It may seem hard to get a grip on anxiety during a panic attack, but learning the right techniques can help you get your anxiety back under control.

By Diana Rodriguez
Medically reviewed by Niya Jones, MD, MPH

Panic attacks can be terrifying. These attacks stem from profound anxiety that can make your heart pound and your knees go weak. Panic attacks can make it difficult to catch your breath and can also cause chest pain and dizziness — you may even think you’re having a heart attack. A panic attack may only last a few minutes, but it can leave you feeling frightened and uneasy.

Understanding Panic Attacks

A panic attack and its symptoms of tremendous anxiety can strike suddenly, out of the blue. While a panic attack itself may be brief, it can lead to a lasting fear of having another episode. When panic attacks and the fear of having attacks occur repeatedly, people are said to have a panic disorder, a type of anxiety disorder.

“People have these panic attacks under various circumstances,” explains Martin N. Seif, PhD, a clinical psychologist in New York City and Greenwich, Conn. They constantly worry about having an attack and may avoid certain situations as a result. Eventually, people with panic disorder may realize that they aren’t actually afraid of the situation they’re avoiding, but rather of experiencing additional panic attacks, notes Seif.

Fortunately, you don’t have to live in fear of panic attacks. There are specific strategies you can use to help manage your anxiety and control your physical symptoms as well.

Panic Attacks: How to Take Control

The best way to stave off future panic attacks is by learning how to control your anxiety so that if you do start to notice symptoms of a panic attack, you can calm your mind and body until the symptoms fade.

“People who experience panic attacks have to learn how to cope with their feelings of panic,” says Seif. While medication can be effective, cognitive-behavioral therapy is one of the best techniques for managing panic and anxiety. “It involves recognizing that the panic-producing process is fueled by future-oriented, catastrophic thinking,” explains Seif. People with panic disorder have to become aware that their thoughts trigger a physical reaction, which results in a panic attack.

To gain control over panic disorder, it’s important to learn and practice anxiety management techniques, says Seif. Strategies that you can use to help you curb a panic attack include:

Breathing slowly and deeply. Anxiety can cause you to breathe very quickly, which makes both the mental and physical symptoms of a panic attack even worse. When you start to feel panicky, be sure to take slow, deep breaths to soothe your mind and body.
Stop and think. When your thoughts start spinning out of control, simply tell yourself to stop. Organize your thoughts and decide what you need to do to get yourself calm again.
Think positively. Push negative thoughts out of your mind, and remind yourself that you are in control. Think about times when you’ve been able to manage situations successfully and reduce anxiety.
Stand up for yourself. If you need to leave a situation, do so or tell someone you need to leave. Don’t be afraid to ask for help. Allowing yourself to become more upset will not help if what you really need is to take a walk and blow off some steam.
Relax your muscles. Anxiety causes your entire body to tense up, so make a conscious effort to relax each muscle from your toes all the way up to your neck and face.
Don’t wait for a panic attack to begin to try these techniques. Seif notes that it’s important to use these strategies regularly and learn to manage your anxiety in gradual stages. As you become more confident that you can rein in a panic attack, you can walk out the door each day breathing easier.

By TRACI PEDERSEN Associate News Editor

Oxytocin Shows Promise in Treating AnorexiaOxytocin, sometimes called the “love hormone,” could be a promising new treatment for anorexia nervosa, according to two new studies.

Researchers found that when patients with anorexia are given a dose of oxytocin, they are less likely to fixate on images of high calorie foods, fat body parts, and angry faces.

Oxytocin is released naturally during relational bonding, such as sex, childbirth and breastfeeding. It has been tested as a treatment for many mental disorders, and has been shown to lower social anxiety in people with autism.

“Patients with anorexia have a range of social difficulties which often start in their early teenage years, before the onset of the illness,” said senior author Dr. Janet Treasure from the Department of Psychological Medicine at King’s College London.

“These social problems, which can result in isolation, may be important in understanding both the onset and maintenance of anorexia. By using oxytocin as a potential treatment for anorexia, we are focusing on some of these underlying problems we see in patients.”

For the first study, published in Psychoneuroendocrinology, 31 patients with anorexia and 33 healthy controls were given either a dose of oxytocin, delivered as a nasal spray, or a placebo. The participants were then shown a series of images relating to food (high and low calorie), body shape (fat and thin), and weight (scales).

As the images flashed on the screen, researchers measured how quickly participants identified the images. If they had a tendency to focus on the negative images, they would identify them more rapidly. The test was done before and after taking oxytocin or placebo.

After receiving oxytocin, patients with anorexia reduced their focus on images of food and fat body parts. The effect of oxytocin was especially strong in patients with anorexia who had greater communication problems.

In another study, published in PLOS ONE, researchers evaluated the same participants’ reactions to facial expressions, such as anger, disgust or happiness. After taking oxytocin, patients with anorexia were less likely to focus on the “disgust” faces and also less likely to avoid looking at angry faces.

“Our research shows that oxytocin reduces patients’ unconscious tendencies to focus on food, body shape, and negative emotions such as disgust,” said lead author Dr. Youl-Ri Kim from Inje University in Seoul, South Korea.

“There is currently a lack of effective pharmacological treatments for anorexia,” she said. “Our research adds important evidence to the increasing literature on oxytocin treatments for mental illnesses, and hints at the advent of a novel, groundbreaking treatment option for patients with anorexia.”

By PSYCH CENTRAL STAFF

Dysthymic Disorder (also known more generally as dysthymia) is characterized by an overwhelming yet chronic state of depression, exhibited by a depressed mood for most of the days, for more days than not, for at least 2 years.

In children and adolescents, the mood can be irritable and it must have lasted at least one year.

The person who suffers from this disorder must not have gone for more than 2 months without experiencing two or more of the following symptoms:

Poor appetite or overeating
Insomnia or hypersomnia
Low energy or fatigue
Low self-esteem
Poor concentration or difficulty making decisions
Feelings of hopelessness
Furthermore, in order to be diagnosed with Dysthymic Disorder, no Major Depressive Episode has been present during the first two years (or one year in children and adolescents) and there has never been a Manic Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for Cyclothymic Disorder. This generally means that the person needs to have had an uncomplicated, long-term, low-grade depression for two or more years in order to meet this diagnosis.

In order to meet the diagnostic criteria for Dysthymic Disorder, the symptoms may not be due to the direct physiological effects of a the use or abuse of a substance (for instance, alcohol, drugs, or medications) or a general medical condition (e.g., cancer or a stroke). The symptoms must also cause significant distress or impairment in social, occupational, educational or other important areas of functioning.

With a brain-stimulating procedure to relieve Parkinson’s disease and epilepsy and another that purports to prevent Alzheimer’s disease, it was only a matter of time before neurostimulation became an accepted treatment for migraine headaches, which affect about 1 in 10 people worldwide.

The FDA recently approved an external device that uses nerve stimulation to decrease the frequency of debilitating migraine headaches. The Cefaly headband, which connects to a stick-on electrode to stimulate the endings of the trigeminal nerve, is the first non-pharmaceutical treatment for chronic migraines to get the agency’s okay.

cefaly-migraine-nerve-stimulation“Cefaly provides an alternative to medication for migraine prevention. This may help patients who cannot tolerate current migraine medications for preventing migraines or treating attacks,” Christy Foreman, director of device evaluation at the FDA’s Center for Devices and Radiological Health, said in a statement.

Cefaly, made by the Belgian company STX-Med, was already approved for sale in Europe and has sold roughly 50,000 units.

Migraine sufferers wear the headband for 20 minutes a day and can go about their daily routines as they do so. A 67-person clinical trial cited by the FDA showed that wearers experienced fewer headaches in a month. However, the device doesn’t prevent all migraines and, despite the company’s claims to the contrary, the FDA found no evidence that it relieves the pain of a migraine already in progress.

Patients experience a mild tingling sensation on their forehead while the headband is active. Some users disliked the sensation enough to discontinue use, but among the existing European users, more than half say they plan to continue using Cefaly.

migraines, migraine headaches, nerve stimulation, cefalyCefaly’s innovation is not neurostimulation, but neurostimulation without surgery to install the device.

Medical devices far more sophisticated than the anti-migraine headgear confront the same challenge: Researchers are developing a number of prosthetic devices that hook into the patient’s nervous system, but most require surgery.

For instance, Switzerland’s EFPL is testing a prosthetic hand that sends some sensory information back to the brain, giving the patient the illusion of feeling with the artificial hand. Cambridge scientists have proposed a neuroprosthetic bladder that would allow quadriplegics to control elimination with the touch of a button.

But in amputees and quadriplegics, the cost-benefit equation of surgical implantation is quite different than it is for those who suffer migraines, which, however miserable, do not threaten the patient’s long-term health.

Inquiries into brain-to-machine interfaces also rely on successfully linking nerves and machines together. Many are also currently focused on providing services for patients with paralysis due to the invasive installation. But if they are to gain acceptance among the general population, non-surgical hookups will likely be necessary.

Some doctors are too quick to prescribe antidepressants to parents who have suffered the death of a child either during pregnancy or within the first month of life, according to a study conducted by Florida State University researcher Jeffrey R. Lacasse.

In a study of 235 bereaved parents participating in an online support community, Lacasse found that 88 – or 37.4 percent – of them were prescribed a psychiatric medication to help them cope. Some women received prescriptions within a week of losing their children.

“This is simply too soon after the loss to reasonably conclude that these women need long-term treatment with antidepressants,” said Lacasse, an assistant professor in the College of Social Work. “Even though our sample is select, the data raise disturbing questions about prescribing practices for grieving parents.”

The study, “Prescribing of Psychiatric Medication to Bereaved Parents Following Perinatal/Neonatal Death: An Observational Study,” conducted with Joanne Cacciatore, a professor of social work at Arizona State University, has been published in the journal Death Studies.

Of the 88 parents, the study found that 79.5 percent were written prescriptions for antidepressants and 19.5 percent were only prescribed sedatives or sleep aids. Prescriptions were written shortly after the loss in many cases: 32.2 percent within 48 hours; 43.87 percent within a week; and 74.7 percent within a month. Most women prescribed antidepressants took them long term, some for years.

The research revealed that the clinicians doing the bulk of the prescribing were obstetrician/gynecologists.

