Depression Symptoms in adolescents and the consequences can then be derived

 

The signs of adolescent depression are often misunderstood by their parents. Parents often believe that adolescent depression is just a development of a normal teenage life. If depression is left alone, so young people will be serious problems that affect its development.

Recognize the signs of teenage depression
Parents often overlook the most common symptoms associated with depression as well as typical adolescent behavior. While the other kids are suffering for what happened to them, but will be more inclined to cover what was happening to them. When asked what happened, you would say I'm fine.

There are some signs of symptoms of adolescent depression in general, which mimic the symptoms of depression that occurs in adults. Moreover, children will experience chronic fatigue, can not concentrate on what is being served, loss of concentration and irritability. When depression takes place, young people feel confused and anxious, because they will try to overcome this debilitating problem. Other symptoms are often seen shouting, crying, complaining, and feeling tired.

As in adults, symptoms of depression affects the physical health of adolescents. Teens readily headaches, pain and gastrointestinal problems such as abdominal pain. Other signs of the presence of sleep problems like insomnia or chronic fatigue. More serious symptoms of teen depression is a desire to end his life or suicide.
If within two weeks of adolescents has not changed, parents should speak to children and seriously seek professional help.

Causes and consequences of juvenile depression

Depression is often caused by external factors that can cause stress. As an example of their parents' divorce, a disappointment in family dynamics, financial problems, sexual abuse, the loss of a loved one, or because of trauma can also be a state.
Other adolescents who see depression as a result of the inability of a young man reaches a certain goal. This objective can be interpreted as an objective academic, social, or otherwise. For example, adolescents will feel depressed and sad when it can not be accepted by their peers, this can lead to adolescent depression.

Impact of adolescent depression are more common is the falling value of their academic schools. Usually teens are showing a decline of familiar from school, loss of focus when the lesson, or lose the passion to achieve the goal to succeed. Moreover, they can be out of extracurricular activities and that more teens hurt again is more vulnerable to fall prey to drugs and alcohol.
We, as parents, could at least find out the problems of young people, so if there is a change for the child, we can better understand and solve problems with wisdom. It may be useful ...

• What is ADHD?

• Reflexology Massage Therapy and Reiki Can Work Together 

• Wise Tips of Mental Health Treatments

• 3 Simple Tips Of Health Solutions for 

• Exercise Your Brain For Mental Health

• Mental Health Illness Medications: 3 Points To Raise With Your Doctor Before Taking a New Medicine

• The Anatomy Of A Natural Health Education

•  The Deviant in Mental Health

Mental Health Assessments (Available instantly for your Android device)

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• Reflexology Massage Therapy and Reiki Can Work Together

• Wise Tips of Mental Health Treatments

• 3 Simple Tips Of Health Solutions for 

• Exercise Your Brain For Mental Health

• Mental Health Illness Medications: 3 Points To Raise With Your Doctor Before Taking a New Medicine

• The Anatomy Of A Natural Health Education

•  The Deviant in Mental Health

Mental Health, Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body (paperback) review

Book Description

Those seeking alternative methodologies for achieving optimal mental health will learn effective, safe, natural, and generally more affordable strategies and treatments in this guidebook. With up-to-date research, illustrative examples, and a practical approach for individuals and families, this handbook features an overview of mental health disorders, basic strategies for improving as well as preventing mental health issues, therapies that go beyond the fundamentals, and specific strategies for those struggling with ADHD, depression, anxiety, stress, and substance abuse. In addition to outlining the basics—such as the role of exercise and activity, restful sleep, nutrition, and supplements—the text details stress-management practices and discusses alternate techniques including homeopathy, massage and bodywork therapy, acupuncture, and chiropractic and osteopathic work. A section on advocacy and resources is also available.

Threatening Children's Toys Children's Mental Health?

 Once we understand the importance of mental health, then we can see around us especially in our immediate neighborhood as a family. Whether in our family there are signs or symptoms of this mental health disorder. Mental health condition at this point tend to have a concern, as data released in solo.com (12/11), it looks at the increasing number of negative behaviors such as fighting, drug abuse, promiscuity, suicide, religious radicalism, and the like. That's why all parties are expected to increase the awareness for the fight with the build quality and mental health of the nation. "Data in 2007, 11.6% or about 19 million children and adolescents Indonesia impaired mental and social health. It makes them easily swept away and easy activities that are involved in negative activities. So let us together try to make efforts to promote mental health from an early age, starting either from family, government, educators and all interested parties.

Starting from an early age, then what should we do since from now on our children at home, school and neighborhood? Beginning of the foundation of a good awakening of a nation is of the family. It is inevitable role of the family here is very important. With care and good reception from the family of his son would reduce the potential for the formation of aberrant behavior in children. Good parenting will shape the child's emotional development degan good. The newly born child as white papers, was dropped as it would then that is what will shape the personality and build children's mental health.

Why in this paper the authors want to convey that the toys could threaten the health of children. The most effective teaching methods for children at preschool age children to play while learning, and the activities that one used yag is a toy. Toys for children at the age of 0-6 years are most commonly used tools and activities to accompany the child in learning or play well wherever he is. Even after that age is still a lot of toys that children used to accompany all its activities to hobbinya. Part of patterns of parenting in child pick out or facilitating the child's toy that will be used is one element that contributed to building a child's mental health.

Toys are having a devastating effect on children can be started from the ignorance of children with the function of the toy. Parents have an obligation to facilitate a child with a toy that could increase the potential of children and give children the opportunity to explore the game. If a game does not make a child can enhance creativity and potential of children and having a devastating effect on his personality then the parents are obliged to steer. It is conceivable that children really like toys that are too trigger aggressiveness of children? Such as toys that can increase the aggressiveness of the child and interfere with the child's emotional development: a pistol, a sword that looks almost like the original size, parents may introduce various forms and uses of various objects around him but can with a picture, or shape of objects is quite safe for children and not harm the child's emotional development and personality in general.

Children who already have aggressive potential in him, if parents are not sensitive in nurturing and providing support to developing toys that aggressiveness is likely the child will grow up because there are no mental health problems. Vice versa if children with high levels of sensitivity with a game that is not appropriate then the kids grow into a vulnerable adult at the time of her transplant. So it's good for parents mom and dad have to recognize the personality of the child in advance so that it can provide the right toys for child development. Parents should be wise in choosing a toy, not only if the child is quiet / do not cry then give all the parents what the child asks.

