Thursday 22 December 2011

Podcast 64: Brain Freeze

Happy Holidays, everyone.  We taped this a few weeks ago, but Shrinky Podcasts always make for good holiday chatter.   Today we talk about 
1) Brain Freeze-- inspired by a Well article in the NYTimes for 11/10 on Rick Perry's Brain Freeze.  You'll note that in this podcast, Dinah reads Roy's mind, and no has brain freeze from eating cold ice cream.  We kind of ramble, and so what else is new?  We talk about memory and attention and learning and Dinah explains why men don't take out the garbage during football games.  Clink talks about the scientific phenomena of "brain overload."


2) Siri-- ah, we did this podcast right after I got my new iPhone and it was new and exciting and I was working on an article on Siri and the Psychiatrist.  We ask Siri where we can buy a duck and when the world will end.  Apparently we have 5 billion years.  And Sigourney Weaver was 62 years, 1 month, and 5 days old at the time we recorded.

3) Prison Food-- inspired by a lawsuit in which a prisoner contends that the soy-based food being served in prison is 'cruel and unusual punishment' which caused him cramps. Clink talks about how prison food is handled.  She also talks about nutrient rich Nutraloaf that can be eaten without utensils and she discusses an NPR story which includes the recipe for anyone who would like to try nutraloaf. 

If you'd like to try it:
Special Management Meal
Yield - Three Loaves

• 6 slices whole wheat bread, finely chopped
• 4 ounces imitation cheddar cheese, finely grated
• 4 ounces raw carrots, finely grated
• 12 ounces spinach, canned, drained
• 2 cups dried Great Northern Beans, soaked,
cooked and drained
• 4 tablespoons vegetable oil
• 6 ounces potato flakes, dehydrated
• 6 ounces tomato paste
• 8 ounces powdered skim milk
• 4 ounces raisins

From Clink: You mispelled nutraloaf. Don't worry, I fixed it. Also, by pure coincidence today's correctional nursing topic on Lorry Schoenley's Blogtalk radio show was all about managing food allergies in corrections. For those of you who want to know what happens to inmates with peanut allergies, here it is directly from someone in the know.



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Sunday 18 December 2011

What is a depressive disorder?


Depressive disorders are with mankind since the start of recorded history. within the Bible, King David, still as Job, suffered from this affliction. Hippocrates remarked depression as melancholia, which accurately means that black bile. Black bile, in conjunction with blood, phlegm, and yellow bile were the four humors (fluids) that described the fundamental medical physiology theory of that point. Depression, additionally remarked as clinical depression, has been portrayed in literature and therefore the arts for many years, however what can we mean nowadays once we sit down with a depressive disorder? within the nineteenth century, depression was seen as an inherited weakness of temperament. within the initial 1/2 the twentieth century, Freud linked the event of depression to guilt and conflict. John Cheever, the author and a contemporary sufferer of depressive disorder, wrote of conflict and experiences along with his folks as influencing his development of depression.

In the Nineteen Fifties and '60s, depression was divided into 2 varieties, endogenous and neurotic. Endogenous means the depression comes from among the body, maybe of genetic origin, or comes out of nowhere. Neurotic or reactive depression encompasses a clear environmental precipitating issue, like the death of a spouse, or different important loss, like the loss of employment. within the Nineteen Seventies and '80s, the main focus of attention shifted from the reason behind depression to its effects on the afflicted individuals. that's to mention, regardless of the cause in a very specific case, what are the symptoms and impaired functions that specialists will agree structure a depressive disorder? though there's some argument even nowadays (as in all branches of medicines), most specialists agree on the following:

    A depressive disorder may be a syndrome (group of symptoms) that reflects a tragic and/or irritable mood exceeding traditional disappointment or grief. a lot of specifically, the disappointment of depression is characterised by a bigger intensity and period and by a lot of severe symptoms and useful disabilities than is traditional.


    Depressive signs and symptoms are characterised not solely by negative thoughts, moods, and behaviors however additionally by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, still as issues with eating, weight, or sleeping). The useful changes of clinical depression are typically referred to as neurovegetative signs. this suggests that the nervous system changes within the brain cause several physical symptoms that lead to diminished participation and a decreased or increased activity level.


 sure individuals with depressive disorder, particularly bipolar depression (manic depression), appear to own an inherited vulnerability to the present condition.


    Depressive disorders are an enormous public-health downside, attributable to its affecting various individuals. concerning 100 percent of adults, up to eight of teens and a couple of of preteen kids expertise some reasonably depressive disorder.

        The statistics on price attributable to depression within the us embrace huge amounts of direct costs, that are for treatment, and indirect prices, like lost productivity and absenteeism from work or faculty.


        Adolescents that suffer from depression are in danger for developing and maintaining obesity.


 in a very major medical study, depression caused important issues within the functioning of these affected a lot of typically than did arthritis, hypertension, chronic lung disease, and diabetes, and in some ways that as typically as coronary artery disease.