“We did not see the same pattern of prescribing from psychiatrists or general practitioners,” said Lacasse, who suggests that OB/GYNs should refer their patients to mental health practitioners in such tragic and highly emotional situations.

The study raises a number of thorny questions surrounding the practice of prescribing psychiatric medication to someone who is grieving, according to Lacasse.

The usefulness of prescribing antidepressants in this situation is questionable given the time it takes for them to take effect – two to four weeks, in some cases.

“We also don’t know how prescribing a psychotropic drug so soon after a bereavement affects the normal process of grieving,” Lacasse said. “The assumption is that it helps, but we don’t know that.”

There is no evidence that says giving antidepressants to parents who have lost a child will help them get over the loss faster than through a grieving process that does not include psychiatric medication, he said.

The effectiveness of antidepressants, which were highly touted in the 1990s and 2000s, has been called into question in recent years.

“It is pretty well accepted at this point that antidepressants are not as effective as it was hoped they would be, and thus should be used carefully,” he said.

Common sense dictates that grief is not a mental illness. By the very act of prescribing an antidepressant, clinicians are tacitly labeling a patient as mentally ill, according to Lacasse.

“If it’s only been 48 hours since a mother lost a child, it would be normal for her to experience an extreme state of grief,” he said. “This is a natural reaction to tragic circumstances, not a mental disorder. To treat it as a mental disorder so soon is contrary to the concept of evidence-based medicine.”

These concerns should cause medical practitioners to hesitate before they write a newly bereaved parent a prescription for an antidepressant.

“Nowhere in our paper do we say that people should never be prescribed antidepressants,” Lacasse said. “But there are other options that should be tried first. Given the lack of evidence to support the efficacy of antidepressants in bereavement, physicians should take a conservative approach in prescribing to avoid overtreatment.”

The researchers suggest first using psychosocial interventions such as peer support or psychotherapy with social workers, psychologists and mental health specialists.

“If these options do not work, and it’s clear that something beyond normal grieving is going on, then we can have a conversation about psychiatric treatment,” he said.

Don’t give up if your depression treatment isn’t helping you feel better. A change in your medication or a new approach might be the answer you need. Here are some of the many options.

By Beth W. Orenstein
Medically reviewed by Cynthia Haines, MD

understanding treatment-resistant depression
Though you may be faithfully following your depression treatment plan, you might not feel that sense of despair lifting. If some of your depression symptoms are lingering, you could have what’s called treatment-resistant depression.

About two-thirds of people with severe depression find that the first antidepressant they’re given doesn’t work, and as many as one-third still suffer from depression symptoms after trying several different depression treatments.

The definition of treatment-resistant depression is open to debate. “Some define it as a person who fails one antidepressant trial, but more commonly, treatment-resistant depression is defined as failing two different antidepressants from two different classes,” says Adam Lowy, MD, a psychiatrist at the Psychiatric Institute of Washington in Washington, D.C. In this case, “failing” simply means that a person isn’t helped by a particular medication. The good news is there’s a wide variety of antidepressant medication available today “and once the right one is found, antidepressants should be able to treat most people with depression.”

Learning to Be Patient With Depression Treatment

Don’t jump to the conclusion that your depression treatment isn’t making you better without giving it enough time. “Everyone wants to get better quickly, and if you’re not seeing improvement after two or three weeks, you can sometimes be inappropriately labeled as a ‘nonresponder,’” Dr. Lowy says. That’s because you really should wait at least six to eight weeks before you or your doctor decides that a particular medication isn’t working.

It’s also important to share pertinent information. Before you are considered treatment-resistant, your doctor might ask:

Are there any life events that could be contributing to your being depressed?
Are you taking your medications exactly as prescribed?
Are you experiencing side effects and taking your drugs less often as a result?
Do you have symptoms of any other mental health conditions, such as bipolar disorder or schizophrenia?
Are you experiencing any other health issues, such as heart problems, anemia, or pain, that could be causing you to become depressed? Are you taking medications for any of these conditions?
Your answers can help your doctor determine whether you have treatment-resistant depression or if something else is causing you to still feel acutely sad while taking an antidepressant.

Other Depression Treatments Available to You

What if you do have treatment-resistant depression? If your depression treatment isn’t working or isn’t working as well as you would like, don’t give up. You have options, such as:

Trying a different medication. A different drug may work more effectively for you. One category of antidepressants is selective serotonin reuptake inhibitors, or SSRIs; another is serotonin and norepinephrine reuptake inhibitors, or SNRIs; and a third is monoamine oxidase inhibitors, or MAOIs. “There is little evidence that any one of the SSRIs is better than any of the others,” Lowy says. But some people find they can tolerate one better than another. Therefore, your doctor might suggest switching from one antidepressant to another in the same class or to an antidepressant in a different class.
Adjusting your dosage. In cases of severe depression, a person may need to increase their dosage to the highest safe amount before deciding it’s not effective.
Taking an add-on medication. Your doctor might suggest you try a combination of drugs, possibly from two different classes of antidepressants or an antidepressant and a medication that is used secondarily to treat symptoms of depression. Lowy says, among others, some schizophrenia and bipolar disorder drugs are sometimes given as add-ons for depression.
Other options for treatment-resistant depression include:

Counseling. Just as there are different drug options, there are different talk therapies you can try, including cognitive behavioral therapy, or CBT, a style that’s been shown to be effective for depression. CBT encourages you to see how your thoughts and behaviors can contribute to your depression and helps you change them. You might try one-on-one talk therapy or group therapy.
Support groups. You may feel less alone and more encouraged if you talk with other people who are dealing with depression as well. Find a support group online or look to local hospitals for in-person groups near where you live.
Neurostimulation. Stimulating the mood centers of the brain is another option used in certain cases of treatment-resistant depression. Types include:
Electroconvulsive therapy (ECT). ECT uses electric impulses to induce a brief seizure. Given while you are under sedation, it is an incredibly effective treatment for severe depression, Lowy says, although there’s a stigma attached to it due to side effects it caused before general anesthesia was introduced. The more people speak out about ECT as an effective treatment, the more these misconceptions can be eliminated. Lowry notes that on the current Showtime series Homeland, the character Carrie voluntarily undergoes ECT for her bipolar disorder. “Maybe that media exposure will help take some of the stigma away,” he says. Still, the procedure’s potential side effects are riskier than more conventional therapies used for depression today and ECT is only considered an option for those who can’t take medications or for whom medications alone don’t work.
Vagus nerve stimulation (VNS). The vagus nerve stretches from the brain to the belly. Like ECT, this therapy uses electrical current to stimulate the brain. VNS is a serious surgery that requires that a device be implanted in your chest to send the impulses. Studies are still ongoing to determine its level of effectiveness.
Transcranial magnetic stimulation (TMS). This treatment uses magnetic coils to stimulate the areas of the brain that control mood. TMS is a relatively new treatment for depression and may be best for moderate cases.
Also, don’t neglect the importance of healthy habits: Making lifestyle changes can help treat depression. Be sure to eat a healthy diet, get regular exercise, foster your relationships, and get quality sleep.

Finding Depression Treatment That Works

Everybody is different — what works for one person’s depression may or may not work for you. It may take some trial and error. It also may take some time for the therapies to work. But if you’re patient and work closely with your doctor, together you can find effective treatments for your depression.

Your math-related anxiety may not be solely attributed to that one year in school when your teacher forced you to recite the seven-times tables in front of the class. A new study suggests your genes could play a role, too.

Researchers from The Ohio State University found that genetic factors could play some role in people’s math anxiety, particularly through disposition to general anxiety and through cognitive performance in math skills.

“You say the word ‘math’ and some people actually cringe,” study researcher Stephen Petrill, a professor of psychology at the university, said in a statement. “It is not like learning how to read, in which people don’t normally have any general anxiety unless they have some kind of difficulty.”

However, the researchers emphasized that genes should not be wholly blamed for a person’s math anxiety (in fact, they found that just 40 percent of individual differences in math anxiety seemed to be explained by genetics). Environment and teaching quality also play a huge role.

But the study does show that “if you have these genetic risk factors for math anxiety and then you have negative experiences in math classes, it may make learning that much harder,” Petrill said in the statement. “It is something we need to account for when we’re considering interventions for those who need help in math.”

The study, published in the Journal of Child Psychology and Psychiatry, is based on data from 216 identical twins and 298 same-sex fraternal twins in Ohio who completed assessments in math anxiety and general anxiety, as well as in reading comprehension and math problem-solving. The participants began the study when they were in kindergarten or first grade, and then researchers followed up with them via home visits. This study in particular used data from these home visits that were conducted until the study participants were between ages 9 and 15.

Previous research on math anxiety has shown that people who have it have increased brain activity in the regions linked with fear. Plus, that increased activity in the “fear” regions of the brain was associated with decreased activity in the brain’s problem-solving regions, according to a recent Psychological Science study.

By ATHENA STAIK, PH.D.

Empathic listeners are relationship builders. They have a cultivated ability for being present, empathically connected. How do you cultivate empathy however? It starts with set intentions, at least four of them.

For human beings, empathy may be one of the greatest gifts to give or to receive, and perhaps one of our deepest yearnings. It is a form of love, an aspect of love that is expressed through the act of listening to understand from the eyes and heart of another. This is what makes empathy an essential ability to cultivate and give to others as well as our self.

When someone we love disappoints us in some way, this can automatically trigger painful emotions inside.

And when we are in pain, for example, feeling hurt, angry, or disappointed, often one of our greatest yearnings is for empathy, that is, an understanding love from another human being that affirms, in a moment of need, that we are valued. We want to know that our feelings and life matter. And thus a common human undertaking is to look for evidence that another loves us enough to want to understand us from our own perspective, to want us to have what we want (even when not possible), to want to see us happy and fulfilled, personally as well as in our relationship, and so on.

All of these are natural human yearnings or emotion-drives.

It is when we feel pain inside that we feel most unlovable or undeserving of love, in a sense, most vulnerable. In our culture, most of us think of this vulnerability as a sign of weakness, defect, inferiority, and on on. As a result, we “act” as if we don’t care, are tough, can take the pain and swallow it. Swallowed up pain however shows up unannounced in the form of addictions, mental and physical health issues. The body doesn’t lie.

