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Nervousness and insomnia (trouble falling asleep or waking often during the night) these may occur during the first few weeks order lasix cheap heart attack indigestion; dosage reductions or time will usually resolve them order lasix 100 mg on line arrhythmia synonym. Agitation (feeling jittery) if this happens for the first time after the drug is taken and is more than transient discount lasix 40mg mastercard blood pressure medication what does it do, the doctor should be notified. Sexual problems the doctor should be consulted if the problem is persistent or worrisome. In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses. The study was designed to include 336 patients with major depression of moderate severity, randomly assigned to an 8-week trial with one-third of patients receiving a uniform dose of St. The study participants who responded positively were followed for an additional 18 weeks. At the end of the first phase of the study, participants were measured on two scales, one for depression and one for overall functioning. There was no significant difference in rate of response for depression, but the scale for overall functioning was better for the antidepressant than for either St. The Food and Drug Administration issued a Public Health Advisory on February 10, 2000. Therefore, health care providers should alert their patients about these potential drug interactions. Some other herbal supplements frequently used that have not been evaluated in large-scale clinical trials are ephedra, gingko biloba, echinacea, and ginseng. Any herbal supplement should be taken only after consultation with the doctor or other health care provider. Many forms of psychotherapy, including some short-term (10-20 week) therapies, can help depressed individuals. Two of the short-term psychotherapies that research has shown helpful for some forms of depression are interpersonal and cognitive/behavioral therapies. Cognitive/behavioral therapists help patients change the negative styles of thinking and behaving often associated with depression. These therapies are often reserved until the depressive symptoms are significantly improved. In general, severe depressive illnesses, particularly those that are recurrent, will require medication (or ECT under special conditions) along with, or preceding, psychotherapy for the best outcome. Depressive disorders make one feel exhausted, worthless, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and typically do not accurately reflect the actual circumstances. Negative thinking fades as treatment begins to take effect. In the meantime:Set realistic goals in light of the depression and assume a reasonable amount of responsibility. It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant transition change jobs, get married or divorced discuss it with others who know you well and have a more objective view of your situation. The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Invite the depressed person for walks, outings, to the movies, and other activities. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure. Do not accuse the depressed person of faking illness or of laziness, or expect him or her "to snap out of it. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better. If unsure where to go for help, check the Yellow Pages under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians" for phone numbers and addresses. In times of crisis, the emergency room doctor at a hospital may be able to provide temporary help for an emotional problem, and will be able to tell you where and how to get further help. Family service, social agencies, or clergy 1 Blehar MD, Oren DA. Depression as an antecedent to heart disease among women and men in the NHANES I study. Archives of Internal Medicine, 2000; 160(9): 1261-8. Diagnosis and treatment of depression in late life: consensus statement update. Journal of the American Medical Association, 1997; 278:1186-90. Psychiatric Disorders in America, The Epidemiologic Catchment Area Study, 1990; New York: The Free Press. Estrogen-serotonin interactions: Implications for affective regulation. Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. Journal of the American Medical Association, 1998; 338:209-16.

