Saturday, May 10, 2014

Do I Have Depression?

Do you think you have symptoms of depression? Have you lost interest in things you used to enjoy, or lost the zeal you used to have for life or suddenly adopted some dangerous lifestyle? If yes, it could be you have depression. But if it's depression, what type of depression? That is, are you suffering from major depression also known as clinical depression or a less serious form of depression?

Some types of the common depression are:

Major depressive disorder also known as major depression and clinical depression

Dysthymic disorder

Manic depression

Symptoms common to the above types of depression are:

Lost of interest in daily activities

Regular feelings of sadness

Regular feelings of helplessness and hopelessness

Feelings of worthlessness

Significant weight lost or weight gain as a result of your lack of eating or over eating.

Changes in sleep pattern.

Feeling restless and on edge all the time.

Easily agitated.

Regular feelings of lack of strength or energy. Feeling fatigue, sluggish and physically drained.

Finding it difficult to concentrate.

Regular feelings of aches and pain. Headaches, back pain, aches in the muscles and stomach pain.

Thoughts of death or suicide.

Having trouble making decisions.

If you are experiencing most of these symptoms consistently for at least two weeks, then you're suffering from clinical depression. But don't panic, clinical depression can be successfully treated with a combination of antidepressant and cognitive behavioral therapy.

If it turns out you may be suffering from depression, talk to your doctor about it, he or she will be able to direct you to a qualified doctor who will discuss with you effective treatment options.

What if it is Adjustment disorder or Situational Depression?

Adjustment disorder also known as situation depression is depressive symptoms developed in response to specific stressful situation or event. A depression that result due to a significant change in your life. If you have moods, try to remember the last events and think if they could cause your depression. This is the way used to determine whether a person is suffering from clinical or situational depression.

Often this type of depression doesn't need medicine and it's short lived, at most 6 months. You may overcome it without doing anything or simply my building your coping skills and/or talking through your feelings with a therapist.

To build your coping skills, find what makes you feel good about you and your life. Resist getting caught up with people's perception of you. Live your life and do what you want. Find what is going to make you happy regardless of any other factor and aim to achieve that for yourself. If you find it difficult to do it alone, get a therapist and do some soul searching.

Are Depression and Anxiety Hereditary? It Sure Looks That Way

It is not a rare case to find that a person who experienced depression, anxiety or both also have other family members experiencing the same thing. Most people rarely admit to being depressed and when someone opens up to a member of either the extended or nuclear family, they would be surprised to learn that their cousin is experiencing the same thing.

In fact, there are some families where every member experiences anxiety and depression and is very weak in experiencing happiness. These cases lead some people to think that depression and anxiety are both hereditary, because after all, it seems to be that way because every member of one's family seems to have the same experience. This idea will be brought to light by this article.

It is not rare that people who have diabetes, a hereditary medical problem, have other members who have the same medical problem, this kind of logic is what leads some of us to think that since some families have all of its members experiencing anxiety or depression, then those two might be hereditary. However, this is not supported by scientific findings because there are no genes found to be causing anxiety or depression - at least, not as of now. This means that just because it is not rare to find a family that has every member experiencing depression or anxiety could mean that depression or anxiety is hereditary. While it is concluded that depression and anxiety are not genetically inherited and thus, are only learned behaviors, it is only true for most forms of depression and anxiety. The exception to this conclusion is manic depression or the bipolar disorder, which will be one of the focal points in this article.

The bipolar disorder, which is also referred to sometimes as manic depression, is a case where a person experiences swinging of moods from depression to mania. This one is more hereditary than learned thus a person who has manic depression has very little control over this problem. A person who has bipolar disorders may at one point experience mania or the loss of control, exhibited through overspending, too much taking of risks, rage, sudden increase in sexual appetite, and other forms of losing self-control. After a few moments of being in a normal state, and in some cases, just right after the manic episode, the person may then feel depressed where he lacks motivation along with stress and insomnia.

Since bipolar disorder is a genetic defect that leads to such problems, natural solutions to anxiety and depression have almost futile potency in treating it. Treating manic depression or bipolar disorder, unlike other forms of learned depression and anxiety, requires very long period of treatment along with faithful dosages of medications. In order to achieve at least good results in treating manic depression, those who seek help either for their friends or for themselves must seek a professional who has had a very wide experience and has enough facility and personnel to assist in treating this type of disorder.

Manic Depressive Illness

Manic Depressive Illness, also known as Bipolar Disorder, is not something that you experience once and then snap out of. It is with you all your life, can make your life an emotional roller coaster of hell, and is something you have to learn to live with.

As human beings, it's normal for us to swing from happiness to sadness and back again depending on the circumstances. What separates this behavior from manic depressive illness is the intensity of the swings. It's not unusual for the mood of a person with manic depressive illness to swing from giddy exhilaration to the deepest suicidal depression. It's trying to control and live with those extremes that can make life very difficult for these people.

The symptoms of bipolar disorder usually arrive sometime in the late adolescent years. It can be extremely difficult to diagnose because it arrives at precisely the same time that hormonal and other factors are affecting them. Even normal teenagers' emotions can swing wildly from one moment to the next.

The keys to living with manic depressive illness are to 1) get diagnosed early and 2) get proper treatment. Bipolar disorder, once diagnosed, is normally treated with a combination of mood stabilizers and therapy.

Mood stabilizers are psychiatric medications developed to stabilize the extreme mood shifts from mania and depression in those suffering from manic depression or bipolar disorder. Popular mood stabilizers are Lithium, Valproic acid, Lamotrigine, and Carbamazepine. A variety of mood stabilizers are constantly undergoing clinical trials in an attempt to find the best treatment possible for manic depression.

Before a medication can be advertised as being effective for a certain disease, it must be approved by the FDA. However, just because a medication does not have FDA approval does not mean that it is ineffective. It could simply be in trials or it could be that money is not available to do long term clinical trials. The best thing is to find a doctor or health provider that you trust and follow their recommendations.

Therapy, for many people, has an undeserved negative connotation. They feel that they'll be stigmatized or viewed as crazy if they seek psychiatric help. But, for many people it can literally be a godsend.

Manic depression therapy treatment can be personalized or can take place in a group setting. Therapy can be very helpful in helping people understand themselves, understand their emotional swings, and understand that they have some control over this illness. Therapy can help them realize that they do not have to be an innocent bystander in their own life.

In the best cases, with the right treatment and medications, those suffering from bipolar disorder can manage to live an almost normal life. The more difficult cases may require hospital stays of various lengths to treat the problem.

Manic depression is an illness that affects millions of people. The best way to help those suffering from it is to bring it out of the closet and help them get the treatment that they need.

How You Can Use Daily Inspiring Quotes

How you can use daily inspiring quotes to help you out during tough times. Well it's just something that you can come up with in many ways. A saying that is going to provide you the strength that is needed for certain situations that you face.

It doesn't need to be anything complicated. Using movie lines has been done by many, and it will work just fine. Maybe even lyrics to a song or a favorite poem that they love. It's a way that you can create a personal mantra or chant for your tough times in life.

How do you actually go about finding those quotes to use though? Well it doesn't need to be the same way anyone else goes about it. You just need to find something that when you hear it read it or say it makes you feel better. That's why you have so many ways to find these quotes.

When the country song "Before he cheats" first came out I had a friend who used that as their inspiring quote. Well more of a song because it fit their situation all too well. She had found out that her husband had cheated, and it just fit the situation so well. It was almost funny every time the song came on she would belt it out.

Hey it helped her move on past the situation and start to enjoy life again, so it worked. Your quote can be found in any way that you want it. Many people love to use quotes they have from Bible verses that help them out.

It will work because a lot of time they will be reminded that they are not alone in their tough times. Reaching out for God is a way that many people do find relief in those situations when they feel they can't go on.

In closing use anything to find your quotes from, books, movies, songs or anything else. As long as it helps you out, it will be inspiring!

Beware of Subtle Manipulation by Drug Companies

Drug companies want you to buy their products, and they spend a lot of time and money on researching just how to persuade you to try a pill or two to cure whatever ails you. Television commercials are a particularly successful method of manipulation.

A sad little ball that looks like a kid drew it appears on your television. Then you hear: "You know when you feel the weight of sadness. You may feel exhausted, hopeless and anxious." Now a cute little blue bird flies down next to the ball and a dark cloud appears. Next, you hear symptoms of depression, a serious medical condition affecting over 20,000,000 Americans.

Your response: You feel sad, don't you? You realize you are exhausted too. You didn't feel hopeless or anxious until now. But come to think about it, you do feel hopeless and anxious.

There are people who are depressed and need treatment and if you truly feel you are depressed, talking to your doctor is one of the best decisions you can make. But there is a difference between being depressed and being sad.

The drug companies have decided to market their products directly to the consumer by creating commercials that suggest we ask our doctor for a particular drug. This commercial and many like it are meant to manipulate you. The drug companies want you to feel these symptoms, go to your doctor and ask for the drug. If you watch these commercials, you are supposed to think that you are not just sad, but depressed. You will also make a mental note of the symptoms of depression. When you go to the doctor, you will tell the doctor you are depressed and have certain symptoms - the same ones in the commercial. As a result, there's a good chance the doctor will prescribe whatever drug you ask for.

You are not the only one being manipulated. Doctors are also being manipulated.

One of the most popular periodicals read by physicians is The Journal of the American Medical Association. Can you guess who their main advertisers are? Pharmaceutical companies. If you take a look at one of the ads, you will notice that it is intended to manipulate the reader by exaggerating the benefits of a drug. The side effects can be found in small print at the bottom of the ad.

