Antidepressants Blog

OVERCOMING BARRIERS TO BDD TREATMENT: DIAGNOSING BDD   Accurately diagnosing BDD is a necessary step toward effective treatment. If BDD isn’t diagnosed, it probably won’t be successfully treated. Unfortunately, BDD is still unfamiliar to some mental health professionals, and many people with BDD seek nonpsychiatric treatment, such as surgery, which doesn’t seem to work. Perhaps most important, secrecy about BDD prevents the diagnosis from being made. In fact, studies have shown that although BDD is relatively common, it nearly always goes unrecognized and undiagnosed in clinical settings.What To Do: Fill out the BDDQ to see whether you may have BDD. The information in special books and articles should also help you figure out whether the diagnosis applies to you. Then I’d suggest following the advice above—getting an evaluation from a mental health professional familiar with BDD and telling them you think you have this disorder and want treatment for it.*233\204\8*

DEALING WITH UNPREDICTABLE PERIODS: COULD A SLUGGISH THYROID BE MY PROBLEM?I missed three months of my period and when my doctor checked me he found that my thyroid was underactive. He put me on birth control pills. I began to menstruate but now I’m off the pills and I’m not bleeding anymore. I’m wondering if my sluggish thyroid could be my problem? I’m also overweight.—P.L.Hudson, WisconsinThe thyroid gland is involved in stimulating the brain hormones LH and FSH, which trigger the menstrual cycle. So if a woman’s thyroid is underactive, it will not be able to stimulate the brain hormones and ovulation will not take place.This letter is a good reminder that the thyroid is very important in controlling a woman’s menstrual cycle. A woman who has not had her period for a while might be given a thyroid test along with other hormonal evaluations. A low thyroid hormone production—hypothyroidism—can be corrected with thyroid medication and once the gland is functioning properly, menstruation will probably recur.The woman who wrote this letter is also overweight, and her underactive thyroid may be the reason for her condition. If she takes the thyroid medication she might not only start menstruating, but she might also find that she is able to slim down more easily.*45\333\2*

TREAT WHAT AILS YOU:  SENSITIVE AND IRRITATED SKINSometimes, identifying your specific skin condition can turn into a guessing game that you seem to never have the answer to. One of the best examples of this form of mistaken identity is skin that is irritated and overly sensitive. Since redness and peeling, usually around the nose and forehead, are characteristic of sensitive and irritated skin, it is often brushed off as bung dry. In reality, this type of skin is brought on by a genetic condition that can become worse, usually while you’re under stress.SolutionThe very first step in controlling sensitive and irritated skin is to calm the skin down. This can be accomplished with soaps that contain zinc as well as with a low-dose hydrocortisone cream. Botanical ingredients like rosemary and aloe are also fantastic at naturally relaxing the skin. A standard regime involves using such ingredients for a month. After the skin has normalised it can then tolerate more active ingredients that in the past weren’t a viable option for such sensitive skin.What you can expect…The peeling, rough texture will be vastly improved and the uncomfortable tightness alleviated.*26\82\8*

