Cognitive Therapy of Depression

We are often taught to ignore and bury our problems and upsets and to ‘be strong.’ This is a temporary solution for distress that has serious drawbacks. Learning to identify and to release our feelings are much better ways of handling them. Varieties of self-treatment methods enable us to do this, with excellent results, including the release of anxieties about having problems in the first place.
Bandages
I was taught in medical school in the 1960s that psychological wounds, like physical wounds, are often best handled at the time of emotional injuries by bandaging them, ignoring them as best one could, and carrying on with life. This was then, and continues to be now, the prevalent attitude of the majority of people.
Most of us develop habits of doing just that from childhood, both on our own and with the encouragement of family, friends and other authority figures. We cover over our wounds, burying them in our unconscious mind, and do our best to ignore them, or better yet, to totally forget them.
In childhood, this may be truly helpful. When we have only a limited understanding of the world, and limited coping abilities, it far less painful to bury our hurts than to suffer with them.
‘Billie’ started out in life a bright and cheerful girl with lots of curiosity and good energies. She had the misfortune to be born into a family stressed by her father’s limited earning capacity and her mother’s chronic depression, which was self-medicated with whiskey. Billie suffered neglect and the abuse of her parents’ violent arguments. She learned to grit her teeth to remind herself to be silent, lest she draw the angers from between her parents to herself. She also suffered from frequent criticisms from both her parents, never seeming to be able to do anything that would gain her their praises. The best she could manage was to draw the least attention possible to herself.
Baggage
As adults we have far better coping mechanisms for dealing with hurts. However, at that point we already are in the firm habits of burying our hurts and running away from them. These habits are so much a part of ourselves that we don’t even know they’re there.
The problem is, when we bury our hurts, we end up carrying them around with us in our unconscious mind. Through the years, we may accumulate enormous collections of such buried emotional baggage.
A buried hurt is like a festering sore. It sits in an internal trash bucket in our unconscious mind and exudes negative energies. The unconscious mind senses these as warnings about having been hurt in the past and remains alert lest we be hurt again in the present.
The unconscious mind then keeps us away from anything in the present that is similar to the warning signals it is getting from the buried hurts. In milder cases, we may have aversions for occasional foods, people and places with which we had negative experiences – often without conscious awareness we are doing these things for those reasons. In moderate cases, we may generalize from hurts in a specific situation and then we avoid anything similar to the original trauma. People who had an abusive parent my avoid relationships in their present lives with anyone of the same sex as their abusive parent. In severe cases, people may respond to the approaches of a person of the same sex as their abusive parent with stress reactions. This is called a post-traumatic stress disorder (PTSD).
It is often in our most intimate relationships that these buried issues become apparent. A colleague at work, a close friend or a life partner may stir the buried hurts in our inner buckets and be utterly blindsided by our inappropriate responses. The behaviors of people in our lives today trigger us to respond with feelings that have been buried in the past.
It is at this point that many people will seek me out for psychotherapy, as they waken to the fact that they are not behaving rationally but don’t fully comprehend why this is happening. Others come with requests for psychiatric medications, thinking they need stronger bandages.
Billie suffered from frequent, severe tension headaches. She knew they were set off by stresses in her life, but could not figure out how to not get stressed when she was confronted by any criticisms from her boss, her fiends or her boyfriend.
Balms
Varieties of treatments are available to help with these sorts of problems. Each has its benefits and limitations.
Medications are the quickest ‘fix.’ They require the least efforts on the part of family physicians, psychiatrists and people who just want to be free of their symptoms, but have little sense of the emotional baggage that may be contributing to the symptoms. Not only do then not address the underlying problems, they also carry risks of side effects, including fatalities. It is a little publicized fact that over 100,000 people die annually in the US from medications that are properly prescribed and properly used. Pain medications contribute to significant numbers of these deaths.
For those who are willing to take the reins of their lives into their own hands, there are many helpful approaches. The most popular today is Cognitive Behavioral Therapy (CBT). This can include relaxation exercises to reduce tensions; imagery exercises to reprogram the mind to not respond in the present with reactions from the past; and developing more constructive plans of action to handle inappropriate responses. CBT is a methodical approach for developing better habits to deal with buried hurts, but a rather slow one. It can take many weeks and months to make modest progress in changing one’s habits of reacting to stresses that trigger unhealthy responses.
Many varieties of complementary/ alternative therapies are available for addressing problems. Some are symptom-based and some are person-based, and the ‘how’ of the therapist administering the therapy may determine which approach is taken. For instance, acupuncture, homeopathy, Ayurvedic medicine, hypnotherapy, massage and relaxation techniques can all be offered as doorways to transforming one’s life, or as balms for particular symptoms.
Billie explored acupuncture because it has a good reputation for alleviating pain, but her acupuncturist was a physician who had only been on several weekend courses and used the needles much as he used medications – i.e. to alleviate the symptoms. Relaxation exercises provided temporary relief when she had the headaches, but they kept coming back, often at stressful times at work when she was unable to use these methods.
WHEE: Whole Health – Easily and Effectively finally provided permanent relief, with the release of fears, angers and hurts that had been buried since childhood.
Blessings
As we learn to deal with our physical and emotional pains, we often grow wiser in the process. We come to realize that our body is an intimate part of our whole being. When we have symptoms and illnesses, we learn to ask, “What is my body telling me about stresses and disharmonies in some part of my life?”
Many therapies end with the release of symptoms and problems. WHEE teaches how to install positive feelings and awarenesses to replace the negatives that have been released.
As she learned to listen to what her body was telling her, Billie came to understand that when she was clenching her teeth she was unconsciously ‘biting her tongue’ to hold back from sharing her feelings of anger and frustration and telling people off. She learned to use WHEE on her negative feelings and was then able to prevent her headaches and other pains from recurring
As we use self-healing methods, we can also come to understand how to nurture ourselves and to be more considerate of our physical and emotional needs. With continued practice, we even free ourselves of the fears about getting upset.

