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David: I read somewhere that people who suffer from social anxiety usually have another disorder along with that discount 160mg super avana overnight delivery erectile dysfunction symptoms treatment. In many cases buy super avana 160 mg on line causes of erectile dysfunction in 30s, either depression or an addiction purchase super avana 160mg online erectile dysfunction vitamin shoppe, like alcoholism discount super avana 160mg with visa erectile dysfunction jelly. Linquist: No, that is not my experience with my clients. David: Individuals who suffer from social anxiety, are they afraid of only certain situations or is it most social situations that cause severe anxiety? Linquist: There is a range of suffering, from one type of situation like public speaking to a generalized suffering under any social situation. For instance, many men and women suffer from inability to use the public bathrooms. David: What types of treatment for social phobia are available and which are most effective? Linquist: The traditional treatment is desensitization, a newer one is EMDR (Eye Movement Desensitization and Reprocessing), and my specialty is DELETE Techniques. David: Can you briefly describe each, their purpose and how they work? The first one, desensitization, exposes people to the situation that is producing the anxiety and panic. This is usually a graduated process over a period of time. Many people have found relief and freedom from all three of the methods. DELETE is my favorite and gives the best results quickly. You can click on this link and sign up for the anxiety mail list at the top of the page so you can keep up with events like this. Linquist:bigmac: I have been suffering from social anxiety for over 10 years and have tried practically all antidepressants. Linquist: Medications, without addressing your thoughts, feelings and beliefs is obviously not doing the job. There is an ongoing battle and habit of going over-and-over the same limited thinking. What is needed is a way to break through that thinking and get rid of it... Tray: I have just recently read a book by a physician and he believes anxiety and panic are actually diseases of the brain we are born with. Linquist: There is research to indicate this is true. In addition, researchers have also found that some causes of anxiety and panic are situational in nature--the result of being exposed to possibly a traumatic incident. Linquist, is: how does one find a good therapist experienced in treating social anxiety? Linquist: Traditional ways are to ask your medical doctor, look in the phone book, and make some calls. Really, you may consider going to a marital therapist and also learn how to form a small support system. One of the signs of good mental health is having a support system of at least 3 people. David: And can you go into a bit more detail about how that works? Well, DELETE teaches you how to use a method you use all the time unconsciously, and use it consciously. Chris B: Can an embarrassing, frightening moment happen when a person is very young, disappear and then surface again years later? Michelle6: Why would one bad experience in a social situation cause a lifetime of social panic? Linquist: Because when this happens to a small child, that child makes a decision as best they can about life. Then, they learn all sorts of ways to compensate, hide, overcome (seemingly) all situations. And then, the original situation bubbles up --seemingly out of nowhere. Is this a social problem or do you think there is another problem? Linquist: Sounds like you have several things going on here. One of the best antidotes for depression is to get out and help --volunteer someplace-- any place. Sharon1: What is the difference between panic disorder and social anxiety? Linquist: They can both be present in the same person. However, most people who have social anxiety avoid panic by not getting into situations that trigger them. David: Have you seen people make a complete recovery? And secondly, do you feel anti-anxiety medications are helpful to those who suffer from social phobia? Most of my clients have panic, anxiety and one of the phobias. Linquist: People can and do find relief and freedom from anxiety, panic, and phobias. Certainly, if they re-connect with the same situation, there may seem to be a relapse. However, if they follow a good program, they can have the freedom again. Also, is group therapy better than individual therapy? Linquist: Cognitive therapy is a part of my work, and it depends on the therapist. However, a phobia (social anxiety) is irrational by definition. Have you ever tried to be rational with an irrational person? What happens is they will out-irrationalize you every time. People with anxiety, panic, phobias are fighting within themselves all the time ---part one is the rational side and part 2 is the irrational side. Taryn--talk to a school counselor or another adult you trust, reach out to someone else who may be able to help you with the problem and with your parents. Agoraphobia is usually a combination of several phobias. David: Here are two similar questions about EMDR (Eye Movement Desensitization and Reprocessing):nadineSeattle: Can you explain in more detail what EMDR is? Amber13: Can this EMDR help other phobias, as it does with social phobia? Linquist: Eye Movement Desensitization and Reprocessing, EMDR, has a web site.