• Reflexology Massage Therapy and Reiki Can Work Together

   

• Wise Tips of Mental Health Treatments

• 3 Simple Tips Of Health Solutions for 

• Exercise Your Brain For Mental Health

• Mental Health Illness Medications: 3 Points To Raise With Your Doctor Before Taking a New Medicine

• The Anatomy Of A Natural Health Education

•  The Deviant in Mental Health

Windmill Health Products Focus Formula Brain Enhancement Supplement Caplets, 60-Count Boxes (Pack of 2)

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Women and Gender

Women are subject and object. There are opinions that say that women were actually in the "master" it. This means that he is respected. Likewise it is still not reducing the weight of himself as an object. It could even be said to attempt an explanation, as mentioned above arises when the object dimensions are so prominent.

Women's issues are also gender issues. Understanding of Gender in essence is a concentrated understanding of the nuances of the West (Western invention-Connell, 1993). Gender as a concept rests on the biological aspects (biological reductionism). Cucchiari (1994) says that in her Gender has two biological categories different but complementary categories: first male and the second is the category of women. Each category contains a sense of meaning varies from one society to another. Every activity, attitudes, values ​​and symbols are given meaning by the supporters according to their biological category. Therefore, the actual status and role of women in every place and culture is not always the same. In Bali, women actively make highways or transport sand from the river, the strange thing is done by women in Java or Sumatra. In Africa, is a commonplace that women participate in farming and logging, while elsewhere it is probably in tabukan.

Gender in the West feel concentrations as expressed by Connell (1993) said, rests on the West civilisasi through the Industrial Revolution. Industrial phase, and then worldwide, is the phase of the hegemony of men. In the period of the Industrial Revolution, the most important element is the matter of division of labor based on gender differences. This is where the emerging injustices against women. Women, like dikemukakn by Simone de Beavoir, described as "nature" is characterized by things-static passive, permissive, domestic and gentle. Men, on the contrary, is characterized as a battering ram, active, and strong public control. In the phase of the Industrial Revolution in which the shape of physical strength is the determining factor, it is practically excluded women from production processes. Way of looking at the division of labor based on gender differences between the simple and it is contrary to the industrial community. If the community is simply the difference in nature to co-exist and complement, and full of harmony, then vice versa in the industry was used to abolish the distinction and demeaning the dignity of women in an effort to elevate the status of men.

Patriarchal culture (where the position of the dominant male) is in line with the Industrial Revolution is the main pillar of Western civilization. Indonesia, not the exception especially since he also had the experience of the colony of Western colonialism for approximately 350 years old. Numerous studies show how women experience marginalization of the agricultural sector in the event of "green revolution" in the mid 70's and early 80's.

Paradigm In Mental Health

Paradigm in Mental Health
Understand the principles of the Mental Health has revealed
Schneiders since 1964, which includes three things:
11 principles based on human nature, namely:
A. Mental health and adjustment can not be separated from physical health and
integrity of the organism.
2. In mental health care, is inseparable from human nature as
personal moral, intellectual, religious, emotional, and social.
3. Mental health and adjustment requires the integration and control
themselves, include: control of thought, imagination, passion, emotion and behavior.
4. Expanding self-knowledge is a necessity in achieving and
mental health care.
5. Mental health requires a healthy self-concept, including: acceptance
self and a realistic effort to status and self-esteem.
6. Understanding and self-acceptance should be increased in an attempt
enhance the self and self-realization to achieve mental health.
7. Mental stability requires the continued development of self-menerusdalam
individuals, is associated with: wisdom, courage, law, fortitude,
moral, and humility.
8. Attainment in mental health care associated with the planting
good habits.
9. Mental stability requires adaptability, capacity to change the situation
and personality.
10. Mental stability requires a maturity of thought, decisions,
emotionality, and behavior.
11. Learn to cope with mental health needs effectively and
sense of mental conflict, failure, and the tensions that arise.
Then as the second principle is based on three principles
man's relationship with its environment, namely:

A. Mental health is influenced by a healthy interpersonal relationships,
especially in the family.
2. A good adjustment and peace of mind influenced by the adequacy
individuals in job satisfaction.
3. Mental health requires a realistic attitude, ie accept the reality
without distortion and objective.
And the latter principle, the two principles are based on the relationship
individual with God, namely:

A. Mental stability requires the development of awareness of the realities of the largest
of itself as the place to rely on any action
fundamental.
2. Mental health and sobriety requires a constant relationship
between man and God.
The paradigm used in the study of Mental Health
which is believed to be multifactorial review, among others: BIOLOGICAL APPROACH. By studying brain function, endocrine,
and sensory function, this approach believe that mental health
individual is strongly influenced by genetic factors and conditions during pregnancy, as well as
related to external factors: nutrition, radiation, age, complications of the disease.
PSYCHOLOGICAL APPROACH. Such an approach is believed that the factors
large psychological effect on a person's mental condition, which in
psychological approach has three major views that address
on the matter, namely:
A. Psychoanalysis
Approach believe that the individual interactions in early life
and intrapsychic conflicts that occur will affect the development
one's mental health. Epigenetic factors studied maturity
developing a person's psychological as physical growth in tahaptahap
individual development, is an important determinant of health
mental individual.
B. Behavioristic
The learning process approach and believe in the social learning process
will affect a person's personality. Individual errors in the process
learning and social learning will lead to mental disorders.
C. Humanistic
Individual behavior is influenced by the need to have hierarchies. In addition,
individuals believed to have the ability to understand their potential and
developed to achieve self-actualization.
Social cultural approach. Has several approaches, namely:
Social stratification that addresses socio-economic factors and social selection;
SOCIAL INTERACTION which discusses the function in an interpersonal relationship
(Psychodynamic Theory, Theory of low social interaction: isolation, loneliness); THEORY OF FAMILIES who studied the effect of parenting, the interaction between
family members, and family functioning of individual mental health:
Social Change, which relates the long-term change, migration and
industrialization, as well as a crisis situation with an individual's mental condition;
SOCIO-CULTURAL, who studied the influence of religion and culture conditions
mental one;
Social stressors, which studied the effect of various social situations
psychological impact (eg, marriage, death, crime, the recession)
to the mental condition of individuals.
APPROACH TO THE ENVIRONMENT. This approach has two dimensions, namely:
DIMENSIONS PHYSICAL ENVIRONMENT, related to: space, time, and means
(Nutrients) that accompany.
CHEMICAL AND BIOLOGICAL ENVIRONMENT DIMENSIONS, related to: pollution,
radiation, viruses and bacteria, the population of other living creatures.