As a long term yogic and vipassana meditator, and a mindfulness-based psychotherapist who regularly teaches meditation practices to my patients, I find the growth of mindfulness as a clinical intervention very timely. Last year, I attended two conferences focused on the use of mindfulness as a clinical intervention:  “Meditation and Psychotherapy” at Harvard Medical School and “Mindfulness and Psychotherapy” at UCLA. Interestingly, the conference at Harvard featured a greater percentage of presenters who do not use meditation as an intervention in their clinical work. For them, mindfulness is a teachable skill set, extrapolated from a way of viewing life gained from sustained Buddhist meditation practices. These presenters included: Steven Hayes, founder of ACT, Lizbeth Roemer, U Mass GAD researcher and clinician, Tal Ben-Shahar, Harvard Lecturer on Positive Psychology, and Jayme Shorin, LICSW, sensorimotor trainer. The fact that the organizers of the Harvard conference felt it necessary to devote over half of the presentation time to methodologies that do not include meditation was, for me, significant. Though this might be expected at a “Mindfulness and Psychotherapy” conference, in fact the UCLA conference featured more presenters discussing the use of meditation and compassion practices as a clinical intervention. These presenters included: Thich Nhat Hahn, Vietnamese Buddhist monk and meditation teacher, Jack Kornfield, Tara Brach, Harriett Kimble Wrye, and Trudy Goodman, all psychologists and meditation teachers, and Dr. Daniel Siegel & Harvard neuroscientist Sara Lazar presenting the neurobiology of meditation.Due to the continuing trend in mental health toward brief, CBT methods and away from depth-oriented, psychodynamic therapies, one can easily see how a reduction of “mindfulness” to an easily deliverable skill set would be a natural outcome of the environment in which it is delivered. But is the doing away with meditation practice psychotherapeutically wrong or ineffective? Not necessarily. Even in the East, Karma Yoga is an example of a path to liberation which eschews formal meditation practice in favor of a commitment to the work one does in the world as spiritual practice. Also, with neuroscience showing significant brain changes from long-term mindfulness meditation, one can easily see how a researcher like Steven Hayes could create mental exercises that simulate, through active questioning of the validity of language, the realization of the contextual nature of the self., i.e., “Am I really these thoughts and beliefs that my mind continually comes up with?” Years of meditation cultivates a natural non-reactivity to experience. But why wait years, when simple instructions for distress tolerance, like those featured in DBT can be dispensed to patients suffering from emotion dysregulation? Following in the footsteps of ACT is Acceptance-based psychotherapy which focuses on delivering skills for realizing and accepting here and now experience with compassion; something vipassana meditation and metta practices are well documented at cultivating in long-term practitioners. Yet again, why practice meditation at all when mindfulness skills can be learned and behaviors changed?Additionally, it must be acknowledged that most psychotherapists will not want to learn and commit to a daily mindfulness meditation practice, or be trained to teach mindfulness meditation. Therefore, it may be more desirable and practical in clinical settings to deliver a CBT-like mindfulness skill set rather than teach meditationIn light of all these benefits, what do we lose in clinical practice when we allow instruction of vipassana/mindfulness meditation to fall into disfavor or become outmoded? The following list is my best guess at an answer to this question: 1.The long and short term stress-reducing physical effects of meditation2.The plethora of profoundly, positive neural changes evidenced in the brains of long term vipassana/Tibetan Buddhist meditators 3.The deep emotional healing that comes from metta/forgiveness/compassion meditation practices 4.The benefits of setting aside time in our busy lives for silence, meditation and contemplation5.The cultivation of peacefulness6.The deepening of connection with and respect for our planet and all living things upon it, which naturally arise from sustained meditation practice7.The shared joy of a community of meditators; whether traditional sanghas or 8-week mindfulness-based groups like Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy for Depression Relapse Prevention (MBCT), or Mindfulness-Based Relapse Prevention for addiction recovery (MBRP). I have seen patients experience radical change from incorporating mindfulness meditation and mindfulness skills into their daily lives and I am excited to offer MBRP, a mindfulness-based intervention for addiction relapse prevention in San Jose, CA in March 2008. Please contact me for more information.