Drug companies spend billions of dollars a year on advertising. They manipulate you to think you are depressed (or something else) and to also think that their product is the magic remedy. Their manipulation strategy for doctors is to place their ads in publications read primarily by doctors. Another manipulation tactic used by big drug companies is to publish a journal that appears to be a paper on a particular medical condition with, of course, a solution: the perfect drug to prescribe for the ailment. It gets better. Ads appear in the journal that favor the drug. The publication is nothing more than a marketing brochure appearing to be an authentic medical report, encouraging or manipulating doctors to prescribe the drugs.

When it comes to manipulation, drug companies are among the worst. The next time you see an advertisement on television, read a blog on the internet, or read an article in the newspaper, ask yourself if the author's intent is to manipulate you. And the next time your doctor recommends a medication, have the courage to ask him or her why it is that medication and not some other that would be best for you.

Residential Treatment For Women Suffering From Depression and Anxiety During Menopause

Today, there are numerous communities that offer residential treatment for women suffering from depression and anxiety during menopause. They provide quality care and counsel on women's journey to independent living especially during the so called "midlife crisis". They have specialized programs for women that will assist them in developing skills to help free themselves from feelings of dependency, low self-esteem and limited personal resources. Some of these communities also help women provide medications services and depression and anxiety management instruction during menopause.

There are millions of women all over the world who have been an alcoholic or drug dependent and have ruined their lives because of depression and anxiety. The services that these communities are offering will help to develop the psychological, behavioral and life skills needed for building a satisfying, alcohol and drug free lifestyle. They treat women and help them recognize that addiction is a disease and that abstinence is the best way to manage the condition. Most of these residential treatment for women suffering from depression and anxiety during menopause are delivered by a team of professionals including nurses, physicians, counselors, psychologists and psychiatrists. They also assure a comfortable, ordered home life, benefits of structured treatment and a carefully guided transition into new ways of being.

Residential treatment for women suffering from depression and anxiety during menopause is an ideal way to help them benefit from the consistent support of treatment while working toward creating a more independent and self-reliant lifestyle. This treatment integrates a number of evidence-based practices and other skills-based approaches that provides patients with optimal tools for recovery. An important aspect of residential treatment for women suffering from depression and anxiety during menopause is to encourage these women to develop supportive relationships with their family and among themselves.

The centers are designed for women under menopause. They help them create a healthy relationships and let them realize that there are people who care for them. Despite the differences in treatment programs, client profiles, follow up intervals, data collection methods and other factors, residential treatment for women suffering from depression and anxiety during menopause are believed to be an effective way of helping these women to regain their lives even after menopause.

Friday, May 9, 2014

Postpartum Depression In A Nutshell

Postpartum depression, as it has traditionally been known, is now called major depressive disorder with postpartum onset. The postpartum onset specifier may also be applied to bipolar disorder (I or II) or brief psychotic disorder. Thus postpartum symptoms may appear as depression, mania, or psychosis.

The common feature is onset within four weeks of the birth of a child in women who do not have either cyclothymia or dysthymia. Postpartum mood episodes with delusions or hallucinations may be more common with a first birth, and 30% to 50% of women who have had one such episode have another with subsequent deliveries.

The symptoms of postpartum onset mood disorders and nonpostpartum mood disorders are the same. However, the course of the symptoms may vary more in postpartum depression, and the moods are frequently less stable. For a diagnosis of postpartum onset depression, a depressed mood or loss of pleasure or interest in nearly all activities must last for at least two weeks, accompanied by at least four other symptoms affecting appetite, sleep, activity level, self-concept, or thinking.

Mothers with a postpartum onset mood disorder may contemplate suicide and may be obsessed with thoughts of the new child being injured or killed. They may find it difficult to concentrate, and they may be physically agitated.

If delusions are present, as they are in as many as 1 in 500 births, they are usually about the baby. As the delusions may be that the baby is possessed by a demon or has special powers, a pastor or Christian therapist may be especially helpful. Christian counselors may be well prepared to assist women with postpartum depression who feel guilty about being depressed at a time when others are telling them that they should be happy.

New mothers who do not have a postpartum onset mood disorder may experience some of the same symptoms, but these so-called baby blues typically last for less than one week after the birth. Clinicians should consider a diagnosis of a postpartum onset mood disorder only if the symptoms (especially those of severe anxiety, repeated weeping, and lack of interest in the new baby) persist for more than one week. Lack of interest must be distinguished from lack of attention or awareness, which may indicate delirium during the postpartum period rather than depression.

Postpartum mood episodes may be severe. Especially if they are accompanied by delusions or hallucinations, they may interfere with developing a bonding relationship with the baby and may even lead the mother to attempt to kill her infant.

Many factors contribute to postpartum onset mood disorders. Physical exhaustion from the pregnancy and labor probably plays a role, as does the accompanying dehydration. Within a few days after delivery, the mother's hormone levels drop abruptly, and estrogen levels in particular have been linked to mood.

Psychological pressures on new mothers and fathers are significant. Both must cope with the physical demands of parenting, with sleep disruption increasing the difficulty. They must learn to communicate with the baby and in a new way with each other. They may be ambivalent about their new family status and roles, and the baby may bring financial and emotional pressures.

The most effective treatment appears to be postpartum counseling within a few days of the birth. Women who know that they should expect their emotions and attitudes to fluctuate for awhile can anticipate recovery in two to three weeks. Those who do not may need clinical treatment for a mood disorder.

What You Need to Understand About Bipolar Symptoms in Women

Bipolar Symptoms In Women

Bipolar Disorder was once commonly known as "manic depression" and basically consists of several medical conditions known as depressive disorders, which effect the way in which an individual's brain will function.

Although Bipolar Disorder affects males and females in approximately equal numbers, the actual symptoms exhibited by both genders can be vastly different. Bipolar symptoms in women tend to manifest mostly as depressive episodes, whereas men will more than likely experience more manic symptoms. Typically this pattern emerges in a patients first episode also, women tend to experience a depressive episode first and men will generally have a mania episode initially.

Women will generally be diagnosed mostly with Bipolar type II, which could be described as a milder form of Bipolar Disorder. However, rapid-cycling Bipolar, which is described by experiencing at least four episodes of depression or mania in one year, are more likely to be experienced by Women. Rapid Cycling Bipolar can be more difficult to treat than other forms of the disorder.

There has been extensive research that suggests Bipolar symptoms in women (especially rapid-cycling) could be influenced by abnormal thyroid levels. Thyroid imbalances are said to be more common in women than men. Women are also more likely to suffer from some of the following medical conditions than men. Obesity, anxiety, panic disorders and migraines. Hormonal imbalances can play a major role in developing Bipolar Disorders, declining estrogen levels during perimenopause can leave a women at risk of depressive disorders. During and after pregnancy can leave a women more vulnerable to the condition also.

Bipolar disorder is a higher risk in somebody who comes from a family with a history of Bipolar. This is not difinitive and absolute. Although there is a genetic link, it does not mean that someone that has a Bipolar parent will necessarily be Bipolar. Risk factors that contribute to Bipolar Symptoms in women include stressful life events, drug or alcohol abuse, harsh changes to sleeping patterns or other chronic medical conditions can contribute to the risk of Bipolar.

Medications used in the treatment of Bipolar are known as "mood stabilizers" These medicenes can reverse depressive or Manic episodes and prevent an individual from suffering a potential relapse. A Doctor or healthcare professional will prescribe either individual or a combination of medications that best suit your needs.

It is important to understand that whilst there is no actual cure for Bipolar Disorders, it can be treated successfully once diagnosed with ongoing psychological treatment and a successful prescription for medication. Studies are ongoing and new treatments are continuously being developed that help in the fight against Bipolar Disoder. It is possible to lead a complete and full life after a Bipolar disorder diagnosis.

Around one person in a hundred is diagnosed with a Bipolar Disorder, once diagnosed it can be treated successfully but many people are unaware that they have the condition and this can obviously be dangerous. It can occur at any age although commonly develops between the age of 18-24. The patterns of Bipolar symptoms in women can vary between individuals, with long term depressive episodes mixed with short term mania and vice versa. Please make sure that you contact your Doctor or healthcare professional if you or someone close to you is displaying symptoms of Depression or mania.

Seasonal Affective Disorder - Treating Cyclic Depression With NLP

Seasonal Affective Disorder is more than just feeling sad when the weather is bad. This disorder starts to develop when fall heads toward winter and the days become shorter. The majority of people experience symptoms at some point during late summer or early fall. Moreover, because of the severity and consequences of SAD and other types of depression, physicians need extensive evidence of the condition before they are willing to make a definite diagnosis. Despite the fact that symptoms can be very severe, physicians rarely diagnose a patient with this condition until after he or she demonstrates strong evidence of the disorder for at least three winters in a row.

Individuals who suffer from this disorder start to experience feelings of depression, decreased enthusiasm, and often sleep for excessive periods. Furthermore, they develop a dependence on sugar or sweets. In addition, the majority of persons who experience SAD also have poor immune system functioning. Frequently, they become ill much more quickly than persons who do not suffer from SAD.

This disorder can negatively decrease an individual's ability to function professionally or at school. This lack of motivation often makes getting out of bed or engaging in one's usual daily activities difficult. Sufferers find it difficult to participate in social situations, or even at home. These persons often experience episodes of intense anxiety and negativity. Sometimes, the problem becomes severe and distressing enough that people even think about suicide and have to be hospitalized for therapy.