For those not afflicted with the Borderline Disorder this is a nightmare we hope never happens to us order lasix once a day blood pressure erectile dysfunction. Borderlines experience it over and over - especially when confronted with stress purchase generic lasix prehypertension quiz. Borderlines will do almost anything to make dysphoria go away order lasix 40mg visa pulse pressure variation formula. Most impulsiveness and self-destructiveness is an effort to relieve dysphoria. Some borderlines, especially those suffering very severely, will literally cut their bodies during dysphoria. Borderlines are victims of an incredibly painful illness... The symptoms can be so unpleasant to those interacting with borderlines that feelings of compassion and understanding may be difficult or impossible to feel. Borderlines desperately want to be loved, but their illness makes them at times seem unlovable. They are terrified of being abandoned, yet are powerless to keep the illness from destroying relationships. Genetic factors are important - borderline tends to run in families. The risk of developing borderline is 6 times higher when a close relative has the disorder. In studies of identical twins, researchers have discovered that many personality traits are genetically determined. Borderlines commonly suffer from other disorders as well. PMS, depression, hypothyroidism, vitamin B 12 deficiency, other personality disorders, anxiety, eating disorders, and substance abuse problems are the most common. Intelligence is not affected by the disorder, but the ability to organize and structure time can be severely impaired. While many borderlines suffered from abuse or neglect in childhood, some developed the disorder from head injuries, epilepsy, or brain infections. Early parental loss and incest are commonly associated with borderline. The facts indicating a medical origin are impressive: Brain wave studies are frequently abnormal. If borderline was exclusively an emotional illness, why would all these medical neurological abnormalities be present? Serotonin problems can cause anxiety, depression, mood disorders, improper pain perception, aggressiveness, alcoholism, eating disorders and impulsivity. Serotonin deficiencies can cause many problems, especially suicidal behavior. Low levels of serotonin increase the risk of self-destructive or impulsive actions during a crisis. In those who attempted suicide unsuccessfully, 2% will likely be dead within one year. If the serotonin metabolite level is low, that risk increases to 20%. Due to new developments in medicine, borderlines can now be treated and often cured. The medication fluoxetine (Prozac) usually stops most of the mood swings in a few days. It is, in my opinion, as big a breakthrough for borderlines as insulin was for diabetics. Borderlines generally see themselves very profanely. Feelings of desperation and hopelessness are often replaced by optimism and motivation once Prozac stops the mood swings and the patient begins to realize that a happier, more successful life is possible. While the underlying problems are probably structural within the brain, the borderline is left with a lifetime of bad experiences and inadequate skills for recovery. No medication should be given without proper medical supervision. This is particularly true for the drugs used to treat the borderline disorder. Some medicines make the symptoms of borderline worse, especially amitryptiline (Elavil) and alprazolam (Xanax). The antidepressant fluoxetine (Prozac), a serotonin increaser, virtually eliminates the mood swings. Feelings of anger, emptiness and boredom are often eliminated or reduced as well. While some need the medication indefinitely, many have been able to stop it after a year without the mood swings returning. They are remarkably helpful for treating dysphoria and psychosis, and can be preventive when the borderline is undergoing stress. They should only be used as needed, like using an antacid for heartburn. These medications can be effective at low doses, and must be taken with great caution. While medications can help with some symptoms, the brain is clearly broken. After a stroke, the brain needs therapy to let the healthy areas take over for the broken ones. The psychology of positive thinking is very helpful. Devote as much time as possible for 3-6 months reading positive self-help books and listening to motivational tapes - especially those by the motivational speaker Zig Ziglar... Common symptoms include unawareness spells, feeling like things are unreal, and numbness of body parts. These symptoms are more common under stress, depression, severer dysphoria, and incest crisis. They can be treated with the epilepsy medication carbamazepine (Tegretol)... Borderlines are VICTIMS - they did not cause their illness. The National Institute of Mental Health (NIMH) has been the single most influential source of unbiased study and information regarding the true biology behind the borderline personality disorder. Cowdry and Gardner in 1987 showed the effectiveness of Tegretol (carbamazepine) and neuroleptics, and the dangers of Xanax (alprazolam).