Having trouble getting to sleep, or experiencing tiredness and other forms of daytime distress? If this looks like a day in your life then chances are you have insomnia. If you have this, please don’t feel alone. This is a common health issue in many countries. In fact in the United States alone, around 30 to 40 percent of the adults have indicated that they have felt the symptoms of this sleeping disorder. And at the same study conducted by the National Center for Sleep Disorders Research, 10 to 15 percent of the adults indicated that they have chronic insomnia.

There are a number of factors that come into play as to why insomnia and chronic insomnia happens. Health professionals point to stress, depression, other medical illnesses, pain and other disorders as the main culprits. Tiredness and fatigue is just the start. For those who have chronic insomnia, the patients may complain about poor brain function, physical complaints and changes in mood. Though these things are not life threatening, the inconveniences are too much and these can affect the lifestyle and the quality of life of the person.

But this doesn’t mean that this is the end of the road for insomnia sufferers. There is a way out of this sleeping disorder and persons can get back to their usual ways and get a good night sleep. Treatment options are available, and examples of treatment options that can be selected include cognitive behavioral therapy, the intake of FDA-approved medications and other natural treatment options like change in lifestyle.

Cognitive Behavioral Therapy or CBT

One popular chronic insomnia treatment option is through the use of cognitive behavioral therapy or CBT. This is considered as a non-medical approach in tackling the sleeping disorder. This treatment option is founded on the belief that the chronic insomnia often happens alongside a number of factors. In this treatment option, the patient will be asked about the sleeping disorder and this is known as the clinical interview. And to effectively treat the disorder, a number of approaches will be considered like sleep restriction, stimulus control and proper sleep hygiene. All these approaches are to be complemented by proper relaxation.

Use of FDA-approved medications

There are a lot of medications that are used and abused by many insomnia patients, and a number of these medications are considered as over-the-counter medications. But not all of these medications are helpful for insomniacs. According to the 2005 NIH conference on the management of insomnia, only the benzodiazepine receptor agonists are considered to be effective and safe against insomnia. The conference also elaborated on the fact that other medications are backed by insufficient evidence when it comes to efficacy and safety.

Use of natural approaches and lifestyle changes

For those who can still sleep and bothered by insomnia in some cases, the issue can be addressed by some lifestyle changes. For example, the person can maintain a regular bedtime and wake time schedule. It is also suggested that the patient should allow the biological clock to promote sleep at the right time and also allow the body to anticipate the body if it’s time to sleep.

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ADHD or attention deficit hyperactivity disorder is a biological condition of the brain involving the neurotransmitters (brain messengers) dopamine, norepinephrine, and perhaps serotonin with a genetic backdrop. It impacts as many as one out of four school aged children and at least one in twenty adults. It is estimated that most classrooms have at least two student who have attention deficit hyperactivity disorder, providing extra challenges for the educators involved and pulling resources away from the other children who may need extra help. So it is no surprise  that finding the best ADHD treatment is on the list of so many parents of ADHD children and teachers alike. 

*In ones quest to find the best ADHD treatment or treatments there are any number of questions that must be answered. Once answers are found the results must be weighed with the potential benefits. For example the most often prescribed prescription medications for attention deficit hyperactivity disorder in both children and adults are stimulants such as Ritalin, Adderall, Dexedrine, and Cylert. They have been shown to improve ADHD symptoms about eighty percent of the time but the list of side effects include tics, insomnia, restlessness, nervousness, headaches, stomach upset, irritability, mood swings, depression, dizziness, and a racing heartbeat. Most doctors are animate in their belief that stimulants are the best ADHD treatment and point to the fact that fewer than ten percent of those taking these medications suffer any side effects whatsoever.

 *Psychologists on the other hand are not as convinced throwing much of their weight behind behavioral therapies such cognitive behavioral counseling. Pointing to a recent study comparing stimulants and CBT that found CBT to be as effective in treating symptoms while producing longer lasting results. So for many psychologists and psychotherapists behavior modification therapy is considered to be the best ADHD treatment.

 *The third group throwing their hat behind a treatment option are those in the field of natural health who are somewhat spit as to what actually is the best ADHD treatment. Instead they advocate a plan which includes homeopathic and/or herbal remedies, diet modification, proper nutrition, along with lifestyle adjustment techniques. In evaluating this alternative it is important to remember that the number one rule in the naturopathic oath is to do no harm.

 In summary, whether it is stimulant medications, behavioral therapy, or natural remedies for ADHD what we do know is that that certain combinations of the above therapies tend to improve overall results. For example when behavioral therapy is combined with either stimulant medications or homeopathy the overall results climb about ten percent. In conclusion the best treatment for ADHD is not a single treatment option but finding the proper combination of treatment options that work best for you or your child’s particular situation without producing the unpleasant side effects so often associated with prescription medications.

