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With time lady era 100mg low price women's health center at evergreen, most suicidal people can be restored to full and happy living buy cheap lady era 100mg on line pregnancy 38 weeks. But when they are feeling hopeless, their judgment is impaired. In that case, it is up to you to use your judgment to see that they get the help they need. What at the time may appear to be an act of disloyalty or the breaking of a confidence could turn out to be the favor of a lifetime. Your courage and willingness to act could save a life. If a friend is talking about suicide or displaying other warning signs, you can start by listening to and reassuring him. This means sharing your concerns with an adult you trust as soon as possible. If necessary, you can also call a local emergency number or the toll-free number of a suicide crisis line. The important thing is that you notify a responsible adult. Perhaps you yourself have sometimes felt like ending your life. If you like, you can call one of the agencies mentioned above and talk about the way you feel without telling them who you are. Sudden changes in behavior (withdrawal, apathy, moodiness) Depression (crying, sleeplessness, loss of appetite, hopelessness) Final arrangements (such as giving away personal possessions)Discuss it openly and franklyShow interest and supportPrepared by the Suicide Prevention and Crisis Center of San Mateo County, California, in cooperation with the American Association of Suicidology. Recent losses: This may include the death of a relative, a family divorce, or a breakup with a girlfriend. Social isolation: The individual does not have social alternatives or skills to find alternatives to suicide. Drug abuse or alcohol abuse: Drugs decrease impulse control making impulsive suicide more likely. Additionally, some individuals try to self-medicate their depression with drugs or alcohol. Exposure to violence in the home or the social environment: The individual sees violent behavior as a viable solution to life problems. Some research suggests that there are two general types of suicidal youth. The first group is chronically or severely depressed or has Anorexia Nervosa. Their suicidal behavior is often planned and thought out. The second type is the individual who shows impulsive suicidal behavior. He or she often has behavior consistent with conduct disorder and may or may not be severely depressed. This second type of individual often also engages in impulsive aggression directed toward others. Adolescents often will try to support a suicidal friend by themselves. They may feel bound to secrecy, or feel that adults are not to be trusted. If the student does commit suicide, the friends will feel a tremendous burden of guilt and failure. It is important to make students understand that one must report suicidal statements to a responsible adult. Ideally, a teenage friend should listen to the suicidal youth in an empathic way, but then insist on getting the youth immediate adult help. What causes a person to consider taking their own life? Risk factors for teens thinking about suicide or self-harm and how to help. Teen suicide is becoming more common every year in the United States. In fact, only car accidents and homicides (murders) kill more people between the ages of 15 and 24, making suicide the third leading cause of death in teens and overall in youths ages 10 to 19 years old. Read on to learn more about this serious issue - including what causes a person to consider taking their own life, what puts a teen at risk for suicide or self-harm, and warning signs that someone might be considering suicide and how they can get help to find other solutions. They may begin to consider spiritual or philosophical questions such as what happens after people die. To some, death, and even suicide, may seem poetic (consider Romeo and Juliet, for example). To others, death may seem frightening or be a source of worry. For many, death is mysterious and beyond our human experience and understanding. Thinking about suicide goes beyond normal ideas teens may have about death and life. Beyond thoughts of suicide, actually making a plan or carrying out a suicide attempt is even more serious. What makes some teens begin to think about suicide - and even worse, to plan or do something with the intention of ending their own lives? Suicide attempts are usually made when a person is seriously depressed or upset. A teen who is feeling suicidal may see no other way out of problems, no other escape from emotional pain, or no other way to communicate their desperate unhappiness. Warning signs of suicide that parents and family members should know. Even in the most open families, teens may still be hesitant to tell their parents they are depressed or thinking about suicide. However, an estimated 80 percent of individuals who attempt or commit suicide give out signs. Following are warning signs of suicide to watch for from the National Youth Prevention Commission:frequent episodes of running away or being incarcerated;family loss or instability, significant problems with a parent;expressions of suicidal thoughts, or talk of death or the afterlife during moments of sadness or boredom;withdrawal from friends and family;no longer interested in or enjoying activities that once were pleasurable;unplanned pregnancy; andimpulsive, aggressive behavior, frequent expressions of rage. Daniel Hoover, PhD, a psychologist with the Adolescent Treatment Program at The Menninger Clinic adds that extreme distress over the breakup of a relationship, or conflict with friends, may also be a warning sign of suicide. If you suspect your child may be contemplating suicide, treat it seriously. Ask directly if he or she is considering suicide and whether he or she has made a specific plan and has done anything to carry it out. Then, get professional help for your child from a psychologist, therapist, primary care doctor, community mental health provider or call a suicide hotline or local crisis center. If your child has a detailed plan or you suspect he or she will commit suicide, seek help immediately, taking your child to a hospital emergency room if necessary. Peterson, USA TODAYA controversial new study links teen sexual intercourse with depression and suicide attempts.