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Addiction to heroin often leads to joblessness cheap super avana 160mg without prescription erectile dysfunction va rating, homelessness and crime to afford more heroin generic super avana 160 mg online erectile dysfunction medicine reviews. Facts regarding an addiction to heroin include: Overdose is the number one cause of death among those with a heroin addiction cheap super avana 160mg amex impotence at 16. The death rate among those with an addiction to heroin is estimated at 50 - 100 times that of the general population cheap super avana 160mg without a prescription erectile dysfunction protocol pdf free. Heroin addiction also causes an increased risk of cancer and several other life-threatening diseases. Using other drugs like alcohol and cocaine while using heroin increases the risk of death. It is now known marijuana is addictive to some people, particularly chronic and severe users. There is less potential for weed addiction than for tobacco, alcohol, heroin and cocaine but marijuana is more addicting than psychedelic drugs like lysergic acid diethylamide (LSD). Marijuana dependence, defined in the Diagnostic and Statistics Manual (DSM IV) of mental illness, is part of weed addiction. Nearly 7% - 10% of regular marijuana users go on to become dependent on it (read: marijuana use statistics ). Cannabis abuse, which includes marijuana addiction, is a recognized disorder in the DSM-IV. While weed addiction is often not diagnosed by medical personnel, it is a major concern for many of the people who access drug addiction services. In the United States, 100,000 people are treated yearly for marijuana addiction (read: marijuana addiction treatment ). It is estimated that up to 50% of daily marijuana users develop a weed addiction. Characteristics of weed addiction include:Compulsive marijuana-seeking behaviorA pattern of self-destructive behavior due to weed useFailure to fulfill major life obligations at work, home or school because of pot useMarijuana use continues in spite of recurring negative consequences, including legal consequencesWeed use continues in spite of recurring social or interpersonal problems caused by or made worse by drug useMarijuana is used in dangerous situationsBecause weed addiction can cause serious legal, social, family, work, school and interpersonal problems, pot addiction should be taken seriously. Marijuana users have decreased mental abilities, memory problems, more chest and lung infections and an increased chance of cancer, among other things. Marijuana addiction also increases the likelihood of the user engaging in behaviors like driving while intoxicated which can be dangerous. It was shortly after methamphetamine started being used for legitimate, medical reasons that its euphoric side effects were noticed, leading to methamphetamine addiction. When methamphetamine is used a chemical, dopamine, is released in the brain, bringing about a sense of well-being. When subsequent dosages of meth are taken, this chemical is depleted leading to a lesser high creating a need to take more methamphetamine in an attempt to regain the first high. This repeated use is a common cause of addiction to meth. Crystal meth addiction can happen due to use in party settings. Crystal meth is often considered a party drug as its stimulant properties can keep partiers up and energetic for hours, or even days, without sleep. In spite of tighter drug laws in the United States, meth is still inexpensive and easy to find. Other reasons people develop an addiction to meth on the club scene include:Increased sexual pleasureWhile gay men have been depicted as commonly engaging in meth addiction-fueled sex orgies, 80% of male meth users identify as heterosexual. Addiction to meth often means extended periods of risky sexual encounters producing a serious risk of HIV or a sexually-transmitted infection. Methamphetamine use and methamphetamine addiction are also common in populations needing extended energy or wakefulness, or those looking to lose weight. Addiction to meth happens to these people due to their extended perceived need for the drug and the lack of knowledge of the risk. Few people understand the substantial brain chemical changes being made during a meth binge or the long-term effects of meth on the brain and body. Few people think that by taking a drug to lose weight or work the night-shift think it will develop into a meth addiction. Methamphetamine produces a prolonged sense of well-being and energy but after the high there is a crash often comprised of severe depression, fatigue and irritability. These highly unpleasant symptoms combined with a chemical craving for the drug lead the user to use more meth, leading rapidly to addiction to meth. Similar to other drug addictions, it can be very difficult for someone addicted to meth to stop using the drug as meth addicts often exist in a subculture permeated by meth creation, use and sale. The person addicted to meth can find it very difficult to separate from that kind of the environment. The definition of alcoholism is chronic alcohol use to the degree that it interferes with physical or mental health, or with normal social or work behavior. Alcoholism is a disease that produces both physical and psychological addiction. Alcohol is a central nervous system depressant that reduces anxiety, inhibition, and feelings of guilt. It lowers alertness and impairs perception, judgment, and motor coordination. In high doses, it can cause loss of consciousness and even death. Alcoholism is a disease that damages the brain, liver, heart, and other organs ( short-term, long-term effects of alcohol ). Spotting the signs and symptoms of alcoholism is not always easy. Alcoholism is a disease that can be seen through drinking-related arrests or job loss, but they tend to happen late in the disease. These signs include:An increasing tolerance to the effects of alcohol. You may have heard the expression that someone can "hold their liquor. A growing preoccupation with or interest in drinking. Also drinking alone or drinking before an activity where there will be drinking. We now know that these can be part of the definition of alcoholism. This symptom, called denial, is almost always present in the disease of alcoholism. Later, difficulties in relationships, on the job, or with the law often occur. Other signs and symptoms closely matching the definition of alcoholism are:Hiding alcohol or sneaking drinksGulping the first few drinksWanting to drink more, or longer, than the rest of the crowdLosing control of drinking, leading to attempts to control it ("going on the wagon")It is very important to seek help early as alcoholism is a disease. As the disease progresses, severe health problems can occur in almost every body system. If you want to learn more about the signs and definition of alcoholism, consult your healthcare provider or look in the yellow pages for "alcoholism" or "alcoholism treatment. These are meetings for people who have a family member with a drinking problem. DSM IV - American Psychiatric AssociationNational Institute on Alcohol Abuse and AlcoholismFor more in-depth information on signs-symptoms, causes and treatment of alcoholism, click the "next" article below.