A loved one who has mastered listening for understanding is an empathic listener. They can hear past the words, past their own intimacy fears and challenges, and they can be present as a holding place for another.

The actions they take when they listen, however, are meaningful to the extent they are guided by certain intentions.

Four Intentions of Empathic Listeners

Consciously or subconsciously, an empathic listener has at least four intentions in mind. And intention to:

1. Understand another person from their own perspective, rather than from the listener’s own projection of feelings, beliefs, experiences, assumptions, etc.

2. Refrain from taking another’s words or actions personally to the point of getting triggered and thus activating defensive strategies. This allows their brain to remain in a growth (learning) state of mind and body, rather than a protective (defensive) one, which makes it difficult if not impossible to listen to another’s communications.

3. See another as a separate person, and thus curious to ask questions and learn about them, their views and experiences of life, rather than view the other as an extension of the listener’s wants and needs and thus judge differences as threatening or inferior.

4. Listen objectively, not as an evaluator or critic, rather as one who wisely recognizes the value of relationship building and understands that the strength of a relationships rest on fostering mutual respect and understanding, which is developed and fostered by regular acts that express love, caring, kindness.

In other words, wittingly or unwittingly, empathic listeners overall intend to listen with compassion and thoughtfulness to others.

How important is empathy, to give and to receive?

Think back to persons who have had the most influence in your life. How would you describe the communication between you? Was it meaningful, fulfilling, perhaps inspiring? Did you feel accepted for the unique being you are, warts and graces?

Chances are that those who influenced you the most were powerful listeners. You were likely drawn less by their accomplishments and status, and more because of how you felt in their presence, perhaps, valued, seen, understood at levels that touched and stirred these already present yearnings or values. Whether they did so instinctively in rare moments or through years of consistent practice, they likely have you the gift of being present and empathically connected at some level.

Ultimately, these yearnings remind us that we need (not just want) our own love and acceptance, something we ideally cultivate in our experiences of connecting to affirming love from another.

It is in the context of relationships that we learn to love others, our self and life; and this is particularly true in the formative years of early childhood. The experience of love cannot be learned on our own, through logic, intellect and books , and certain not computers and other technological advances.

We are wired for love and relationships. Our relational yearnings are emotional needs, just as real as our physical needs for oxygen, food and water.

Human beings need a way to express themselves authentically, but we also need a way to listen more deeply, with our hearts, so that we may build a better understanding of another person or our self, and thus also, our relationships. And that’s where empathy enters a saving grace in our lives and relationships.

By MARGARITA TARTAKOVSKY, M.S.

3 Therapy Exercises to Help Couples ConnectBecause of daily responsibilities, long to-do lists and stressors big and small, it’s easy to feel disconnected from our partners. It’s also easy to take each other for granted, especially if you’ve been together for a long time.

Your connection with your partner needs cultivating. That’s why we asked relationship experts to share the exercises they assign to couples to help them get closer and nourish a stronger bond. Here are three activities to try.

Intimacy Builder
Mudita Rastogi, Ph.D, a marriage and family therapist in Arlington Heights, Ill., suggested couples turn off their phones and put the kids to bed. Go into a room that isn’t your bedroom, and sit so you’re facing each other and your knees are almost touching, she said. Take a minute or several minutes to look into each other’s eyes.

Consider your own reactions and thoughts. Then share them with your partner, she said.

“This exercise works because it promotes the kind of intimacy that is often lost in the busyness of our day. It is a great way to connect with a partner, and tune into one’s own and his or her inner world.”

Appreciation List
“For five days, write down one thing your partner did for you that you appreciated,” said Christina Steinorth-Powell, MFT, a psychotherapist who specializes in couples counseling in Santa Barbara, Calif. These don’t have to be grand gestures; they can be small, sweet acts.

For instance, Steinorth-Powell’s list would include her husband joining her to walk the dogs. This shows her that he wants to spend time together.

Her husband’s list would include Steinorth-Powell making sweet tea. “He’s told me that he appreciates the fact that I actually took the time to learn how he likes his tea and that I go through the effort to make it for him.”

After the five days, exchange your lists. “It’s very easy to feel taken for granted in relationships and feel that the little things we do for our partner are overlooked.” This exercise helps partners see that their gestures are noticed and appreciated, she said.

Love List
“Many times, we get so caught up in doing the things we think our partners will value that we don’t really know and/or pay attention to the things they really want or desire,” said Steinorth-Powell, also author of the book Cue Cards for Life: Thoughtful Tips for Better Relationships.

Instead, each of you can write down five things your partner can do or already does to show their love, she said.

“For example, when my husband helps me with housework, or cooks dinner, this shows me he loves me because he’s trying to lighten my load.” For Steinorth-Powell’s husband, running errands or simply sitting together in the mornings and evenings makes the list.

Steinorth-Powell has found that her clients are often surprised at how easy it is to let their partners know they love them. “Most of the time it’s not big, expensive gestures that show love, but day-to-day little things that are simple to do.”

“Intimacy is not easy,” Rastogi said. Any of these exercises can trigger complex reactions. That’s why she suggested seeking counseling, which is especially important if your relationship is in distress.

Research Reveals These 3 Tips to Increase your Personal Power
By MIKE BUNDRANT

personal powerEver feel frustrated, constricted, trapped or powerless?

Most of us know how these emotional states inhibit us psychologically, but that’s not the whole story.

Feeling emotionally powerless also makes you physically weaker, according to science. Read the research summary below. Then move on to the three tips to increase your personal power.

Everyone has had a day where they just don’t seem to have the physical strength to accomplish everything required. New research has shown that your personal sense of inner power could be the cause.

According to a recent study conducted by scientists at the University of Cambridge in the UK and published in the Journal of Experimental Psychology, your state of mind can affect your physical strength. The researchers conducted a series of three experiments that tested a person’s mood and sense of power against physical tasks such as lifting boxes.

The First Personal Power Experiment
In the first test, participants were given a survey to rate their sense of power by ranking how strongly they agreed with various statements such as “I can get people to listen to me.”

After the survey was conducted, each person was asked to lift various boxes and estimate the weight. Researchers found that though all of participants overestimated the weight of the boxes, the more socially powerless a person felt, the heavier they believed the boxes were.

The Second Personal Power Experiment
In the second experiment participants were split into two groups. One group was asked to sit in a socially powerful position, with one elbow on the arm of their chair and one on the desk beside them. The second group sat in a more constricted position, with shoulders dropped and hands under their legs.

In this experiment the participants who sat in the more powerful position gave more accurate weights for the boxes, while those who were constricted continued to overestimate the box weight.

The Third Personal Power Experiment
In the final experiment, participants were given a choice of remembering a situation in which they felt either powerless or powerful. After, they were asked to estimate the weight of the boxes once again, but were told they were being tested on the effects exercise has on autobiographical memory.

In this test, researchers discovered that participants who chose a powerful memory more accurately guessed box weights, while those who remembered situations where they felt powerless continued to overestimate the weight.

Based on the combined results, researchers believe that feelings of powerlessness, whether due to a person’s inherent personality or because of their social status, can result in a physical manifestation.

Three Tips to Increase your Personal Power
Each of the above experiments leads to simple conclusions about what you can do to increase your personal sense of power and access to more physical strength. Here are three:

1. Listen and consciously repeat what you say to yourself
Most of us have an autopilot voice in our minds that comments on what’s happening around us. Often, this is a critical voice that says things like:

You can’t do it.
You’re stupid.
There’s no point.
Who do you think you are?
You’re going to fail.

Saying things like this to yourself makes you physically and psychologically weaker. The participants in experiment number one above who disagreed with the statement must have had a voice in their head or a belief that said, “No, you can’t get people to listen to you.”

One of the best ways to manage a critical voice is to simply listen to it and realize that this is what you are saying to yourself. For example, when your inner critic says, “You’re stupid,” follow up that remark by saying to yourself, “I just said to myself, ‘You’re stupid.’”

Repeat this heightened awareness pattern objectively and you’ll soon have a fuller realization of what you’re doing to yourself, which may help you make different choices. Don’t allow a critical voice to run your mind and emotions on autopilot. And don’t try to make the voice stop from a victim’s point of view. Just get off autopilot and you will – by definition – have more choice!
 Try it.

Autopilot thinking and behavior is one of the primary symptoms of self-sabotage.

2. Manage Your Posture
Experiment two above demonstrated that posture has a lot to do with personal power and available strength. Do you spend a lot of your day in a physical slump? Do you hunch over, breathe shallowly, and walk around with your tail between your legs?

Again, just be aware. You don’t have to throw your shoulders back, pound your chest and bust out a Tarzan call. Just notice when you are constricting yourself and make minor adjustments to loosen up, straighten up, and breathe more freely.

3. Step Back From Negative Memories
When you relive memories, you reenter the same emotional state you experienced at the time. You can relive positive memories and recapture the joy (highly recommended). Or, you can relive negative memories and re-experience pain and failure.

Negative memories and the emotions that go with them are often triggered on autopilot by present situations. The key here is to let go of the feelings that are wrapped up in the trauma of the memory, while still being able to learn from it.

One way to do this is to mentally “step back” from the memory by viewing it from a distance. This is a classic, time-tested NLP method. Interesting research suggests that viewing memories from a distance significantly reduces the negative emotional effects of the experience and enhances an adaptive response.

The simplest way to view troubling memories is to do the following:

Think of the memory.

Now, imagine the image of the memory moving off into the distance until you “pop out” of it and can see yourself “over there.” When you are at a comfortable distance, you’ll feel like a more neutral observer. From this objective perspective, you don’t have the emotional attachment and it is much easier to learn from the experience.

The above methods work. If for some reason you are reluctant to try them, or give up too easily, then you could be overly attached to negativity. You need to learn about self-sabotage, which is often the culprit when you know what you should be doing, but don’t do it.

What is generalized anxiety disorder?

Generalized anxiety disorder occurs when you feel worried and stressed about many everyday events and activities. Often the things you are worried about are small or not important. This type of worry disrupts your life most days. Everyone gets worried or anxious sometimes. But people with generalized anxiety disorder experience more than normal everyday worries.

Many people who have generalized anxiety disorder have physical symptoms, such as headaches or being tired all the time.