Tinitus Help

After exhausting conventional treatments for tinnitus, a lot of people supply up hope of of all time going down or becoming rid of the ringing noises properties hear in this ears. Not only can their be especially annoying for the sufferer but it can also leave them irritable, depressed and cause to anxiety. Tinitus Help

One tinnitus therapy that is thought to work, where other treatments have not, is CBT – Cognitive Behavioral Therapy. This is an approach that aims to study the sufferer in order to solve problems systematically that are thought to be behavioural or emotionally related.

There is no ‘route’ with the therapy as a plan is outlined for each patient depending on the suspected cause of the problem. For example, when treating anxiety which has been linked to tinnitus, the treatment may involve gradual exposure to the cause of anxiety. Tinitus Help

CBT is not, however, a quick process and will not cure you overnight. It can actually take several months or more because first of all the cause or trigger of the problem needs to be located and then steps need to be taken to replace the dysfunctional behaviour with one that does not trigger it.

The time involved will vary from patient to patient and will depend on a lot of circumstances, but it is surely worth the effort in order to stop the ringing on a permanent basis? Finally, some people also report reduced symptoms from doing Yoga regularly. As this is designed to help relax that it may indicate that the problem has been caused by stress or anxiety. Tinitus Help

There are lots of yoga classes around and some informational videos will also guide you through doing this at home, so this is also worth a try in the short term. Suffering from Tinnitus and Ringing in Ear? Get your life back forever by checking out Tinitus Help now.

Your doctor’s first line treatment for panic attack is usually drug-based medications. These work quite well for many people, but their downsides are that they treat the symptoms rather than the root cause, and, they do have many negative side effects. In addition they can be expensive, especially where they have to be used over a considerable period of time. Here, you’ll discover why you don’t need panic attack medications to succeed.

First, let’s consider how a panic attack occurs…

An attack normally occurs where a sufferer already has much higher-than-normal levels of anxiety. So when an everyday stressful event occurs, such as; shopping in a crowded supermarket, driving in the rush hour, etc., the additional stress pushes their overall anxiety up to such an intensity that a panic attack is triggered.

Nowadays, more and more folks are seeking to eliminate their attacks using totally natural remedies without the bad side effects of drug-based medications. Typical of these are; dizziness, nausea, disorientation, depression, fatigue, blurred vision, light headedness, memory loss, and, in some cases, dependency.

Nevertheless, drugs can be effective short term solutions and are widely prescribed. However, in many cases, after patients come off the drugs at the end of their course, the anxiety and their associated attacks can re-occur, because the root cause hasn’t been tackled.

Sufferers are then faced with the choice of going back on drugs where appropriate, or, using other non-drug therapies such as Cognitive Behavioural Therapy (CBT). Many prefer to go the therapy route, with CBT and others such as hypnosis, self-hypnosis, meditation, etc. There are also things like yoga, acupuncture and support groups etc.

The aforementioned can be looked upon as techniques to help you cope with, or manage, your general anxiety and panic attacks. But that’s all they do; help you cope. And drugs only help you with the symptoms. You want to get to the root of the problem and tackle that in order to get to a successful conclusion…

One of the key elements in arriving at a proper cessation of anxiety and panic attacks is your natural fear of having a panic attack. This can be a conscious or subconscious fear, but, either way, it can hold you back and is at the root of things.

You see, your fear of another attack can be the very thing that causes that panic attack to occur. Try to look at it like this: your understandable fear builds on your already higher-than-normal general anxiety so that a normal, everyday stressful occurrence — that under normal circumstances you would take in your stride — can raise your overall anxiety level to such a height that an attack is triggered.

Look on this process as a ‘cycle of anxiety’ that can be described as; anxiety > panic attack > fear > raised anxiety > panic attack > fear > raised anxiety > and so on. You need to break this vicious cycle in order to prevent further panic attacks and cure your general anxiety.

Now, only you can break the cycle; drugs won’t do it and, even with the best therapies to help you, you’ll need a great deal of determination and a positive attitude to succeed. But there is a special technique that you can use called the ‘One Move’ technique that can help enormously.

To discover the simple ‘ONE MOVE’ technique that will eliminate your fear factor and so break your vicious cycle of anxiety at last, go here now http://eliminatepanicattacks.blogspot.com and prepare to get your old self back again.

Bipolar disorder, also known as manic depression, is a mental illness caused by a number of factors including neurological, biological, emotional, and environmental factors. It is typically characterized as mood cycling from manic, or extra happy, moods to depressed, or extra sad, moods.

Many people are not aware that in the last few years doctors have begun diagnosing bipolar disorder as two different types, based on how the moods cycle in the patient. Bipolar disorder type 1, also known as raging bipolar disorder, is diagnosed when the patient has at least one manic episode lasting at least one week or longer. Bipolar disorder type two, also known as rapid cycling bipolar disorder, is diagnosed when the patient has at least one manic episode and one depressive episode within four days to one week.