Gracefully Insane: Life and Death Inside America's Premier Mental Hospital

Its landscaped ground, chosen by Frederick Law Olmsted and dotted with Tudor mansions, could belong to a New England prep school. There are no fences, no guards, no locked gates. But McLean Hospital is a mental institution-one of the most famous, most elite, and once most luxurious in America. McLean "alumni" include Olmsted himself, Robert Lowell, Sylvia Plath, James Taylor and Ray Charles, as well as (more secretly) other notables from among the rich and famous. In its "golden age," McLean provided as genteel an environment for the treatment of mental illness as one could imagine. But the golden age is over, and a downsized, downscale McLean-despite its affiliation with Harvard University-is struggling to stay afloat. Gracefully Insane, by Boston Globe columnist Alex Beam, is a fascinating and emotional biography of McLean Hospital from its founding in 1817 through today. It is filled with stories about patients and doctors: the Ralph Waldo Emerson protégé whose brilliance disappeared along with his madness; Anne Sexton's poetry seminar, and many more. The story of McLean is also the story of the hopes and failures of psychology and psychotherapy; of the evolution of attitudes about mental illness, of approaches to treatment, and of the economic pressures that are making McLean-and other institutions like it-relics of a bygone age.

This is a compelling and often oddly poignant reading for fans of books like Plath's The Bell Jar and Susanna Kaysen's Girl, Interrupted (both inspired by their author's stays at McLean) and for anyone interested in the history of medicine or psychotherapy, or the social history of New England.

The Package Deal: Mental Illness, Stigma, and Discrimination [Kindle Edition]

Editorial Reviews

Product Description

My longtime friend, Jean Lyon, encouraged me to write a book about my experiences with the mental health system. "You should write a book," she said.

"No, I couldn't. No one would believe me," I replied.

"Yes, you could," Jean insisted. "You could call it One Flew Over the Cuckoo's Nest, the Sequel--it's worse than the original."

The Package Deal is a short, 4500-word memoir that takes the reader into a world that most people do not know about. My non-fictional account provides an inside, uncensored look at societal discrimination against people with mental illness.

This eBook consists of two distinctly different parts. Part one, titled Unplanned Patienthood, provides a humorous glimpse of the mental health professionals whom I have been fortunate, and not so fortunate, to encounter. Part two, titled A System Without Oversight, opens with my voluntary admission to a psychiatric unit in Northern Virginia. This part chronicles my conflict with the mental health system, which began when hospital personnel assaulted me. It covers the facts surrounding the assault, as well as my resultant struggle for justice, not only with the mental health system, but also with the criminal justice system and government oversight agencies.

At every turn in my search for justice, I faced discrimination. This eBook echoes an all-too-common situation for those who happen to have a mental illness. Discrimination against this marginalized population too often goes unreported and unchallenged. In addition to being enlightening, the narrative is entertaining, suspenseful, and incorporates humor as a powerful communication tool.

From the Author

I humbly hope that my eBook serves not only to help open society's blind eye to the plight of mentally ill persons, but also as a catalyst for change.

Just Like Someone Without Mental Illness Only More So

I'll cut to the chase: I loved this book.
Five stars. Two thumbs up.

When I read books, especially psychiatry books that I write about on Shrink Rap, I often read more carefully and sometimes more critically. I was so immersed in reading Just Like Someone Without Mental Illness Only More So that I didn't stop to think, I just went on the journey.

Mark Vonnegut is a pediatrician and he is also the son of my favorite author from when I was in junior high school. His memoir is a poignant and candid account of his struggles with...well... life in general, and life with a psychotic illness in particular. Schizophrenia, bipolar disorder---who knows (I'll vote for bipolar disorder)? Some illness where he had three episodes in his twenties, then another episode 14 years later. Thorazine and lithium and megavitamins and psych wards. Xanax and alcohol and how humiliating it is to be psychotic on a stretcher in the ER hallway of the hospital where he works. Divorce and remarriage. First and second families. Childhood as the son of a financially struggling, not-yet-famous, eccentric writer, and adulthood as the son of an icon. Vonnegut is a hippy, a mainstream doctor, a middle-aged softball player, then finally a guy who accidentally poisons himself with wild mushrooms.

Dr. Vonnegut's struggles are those of vulnerability, fragility, hope, and resilience. He comes back from these life-altering episodes of psychosis and applies to 20 medical schools. He gets in to Harvard, and only Harvard. If you're going to apply to med school with a 1.8 science GPA from college, then I imagine it's helpful to have a very famous dad who teaches at Harvard. Vonnegut does well enough that he stays for residency and teaches there after. His illness and the possibility of its return hang on him--once you've heard voices, he says, you're never like someone who hasn't. As serious as the topic is, the author is able to make light of himself and the writing is funny and tragic all at once. It's a quick and engrossing read.

In case I didn't like this memoir enough, Vonnegut makes intermittent jabs about the tedious things that weigh down life as a doctor-- paperwork (my favorite rant), the influence of big pharma, and insurance companies.

So would I like Mark Vonnegut in real life? I liked him in his book. And so it goes.

Fishy Pedicure Ban

I was rummaging through the legal news lately when I came across a case that made me flash back to our old Cure for Fish Phobia post.

It appears that the state of Arizona has passed a law banning the use of tiny little fish for pedicures. Arizona wasn't the first either. New Hampshire decided that the fish were "beauty salon tools" that had to be cleaned in between use. Texas is concerned that the fish bowls aren't cleaned between use and could transmit disease.

Will pedicure fish now come with a black box warning? CAUTION: Fish, use only as directed. For external use only. Possible side effects may include drowsiness, dry mouth, blurred vision, constipation, the aftertaste of sushi, syncope, seizures, coma and death. Oh yeah, and scaly skin.

How To Find A Psychiatrist

Seems like a simple enough questions: How do you find a shrink?

It's not that easy to answer. There are all sorts of shrinks who do all sorts of things (therapy, not therapy, specific forms of therapy like psychoanalysis or CBT), and then there's the overriding insurance question. Not to mention location, location, location.