Anyone can get generalized anxiety disorder at any age. But it usually starts when you are a child or teenager. Most people with generalized anxiety disorder have felt nervous or anxious as long as they can remember. About 5% of people have generalized anxiety disorder at some time.1 Women are twice as likely as men to have the problem.

Many people with generalized anxiety disorder also have other problems such as depression, other anxiety illnesses (obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, or social anxiety disorder), alcohol abuse, or personality disorder.

What causes generalized anxiety disorder?

The cause of generalized anxiety disorder is not known. Some studies show that it might be passed through the family (genetic).

Some problems such as hyperthyroidism can cause generalized anxiety symptoms.

Some medicines can cause worry and stress or make your stress worse, such as medicines with amphetamines (Ritalin) or too much caffeine. Illegal drugs such as cocaine can also cause these symptoms. Be sure to talk with your doctor about any medicines you are taking.

What are the symptoms?

People who have generalized anxiety disorder get worried and stressed about many things almost every day. They have a hard time controlling their worry. Adults with this problem often worry about money, family, health, or work. Children with this problem often worry about how well they can do an activity, such as school or sports.

You might also have physical symptoms, such as:

Feeling tired or irritable, or having a hard time concentrating.
Having headaches or muscle aches.
Having a hard time swallowing.
Feeling shaky, sweating, or having hot flashes.
Feeling lightheaded, sick to your stomach, or out of breath.
Having to go to the bathroom often.
Feeling like you can’t relax, or being startled easily.
Having problems falling or staying asleep.
How is generalized anxiety disorder diagnosed?

To find out if you have this problem, your doctor will ask questions about your symptoms and how long you have had them. Your doctor will also do a physical exam, ask questions about your medical history, and ask questions about medicines you are taking. This information helps your doctor find out whether you have any other condition.

To be diagnosed with generalized anxiety disorder, you must have more worry and stress than normal. You must feel worried and stressed about many things almost every day. And these feelings must last for at least 6 months. You will also have some physical symptoms. The worry, stress, and physical symptoms might make it hard for you to do normal activities such as going to work every day or doing grocery shopping.

How is it treated?

Generalized anxiety disorder is treated with medicines and/or therapy.

The two kinds of therapy that are used to treat generalized anxiety disorder are called applied relaxation therapy and cognitive-behavioral therapy. In applied relaxation therapy, your therapist might ask you to imagine a calming situation to help you relax. In cognitive-behavioral therapy, your therapist will help you learn how to think positive thoughts instead of thoughts that make you feel stressed and worried.

Some of the medicines that are used to treat generalized anxiety disorder are:

Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft). Studies show sertraline to be a good medicine for children or adolescents with generalized anxiety disorder. These medicines usually take several weeks to a few months to work well.
Serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine (Effexor). Studies show venlafaxine to be a good medicine for people who have another problem along with generalized anxiety disorder, such as panic disorder or depression. These medicines take several weeks to work well.
Benzodiazepines, such as diazepam (Valium) or alprazolam (Xanax), which traditionally have been used to treat generalized anxiety disorder. In some people who take benzodiazepines, the body becomes too used to the medicine and the doctor might need to prescribe more of the medicine for it to work. If you stop taking benzodiazepines all of a sudden, you might feel more jittery or worried than usual (withdrawal symptoms). Some people might have seizures from stopping the medicine too quickly. Be sure to talk with your doctor before you stop taking your medicine. People can become addicted to it. Be sure not to let anyone else take this medicine.
Tricyclic antidepressants (TCAs), such as amitriptyline or nortriptyline (Pamelor), which have also traditionally been used to treat generalized anxiety disorder.
Buspirone, which is often used with other medicines to treat generalized anxiety disorder. It may be used alone if the anxiety is mild. It can take 2 to 3 weeks to start working. People who take buspirone will not become addicted to the medicine.
Trifluoperazine (Stelazine), an antipsychotic medicine that has been approved by the FDA to treat generalized anxiety disorder. Other antipsychotic medicines are also being studied. These medicines are not commonly used for generalized anxiety disorder because of their side effects, including mild to severe problems with body movements.
Tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs) can sometimes have side effects such as being restless and not being able to sleep. These symptoms can be similar to generalized anxiety disorder. But they usually go away after you take the medicine for a while.

Some medicines work better for some people than for others. Be sure to talk with your doctor about how the medicine is working for you. Sometimes you might need to try more than one type of medicine before you find one that works best for you.

Taking medicines for anxiety during pregnancy may increase the risk of birth defects. If you are pregnant, or thinking of becoming pregnant, talk to your doctor. You may need to keep taking the medicine if your anxiety is severe. But your doctor can help you weigh the risks of treatment against the risk of harm to your pregnancy.

Treatment for generalized anxiety disorder helps reduce the symptoms. Some people might feel less worried and stressed after a couple months of treatment. And some people might not feel better until after a year or more.

Unfortunately, many people don’t seek treatment for anxiety disorders. You may not seek treatment because you think the symptoms are not bad enough or that you can work things out on your own. But getting treatment is important.

If you need help deciding whether to see your doctor, see some reasons why people don’t get help and how to overcome them.

Older people experience anxiety and anxiety disorders, often because of age-related stressors. Here’s how caregivers can help them cope.

By Juhie Bhatia

Feeling anxious or nervous when you’re stressed out is common, but when this anxiety is frequent, overwhelming, and affects daily tasks, social life, and relationships, it may be an anxiety disorder. Anxiety disorder can affect anyone at any age, and the elderly are no exception.

In fact, anxiety may affect as many as 10 to 20 percent of the older population, although it is often undiagnosed and often goes hand-in-hand with depression.

Anxiety Disorder: Why the Elderly Are Affected

“Although anxiety disorders beginning in later life are uncommon, the symptoms of anxiety are quite common in older adults,” says George T. Grossberg, MD, professor and director of the division of geriatric psychiatry at Saint Louis University School of Medicine. “The main reason is that older adults are subjected to a variety of stresses and losses, any of which can cause or be accompanied by anxiety symptoms.”

These stresses can include retirement, especially if it is sudden; loss or illness of a loved one; a decline in physical, cognitive, or emotional health; or financial concerns, explains Dr. Grossberg. Many older adults are also afraid of falling, being dependent on others, being left alone, and death.

Anxiety Disorder: Getting Needed Help for Loved Ones

Left untreated, anxiety and anxiety disorders can lead to other problems, such as cognitive impairment, poor physical health, and a poor quality of life. So have your loved one examined by a primary care physician if you suspect that he or she has an anxiety disorder. Fortunately, there are a variety of treatments available if an anxiety disorder is diagnosed:

Psychotherapy or counseling. A mental health professional, such as a geriatric psychiatrist, psychologist, or social worker, can help determine what is causing the anxiety disorder and how to deal with its symptoms. “In many cases, a ‘behavioral’ approach, such as cognitive-behavior therapy, will give a person the tools to manage themselves,” says Stephen Read, MD, a geriatric psychiatrist and clinical professor at the University of California, Los Angeles.
Medication. While drugs won’t cure anxiety disorders, they can help control these disorders while your loved one is in therapy. The main medications used to treat anxiety disorders are antidepressants, anti-anxiety drugs, and beta-blockers. Antidepressants (specifically selective serotonin reuptake inhibitors or SSRIs) are preferred over anti-anxiety medication, as they are non-addicting and generally well-tolerated.
Stress reduction. Adopting stress management techniques, such as meditation, prayer, and deep breathing from the lower abdomen, can help lower anxiety. Yoga, progressive relaxation, and tai chi may also be beneficial, says Grossberg.
Getting better-quality sleep. A good night’s rest may also help. “Sleep disorders are of course rampant in those with anxiety, and improving sleep, which often requires medicine, will be a big help,” says Dr. Read.
Staying active. Activity of any kind, be it physical or intellectual, can ease anxiety symptoms. “Encouraging the use of routines, exercise and activity, and socialization may be useful. Relaxing activities and hobbies should be encouraged. Gardening, fishing, art, and music are particularly relaxing for some older adults,” says Grossberg.
Avoiding triggers. Your loved one should avoid things that can aggravate the symptoms of anxiety disorders, such as caffeine, smoking, over-the-counter cold medications, and alcohol.
As a caregiver for an older person with anxiety or an anxiety disorder, the responsibility may be on you to ensure that your loved one is receiving treatment. Fortunately, there is much you can do to help.

The mission of Friends of Karen is to provide emotional, financial and advocacy support to children with a life-threatening illness and their families.

Friends of Karen is a registered 501(c)(3) charity and the only organization in the New York metropolitan area to provide a comprehensive range of services — at no cost — to families caring for a child with a life-threatening illness.

Driven by compassion for families facing the most difficult experience imaginable, our expert social workers, committed staff and dedicated volunteers provide vital, practical and comprehensive services tailored to the specific needs of each family — and each family member — to help free them of everyday concerns so they have more time to love.

What We Do: Friends of Karen’s core Family Support Program offers individualized case management provided by a team of experienced, professional social workers.
Our support includes:

Emotional support, including supportive guidance, bereavement support and a Sibling Support Program that provides specially-trained counselors who work one-on-one and in small groups with sisters and brothers of the children who are ill, allowing them to express their feelings and thoughts, and to develop the means to cope with what is happening in their family.
Financial support through direct payment of illness-related expenses not covered by insurance (i.e., doctor and nursing fees, prescriptions and lab bills) and basic living expenses (i.e., rent, mortgage and utility bills) that are no longer affordable when parents leave their job to care for their child. We also help cover the cost of childcare for siblings, and hospital travel and meals.
Advocacy support to ensure families have access to all available benefits from government and other agencies; support from other organizations; pro bono legal counsel; and help with special educational needs.
“When we were going through our daughter’s illness, we would not have made it through without Friends of Karen. We will NEVER forget all that you did financially and emotionally.” Myra and Jesse Poe

Questions? Click here to contact us or call 914-617-4042
In Queens and Long Island, you may call 631-473-1768 x304.

friendsofkaren.org

By JANET SINGER

OCD, Lying, Hyper-responsibility & HonestyMy son Dan was an honest child; an unusually upfront, truthful boy, who as far as I know, never lied to me. Teachers and relatives would comment on his honesty as well, saying things such as, “If we want to know what really happened, we ask Dan.”