OTHER PEOPLE’S PAIN AND SOCIETYGiven the slow start of the professions in facing the challenge of pain, it is not surprising that most governments have trailed behind. The largest medical research centre in the world is the National Institute of Health in Bethesda, Maryland. The size of at least ten medical schools, it contains institutes dedicated to the major conditions such as cancer, heart disease and so on, but not even a section concerned with pain. The French national medical research organization has one excellent unit on pain problems, the Germans have two but the British have none.Charities are crucial in the support of medical research. In Britain, the Wellcome Trust alone funds as much research as the government’s Medical Research Council, and the cancer charities support more cancer research than the government. In any country, a multiplicity of charities finance research and the well-being of those with many types of illness, including some with very obscure diseases. Yet no country in the world has a major charity devoted to those in pain. Why is that so? It could be that people wish to see their money spent on fundamental cures not on symptoms. There are societies who reasonably seek a cure for arthritis, knowing that if they succeed the pain will go. The Multiple Sclerosis Society does not divert funds to determine why those who suffer multiple sclerosis are in pain. The International Spinal Research Trust has in its charter that money may be used only for research on the regeneration of nerves in the spinal cord, and may not be applied to symptom relief. There are headache and migraine societies but headaches could be considered self-contained entities.This insistence on fundamental cure may be a partial explanation for the absence of pain charities but I believe that it cannot be complete. After all, there are many excellent, powerful charities for the blind, the deaf or amputees, with the side intention of enriching their daily lives and with no talk of cure or restoration. I suspect that the entire subject of pain encompasses one of the last taboos. It is not a topic of easy conversation. Better to speak of something else which offers a chance of control. I have written this entire book with trepidation. Has it skimmed over an abyss of dark horror which hides a terrible threat? Presumably the reader who has reached this far has found some method of coping with their own distaste of so disturbing a topic. One may read about cancer from a psychologically isolated refuge even if you have cancer, as I do. When I see someone in pain, I confess that I still react with horror and would prefer to retreat. My response is the occupational therapy of working on the topic. I do not believe one can ever be familiar with pain. It is too deep.Society is not kind to people in pain. Fifty million Americans are partly or totally disabled for periods ranging from a few days to weeks or months. Some are permanently disabled. A significant proportion of chronic pain problems relate to the lower back. Some 60 per cent of the British population take more than a week off work for back pain during their working life. In a telephone survey of 1,254 adult Americans, 56 per cent reported some back pain in the preceeding year with 3 per cent reporting low back pain for more than a month. Surveys of this type have been carried out in many countries and always show the presence of very large numbers of people in trouble with pains, of which back pains, headaches and arthritis are the most common. The fact that a proportion are suffering from very prolonged episodes means that available treatment must be ineffective.One might think that such a vast problem would be a subject worthy of media attention but in practice there is a wall of silence. The reason for this neglect may be that everyone is so familiar with the problem in themselves or in their friends and relatives that the unpleasant facts are ignored in favour of something new and the evanescent breakthroughs which enchant the press. It may also be an example of a taboo subject from which we cringe.While silence reigns in public, some doctors have been paying close attention and some label low back pain as an epidemic. Attacks of low back pain are usually of sudden onset. In a ten-year survey of all workers in the Boeing aircraft factories, attacks were found to be equally common in shopfloor workers engaged in heavy lifting and in clerical workers whose occupation involved only light work. Some 80 per cent of the victims had a relief of pain within two weeks but 10 per cent were still in pain five months later. Even the brief episodes tend to recur and may become more frequent and prolonged. Very careful testing of people with sudden-onset low back pain reveals up to 15 per cent may have one of five disorders which may explain the pain: slipped discs, displaced vertebrae, overgrowth of bone, unstable vertebrae, and fractures, tumours and infections. This leaves 85 per cent of the victims in the highly unsatisfactory category of ‘nonspecific low back pain’.Many countries have set up commissions to give official guidelines on how to cope with these people. The most recent and infamous is entitled Back Pain in the Workplace. The Management of Disability in Non-specific Conditions and was written by an international team of experts. Society intrudes to form an unholy coalition of employers, insurance companies, lawyers and workers’ compensation bureaux with puzzled doctors. They emphasize the ruinously rising costs of lost work hours, sickness benefits and insurance plans. Because the doctors could define no traditional cause for the pain and disability, many of the inspecting alliance were eager to turn to the attitude of the victims as the cause of their pain. A recent survey of the British civil service showed absenteeism to be relatively low among the top-grade executives and the lowest grades, such as postmen, whereas the middle ranks, who face daily hassles, had the highest rate. The Boeing survey identified job dissatisfaction as predicting those most likely to complain to the company of back pain. It seems to me such obvious common sense that those who hate their job and the company will complain to the company. It is hardly worth the trouble of a vast survey.Ignoring this common-sense explanation, the report on back pain in the workplace concludes that dissatisfied workers cause their own pain. In order to treat this common problem, the report proposes specific treatment. For the first six weeks, the victim of nonspecific low back pain is permitted only a day or two of bed rest, after which movement is vigorously encouraged with professional help and with minimal analgesic medication. It is quite true that the majority recover during this conservative regime, at least until their next episode. The commission is even more specific about the proper treatment of those still in pain after six weeks. The diagnosis of back pain is to cease and the patients are now to be labelled ‘movement intolerant’. I take this phrase to be a politically correct neologism implying a work-shy shirker. Furthermore, it recommends a cessation of all further medical treatment on the grounds that it positively encourages patients to consider themselves sick. In order to reinforce this, it proposes an abrupt end to the payment of sickness benefit and the relabelling of workers as unemployed.This report is the considered opinion of a very eminent international grouping of establishment experts. They conclude that the problem is no longer for traditional medicine but is instead a social, psychological epidemic and should be treated as such. The Canadian Pain Society objected strongly to the report. All societies contain large numbers of ‘experts’ who have diagnosed precisely the causes of what is wrong with their societies. Immigrants, minorities and criminals are popular explanations for society’s ills.One popular idea is that society is sinking under a mass of people who live a life of ease and luxury supported by social benefits. The Australian psychologist Pilowsky invented the term ‘hypochondriophobia’ to label the tendency in our population to suspect and fear the validity of people on prolonged sickness benefits. For example, Italians love to repeat a press fabrication about a man who was on a pension for the blind while also being paid as a traffic policeman. In this atmosphere, in which social and sickness benefits are considered mainly in terms of cheating, fraud, hypochondria and lack of moral fibre, governments concentrate on ways to reduce their social-security budgets. This is not a good atmosphere in which to mobilize the mass of good-hearted citizens who would love to take part in social action to help and encourage the lonely abandoned folk who live in pain. *84\219\2*