        Depression will increase the risks for developing coronary artery disease, HIV, asthma, and plenty of different medical diseases. different complications of depression embrace its tendency to extend the morbidity (illness/negative health effects) and mortality (death) from these and plenty of different medical conditions.


        Depression will coexist with just about each different mental health illness, aggravating the standing of these that suffer the mixture of each depression and therefore the different mental illness.


        Depression within the elderly tends to be chronic, encompasses a low rate of recovery, and is usually undertreated. this is often of specific concern provided that elderly men, notably elderly white men have the best suicide rate.

    Depression is sometimes initial identified in a very primary-care setting, not in a very mental-health practitioner's workplace. Moreover, it typically assumes varied disguises, that causes depression to be frequently underdiagnosed.


    In spite of clear analysis proof and clinical tips concerning therapy, depression is usually undertreated. Hopefully, this case will modification for the higher.


    For full recovery from a mood disorder, notwithstanding whether or not there's a precipitating issue or it looks to return out of the blue, treatment with medication and/or electroconvulsive therapy (ECT) (see discussion below) and psychotherapy are necessary.

What is Mental Health: Key ideas in Mental Health

Definition of mental health

Mental health is outlined as a state or condition on that a private feels a way of well-being. this offers him or her the capability to measure life in fulfillment of what he or she desires to realize in accordance to the on the market resources. This condition conjointly provides a private the capability to be resilient to the stresses he meets and to reply to those challenges while not having to compromise his well-being. This conjointly makes him productive and fruitful for himself and his community.

Mental wellness might even be outlined because the lack of mental issues or disorders. people that don't gift diagnosable behaviors that would qualify as a mental disorder are seen as mentally healthy. for instance, somebody who has an obsession on things might not essentially have a mental disorder like obsession. so he's said to own mental wellness. however when this obsession is combined with unrelenting compulsion to try to to the thing of obsession, the person could already be diagnosed with a mental disorder referred to as Obsessive-compulsive Disorder or OCD.

It might even be seen as a positive component in an individual’s temperament that makes it potential to reinforce mental wellness notwithstanding a diagnosable mental disorder. This definition covers a person’s capability to “live life to the fullest”, to reply well to his atmosphere through the acutely aware or unconscious use of coping mechanisms and to be ready to balance emotional also as psychological well-being in relation to constant flow of experiences.

Mental health across culture

The World Health Organization (WHO) believes that there's no single definition for mental health thanks to variations in culture. What may well be mentally healthy (or acceptable behavior) in one culture could gift one thing too eccentric in another. for instance, cannibalistic behavior in some tribes living in remote areas is very considered a non secular apply but, within the majority of urbanized world this might be seen as barbaric or insane.

Disruption in mental health

Abnormalities in mental health may lead to variety of issues with numerous representations. Some folks with mental diseases have aggressive behaviors whereas others are withdrawn and lack social interest. every form of disorder has its own signs and symptoms therefore; diagnosis also as treatment vary betting on the character of the mental heath downside.

There are many factors that disrupt mental health including: atmosphere or upbringing, biological make-up of an individual, pre-programmed directions within the genes, medical disorders, traumatic experiences like loss and abuse and substance abuse. whereas one issue may well be dominant than the opposite, all of those are contributors to the event of the bulk of mental health disorders. In some cases, one issue is also sufficient to trigger the disorder however the bulk of disorders need an accumulation of expertise that constantly challenge the well-being of an individual.

What preserves mental health?


The preservation of mental health is very obsessed on the capability of the person to;

 mix in his atmosphere and handle its stresses

    achieve an honest internal balance in his temperament that's sufficient to offer a stable character

 produce an honest perspective that might limit the damages of negative experiences.

For some folks an honest support system like a sympathetic family or a powerful social cluster may fit well to safeguard mental health.


Friday 16 December 2011

If you have got bipolar disorder

If you have got bipolar disorder, call 911 or different emergency services if you:

 assume you can't stop from harming yourself or somebody else.
    Hear voices that are new or a lot of upsetting than traditional.
 wish to commit suicide, otherwise you recognize somebody who has mentioned desperate to commit suicide.

Warning signs of suicide include:

    Use of illegal medication or drinking alcohol heavily.
    Talking, writing, or drawing regarding death, together with writing suicide notes and speaking of things that may cause physical damage, like pills, guns, or knives.
    Spending long periods of your time alone.
 giving for free possessions.
    Acting aggressive or suddenly showing calm.

Watchful Waiting

Watchful waiting is also enough if a mood episode has simply started and you're taking correct medicines. If your mood episode has not improved among a pair of weeks, decision your doctor.

If you have got a loved one who is experiencing a manic episode and is behaving irrationally, facilitate the person obtain treatment.

Who To See

Bipolar disorder is advanced and arduous to diagnose as a result of it's several phases and symptoms. generally it's misdiagnosed as solely depression (unipolar depression), as a result of individuals are a lot of doubtless to hunt treatment throughout a amount of depression.

After you're diagnosed with bipolar disorder, it's necessary to stay a long-term relationship together with your doctor or therapist to create positive that your treatment is consistent which your medicines may be adjusted as required.