Enter obsessive-compulsive disorder (OCD).

Now Dan is telling us he doesn’t realize his fingerprints are all over the walls. He said he’d recently eaten, so that’s why he wasn’t hungry at dinnertime. He couldn’t go here or there because he was too tired. These were all lies (which worked) to cover up his obsessive-compulsive disorder.

Even after he was officially diagnosed and his secret was out, he’d still lie. He always said he was “fine,” despite the fact that he was obviously so not fine. He lied about his feelings, he lied about taking his meds, and he lied about his thoughts. And not just to his family.

My hunch is he lied to the first few doctors he saw, or at the very least, wasn’t completely honest with them regarding the symptoms of his illness. Like so many others with OCD, he was embarrassed and scared. What would people think of him, or what would become of him, if others knew what horrible thoughts were going on in his mind?

And so OCD often turns sufferers into liars. Whether it’s due to the fears mentioned above, or some other reason — related to stigma perhaps, or even commanded by OCD? — those with obsessive-compulsive disorder often do whatever they can to cover their tracks. They become sneaky and deceptive, courtesy of OCD.

What I find ironic is that many of these same sufferers deal with honesty issues as part of their disorder. For example, some people with OCD are so afraid of lying they might have to review their entire day in their minds to make sure everything they said was true. Or they might always answer “I don’t know,” or “maybe” to questions because if they answer “yes” or “no” and then change their minds, they would have lied. Others might even confess to “bad things” they never did, but how do they know for sure they didn’t do them? So the right thing to do is to own up to the wrongdoing.

Concerns that revolve around hyper-responsibility often involve being honest and doing the right thing to keep loved ones, or maybe even the whole world, safe. And of course, scrupulosity is all about upstanding moral behavior, which involves telling the truth. Being truthful is very important to many with obsessive-compulsive disorder, except when it comes to covering up their illness.

So once again we see the disconnect between what sufferers strive for and what OCD delivers. Those who value truth and honesty become deceitful. They struggle to be certain all is well, but OCD, being the insidious disorder that it is, goes ahead and makes sure the opposite happens. All is far from well, and in fact, lives can be destroyed.

While OCD has the capacity to target what is most important to us, and sabotage our lives, we don’t have to let it. If you have OCD, please be truly honest about your disorder and seek help. Don’t let OCD win. Fight back with exposure and response prevention therapy and regain control of your values and your life.

By JANET LEHMAN, MSW
Oppositional Defiant Disorder (ODD) is a childhood disorder that affects anywhere from 6 to 10 percent of children. It is characterized by a negative set of behaviors in a child directed toward the adults in their life, and can sometimes be mistaken for disorders that share some characteristics, such as conduct disorder and even attention deficit disorder.

The diagnosis of Oppositional Defiant Disorder is given by mental health professionals to describe a set of behaviors a child is exhibiting that include:

Often loses temper
Argues with adults and authority figures
Refuses to comply with adult requests
Blames others for his mistakes
Deliberately annoys people
Is easily annoyed by others
Is angry/resentful and spiteful/vindictive.
Sound like a child you may know?

If a child exhibits four or more of these behaviors for six months or longer, he would likely be diagnosed with ODD, unless there was an alternative explanation (for example, if he’s experienced some kind of trauma or if there’s another disorder or condition at play). The most important factor to consider is frequency and intensity. All kids exhibit some of these behaviors, but not to the extent of an ODD child. ODD may develop at any time, over time, and may be secondary to another diagnosis. In other words, it might co-exist with ADHD or a mood disorder.

With oppositional and defiant kids, there are very different levels of misbehavior. You might have a young child who’s having temper tantrums, or an older adolescent who’s exhibited ODD behavior for years and who feels justified in being verbally or physically abusive, or punching holes in the kitchen wall.

A common trait of kids with oppositional Defiant Disorder is that they often see themselves as victims and feel justified in acting out. And sadly, they see so many examples of people in our culture who act out — from rock stars to athletes to politicians — that they feel even more justified in what they’re doing.

Parents are often intimidated by their ODD child’s behavior because it’s so difficult to deal with; sometimes it just seems easier to give in than to deal with trying to manage and respond differently.

Again, it’s important to remember as a parent that you can change at any time. You might feel defeated because of your own stress levels, feelings of blame or failure, and exhaustion. But here’s the truth: you can learn to respond in such a way as to reduce the acting out behavior.

Here are four things you can do as a parent to effectively manage your child with oppositional Defiant Disorder:

Respond without anger: It’s important to respond to your ODD child without anger—try to be as calm and matter-of-fact as possible. Just acknowledge the behavior, state it as you see it, explain how it will need to change and then remove yourself from all arguments. You really have to pick your battles and decide what’s most important to you—and ultimately to your child.

Be clear and consistent: The nature of oppositional defiant behavior is to wear parents down so that they eventually give in. You need to be strong, clear and consistent in your follow through.

3. Do not take things personally. Do not take your child’s behavior personally. When your ODD child acts out, as hard as it might be, stay as neutral and objective as possible. You need to be clear and concise and not get pulled into a power struggle—it’s really not about you, it’s about your child and what he needs to learn. We as parents sometimes need to be great actors and actresses with our kids. The key is to keep practicing calm, consistent parenting and following through.

Don’t be your child’s friend—be his parent: Remember, being a parent is not a personality contest. There are times when he won’t like you—he may even shout, “I hate you,” or call you foul names. But if you keep setting limits with your child and follow through by giving him consequences and holding him accountable, then ultimately you’re doing the best thing for your child.

Believe me, I know from experience that it’s difficult to manage ODD behavior. It takes work and support from partners, friends, and the school system; it requires all the important adults in a child’s life working together to help change the behavior, but it can be done.

By JANICE WOOD Associate News Editor

Mindfulness-based Meditation Eases Cancer Symptoms in TeensMindfulness-based meditation has been found to lessen some symptoms associated with cancer in teens.

That may be because mindfulness-based meditation focuses on the present moment and the connection between the mind and body, according to researchers at the University of Montreal and its affiliated CHU Sainte-Justine children’s hospital.

Teens diagnosed with cancer face not only the physical symptoms of their condition, but also the anxiety and uncertainty related to the progression of the disease, according to the researchers.

They also must live with the anticipation of physical and emotional pain related to illness and treatment, the significant changes implied in living with cancer, as well as the fear of recurrence after remission, researchers noted.

For the clinical trial, the researchers asked 13 teens with cancer to complete questionnaires covering mood — positive and negative emotions, anxiety and depression — sleep and quality of life.

The group was then divided in two: The first group of eight teens was offered eight mindfulness-based meditation sessions, while the remaining five were put on a wait-list, creating a control group.

The eight meditation sessions were 90 minutes long and took place weekly. After the last session, patients from both groups filled out the same questionnaires a second time.

“We analyzed differences in mood, sleep, and quality of life scores for each participant and then between each group to evaluate if mindfulness sessions had a greater impact than the simple passage of time,” said Dr. Catherine Malboeuf-Hurtubise of the university’s Department of Psychology.

“We found that teenagers that participated in the mindfulness group had lower scores in depression after our eight sessions. Girls from the mindfulness group reported sleeping better. We also noticed that they developed mindfulness skills to a greater extent than boys during the sessions.”

The results suggest that mindfulness sessions could be helpful in improving mood and sleep in teenagers with cancer, as previous oncology research suggests with adults, she added.

According to the researchers, differences between the two groups were not large enough to assign observed benefits solely to the mindfulness component of the sessions.

“The social support provided to the adolescents in the mindfulness group could possibly explain observed benefits on mood and sleep,” Malboeuf-Hurtubise said.

“Nonetheless, mindfulness-based interventions for teenagers with cancer appear as a promising option to lighten psychological inconveniences of living with cancer.”

The researchers intend to offer members of the control group an opportunity to take the meditation sessions, she added.

Source: University of Montreal

By MARGARITA TARTAKOVSKY, M.S.

9 Tips to Deal with Forgetfulness in ADHD

Forgetfulness is a symptom that “can impact everything” for adults with attention deficit hyperactivity disorder (ADHD), said Mindy Schwartz Katz, MS, ACC. Mindy’s a coach who empowers clients with ADHD to get over, around and through the obstacles that get in the way of living their unique life.

It can affect how you work. For instance, one of Katz’s clients, a contractor, bought the wrong paint color for a job, costing him extra time and money. Another client got fired from a production line because they forgot a safety procedure.

It also can affect your home life. You might forget to pay the bills, run important errands and acknowledge special occasions. Your spouse and family may interpret your forgetfulness as a sign that you don’t care about them, Katz said.

“Forgetfulness is related to the executive functions in the brain — processes which help us manage, organize, and disseminate information,” according to Stephanie Sarkis, Ph.D, NCC, a psychotherapist who specializes in ADHD.

These functions also include planning and thinking ahead. In ADHD these functions are dysfunctional, she said.

But there are strategies you can employ to effectively reduce and manage forgetfulness. Here are nine suggestions.

1. Take advantage of technology.

Use an electronic calendar, such as Google Calendar, and set it up to text you reminders for appointments and tasks, Katz said. Have it send you the same reminders throughout the day.

Sarkis suggested the apps TravelPro, which creates packing lists for trips, and Errands, which helps you keep track of professional tasks and personal errands.

2. Automate tasks.

Like sending yourself reminders, automating other tasks also helps. For instance, Katz’s client eats the same breakfast every morning because it used to take her too long to locate all the ingredients she needed for different meals.

Katz travels often, so she keeps a toiletry bag with everything she needs. When she purchases a new product, she just adds it to her bag.

You can do the same with a backpack for school and a briefcase for work. Get duplicates and extras of inexpensive items, too, she said.

3. Use self-talk.

Katz suggested pausing, paying attention to what you’re currently doing, and practicing self-talk, such as: “Here are my keys, they’re in my hands, and I’m putting them next to my purse, which is where I always put my keys.”

Sometimes, your self-talk may sabotage your efforts. Many people will say, “I’ll remember that,” Katz said. Instead, it’s better to remind yourself of what really works. So you might say: “I need to write it down. I write everything down. I’m going to put this in my calendar.”

Sarkis also stressed the importance of writing things down. “The more you write down, the less you have to keep track of tasks in your head.”