Clinical depression classifications include:Major depressive disorder (MDD) ??? a period of two or more weeks in a depressed (low or sad) mood episodeDepression with melancholic features ??? depression generic lady era 100 mg on line womens health care associates jacksonville nc, as above purchase lady era 100mg overnight delivery menopause jokes, but with additional symptoms like waking up two hours earlier than usual. Depression with catatonic features ??? depression, as above, but with additional symptoms like extreme negativism or mutism, motor immobility and uncontrollable repetition of words spoken by anotherAtypical depression ??? depression that includes symptoms like an increased need for sleep, increased appetite, weight gain and feelings of heaviness in the arms or legs (see: What is Atypical Depression? Symptoms, Causes, Treatment )Seasonal affective disorder (SAD) ??? depressions that occur corresponding to a season, generally the winter, in the last two years or more; often atypical depression (see: What is Seasonal Depression Disorder? Symptoms, Treatment )Depressive disorder not otherwise specified (NOS) ??? depression identified by a clinician but of a type that does not explicitly fit into a defined categoryMajor depressive disorder is most commonly referred to as simply "depression. Bipolar depression has the same symptoms as unipolar depression during a depressive episode, but bipolar disorder also contains manic or hypomanic episodes. Major depressive disorder is defined in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DMS-IV-TR). A depression checklist outlining symptoms includes the following:Sadness, emptiness, a depressed moodLack of interest or enjoyment in activities previously found pleasurableReduced or increased need for sleep, energyReduced or increased appetiteDifficulty in concentrating, paying attention, making decisionsThoughts of harming oneself or othersThe causes of clinical depression include both genetic and environmental factors. However, in some cases, people experience an inability to cope with a life change or stressor. People in this situation often experience depressive symptoms too, so this scenario is sometimes informally referred to as "situational depression. Adjustment disorders may include depression symptoms, but are short-term and are directly related to an outside stressor. These new drugs affected the same neurotransmitters (serotonin and norepinephrine) that the tricyclics did, but they also affected dopamine. MAO inhibitors work by blocking this cleanup activity, increasing the levels of monoamines in the brain. So when monoamine oxidase gets blocked, levels of tyramine begin to rise, too. Excess tyramine can cause a sudden, sometimes fatal increase in blood pressure so severe that it can burst blood vessels in the brain. In those who take MAOIs, excessive tyramine levels are controlled by dietary restrictions. Because an MAOI can affect many chemicals in the brain, there are a number of contraindications. Studies suggest that phenelzine (Nardil) may not be as effective if you are severely depressed. In order to control the amount of tyramine in the body while taking MAOIs, do not consume the following foods containing tyramineunless advised otherwise by a doctor:Alcoholic beverages (especially chianti, sherry, liqueurs and beer)Alcohol-free or reduced-alcohol beer or wineBologna, pepperoni, salami, summer sausage or any fermented sausageCheeses (especially strong or aged varieties), except for cottage and cream cheeseFruit: raisins, bananas (or any overripe fruit)Meat prepared with tenderizers; unfresh meat; meat extractsSmoked or pickled meat, poultry or fishWhile on MAOIs, these foods may be eaten in moderation:Caffeine (including chocolate, coffee, tea and cola)Your doctor will probably quiz you about a range of medical conditions before prescribing an MAO inhibitor. As long as you note the MAOI foods to avoid, you can avoid this risk. The symptoms of a severe spike in blood pressure due to tyramine and MAOIs include:Severe headache radiating to the front of the headSweating (sometimes with fever or with cold, clammy skin)Chest pain or heart palpitationsA blood pressure rise usually occurs within several hours after taking the drug. Stop taking MAO inhibitors immediately if you get a severe headache or palpitations and then call your doctor. Other MAOI side effects that should be checked by a doctor include:Severe dizziness or light-headedness, especially when arising from a sitting or lying positionSwelling of feet and/or lower legsUnusual