Hypomania is a severe form of mania that typically occurs in bipolar disorder type 1 patients. This state occurs because the patient is almost constantly up; the normal state for the patient is 1 of mania. Therefore, mood cycling in bipolar disorder type 1 patients often involves mania combined with the mood change. Mania combined with mania creates hypomania. Hypomania also can be accompanied by psychotic symptoms such as the patient becoming delusional or having hallucinations. This is a very simplistic way to describe how hypomania and mixed episodes occur.

Mixed episodes also often occur with bipolar disorder type 1. A mixed episode is hard to explain to the general public. It consists of being both happy and sad, up and down, all at the same time. Generally, this translates into the patient being very depressed emotionally, but displaying symptoms of mania such as inability to concentrate and lack of sleep.

Bipolar disorder type 1 is the most common type of bipolar disorder, and the most treatable. Because bipolar disorder type 1 typically manifests itself in the form of long manic periods with possibly one or two short depressive periods each year, treatment options are much more simple. Since mania requires one type of medication and depression requires another type of medication, the ability to treat only mania makes finding effective medications a much simpler task. Mood stabilizers are also quite effective with type 1 bipolar disorder, without the use of mania or depression medications.

The symptoms that the bipolar disorder type 1 patient experiences determines the type of mania medication used to control the excessive moods. In cases of mild but constant mania, lithium is the drug of choice. However, in cases in which mixed mania or hypomania are consistently present, a stronger drug or anti-psychotic, such as Depakote, is typically prescribed.

Bipolar type 1 is also the likeliest candidate for treatment via Cognitive Behavioral Therapy (CBT). This is because the patient is most often in a state that allows them to easily focus their mind on rationalizing situations, recognizing triggers, and suppressing severe episodes. However, when the patient displays symptoms of hypomania, as some bipolar type 1 patients often do, cognitive behavioral therapy is not as effective during these episodes.

Overall, bipolar disorder type 1 is easily controlled through appropriate treatment and medications. If you experience any symptoms of bipolar disorder type 1 you should contact your doctor to make arrangements for diagnostic testing and to discuss treatment options. Ultimately, the patient is responsible for their own illness, and therefore, their own treatment.