4. Have a launch pad.

One of Katz’s clients used to spend an hour and a half every morning searching for her purse, keys, ID badge and other items. Katz suggested she create a launch pad with everything she needs to take to work. She cut down her time to 30 minutes.

Make sure this launch pad is close to the door. As soon as you get home, put all your items in it. Also, if you need to bring something new to work, put it in your launch spot right away. This way, the next morning, you don’t waste time scouring your home, and you won’t forget it.

5. Create visual reminders.

Katz works with another client who’s a case manager. She found herself forgetting a lot of details because she has so many clients and so much information to keep track of. Instead of using scores of sticky notes, she created one circle for every client. In that circle she puts anything about that client.

Adults with ADHD also may forget to do the things they enjoy, she said. A different client forgets what she likes to eat for dinner, so she posts dinner menus on the fridge.

Another part of creating visual reminders is labeling things, Katz said. “I sort of chuckle about how many systems I started and forgot about it. [I had] a drawer for the scissors but couldn’t remember where I put them.”

That’s why it’s key to have a place for everything, and for everything to have a label, she said.

6. Create simple systems.

“Set up your life so that the things you need are where you need them,” Katz said. Another client, who’s in sales, works out of his car. He uses crates to house the different kinds of samples he sells. Once he’s done with a sample, he returns it to its respective crate, which is clearly labeled.

7. Create lists.

“Lists are key to organizing and remembering,” Katz said. Her client, who has significant memory issues, has checklists for everything from cleaning the house to transitioning from work to home to packing for vacation. She writes these checklists on index cards, which she keeps on a binder clip by her front door.

8. Ask others to remind you.

“Let people know that you don’t mind reminders,” Katz said. Sometimes people worry that they’re nagging you. But there’s a difference between “You never remember to ___” and “You asked me to remind you at 3 p.m. that you have an appointment in an hour.”

9. Get help.

“Reach out for help from a mental health clinician; trusted family members or friends; and financial professionals, if your forgetfulness is causing you issues with money management,” said Sarkis, also author of several books on ADHD, including 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals.

Katz suggested hiring a virtual assistant to give you reminders and review your daily schedule and to help with accounting and billpaying. She knows a businessman who hired a high school student to be his “body double.” “Just having someone else in the room, you’re more inclined to do the things you need and want to do.”

Sometimes adults with ADHD can feel defective, Katz said. They think, “I should be able to remember this.”

But your forgetfulness isn’t a defect. It’s a symptom of ADHD. And it’s a symptom you can successfully manage. Focus on finding strategies that work for you, and don’t hesitate to seek help.

By ATHENA STAIK, PH.D.

Here are three important lessons we’ve gained from studying success.

One, success does not create happiness, instead, it is the other way around: happiness creates success. That’s right. Success is an inner job.
It does not come from what is outside of you in the environment—a car, a house, a degree, a promotion, financial wealth—as desirable and wonderful as these can be. Instead, lasting and powerful success stems from what is going on inside of you. It is dependent upon your willingness to consciously produce certain thoughts inside your head, more specifically, thoughts that energy a positive physiology, an energized positive emotional state that makes you virtually unstoppable in creating the success you want.

Happiness is not a goal; it is the means to realizing each and every one of your goals.

The question is, “do you know how to shift to a positive physiology, a radiant felt-emotional state at will?”

A second lesson learned from success studies is that true fulfillment comes from balancing the demands of home and work in way that prioritizes relationships.
That’s right. You cannot find fulfillment in life solely from success at work or at home that involves completing “to do” lists. If your focus and desire is to primarily achieve success in one area of your life, and you ignore key relationships, you are not likely to find true fulfillment. Why? Because your core impulses instinctively drive you to seek to love and be loved unconditionally, these emotional yearnings propel you to balance your giving and receiving, contributing in significant ways to self and others—and having fun and relaxation.

The question is, “do you know how to get your core needs met in key relationships?”

The third lesson is that you are completely in charge of how small or large, near or far reaching our success will be.
In other words, the extent of your success depends specifically on how much you want to succeed, or how narrowly or broadly you define success. This lesson invites you to ask three questions: First, specifically what do you want…do you know? Second, why do you want what you want…what are your reasons, driving purpose? And, third, you need to ask, what are you willing to do to get it…do you know?

Ultimately, the measure of your success depends on how clearly you can picture what you want, appreciate why you want it, and recognize what you’re willing to do to get it. That’s a formula for success.

I haven’t met a person who does not want financial prosperity, great relationships or a strong, healthy and fit body. Have you? It is not enough to just want something, however. You need a clear vision. Once you have this, you need a strong why, a driving purpose or reason to energize your passion to achieve it. Your passion is what will sustain your enthusiasm in spite of any obstacles on the path to achieving your goal.

The question is, “do you have a clear picture of what you want…why you want this…and what you are willing to do to make it a reality in your life?”

The exciting news for those who think they have little or wavering passion for realizing what they want is that studies say: No problem! You can will yourself to shift to a positive physio-emotional state—just “as-if”—as you faithfully follow the formula of success.

You want flaming passion? You want momentum? You want a drive for action? You can have it, easily and elegantly! Begin now to get a clear picture of what you want, why you want it, the beliefs you need to realize your dream, and what you’re willing to do to make it happen, one action and one step at a time, starting today.

Start this moment by turning inside, for a few moments, and just feel the joy, energy and exuberance throughout your body as if you have it! By doing so you are using the amazing powers of your imagination.

Why not begin now, this moment, today, to energize your dreams?

Find out how to strengthen your body’s front line against depression by boosting endorphin and serotonin levels.

By Chris Iliades, MD
Medically reviewed by Farrokh Sohrabi, MD

Whether you have a case of the blues or you’ve been diagnosed with depression, your body may hold the keys to fighting a depressed mood. And once you know how to tap into them, you may be able to boost your happiness.

Neurotransmitters including endorphins, serotonin, and dopamine are the brain’s messengers that regulate mood, concentration, motivation, and other emotions. Antidepressant medications work by increasing the flow of these neurotransmitters to areas of the brain that cause depression. By understanding how these chemicals work, you can use your body to help fight depression.

Endorphins

Know that euophoric feeling after an intense workout? Or the contentment you feel after sex? You can thank endorphins for those happy feelings. These neurotransmitters are released when you’re under physical or emotional stress.

How to boost endorphins:

Exercise. To get that runner’s “high,” you don’t necessarily have to run. Research shows that a regular aerobic program may be just as helpful in treating depression as some medication. However, talk to your doctor before making any changes to your medication regimen.
Laugh. A recent study done at Oxford University found that having a good old-fashioned laugh with friends releases endorphins, which then improve mood and social bonding.
Indulge in chocolate. You know it, and science has backed it up: Chocolate makes you feel good. Researchers have found that a bit of the cocoa treat can trigger the release of endorphins and improve your mood.

Serotonin

The neurotransmitter serotonin works to regulate sleep, reduce pain, and improve your mood. When you’re low on serotonin, you may be at a higher risk for depression and suicide.

How to boost serotonin:

Think happy. Research shows that swapping negative thoughts out for happier ones can increase serotonin levels.
Head outdoors. Natural sunlight can help your body produce more serotonin, so take your workout outdoors during the day. Or, at the very least, take a daily stroll either in the morning or early afternoon.
Eat smart. Your body converts the amino acid tryptophan into serotonin. So load up on tryptophan-rich foods like brown rice, cottage cheese, turkey, sesame seeds, and peanuts.

Dopamine

This neurotransmitter associated with motivation and the reward and pleasure center in your brain is helpful in fighting depression symptoms like anxiety, loss of interest, and withdrawal.

How to boost dopamine:

Play your favorite music. Ever wonder why a favorite song can give you a rush of pleasurable feelings? Researchers at McGill University report that listening to music you like can lead to a release of dopamine.
Eat your favorite food. Can’t live without pizza? Your go-to foods can also boost levels of dopamine. (Just remember to enjoy in moderation.)
Go for a healthy lifestyle. Alcohol, poor sleep habits, caffeine, too much sugar, and stress can all deplete your body’s dopamine supplies. Help protect the neurotransmitter by eating fruits and vegetables rich in antioxidants.

The neurotransmitters gamma-aminobutyric acid (GABA) and acetylcholine may also play a role in depression. GABA is an amino acid that may ease feelings of anxiety, and acetylcholine could improve both your memory and your concentration. GABA is found in fish, especially mackerel, and wheat bran. You can get acetylcholine from eating egg yolks, whole wheat, and soy.

Boosting your endorphins and other neurotransmitters may help you prevent depression and improve your mood, but don’t ignore symptoms of depression like sadness, anxiety, and a lack of energy that keeps you from functioning normally. If symptoms of depression last more than a few weeks, talk with your doctor.

When we were born, we weren’t handed a manual to help us manage life. Most of us didn’t have a perfect childhood, and we may have launched our lives without the necessary tools to take good care of ourselves and sustain healthy relationships. Having a great psychotherapist or counselor can ease our load by helping us understand ourselves better and learn how to navigate our lives in a powerful, authentic way. But how do you find that great therapist you can trust to guide you well on this amazing and tumultuous journey?

Choosing the right therapist takes time and a few conversations, and it’s partially an intuitive process. Remember, psychotherapy is a relationship, too. Here are a few tips to help you find that great therapist:

1. Word of mouth. Do you have friends and acquaintances who talk about therapy? Who do you see that’s really transforming and changing? Find out who helped them, and set up an introduction with that therapist.
2. Look at their website. You’ll get a feel for their language and style. What do they say about themselves, and how do you feel as you’re reading it? Do they seem compassionate, clear and straight forward? Look for specific approaches to your problems or issues.
3. Be clear about what you need. In your first session, share openly and honestly about your concerns. Let them know what you’re issues and challenges are, and what you want and expect to get out of therapy.
4. Ask them about their training. Do they have more than one kind? Do they have different tools and skills so they can customize to fit your needs? Can they approach your issues from different angles to provide more depth? Listen to their responses and pay attention to how you feel as they are speaking.
5. What personal work have they done? A good therapist is continually committed to their own personal growth. Ask them what they’ve done and how they’ve benefited from this work. You want a therapist who’s walked some of the territory ahead of you.
6. Ask them how they work. If you’re pretty clear about where you need help, you want to know how the therapist plans to proceed. Ask them how they work or ask them to show you in the first session.
7. Ask them how they can help you. Once you’ve given them a brief summary of what you’re looking for, ask them how they would help. Do you feel they’re paying close attention to what you’re feeling and thinking? How tuned in, empathetic and insightful do they seem in the first session?
8. Don’t be afraid to shop around. You want to find someone who really feels like a good fit for you, and that might not be the first person you meet. Even if you like them, interview a few more to make sure you’re making the right choice. With a little time and care, you’ll meet the very best therapist for you!