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When you are living with anxiety and fear super avana 160 mg on-line top erectile dysfunction doctor, it is difficult to have a positive outlook or a healthy perspective discount 160 mg super avana with amex venogenic erectile dysfunction treatment, so sometimes you have to "borrow" the perspective of others purchase super avana 160 mg visa erectile dysfunction 5-htp. Once you begin to feel safer order 160mg super avana fast delivery erectile dysfunction xanax, and that will require work on your part as well as reaching out, your perspective will shift. David: I want to mention here that we have a very large journaling community, people who keep online diaries of their experiences. It is not only helpful to the journaler, but also to the visitors who come by and discover they are not alone in their feelings. Joyce1704: The truth is, you are as happy as you allow yourself to be. As I know, if you learn to love all the little pleasures, soon the larger problems melt away. In 1962, I suffered a near fatal auto accident resulting in total amnesia. With faith in GOD and Divine intellegence, I built a new life. Pier: We are not human beings trying to become spiritual, we are spiritual beings trying to become human. Reenie274: What about the severe traumas we may have encountered in our lives, things that we have yet to resolve. Confronting those, very often leads to a Birthquake. Montana: Healing and Growth takes practice, practice, practice and willingness, willingness, willingness! But one that I often suggest is dialoging with our inner wisdom. Each of us contains an enormous storehouse of wisdom that we need only tap into. When we simply write to ourselves, we can get mired in our pain, anger, confusion. If we write to our inner wisdom and then allow that inner wisdom to answer, then we begin to make progress. There is an amazing amount we can learn from ourselves. David: One thing I want to ask: Concretely, how do you move from beyond the pain to starting the transformation, to the "journey to wholeness" as you describe it? Fowles: I think the first step is to ask yourself, "how do I grow from here? James Hillman once said, "Every major change involves a breakdown. Fowles for being our guest tonight and sharing her knowledge and experience with us. And thanks to everyone in the audience for coming and participating. Fowles: I would like to thank you David for providing us with this opportunity to explore this area together. Bill Docket discusses herbal remedies and alternative therapies used for psychological disorders. Dockett studied Traditional Therapeutic Herbalism and is also a certified addictions counselor. To read transcripts of previous chat conferences, click here. Our topic tonight is "Alternative Remedies and Therapies for Psychological Disorders". Our guest, William Dockett, has over nine years of experience in the mental health field. He is a Traditional Therapeutic Herbalist and a certified addictions counselor. I also want to run our usual disclaimer, that we are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment. Can you explain what traditional therapeutic herbalism is? Traditional herbalism is the use of herbs for healing. David: Do various herbal remedies work for mental health issues like depression, bipolar, ADD, etc.? David: Are there any mental health areas where herbs are ineffective in treating a psychological disorder? Bill: Yes, schizophrenia and organic mental disorders. David: Besides herbalism, are there any other remedies that are effective in treating psychological disorders? Also aromatherapy works well for stress and uplifting spirits in general. David: I know you are an herbalist, so maybe this is an unfair question, but would you recommend that a person use herbal treatments rather than standard psychiatric medications? Bill: Herbal treatments can be as effective as medications, but they take longer to be effective. For severe mental illness, I would default to medications, and as always, any treatment should be discussed with your doctor. I am not sure how psychiatrists in general feel about herbal medications, though. It might be hard to find one who will work with herbals. David: So what type of specialist would you go to then? And how much longer do herbs take to be effective vs. Bill: The specialist really depends on the preferences of the main psychologist working with the client. Osteopaths are generally more holistically inclined. As far as effectiveness, herbal medications work with individual body chemistry and it usually takes at least two weeks for herbal treatments to show effects when treating depression. Is there something better and should you take Same with Folic Acid and B12? I have heard 400 mg of Same will work, but then I have heard it must be much much more. Bill: First, I would say that it is important to consult with your doctor or an herbal specialist who has your case history. An additional comment: try eating fresh or pickled ginger for an upset colon. Ellen R: What herbal remedies are being used in the treatment of chemical dependency at this time? Bill: Generally, I use a combination of gingko, chamomile and St. Gingko increases blood circulation, and improves memory.