We've talked before about insurance, and if you haven't read Why Shrinks Don't Take Your Insurance, please do. It's a good place to start. In areas where shrinks are in short supply, often, they do take insurances and they only see patients for medication management. In areas where there are more docs and people have treatment options, they may split between those who do and don't take insurance. You should be aware that if a shrink doesn't take your insurance, you will likely still get reimbursed, but there may be a higher deductible, you'll need to mail in the form yourself, and there will be a long wait (and assorted hassles) for the money to come back. Some people are reimbursed very well, others or not. If your insurance is an HMO or has no out-of-network benefits, then a non-insurance doc will costs you the entire fee.

So start here:
--Does it matter if the shrink is in your insurance network?
If it does, and you live in an area where many shrinks don't participate with insurance, then call the insurance company and get names and numbers and do hope they aren't all dead or not-accepting patients.

--What kind of shrink? If the patient is under age 16-18, your best best is a child & adolescent psychiatrist. Be aware that many psychiatrists at academic centers run research projects and teach, and don't see many outpatients. That's not to say never---and most have a few patients, but they are often a bit harder to reach, especially when they are presenting at conferences or have grants dues, and may have difficult parking. So child, general adult, or is there some specialty need which may be very restrictive---for example treatment of sexual or eating disorders or psychoanalysis? For ClinkShrink, I will throw in that if you are looking for evaluation for a matter pertaining to the legal system, you may want to look specifically for a forensic psychiatrist.

--Finally: does it matter to you if the shrink does psychotherapy or are you fine seeing one person for therapy (if necessary) and another for meds? If it matters, you need to clarify this upfront.

Now you've got the big three questions. There are other obvious ones: parking is always a biggy, the setting may be a concern (is your ex-lover working in the same practice?), how difficult is it to get an appointment? How long do appointments last? If the first evaluation is routinely scheduled for under 50 minutes and you have a choice as to where you go: then go somewhere else. In an institution---jails, a substance abuse clinic, the medical unit of a hospital, an emergency room--- evaluations may be very brief, but in these settings your records may be available for review and the evaluation may have a very specific and limited purpose. But for a thoughtful, comprehensive evaluation before beginning on-going treatment, the usual is a minimum of 50 minutes and often 90-120 minutes. Some psychiatrists do their evaluation over several sessions.

Okay, so to start:
If you have no insurance and no money, your options are limited. The traditional place for treatment in this case is a local Community Mental Health Center or CMHC and the standard has been to have one per geographic catchment area. These clinics usually offer split care, there may be a wait, and you don't get to choose your shrink. They take Medicare and Medicaid, and they sometimes don't take private insurance. How do you find your CMHC (or OMHC)...I'm not really sure. Try Google, and then call any clinic in your area and have a heart-to-heart with the receptionist. He may be able to give you the number of the clinic that serves you.

There are other agencies that over care for the indigent. In Baltimore, HealthCare for the Homeless offers psychiatric treatment, and The Pro Bono Counseling Project will give referrals for free or discounted care from professionals in the community who have agreed to volunteer their time. Again, there's no choice in which shrink you get.

If you have insurance and want to stay in network: Call your insurance company for a list of names.

Aside from money concerns, here are the best ways to find a good shrink:

• If you know someone who likes their doc, see that doc!

• If you know someone who like their doc, but you can't see their doc, ask your friend to get some names from their doc, or call yourself.

• Call your state psychiatric society and ask for a referral. If the office is located near where you live, the staff may well know some of the psychiatrists and you can ask for a nice one.

• Ask your primary care doctor, they are used to making referrals.

• Ask a Shrink. Ask any shrink---shrinks tend to know each other....so if you can get one on the phone, they may give you names even if they can't see you. In our state, we have a shrink listserv, and people frequently post, "Does anyone know a psychiatrist in Timbuktu?" for a patient who is moving, a child of a patient, friend of a friend of a friend. As a rule, shrinks don't know what insurance networks other docs participate in.

• Ask a doc, any doc. A random doc may not be able to help you, but they may. My favorite was the friend who asked me for a referral for a breast surgeon in another part of the state. Not something I'd know, but my neighbor the breast radiologist was able to give some names and so I was email-helpful. Between listservs, Facebook, email, etc...people can sometimes find names.

• If you're a student, try the school's counseling/health center. They may also be able to suggest off-campus referrals.

What to ask on the phone (besides the obvious money issues):
It's fine to tell someone the one-sentence version of what you want help for and to ask if they are taking new patients. It's probably a burden to try to tell them your whole history.
It's fine to ask how long the evaluation is, how long a typical appointment is, and if the shrink sees people for therapy or just meds.

What is Bipolar Disorder?

 

I'd like to ask your help for a moment.  I'm going to write a blog post for this week's Clinical Psychiatry News on Bipolar Disorder.  I'd like to know how you see the term used, or the symptoms that are hallmarks of the illness for you.  If you respond as my favorite commenter, "Anonymous," could I ask that you define yourself...psychiatrist, psychologist, pediatrician, patient with bipolar disorder, friend of someone diagnosed with bipolar disorder....

Also, please just off the top of your head, I can read DSM or Google myself, and I'm more interested in your ideas about what exactly the disorder is.

I may not use your responses (I sort of know what I want to say) but no matter what, I'm curious.  

Thank you so much...