Although different health professionals will diagnose bipolar disorder, you may most likely be noted a psychiatrist who focuses on treating such disorders and might prescribe medicines and supply counseling. different health professionals who will diagnose bipolar disorder include:

    Family doctors (general practitioners).
    Internists.
    Psychiatric nurse practitioners.

Counseling will assist you manage mood changes and also the impact bipolar disorder will have on your work and family relationships. additionally to psychiatrists, health professionals who will offer counseling include:

    Psychologists
    Social staff.
    Licensed skilled counselors.

Family member support

If a loved one has bipolar disorder, it should be useful for you to induce counseling to manage its impact on your own life. Manic episodes may be notably arduous. speak with a psychiatrist, psychologist, social employee, or licensed skilled counselor for your own therapy.

Therapy also can be useful for a baby who contains a bipolar parent. The parent's mood swings might negatively have an effect on the kid, inflicting tearfulness, anger, depression, or rebellious behavior.

To prepare for your appointment, see the subject creating the foremost of Your Appointment.


25 Steps to get rid of a Mental Blocks


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Identify Symptoms of ADHD Children


Hurricane Katrina Survivors Lack Access to Mental Health Services


Wednesday 14 December 2011

Getting anxious over Anxiety Depression

 Anxiety DepressionA lot of busy folks that appear to cannot fathom the concept of relaxing and taking time of from work, also as their worries, tend to truly begin having nervous breakdowns, anxiety depression and every one styles of mental diseases that may cause a person’s sanity to travel haywire, fortunately, if you’re one in every of those poor unfortunate ones who are unable to distress and is continually worried and fussing over things, there are literally offered cures and numerous treatments for treating anxiety depression.

Anxiety depression is really characterised by all styles of irregularities and erratic behavior from the one who is plagued by it, this can be usuallu thanks to sure stress triggers that will tend to simply cause someone undue jitters and stress.

Also, lots of individuals who tend to induce simply nervous over stressful activities are literally vulnerable to having anxiety depression, its simply a matter of being strong-willed when it involves facing tough and stress-prone activities. it's going to be pretty onerous to beat initially, however attempting to be calm and funky in times of utmost pressure is what’ll really save your mental health from going totally downward spiral.

When it involves effectively curing one’s self from a mental illness, one should keep in mind that you just ought to be really honest with yourself and assess what quite depression or mental illness you truly have, attend reputable psychiatrist to induce yourself diagnosed properly also as be able to get the correct depression treatment for yourself. Here are the varied kinds of depression:

Manic or Bipolar depression – characterised by sudden and extreme changes in one’s mood whereby one minute he or she is in an exceedinglyn elevated state of euphoria whereas following minute (day or week) he or she is feeling to be in a personal hell.

Postpartum depression - characterised by a protracted unhappiness and a sense of emptiness by a brand new mother whereby physical stress throughout kid birth, an unsure sense of responsibility towards the new born baby are often some of the doable factors why some new mother bear this.

Dysthimia – characterised by a small similarity with depression, though now, it’s been proven to be lots less severe, however after all with any case, ought to be treated immediately.

Cyclothemia – characterised by a small similarity with Manic or Bipolar depression whereby the individual plagued by this mental illness could sometimes suffer from severe changes in one’s moods.

Seasonal Affective Disorder
- characterised by falling in an exceedingly rut solely throughout specific seasons (i.e. Winter, Spring, Summer or Fall) studies but, prove that additional individuals really fall in to a rut additional throughout the Winter and Fall seasons and lastly, Mood swings, whereby a person’s mood could shift from happy to unhappy to angry in precisely a brief time.


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Symptoms of depression

People who is also laid low with depression or mental disorder truly showed any symptoms of depression that doctors Glossary Links say could be a sign of somebody who is experiencing depression. typically it's truly quite straightforward to ignore these symptoms and may not facilitate themselves or others who are laid low with depression.

Actually there are several symptoms of depression which will be indicated by the depression, however they are doing not ought to bear all of those symptoms before you truly facilitate them to be diagnosed and treated for this disease. Also, as a result of the symptoms of depression truly vary, the time of the "attack" of depression additionally varied.
Here are some common samples of symptoms of depression
Prolonged amount of unhappiness or not feeling "excited".

People who continually feel the mood, who would rather mope round the house and feel sorry for yourself is that the best example for this symptom of depression.

Feeling hopeless, perennial pessimist.

Talk and self-pity, another common symptom of depression is when someone very appears like there is no a lot of reason to continue her life. As for the perennial pessimist, those that show symptoms of depression are typically terribly negative concerning several things, and again, a way of despair comes in their minds.
Driven by guilt, loss of shallowness and powerlessness.

Other symptoms of depression that may be simply seen on folks that favor to mope all day. whenever someone feels thus guilty over one thing, that very makes someone become a really unhappy, feeling like he doesn't need to be happy. Thus, loss of self-worth, if he appears like he doesn't need to be happy or relish themselves like everybody else then clearly it's an indication of symptoms of depression. Helplessness additionally contribute to form individuals depressed, once they felt that things weren't going obviously, fully was} clear that you simply have absolutely no hope in you in the slightest degree.