Interestingly, females seem to experience SAD more frequently than men do. Furthermore, this condition seems to get better yearly at springtime. In fact, in March or April, symptoms usually subside or resolve altogether - until the following autumn. This remains true even in states that are frequently dismal all year long. In fact, almost twenty percent of those who are diagnosed with SAD will at some point exhibit symptoms of bipolar disorder.

These people are usually depressed in the winter months, but report normal moods throughout the rest of the year. At times, however, individuals describe instances of uncontrollable mood elevation, which is also called mania. Like any other type of depression, this condition may become very serious or even result in disability if not treated properly. Moreover, some persons suffer from very low-grade forms of depression; they may struggle with exhaustion, lack of motivation, and loss of appetite. These individuals, however, do not usually endure instances of depressive moods or anxiety.

This kind of depression is fairly rare in sunny regions such as Florida, southern California, and Texas. Others, who reside in places with a large number of cloudy days, such as Ohio, Michigan, or Washington are at higher risk for developing this condition. Citizens of countries such as Denmark, Germany, and Ireland also face an increased risk of seasonal depression.

Medical researchers have tried many alternative strategies to aid affected individuals recover from this debilitating condition. They have tried placing people under artificial light in an attempt to assist them to produce more serotonin and lessen depression symptoms. Researchers have also tried medicines such as anti-anxiety drugs, and supplements, such as melatonin, to help treat these symptoms of depression. Often, those who experience SAD also seek out counselors during those times when they are suffering most greatly.

Each of these treatments result in with different degrees of effectiveness. Despite this, all are significantly more costly and time-consuming than two more recent, innovative techniques. Hypnotherapy practitioners have refined the art of coaching clients to learn both NLP and self-hypnosis methods for depression. Through the latter method, people learn to talk themselves out of a depressive period and resolve their symptoms. These useful treatments, hypnosis and Neuro-Linguistic Programming, have proven to have an astonishing amount of success in assisting clients to heal from, and prevent future problems with SAD.

Summary: SAD is a type of winter blues that reappears each year at almost the same time. Only people who struggle with this disorder can determine whether they wish to continue to fight these symptoms alone, over and over, or to try to get assistance in resolving this problem once and for all. Hypnosis and Neuro-Linguistic Programming for depression are both beneficial, innovative therapies that promise a quick relief from depression without spending enormous amounts of money or energy.

How to Help a Teenager Who Says He Or She Wants to Die

What an important topic! It is true that teenagers these days experience a lot of stress and emotional pain, and often feel overwhelmed. Often, a teenager who says they want to die are experiencing profoundly overwhelming emotions and confusion, and are letting you know that they are in extreme emotional pain and need help. Sometimes when a teen says he/she wants to die it may mean they are an immediate risk for suicide.

1. No matter which option, this statement needs to be taken seriously

If a teenager says, "I want to die, I want to kill myself, or I'm going to commit suicide", always take the statement seriously and immediately seek assistance from a qualified mental health professional. I know that you may feel uncomfortable talking to your teen about wanting to die, or even contemplating suicide. If they have brought it up to you (or even if they haven't directly) they need to talk about it. Rather than putting thoughts in the teens head, asking about their feelings will provide assurance that you care and will give them the chance to talk about their problems.

Depression and suicidal feelings are treatable disorders. The child or adolescent needs to have his or her deep pain recognized and diagnosed, and appropriate treatment plan developed. When parents are in doubt whether their child has a serious problem, a psychiatric examination can be very helpful.

2. Here's some information on teen suicide

Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15 to 24 year-olds and the sixth leading cause of death for 5 to 14 year-olds.

Recently released statistics reveal that approximately three million youths, aged 12 to 17, either thought seriously about suicide or attempted suicide in 2000. More than one third, 37 percent, actually tried to kill themselves. Most were suffering from undiagnosed or untreated clinical depression. An estimated 75 percent of all those who commit suicide give some warning of their lethal intentions by mentioning their feelings of despair to a friend or family member.

Many of the signs and symptoms of suicidal feelings are similar to those of depression. Parents should be aware of the following signs of adolescents who may try to kill themselves:

  • change in eating and sleeping habits

  • withdrawal from friends, family, and regular activities

  • violent actions, rebellious behavior, or running away

  • drug and alcohol use

  • unusual neglect of personal appearance

  • marked personality change

  • persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork

  • frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.

  • loss of interest in pleasurable activities

  • not tolerating praise or rewards

A teenager who is planning to commit suicide may also:

  • complain of being a bad person or feeling rotten inside

  • give verbal hints with statements such as 'I won't be a problem for you much longer', 'Nothing matters', 'It's no use', and 'I won't see you again'

  • put his or her affairs in order, for example, give away favorite possessions, clean his or her room, throw away important belongings, etc.

  • become suddenly cheerful after a period of depression

  • have signs of psychosis (hallucinations or bizarre thoughts)

If one or more of these signs occurs, parents need to talk to their child about their concerns and seek professional help from a physician or a qualified mental health professional.

3. Realize that being a teen can be really tough these days

Adolescence is a stressful experience for all teens. It is a time of physical and social change with hormones producing rapid mood swings from sadness to elation. Lack of life experience may result in impulsive behavior or poor decisions. The teenager's brain is "under construction" and is not fully formed until age 25. This includes areas such as forethought, planning, and delayed gratification.

Even an emotionally healthy youngster may have constant fears of "not being good enough" to be asked out on a date, make the varsity team, or get good grades. Special situations such as parental divorce or the breakup of a dating relationship may trigger intense sadness and feelings of wanting to die.

For a teen suffering from severe or chronic depression, feelings of worthlessness and hopelessness magnify and dominate waking hours. The ratio of "sad" to "happy" moments becomes lopsided. Despair is ever- present and emotional pain feels like it will never end. Any situation of anger or disappointment may cause a fragile youngster to cross the line from wanting to die to actually attempting suicide.

Unfortunately, adolescents do not wear a sign saying whether they are temporarily sad or chronically depressed. External indicators such as clothing, music preferences, grades, or even attitude are not accurate indicators of propensity for suicide.

All statements regarding suicidal ideation and/or concrete plans need to be taken seriously by adults.

Chronic hopelessness, harsh self-criticism, and feeling unlovable and unwanted, create a pain that cannot be described. Some severely depressed teens try to rid themselves of this awful feeling by self-medicating with alcohol or other drugs. Others self-injure by cutting, burning, biting or even breaking their own bones in an effort to release the excruciating self-hatred.

Fortunately, most teens will communicate this pain through conversations or writings. Our job as adults is to provide both an ear and a path to professional help when this information is shared.

Depression is a treatable disease and, with proper intervention, most suicidal teens can be helped to lead long and productive lives.

4. What to do when a teen says he/she wants to die or is suicidal

Talk to them by letting them know:

  • I care about you. I do not want you to die. I would miss you so much, you are so important to me.

  • Ask them "what is causing you so much pain?" Listen, listen, listen and do not try to be logical or talk them out of their pain. At that moment the person can't think of the future, they can only think about now. They are preoccupied with a painful past and present. You are trying to accomplish two things -- give them someone to listen to them fully so they know they are loved and cared about, and to get valuable information about their frame of reference.

  • Ask them, if you could wave a magic wand and could change your life, what would you change? This will give you important information about where they are experiencing pain, and what in their life feels like it won't change.

  • Tell them a part of them wants to live (even if it is tiny). Tell them again you want to help them to live, and will get them help.

  • Let them know you are taking them seriously. You might say, "Look, you let me know you were feeling suicidal. If you didn't want help, you would never have said anything to me, so I'm not going to let it go. Come on. Both of us will go see someone." This kind of response lets the person know how serious you are and how much you care. It brings them back in touch with that part that wants to live. In most cases they will agree to see someone after hearing this. If they still insist on not talking and take off, it is critical that someone who can get to that youngster be told immediately.

  • Tell them that even if they have no hope for them, you have hope, and they can barrow some of your hope for them.

5. Realize that you are an important person to them, or they would not have told you anything at all.

You are already a safe person that they trust and are hoping can help them. By acknowledging their feelings of devastation or depression you will continue to build a strong relationship with them. Your listening to them and trying to understand them will help the teen feel like there is help available. You are really important to them, and you matter to them. Do not feel like you have to take the burden of what they've shared completely on yourself. There are medical and mental health professionals you can enlist who can help the teen who has confided in you.

6. Try to assess if the threat is immediate, ask

"Have you thought about how you might do this?" If they say I have a gun, pills, etc. in my car/in my room that shows they have a plan and are at high risk -- you need to get help right away by calling 911, their parents, their primary care doctor, anyone. Don't send them home by themselves, even if they insist they are fine or were just kidding. If they really want to end their life, they will be mad at you for taking action, but getting them immediate help is more important than their displeasure with you. Most likely, later they will understand. If you begin to doubt the wisdom of getting psychological help, ask yourself if you would hesitate taking your child to a doctor if his leg was broken just because she "did not want to go."

Because of the thin line that exists between "having an idea" and "acting on that idea," it is critical that any suicide threat be taken seriously. If your child says he or she wants to die and/or shares a suicide plan there is no time to speculate whether the words are "real" or if the "mood will pass."

If the threat does not seem immediate, do not take a risk -- let the teens parents know, make sure they get an appointment with their primary care doctor, go to ER, etc. While both "situationally unhappy" and "clinically depressed" teens may become suicidal, the second group is more likely to have a plan and materials necessary to carry out this project successfully.

