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Una: Would you elaborate on the importance of sleep for a Bipolar person? Watkins: If you are going into a manic spell buy norfloxacin once a day bacteria on face, you often begin to sleep less buy norfloxacin 400 mg antibiotics for uti macrobid. Many people find that they have fewer breakthrough mood swings if they maintain a regular sleep-wake cycle and a regular amount of activity order norfloxacin with mastercard bacterial 70s ribosome. Even time shifts and jet lag can set off some mood shifts. Because of financial considerations and geographic distance, it is difficult to get professional help. My question concerns side effects of Effexor and long term use of it. My side effects are sweating on my upper body with the least amount of activity, and sweating on the sides and back of my head when I rest. Watkins: The SSRI medications can cause excessive sweating in some people and I would expect that Effexor might do this also. You could talk to your doctor about a medication change. Alternatively, you could wear loose clothing and turn down the thermostat. David: In this case, what other medications might prove effective without these side effects? Wellbutrin, Serzone and possibly the tricyclic antidepressants might be less likely to cause sweating. David: On the subject of side-effects from psychiatric medications, should people taking these meds expect side-effects? Watkins: The SSRI medications generally cause fewer side effects than some of the older antidepressants, but they can cause side effects in some people. Many people, especially those on high doses of SSRIs, get sexual problems from medications; often decreased desire or delayed orgasm. I see the restlessness more in children and adolescents. That is why I am less likely to use Prozac as my first choice for a SSRI in some children. There are a number of other side effects of SSRIs including weight gain and headaches. If you have decreased sexual desire on a SSRI, there are several options. You might switch to another class of medications such as Wellbutrin or Serzone. If despite the sexual side effects, you wanted to stay on the SSRI, you could lower the dose, or you could add Ritalin, or Wellbutrin. Sweating is one of the side effects listed for Effexor in Healthy Place psychiatric medications list. Watkins: The sweating is usually more annoying than serious. If it were accompanied by confusion, excessive salivation or other bad side effects, then call the doctor. Watkins: Some women with PMS, take a higher dose of an SSRI the five or six days before their menstrual period. Before you do this, you and your doctor should chart your moods daily for about three months. See if there is a correlation between your monthly cycle and your moods. Moody Blue: What do you think about the drug Topamax being used for patients with mixed states? Johns Wort in a few patients who did not do well on several other antidepressants. I have also used Fish Oil (Omega 3 Fatty Acids) for mood swings. However, I prefer to try the more established medications first. Since we have very little data on mixing these herbal compounds with traditional medications, I prefer the person to be off other antidepressants before we try the alternative treatments for depression or bipolar disorder. Is it possible my son can get depression, and are there ways I can help prevent serious depression? Watkins: You should be sure that your son gets a lot of affection from family. Encourage him to develop a mind-set that he can solve problems and that life is not a helpless situation. If he does get depression, you may be in a good position to see it and get him help early. I recommend that children with a family history of depression or bipolar disorder get education about drug abuse and responsible sexual behavior. They are at increased risk for these problems, and a lot can be done for prevention. David: How important a role does nutrition play in maintaining mood stability? Watkins: My patients sometimes say that I act like their mother: Eat your breakfast, eat a balanced diet and exercise regularly. I believe that there was a recent study out of Duke that suggested that regular exercise helped depression. I have sometimes thought that the extreme Ketogenic diets make some people more irritable. You can click on this link, sign up for the mail list at the top of the page so you can keep up with events like this. Johns Wort being dangerous in combination with certain foods, much the way the MAOIs are. The jury is still out on combining it with other medications. Also the herbal compounds are not tightly regulated like regular medications. The dose of St Johns Wort can vary from pill to pill. There is an active ingredient in SJW that is a chemical, just like the active ingredient in traditional meds are chemicals. I have Hepatitis C and I am worried about the effects that Lithium will have on my liver. Watkins: With Lithium, we keep track of the kidneys and the thyroid.