Not inquisitive about creating or doing one thing fun.

Forgetting hobby simply further as alternative things that are typically glad they did. Signs symptoms of depression simply shows how depressed someone, if somebody is actually  too unhappy to possess fun even for the items they adore it typically is that this person really lose something, a lot of exactly, that person might are exposed to 'Glossary Links viruses 'depression.
Fatigue, continually tired.

People laid low with depression, as a result of they need lost any interest in their lives, might really lack of physical energy at any time, if one would rather mope, maybe not even wish to eat and not enough sleep, a depressed person might not solely cause mental illness however depression also can injury a human physical health.

Having bother concentrating, having dangerous memory and hesitant.

People laid low with depression simply show these signs. Lack of interest during a person with everything connected with the skin world or of something will cause the lack of man to rediscover his stuff and very powerless to recollect things that happened or what anyone else says. Lack of interest truly makes depressed individuals terribly inattentive.

There are several a lot of symptoms of depression that actually will really assist you see if somebody (or you) ought to be taken to the doctor to induce facilitate when it comes depression, lack of or an excessive amount of sleep, arise at too early are all symptoms of depression (if it It happens each day), loss of appetite and eating an excessive amount of might show one's lack of enthusiasm always. Beware with the decrease / increase in weight suddenly. tried suicide, talking concerning death or concerning desperate to die could be a clear indication that the person is depressed. Restless and irritable and physical symptoms that are typically caused by poor mental health like headaches, digestive disorders and varied body pains.



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Bipolar Disorder

Introductions On Bipolar Disease

Bipolar disease or bipolar disorder, otherwise called manic depression or bipolar depression, could be a disease of the liver atmosphere (mood) is comparatively common affecting approximately five.7 million Americans. characterised by episodes of depression alternating with Euphoric circumstances (very excited), the symptoms of bipolar disorder are multiple, and infrequently affects the daily functioning of people and interpersonal relationships.

The symptoms of bipolar disorder embrace depression and feelings of despair throughout the depressed part of the condition. different symptoms of depression together with suicidal thoughts, changes in sleep patterns, and lose interest in activities that are a supply of delight. What distinguishes bipolar disorder from major depression is that the prevalence of episodes of manic-spidoes, usually described as "peaks" emotional, between episodes of depression. Symptoms of manic states are varied and embrace restlessness, increased energy, a awfully happy mood, thoughts hasty, unhealthy choices, disruptive or provocative behavior, issue concentrating, and a reduced want for to sleep. those that expertise manic episodes usually speak dengabn quick, it looks terribly irritated, and should have beliefs that don't seem to be realistic concerning their own strengths and talents.

Fortunately, bipolar disorder could be a condition that may be treated. With correct care, the general public that suffer from bipolar disorder ready to do|can do} substantial stabilization of their mood swings and able to lead a traditional life. Treatment of bipolar disorder embrace medications called "mood stabilizers (stabilizer-mood stabilizers)". Lithium (Eskalith, Lithobid) could be a mood stabilizer is that the most typically prescribed for folks with bipolar illness, however some anticonvulsant medication, together with valproate (Depakote) or carbamazepine (Tegretol), can also have effects of mood stabilizers and should be employed in the treatment of bipolar disorder.

Definition of Bipolar Disease

Bipolar disorder, conjointly called manic-depressive illness, could be a brain disease that menyebabk changes don't seem to be uncommon in mood, energy, activity levels, and talent to perform daily tasks. The symptoms of bipolar disorder are severe. they're completely different from the traditional ups and downs that everybody through it from time to time. The symptoms of bipolar disorder may end up in broken relationships, college achievement or a foul job, and even suicide. however bipolar disorder will be treated, and other people with this disease will run a life-full and productive life.

Bipolar disorder usually develops in late adolescence or in one's early years of adulthood. a minimum of 1/2 all cases begin before age twenty five years. Some folks have their initial symptoms throughout childhood, whereas others could develop symptoms a lot of later in life.

Bipolar disorder isn't straightforward for the spotlight when he started. The symptoms could appear like separate problems, not recognized as elements of a giant downside. Some folks suffer for years before they were diagnosed and treated properly. like diabetes or heart disease, bipolar disorder could be a long-term illness that has got to be managed rigorously sepanjag person's life.