If you are the parent, and it is daytime, call your primary physician for immediate help. If the doctor is not available, many communities have mental health hot-lines offering guidance or a 24-hour center where psychiatric emergencies can be evaluated. If all else fails, calling 911 or your local police will generate needed assistance.

If the threat is not immediate, it is still important to follow up with a psychological evaluation. Again, your primary physician should be able to provide you with an appropriate referral. If you don't know if the threat is immediate, err on the side of taking action sooner.

Realize that sometimes wanting to die is a sign of clinical depression, which means that chemical changes have taken place in the teens brain to the point that medication is needed for a time to restore balance in the brain chemicals. An evaluation by a psychiatrist and/or primary care doctor is needed to determine the course of treatment. Multiple research has found that the best treatment for depression is a combination of medication and talk therapy.

I hope this has been helpful for you in helping the teens in your life. You are very important to them, and you and your relationship with them matters.

Note: This question was submitted by one of the subscribers of my Podcast, Encouragement for Your Soul.

Feeling Depressed in a Financial Depression

Recently it seems like more people are looking into therapy in Los Angeles as more people are seeking support for depression in the 'Financial Depression'. We are depressed because some of us have forgotten what matters most and instead, sought those things we believed would make us happy. Our values have been tweaked to the point of confusion. We take pride in our financial status, not our loved ones. Our self-esteem depends on how high we get on the corporate ladder.

The perception of success is based on the bigger or better houses and cars that we can acquire. Society snowballed into a battle of keeping up with 'the Jones''. When we realized the Jones' were crooked, fake and suffering major loss on the financial front, we all collapsed into identity crisis. We no longer knew who we were, how we mattered or if we even existed. Without a sense of self, depression can slowly make it's way into our being.

Now with the economy tanking, and our financial stability shaken to the core, it's almost impossible to sanely keep things together. Some people are working two jobs or not working at all due to layoffs. Suddenly, our survival mode kicks in with only the basic things such as food, shelter and clothing becoming top priority and concern. We are so busy struggling to provide for ourselves and our family that we begin to unravel. As a result, we're left to our own defenses, emotionally and physically. No doubt this takes a toll on our emotions. We start feeling depression, stress, anxiety and fear and that was all in the last minute!

It seems more people are getting desperate in wake of today's dire economy. Unfortunately, we hear on the news about more suicides and homicides of family members and employees. In some form or another, depression most likely played a role in these tragedies. When someone is severely depressed, he sees no hope for the future. His mind set is one of despair as he feels there is no escape from extreme negative thoughts.

A high level of stress can cause major health problems. Many people do not realize that depression should be considered one of those problems. There are several types of depression. One is biological (organic) where people can get depressed due to genetics or biological chemistry. Another form of depression is reactive, when a psychosocial stressor such as divorce, disappointments, a loss, or a life adjustment, interferes with an individual's daily functioning . Grief is similar to reactive because it is a result of a psychosocial stressor and is necessary and normal in the grieving process. However, grief can slowly manifest into clinical depression which is more severe if continuous in duration, intensity and impacts life functioning. Perhaps, if we are more aware of the characteristic in clinical depression we can help our loved ones or ourselves in getting help before it's too late. The major symptoms of depression are:

Low self esteem
Mood of sadness, despair, emptiness
Anhedonia (Can no longer find pleasure in things)
Isolating from others
Apathy, low motivation
Extreme emotional sensitivity
Negative thinking
Suicidal ideas

It may seem like we all have these symptoms at one time or another. But, remember to look at duration (months to years), intensity(to the extreme) and impact of functioning(severely affected).

Impact of functioning symptoms are some of the following;

Giving away personal items
Early morning awakening
Insomnia or disturbed sleep
Extreme weight loss or gain
Excessive sleeping
Panic attacks

Types of help:

* If severe please contact your Doctor or Therapist
* Get involved with him/her let them know you are available to listen
* Go out and do things like exercise, walk, hike, bike, etc.
* Ask if they have thought of suicide, if so is there a 'plan' on how (if have plan then more serious in suicide)
* Contact suicide hot-line 1 800 273 TALK
* Have them start journaling or writing feelings
* Let them know there is hope and they don't have to feel this way forever

We will eventually overcome this Depression and also our own depression. Both will take a lot of work and perseverance, but not all is lost in our will to survive. Hopefully, if we get anything out of this day and age is that what matters most is our family, loved ones and friends. We can love our things and it may make us happy today, but can it love us back and take care of us when we're down tomorrow?

**Not a substitute for medical advice or treatment. If need help please advise your Doctor.

Whether You Call It Manic Depression Or Bipolar Disorder There Are Alternatives You Should Know

Truth be told there happen to be quite a few all natural treatments that have been successful for many; for those who are afflicted by bipolar disorder as they quite simply may very well help one deal with its effects.

Natural treatments' objective is certainly to help people along with bipolar disorders to handle their manifestations so they are able to keep on performing their particular way of living.

The main thing when testing out any holistic treatment options for bipolar condition is to do the research concerning this kind of techniques as well as inquire about them with your doctor.

This will bring some peace of mind that this treatment is going to be safe and probably will not be a hindrance affecting your existing medications.

Nutritional approach is among the holistic treatments regarding bipolar dysfunction. By taking vitamin supplements, minerals, amino acids, emotional swings are controlled, thus avoiding mood attacks.

On the other hand, you might attempt emotion stabilizing ingredients such as Phosphatidyl Choline (Lecithin), L-Taurine, as well as Gamma aminobutyric acid besides the typically recommended lithium.

Various other natural ingredients which helps to maintain a comfortable mood are also available in case you are wary of consuming such substances. Vitamin B complex are generally incorporated. Thiamin, B12, folic acid, magnesium mineral as well as calcium, manganese, zinc, and the amino acid methionine.

Local culture based therapeutic disciplines is another kind alternative treatments regarding bipolar disorder. These techniques have been utilized way before present approaches by our forefathers when they deal with their body..

While a number of research has in fact found they can promote mental and physical well-being, providers of Western medicine even now disputes the effectiveness of these theripies.

Acupuncture, Ayurveda Yoga, Native American traditional treatments are a handful of the culturally based treatment disciplines.

Certainly, there are in addition a number of relaxation as well as stress reduction methods that may well end up being thought to be as optional therapy with regard to bipolar condition. You may obtain a whole lot of understanding through this courses.

Considering that tension could trigger a occurrence, decreasing or limiting it is quite critical. Throughout stressful circumstances, these kinds of relaxation techniques can help you keep in place your emotions. Carefully guided imagery or visualization, restorative massage therapy, and biofeedback are generally a number of good examples regarding stress reduction and relaxation techniques.

Remember, if you're considering a Bipolar or Anxiety Drug for your condition, you should learn more about their effectiveness and side effects too.

Thursday, May 8, 2014

Research Paper About Depression

Depression is a common disease affecting people from all ethnic groups, ages and professions. It is caused by the unbalanced chemicals in brain called "neurotransmitters". It is diseases which cause you to feel sad and gloomy and create a feeling of hopelessness about future. This feeling prohibit the person suffering from it to enjoy his routine life, hobbies and things which he loves to do normally. The most common problem about depression is that many people leave it unnoticed and untreated. Some people are ashamed of having depression just because they do not want their weak point to get exposed in front of others. People with little knowledge of depression take it as a normal mood swing but it is not. This feeling of sadness or despair is not normal as it does not go away or come with normal incidents that are meant to cause these reflexes. A person may get depressed even when there is no reason of being sad.

People suffering from depression say that "it is a black curtain of despair coming down over their lives" ( This feeling of worthlessness and despair often takes the patient to a point of no return where he could only think about ending the worthless life by committing suicide.

The disease is directly associated to unbalanced chemicals present in the brain. The human brain is a gigantic messaging system which controls everything from heat beat to the breathing, skin functions, organ working and reflexes. The brain is made of millions of nerve cells called neurons. These neurons send and receive messages from rest of your body through neurotransmitters present in the brain. These brain cells are responsible for emotional states of human being. When an unbalanced chemical reaction occurs in the brain cells the messages are not delivered correctly and disrupt the communication resulting in causing depression.

A person having depression feels sadness, helplessness and worthlessness. Some authors says that feeling depressed or in a low mood increase the ability of a person to cope with tough situations. Depression may happen in life as a normal phase when it is backed by certain types of life occurrences like sudden death of a loved one, divorce, loss of status or death of spouse child. Depression may be an aftereffect of any disease like influenza or flue.

Depression may also be due to some psychiatrist disorders like Bipolar Disorder, Anorexia Nervosa, and Bulimia Nervosa etc. Symptoms of psychological disorders are dullness, chronic sadness never seems to end, obsession, shakiness when feeling most down and mood swings. The cure to psychological disorders is constant therapy and responding to the disease well in time.

As mentioned earlier most of the people do not know that they have been suffering from depression. This is due to lack of information about this common problem amongst people. The first thing is to identify whether you have depression or not. The next phase is to get to a physician. In case of depression both the things are difficult for a person who is suffering from the disease. This is because the patient is already down in mood and is never ready to rectify any wrong done to him. The patient is already having sad feelings about himself which forbid him to take any measures to get to solution. This worthless feeling if not identified well in time can push a person to end his life. In some cases the patient often get irritated to that extent that he never hesitates to harm those who he love the most and this is done under the immense pressure of depression that a person feel upon himself. It is like no dawn forever and no way out. The second phase is how to get out of depression when you have done diagnosing that you actually have depression. This phase is easy for some people and is extremely difficult for some people. In such case it is the collective responsibility of the family members or relations of the person to convince him to visit a doctor.