Instead purchase lasix 100mg on line pulse pressure of 20, I tried to think of the happiest purchase lasix 100 mg online hypertension 180100, healthiest people I knew who would not judge or reject me for seeking their company best 40mg lasix blood pressure medication refills. Over the next two years, I watched these "normal" friends eat and party and talk, and I tried to imitate them, spending less time by myself, seeking out people who made me feel good and accepted. Two months after that summer turning point, I fell in love with a grad student who was so exuberant, so joyful, that I learned what it means to revel in life. I wrote Solitaire as I was phasing out of bulimia - still on my own, with no therapy. Aimee Liu: When Solitaire was published in 1979, I was 25, and I did think I was cured. I was still faking a lot of my confidence, still trying on and throwing off different roles and jobs and relationships in an attempt to find one that would tell me who I was. What I did not realize until many years later, when I wrote GAINING , was that I was still restricting, binge eating, and purging - but I was doing it with sex, work, friends, alcohol, and exercise, instead of with food. Aimee Liu: Because I defined anorexia purely in terms of self-starvation and the confusion of hyper-thinness with identity, I really did think I was done with it. However, I remained a vegetarian well into my thirties, when I became so weak that I consulted a nutritionist who insisted I eat red meat (and when I did, I felt dramatically better overnight). For many years, I ran compulsively, especially during periods of emotional stress, and did more damage to my body through exercise than I had through anorexia. Was getting to the point of saying "I need help" harder this time around than the first time? It did not strike when our marital struggles began a year earlier. It struck when I found myself alone with myself and realized I still had no idea who I was! What was crucially different for me this time around was the therapist my husband and I were already seeing. He was not an eating disorder specialist, but he was a tremendously empathic and wise individual who refused to indulge me when I joked about the "benefits of the divorce diet. I learned to be interested in my actions and feelings instead of running from them. Fortunately, I had not lost a great deal of weight and was nowhere near a dangerously low weight, so my brain was in good shape to cooperate with my mind in this process. I was in psychological but not physical distress, and that made it much, much easier to commit to therapy. I realized just how much of my life had been short-changed by my failure to enter therapy when I was in my teens. Natalie: What, specifically, were the differences between the treatment you received after the eating disorder relapse compared to the first time in your 20s? Aimee Liu: There was no comparison because there was no treatment when I was in my 20s! Mindful awareness has dramatically changed my life today. As the genetic research proceeds, there will also doubtless be more effective medications that should help some people. Mindful awareness has scientific support as a means to reduce stress, improve attention, boost the immune system, reduce emotional reactivity, and promote a general sense of health and well-being. Eating disorders overlap with so many other conditions - OCD, anxiety disorders, PTSD, personality disorders, depression - that there can be no "one size fits all" treatment. It does seem to me, however, that all eating disorders serve as distress signals. I believe these signals come through the body from regions of the brain that are not fully conscious, and so the goal in treatment has to be to "read the signal" and identify the true source of distress, then develop effective coping strategies to resolve, minimize, or learn to tolerate the real distress. Sometimes these strategies involve medication, sometimes mindful awareness training, sometimes cognitive or behavioral therapy. Almost always, full recovery requires the development of a strong and trusting relationship with a compassionate and insightful therapist. I have to emphasize that eating well does not constitute a cure for eating disorders, however vital a first step it may be. Aimee Liu: I call my book GAINING because I really do think that the ability - eagerness, even - to "gain" in all areas of life is a good definition of eating disorder recovery. Note that I say gaining in "life" because I think that eating disorders are seated in core anxieties over what it means to be alive. Someone who is fully recovered embraces genuine (as opposed to superficial) gains in confidence, trust, intimacy, personal power, perspective, insight, faith, joy, nourishment, health, peace, love, and pleasures of the body and mind. Crucially, she makes choices in life out of desire, passion, compassion, and love instead of fear. She does not confuse perfection with suffering, nor does she feel she must measure up to some external standard of perfection. Can you look at your body with appreciation for all that it does, and not berate yourself for how it looks? Can you enter an argument without feeling that you either have to dominate or disappear? Are you able to joke about your human failings and your flaws without secretly feeling ashamed of them? The bottom line is that a person who is fully recovered feels comfortable enough in her body and compassionate enough toward herself that she can extend - offer -- that feeling of comfort to others. Aimee Liu: This is a huge question, and there is no "right" answer. I believe that the ability to connect with another person -- to accept their wisdom -- and to grow with it is key. Most of the people I know who have recovered, have managed to heal this connection with the help of a great therapist or lover or serious friend. This is at the foundation of the new therapies I mentioned earlier... Natalie: One audience member asked this question Aimee: Many of us are told that recovery is an "ongoing process" that never ends. Yet, you speak about having fully recovered as "being cured. Aimee Liu: What never ends are the temperament traits that make us vulnerable to eating disorders. Genetics combine with family dynamics to create the personality types that are most at risk. We have these personalities as long as we live, but once we learn to re-direct our core traits -- perfectionism, hyper-sensitivity, persistence -- to goals and values that have genuine meaning TO US... It helps to develop an arsenal of positive, constructive coping mechanisms -- true friends, passions, interests, music, etc -- that can help us through the bad times. These are "life skills" that will help anyone; we just need to work harder to learn them! Natalie: You interviewed 40 people, women and men, who you knew from your youth. One of the things that really struck me, was the common theme of "shame" that each felt.