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The entire edifice of the Narcissistic Personality Disorder is an elaborate and multi-layered reaction to past narcissistic injuries super avana 160 mg with visa erectile dysfunction facts. A gap opens between the way the narcissistic imagines himself to be (grandiosity) and reality (unemployed order super avana 160mg free shipping erectile dysfunction bob, humiliated order super avana 160mg amex erectile dysfunction treatment hong kong, discarded cheap super avana 160 mg mastercard erectile dysfunction after prostatectomy, unneeded). The narcissist strives to bridge the grandiosity gap but sometimes it is simply to abysmal to deny or ignore. So, some narcissists go through decompensation - their defense mechanisms crumble. The narcissists redouble their efforts to obtain narcissistic supply by any means - sex, exercise, attention-seeking behaviors. Yet others withdraw altogether to "lick their wounds" (schizoid posture). What is common to all these narcissists is the ominous feeling that they are losing control (and maybe even losing it). In a desparate effort to re-exert control, the narcissist becomes abusive. Others seek "easy targets" - lonely women to "conquer" or simple tasks to accomplish, or no-brainers, or to compete against weak opponents with a guaranteed result. The accepted wisdom is that NPD is tan adaptative reaction to early childhood or early adolescence trauma and abuse. The more familiar ones - verbal, emotional, psychological, physical, sexual - of course yield psychopathologies. But are far more subtle and more insidious forms of mistreatment. Doting, smothering, ignoring personal boundaries, treating someone as an extension or a wish-fulfillment machine, spoiling, emotional blackmail, an ambience of paranoia or intimidation ("gaslighting") - have as long lasting effects as the "classic" varieties of abuse. Mental health disorders - and especially personality disorders - are not divorced from the twin contexts of culture and society. Disparate scholars and thinkers - Christopher Lasch on the one hand and Theodore Millon on the other hand - have concluded as much. Narcissistic behaviors - now labeled "misconduct" - have long been nornmative. The basically narcissistic traits of individualism competitiveness, unbridled ambition - are the founding stones of certain versions of capitalism. Thus, certain forms of abuse and bullying actually constitute an integral part of the folklore of corporateAmerica. As long as this is the case, workplace abuse would be hard to overcome. Vaknin, for being our guest this evening and for sharing this information with us. And to those in the audience, thank you for coming and participating. We have a very large and active community here at HealthyPlace. You will always find people interacting with various sites. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment. As a Family Physician, I have a different perspective on mental health than those that deal only with mental health issues. I have treated thousands of patients for the disorders involving "Biological Unhappiness. In my regular practice, I see patients with BPD (borderline personality disorder) from all over the world. My first book was " Life at the Border - Understanding and Recovering from the Borderline Personality Disorder. I hope you enjoy your visit and get a positive experience from my site. These definitions - which are criteria based - are the results of consensus building from hundreds of psychiatrists of many different perspectives and belief systems from all over the world, not just the U. Definitions are regularly being revised as research and other information becomes available. The DSM IV is the latest edition, being published in 1994. Like other diagnoses, diabetes is established by specific criteria such as fasting sugar greater than 126 on two separate occasions. Physicians do have the right to explain and treat disorders according to their knowledge, training expertise - but not to establish their own criteria. If a physician disagrees with the established criteria, he/she needs to explain the reasoning in the chart. There are many common misconceptions about the BPD diagnosis:that the diagnosis is based on why it may have happened - NOT TRUE! Many individuals would like to see a different name for the diagnosis since the name "borderline" came from a different era and has continued through the present time. They are not mutually exclusive and many individuals have more than one diagnosis, including both BPD and bipolar. I wanted to be a doctor since age five, and pursued that goal until I graduated from medical school in 1979. I graduated from my family practice residency program in 1982, and went into solo practice in Lake Worth, FL (near West Palm Beach). My residency program emphasized psychiatric problems and behavioral medicine, with a special emphasis on alcoholism. I also had the enormous privilege of being exposed to Dr. Talley from North Carolina, a rural family physician who pioneered treating psychiatric problems as medical ones in a primary care setting. When I read about the BPD, I realized it was a medical disorder masquerading as an emotional one. Prozac was bringing miracles to the lives of borderlines. I did some medical research, particularly the work of Dr. Rex Cowdry at NIMH, and found their research to work in the "real world. At the time, there was nothing for BPD patients to read, and my patients convinced me to write a book about it. My book "Life at the Border: Understanding and Recovering from the Borderline Personality Disorder" was placed on the NIMH recommended reading list and in their reference library. The life-changing successes were extremely rewarding. Ways to change negative thought patterns were developed. I began running seminars and support groups, eventually running three 6-week intensive outpatient treatment programs - the third with some very impressive data. My work was noticed nationally, and in 1992 a "Geraldo" program was dedicated to the BPD and how recovery was possible. There were over 10,000 phone call responses in the first 24-hours after the show aired. She was very skeptical at first, and was particularly interested in what family members had to say.