People suffering from depression need sympathy and need extra attention from those who are around them. This is kept in mind that in today's hectic world where everything is traveling very fast, a struggle between individuals to reach the top has created things worse. The fight for needs is converted into fight for wants which is creating unwanted problems for the society. In such case depression is becoming a global issue which is affecting every social group of every race and ethnicity. The solution for the problem is addressing the problem before it becomes a serious problem. Adopting healthy and natural life styles, living close to the nature and by avoiding unnecessary and complex life styles can reduce the problem of depression.

People should not take depression lightly as it is a catalyst which speedups the process of disorders which are virtually not affecting the person in normal life. Identifying the problem and consulting a physician can reduce the risks involved and can improve the quality of life of the patient and helps him recover and pursue his course of life in the normal manner. Eliminating gloominess, despair and worthlessness from the patient's life.

The Why's and Where-For's of Religion

Wise people say we should never discuss politics or religion at a festive event, and usually for good reason. There are many, many conundrums to life and the aspect of religion is one of them. So, when all's boiled down, what's the point of religion? (Let's consider that religion and spirituality are one and the same concept--for simplicity purposes.) We often have to look in special places for these answers.

Let's look to the words of Helen Keller:

"The reason why God permitted me to lose both sight and hearing seems clear now--that through me He might cleave a rock unbroken before and let quickening streams flow through other lives desolate as my own once was. I am content."

It seems religion is more about others than anything else. But, we can't do that very well if we don't self-relate very well; God in an instant helps us accept ourselves. We get religion all wrong when it becomes about ourselves (our wishes, our preferences, our views, our desires). And if we don't accept ourselves, life can only ever be about "us." Religion is an opportunity to connect with God and the world, relationally, and in a way to offer the self (free of burden) to both those entities.

Keller continues:

"The mortally wounded must strive to live out their days cheerfully for the sake of others."

So, perhaps religion is about embracing God, our world and everything in it; all life circumstances and situations equally. It appears to be a middle-of-the-road approach to life--a 'narrow way' of negotiating the plethora of treacherous twists, turns, crests, valleys and pikes.

This throws up for us a few further opposing thoughts.

Is religion the answer for the world's (and the individuals') ills? Can it ameliorate these ills, for instance, mental illness--take depression, for example.

It seems that religion (through us/me) is about sowing hope for others. If that were true then someone (or more than one person) might 'minister' to me, helping me with my issues and problems; notwithstanding God or complementing him in his work.

In the context of the world's ills (and further, that of individuals'), I'd venture to say that religion both contributes as a cause for suffering depression and is something that prevents it. Both opposing standpoints agree, depending on the context.

Perhaps these two opposing views combine over the process of time, one preceding, the other proceeding. Let me explain. For religion to cause ills means something in that process is wrong. Once this can be resolved, religion can actually help. Again, we've established that religion is necessarily about others.

But, let's consider two spiritual people: one well, the other not. Both of these people need religion--a spiritual connection with God and the world. One is in a place of entrance and discipleship; the other's in a place of going on (to higher places) in the faith. Both of these people can benefit acutely from a focus on others, and on God.

Taking Keller's quotes and amalgamating them in the context of 'religion,' we find that it's about others and it's a correct way of viewing the lifespan--a determined race where we are designers (with God) toward our own destiny.

© S. J. Wickham, 2009.

How To Help Someone With Depression, Suicidal Tendencies or Borderline Personality Disorder

Mental illness is a terrible malady. Many of us don't understand this disease and don't know how to handle it. We are frightened by it, somehow believing it may be contagious. Mental health hospitals and professionals also have a formidable challenge and there aren't any certain remedies. As a result many people with this illness die every year, from being misunderstood.

Borderline personality disorder is one of the worst forms of mental illness. People with this disorder attempt suicide often. It is a disease which normally occurs from being abused as a child. It is so dreadful that many family members abandon their loved ones who have [BPD], because it is extremely stressful on them. Although it is challenging, people can help victims of [BPD] if they understand this disease better.

There are many websites offering helpful information about this serious subject. Some suggest medications, where other websites state that the only real remedy is cognitive behavioral therapy (counseling). Love and family support is likely to be the best medicine. Below are some helpful tips about caring for a person with Borderline Personality Disorder.

  1. Validation - Very important! Ask them questions about their problems and the very real pain they suffer.

  2. Listen - When they need to talk, sit still and really be present for them.

  3. Empathize - Express understanding and apply effort to helping them get relief from their misery.

  4. Love - Tell them how much you love them and Jesus truly loves them, too!

  5. Reassurance - Tell them you won't ever leave them or, "I'll always be here for you," and mean it.

  6. Guilt - Tell them it isn't their fault and don't blame them for their illness.

  7. Comfort - Continue to tell them everything will get better. Say it over and over!

  8. Suicidal - Don't ever leave a person alone who is suicidal! Treat them as a baby and get a baby sitter if you have to go elsewhere. This is crucial!

  9. Promises - Depressed people are hypersensitive and anxious. They can't stand having to wait or being lied to. Keep your word and always be truthful with them!

  10. Friends - Contact their friends and alert them to the problem to design a circle of love.

While I hope this information is helpful, I realize the heavy burden you may be suffering and the many challenges you face. There are no easy answers - but nothing can take the place of love and understanding.

Health Insurance - Bipolar Patients

A diagnosis of bipolar or manic depression is often thought of as an automatic denial when it comes to health insurance, even if the diagnosis comes long after the health insurance policy has been purchased and put in place. While is can be very complicated to get coverage for bipolar disorder related treatment, it is not impossible. This is especially true if the bipolar diagnosis is not a pre existing condition, but was discovered and diagnosed after the health insurance policy has been in place for awhile.

Bipolar is a mental health disorder that is characterized by wild mood swings that alternate from extreme happiness and elation to severe depression and sadness, even suicidal. Once the diagnosis is made and treatment is to begin, there are a few specifics that the health insurance company will likely require before they will cover any bipolar treatment. The first thing that will be verified is the employment status of the bipolar patient. Health insurance companies must be sure that the patient is able to pay for the policy premiums as well as any out of pocket expenses that will be left after applicable costs are covered.

The insurance company will also likely ask the exact date of the bipolar diagnosis, who diagnosed the patient and when was the last manic episode. Typically all of these questions can be fully answered in great detail by the medical records, so the insurance company will likely request copies of all available medical records. If the patient has not had any hospitalization, either in patient or outpatient in recent months, that alone may serve to answer the question of how often hospitalization may be required. The health insurance company has to weigh the risks of insuring such a huge risk, that is the reason for the exhaustive research and questioning.

The last thing that will be checked into is medication for the bipolar patient. The effectiveness of the current medications will be weighed against the medical history. How often have new medications or a change in medications been needed? This type of information is indicative of how much medical care the patient needs and if the current treatment plan is working or if it appears that doctor visits and medication changes happen often and therefore the cost of the patient's medical care will be higher. Bipolar patients have to jump through many hoops to secure insurance coverage, but it can be done.

Highly Sensitive People and Depression: Overstimulation May Lead to Depression.

Recent research by social psychologist Elaine Aron and her team describes a set of human characteristics which she calls "high sensitivity." Her research suggests that approximately 15-20% of the human (and for that matter animals) have evolved to be markedly more responsive to their environment. It is not that these "highly sensitive people" (HSPs) are gifted with super-hearing or hyper-acute vision but rather, that they have nervous systems and minds which permit more stimulation to enter without automatically and unconsciously shutting it out, and further, that they then cognitively process the stimulation that they receive in more detail than others do.

What do we mean by "stimulation?
Stimulation comes in on all sensory channels: sights, sounds, smells, vibrations, touch.
HSP's typically respond strongly and quickly reach their natural level of tolerance in loud, bright or chaotic environments.

  • Managing this kind of overstimulation could be treated as a "technical problem" of reducing environmental intensity or leaving it when possible.

Five kinds of over-stimulation which can contribute to depression

(1) Chronic environmental overstimulation.
Unfortunately "leaving" an over-stimulating environment is not always possible.

  • A sensitive child may not leave a busy classroom...
  • A worker may not always have the luxury of leaving an intolerable workplace...
  • A loving, sensitive mother cannot abandon her children when they are "over-stimulating "

Animal models have shown that when a creature comes to believe that it is unable to flee a tormenting environment it develops feelings of "learned helplessness" and becomes hopeless and depressed (Seligman,1967).

Over-stimulation is an unpleasant, aversive experience for everyone.
HSPs who are chronically over-stimulated and feel incapable of exercising control over their environment may be at higher risk for developing feelings of helplessness, hopelessness... and then depression.

(2) Internal bodily stimulation

HSPs are closely tuned in to information and signals from their bodies. Internal sensations of hunger, thirst, over-heating, physical tiredness, insufficient rest... all are very compelling and evident to them. As a result, HSP's sometimes become overly concerned about their health or frailty and may make urgent demands on their environment for attention or support.

This heightened awareness of their human vulnerability may contribute to feelings of anxiety and a sense of vulnerability which again contributes to the growth of depressive feelings.

(3) A rich and stimulating inner life.
Another set of stimuli arises in the form of fantasies, dreams and internal reflections... all those, anxious, critical or magical thoughts, which float around in the background of our usual conscious thinking are more easily accessible, more credible and interesting to most HSP's.