MENTAL HEALTH HISTORY

Mental health history is not as clear as the history of medical science. Mental problem is not primarily a physical problem that can be easily observed and visible. Even more so when it is used to the everyday behavior such as relatives or family, mental disorder has been regarded as a matter of course, not as a thing that is annoying.
Mental disorders in Indonesia still lacks focus and attention. Moreover with a low education level, the people of Indonesia is still considered a mental disorder is often associated with mysticism. Here is a history of mental health, especially in the Americas and Europe.
• In 1600 and previous
At this time, people often think mental disorders caused by the spirits near environment, and often the mediation between humans and the spirits who want to convey meaning. Therefore, they are often considered to be sick so they were not removed and still have a place in society.
• Year 1692
In America, the influence of European immigrants, who are Christians, often regarded as affected by magic or witchcraft of the evil that enters the body. Thus the fear and hate those who have magical powers. John Locke (in Siswanto, 1997) states that there are degrees of madness in people caused by the emotions that compel people to come up with any ideas and no sense a continual basis. John Locke's view is survived in Europe until the 18th century.
• Year 1724
Reverend Cotton Mather (1663-1728) broke the superstitions that exist in society by advancing physical explanations of mental illness itself. At this time, the medical approach was introduced to provide an explanation of psychiatric problems as a result of the disturbance in the body.
• Year 1812
Years 1830-1860 in the UK appear optimism in dealing with mentally ill patients due to the development of theories and techniques in dealing with mentally ill people. Psychiatrists began to emerge in 1842 and got an important role in the hospital to replace the role that lawyers play a role dealing with mentally ill at the time. However, because many have failed, it appears the pessimism therapy (therapeutic pesimism) and influenced by Darwin's statement that states that mental disorder is a developmental evolution that is innate and can not be changed anymore.
• Year 1843
There are only 24 hospitals and 2561 beds to deal with mental illness in the United States.
• In 1908
In this year, applied to the attitude of the association with the aim of which is to improve public attitudes towards mental illness and people with mental illness, improve services for people with mental illness, working for the prevention of mental illness and promote mental health.
• In 1909
Sigmund Freud visited the United States and taught psychoanalysis at Clark University in Worcester, Massachusetts.
• In 1910
Emil Kraeplin first described Alzheimer's disease and she also developed a test that can be used to detect the presence of epileptic disorders.
• In 1918
American Psychoanalysis Association made a rule that people who have graduated from medical school and practiced psychiatry that can be candidates for psychoanalytic training.
• In the 1920s
National Committee for Mental Hygiene generate a set of models of commitment laws that put in atura in some States. The committee also helped research the effect on mental health, mental illness, and treatments that bring about real change in mental health care system.
• In the 1930's
Psychiatrists began to inject insulin that causes shock and temporary coma as a treatments for patients with schizophrenia.
• In 1936
Moniz gnats publish a report on the first human frontal labotomi. Consequently in 1936 until the mid-1950s, an estimated 20,000 surgical procedures in use in American mental patients.
• In the 1940s
Electrotherapy, namely by applying electrical therapy to the brain. Was first used in American hospitals to deal with mental illness. In 1940-1950 the commencement of community care for people with mental disorders in Britain.
• In 1947
Fountain House in New York City launch of psychiatric rehabilitation of people suffering from mental illness.
• In 1950
Formed the National Association of Mental Health (NAMH) which is a merger of three organizations, namely the National Committee for Mental Hygiene, the National Mental Health Foundation, and the Psychiatric Foundation.
• In 1952
The first conventional antipsychotic drugs, ie chlorpromazine, allowed for patients to deal with schizophrenia and other major mental disorders.
• In the 1960s
British media began to reveal mental health by showing the people who have experienced mental illness to share their experiences. At this time all the taboos associated with mental disorders began to be opened and discussed in general.
• In 1961
Thomas Szasz makes writing the book The Myth of Mental Illness, which put forward the theory that states that "mental illness" is actually not really "sick", but an act of people who are mentally distressed at having to react to the environment.
• In 1962
There are 422 000 people living in the hospital for psychiatric treatment in the United States.
• Year 1970
Deinstitusional start of mass. Patients and their families back on their own resources as a result of the lack of programs for patients who have been discharged from the hospital for rehabilitation and reintegration back into society.
• In 1979
NAMH became the National Mental Health Association (NMHA).
• In 1980
The emergence of a planned treatment, with hospitalization in the short term and the public become standard treatments for mental illness treatment.
• In 1990
NMHA played an important role in eliciting Disabilities Act, which protects Americans who are mentally and physically disabled from discrimination in several areas, such as employment, public accommodations, transportation, telecommunications, and central and local government services. Meanwhile, brain describe the technology used to study the development of a major mental illness better.
• In 1994
Bpertama atypical antipsychotic drugs were introduced. This is the first new antipsychotic drugs after nearly 20 years the use of conventional medicines.
• In 1997
Researchers find genetic link to bipolar disorder who showed that the disease is inherited.



REFERENCES

Siswanto. , 2007. mental health, Yogyakarta: Yogyakarta andi,

Sarwono, Sarlito. 2010.pengantar general psychology, Jakarta: eagle release

One Of Us: Physicians Who Kill

"I have already said that if you kill a doctor, all the doctors are instantly on your neck. But what if the man who does the killing is a physician himself? That complicates the situation most damnably..."

---Foursquare: The Story of a Fourfold Life by John Oliver

I've been reading, along with everybody else, the story of the Army major and psychiatrist Dr. Nidal Hasan who killed thirteen people in a spree shooting at Fort Hood yesterday. Let me say first that I've never met Dr. Hasan and know nothing about him; I have no particular information or insights about this offense beyond what I've read in the media.

The CNN article today interviewed two of Dr. Hasan's patients, who both said nothing but glowing things about him and his care. I've blogged about spree killers before ("Shooter Psychology") but this case is different. It got my thinking about the general issue of physicians who kill.

Physician killers are certainly a relative rarity, but they are not unknown. Dr. Jack Kevorkian is probably the most famous here in the United States, but in the United Kingdom there was the case of Dr. Harold Shipman. Dr. Shipman forged the will of, and then killed, several elderly female patients. Then there was Michael Swango, a serial poisoner who killed his patients specifically so that he could take credit for his heroic "resuscitation" efforts. As far back as 1920 Dr. John Oliver wrote about an anonymous psychiatrist colleague who killed another physician and was found legally insane. The quote at the start of this post is from Dr. Oliver's autobiography were he discussed the case. For anyone really fascinated by the topic, I refer you to the book Demon Doctors: Physician Serial Killers. I haven't read it myself so I can't vouch for it; feel free to write in reviews.

But I digress. Getting back to what happened at Fort Hood, the news reports don't indicate anything to suggest that Dr. Hasan was psychotic, motivated by greed or financial gain or out of a need to be a hero. He wasn't an infantryman who had been exposed to combat and who might have been terrified of going back to a traumatic environment. He was educated and presumably in a better financial and social situation than most of the patients he treated, unlike many of my murderer patients who have burned multiple social bridges prior to the killing.

Regardless, a killing by a physician---particularly by a psychiatrist---creates a bizarre aftermath. The military is sending mental health professionals to counsel the victims and witnesses; I'd be willing to bet those military mental health professionals will be required to check their weapons at the door.

My Three Shrinks Podcast 51: Vegan Gingerbread Cookies

For this podcast I brought some homemade vegan gingerbread cookies that I baked using a recipe from the Steph Davis blog. I'm also looking for a good sugar cookie recipe that doesn't use refined sugar or all-purpose flour. If you've got one, send it along.