INTERNAL MALE ANATOMYThe testes, or male gonads, are comparable to the ovaries of the female. Both testes are about the same size; and one of their usually the left one, hangs lower than the other one. Whether the lower one is the right or left one does not seem to be influenced by left- or right-handedness, ethnic background, etc. Like the ovaries, the testes perform two main functions: they produce sperm and they manufacture the male hormone, testosterone. The testes descend from the abdominal cavity into the scrotal sac during the seventh month of prenatal development. It is estimated that about four percent of males are born with undescended testicles (cryptorchidism). If this condition persists, it should be surgically corrected by the time the boy reaches the age of four or five.Each testis is surrounded by a tight, whitish fibrous sheath (tunica albuginea) which divides the testis into many sections or lobules (small lobes). Each lobule contains several winding and tightly coiled seminiferous (sperm-bearing) tubules, the site at which sperm are produced. The cells which are engaged in the manufacture of testosterone are located between the seminiferous tubules and are known as the interstitial, or Leydig’s, cells.It is the tunica albuginea which accounts for the sterility which may follow a case of mumps in the adult male. When the mumps virus involves the testicles, it causes them to swell. Since the tunica albuginea is tight and does not expand, the pressure of the swelling testicle crushes the delicate seminiferous tubules and impairs their ability to produce sperm. If an adult female contracts a case of mumps, there is no analogous problem because the ovaries are not enclosed in a comparable tight sheath; they swell up and then return to their normal size and functioning.A male has approximately 1,000 seminiferous tubules, comprising an elaborate system which produces between about 100 and 500 million sperm daily. Each seminiferous tubule is one to three feet long and their combined length measures several hundred yards. Their convoluted and compact structure is a wonderful example of efficient design.*115\265\8*

HIV: PRACTICAL MATTERS-FINANCING MEDICAL CARE: PRIVATE, THIRD-PARTY PAYERS FOR FINANCING HEALTH CARE-UNINSUTABILITYAbout 8 percent of the applicants for individual plans are denied. Those whose applications are denied include virtually all people with AIDS, cancer, coronary artery disease, and diabetes. This and other health-related information obtained by insurers is recorded in the Medical Information Bureau in Boston, an insurance industry clearinghouse. Most people with preexisting conditions will find their access to individual insurance coverage limited unless that coverage comes through what is called an exclusion rider or unless they pay extremely high premiums.     People unable to purchase insurance because of preexisting conditions may have access to high-risk pool insurance at inflated prices. Pool policies are provided in twenty-three states. Requirements for eligibility include residency in the state for at least six months and a notice from an insurance company of rejection, of a high-risk rate, or of an exclusion rider. Problems with the pool policies are that only twenty-three states carry them, that waiting lists are long, and that premiums are high. Information about pool policies can be obtained from state insurance departments.     Another option is the open enrollment policies periodically available in some Blue Cross/Blue Shield plans in thirteen states. Open enrollment means that any applicant, including anyone with AIDS, is granted insurance regardless of health status. Not surprisingly, the premiums are higher, the waiting period for preexisting conditions is longer, and some preexisting conditions have limits on their coverage.*206\191\2*