This detailed cognition about anxiety-producing possibilities is undertaken in order to anticipate and avert potential problems... but it can easily become overwhelming and contribute to feelings of fragility and inadequacy and lead again towards helpless, hopeless depression.

(4) Interpersonal over-stimulation
Other human beings are highly stimulating to be around!

All human beings are constantly signaling their emotional states to one another through tone of voice, posture, gestures and eye contact. It is a natural human ability to respond empathically to these signals... to understand and"feel together" with those around us.

HSPs with their porous stimulation barriers and detailed cognitive processing are skilled conscious and unconscious interpersonal signal readers. As a result they are often unknowingly buffeted and captured by the emotional states of those around them...or even by the plight of people on the news or in fictional representations. They may experience these resonances very strongly.

If an HSP is living closely with a depressed or mentally ill person or in a depressing environment, they may find it very difficult not to become depressed themselves.

(5) Chemically related depressive responses
Since HSPs are very attuned to their bodies, they notice the physical changes which occur in response to very low levels of environmental contaminants or very low doses of medications.

Side effects which might be minor in others may be very prominent in sensitive individuals.
Some medications may have depression as a side-effect:

  • Hypertension and cholesterol medications can sometimes cause depression symptoms, as can some medications for cardiac disease because these medications affect the brain as well as the rest of the body.
  • Oral contraceptives and hormone replacement medications also may affect mood.
  • Anti-anxiety drugs, and mood stabilizers which are intended to reduce anxious tension also carry the risk of depression as a side effect.
  • Strong prescription acne medication is known to cause depression in some individuals.

A vicious circle...
The intersection of these factors may create a "perfect storm" for some HSPs. Sensitivity to their own responses leads to feelings of fragility which in turn convince the individual that they cannot change or influence their environment. Anxious the cognition also contributes to the feeling of helpless, hopelessness that leads to depression. Contamination by the depression or anxiety of others around them may add to their bleak view

Feeling empowered helps...
Fortunately, studies have also suggested that sensitivity works both ways. Sensitive individuals are also particularly able to enjoy pleasurable stimulation, and benefit powerfully from the love, support and interest of those around them.

HSPs often benefit quickly from psychotherapeutic support which helps them re-frame their experience towards an equally detailed but more positive and empowered perspective on themselves, their capabilities and their potential to control their environment effectively.

High sensitivity is part of the normal spectrum of human responsiveness. It comes bearing gifts of perceptiveness, intuition, conscientiousness and empathy for others... qualities which are of inestimable value to human society. Unexplored and untreated depression in HSPs robs us all of the benefits of their special gifts.

If you or someone you care about is highly sensitive and struggling with depression it may be time to reach out for help and support.

Lithium and SSRI - Lithium Interaction With SSRIs and Your Health

Lithium has been used for decades to treat bipolar disorders and the manic episodes during manic depression. With the development of SSRIs (Selective Serotonin Reuptake Inhibitors), it was thought that lithium would no longer be needed, as SSRIs generally have less severe side effects than lithium. This did not happen, as many therapies to treat depression and bipolar mood swings that involved an SSRI are now being augmented with lithium.

How does Lithium Work with an SSRI?

Lithium is one of the most common substances used in conjunction with SSRIs. The method by which lithium works is in its altering of the transportation of sodium throughout nerve and muscle cells. It is sodium that plays a major role in the excitability of those suffering manic episodes as they deal with manic depression and bipolar disorder.

The dosing of lithium is used extensively in maintenance therapy, by reducing the intensity of manic episodes and, as a means of maintenance dosing, to aid in the prevention of manic episodes and bipolar disorder symptoms. There is, however, the possibility of an adverse interaction by using lithium and an SSRI. Lithium can increase the serotonin regulatory effects of SSRIs more than needed, which can lead to serotonin syndrome, a potentially fatal disease.

Effects of Lithium during SSRI Treatment

Though lithium is a proven treatment in certain personality disorders, it does come with side effects. These side effects are more common, and sometimes more severe, than those of SSRIs which was the inspiration for the development of SSRIs. Some of the side effects of lithium are as follows:

  • Drowsiness

  • Excessive Thirst

  • Fatigue

  • Hand Tremors

  • Increased Urination

  • Nausea

  • Thyroid Problems

  • Weakness

  • Weight Gain

Interactions with Lithium during SSRI Therapy

There has been some cause for concern when augmenting SSRI therapy with lithium. Lithium has been known to interact negatively with fluoxetine, an SSRI known by several brand names most popularly Prozac. Of all the current SSRIs, citalopram (Celexa) has had the least complications due to interactions with other drugs and has not shown to have any adverse affects in combination with Lithium.

The most common and worrisome complication due to interactions between SSRIs and lithium is serotonin syndrome. Serotonin syndrome is simply an increased amount of serotonin that gathers in the central nervous system. The excess serotonin is caused by over stimulation from drugs that are used to regulate serotonin levels in the body, such as an SSRI. This can be caused simply by an overdose of an SSRI, or by taking other substances, such as lithium, in concert with an SSRI.

Wednesday, May 7, 2014

Depression and Gallbladder Connection

Although depression itself cannot cause gallbladder problems per se, not being able to eat anything can certainly be depressing. Many antidepressant medications are anticholinergic which means they slow down gallbladder contractions, thus contributing to gallbladder troubles. However, beyond that, there is a physiological connection via the thyroid. If you suffer from chronic depression or even bouts of depression now and again, it could possibly be due to a particular condition of low thyroid that is brought on by low serotonin and/or dopamine levels.

Here's how it works. Low serotonin or dopamine levels affect the functioning of the thyroid gland resulting in low (not high) TSH levels. It is high TSH levels that alert your doctor that your thyroid is working overtime and needs some support. However, these low levels along with other markers, may show that the thyroid is not functioning optimally, even though these markers may be within "normal" laboratory range. Insulin surges and excess cortisol production from, for example, blood sugar highs and lows, are major contributors to this thyroid pattern.

To support this pattern, it is not the thyroid itself that needs support, but the thyroid-pituitary connection, along with proper balancing of blood sugar. Along with blood sugar dysregulation, gut inflammation, a poor diet, and adrenal stress are also factors that contribute to poor thyroid health. Are you seeing the connection to digestion here? Many gallbladder conditions are accompanied by gut inflammation. And gut inflammation has a corresponding inflammation in the brain. Low thyroid function, diagnosed or not, affects brain function which can result in depression and poor memory. "An unsupported thyroid condition guarantees some degree of brain degeneration in time." (1., 2.) How can we support the brain's neurotransmitters?

  • physical exercise

  • mental exercise such as Sudoku

  • diet rich in such things as fish oils, and one that balances blood sugar

  • improving digestion of fats which are integral to brain function

  • supplemental brain support that contains the applicable amino acids and specific nutrients

Supporting the brain helps the thyroid; supporting the thyroid helps the brain. It's a win, win. Reducing gut inflammation also reduces inflammation in the brain. What's all this got to do with my gallbladder problem? Well, here's the clincher: Low thyroid function slows down digestion and gallbladder functioning contributing to low HIDA scans and to the formation of gallstones. (3.) And if you are on thyroid replacement and still suffering from low thyroid symptoms, chances are there is something more going on that is not being addressed. So if you are prone to depression, brain fog or poor memory, and if you have gallbladder disease of any kind, read our page dedicated to low thyroid and gallbladder function. There's a list of other symptoms connected with thyroid function that may surprise you too.


  1. Bernal J, et al. Thyroid hormones and brain development. Eur J Endocrinol 1995;133:390-398

  2. Flavin RSL, et al. Regulation of microglial development: A Novel role for thyroid hormones. The Journal of Neuroscience 2001;21(6):2028-2038.

  3. Henry V繹lzke, Daniel M Robinson, Ulrich John,Association between thyroid function and gallstone disease,World J Gastroenterol

The Difference Between Major Depression and Minor Depression

Broadly depression can be classified in two categories:

Major depression:

Major depression is one of the most serious forms of depression. It is also referred to as clinical  or unipolar depression. Some Clinicians call it major depressive disorder. It is not an illness since it can be treated very easily once diagnosed. Major disorder can be cured even at the severe stage with the help of good care and medication.

Major disorder means a prolonged feeling of sadness. Sufferer doesn't show interest in any activity or pass time. Loss of appetite, loss in weight, hopelessness, lack of concentration, low self esteem and isolation are the common symptoms of this disease. The negative feelings are very common in the patient suffering from major depression. Patient is always occupied with thoughts of suicide. A person with this type of depression needs good care and attention as he can harm himself anytime. This type of disorder is not short term, it lasts for years.

Minor depression:

This type of depression is just contrary to the major depression. Minor depression means ordinary sadness which doesn't need any medication. A person himself can cure it by taking action. He has no need to be dependent on drugs and doctors. In the cases of major depression people need drugs. But mild one can be cured by being active and creative. People take prescription drugs and then lay dormant. Only drugs can not remove depression. If you have minor depression, you are suggested to take some actions like - read good books, see nature, call friends or relatives and listen to good music.

Book Summary: Focus - A Simplicity Manifesto in the Age of Distraction - Written by Leo Babauta

I have some of the other works from Leo and he has an excellent mindset. To accomplish high value task and achieve goals, focus is required. To help in my quest to understand focus, I read this book.

Why is this important to me?

I don't want to waste your time. If you are investing your time reviewing this summary then it has to be worth it for you. Marcus Aurelius said: Most of what we say and do is not essential. If you can eliminate it, you'll have more time, and more tranquility. Ask yourself at every moment, "Is this necessary?"