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Group experiences are critical to all survivors if they are to overcome the secrecy order discount norfloxacin infection high blood pressure, shame buy norfloxacin 400mg cheap antibiotics haven't worked for uti, and isolation of survivorship order norfloxacin with american express bacteria animation. Stabilization may include contracts to ensure physical and emotional safety and discussion before any disclosure or confrontation related to the abuse, and to prevent any precipitous stop in therapy. Physician consultants should be selected for medical needs or psychopharmacologic treatment. Antidepressant and antianxiety medications can be helpful adjunctive treatment for survivors, but they should be viewed as adjunctive to the psychotherapy, not as an alternative to it. Developing a cognitive framework is also an essential part of stabilization. This involves sorting out how an abused child thinks and feels, undoing damaging self-concepts, and learning about what is "normal". Stabilization is a time to learn how to ask for help and build support networks. The stabilization stage may take a year or longer--as much time as is necessary for the patient to move safely into the next phase of treatment. Diagnosis is in itself a crisis, and much work must be done to reframe DID as a creative survival tool (which it is) rather than a disease or stigma. The treatment frame for DID includes developing acceptance and respect for each alter as a part of the internal system. Each alter must be treated equally, whether it presents as a delightful child or an angry persecutor. Mapping of the dissociative personality system is the next step, followed by the work of internal dialogue and cooperation between alters. This is the critical stage in DID therapy, one that must be in place before trauma work begins. Communication and cooperation among the alters facilitates the gathering of ego strength that stabilizes the internal system, hence the whole person. Revisiting and reworking the trauma is the next stage. This may involve abreactions, which can release pain and allow dissociated trauma back into the normal memory track. An abreaction might be described as the vivid re-experiencing of a traumatic event accompanied by the release of related emotion and the recovery of repressed or dissociated aspects of that event (Steele Colrain, 1990). The retrieval of traumatic memories should be staged with planned abreactions. Hypnosis, when facilitated by a trained professional, is extremely useful in abreactive work to safely contain the abreaction and release the painful emotions more quickly. Some survivors may only be able to do abreactive work on an inpatient basis in a safe and supportive environment. In any setting, the work must be paced and contained to prevent retraumatization and to give the client a feeling of mastery. This means that the speed of the work must be carefully monitored, and the release painful material must be thoughtfully managed and controlled, so as not to be overwhelming. An abreaction of a person diagnosed with DID may involve a number of different alters, who must all participate in the work. The reworking of the trauma involves sharing the abuse story, undoing unnecessary shame and guilt, doing some anger work, and grieving. Throughout this mid-level work, there is integration of memories and, in DID, alternate personalities; the substitution of adult methods of coping for dissociation; and the learning of new life skills. This leads into the final phase of the therapy work. There is continued processing of traumatic memories and cognitive distortions, and further letting go of shame. At the end of the grieving process, creative energy is released. The survivor can reclaim self-worth and personal power and rebuild life after so much focus on healing. There are often important life choices to be made about vocation and relationships at this time, as well as solidifying gains from treatment. This is challenging and satisfying work for both survivors and therapists. Coming through this intense, self-reflective process might lead one to discover a desire to contribute to society in a variety of vital ways. Diagnostic and statistical manual of mental disorders (4th ed. An office mental status examination for complex chronic dissociative symptoms and multiple personality disorder. Psychiatric Clinics of North America, 14(3), 567-604. Facilitating the identification of multiple personality disorder through art: The Diagnostic Drawing Series. Diagnosis and treatment of multiple personality disorder. Multiple personality disorder: Diagnosis, clinical features, and treatment. Abreactive work with sexual abuse survivors: Concepts and techniques. The structured clinical interview for DSM III-R dissociative disorders: Preliminary report on a new diagnostic instrument. Psychotherapy and case management for multiple personality disorder: Synthesis for continuity of care. Psychiatric Clinics of North America, 14(3), 649-660. The empowerment model for the treatment of post-abuse and dissociative disorders. Skokie, IL: International Society for the Study of Multiple Personality Disorder. She is the medical director of The Center: Post-Traumatic Dissociative Disorders Program at The Psychiatric Institute of Washington. A general and forensic psychiatrist in private practice, Dr. Turkus frequently provides supervision, consultation, and teaching for therapists on a national basis. She is co-editor of the forthcoming book, Multiple Personality Disorder: Continuum of Care. Dissociative Disorder CommunityFrom the Archives of Dissociative Living... Multiple Personality Disorder Part 3We have 2514 guests and 3 members onlineHTTP/1. Since then, Debbie has devoted her life to keeping children safe. She is the Founder and President of the child protection group, Safeguarding Our Children - United Mothers (SOC-UM).