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Review Details Adolescent ADHD


  As a results of increased growth of youth, are diagnosed with Attention Deficit Hyperactivity Disorder, several folks and others who work and / or live with this age cluster have an interest in learning a lot of regarding ADHD adolescents. Medical condition has been identified because the commonest medical conditions among single people up to eighteen years. Up to an incredible 100% of all teenagers within the world these days suffer from this condition. In several cases, an adolescent who has this condition was diagnosed as a baby. In alternative cases, the condition becomes a lot of apparent over the years remaja.Jika you think that your teen is full of ADHD adolescents, it's necessary to confirm that no alternative medical issues which will contribute to the symptoms you observe. many folks within the age cluster of adolescents expertise symptoms almost like ADHD teens if they suffer from learning disabilities or perhaps anxiety-based disorders will result in gejala.Jika you discover that your teenager is somewhat impulsive, or they need issues with listening and it looks alittle on the hyperactive , they'll fine be full of ADHD adolescents. with the exception of the symptoms mentioned earlier, there are alternative symptoms related to ADHD adolescents. several teens can show signs of restlessness and distractibility. There are people who would appear to own problem with sleep disorders like insomnia.Sekarang, if you're attempting to see whether or not you're managing cases of adolescent ADHD, it's necessary to grasp that alternative forms of things will cause identical symptoms. Examples embrace increased activity of hormones within the body and drug use. the most effective thanks to ensure the diagnosis is to debate having your teen evaluated by a doctor or specialist within the field of adolescent ADHD.





Cope with ADHD: the marriage & Relationships Romance

Overcoming ADHD in weddings & romantic relationship could convince be terribly difficult. There are many folks within the world who believe that the medical condition of Attention Deficit Hyperactivity Disorder is one that's gift among the kids alone. sadly, this can be a typical misconception. There are several adults who have ADHD. Adults who are suffering from this medical condition usually expertise several symptoms that produces strain on the social aspects of their lives. This includes their marriages and relationships. ADHD within the guide, you may learn the method of overcoming ADHD so your relationship remains produktif.Langkah initial to deal with ADHD in wedding or in an exceedingly relationship is to coach your partner on the general condition. it's necessary that the person you're to {understand|to grasp} and understand that spotlight Deficit Hyperactivity Disorder may be a medical condition that involves many totally different symptoms which will have an effect on the flexibility sosialisasi.Ini symptoms embrace the shortcoming to essentially listen and concentrate to true and also the folks around you, you will realize it tough to finish the tasks began to try and do, and you will come upon as irresponsible, and even could react inappropriately when it involves emotional things. If you wish to beat ADHD in wedding & relationships, it's necessary to form certain that you just apprehend what you ought to do when it involves your responsibilities. create an inventory and raise your partner to assist you may be a productive step. you ought to confirm that life is as straightforward as mungkin.Ini means, obtain it and use planners, clean your home so no confusion that will distract you mentally, and look for facilitate from a counselor if ADHD is that the reason for issues in your wedding. Overcoming ADHD & romance within the wedding relationship doesn't have complications.




Thursday 8 December 2011

The Secret Lives of Patients


In yesterday's post on e-prescribing, the issue of patient confidentiality came up in the context of doctors being able to see a patient's full medication history in an electronic program, and one commenter brought up that she doesn't necessarily want to tell her shrink about a yeast infection, perhaps because she finds it embarrassing.  The writer of the post, a guest blogger, suggested that this might lead to useful information that should be addressed in therapy, for example the patient's sexual life. 


Years ago, I remember being a bit taken back when a patient brought up some rather problematic (to him) sexual issues in his marriage.  It wasn't the nature of the issues that surprised me (I spent more than a decade consulting to a sexual behaviors unit and I spent several months of residency training on an inpatient sexual disorders unit: it takes a lot to shock me).  What surprised me was that this was the first I was hearing about this issue after seeing the patient for 5 years of psychotherapy.  He had a secret life.


There's not really much to do about this.  One can only help people with the things they bring forward as problems, and we don't, as one commenter pointed out, get notified by the bars every time a patient drinks, or doesn't exercise, or begins yet another dysfunctional relationship, or surfs over to a porn website.  Oh, and I am so glad.  


When it comes to hiding medications, or treatments, then perhaps that's different.  Is it okay for a patient to see one doctor for a Xanax prescription, and if he's not happy with the dose, to see another doctor for more Xanax?  If he's not selling it, I don't think this is illegal, but we'd (meaning docs) all agree that this is wrong, that the patient is deceiving us, and wouldn't  prescribe to someone doing such things.  Is it okay for a patient to hide the fact that he has AIDS, a condition with known psychiatric complications, from his psychiatrist?  We might say that if we're not aware of the medications a patient is taking, then we can't be liable for the interactions, but please-- in therapy it's not just about the fears of lawsuits between strangers, it's also about not wanting to see your patient get sick for completely preventable reasons.


So where is the line?  Is it okay to hide manic behaviors from a psychiatrist---it's none of his damn business if I wanted to sleep with 8 gorgeous women last night and buy them all diamond rings!  Is the psychiatrist entitled to know every behavioral transgression? That he's worth millions when he's getting a discounted fee from the shrink?  That mom thinks he's getting sick again?  Every fantasy that pops into his head?  Is it okay to withhold your dreams from your psychoanalyst?

I won't go on.  You tell me where the exact line is.  I have no idea. 