We discuss my post Is it malpractice to lie? which involves a surgeon sued for malpractice for allegedly lying to a patient regarding his professional background. We wonder how much, if any, information physicians may some day be obliged to disclose to their patients prior to treatment.

There is a new type of research being done, called "in silica" research, in which people write computer programs to model behavior. We talked about computer models of suicide and how this can replicate suicide epidemics in real life. Roy is inspired to talk about a computer program that models how guys choose urinals in public restrooms, and how people stand in elevators.

We never got to the FAA policy discussion or the cell phones in therapy topic. That was saved for our next podcast.

Last but not least, Dinah takes her dog Max to the new office. Who knew that dogs could be terrified of elevators??

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This podcast is available oniTunes or as an RSS feed orFeedburner feed. You can also listen to or download the .mp3or the MPEG-4 file frommythreeshrinks.com.

Thank you for listening

Send your questions and comments to: mythreeshrinksATgmailDOTcom

I Am Not 'One Of Them'

Since the Fort Hood shooting I've been hearing and reading a lot in the media about 'compassion fatigue' and 'vicarious trauma'. I feel compelled to blog after reading yesterday's New York Times article on the topic, which I'm sure won't be the last.
The idea is that any mental health professional who spends their days listening to patients tell their stories of traumatic events will eventually end up having emotional difficulties from it as well. The other term for this is 'compassion fatigue', in other words losing the ability to empathize with others or becoming numb to trauma due to exposure to patients' traumatic stories. The Times article is careful to point out that vicarious trauma and compassion fatigue will not automatically lead one to become a killer.
Well, I'm relieved to hear that.
Over the years as both a forensic and correctional psychiatrist I've heard plenty of trauma-related stories. I've reviewed autopsy photos and crime scene photos and read police reports of violent offenses and watched videotapes of violent offenses. I've heard people talk about
their crimes and talked to victims of violent crimes (if they survived). People who have read my "What I Learned" posts know that the annual conference of the American Academy of Psychiatry and Law regularly features presentations about serial murderers, psychotic killers, crime scene investigation techniques and other topics that can be a bit gruesome.
If all 1700 forensic psychiatrists in this country are exposed to this regularly that's a whole lot of vicarious trauma. It's good to know I won't automatically become a spree killer.
Frankly, I wasn't worried.

Academy for Film and Psychiatry

There's nothing quite like blogging in a blizzard. My house, by the way, is the one with the gutters torn off one side and draped across the front with the disconnected downspouts. You will notice that our flat roofs have been shoveled off-- makes for a fine family project in the snow-- after having the insight that another 20 inches could well cause their collapse.

So I thought I'd give a plug to Dr. Fred Miller and his Academy for Film and Psychiatry. His 'filmosophy' reads:

FILM IS NOTHING SHORT OF OUR STRUGGLE TO UNDERSTAND PEOPLE, CULTURE AND OURSELVES. FILM ENGAGES ALL OF OUR SENSES AND IN THAT WAY IS LIKE NO OTHER MEDIUM. THE PARALLELS BETWEEN THE FILMMAKER AND THE PSYCHOTHERAPIST ARE MANY. EACH IS ACUTELY AWARE (OR SHOULD BE) THAT HE OR SHE IS PRESENTING AN UNDERSTANDING OF THE HUMAN CONDITION AND ALSO THAT THE PROCESS OF UNDERSTANDING IN AND OF ITSELF IS HEALING AND FULFILLING. BOTH ARE SUBJECTS OF INTENSIVE STUDY AND ENDLESS DEBATE. ENJOY!

Film seems like as a good a thing as any to do today, so long as the power holds. Brrrr from Maryland, hon!

Am I Normal?

Paperdoll commented that ?she (?he-- do paperdolls have gender?) likes posts about "normal."

The quick answer is: No, you're not normal! Normal people don't call themselves "paper doll." Normal people also don't write blogs called "Shrink Rap" or post photos of their feet all over the internet.

I'm a psychiatrist and people ask me all the time "Is that normal?" or worse, "Am I normal?"
And we start with a semantic disconnect here: I equate "Normal" with "Booooring!" and would gladly wear a pin that says "Why Be Normal?" Like Why? What is normal? Why would anyone aspired to that. Normal is an IQ of 100, corn flakes for break fast and tuna fish for lunch (ok, I like tuna)..normal entails conforming to some exact mediocre standard. Why would you want to be Normal. Please don't call me normal (I think I don't have too worry too much here).

To my patients, however, "Am I normal?" doesn't mean Am I normal, it means "Please tell me I'm not crazy." You're not crazy. Okay, Paperdoll, I don't know you, and I don't know what crazy means to you, but there's probably a good shot you're not crazy. And I am definitely not crazy. Oh, yeah, I'm a psychiatrist and I'm not supposed to use the word crazy. Okay, you're normal.

So sometimes I'm told that I'm too normal to be a psychiatrist. Oh, all the Shrink Rappers---believe it or not--- kind of "look" normal....except for ClinkShrink who has started acting like Spiderman while she repels off steep cliffs. Apparently-- or so I'm told-- psychiatrists don't look normal.

Where am I going with this? And why? Is this kind of bloggy discourse normal?

Obama Mama it's Health Care Reform!

In case you haven't heard, we've got ourselves health care reform.
What do you think?
Will this be a good thing for psychiatric patients?
Will this be a good thing for psychiatric docs (the shrinks among us?)

Personally, it's been so much commotion and so many pages, it's been way too much to follow (and no one asked my opinion anyway). I think I'm happy for movement, we've been stuck for so long with a system that just doesn't make sense. I'm told most people are happy with their health insurance. Are you?

Go for it, write in our comment section!

Guest Blogger Dr. Darell on Not Being Funny in Psychotherapy

A while back, I put up a YouTube video that I thought was funny. A commenter didn't like it and felt it promoted stigma. So I took a vote, and while most people were fine with it, a number did not like it, and I took the post down. We received this note, and I thought it was substantial enough to be it's own guest post (with permission, of course).
------------------

Hi. I am a practicing psychiatrist based in New York City. I find your blog interesting, informative, and, at times, funny. Now, can you guess which entry I'd like to comment on?

Mel Brooks once said, (paraphrased), that if you slip on a banana peel and land on your butt, it's comedy. If I fall down a flight of stairs, it's tragedy.

I've had a long-term interest in humor, and a brief career as an unpaid stand-up comic in L.A. (Brief because my bombing to "killing" ratio was about 15 to one.)