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Overall order norfloxacin now antibiotic yeast infection symptoms, self-harm can be seen as a way of dealing with stress cheap norfloxacin 400mg mastercard antibiotics for acne and yeast infections. The goal of self-harm is to physically injure the self and not to die discount 400mg norfloxacin mastercard infection map. In fact, many people use self-injury as a way to avoid suicide. Suicide attempts and self-mutilation behaviors do correlate, however, with those who have self-harmed being much more likely to attempt suicide or have a plan for suicide. The cause of self-injury can really be seen as emotional distress and if this distress is not alleviated, it can result in suicidal behavior. As the main reasons for self-injury relate to stress, one of the main environmental components of self-harm is the presence of trauma or stress. This may be a past trauma, such as sexual assault, or current stress such as the pressure to succeed. One of the stressors known to create a risk for self-harm is sexual orientation. Those in a sexual minority group are more likely to self-injure. Specifically, females who identify as bisexual are at a higher risk for self-mutilation. There are various psychological reasons for self-mutilation but the overwhelming factor is the presence of unmanageable anxiety. The self-injury, then, is a way of releasing or dealing with this chronic anxiety. Self-harm becomes a coping mechanism, albeit a negative one. Self-injury is also commonly used to deal with overwhelming sadness or emotional numbness. While a disorder does not specifically cause the behavior, those with certain mental health disorders are at a higher risk. Disorders associated with self-mutilation include:Posttraumatic stress disorderPeople cite other reasons they self-harm, however. These self-harm quotes may provide insight into that. Some other causes of self-injury include desires to:Experience a feeling in the face of numbnessControl the body and mindExpress feelings or needsDistract from other problemsCreate visible and noticeable woundsReenact a trauma in order to resolve itProtect others from emotional painA small number of people also report good feelings and a rush of energy as the reasons for self-harm. The effects of self-harm, also known as self-injury and self-mutilation, are varied and are both physical and psychological. While the physical effects of self-injury might be obvious and harmful, the psychological effects of self-mutilation are no less damaging. People are often devastatingly tormented by both their self-harming behaviors and their desire to self-harm. The effects of self-injury are not all bad though, and this is why some people continue to self-mutilate. Some of the positive effects of self-harm might be:Expression of difficult feelingsCommunicating that you need helpRelease of pain and tensionDistraction from overwhelming, painful emotions or circumstancesFeeling alive or feeling something rather than feeling numbThe positive effects of self-harm, though, are temporary and are outweighed by the physical and psychological damage caused by self-mutilation. The physical effects of self-harm can be minor, such as a scratch or small bruise or, in rare cases, life-threatening. No matter how severe though, all physical effects of self-injury indicate the unmanageable pain the person is in and the severity of the injury does not indicate the severity of the pain. Most people who self-mutilate do so more than once, so any physical effect of self-mutilation seen may indicate a worrisome behavioral pattern. Not only do strong emotions tend to drive people to self-harm, the self-harm itself, in turn, may cause strong emotional reactions. Some of the psychological effects of self-injury include:A desire to be alone in order to self-harm or to hide the evidence of self-harm. The stress and difficulty of having to lie to those around you about the self-injuryUsing self-injury to deal with any emotional stress instead of building positive coping techniquesAn overwhelming desire to self-injure to the point where it feels like you can no longer control the behaviorLow self-esteem and self-hatredSelf-injury behaviors are any behaviors that a person does with the purpose of hurting oneself. How to stop self-harm once you start though can be a big problem. Many people go on to years though because they find it so difficult to stop self-harm. The environment is part of what causes, or allows for, self-harm and changing it can help stop self-injury. The first step is analyzing what role the environment has on self-injury behavior. For example:Do you self-injure at a specific time of day? Knowing the answers to these questions can help you change those aspects of your environment that contribute to your self-harm behaviors. For example, to help stop self-harm, you can:Keep yourself busy at the times of day you are likely to self-harm. Stay away from any place where you typically self-injure. Stop yourself from committing self-harm rituals by adding or removing steps from them. Altering your rituals will likely make you uncomfortable and this discomfort can help stop self-harm. Many people battle to stop self-mutilation but lose this battle when fighting alone. Self-injury help and support can come from professional sources such as a self-harm treatment center, program or psychotherapist, or it can come from friends, family members or others. The important thing is to have supportive people around you who you can turn to for help when you need it. If you feel the urge to self-harm, call one of these supports and have them talk or sit with you. This can be one of the easiest ways to stop self-mutilation. Changing the way you think is no easy task; that is for sure. However, changing some of the negative thoughts that lead to self-injury is possible and important. Some questions to think about might be:How accurate are my thoughts surrounding self-harm? Handling those thoughts can be tricky but there are techniques used to challenge, stop and alter negative thoughts of self-harm. If you find yourself in a spiral of negative thoughts, think (or even shout) stop and change your thoughts to something else. A therapist can help you with more self-harm stopping techniques.