Eleven years ago buy lasix 40mg lowest price arteria supraorbitalis, I got a therapist order lasix uk blood pressure wrist cuff, who after one year together drew up a self injury contract order generic lasix canada arteria zygomatica. By that time, we had developed enough trust and we both hoped I would follow a contract. The contract also stated that if I wanted to voluntarily enter the psych hospital, I had to have her approval to do that. I had been going to hospital every other month and now I had to check with my therapist before I went in. It shocks me because I used to slash myself up on a daily basis and attempt suicide every other month or so. Now, as a self-harm alternative, I shave the sides of my head when I feel agonized. It gives me a Mohawk, like an Indian going to war, only I am warring with myself. Both my parents live in the same house with me, and I have one little brother named Matt. I hate confrontation, and I never feel I can fight back because my greatest fear is being abandoned by the people I care about. I tend to lose a lot of best friends, and my mother and I can barely stay in the same room for five minutes without exploding into argument... A friend of mine had gotten hooked on the world of drinking and casual sex. I remember starting out small, just experimentally, wanting to "see how much I could take. I scratched my arm a little with fingernails and paper clips and pricked myself with sewing needles a couple of times. At the beginning of school this year, I was thrown into the worst depression yet. My best friend and the guy I was in love with, Brandon, who I met over the Internet, came up to visit me and fell in love with my only close friend in my town, Heather. Their secret was carried out for a few weeks behind my back before I found out about it. Once I did, Brandon showed no remorse, and Heather broke down into pieces. Desperate to fix both of their lives, I tried to put up a front that I could deal with losing the only two people in my life that I had trusted. One day I swung my shoulder bag over one shoulder, and the braid of wire that my house key dangles from caught the skin of my arm at the sharp end and left a long red scratch in my skin. My days were incredibly difficult to get through, especially trying not to let on how severe my depression had gotten. I went home that night and disassembled my little key chain, coming up with a thick piece of wire with two razor sharp ends (we use it in art class for sculptures). I dragged one end across my arm and red welts popped up. When my parents were told about this, they found it difficult to comprehend, and my mother eventually chose to either ignore it or not care about it. Now, whenever my parents yell at me, which I absolutely cannot take in my state of mind, even over something small, I start shaking. I go into my room and lock the door and frantically go about raising blood drops on my skin until I feel calm again. The sight of my own blood spilling forth sets me back in control. I like to think when I cut, "Okay, now all the pain in your head is in your skin. I refuse to cry in front of people whenever I can help it, so I cut instead. I can count two dozen self-injury scars or cuts on my forearms, which is mainly where I injure myself. When there are absolutely no implements available and I am hurting emotionally beyond what I can take, I hit myself in my shoulders until they bruise. Only one person beside my therapist knows I do this, and some of my friends online that do it as well. A Teenager Cutting Myself: "being a cutter, it is the scars that make me remember. Scars and blood say more for me then words ever could. In speaking to other cutters, I believe the emotions I feel are similar to those of other people cutting themselves. Before I cut, something has usually happened to worsen this. Other times, I feel as if my entire body and mind has gone numb. Normally, when I have what most people call a "good day," I get this sweeping numbness in place of depression... I do feel the calm and the feeling that my pain is draining from mind into body. Eventually, someone will say or do something within the next day that triggers me, and this will combine with my self-hatred and make me lock myself in my room again. Now, hopefully, you have a better idea of why people cut themselves. You might also find it interesting to read about the common personality traits of self-injurers. Celebrities and self harm have gotten more media attention than ever before with breaking stories about Miley Cyrus. Allegations that Cyrus engages in self-injury cutting began to emerge in May 2012 when pictures surfaced in the media showing definite cuts on her wrists. Rumors that the 19 year old is a self-harmer and has an eating disorder abound on the Internet. She says that she checked her closets to make certain no one was hiding in the house for years afterward. Even as an adult, she claims to suffer from horrible, violent dreams due to the experience; one of the effects of rape. During her teen years, Apple suffered from an eating disorder, saying that she had become terribly depressed after the sexual assault. It was after these biting reviews that she began scratching her wrists with her fingernails until her skin bled, which is one of the ways to self-harm. British comedian and actor, Russell Brand, talked about self injury as a teen in his autobiography, My Booky Wook: A Memoir of Sex, Drugs, and Stand-Up. He admitted in a "Time Out Chicago" interview that, in the past, doctors had diagnosed him with bipolar disorder and attention deficit hyperactivity disorder.