Pablo Picasso - Without great solitude no serious work is possible. These two quotes have real power once they are implemented.

Focus is divided into 4 major parts. For the sake of time, I will touch on a concept in each section.

1. Step Back - Email, web browsing, YouTube, Twitter and Facebook. All of these mediums spell one thing - Distraction. Distraction creates stress and wastes time. In May 2011, Americans spent 53.5 billion minutes on Facebook. On average people spend 24 hours per week watching TV and surfing the web. That equates to three full time working days per week. Needless to say, these stats clearly show that people are distracted.

2. Clearing the Stream - Focus requires setting a schedule. So one way to clear some of the distractions is to schedule your internet time. Once you put this on the calendar, you can monitor how much time you are truly spending on these activities. This also consolidates your usage and makes you more productive because you are focused on just the internet. Once the time is up then disconnect and tend to your other tasks.

3. Simplify - One excellent technique to simplifying your life is to de-clutter. This means eliminate the non-essentials. Clear off your desk and have a clean working environment. This will eliminate distractions. If you have a stack of crap on your desk then go through it and make a decision - File, Trash or Donate. Make the decision quick and move on. You can do this in your house as well. Having a minimalist life style reduces stress so you can use the same process for your house as you do your desk at work.

Focus - Now that you have performed the first three steps, you can focus on what is meaningful. Decide what the top five priorities are each day and focus on those. Single task each priority until they are done. Multi-tasking on high value tasks does NOT work. Multi-tasking is a recipe for mediocre work and frustrated peers. Have you ever had a conversation with somebody while they are reading email?

Focus is a quick book to read and provides functional "how to" tactics so that you can accomplish high value tasks. You will be amazed at what you can accomplish when you eliminate the non-essentials.

I hope you have found this short summary useful. The key to any new idea is to work it into your daily routine until it becomes habit. Habits form in as little as 21 days. One thing you can take away from this book is to de-clutter. Start de-cluttering your work space and house each day. Do this for 21 days and see how much better you are able to focus on what is really important.

Meditation, Using Brainwave Entrainment, Is Good For Memory Loss

When we think of stress, most of the time, we think of the physical effects it produces, like tension in the neck, back and shoulders, a rapid heartbeat, a tight throat, cold sweaty hands and feet, clenched fists, ulcers, high blood pressure, and a deep furrow between the eyebrows.

However, it's our emotional response to stress that can be positively impacted by using meditation, which in turn, positively affects, diminishes or eliminates the physical effects of stress.

Our conscious perceptions cause stress and thereby produce emotional problems. Changing our conscious perceptions can change the patterns of emotional responses and behaviours we have hard-wired into our subconscious mind.

In a study from Thomas Jefferson University Hospital, it was determined that Kundalini meditation-mantra based chanting, had a positive impact on the emotional response to stress, fatigue and anxiety in adults with memory impairment or loss.

After 12 minutes of meditation a day, for eight consecutive weeks, the subjects with mild age-associated memory impairment to mild impairment from Alzheimer's disease, showed significant increases in cerebral blood flow in the prefrontal, superior frontal, and superior parietal cortices as well as huge improvements in cognitive function.

Cognitive function refers to a person's ability to process thoughts like memory, the ability to learn new information, speech and reading comprehension and in a diseased or impaired mind, will be marked my memory loss, inability to process thoughts or communication, and loss of reading and speaking ability.

When one experiences memory loss, whether age related or disease related, cognitive impairment is accompanied by depression, anxiety, and changes in mood.

Meditation has been proven to improve symptoms of anxiety, fatigue, depression, anger and confusion, and mood.

A specific brainwave frequency, in alpha, has been reported to stimulate the amygdala, an area of the brain responsible for the formation and storage of memories associated with emotional events; caudate, an area that is involved with learning and memory; prefrontal cortex associated with depression; interior frontal lobe, parietal region, and cingulated cortex correlated with feelings of tension.

Meditation significantly improves the symptoms of confusion, depression, and memory loss.

Meditation is a practice that may take years to master, but with the accompaniment of brainwave entrainment, can be used faster and in more efficient way, to improve the emotional response to stress, in people with memory impairment.

Brainwave entrainment is a clinically proven technology that uses audio and/or visual pulses to stimulate the brain to follow a specific pattern, with the intention of changing its state of consciousness.

Meditation, along with brainwave entrainment, can increase blood flow to areas of the brain necessary for mood and emotional response, removing anxiety for those with memory loss.

The brain can be changed, for the better.

Brainwave entrainment speeds up the benefits of meditation, so that memory loss symptoms of depression and anxiety, can be diminished or eliminated more quickly.

Your Period in Your 30s, 40s, and Beyond - What You Need to Know Between Puberty and Menopause

For many women, the only times we receive much education about our periods are at puberty and menopause. You might assume that after the teenage years, your period should be on a regular cycle, unchanged until menopause, but this isn't true. Along with the menstrual cycle disruptions of pregnancy, birth control pills, and illnesses, you may have very different periods through the different decades of your reproductive years.

The 20s: Typically, by the time you reach your 20s, the hormonal chaos that accompanies puberty has mostly subsided, and your hormone levels are as balanced as they will ever be. There is no one "right" menstrual cycle, but the average time between one period and the next for a woman in her 20s is 32 days. Periods may be very predictable-like clockwork, even-especially if you are using birth control pills.

This doesn't mean, however, that you should necessarily be concerned if your periods are irregular. A woman's menstrual cycle is a complex interaction between her reproductive system; hormones produced in the pituitary glands, hypothalamus and thyroid; and the environment. Stress, diet, and the amount of sleep and exercise you get all influence your cycle, too.

When should you be concerned? Generally, these are signs that you should see a health care provider:
Severe PMS: If you are bothered by physical changes or changes in your mood consistently each month, see a health care provider to rule out underlying causes, such as clinical depression, uterine fibroids, or endometriosis.
Painful periods: Some discomfort is normal, but if the pain is severe, consistent, and not relieved by an over-the-counter medication such as ibuprofen, see a health care provider to rule out an infection, scar tissue, or another underlying cause.
Missed, or infrequent, periods: If you are sexually active, have a pregnancy test done first. An occasional missed period, even if you aren't pregnant, shouldn't be a concern. They can be caused by too much exercise, stress, and certain medications. If you have gone more than 3 months without a period and are not pregnant, see a health care provider to rule out a hormone imbalance, ovarian cysts, or certain hypothalamus or pituitary conditions.
Unusually heavy periods: If a pregnancy is possible, an unusually heavy period could be a sign of miscarriage. If you consistently have heavy periods, your health care provider may want to rule out endometrial cancer or an underlying thyroid or blood-clotting disorder.

These conditions are all treatable. Don't be afraid to see your health care provider if you feel there is something unusual or wrong about the way your body functions.

The 30s: As you transition from your 20s to your 30s, and especially by the age of 35, your body begins to produce less estrogen. You may find that your menstrual cycle has shortened, from an average of 32 to 28 days. You may also notice shorter or irregular periods, increased symptoms of PMS, a heavier menstrual flow, or a combination of these changes. These hormone fluctuations are sometimes referred to as perimenopause, which simply means "the time around menopause."

As our estrogen levels begin to decline, our fertility begins to decline as well. We may experience some of the changes associated with menopause, including the thinning and drying of vaginal tissue, breast tenderness, an increased buildup of body fat around the waistline, hot flashes, and night sweats. A woman may experience these changes for up to fifteen years before her last menstrual period. For some women, these body changes will be more severe during perimenopause than during menopause itself. In fact, seven to eleven percent of women in their late 30s will stop having periods.

If you are severely bothered by the hormone fluctuations and the body changes associated with them, you might first consider lifestyle changes to ease the symptoms. Eating well, getting moderate exercise, reducing your stress level, and getting adequate rest may make the symptoms more manageable. If lifestyle changes don't solve the problem, you may want to see your health care provider and find out whether hormone therapy, either in the form of birth control pills to help regulate hormones or estrogen replacement therapy, is appropriate for you.

For some women, the perimenopausal years may mean changes in heart health. If you experience any heart symptoms, including skipped beats or moments of rapid heart fluttering, see your health care provider immediately to rule out an underlying heart problem. After you have had these heart symptoms checked out by your doctor, you may find that some heart symptoms become a consistent part of your cycle. Know your own body and what is normal for you.

The 40s: Women typically experience the body changes of perimenopause six to ten years before our menstrual periods stop. For most of us, this means we'll experience perimenopause by our late 40s. Depending on family history and other factors, you may also stop having periods in your 40s. The average woman will experience shorter cycles. In contrast to what many of us experience in our 30s, you may also have lighter menstrual flows. Ovulation occurs less frequently than it did in your 20s and 30s, and fertility continues to decline.

If you haven't already learned what to expect from your body during and after menopause, now is the time to educate yourself. If possible, talk to your mother, grandmother, and aunts about their experiences. Even if lifestyle changes worked well for you in your thirties, you may now want to talk to your health care provider about hormone replacement therapy.

Remember, too, that for many women, the transition from the menstrual to the post-menopausal years is a relief and has many positive aspects. Our bodies will change; this is inevitable. Suffering, physically or emotionally, because of these changes is not inevitable.

Women of any age should keep track of when our periods begin and end each month, and be aware of changes in our bodies' rhythms. This way, when we do notice something unusual or bothersome, we'll be better prepared to discuss the changes with our health care providers.