Study 2 was a 12-week fixed-dose study discount 160 mg super avana erectile dysfunction zyprexa, including ZOLOFT doses of 50 generic super avana 160 mg line adderall xr impotence, 100 super avana 160mg online erectile dysfunction information, and 200 mg/day order super avana 160mg overnight delivery erectile dysfunction therapy treatment. Patients receiving ZOLOFT doses of 50 and 200 mg/day experienced mean reductions of approximately 6 points on the YBOCS total score which were significantly greater than the approximately 3 point reduction in placebo-treated patients. Study 3 was a 12-week study with flexible dosing of ZOLOFT in a range of 50 to 200 mg/day; the mean dose for completers was 185 mg/day. Patients receiving ZOLOFT experienced a mean reduction of approximately 7 points on the YBOCS total score which was significantly greater than the mean reduction of approximately 4 points in placebo-treated patients. Analyses for age and gender effects on outcome did not suggest any differential responsiveness on the basis of age or sex. The effectiveness of ZOLOFT for the treatment of OCD was also demonstrated in a 12-week, multicenter, placebo-controlled, parallel group study in a pediatric outpatient population (children and adolescents, ages 6-17). Patients receiving ZOLOFT in this study were initiated at doses of either 25 mg/day (children, ages 6-12) or 50 mg/day (adolescents, ages 13-17), and then titrated over the next four weeks to a maximum dose of 200 mg/day, as tolerated. Patients receiving sertraline experienced a mean reduction of approximately 7 units on the CYBOCS total score which was significantly greater than the 3 unit reduction for placebo patients. Analyses for age and gender effects on outcome did not suggest any differential responsiveness on the basis of age or sex. In a longer-term study, patients meeting DSM-III-R criteria for OCD who had responded during a 52-week single-blind trial on ZOLOFT 50-200 mg/day (n=224) were randomized to continuation of ZOLOFT or to substitution of placebo for up to 28 weeks of observation for discontinuation due to relapse or insufficient clinical response. Response during the single-blind phase was defined as a decrease in the YBOCS score of >/= 25% compared to baseline and a CGI-I of 1 (very much improved), 2 (much improved) or 3 (minimally improved). Patients receiving continued ZOLOFT treatment experienced a significantly lower rate of discontinuation due to relapse or insufficient clinical response over the subsequent 28 weeks compared to those receiving placebo. This pattern was demonstrated in male and female subjects. Panic Disorder -The effectiveness of ZOLOFT in the treatment of panic disorder was demonstrated in three double-blind, placebo-controlled studies (Studies 1-3) of adult outpatients who had a primary diagnosis of panic disorder (DSM-III-R), with or without agoraphobia. ZOLOFT was initiated at 25 mg/day for the first week, and then patients were dosed in a range of 50-200 mg/day on the basis of clinical response and toleration. The mean ZOLOFT doses for completers to 10 weeks were 131 mg/day and 144 mg/day, respectively, for Studies 1 and 2. In these studies, ZOLOFT was shown to be significantly more effective than placebo on change from baseline in panic attack frequency and on the Clinical Global Impression Severity of Illness and Global Improvement scores. The difference between ZOLOFT and placebo in reduction from baseline in the number of full panic attacks was approximately 2 panic attacks per week in both studies. Study 3 was a 12-week fixed-dose study, including ZOLOFT doses of 50, 100, and 200 mg/day. Patients receiving ZOLOFT experienced a significantly greater reduction in panic attack frequency than patients receiving placebo. Study 3 was not readily interpretable regarding a dose response relationship for effectiveness. Subgroup analyses did not indicate that there were any differences in treatment outcomes as a function of age, race, or gender. In a longer-term study, patients meeting DSM-III-R criteria for Panic Disorder who had responded during a 52-week open trial on ZOLOFT 50-200 mg/day (n=183) were randomized to continuation of ZOLOFT or to substitution of placebo for up to 28 weeks of observation for discontinuation due to relapse or insufficient clinical response. Response during the open phase was defined as a CGI-I score of 1 (very much improved) or 2 (much improved). Relapse during the double-blind phase was defined as the following conditions being met on three consecutive visits: (1) CGI-I >/= 3; (2) meets DSM-III-R criteria for Panic Disorder; (3) number of panic attacks greater than at baseline. Patients receiving continued ZOLOFT treatment experienced a significantly lower rate of discontinuation due to relapse or insufficient clinical response over the subsequent 28 weeks compared to those receiving placebo. This pattern was demonstrated