Advil and effexor xr ? has anyone heard or read about a possible negative interaction between these two medication.? – I take Effexor XR and tylenol, and an anti-inflammatory (like advil) and have for years with no problems. Yes, there can be some complications beside interacting those 2 medications (even though one is over the counter for pain relief). Effexor xr…Does effexor xr facilitate for panic/anxiety disorder? Yes, it is indicated for both depression and anxiety. I only get anxiety on occasion, but even smaller amount often on Effexor. Edit- I should note though, that while it helped me avoid anxiety, the withdrawal effects made me even more anxious… you necessitate to be rigorous with staying on schedule with Effexor. …Does effexor xr minister to beside massive madness attacks? All of those drugs have a tendency to stop working after being on them for a while. I wouldn’t quit taking your drugs abruptly incase you suffer mental and physical bill symptoms which will be likely if your body is used to them. Hi, There is this guide by anxiety expert Joe Barry , he…Does effexor xr work for ocd? Also if you found it worked for your ocd and depression symptoms did you find it took a higher dosage to alleviate your symptoms. – If you have been diagnosed with OCD, you are doing yourself a disservice by not adjectives in a form of therapy known as cognitive behavioral therapy (aka CBT) and the specific skill…Does the use of tobbacco products affect the course effexor xr works? not that I have heard of NO. – Nicotine is in it’s self an anti depressant. It releases acetylcholine which produces a re-energizing effect in your body. Nicotine also stimulates cholinergic neurons. These neurons release dopamine which cause us to feel pleasant, jovial feelings. Along with this Glutamate is released…My doc prescribed effexor xr.I am currently on celexa. Cold turkey switch. Anyone ever done that? How’d u do? You should be able to trust your doc, right? I dunno this makes me nervous. (taking these meds for panic disorder after all) It merely doesn’t seem like I should quit taking one immediatly and start the other. Celexa is a SSRI and Effexor is a…My friend is preg she take effexor xr will that hurt her or the kid? I am 30 weeks pregnant and I take Effexor-XR .It is one of those situations where you have to keep taking it if the benefits outweigh the risks.I took it my end pregnancy and my daughter was totally fine.I did take less than I was supposed too.I be supposed…My psychiatrist have me on effexor xr along near zoloft? he said he never did a combination like that in his career. can they interfere with respectively other? When you take more than one serotonin drug there is a chance that you could get someting call seratonergic syndrome. Basically you go into shock, get a fever, breakout in sweat, shivering,, hyperthermia, hypertension, and tachycardia, …Vicodin and effexor xr within pills cabinet ? so i was visiting some of my family and i was going threw the pills cabinet and i found some vicodin (score!!) and some effexor xr and some other stuff but i only took the vicodin and the effexor xr my question is what is effexor xr ? and what does it do ? there 150…What happen if i hold effexor xr if i dont have need of it ? and what exactly is it for ?? i took a 150 mg capsule will i be ok … i only took 1 You should talk to your parents or call a doctor right away. I think you will be ok maybe but your lately a kid 150 mg not…Effexor xr – sleepless, enlarged pupils, speedily heart? i just took my first dose of effexor xr yesterday afternoon and i cant get to sleep for the life of me, my pupils are enlarged and my heart is at a faster rate. does this go away and is this is a dodgy med? im scared to stop taking it because ihave horrible panic attacks…Effexor XR = severe diarrhea? i take effexor xr and never had that problem. since you’ve tried so many different brands with like problem, it may be something in the medication your body is not agreeing with or you are allergic to. only your doc can help you near this one. Effexor XR and tiredness and counterbalance gain? Does anyone take effexor xr and get spells of being tired throughout the day? I run 225 mgs all at once and i have been taking for several months. I also have no sex drive at adjectives. I also take 1 mg of Klonopin at bedtime so maybe that’s making me tired also. I have also gained around…Effexor xr withdrawal in a minute valium? Horrid withdrawals from effexor xr now prescribed valium to help me through. Anyone with similar or same presciption experiences? hey, i’ve just come off the exact tablet as of yesterday… i be getting bad night sweats so they weened me off them because i suffer badly beside short temper, pulsating, and concentrating when ever i’m off them.Effexor XR withdrawal? I have missed 2 days of my effexor xr and I tell you what I feel so sick right now. I grain very spacey like my detached from my body, my head hurts, I just discern terrible. With only 2 days of not taking it can withdrawals already be starting? I have taken this medication for at most minuscule 7 months now…Effexor xr? I am currently taking effexor xr for depression and anti-anxiety disorder. I have done some research and have found that some people have a big problem getting sour it. Has anyone been on effexor for awhile and stopped taking? If so what was it like for you? I am on it too. I am told you should slowly come off…What is surrounded by effexor xr? what kind of drug compounds are in effexor XR? effexor is for general depression. the xr stands for extended release. a normal antidep. pill close to zoloft, paxil you take it once a day. the levels of med kinda go up and down so to speak where on earth as xr releases through out day to keep your…What is the best time to purloin effexor xr? In the morning or at night? Does it give you a jolt? If anyone has tried it how did it put together you feel at first.Does it really help? – My husband takes it in the morning. Always have, with his breakfast, take it with food. My sister tried taking it at…What is the difference between effexor and effexor xr? i was on effexor xr for 2 1/2 yrs. been off of it for 4 yrs. i havnt felt “normal” since i stopped taking it. i lately had a severe anxiety attack and actually called an ambulance. thought i was dieing i guess. my doc give me pristique 50 mg, a new med. i…What would come to pass if i took effexor xr short self prescribed? it’s antidepressant. i want to know what could happen and will happen? – Not a great idea. Effexor is supposed to be taken on a daily proof. Once you have been taking it every day for a couple weeks, missing a dose gives you bill effects. Coming off Effexor…Getting sour effexor xr to wellbutrin or celexa? My own experience – when I stopped taking Effexor, my doctor did not instruct me to taper off it so I quit it cold turkey. The Wellbutrin was started at a low dose. I had very doomed to failure vertigo and suicidal thoughts. It took a few days for me to realize it must…Going backbone on Effexor XR and I’m really strung-up give or take a few it… any comments? I took effexor xr when I was 14 after my father died. I dont really remember a lot from that time but I can notice that I lost weight at that time and presently I’ve definetely gained it. I dont know if the weight loss was because of…Has any ever taken effexor xr or lexapro for anxiety? i have PMDD and i’m discovering that the yaz i’m taking helps with those symptoms but doesn’t relieve my tension and anxiety so i’m considering taking something else next to it. i’ve tried zoloft but it made me sluggish and zombie-like… has anyone taken lexapro or effexor xr? do they make you sleepy?…Has anybody tried effexor xr? Just curious to find effects.? Yes, I am on it now. No side effects whatsoever. I love it!!! I have tried merely about every other anti-depressant out on the market, and this is by far the best. I no longer have any crying bouts. I no longer feel the flight or argument, and this is what effexor is…Has anyone bought effexor xr online? – You can save some money if you order meds online, just check the pharmacies very measured before you buy anything. Here are some tips from my experience with online drugstores. One thing I know for sure – do not buy anything from a pharmacy that sends spam emails, I know a few guys who been ripped…Has anyone else weaned themselves rotten effexor xr? I am on effexor xr. Have be over a year. I seem to talk more, sleep alot longer in the mornings etc. I have notice my vision as well isn’t as good. I am still on it. i am on effexer XL and i had a panick attack last night, i own never had one…Does suboxone show up within a association urine examination??or antidepressants such as effexor xr and wellbutrien? – The antidepressants, no. The Suboxone, since it’s main ingredient is an opiate, will. Suboxone contains Buprenorphine, which is an opiate. 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In 2006 in the US, the clinical gold standard for insomnia was controlled-release Ambien. Millions of prescriptions a year were and are written. Moving across the Atlantic, the situation is no less “impressive”. According to the latest figures, there are around half a million people in England taking sleeping pills at any one time. The National Health Service records show 820,000 prescriptions are written every month. It is estimated that some 330,000 pills are taken every day. This would make insomnia the most common psychological condition in Britain.