This is for your safety and so your health care provider can develop a comprehensive treatment plan buy lasix toronto pulse pressure 60 mmhg. If you use a CAM therapy provided by a practitioner buy lasix visa blood pressure medication used in pregnancy, such as acupuncture best 40 mg lasix heart attack at 20, choose the practitioner with care. Check with your insurer to see if the services will be covered. Is it Government, a university, or a reputable medical or health-related association? Is it sponsored by a manufacturer of products, drugs, etc.? Is it based on scientific evidence with clear references? Advice and opinions should be clearly set apart from the science. For More Information Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be a part of conventional medicine. CAM therapies used alone are often referred to as "alternative. For more about these terms, see the NCCAM fact sheet "What Is Complementary and Alternative Medicine? It is not a good idea to use a CAM therapy simply because of something you have seen in an advertisement or on a Web site or because someone has told you that it worked for them. Scientific research on many CAM therapies is relatively new, so this kind of information may not be available for every therapy. However, many studies on CAM treatments are under way, including those that NCCAM supports, and our knowledge and understanding of CAM is increasing all the time. Here are some ways to find scientifically based information:Talk to your health care practitioner(s). Tell them about the therapy you are considering and ask any questions you may have about safety, effectiveness, or interactions with medications (prescription or non-prescription). They may know about the therapy and be able to advise you on its safety and use. If your practitioner cannot answer your questions, he may be able to refer you to someone who can. Your practitioner may also be able to help you interpret the results of scientific articles you have found. Use the Internet to search medical libraries and databases for information. One database called CAM on PubMed (see " For More Information "), developed by NCCAM and the National Library of Medicine, gives citations or abstracts (brief summaries) of the results of scientific studies on CAM. The articles cited in CAM on PubMed are peer-reviewed--that is, other scientists in the same field have reviewed the article, the data, and the conclusions, and judged them to be accurate and important to the field. Another database, International Bibliographic Information on Dietary Supplements, is useful for searching the scientific literature on dietary supplements (see " For More Information "). If you do not have access to the Internet, contact the NCCAM Clearinghouse (see "For More Information"). The staff is available to discuss your needs with you and assist you in searching the peer-reviewed medical and scientific literature. Visit your local library or a medical library to see if there are books or publications that contain scientific articles discussing CAM in general or the treatment in which you are interested. Thousands of articles on health issues and CAM are published in books and scientific journals every year. A reference librarian can help you search for those on the therapy that interests you. However, here are some issues to think about when considering a CAM therapy. Many consumers believe that "natural" means the same thing as "safe. For example, think of mushrooms that grow in the wild: some are safe to eat, while others are poisonous. For a CAM product that is sold over the counter (without a prescription), such as a dietary supplement,safety can also depend on a number of things:The components or ingredients that make up the productWhere the components or ingredients come fromThe quality of the manufacturing process (for example, how well the manufacturer is able to avoid contaminationThe manufacturer of a dietary supplement is responsible for ensuring the safety and effectiveness of the product before it is sold. Food and Drug Administration (FDA) cannot require testing of dietary supplements prior to marketing. However, while manufacturers are prohibited from selling dangerous products, the FDA can remove a product from the marketplace if the product is dangerous to the health of Americans. Furthermore, if in the labeling or marketing of a dietary supplement a claim is made that the product can diagnose, treat, cure, or prevent disease, such as "cures cancer," the product is said to be an unapproved new drug and is, therefore, being sold illegally. For CAM therapies that are administered by a practitioner, the training, skill, and experience of the practitioner affect safety. However, in spite of careful and skilled practice, all treatments--whether CAM or conventional--can have risks. Statements that manufacturers and providers of CAM therapies may make about the effectiveness of a therapy and its other benefits can sound reasonable and promising. However, they may or may not be backed up by scientific evidence. Before you begin using a CAM treatment, it is a good idea to ask the following questions:Is there scientific evidence (not just personal stories) to back up the statements? Ask the manufacturer or the practitioner for scientific articles or the results of studies. They should be willing to share this information, if it exists. Does the Federal Government have anything to report about the therapy? Check with the Federal Trade Commission (FTC) at www. Visit the Diet, Health, and Fitness Consumer Information Web site at http://www. How does the provider or manufacturer describe the treatment? The FDA advises that certain types of language may sound impressive but actually disguise a lack of science. Be wary of terminology such as "innovation," "quick cure," "miracle cure," "exclusive product," "new discovery," or "magical discovery. Legitimate scientists want to share their knowledge so that their peers can review their data.

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