25 Steps to get rid of a Mental Blocks


Review Details Adolescent ADHD


Identify Symptoms of ADHD Children


Hurricane Katrina Survivors Lack Access to Mental Health Services

Tuesday 6 December 2011

What to Get Your Psychiatrist for the Holidays


This is an update of a Shrink Rap post that originally was posted in 2006.  Seems like a good time for a re-run.
Sarebear mentioned some time ago that she didn't know what to get her psychiatrist for the holidays. I thought about this and decided the answer is easy:

Give your psychiatrist a holiday card and write something meaningful and kind in it. Say, "Thanks for helping me." Or "I'm glad you're in my life." "You're the best psychiatrist in the world" works nicely, too. If you hate your psychiatrist and for inexplicable reasons feel compelled to get them something anyway, then skip the note and just give a generic Seasons Greetings card.

Don't get your psychiatrist an expensive gift. And don't, not even as a joke, give your psychiatrist money-- unless you're paying an overdue bill-- and don't  make comments about a holiday "tip."

So gifts and shrinks are often an unsettling combination. As psychiatrists, we're taught that treatment is offered for a fee. End of discussion and anything more represents a violation of boundaries. Psychiatrists-in-training are told not to accept gifts, and psychotherapists as a whole are taught to try to understand behaviors that skim the usual boundaries. So, theoretically, the psychiatrist should refuse the gift and explore with the patient what meaning the gift, the refusal, the whole exchange, has to the patient.

When residents ask me what to do when patients want to give them gifts, I say "Tell them the program has rules that say you're not allowed to accept gifts." This is the truth and the resident risks getting in trouble if they do accept gifts. If you can't take a pen from a drug rep anymore, why should you be allowed to take a timeshare from a patient? Okay, I made that up, I've never heard of a patient gifting a resident with a timeshare, but we can all have fantasies, right?

I'm in private practice, there's no program director, I make the rules. When a patient gives me a gift, I accept it and say, "Thank you." Why? Because it seems intentionally hurtful to do otherwise-- I assume it has meaning to the patient, that their feelings will be hurt if I refuse the gift, that the patient has taken the time, effort, and money to pick out a gift and this represents something meaningful to him and that it might be painful to have this refused. While the act of giving a gift might have a multitude of meanings, depending on the gift, depending on the patient's illness, depending on the circumstances, I just can't find a way to say No that would feel anything other than rejecting. So I accept the gift and thank the patient, and if the gift is edible, I eat it. This is the thing though: while I've decided that this is the way to go, at least so far for me within the realm of my own practice, I always feel like I'm doing something wrong by accepting a gift.  Training issues remain in the back of my head, and I'd really rather just have a card that says I'm the best psychiatrist in the world.

Disclaimer in honor of other non-shrink physicians: Doctors in other specialties have no such concerns with accepting gifts. They probably don't want anything that taxes your budget. Food is usually good, a bottle of wine, a plant, candles, all will do nicely, and no doctor expects gifts from their patients.  

Understanding the Symptoms of ADHD


 If you or someone you know has recently been diagnosed with Attention Deficit Hyperactivity Disorder, it is important that you get a complete understanding of the symptoms of ADHD. Individuals who suffer from this medical condition have symptoms that reflect three unique characteristics. These characteristics include experience hyperactivity, was negligent, and also moderate to severe levels of impulsivity. While this particular medical condition is fairly common in children and adolescents, the latest figures state that there are a large number of adults who really suffer too. Here, you will gain insight into the symptoms of ADHD. When experiencing symptoms of ADHD are associated with being negligent, an individual will experience symptoms such as complications with the details, the inability to devote their attention to particular situations, people, places, or things and problems with errors that are viewed as "frivolous". Many people also find themselves truly disturbed. In many cases, these people - whether young or old - may have a lot of unfinished tasks. Procrastination, disorganization, and forgetfulness is quite common in those who suffer from lack of attention that is directly related to Attention Deficit Hyperactivity Disorder.Bagi those who are experiencing symptoms of ADHD are associated with hyperactivity, there are many behaviors that may be exhibited. These include frequent walking, inability to sit still, moderate to severe degree of restlessness, talking excessively, and the symptoms are similar in nature. Then there are those who suffer from symptoms of ADHD is impulsivity pameran.Yang The most common symptoms are impatient, the difficulties associated with waiting for their turn, interrupting others, blurting out inappropriately in social settings, and the same symptoms. In some cases, one person may show symptoms from all three major characteristics - impulsivity, inattention, and hyperactivity. However, in many cases, ADHD symptoms associated with the dominant characteristics of the individual.


Sunday 4 December 2011

Cope with ADHD: In The Workplace

  
Overcoming ADHD in the workplace is often very difficult for adults. Although it is true that most children suffer from Attention Deficit Hyperactivity Disorder, there are quite a few adults in the world who suffer as well. Given the current state of the economy, it is important to make every effort to remain in the position you hold a professional. However, if you suffer from ADHD may be very challenging. Most employers look for individuals who are organized, focused, and have the skills to work with the details. If you have ADHD, you will need to put in much effort to ensure that your company values ​​you as a first karyawan.Langkah to cope with ADHD in the workplace is to understand the region in which your work will be affected. If you are aware of the fact that you may experience some symptoms that will affect your work, then you will be more inclined to focus on areas tersebut.Hal is not uncommon to find that simple tasks such as following directions, finishing the project, attention to detail, time management, and even keep your emotions intact a challenging job in themselves. However, you must compete with these issues. If you have, inform you of a supervisor or Human Resources department of the challenges you alami.Jika you find it too difficult to modify your behavior to cope with ADHD in the workplace, you should consider making an appointment with a doctor or medical professional who specializes in care of Attention Deficit Hyperactivity Disorder.Ada many drugs may be prescribed to treat the condition. In addition to prescription drugs, you can choose to go through a behavior modification program with a professional. EEG biofeedback is a new treatment that is becoming very popular. If you are looking for ways to cope with ADHD in the workplace, you will find that you have different options.