Why is insomnia so common? One explanation is that we now live a 24/7 lifestyle. Television and cable transmit tempting programs into our homes round the clock. We can surf the net, talk or sms on our handphones. We drink too much coffee. We live in an overstimulated world. But why would that lead to what, in real terms, would have to be described as an epidemic? Perhaps it is an age thing. As we all get older, do we need less sleep?

A better explanation seems to be that we have changed our attitude towards sleep. The first step is to distinguish between insomnia as the inability to get to sleep when we want to and sleeplessness where something keeps us awake, e.g. a change in our biological clock after flying to a different time zone. This makes insomnia mainly a psychological condition with insomniacs significantly more likely to be depressed than ordinary sleepers. This means that the more anxious we get about “falling asleep” the more difficult it is likely to become.

Generations ago, people did not take sleep for granted. Indeed, they were often worried about appearing lazy if they slept too much — Leonardo da Vinci pronounced sleep a waste of valuable time, napping about fifteen minutes every four hours. Now we are indoctrinated with the idea that unless we sleep seven or eight hours a night, our worlds will end. Hence, the National Sleep Foundation in the US recommends eight hours, but it is a fact that 70% of the population get less than this. A range of between five-and-a-half and nine-and-a-half hours per night is probably normal. In The New Black: Mourning, Melancholia and Depression, Darian Leader suggests that insomnia is usually a symptom of anxiety. Rather than routinely prescribe ambien, he consistently seeks to identify and treat the cause of the inability to sleep.

We could enjoy the peace of the night-time world when everyone else is asleep. The phone does not ring. No-one disturbs us. But the sleep-deprived brain does not function well and, for the majority, nights cannot be used creatively or productively. People are simply too tired whatever time of the day or night it is. Go for long enough without sleep and madness waits for us. This creates a billion dollar/pound industry to produce medications to knock us out. We are not deterred even though there can be withdrawal symptoms to negotiate when we try to stop taking the pills. Ambien is better than no treatment. Cognitive behavioural therapy (CBT) is a good alternative but often not available. Other than CBT, we are into the self-help world of relaxation techniques. Perhaps this last option recognises that insomniacs are often too busy thinking about “stuff” to get to sleep. If they were bored, they might just drop off. One thing is certain, if you are not going to rely on ambien, the worst thing is to try to make yourself sleep. Like most things, the harder you try to do what should come naturally, the more unnatural you make it and the harder it becomes.

Helping Those With Eating Disorders

Dr. Samson Omotosho, PhD, APRN/PMHN

Definition: An eating disorder is a maladaptive response due to inability to regulate eating habits and the tendency to overuse or under use food. It is more common in females. The problem may be characterized by an imbalance in the eating pattern, an excessive or inadequate caloric intake or an inappropriate body weight for the individual’s age and height. Types of Eating Disorders: Bulimia Nervosa, Anorexia Nervosa, Binge Eating Disorder, and Night Eating Syndrome.

 Bulimia Nervosa: This is an eating disorder characterized by uncontrollable binge eating, alternating with vomiting or dieting. Most (90%) of bulimia nervosa is found in females. It occurs in 2.5% of the population. The age of onset is 15-18 years. About 72% of patients recover. Early detection and treatment of the illness improves chances of recovery. It is mostly found in normal weight persons. The patient may, in addition, have anorexia nervosa.

 Anorexia Nervosa: This is an eating disorder in which the person experiences hunger but refuses to eat because of a distorted body image and false perception of fatness, leading to starvation. It occurs in about 1% of the population. The onset may be at any age, mostly 13-20 years. Mostly (90%) occurs in females. About 72% of patients recover and about 5% die. Alcohol use increases mortality from anorexia nervosa.

 Binge Eating Disorder (BED): This is an eating disorder in which the person rapidly consumes large quantities of food without any attempt to control weight gain. It is found in about 3% of the population. About 30% of obese persons have this disorder. Therefore, clinicians want to assess obese persons for BED.

Night Eating Syndrome (NES): This is a severe eating problem in which the person experiences anorexia in the morning, depression in the evening, insomnia at night and multiple awakenings to eat at night. About 1.5% of the population has NES. 8% of obese persons have NES.