in male and female subjects. Posttraumatic Stress Disorder (PTSD) -The effectiveness of ZOLOFT in the treatment of PTSD was established in two multicenter placebo-controlled studies (Studies 1-2) of adult outpatients who met DSM-III-R criteria for PTSD. The mean duration of PTSD for these patients was 12 years (Studies 1 and 2 combined) and 44% of patients (169 of the 385 patients treated) had secondary depressive disorder. ZOLOFT was initiated at 25 mg/day for the first week, and patients were then dosed in the range of 50-200 mg/day on the basis of clinical response and toleration. The mean ZOLOFT dose for completers was 146 mg/day and 151 mg/day, respectively for Studies 1 and 2. Study outcome was assessed by the Clinician-Administered PTSD Scale Part 2 (CAPS) which is a multi-item instrument that measures the three PTSD diagnostic symptom clusters of reexperiencing/intrusion, avoidance/numbing, and hyperarousal as well as the patient-rated Impact of Event Scale (IES) which measures intrusion and avoidance symptoms. ZOLOFT was shown to be significantly more effective than placebo on change from baseline to endpoint on the CAPS, IES and on the Clinical Global Impressions (CGI) Severity of Illness and Global Improvement scores. In two additional placebo-controlled PTSD trials, the difference in response to treatment between patients receiving ZOLOFT and patients receiving placebo was not statistically significant. One of these additional studies was conducted in patients similar to those recruited for Studies 1 and 2, while the second additional study was conducted in predominantly male veterans. As PTSD is a more common disorder in women than men, the majority (76%) of patients in these trials were women (152 and 139 women on sertraline and placebo versus 39 and 55 men on sertraline and placebo; Studies 1 and 2 combined). Post hoc exploratory analyses revealed a significant difference between ZOLOFT and placebo on the CAPS, IES and CGI in women, regardless of baseline diagnosis of comorbid major depressive disorder, but essentially no effect in the relatively smaller number of men in these studies. The clinical significance of this apparent gender interaction is unknown at this time. There was insufficient information to determine the effect of race or age on outcome. In a longer-term study, patients meeting DSM-III-R criteria for PTSD who had responded during a 24-week open trial on ZOLOFT 50-200 mg/day (n=96) were randomized to continuation of ZOLOFT or to substitution of placebo for up to 28 weeks of observation for relapse. Response during the open phase was defined as a CGI-I of 1 (very much improved) or 2 (much improved), and a decrease in the CAPS-2 score of > 30% compared to baseline. Patients receiving continued ZOLOFT treatment experienced significantly lower relapse rates over the subsequent 28 weeks compared to those receiving placebo. This pattern was demonstrated in male and female subjects. Premenstrual Dysphoric Disorder (PMDD) - The effectiveness of ZOLOFT for the treatment of PMDD was established in two double-blind, parallel group, placebo-controlled flexible dose trials (Studies 1 and 2) conducted over 3 menstrual cycles. Patients in Study 1 met DSM-III-R criteria for Late Luteal Phase Dysphoric Disorder (LLPDD), the clinical entity now referred to as Premenstrual Dysphoric Disorder (PMDD) in DSM-IV. Study 1 utilized daily dosing throughout the study, while Study 2 utilized luteal phase dosing for the 2 weeks prior to the onset of menses. The mean duration of PMDD symptoms for these patients was approximately 10. Patients on oral contraceptives were excluded from these trials; therefore, the efficacy of sertraline in combination with oral contraceptives for the treatment of PMDD is unknown. Efficacy was assessed with the Daily Record of Severity of Problems (DRSP), a patient-rated instrument that mirrors the diagnostic criteria for PMDD as identified in the DSM-IV, and includes assessments for mood, physical symptoms, and other symptoms. Other efficacy assessments included the Hamilton Depression Rating Scale (HAMD-17), and the Clinical Global Impression Severity of Illness (CGI-S) and Improvement (CGI-I) scores. In Study 1, involving n=251 randomized patients, ZOLOFT treatment was initiated at 50 mg/day and administered daily throughout the menstrual cycle. In subsequent cycles, patients were dosed in the range of 50-150 mg/day on the basis of clinical response and toleration. ZOLOFT administered daily throughout the menstrual cycle was significantly more effective than placebo on change from baseline to endpoint on the DRSP total score, the HAMD-17 total score, and the CGI-S score, as well as the CGI-I score at endpoint. In Study 2, involving n=281 randomized patients, ZOLOFT treatment was initiated at 50 mg/day in the late luteal phase (last 2 weeks) of each menstrual cycle and then discontinued at the onset of menses.