How did you choose your therapist? Did you find a great one right away, or have you “kissed a few frogs?” Please leave a comment; it makes a difference for all of us!

Depression and pain can often co-exist. Learn why they’re linked, and find out about depression treatments that can also ease headaches and other chronic pain.

By Elizabeth Shimer Bowers
Medically reviewed by Farrokh Sohrabi, MD

As many people with depression know, the mind and the body are intricately connected. When you’re depressed, pain can feel worse for you than it might for someone who doesn’t have depression.

“When people have both depression and pain, it’s hard to tell which came first,” says Ian Cook, MD, an associate professor in residence in the department of psychiatry and bio-behavioral sciences at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA) and a research scientist at the UCLA Neuropsychiatric Institute.

What scientists do know is that depression and pain are clearly linked. “Pain and mood are actually regulated by the same part of the brain,” says Joseph Hullett, MD, senior medical director for clinical strategy at OptumHealth Behavioral Solutions in Golden Valley, Minn. Hullett says the loss of certain neurotransmitters in the brain can cause depression symptoms and make pain feel even more uncomfortable.

Depression seems to be especially closely linked to certain kinds of chronic pain in the body, including migraine headaches, severe non-migraine headaches, and lower back pain. As a result, depression and pain treatments often overlap.

Depression and Headaches

Depression is linked to both migraine headaches and non-migraine headaches, although the strongest relationship is between depression and migraines.

“People with migraines are two to three times as likely to have depression as the general population,” says Richard B. Lipton, MD, a professor and vice chairman of neurology and a professor of epidemiology and population health at the Albert Einstein College of Medicine and director of the Montefiore Headache Center in New York City. People who have chronic migraines — those who experience migraines 15 or more days of the month — are about twice as likely to have depression as people with episodic migraine, meaning those who experience migraines less than 15 days a month.

The research on migraines and depression shows that the relationship goes both ways: People with depression are more likely to get migraines, and people with migraines are more likely to become depressed. In fact, 40 percent of people with migraines also have depression. “Migraines and depression have common underpinnings in the brain, which can develop due to environmental factors, genetic causes, or a combination of both,” Dr. Lipton says. “Migraine pain and depression are also linked because both conditions respond to some of the same medications.”

However, the link between depression and pain from non-migraine headaches isn’t a two-way street. “Severe non-migraine headaches clearly increase your risk for depression, but depression doesn’t increase your risk for non-migraine headache,” Lipton says. A study published in the journal Headache showed that people with a form of non-migraine headache called cluster headache are more likely to have depression than people who don’t have cluster headaches.

Depression and Pain Treatment: “Overlap” Medications

There are a number of medications that can help ease both depression and pain. “Whether you’re depressed or not, antidepressant medications seem to have some ability to turn down pain signals, so they’re usually part of a treatment plan for back pain, migraines, and other forms of chronic pain,” Dr. Hullett says.

Antidepressants work for both depression and pain because they act in the same parts of the brain where mood and pain tend to overlap. For both migraine and non-migraine headaches coupled with depression, an older class of antidepressants called tricyclic antidepressants can work well. “Interestingly, in people who have both migraine pain and depression, a small ‘anti-migraine’ dose is usually sufficient for depression treatment as well,” Dr. Cook says. “This may be because when the pain gets better, the depression often gets better, too.”

However, other types of pain require different solutions. “If you have arthritis, muscle strain, or pain from a recent surgery, using a medication that works at the site of the pain or injury is important,” Cook says. Luckily, some of the medicines that affect pain in the body also affect mood areas of the brain, and thus work as depression treatments, too. “Opiate medications such as codeine can do this, for example,” he says.

Other Options for Treating Depression and Pain

“Non-drug treatments can be very effective in making both depression and pain less severe and incapacitating,” Hullett says. These treatment options include:

Cognitive behavioral therapy (CBT). This is one of the best-studied treatments for depression and pain. “CBT is specifically designed to deal with the emotions, sensations, and anticipations that occur in the mind because of pain,” Hullett says.
Psychotherapy. Experts say you’re more likely to feel pain in response to negative feelings. For people who see the world through physical sensations rather than emotional ones, Hullett says that psychotherapy, or talk therapy, can help with both depression and pain.
Relaxation therapy. “By activating what is known as the ‘relaxation response,’ relaxation therapy can be of great benefit in treating both depression and pain because it changes the steroid hormone response in a way that allows the body to repair itself,” Cook says. “Plus, it affects the way you experience pain in a positive way.”

One form of relaxation therapy that may be particularly useful as a treatment for depression and pain is progressive muscle relaxation. “Chronic pain often involves muscle spasms or muscle tension,” Hullett says, “so it’s great if you can learn how to relax those muscles.”
Complementary therapy. If you’re open-minded about complementary therapies, Hullett says that acupuncture, acupressure, yoga, massage, and hypnotherapy can all help treat depression and pain.
Support groups. “People who have depression and pain should recognize that they’re not alone,” Cook says. “In addition to the professional help you may be able to get from your primary care physician, psychiatrist, or pain specialist, you may also find benefit in support groups.” To find a support group in your area, refer to the American Chronic Pain Association. For online support, check out the Everyday Health Managing Pain group.

Antidepressants are designed to ease overwhelming sadness and depression — but that doesn’t mean you should be numb to happiness, love, and satisfaction. Here’s what to do if your medication is depleting you of all your emotions.

By Madeline Vann, MP

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

Emotional blunting — an overall unfeeling or numbness — is a common complaint of depression patients prescribed to certain antidepressants. This diminished capacity to have feel-good emotions during positive moments can be a significant side effect for some people taking selective serotonin reuptake inhibitors, or SSRIs.

And when research supporting the idea was first discussed at a national conference in 2002, mental health professionals nodded in agreement over the existence of this unwanted side effect, recalls psychiatrist Heidi Combs, MD, an assistant professor of psychiatry at the University of Washington in Seattle.

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

Who Experiences Emotional Blunting?

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

“If something positive is going on, these patients might not have the full response,” Combs says. Though there are many case studies, the lack of large clinical studies makes it difficult to predict which people will experience this side effect — and which ones won’t.

Part of the problem is the very nature of depression. People struggling with depression often complain that they have lost some of their ability to respond emotionally to events and people around them. So for a long time, emotional blunting caused by antidepressants was written off a as symptom of hard-to-treat depression.

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

Get Your Glee Back: What to Do About Emotional Blunting

To regain your pleasure response, Combs recommends these solutions:

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

Some experts say depression comes with a number of upsides. Here are seven ways the condition could actually make you healthier — and happier — once your symptoms get better.

By Madeline Vann, MPH

is depression good for you
If you’ve ever grappled with depression, there’s a good chance you’ve got nothing pleasant to say about the illness — and for good reason: Depression can leave you brokenhearted, hopeless, and uninterested in the activities you once loved.

But according to some mental health experts, depression has a positive side. These “glass-half-full” specialists say that the symptoms of depression may actually be evolutionary adaptations.

“One way to think about it is the natural problem-solving capacities of depression,” explains J. Anderson Thomson, MD, assistant director of the Center for the Study of Mind and Human Interaction at the University of Virginia in Charlottesville.

The idea: Depression lets your body know that there’s a big problem in your world — and it forces you to focus on that problem and solve it. That may be why people who are depressed can’t seem to get moving in other areas of their lives. In that regard, says Dr. Thomson, depression is similar to pain, which signals your brain that some part of your body needs help. If the problem is too big for you alone, chances are that pain will make you cry out, signaling to people around you that you need help. Similarly, depression’s severity is a way of calling out to friends for help. At the extreme, suicidal thoughts and even attempts are their own cries for help.

“Depression tells you there’s a problem, tells you where the problem is, stops business as usual, and signals others that you are in distress,” explains Thomson.

But that’s not all: Recent research has explored a number of possible positives to depression, keying in on the unique skills you learn in order to deal with depression.

7 Ways Depression Makes You Stronger

Here’s what research is showing:

You’re a better problem-solver. One of the symptoms of depression is poor concentration; another: an almost obsessive rumination about a problem in your life. To work out these symptoms, you may need a therapist or adviser to help you work your way through it — to help you focus your attention on solving an existing problem. The upside? Those analytical skills could be put to use effectively in your life. In fact, recent research suggests that depressed people make more informed decisions because they take longer and invest more effort in making their decision. “There’s an implicit assumption that we are sadder but wiser,” explains Andreas Wilke, PhD, assistant professor of psychology at Clarkson University in Potsdam, N.Y., and a memory and cognition researcher who has tested depressed people’s decision-making abilities.
You learn how to cope. The process of finding your way out of depression may help you become better at coping. The problem, Thomson says, is that many people initially choose disastrous coping mechanisms. “Drinking won’t help a fishhook in your hand and it won’t help depression,” he says. Poor coping choices will just compound your troubles. Instead, work with your therapist to learn the coping skills you need.
You have better relationships. Some people find that depression is a wake-up call for prioritizing what’s important in their lives. “Most of the things that involve depression are interpersonal problems,” says Thompson. Pay attention to what you learn from depression, and use it to make your relationships better. In addition, research suggests that depressed people actually have greater sensitivity to social dynamics.
You’re more compassionate. According to some experts, depression may help you gain a deeper sense of compassion for others going through tough times.
You buck stress. Depressed people spend a lot of time trying to figure out what went wrong, and through this process, with the help of a therapist or others, they can learn how to avoid or manage future stressful situations.
You’re a realist. Research suggests that depressed people have a more realistic understanding of when they have control in situations than people who are not depressed. They also seek out negative feedback about their performance. The upside? A sensible view of situations and the people in them.
You can detect deception. Sniffing out a lie can be tricky, but people who are depressed seem to be better at knowing when someone is deceiving them. Chalk it up to the enhanced social awareness and a more realistic view of life that seems to come with depression.
“Depression is part of the design of human nature, and just because it’s painful doesn’t mean it’s bad or without its uses,” Thomson says.