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Depression has been reported as a birth control side effect trusted norfloxacin 400 mg virus x reader dmmd; however cheap norfloxacin online visa bacteria cell, birth control pills have also been shown safe in women with depression generic 400mg norfloxacin fast delivery homeopathic antibiotics for acne. Alcohol is a depressant and acts on the brain in varied and complex ways. Among other things, alcohol affects serotonin and glutamate, two chemicals thought to play a role in depression and about 40% of those who drink heavily show depressive symptoms. While alcohol likely does not cause depression directly, drinking does increase the risk of depression and tends to worsen existing depression symptoms. Alcohol can also cause severe interactions with some depression medications. While the idea that Facebook causes depression may seem outlandish, there are psychological impacts of social media that can contribute to feelings of loneliness and lower life satisfaction. Teens that spend too much time online tend to overestimate the positive aspects of the lives of their friends, seeing only the positive information their friends share on Facebook. Cyber-bullying, which commonly occurs on Facebook, is another possible cause of teen depression. Heavy marijuana smokers are diagnosed with depression more frequently than nonsmokers; however, it is not thought marijuana causes depression directly. It is thought many people with depression use marijuana as a way to cope with their depressive symptoms. A 2007 study shows small amounts of the active chemical in marijuana (THC), can actually reduce depressive symptoms while larger doses worsen depression and other mental illnesses. However, an unhealthy diet has been shown to increase your risk of developing depression as well as other illnesses. Those with depression may also want to limit caffeine intake. Low testosterone has not been conclusively identified as a cause of depression. However, low testosterone levels are associated with depression in older men. There is no documented evidence antidepressants cause depression; however, there is a warning on antidepressants indicating antidepressants may worsen depression symptoms. This warning was issued by the Food and Drug Administration (FDA) and is called a "black box" warning, which is the most serious warning the FDA can place on a product. Any changes should be reported to the prescribing physician immediately. Changes in hormones may be a contributing factor to depression. In menopause, women experience changes in estrogen levels. Women, particularly those with a past history of depression, are at an increased risk of developing depression during menopause; however, menopause does not directly cause depression. Postpartum depression is common with between 10% - 15% of women experiencing depression after the birth of a child. Postpartum depression is most common in women with existing risk factors such as: Previous mental illnessExperiencing a stressful birthHTTP/1. Falcon, Counseling PsychologistStep-by-step guidelines for overcoming depression and finding happiness. Why people become depressed and ways to overcome depression. Trials give you strength, sorrows give understanding and wisdom. Depressed people often lose interest in many activities and social contacts because of loss of pleasure in and enthusiasm for their usual activities. Low energy, chronic tiredness, excessive sleeping, and insomnia are common. Other possible symptoms of depression include poor appetite, heavy eating, weight loss or gain, feelings of inadequacy or worthlessness, anxiety, regrets, decreased productivity, poor concentration, or recurrent thoughts of death or suicide. Four out of five cases of severe depression clear up without treatment within six to nine months, but half of the people with severe depression experience it again later. People often become depressed about marital, romantic, or family problems. For example, one study found an unhappy marriage increased the risk of clinical depression 25 times over untroubled marriages. A personal loss often triggers depression: divorce, separation, loss of a job, the end of a love relationship, physical or mental problems from old age, the death of a loved one, etc. Many stressful events or major changes may also help bring on depression. Going away to college or moving far away from family and friends after getting married may lead to depression. No matter how much you wanted to have a child, the resulting loss of freedom may cause depression. When children grow up and leave home, you may become depressed. Retirement can lead to depression because of loss of work activities to fill the day and loss of friendships with coworkers. Depression may occur without any loss or great stress to trigger it, however. The chronic use of alcohol or other drugs often leads to mood swings, personal problems, and depression. Using alcohol or other drugs to improve your mood is especially risky because addictive substances often intensify pre-existing mood or personality problems. Even prescribed medications may lead to severe depression. There are many effective ways to overcome depression. Fortunately, we can control our thoughts and feelings much more than most people realize. With enough work and effort, you can change habitual thoughts and feelings. First, however, if you are on any medicines, check with your doctor to see if a medicine may be causing your depression. A surprising number of medicines can do this, including many tranquilizers or sleeping pills, many high blood pressure medicines, hormones such as oral contraceptives, some anti-inflammatory or anti-infection drugs, some ulcer medicines, etc. Changing your prescribed medications may be all you need to eliminate depression. Some severely depressed people need medicines to control their depression, but most people can conquer depression by following the suggestions in this excerpt. Even those people on prescribed medicines for depression will benefit from the suggestions here. If you feel severely depressed, most psychiatrists will use trial and error to find a drug that will help you.

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