excitement or nervousnessThere is also a range of less serious MAOI side-effects. Like all antidepressants, the MAOIs are capable of inducing a manic state in people who have bipolar disorder and may cause memory problems. Other possible side effects of MAOIs include:Feeling drugged and sluggishFainting and/or dizziness, particularly on standing upBlood sugar levels changes, particularly a concern for diabeticsSexual problems such as delayed orgasmWhile aspirin, acetaminophen (Tylenol) (plain), ibuprofen (Motrin) or antibiotics are safe when combined with an MAOI, you should check with your doctor before taking any other medicine. The anesthesia combined with the MAOI can cause a drop in blood pressure or other problems. Other drugs that can cause potentially fatal MAOI interactions include:Cold, cough, sinus, allergy, antihistamine medicationsBlood pressure medicationAnticholinergic medication such as DitropanThe MAO inhibitors are somewhat more dangerous drugs than other antidepressants when taken in excessive amounts -- far more so than newer drugs such as fluoxetine (Prozac) or sertraline (Zoloft). Symptoms of overdose include severe anxiety, confusion, convulsions or seizures, cool clammy skin, severe dizziness, severe drowsiness, fast and irregular pulse, fever, hallucinations, severe headache, high or low blood pressure, muscle stiffness, breathing problems, severe sleeping problems, or unusual irritability. MAOIs are considered risky to the fetus and should be avoided when possible; both when pregnant and when breastfeeding. Older patients are usually more sensitive than younger adults to the MAO inhibitors, and they may be more likely to experience dizziness or light-headedness. Because of the danger of an abrupt increase in high blood pressure (hypertensive crisis), the MAO inhibitors are often not prescribed for people over age 60, or for those with heart or blood-vessel diseases. This article may be helpful to anyone who has issues with sexuality. For many sexual abuse survivors, sex becomes linked with sexual abuse. As a result, some survivors will mistake unsatisfying and unpleasurable sex, or even sexually abusive behavior, for sex. This means that survivors can be vulnerable to being further abused. You may not know: that you have the right to enjoy yourself sexually; what a mutually satisfying sexual experience is; what you want sexually, and that those needs deserve respect; and that you can say "no" and have that respected. These reactions and beliefs are outcomes of abuse and need to be challenged - because they are not true. One of the hardest things for abuse survivors to do is separate sexual abuse from sex. Placing responsibility on the abuser is one of the most important steps in separating the sexual abuse from your sexuality and sex life. After all, it does involve sexual contact, sexual body parts, and sexual stimulation. It is crucial to find ways to separate your sexuality and sex from sexual abuse, and to create an entirely new association with sex - one that is positive, safe, and fun. You may need to discover your own sexuality - what it means to you, what you enjoy, and what gives you pleasure. You may want to fantasize or read about sex, view erotica,and talk about sex with your friends or partner. If you have a partner try to be playful about sex - cuddle, massage each other, talk about fantasies, and ask for what you want sexually. This can cause a lesbian or gay sexual abuse survivor to question her/his sexual identity. Many heterosexual survivors also struggle with questions about their sexuality because of the confusion and negative associations about sex that are created by sexual abuse. It might help to try and remember if you had any sense of your sexual desires prior to the abuse. You may need to see or read about positive images of lesbian, gay, bisexual, or heterosexual sex to help you discover what feels right for you. The challenge is to find ways to connect deep inside yourself and unearth your own truth - your own sexual desires, fantasies, passion, and emotional and sexual attractions. Working on separating the abuse from your sexuality will help clear some of the confusion. If you are gay and fear that your sexual orientation was caused by the abuse, you may want to learn more about gay sexuality from a positive perspective - for example read some gay-positive books, look at lesbian and gay websites, and talk to a gay help line or a gay-positive therapist. Sexual abuse robs survivors of their ability to feel safe in the world and with themselves.

