/relationships. Knowing what not to do can be as informative as learning what to do in an effort to build a better relationship. So remember, if you follow the marriage/relationship help tips below (which isn’t recommended) you will aggravate your spouse/partner, communication will plummet and intimacy will be a thing of the past!

You probably have made some (or all) of the five mistakes listed below—and if you haven’t, it might be just a matter of time. Strong relationships aren’t devoid of mistakes. The goal is to become aware of potential problems in your marriage or relationship before they snowball into major issues.

So don’t panic if you see yourself (or your spouse/partner) in any of these errors that can destroy a healthy relationship.

5 Surefire Ways to Destroy a Healthy Marriage/Relationship (or what not to do!)

1. Make Mind-reading your number one form of communication.

Mind-reading is simple and easy to do. You just guess what your partner is thinking or feeling and staunchly assume you’re right. Sure, it’s like playing darts blindfolded, but you can rest assured that sooner or later a dart will hit the board (just make sure you have plenty of darts). Here’s a brief example of mind-reading in action:

(Lori just arrived home after a very stressful day at work)

Brad: You’re still mad at me. I can tell. [Note the mind-reading.]

Lori: No, I’m not.

Brad: I know you. I can tell when you’re pissed off. [Note the further mind-reading and assuming he’s right.]

Lori: I just got home and I had a terrible day at work. I got a bad evaluation for that big project I’ve been working on.

Brad: Forget it. You never admit it when I’m right. That’s part of your problem!

Sure, Brad could have listened to Lori’s feedback about her work day, but that would have required him to stop mind-reading and actively listen to his wife (we all know how tiresome that can get). Two of the major benefits of mind-reading are that you won’t have to waste your time directly asking your partner how s/he is actually feeling and you can also ignore his/her feedback, since mind-reading usually breeds more mind-reading. Mind-reading can often be pretty subtle (unlike the example above), so look closely at your own ways of communicating to see if you already use this time-tested relationship destroyer.

2. Get passive about passion

Anyone in a long-term marriage or relationship understands the challenges of keeping romance and passion alive. Candlelit dinners, gazing into each other’s eyes, and the priority of talking and making love begin to buckle under the pressure of busy schedules, the demands of maintaining a household, the stresses of work, and for all those parents out there, the constant attention and energy children require. Familiarity is a double-edged sword for most couples. Familiarity and repetitive routines can make you and your partner feel safe and comfortable with one another, but these same relationship staples can slowly cool the embers of passion.

For many, passion and novelty go hand in hand–new love is inherently passionate and sexually exciting. Just remember the level of passion you and your partner experienced early on in your relationship and you’ll know what I’m talking about. But those spontaneous fireworks cannot last indefinitely—at some point attention and effort is needed to nurture this part of your relationship. Expecting spontaneous passion (and waiting for it rather than working on it) can surely hurt this important part of your relationship.

3. Multi-task whenever your partner needs you

There’s no denying it, we live in a world where doing several things at once is the norm. And some of us are becoming really good at it. But the truth is, you can never be fully present for your spouse/partner without slowing down, prioritizing and really listening. For those of you who remain committed to spreading yourself really thin while creating the illusion of emotional availability, it’s important to remember that emotional intimacy (and that sense of feeling deeply understood by and important to your partner) is likely to allude your relationship when your partner becomes one more item to check off on your overwhelming “to do” list.

4. Make unilateral decisions that affect both of you

For those of you who have been single for quite some time before entering into a committed relationship, it’s probably easy to recall the old days of making decisions without having to check in with anyone.

Your favorite color was red and you liked small, fast cars, so you ran out and purchased the cherry red sports car; The one bedroom apartment felt just right to you, so you didn’t think twice about signing the lease; You wanted a tattoo and a few Margaritas later, “I love Hank” was scrawled on your upper back. (Unfortunately, you didn’t know anyone named Hank) But then you fell head over heels in love and made a commitment to another person (and a commitment to the relationship).

You probably wouldn’t argue with the fact that certain responsibilities come with being part of an intimate, committed relationship (you now exist as part of an “us,” in addition to being a “me”). One such responsibility includes consulting with your partner whenever you’re faced with an important decision. The thinking here is that big decisions impact both of you, so it only makes sense to talk about your partner’s feelings regarding any potentially important decision. One surefire way to drive a wedge between you and your partner is to begin making decisions as if you were single again—doing so is guaranteed to make your spouse/partner feel marginalized and before you know it, you’ll be single again and you won’t have to consult with anyone except your lonely self.

5. Forget about the present: There’s no time like the past

Every second of every day you’re faced with a decision. You can focus your energies and attention on events that have already happened in your life, especially past hurts and lingering resentments and grievances.
When you are fully present, you approach new experiences with the openness and awe of a curious child. When couples are fully present with each other, a special connection is created that isn’t weighed down by the expectations and baggage of the past.

If you want to wreak havoc on your marriage/relationship, dwell in the past and resist the present. Rip open the scabs of past hurts, remind your partner of all the things s/he’s done wrong in the past (even when s/he is trying to change in the present) and for heaven’s sake, whenever it feels like the relationship is going well, pull up as many gloom-and-doom expectations that will remind you that life will eventually stink, so you better stop having a good time with your partner. (This is the “being stuck in the bleak future” approach.)