 










Identify Symptoms of ADHD Children

Identify Symptoms of ADHD Children
 Many parents, caregivers, and professionals who live and work directly with children interested in learning how to identify the symptoms of ADHD children. Has been determined that anywhere from 3% to 10% of all children have a problem with Attention Deficit Hyperactivity Disorder. Those who suffer from this medical condition often experienced many challenges when it comes to socializing and relationships, their performance in school, and the ability to focus on anything for a long time. In a medical guide, you will learn the most common symptoms associated with ADHD children. When reviewing the symptoms associated with ADHD children, you will find that they usually fit into three categories. The first category is identified as "Hyperactive". The second is the "lack of attention" and the latter is "impulsive". It is important to understand that when a child has symptoms of ADHD children, they may suffer symptoms from more than one category. Common symptoms include an inability to sit still or stay in one place for long amounts of time, consistent interrupt others when they speak in order to make a point or ask a question, and being easily distracted in one way or another. Many parents, caregivers, and others who work with children who seek to learn more about the symptoms of ADHD children will discover that children are often forgetful and seem to be disturbed when it comes to trying to focus on one thing the number of extended time. In addition to this, personal items such as clothing, toys, and other items may be wrong on a regular basis. ADHD children also produce children who are very active at both mental and physical level. If you're worried that your child may be suffering from the symptoms of ADHD children, you should consult with a specialist in order to arrange testing to confirm the diagnosis.
"Staying healthy can keep the spirit let us walk and meal-fed"



What is ADHD?



What is ADHD? This is a common question that more and more individuals begin to ask. Although there are many who simply refer to this condition as "hyperactive", it stands for "Attention Deficit Hyperactivity Disorder".
  While suffering from this condition may prove to be very challenging, it is considered one of the most common medical condition that affects both children and adults. If you have been asking questions about what is ADHD, it is important that you know it is a condition that can affect a person socially, mentally, and physically.
 
  If you learn what is ADHD, it is important to understand that there are many symptoms associated with the condition. Most symptoms ranging from inattention, impulsivity, and hyperactivity. On average, about 5% of all children suffer from this condition. This figure is derived from the organization known as the National Institute of Mental Health or the "NIMH".
  Medical professionals around the world believe that it could be possible to 10% of all children suffering from ADHD. Although there is a theory which states that most children will cope with these conditions, there is another theory which states that the condition can last a lifetime.
  Those who suffer from Attention Deficit Hyperactivity Disorder often find themselves easily distracted. Time management skills may suffer disproportionately as a result of not being able to concentrate. Frustration can occur as a direct result of the inability to organize and set goals accordingly.
  It is not uncommon for patients with this condition to suffer problems with their confidence, complications in their relationship, and even the inability to avoid a growing addiction that could potentially threaten their mental and physical well-being.
  When learning what ADHD, you will find that the lack of mental control is the most challenging aspects of the condition. If you or someone you know has recently been diagnosed, it is important to learn what ADHD.
"Staying healthy can keep the spirit let us walk and meal-fed"






Friday 2 December 2011

Anxiety Disorder (Part I)

Anxiety Disorders  are the most common disorders, or frequently occurring mental disorders, which in this case involves a group of conditions that are divided between anxiety disorders as extreme or pathological disturbance of mood or emotional tone. Anxiety, which is understood as the opposite of normal fear, is the incarnation by mood disorders, as well as of thinking, behavior, and physiological activity.




Types of Anxiety Disorders

Anxiety disorders can include:
1. Panic disorder (with and without a history of agoraphobia / fear of open spaces),
2. Agoraphobia / fear of open spaces (with and without a history of panic disorder),
3. Generalized anxiety disorder,
4. Specific phobia,
5. Social phobia,
6. Obsessive-compulsive disorder,
7. Acute stress disorder, and
8. Post-traumatic stress disorder (PTSD) (DSM-IV).
In addition, there are adjustment disorders with anxious features, anxiety disorder due to general medical conditions, substance-induced anxiety disorder due, and the category of anxiety disorder not otherwise specified (DSM-IV).

Anxiety disorders are not just happening in America alone, but can be found in various human cultures (Regier et al., 1993; Kessler et al., 1994; Weissman et al., 1997). In the United States alone, the incidence rate of anxiety disorders for 1 year in early adult age group of 18-54 years exceeds 16% and this figure has increased significantly and comorbidity with mood disorders and substance abuse disorders. (Regier et al., 1990; Goldberg & Lecrubier, 1995; Magee et al., 1996).