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UCLOBO: Stacy order super avana 160 mg fast delivery yellow 5 impotence, I am a 17 year old bulimarexic and have suffered for 4 years n ow purchase super avana 160mg erectile dysfunction drugs and alcohol. Do you think its possible to recover without professional help? I am now 38 and just found out 4 months ago that I have it 160 mg super avana visa impotence 21 year old. Ellie: College usually makes it worse because of the stress 160 mg super avana erectile dysfunction vacuum pumps reviews. Zonnie: Stacy, do you ever want to go back all the way to how you were before? Irishgal: I have restricted my calorie intake to 200 calories every other day which I guess turns out to be 100 a day. I am trying to get back to my goal weight of 88 where I was a year ago, but its destroying me now. I passed out and got a bloody nose at swim practice today. Julia: I know that my family and friends are worried about me all the time. If I go out for a walk, if I go out for dinner, if I am not feeling well, etc. See, they would COMPLETELY freak out on me and take me out of b-ball and that is my college tution. Stacy: They may understand, you cannot just push it at them. Let them know you are having that you are, or want to do something about it. UCLOBO, one of the most important keys to recovery is getting the help and support you need. Many people are afraid that if they tell their family or friends, they will be rejected. But most family members care about each other and want to help. And, if your parents are not the supportive type, then you have to seek treatment on your own. Hopefully, you have a friend or two who can be there for you. Bob M: Stacy, I want to thank you for coming here tonight and sharing your story with us. Bob M: The audience has been very receptive to your comments. It is one of the top treatment facilities in the country for eating disorders. Prior to that, he was head of the eating disorders unit at the National Institutes of Health (NIH) in Washington, D. The Center is located in Baltimore, people from all over the country go there for help. After the in or out-patient treatment, they will help you arrange for treatment in your own community. And they will help with sorting out your insurance or medicare/medicaid. They have special financial counselors to help with that. First and foremost, the dangerous behaviors of the illnesses are highly reinforcing. Our culture tends to drive people to continue these behaviors. Bob M: But why, once you recognize them as dangerous, is it so difficult to stop them? Brandt: I think it varies for the different illnesses. In anorexia nervosa, starvation itself is potent perpetuating symptom. As people starve, they want to lose more and more weight. They often describe that after they have lost several pounds, something "clicks in" and they want to lose more and more weight. Similarly, the bingeing and purging of bulimia is also perpetuating. Because the anorexia symptoms are gratifying, they are difficult to give up. The longer they progress, the more difficult it is to give up the primary symptoms. Bob M: So, what you are saying is, if you catch the symptoms early, there is a better chance of recovery and a better chance of a longer-lasting recovery. Brandt: Yes, early treatment is important and highly effective. But, I have seen many people like Stacy ultimately recover as well. Brandt: First, patients undergo a series of psychological and medical assessments. Then, they are engaged in a multi-modality treatment that entails efforts to block the primary symptoms of the disorder while trying intensively to understand the meaning of the symptoms. Most patients are in a combination of various groups, individual therapy, and nutritional counseling. Heatsara: I have restricted my calorie intake to 100 calories a am lucky if I eat 80. I am trying to get back to 88 pounds where I was a year ago. The thing is I passed out and got a bloody nose at swim practice today. There are serious medical manifestations of your ongoing starvation. I am afraid to talk to any of my doctors becasue they write everything down and they have threatened to admit me. Brandt: I suggest you try to get on the same "team" as your physicians. Brandt: The length of inpatient hospitalization can vary widely, but many of our patients are only inpatients for several days. They often then transfer into our partial hospitalization program for longer-term treatment. You deserve a thorough evaluation and appropriate treatment. Bob M: Is there like a cookie-cutter approach to treating someone with an eating disorder or does each person need a separate treatment plan? Brandt: Because of the wide variability of symptoms and their origin, each patient needs an individualized treatment plan. Having said that, I would add that there are some common components of most treatment. In our program, we try to focus on providing structure for patients to block their starvation or bingeing and purging, and at the same time work in intensive psychological therapies. It is this approach that we have found to be most effective. Bob M: I want to post a comment from an audience member.