There you have it, five behaviors that if left unchecked can really knock-out even a healthy marriage/relationship. The antidote for these common relationship mistakes is to be mindful when you and your partner fall into these traps so that they do not become a regular part of your relationship.

Marriage/Relationship Help Resources Are you ready to bring your relationship to the next level? Check out my Marriage Enrichment special offer (this special offer brings together my 3 most popular e-workbooks at a 25% discount).
Dr. Rich Nicastro

Jun 11

By Rick Nauert PhD Senior News Editor Technology has provided researchers with physical evidence of how sleep deprivation can lead to anxiety. Investigators say their findings show that sleep loss markedly exaggerates the degree to which we anticipate impending emotional events. This overreaction often occurs among highly anxious people, making them especially vulnerable.

Experts say that two common features of anxiety disorders are sleep loss and an amplification of emotional response. Findings from this new study suggest that these features may not be independent of one another but may interact instead. University of California, Berkeley researchers used brain scanning on 18 healthy adults in two separate sessions, one after a normal night’s sleep and a second after a night of sleep deprivation.

During both sessions, participants were exposed to an emotional task that involved a period of anticipating a potentially negative experience (an unpleasant visual image) or a potentially benign experience (a neutral visual image). Functional magnetic resonance imaging (fMRI) showed that sleep deprivation significantly amplified the build-up of anticipatory activity in deep emotional brain centers, especially the amygdala — a part of the brain associated with responding to negative and unpleasant experiences.

Amazingly, in some of these emotional centers of the brain, sleep deprivation detrimentally triggered an increase in anticipatory reaction by more than 60 percent. In addition, the researchers found that the strength of this sleep deprivation effect was related to how naturally anxious the participants were.

People who were more anxious showed the greatest vulnerability to the aggravating effects of sleep deprivation. The results suggest that anxiety may significantly elevate the emotional dysfunction and risk associated with insufficient sleep. “Anticipation is a fundamental brain process, a common survival mechanism across numerous species,” said Andrea Goldstein, lead author of the study.

“Our results suggest that just one night of sleep loss significantly alters the optimal functioning of this essential brain process, especially among anxious individuals. This is perhaps never more relevant considering the continued erosion of sleep time that continues to occur across society.”

Source: American Academy of Sleep Medicine

Adolescents who receive prozac for the treatment of major depression are significantly less likely to abuse drugs in the future, say researchers. However, the medication did not reduce the chances of alcohol abuse. The 5-year study, conducted by John Curry, a professor of psychology and neuroscience at Duke University, involved nearly 200 adolescents at 11 sites across the United States.

The researchers found that of the 192 teenagers whose depression receded after 12 weeks of treatment, only 10% abused drugs later on vs. 25% of adolescents who didn’t respond to treatment. Curry explained: “It turned out that whatever they responded to – cognitive behavioral therapy, Prozac, both treatments, or a placebo – if they did respond within 12 weeks they were less likely to develop a drug-use disorder.” The team followed nearly half of the 439 participants from the “Treatment for Adolescents with Depression Study” (TADS). The study was conducted from 2000 to 2003 and was led by Dr. John March, chief of Child and Adolescent Psychiatry at Duke University Medical Center.

At the end of Curry’s 5-year follow up, participants were aged 17 to 23 and had no previous problems with drug or alcohol abuse. In the “Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression” (2004-2005), researchers found that 76% of study participants used marijuana. Other drugs included opiates, hallucinogens, and cocaine.

Before study participants received treatment, they must have had at least 5 symptoms for a length of time in order to be diagnosed with major depression. Symptoms included:
Poor concentration
Loss of interest
Depressed mood
Disruptions in appetite
Loss of sleep or energy
Suicidal thought of behavior
According to the researchers, medications or skills learned in cognitive-behavior therapy, in addition to education and support that all participants received, may have played vital roles in keeping the adolescents away from drugs. However, the team found no differences in alcohol abuse. Curry believes that this may partially be due to the prevalence of alcohol use among individuals aged 17 to 23.

Curry explained: “It does point out that alcohol use disorders are very prevalent during that particular age period and there’s a need for a lot of prevention and education for college students to avoid getting into heavy drinking and then the beginnings of an alcohol disorder. I think that is definitely a take-home message.” The team also found that participants who consumed alcohol were more likely to have repeat bouts with depression.

Curry said: “When the teenagers got over the depression, about half of them stayed well for the whole five-year period, but almost half of them had a second episode of depression. And what we found out was that, for those who had both alcohol disorder and another depression, the alcohol disorder almost always came first.”

According to Curry and co-author Susan Silva, associate professor and statistician in the Duke School of Nursing, further studies are required as the number of individuals who developed drug or alcohol disorders was fairly small. Furthermore, the team were unable to determine whether the rates of subsequent drug or alcohol abuse were higher among teenagers who didn’t receive treatment for depression as this study had no comparison group of non-depressed patients.

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