The longitudinal course of these disorders is influenced by the age of onset of symptoms found. Chronicity, relapsing or recurrent episodes of pain reduction and the period of disability (Keller & Hanks, 1994; Gorman & Coplan, 1996; Liebowitz, 1997; Marcus et al., 1997) . Although few psychological cases of adult suicides has highlighted comorbid conditions (Conwell & Brent, 1995), and it seems like the rate of comorbid anxiety in suicide is often underestimated. Panic disorder and agoraphobia. particularly associated with increased risk of attempted suicide (Hornig & McNally, 1995; American Psychiatric Association, 1998).

Panic Attacks and Panic Disorder
Panic attack is a discrete period of intense fear or discomfort that is associated with numerous somatic and cognitive symptoms (DSM-IV). Collection of these symptoms include palpitations, sweating, trembling, shortness of breath, a sense of choking, chest pain (tightness) , nausea and gastrointestinal disturbances, dizziness or spinning head, tingling, burning sensation that spread in this muka.Serangan usually occurs suddenly, with a long attack ranges from 10 to 15 minutes.
Some victims claim to feel a sense of panic attacks "scared to death", like crazy, or loss of emotional control and behavior (eg, women often screaming uncontrollably when to panic)
Traumatic experiences will be recorded in human memory systems and the experience would lead one to avoid the place, an atmosphere where he gets these panic attacks, panic attacks or if it is followed by a physical disorder such shortness of breath, or chest tightness, then usually the victim would immediately ask medical help even though physically nothing medically that triggered the attack sec-felt by the patient.
Panic attacks are generally rarely lasts more than 30 minutes and a clinical diagnosis of panic attacks can be identified with a minimum 4 simpom cognitive and somatic signs as described above.'s Panic attack is distinguished from other anxiety dilhat formation of the intensity and type of attack (sudden or not) , and these symptoms usually look natural.
Furthermore, panic attacks can be classified to the relationship between the onset serangandan presence or absence of trigger factor. More simply, panic attacks as an attack bus adigambarkan the unexpected (enexpected), dependent / attached to the situation, and greatly influenced by the situation (p. it is a general overview, but may be described differently in special cases)
Noteworthy is that panic attacks are not always indicative of saying a person suffering from mental disorder, and simply note that more than 10 percent of otherwise healthy people experience panic attacks (Barlow, 1988; Klerman et al., 1991). Panic attacks are also not limited to panic disorder panic disorder which commonly occur in the course of social phobia, generalized anxiety disorder, and major depressive disorder (DSM-IV).
Panic disorder is diagnosed when a person experiences at least two simptomp a sudden panic attacks and develops into a sense of fear or worry that persistent (permanent) will be the next panic attack or the discovery of changes in habit to anticipate the occurrence of panic attacks again. When the number and severity of cases of attacks varies greatly, a sense of fear and rejection behavior becomes the main thing to note.
Diagnosis can not be applied when the attack was thought to be caused by medication or medical treatment or because of symptoms caused by other diseases, such as hyperthyroidism.

Causes of Panic Disorder
Epidemiological studies mention the average incidence rate of panic disorder is a lifetime of 2-4 percent and the average incidence during one year was 2 percent (Kessler et al., 1994; Weissman et al., 1997) (Table 4-1 ). Panic disorder is often complicated by major depressive disorder (50-65 percent lifetime comorbidity rates) followed by alcohol and substance abuse (20-30 percent) (Keller & Hanks, 1994; Magee et al., 1996; Liebowitz, 1997).
Panic disorder is often found in conjunction with other anxiety disorders, including social phobia (up to 30%), generalized anxiety disorder (s / d 25%), specific phobia (s / d 20%) and obsessive compulsive disorder (s / d 10%) (DSM-IV). As a separate explanation, approximately one half of patients with panic disorder at some point develop into a serious denial of special needs to be explained separately, panic disorder with agoraphobia.
Apparently gender issues can not be separated from the problem of panic disorder in which the number of patients found the woman doubled diabanding men (American Psychiatric Association, 1998). Age beginning of the attacks occur most commonly at the end of Adolescence (usually occurs at age 17-21 years), and middle adult stage (50-65 years) and the beginning of the attacks rarely occur after the age of more than 50 years. Found also continuous development between syndroma anxiety at a young age, such as separation anxiety disorder will. Usually the younger the attacks of panic disorder is the case, the greater the risk of comorbidity, chronicity, and weakness was carrying.



Calendar Desember 2011


Already entered the month of December in the year 2011, every family prepares to last year long vacation.
As a guide I include a calendar in December 2011.

ok let me keep the spirit remains healthy we can walk and eat-meals




Dec-11





Sun Mon Tue Wed Thu Fri Sat




1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31

 Significant December holidays:

 21 1st Day of Hanukkah †
 22 Winter begins (EST) ‡
 25 Christmas
 26 1st Day of Kwanzaa