A New Way of Treating Depression?

Could this new understanding of depression lead to new ways of treating depression? According to Paul Andrews, PhD, a researcher at the Virginia Institute of Psychiatric and Behavioral Genetics in Richmond, the traditional approaches of medication or therapy to distract or reduce depressive rumination could actually derail this natural process. “The next generation of talk therapy has given up on changing the way patients think,” he says. “Instead, it is helping them accept their thoughts.”

Mindfulness-based therapies and even expressive writing seem to be more effective in managing depression than treatments that seek to change the way you think. “You have a quicker response and reduced risk of relapse,” says Andrews.

Still, if your quality of life is significantly impaired — for example, you can’t eat or sleep, or your relationships are floundering — or you start to believe suicide is a solution to your problems, seek help. With the guidance of your doctor or therapist, you can both treat your depression — and learn how to reap its benefits.

y TRACI PEDERSEN Associate News Editor

In Older Adults, Just One Drink Affects Driving SkillsHaving a blood alcohol level just under the legal limit of 0.08 — typically just one drink — can still affect the driving abilities of older adults, according to a new University of Florida (UF) study.

Sara Jo Nixon, Ph.D., a professor in the departments of psychiatry and psychology at the University of Florida and doctoral candidate Alfredo Sklar conducted the study to see whether non-intoxicating levels of alcohol would affect the driving skills of 72 participants who fell into one of two age groups: ages 25 to 35 and ages 55 to 70.

The study, published in the journal Psychopharmacology, is the latest in a series of studies by Nixon and her team that looks at how even moderate doses of alcohol affect aging adults.

At the beginning of the study, all subjects (completely sober) were given a simulated driving test. Participants — staring straight ahead at a large computer monitor — felt as though they were driving down a winding three-mile stretch of country road.

Two more monitors were placed on either side, mimicking the side windows of a car and showing the drivers what they would see in their peripheral vision. Driving sounds were played through a stereo system. Occasionally, the drivers would encounter an oncoming car, but they did not encounter other distractions.

“There wasn’t even a cow,” said Nixon, who also is co-vice chair and chief of the division of addiction research in the department of psychiatry in the UF College of Medicine and UF’s Evelyn F. and William L. McKnight Brain Institute.

The driving test assessed the participants’ ability to stay in the center of their lane and maintain a constant speed. Researchers also noted how rapidly the subjects moved their steering wheel.

Later, the participants were divided in smaller groups. The first group was given a placebo — a diet lemon-lime soda spritzed with an insignificant amount of alcohol to mimic the experience of drinking alcohol. A second group’s drink was strong enough to produce a 0.04 percent breath alcohol level, and a third group’s drink gave them a breath alcohol level of 0.065 percent — still below the federal legal level for drinking of 0.08.

Participants then completed the same driving task they had performed while sober. Researchers timed the task so participants’ alcohol levels were declining to imitate a situation in which a person would have a drink with dinner and then drive home.

For the older drivers, even the small, legal levels of intoxication affected their driving skills.

In the younger age group, however, alcohol consumption did not affect their measured driving skills at all — a finding that Nixon called a “bit surprising.” She warned that although there was no difference in the laboratory, this does not necessarily mean that their driving wouldn’t be affected in real life.

Nixon noted that the laboratory setting was simplified compared to real-world driving and that the current data doesn’t address potential problems in more complex environments.

Source: University of Florida

Years ago, doctors were mostly concerned with how a child’s health would be affected the longer a mom delayed birth. Now, a father’s age may be a big factor.

Dads who wait until age 45 to have a child may face a significantly increased risk their offspring may have mental health and academic problems including autism, ADHD, schizophrenia, suicidal ideation, low IQ scores and failing grades.

Researchers examined all births that happened in Sweden between 1973 and 2001, and found a child born to a 45-year-old dad was 25 times more likely to have bipolar disorder, 13 times more likely to have ADHD, 3.5 times more likely to have autism, 2.5 times more likely to exhibit suicidal behavior or a substance abuse problem, and twice as likely to have a psychotic disorder like schizophrenia when compared to kids born to a 24-year-old father.

That’s in addition to the increased risk for academic problems.

“We were shocked by the findings,” study author Dr. Brian D’Onofrio, an associate professor in the department of psychological and brain sciences at Indiana University Bloomington, said in a statement.

It presents a worrisome public health risk, given that the average age for childbearing has been on the rise in the past 40 years for both men and women. On average, U.S. married men are about 25.6 years old when they have their first child, compared to 22.5 for single men, according to government statistics. The researchers said fathers in the northeast tend to be older than elsewhere in the country.

For most of the mental health risks identified by researchers, the likelihood for disorders increased steadily the older a dad got, which means there isn’t one particular age threshold that a dad should aim to stay under.

“While the findings do not indicate that every child born to an older father will have these problems, they add to a growing body of research indicating that advancing paternal age is associated with increased risk for serious problems,” said D’Onofrio.

Even when the researchers controlled for other factors that may influence risk for mental health woes in children, including parental income and education levels, the findings remained “remarkably consistent.”

They also compared their findings to siblings born when dad was a younger age, which accounted for different environmental factors since they’d have similar upbringings. They found the risk was even higher for psychiatric and mental health conditions when comparing dad’s age across siblings. The researchers also looked at cousins, finding consistent results for these risk increases.

“These approaches allowed us to control for many factors that other studies could not,” D’Onofrio said.

Other studies have found similar links. Researchers have reported increased risks for autism as dads got older, as well as increased risk in grandchildren. Earlier studies also found intelligence levels dropped in offspring the older the dad got. In many of these studies, genetic mutations transported through a father’s sperm were suspected to increase the risks.

D’Onofrio’s team explained men continue to produce new sperm throughout their lives, and each time they replicate, there’s a chance a DNA mutation might occur. Women meanwhile have a set number of eggs they are born with.

Men also may be exposed to more environmental toxins as they age, which might also cause DNA mutations in sperm.

“Regardless of whether these results should lead to policy changes, clarification of the associations with (advanced aging in dads) would inform future basic neuroscience research, medical practice, and personal decision-making about childbearing,” the researchers concluded.

Their new study was published Feb. 26 in JAMA Psychiatry.

There is a big difference between being busy and being effective. Any fool can be busy but that does not mean that they are doing anything important. When you look back upon your career or your life, you will not focus on the quantity of work that you completed; you will focus on the important achievements and the value you added. That is why the most effective people focus on the most important tasks. If it doesn’t make a difference, it doesn’t get done. They know their priorities and they regularly conduct a time management review to ensure that they stick to them.

Knowing your priorities is critical to effective time management. Once you have a clear vision for the life you desire, your priorities are the key areas of focus which will allow you to make that vision real. When life gets hectic, and there are number of people making requests of you, it is easy to fall into the trap of completing the most urgent tasks i.e. he who shouts loudest wins. This is no way to run your schedule. Urgent tasks are rarely important and rarely aligned with your priorities. It is important to hold a regular time management review where you question the importance of each activity, to help keep you aligned with your priorities. The following questions offer simple but effective ways to remind yourself of your priorities.

6 Powerful questions for your time management review

It is important that you conduct a regular time management review of your schedule, and the work you have completed, to determine whether you are sticking to your priorities. The following questions will help to keep you focused on your priorities:

1. If your workday was halved, what work would you complete?

This will help you to identify your priorities. The first priority of a time management review is to know your priorities. These are the most important tasks for you and the tasks which should be first on your schedule.

2. If your workday was halved, which tasks would you eliminate from your schedule?

There are always tasks which you complete which do not add a lot of value to your day. Once you have identified them, you need to identify ways in which you can remove them from your schedule e.g.

Just do not do them
Automate them
Delegate them
Outsource them
These tasks are offering little value to you and even worse than that, they are stealing time which you could be using to focus on your priorities.

3. Who are the 20% of people who make 80% of the positive contribution?

Pareto’s principle tells us that that 20% of the people we interact make 80% of the positive contribution we derive from relationships. These are your most important relationships. You may think that all relationships are equal but they are not. You need to identify the relationships which add most value to your life and assign to them a level of priority. If you manage and maintain these relationships effectively, they will propel you towards your goals at a much faster speed.

4. Who are the 20% of people who cause 80% of the problems?

Just like the positive contribution, 80% of the relationship problems will come from just 20% of the people whom you interact with. Once you identify these relationships, you can identify ways to manage these relationships better thus reducing the stress and eliminating time waste. In some cases, you will find that it is not necessary to interact with these people, so you are better off distancing them.

Do not overlook relationships when conducting a time management review.

5. Ask ‘What is the one task I could complete to make tomorrow an effective day?’

I like to ask this question every evening, before I sign off for the day. This allows me to identify the most important task for the following day. I generally try to complete the task first thing in the morning, before I even open my email. Once the task has been completed, it doesn’t matter what the world throws at me; I have taken a big stride towards achieving my objectives.

6. Start squeezing time to focus priorities

Parkinson’s Law tells us that a task will expand or contract to fit the time allowed. When you are deciding how long to schedule for a task, you may find that you are allowing a little contingency on top. This is allowing extra time for people to lose focus and go off track. The best example is meetings.

Most people do not have a clue how to run effective meetings. If a meeting requires 45 minutes to cover all the relevant material, they oftne schedule an hour to allow for unforeseen events. With this approach, people will be less focused and stray off topic. The meeting ends up taking much longer than required and becomes a burden for most of the attendees. However, if you allow 40 minutes and strictly adhere to it; people will be prepared in advanced, focused on the priorities, and stick to the agenda. The same is true for all tasks. Set a strict time allowance and you will find yourself, and others, to be more focused and more effective.

The key to an effective day does not lie in the quantity of work completed. It is the quality of the work which determines whether you have been effective or not. You do not need to do everything; you only need to do the right things. You can ensure that you get the right tasks done by focusing on your priorities. The 6 questions, above, will help you to maintain a clear focus on your priorities. Conduct a personal time management review each week, and ask these questions of yourself. You will improve your focus and you will see far better results. Start using a time management review today.