Demon Possession Causes All Types of Mental Illness Including Schizophrenia

What causes mental illness and its various types? The answer lies in demon possession. When a person has mental illness such as schizophrenia, bipolar, major depression, psychosis, multiple personality disorder, or has suicidal thoughts, the individual has quite literally "lost their mind" to invading demon spirits.

Demon spirits pray on those who are weak mentally, physically and emotionally. When a person suffers a trauma in their life and they are unable to cope with the trauma mentally and emotionally, a part of their soul chooses not to have that experience and splits off causing "soul fragmentation". This leaves a vacuum or space for demon spirits to reside within the soul and influence the mind and feelings of the person involved.

These demon spirits enter through holes in the aura when the person is emotionally vulnerable and seeks to "escape" their own life. Take for example, marijuana usage in teenagers who are often emotionally troubled and seek to escape the reality of their troubled lives. Taking drugs such as marijuana causes holes to appear in the aura. It is also a form of "escapism" that fragments the soul, leaving the individual open and vulnerable to demon possession. And this is why schizophrenia has been linked to marijuana usage. It is not the marijuana itself that is causing the schizophrenia, it is the invasion of the demon spirit that hi-jacks the soul and mind of the troubled teenager, after they have used marijuana.

This is why we see ordinary young adults stay healthy all their lives - free of schizophrenia - and then all of a sudden have schizophrenia after taking marijuana. It is because they have lost control of their mind due to demon possession.

Severe or more extreme types of mental illness such as schizophrenia, bipolar, personality disorder, multiple personality disorder, psychosis are caused by a large number of demon and earthbound spirits entering the soul of the person involved. The person has literally lost control of their soul and mind to malevolent or negative spirits. Major depression, suicide and suicidal thoughts are also caused by demon or earthbound spirits influencing the mind and the emotions of the person's soul they inhabit.

Most people on earth have one or more earthbound or demon spirits within their soul, that has gained entry into their soul either during this lifetime or been carried over from a past life. Yet because demon spirits can only possess a soul according to the degree to which it has chosen to give away control of its soul, most demon possession is only partial in nature and the demon spirit expresses itself through the identity of the human ego. Most people cannot distinguish between what is of their own human ego, which is negative and fear-based in nature, and what is of a demon spirit that has infiltrated their soul under the guise of the ego.

The website mentioned below will give you important tools and information on this subject, information that has been channeled from Jesus Christ and other spiritual beings of Light, to help free you of the clutches of this demonic scurvy that has raged the souls of the people on earth. It is time to take back control of your soul.

Tuesday, May 6, 2014

Depression: Causes, Symptoms And Treatment Options

Major depressive disorder, which is usually simply referred to as depression, is a condition that is characterized by chronic feelings of sadness and hopelessness. It is important to note that everyone experiences feelings of sadness from time to time, and that is usually not a cause for concern. However, it is not normal to feel that way all of the time. People who are chronically depressed are at an increased risk for developing physical health problems and committing suicide.

What are some of the symptoms of major depressive disorder?

Feeling sad and hopeless all of the time is the main symptom of this disorder. Fatigue, lack of energy, insomnia, impaired ability to concentrate, weight loss, agitation and worry are some of the other symptoms that may accompany major depressive disorder. Depressed people also have a tendency to isolate themselves from others.

What causes major depressive disorder?

Health experts have not been able to identify the exact cause of depression. However, they have found that genetics, chemical changes in the brain and stressful events may play a role in the development of this condition. Drug and alcohol abuse can also make a person more susceptible to developing major depressive disorder.

What are some treatment options for major depressive disorder?

It is very important for all depressed people to go to their doctor, so that they can get the appropriate treatment. A doctor will usually recommend a combination of therapy and medication. Cognitive-behavioral therapy, psychotherapy and group therapy are the three forms of therapy that are recommended for depressed patients.

Cognitive-behavioral therapy helps a patient fight off the negative thoughts that can contribute to major depressive disorder. The goal of psychotherapy is to help patients understand the issues that are causing their condition. Group therapy helps people communicate with others who are experiencing similar issues.

Antidepressants are the standard group of medications prescribed to treat major depressive disorder.

These medications work by increasing the amount of serotonin in the brain. Health experts believe that serotonin is one of the neurotransmitters that control happiness. Paxil, Prozac, Lexapro and Celexa are some of the most commonly prescribed antidepressants.

Even though antidepressants are extremely effective, they do not come without side effects. Weight gain, appetite loss, dizziness, insomnia, anxiety and decreased sex drive are some of the most commonly reported side effects. Taking antidepressants during pregnancy can be very dangerous. Studies have shown that women who take these medications while they are pregnant are more likely to give birth to a baby with birth defects. Additionally, antidepressants may also increase suicidal behavior in some patients.

What are some things that can be done at home to treat major depressive disorder?

Exercise is one of the most effective home remedies for major depressive disorder. In fact, some studies suggest that exercise may be just as effective as antidepressants. When people exercise, their body releases endorphins. Endorphins are chemicals in the body that promote feelings of relaxation and well-being. People should try to exercise for at least 30 minutes every day.

There has also been evidence to suggest that omega 3 fatty acids can help treat major depressive disorder. Omega 3 fatty acids are a type of polyunsaturated fat found in cold water fish, walnuts and flaxseed oil. Researchers believe that omega 3 fatty acids help improve overall brain health.

Yoga and meditation can also help a person feel better. Even though some patients can treat their condition at home, everyone should consult with their physician before they try any type of natural remedy. Furthermore, no one should stop taking a prescribed medication without first consulting with their doctor.

Copyright (c) 2012 Embracing Depression

3 Powerful Supplements For Your Mind - A Psychotherapist Explains

EPA - This Omega 3 fatty acid, found abundantly in fish oil, tops my list of supplements capable of affecting the way we respond to stress, anxiety and depression

I have been singing the praises of this particular supplement to clients for a couple of years now, and have seen first hand the difference it can make in the lives of those who regularly take it. Indeed, there is a growing body of evidence that pure EPA helps improve mental functioning, stabilise mood and helps us to deal more effectively with stress and anxiety.

Supplementing with pure EPA has proven helpful not only for people suffering from stress, but it has had a real and positive affect on individuals experiencing bi-polar disorder (also known as manic depression), depression, and mood swings. Additionally, EPA has been shown to improve memory, concentration and mental processing. As if this were not enough, it has also been shown to be beneficial in treating skin conditions such as psoriasis, eczema and acne.

Though bottles labelled 'EPA' may be readily purchased from most health food stores, they most often contain too high a proportion of DHA mixed in with the EPA. Almost all of the research has been conducted with pure EPA and so, when choosing to supplement, it is important to select a fish oil high in EPA and low in DHA in order to gain the maximum benefit. UK residents can check when considering purchasing EPA, while those outside the UK will need to go online to locate a supplier. In my experience, it really is worth the effort, and the price.

St John's Wort - Often called 'Nature's Prozac', St John's Wort is also sometimes referred to as 'the sunshine vitamin', though it is not a vitamin but a herbal supplement.

St John's Wort has been used for centuries in Europe in order to treat mental disorders and relieve pain and, while not recommended for cases of major depression, this herb has shown itself to be useful in the treatment of mild to moderate depression, anxiety and mood disorders.

It is thought that the active agent in St John's Wort works by preventing neurons or brain cells from re-absorbing serotonin - commonly referred to as 'the happiness molecule' - thereby stimulating an abundance of this essential, mood-influencing chemical messenger in the brain. Some researchers have suggested that it works by reducing the quantity of a specific protein that is involved in the healthy functioning of the immune system.

But whatever its mechanism, it certainly does appear to have had a remarkable effect on the many clients I have recommended it to.

Because St John's Wort can inter-react with certain medications, do remember to check with your health advisor before taking this powerful supplement.

Once that is cleared, look forward to seeing results within a few weeks of regular supplementation.

Vitamin B Complex - The B complex vitamins are needed for the healthy regulation of the nervous system. Indeed, without these essential nutrients, not only would we cease to function mentally, but eventually everything would grind to a halt.

Vitamins B1, B6 and B12 are needed for the effective functioning of the brain, as well as the whole nervous system. Indeed, a deficiency of any of the B vitamins can lead to feelings of stress, anxiety, and depression, not to mention feelings of fatigue and lethargy.

In an age of convenience and fast foods, with its emphasis on marketing and profit, it can be difficult to obtain a sufficient quantity and quality of these important nutrients. Also, since each of the B vitamins works in close synergy with the others, a deficiency in any one B vitamin can provoke poor functioning of the others - even if they are in abundant supply in the diet. Because of this, it is wisest to take the B vitamins in a complete complex. Since the B vitamins are water-soluble, any excess is readily excreted in the urine.

Do be sure to read the label before buying, however. Cheap vitamin B complex can often be short in vitamin B6, since this is a relatively expensive vitamin to produce. Also, since vitamin B12 in particular is not easily absorbed when taken orally, look for a preparation that ideally has its vitamins in 'chelated' form. This simply means that the vitamins have been bonded with amino acids so that they can be efficiently absorbed and utilised by the body. Of course, chelated vitamins do cost a bit more, but it is well worth that little bit extra.

After all, what is really important is not so much what we swallow, but what we actually absorb.

Give these supplements a try for just three months and notice how your mood and mental functioning change and improve.

IMPORTANT: This Information is not a replacement for medical or nutritional advice. Since certain supplements are contra-indicated for some individuals, especially those taking other medication, before beginning any programme of supplementation you are advised to visit your doctor or other qualified health care professional.