Possible Factors: There has been a genetic link to eating disorders. Other factors include disorder in the appetite regulation center in the brain (hypothalamus); low serotonin and high dopamine levels in the brain; the individual’s psychological makeup such as being a perfectionist, impulsive, or rigidity; early separation problems; low self esteem; high sense of shame and guilt; compulsion and obsession; environmental factors; multiple childhood illnesses or surgeries; parental separation; deaths in the family; parental overemphasis on athletics and slimness; parental disapproval of overweight persons in the presence of the child; skipping meals; preoccupation with wanting to be a model, poor nutritional habits; societal value of thinness; school’s emphasis on weight and size; occupations such as dancing, acting, modeling, and fashion that emphasize body weight and size; mass media reinforcement of the thinness culture; 

What to look for: Look for any of the factors listed above. Do or suggest a full physical assessment. Check for the individuals’ satisfaction with their eating pattern; if they ever eat in secret; actual weight versus desired weight; food avoidances, including restrictions, dieting, and fasting; use of laxatives, diuretics, diet pills, and purging; compulsive exercise patterns; frequency, timing, and preferences about eating. Assessment for Binging: Check for consumption of hundreds or thousands of calories in one sitting; excessive intake and loss of control in eating; secretive consumption of food; eating accompanied with sense of shame; history of unsuccessful dieting in the past. Binging may range form occasional to more than ten times per day. Assessment for Anorexia Nervosa: Look for fasting and restriction of calorie intake to 200-700/day while patient yet perceives her intake as adequate; the design of limited unbalanced diet for self; insistence on particular choice of food repeatedly; insistence on a particular eating time, order, and pattern; bizarre food preferences; avoidance of fatty foods; prolonged fasting; obsession with food, cooking, and food-related jobs. Assessment for Bulimia: Look for forced vomiting, excessive exercise, and the use of diet pills, diuretics, laxatives, steroids, insulin, cocaine, heroine, thyroid hormones, nicotine, hallucinogens, antidepressants, benzodiazepines, and analgesics.

Complications: For Anorexia nervosa: starvation, scanty menstruation, osteoporosis, cold intolerance, fast heartbeat, low blood pressure, constipation, electrolyte imbalance, and leg edema (swelling). Bulimia Nervosa: low blood potassium, muscle weakness, irregular heartbeat, stomach and intestinal problems, dental enamel erosion, and parotid enlargement. Binging – obesity, hypertension, diabetes mellitus. For any form of eating disorder, there may also be accompanying depression, anxiety, substance abuse, and personality disorders.

Other Considerations: Persons with eating disorders are very susceptible to life stressors. Anorexia nervosa is thought to be as a result of the individual’s difficulty in controlling some aspects of the individual’s life or fears (aspects such as maturity, independence, failure, sexuality, and parental demand). Individuals with anorexia are usually angry about concern from others and frequently use denial as a defense mechanism. Bulimia patients use avoidance, isolation of affect and intellectualization mostly.

Help and Treatment: Success in helping actually depends on the patient’s motivation. So, assess the level of motivation of the individual for help and treatment. Ask her to rate her desire for help and treatment on a scale of 1 to 10. Formulate a helper-patient contract and help protocol and gain patient’s commitment. The protocol should specify patient and expectations and responsibilities about meals, weighing, timing of meals, amount of drinking water, vital signs, bathroom privileges, close observation, diet foods, and food substitutions. Graduate the patient’s independence over meal selection and scheduling. Stabilize patient’s nutritional status. Motivate anorexic and bulimic patient to stop trying to lose weight. Motivate her to gain weight. Contract with her to gain at least 1lb per week. Counsel her about healthy eating patterns. Help her to graduate her exercise and focus on fitness. Provide cognitive behavioral therapy (CBT). The CBT should train her in cue avoidance and response change; challenging faulty thoughts, feelings, and assumptions, and finding alternative problem-solving and decision-making responses in high-risk situations. Reinforce her compliance with the contract. Use dance, movement therapy, imagery, relaxation, working with mirrors and depicting the self through art to help her with body image distortion. With patient’s consent, involve chosen family members in planning and intervention. Help family to respect patient’s individuality. Motivate them to serve as support system to the patient. Use group therapy for reality testing, support, peer communication, social alliance, and expression of feelings. Medications are not usually very useful for eating disorders. Antipsychotics, antidepressant and mood stabilizers provide very little benefit.

Check out the following websites:

www.nationaleatingdisorders.org

www.nimh.nih.gov/health/publications/eating-disorders/

Dr. Samson Omotosho

CEO, Futurefocus Wealth Builders. www.futurefocusbiz.com

References:

Copstead, L. C., & Banasik, J. L. (2005). Pathophysiology (3rd ed.). St. Louis, MO: Elsevier Saunders.

Stuart, G. W. & Laraia, M. T. (2005). Principles and practice of psychiatric nursing (8th ed.). St. Louis, MO: Elsevier Mosby.

Varcarolis, E. (2006). Foundations of psychiatric mental health nursing: A clinical approach (5th ed.). Philadelphia: W.B. Saunders.

Williams, P. M., Goodie, J., & Motsinger, C. (2008). Treating eating disorders in primary care. American Family Physician 77(2), 187-195.