With respect to my experience as a therapist, I now occasionally utilize humor in my treatment, but only extremely judiciously, once I have gotten to know my client.

I learned my lesson early. At the beginning of my residency training, during my second session with a client, I commented that perhaps he felt like Groucho Marx when Groucho said that he wouldn't want to be a member of any club with standards low enough to accept him. I sat back, feeling as if I had made the interpretation of the century, and waited for a reaction. I got one. The client stormed out of my office and never returned. My supervisor later told me that, as I suspected, I had screwed up royally.

This memory resonates with Dinah's statement that it's the recipient's reaction to a joke or a comment that counts. So know thy audience, and know thyself. You're obviously on much safer ground if you make a joke about a community or an ethnic group that you belong to. We do, however, live in an era of enhanced sensitivities and political correctness, and need to be extra careful not to anger or offend.

With respect to the Youtube audio, I, like a number of your readers, have heard other versions and have become desensitized to it. Ironically, I read about a version of it being told by a psychiatrist moonlighting as a standup comic years ago. My immediate reaction was, "Keep your day job, doc!"

Since "Psychiatry Hotline" is available to a large and varied audience, including people suffering from mental illness, I would not personally have posted it. Although it appears comparatively innocuous, I voted for it as offensive from a psychiatrist's point of view because it trivializes mental illness and is potentially hurtful to many.

Warmest regards,

Edward W. Darell, M.D.

Blog: ShrinqueRap (on Wordpad). Very soon to be updated. Please do not sue me. I registered the domain name before hearing of your blog, and my pockets are extremely shallow. (just short of being inside-out).

URL: www.shrinqerap.com

----------------
And while we're on the subject of humor---- a nice break before I start writing about In Treatment tonight--- Sarebear sent us a link on A Proposal to Classify Happiness as a Psychiatric Disorder. Hmmm...it's a joke, right?
And don't worry, Dr. Darell, we're not going to sue you, but do keep your day job.

National Strategy to Reduce Prescription Drug Abuse

Nearly 500 people have taken our Attitudes about Psychiatry survey so far. If you haven't yet, [please do.]

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The White House released its plan last week entitled "Epidemic: Responding to America's Prescription Drug Abuse Crisis" [LINK to pdf of this 10-page plan]. Below are some of the elements in this plan that is part of the National Drug Control Strategy (like that has worked so well :-/).

The areas of this plan involve education of prescribers and users, monitoring programs, making it easy to dispose of controlled dangerous substances (CDS for short), and enhancing enforcement. The plan establishes thirteen goals for the next five years, and also creates a coordinating body, the Federal Council on Prescription Drug Abuse, to oversee and coordinate it all.

If any of our readers have comments on specific items (I've numbered them for ease of reference), including unintended (or even intended) consequences, please chime in.

1. EDUCATION
1. require training on responsible opiate prescribing
2. require Pharma to develop education materials for providers and patients
3. require professional schools and organizations to include instruction on balancing use of opiates for pain while reducing abuse
4. require state licensing boards to include relevant ongoing education in their licensure requirements
5. help ACEP develop guidelines for opiate prescribing in the Emergency Department [this should be a big help]
6. increased use of written patient-provider agreements
7. facilitate public education campaigns, especially targeting parents
8. encourage research on low-abuse potential treatments, epidemiology of substance abuse, and abuse-deterrent formulations
2. TRACKING AND MONITORING
1. encourage effective PDMP (Prescription Drug Monitoring Programs) in every state, including use of HIEs and connecting with federal health care systems (VA, DOD, IHS, DOJ), and expanding interstate operability of PDMPs
2. support reauthorization of NASPER, which funds PDMPs
3. explore provider insurance reimbursement for checking the PDMP database before writing CDS prescriptions [interesting...might work]
4. reduce "doctor shopping"
5. issue Final Rule on electronic CDS prescribing [finally!]
6. increase use of SBIRT programs, including via EHRs (Electronic Health Records)
3. DISPOSAL
1. expand on "take-back" programs (eg, allowing pharmacies to accept unwanted pills for disposal)
2. develop DEA regs on CDS disposal and educate public on it
3. get Pharma involved
4. ENFORCEMENT
1. increase training for law enforcement personnel and prosecutors
2. aggressive action against "pill mills" and inappropriate prescribers
3. establish a Model Pain Clinic Regulation Law for states to use
4. increase surveillance of prescription drug trafficking
5. use PDMP data to identify "doctor shoppers" and do something about it

This is long enough, so I won't list the plan's thirteen goals; these begin on page 9.

While I am concerned that the enforcement aspects will continue to criminalize actions against people with addictions (which should be viewed more as a health problem rather than a criminal problem, IMO), the increased use of Prescription Drug Monitoring Programs to increase identification of and assistance for people with prescription drug abuse problems should be helpful. Recent articles about the diversion of opiates, even by elderly folks who are supplementing their fixed income by selling their Percocets to neighbors, make it clear how deep this problem is. Some of these interventions have a decidedly Big Brother feel to them. But people are dying, so something must be done.

In Electronic Health Information, Who Decides Which Info is "Sensitive"?

I participate in a committee that establishes policies for our state's health information exchange (HIE). The HIE is the electronic infrastructure that permits hospitals, physician groups, labs, imaging companies, pharmacies, and others to share information about patients. The idea behind the sharing is to make it easier for your primary care doctor to share your health data (ideally, with your permission) with your cardiologist and your dermatologist. The potential benefits to this sharing include:

• quicker exchange of information than with faxing or mailing
• less likely for papers to get misfiled or lost (eg, think Hurricane Katrina)
• better tracking of who accessed what information
• less duplication of tests ("I know you had a CAT scan at the other hospital last week but I can't wait for the results to be sent to me so I'm getting another one.")
• improved coordination of care
• fewer medical errors due to more information available
• decreased liability due to sharing of important information with other providers

The potential risks include:

• decreased privacy due to potential for data breach, identity theft
• loss of data due to technical problems (viruses, hardware failure, etc)
• failure to secure data due to inadequate authentication, authorization, encryption, etc
• more errors in health record due to automated data collection processes
• increased liability due to sharing of sensitive information with other providers

I wanted to talk briefly about this notion of "sensitive health information." Our committee has spent many hours discussing what this might mean and how to define it. One view is that all health information should be treated as "sensitive," while another is that only certain categories of health information, such as mental illness, substance abuse, HIV status, domestic violence, abortion history, and genetic data, should be treated with additional safeguards against inadvertent access or disclosure. This latter viewpoint promotes the stigma about mental illness that we have been trying to erase.  It wasn't so long ago that epilepsy and cancer might have been on this list. My viewpoint is that patients should be the one to decide which elements of their health information should be treated with extra precautions and which should be considered routine.