Blue also calms such physiological functions as pulse rate buy 160mg super avana with amex erectile dysfunction normal testosterone, breathing proven super avana 160 mg erectile dysfunction protocol pdf free, and perspiration buy cheap super avana 160mg impotence effect on relationship, and relaxes the mood buy super avana 160 mg amex impotence nerve damage. If you experience chronic fatigue and are tense, anxious, or irritable, or carry a lot of muscle tension, the first exercise will be very helpful. The second exercise uses the color red, which can benefit women who have fatigue due to chronic anxiety and upset. Red stimulates all the endocrine glands, including the pituitary and adrenal glands. Emotionally, red is linked to vitality and high energy states. Even though the color red can speed up autonomic nervous system function, women with anxiety-related fatigue can benefit from visualizing this color. I often do the red visualization when I am tired and need a pick me up. You may find that you are attracted to the color in one exercise more than another. Use the exercise with the color that appeals to you the most. Sit or lie in a comfortable position, your arms resting at your sides. As you take a deep breath, visualize that the earth below you is filled with the color blue. This blue color extends 50 feet below you into the earth. Now imagine that you are opening up energy centers on the bottom of your feet. As you inhale, visualize the soft blue color filling up your feet. When your feet are completely filled with the color blue, then bring the color up through your ankles, legs, pelvis, and lower back. Each time you exhale, see the blue color leaving through your lungs, carrying any tension and stress with it. Continue to inhale blue into your abdomen, chest, shoulders, arms, neck, and head. Repeat this entire process five times and then relax for a few minutes. Sit or lie in a comfortable position, your arms resting easily at your sides. As you take a deep breath, visualize a big balloon above your head filled with a bright red healing energy. Imagine that you pop this balloon so all the bright red energy is released. As you inhale, see the bright red color filling up your head. It fills up your brain, your face, and the bones of your skull. Let the bright red color pour in until your head is ready to overflow with color. Then let the red color flow into your neck, shoulders, arms, and chest. As you exhale, breathe the red color out of your lungs, taking any tiredness and fatigue with it. As you inhale, continue to bring the bright, energizing red color into your abdomen, pelvis, lower back, legs, and feet until your whole body is filled with red. Exhale the red color out of your lungs, continuing to release any feeling of fatigue. At the end of this exercise, you should feel more energized and vibrant. Your mental energy should feel more vitalized and clear. The following two exercises give you healthful affirmations that are very useful for women with anxiety. As described earlier, anxiety symptoms are due to a complex interplay between the mind and body. Your state of emotional and physical health is determined in part by the thousands of mental messages you send yourself each day with your thoughts. For example, if fear of public places triggers your anxiety symptoms, the mind will send a constant stream of messages to you reinforcing your beliefs about the dangers and mishaps that can occur in public places. The fright triggers muscle tension and shallow breathing. Similarly, if you constantly criticize the way you look, your lack of self-love may be reflected in your body. For example, your shoulders will slump and you may have a dull and lackluster countenance. Affirmations provide a method to change these negative belief systems to thoughts that preserve peace and calm. Positive statements replace the anxiety inducing messages with thoughts that make you feel good. The first affirmation exercise gives you a series of statements to promote a sense of emotional and physical health and well being. Using these affirmations may create a feeling of emotional peace by changing your negative beliefs about your body and health into positive beliefs. The second affirmation exercise helps promote self-esteem and self-confidence and also helps to reduce anxiety. Many women with high anxiety lose their self-confidence and feel depressed and defeated by their condition. They feel frustrated and somehow at fault for not finding a solution. Repeat each affirmation to yourself or say them out loud 3 to 5 minutes. Use either or both exercises on a regular basis to promote healthful, positive thought patterns. I handle stress and tension appropriately and effectively. I can cope well and get on with my life during times of stress. I enjoy thinking positive thoughts that make me feel good about myself and my life. I can effectively handle any situation that comes my way. I think through the solutions to my emotional issues slowly and peacefully. I am thankful for all the positive things in my life. My body wants food that is easy to digest and high in vitamins and minerals.

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