BACH FLOWER REMEDIES: WHITE CHESTNUT – MR. T. SINGH’S CASEMr. T. Singh was suffering from chronic itch for the last 23 years. He had tried all types of treatment without getting any relief. The skin specialist had given him injections, oral medicines and lotions for surface application. All he could get was only temporary relief. He confessed  that sometimes he was forced to consume full tube of Betnovix as surface application in one day. This was a hereditary disease, and he did not think these small homoeopathic globules could eradicate this full tube of chronic poison from his system. Treatment was started by giving GORSE T.D.S. for1 week in order to remove his feeling of hopelessness. GORSE + WHITE CHESTNUT was given T.D.S for the next week, when he confessed having some relief because he had less itching even without using Betnovix at all. Gorse was then discontinued, and White Chestnut + Walnut T.D.S was given for the next 6 months to cure Mr. Singh finally was because he his age old hereditary disease. For clear conception of suitable Flower Remedy for preoccupied mind, remember: WHITE CHEST NUT remedy is called for a mind always preoccupied with useless thoughts which a person cannot get rid of, despite his best efforts. CLEMATUS is required for a person who keeps his mind pre-occupied in day-dreaming, or building castles in the air.HONEY SUCKLE is required for a person whose mind keeps his is always occupied by memories of the past. *209\308\8*

COPING WITH THE UNCERTAINTIES OF SEIZURES AND EPILEPSY: COPING WITH LABELS – HOW CAN I TELL FOR SURE?”I don’t believe my child is retarded; I think his problems are due to all those medicines he’s taking. How can I tell for sure?”Parents may prefer to believe that a child’s slowness is a result of the medication, but the effects of medication overdose seldom resemble mental retardation. Children with retardation tend to progress at their own rate, while drug toxicity usually causes a decline in function. Over-medicated children often are sleepy during the day or unsteady; mentally retarded children are neither.The only way to rule out dosage as a cause is to decrease or eliminate one or all of the drugs in use. Do not do this on your own. With your physician’s advice, you may want to consider tapering medication slowly, decreasing a single type of medication at a time. If, on tapering medicine, your child’s function obviously improves, then the slowing, or a portion of the retardation, may have been drug related. You and your physician will have to decide whether the risk of decreasing or changing the medication, as well as the chance of recurring or worsening seizures, is outweighed by the possible benefit of improved intellectual function.Barbiturates like phenobarbital and benzodiazepines like diazepam (Valium), clonazepam (Klonopin), clorazepate (Tranxene), or loraze-pam (Ativan) may cause slowness, dullness, sleepiness, and depression, symptoms that may resemble the characteristics of retardation. Any anticonvulsant, even when in the therapeutic range, may, on occasion, interfere with mental function.*196\208\8*

AORTIC DISSECTION – WHO IS AFFECTED BY DISSECTION? HOW SERIOUS IS DISSECTION?Who Is Affected by Dissection? Dissection of the aorta is two to three times more common in men than in women. It usually occurs between ages 40 and 70 years.How Serious Is Dissection? This condition is often fatal if the blood erupts outside the aorta. The dissection can extend into or block branch vessels of the aorta, such as the carotid arteries to the brain and arteries to the arms, kidneys, legs, or spinal cord. The result is decreased or absent blood flow to these organs. Dissection of the aorta may require urgent surgery, depending on the areas of the aorta that are involved. Even before surgery, though, the first goals of management are to reduce blood pressure to the lowest acceptable level and to determine the portion of the aorta involved by the tear.The aorta may be ruptured in crushing injuries or with sudden deceleration such as in automobile accidents or falls. With sudden deceleration, aortic rupture usually occurs in the chest and is usually fatal. Aortic injury due to penetrating wounds usually results in life-threatening hemorrhage (bleeding).*199\252\8*

EFFECTS OF SMOKING ON PREGNANCY, INFANTS, AND GENETICSWhile smoking does not affect fertility in males, it does affect fertility in females. It took 50-70 percent longer for female smokers to conceive than it did for female nonsmokers.The birth weight of a baby born to a woman who smoked during the pregnancy is considerably lower than the birth weight of a child of a nonsmoker. The more the mother smokes, the more the infant’s birth weight decreases. This weight deficiency is due to retardation of growth, probably from the harmful effects of carbon monoxide, which decreases the amount of oxygen delivered to the fetus. Smoking during pregnancy may affect subsequent child development, physical growth, and mental development at least up to the age of 11.Smoking during pregnancy increases the developing fetus’s risk of cancer by 50 percent.   Other studies have confirmed this finding.The risk of spontaneous abortion and of the fetus dying at birth are higher if the mother smoked during pregnancy, probably because there was less oxygen delivered to the fetus. There are more premature births and more deaths of these premature infants—and a higher incidence of the “sudden infant death syndrome”—in babies delivered from mothers who smoked during pregnancy.Heavy cigarette smokers have a higher frequency of genetic abnormalities and have a high frequency of sperm abnormalities, the latter probably due to the genetic damage caused by smoking. In addition, smoking has a pronounced effect on some drugs, food products, and laboratory blood tests.*70\360\2*