This was ultimately agreed upon by the other committee members, but it still didn't help us much because the technology for patients to review their health information and mark which bits should be tagged as sensitive is not yet built into nearly any of the electronic health record products or the HIE systems. There is no standard for doing so nor is there even any agreement about how or whether it should be done. Groups like healthdatarights.org and speakflower.org have promoted these ideals, but we are not much closer to achieving them.

Anyway, I discussed this topic in my Shrink Rap News blog post this week over on Clinical Psychiatry News. Read more about it over there. If you are a psychiatrist, log in or register on CPN and join the discussion (my mistake -- other professionals and also consumers are allowed to register over there).

Hanging On

It's been a little quiet here at Shrink Rap this week, in between the earthquake and the upcoming hurricane. Please bear with us. If we have power this weekend (and if Dinah has her network back up) we may try our first-ever videoconference podcast.

In the meantime, best wishes to all our readers and listeners in the path of the storm. Please heed precautions and take care of yourselves!

See you on the other side.

In the meantime, you might be interested in reading a followup comment on my Clinical Psychiatry News post about the psychological autopsy done on the alleged anthrax mailer, Dr. Bruce Ivins. Not surprisingly, the expert behavioral analysis panel (EBAP) disagrees with me. They feel they did the right thing by publishing and selling his medical data. Read the EBAP response.

How to be a Successful College Student

It's Labor Day and kids are getting ready to go back to school.  The Shrink Rap duck pictured here is getting in his last moments of holiday relaxation, and I am so happy to be up and running on my new Macbook pro.

Here at Shrink Rap, we don't offer medical advice, so this is not medical advice.  It's not based on anything even vaguely resembling evidence-based medicine, but I have treated many college students over the years and I have been impressed by those things that seem to make or break the college experience.  Back-to-School, but none of us treat the under-18 crowd, so my bullet point suggestions are limited to college students.  If you're a parent, feel free to send this to your college student, and if you're a student, feel free to ask "Who are those blogging shrinks with the duck? They must be quacks." 

Here are my quick & dirty pointers for how to succeed in college:

1) Show Up.
Being present in class, on time, in a state that vaguely resembles conscious is most of the battle.
If you don't go to class, with the exception of the unanticipated onset of a febrile or gastrointestinal illness, then you should know well in advance that you're not going to go and have a strategy for how you are going to make up the work.  By these criteria, "I don't want to get out of bed" doesn't work.  But "The professor doesn't speak English and lectures straight from the book, so it's a better use of my time to read the book and get notes from my roommate who takes great notes," may be a valid reason to skip class.

2) Don't smoke weed.
This is a tricky one-- many college students smoke weed (or at least those who end up my office almost all do).  Some people smoke marijuana regularly and still seem to live fully productive lives.  Some people seem to find it very "beneficial" to them even though it appears to be killing their motivation and decreasing their anxiety to the point where they have no ambition, barely move,  and don't do the things it's necessary to do in order to succeed, for example #1 above: Show Up.  Oddly enough, marijuana smokers do not see the connection between their  low motivational level and their low success status and they are absolutely sure their consumption of marijuana has nothing to do with their problems.  They become very skilled at telling others why weed isn't part of the problem and many are quite well versed on the rhetoric of NORML and how the it's a political agenda to keep marijuana illegal.   If you're not successful and you smoke weed, stop and see if your life gets better.  Oh, and by the way, two weeks off is not a 'trial.'  Don't smoke at all, ever, for 6-12 months and see if you're in a better place.  If you are successful and you smoke weed, you're probably not reading this article, but even in the best scenarios, it increases your risk of lung cancer and it causes the munchies which can make you fat, and if you get caught and arrested it's a lot of explaining to do for a very long time.   

3) College Students and Drinking.
This is even trickier because while there are college students who don't smoke weed, the role of alcohol in college life is huge and the pressure to drink is immense.  It's not legal if you're under 21, it seems to lead to all sorts of problems, but it seems to be an impossible sell to college students, so let me make suggestions based on the assumption that there is nothing I can say that would stop anyone from drinking:
--Don't drink on any night when you need to be somewhere the next morning.
--Don't drink enough that you vomit, pass out, or black out.
--Don't drive after you've had anything to drink: being dead is a lot worse than not finishing college.
--Keep your total consumption under 15 drinks a week for a man and 8 drinks a week for a woman.
--If you can't keep abide by the above suggestions, you have a problem and should get help.
NPR had an interesting show on Why College Students Drink So Much and Party So Hard about a book by Thomas Vander.
Add to the How to Stay Alive Issue :  Before you go out drinking, Eat.  If your friends pass out, roll them on their side and don't ever leave someone who is passed out alone.  If they really can't be aroused to at least push you away and groan, call an ambulance.  Don't do shots.  Beer pong is more fun and much safer. Don't drink in settings where you may be sexually vulnerable.

4) Get enough sleep.
If this means not scheduling early classes or taking naps during the day, then consider those things when you set your schedule, but sleep is really important.

5) If you have a psychiatric disorder, don't stop your treatment.
It's not unusual for kids to try this when they go off to college and don't have the 'rents handing them medications or driving them to therapy appointments.  It's a really bad idea.  Particularly bad times to cease treatment are first semester Freshman year and any year during mid-terms or finals.    I'll add: if you have a psychiatric disorder, don't drink, it makes everything worse.

6) Take a large, heavy brick and throw it through your Nintendo/PlayStation/XBox.
  Ditto for online fantasy games.  Anything outside of school work or employment that captures you for more than two hours a day may be a problem.  Reading psychiatry blogs is fine.

7) If you're a sensitive or problem child, don't have a roommate who shares the same bedroom with you, it adds to the stress of college and it's helpful to have space you can escape to.

8) If you're having a rough time, get help.
If you're struggling in class, talk to the professor and consider getting a tutor.  If you're very depressed, call the counseling center.  If you're feeling sick, go to the health center.  College is not the time to suffer alone.

9) Know the final drop date for your classes and if you're failing, drop the class.  Remember to turn in the form.

Anyone want to add to the list?
Best wishes for a happy, fun, and educational school year.