I know that you teach therapists how to treat self-injurers discount lady era 100mg with mastercard womens health 4th edition by youngkin. In your estimation lady era 100mg low cost breast cancer store, are there many qualified therapists out there right now to provide proper self-injury treatment? One is that therapists become very anxious around people who hurt themselves, and really, there is nothing much in our training that teaches us how to handle people who do this to themselves. One of the things I have become very interested in doing, and have begun doing, is teaching other mental health professionals how to understand and how to treat people who harm themselves. One of the ways that I am doing this is this summer I will be teaching a seminar at the Cape Cod Institute in July on the treatment of people who harm themselves, and anyone who is interested can go to the Cape Cod Institute website. I also have a toll-free phone number (888-394-9293) for information about the program this summer. You will receive a catalog with the registration information. David: I ask that because I know that self-injury is still not understood, or is misunderstood, by many. Then, you really need to search for qualified professionals. I know there are a number of websites about self injury that have names and addresses of different clinics or therapists that are interested in working with patients who self injure, so that may be a good way to do it. Also, there are some therapists that are learning to do DBT (Dialectical Behavioral Therapy) and this is often a group treatment for people who harm themselves in different ways, who have various kinds of self-destructive behavior. David: So, for those in the audience, that means if you are looking for treatment, you need to interview the therapists before starting treatment with them. Make sure they have an understanding of self injury, or at the very least, they are willing to find out more about it. Here are some audience questions: shattered_innocents: Hi Dr. Do you recommend any kind of art therapy for dealing with self-injury? Farber: I think that anything that can help you express your emotional pain can be helpful - art therapy, poetry, music. Crissy279: Are there any alternatives to cutting or burning that you find have a high success ratio? Farber: As I have already said, I think if people can get themselves to sit down and write what they are feeling inside, that can be enormously successful. You are not writing for publication, so forget about grammar and spelling. Just as you could use art or poetry or music or dance to express what is feeling inside - these are all much healthier, much more constructive ways of dealing with your emotional pain than using your body to express your pain. You deserve better than to hurt yourself in that way. Farber: As I have said before, trauma comes in all different forms and sometimes it is not nearly so obvious. If you can sit down with a therapist who wants to understand, you may be able to piece together why self-injury came about in your life and why it is something you need to use. You may not be able to know this now or articulate this now, but in time you may be able to. I try so hard to get through the feelings, but they are intolerable. Farber: Well, to be able to feel your feelings, I think first you need to be able to try to express them to somebody. It is also one of the reasons that short-term therapies are not that effective. Farber: Most people who self-injure dissociate either when they are self-injuring or right before. What the self injury does is, if you are in a dissociated state that starts to feel intolerable, the SI can help bring you out of that state. For some people, they can be in a state of extreme anxiety (hyper-arousal). Sometimes, when they self injure, the self-injury ends that state of hyper-arousal and brings about a dissociative state which may be more desirable. So self injury can be used to interrupt a dissociated state or a state of hyper-arousal or a state of depression or a state of anxiety. Are these feelings normal or should I have some concerns about these thoughts? Farber: You should have some concerns about these feelings because there are some people who do not have the intention to end their lives but they like to flirt with the idea of going a little further and die in the process, although that was not the intention. David: Earlier, you mentioned substituting one self-injurious behavior for another. Farber: I think if the person gives up the cutting before they are ready to do it, psychologically, they will find some other ways to hurt themselves or find other people to do it. So before someone gives up their cutting implements they need to think about whether they are ready to do this or not. You really need to be honest with yourself about it. Asilencedangel, why did you turn your razors over to your therapist? Farber: I would say that if you turned over your razors to your therapist because the therapist requested it, and you did it for your therapist and not for yourself, then it is not going to work. At least if I have the razors, I can talk myself down or write a lot of times. Making the decision to give it up makes someone feel more desperate - forbidden fruit always tastes sweeter. When you give something up, it makes you yearn for it more. I think getting beyond self-injury is more than giving up a certain behavior. Jus: That was kind of my question too because someone told me that you should be SI free for 7 months before getting rid of your blades, etc. I want help from friends and family, but I am afraid they will call me crazy. Farber: I think you need to be able to talk about it with someone that is not your family or friends. Someone that will help you find a way to tell your family or friends. SI thrives in an atmosphere of secrecy and that promotes the shame. You are starting to connect more with the other people in your life and that can only be good. Besides family and friends, where can they go to talk about their self-injury?

The original personality is usually amnesiac for the secondary personalities while the secondary personalities may have varying awareness of one another lady era 100 mg cheap menopause 1 year without period. Sometimes a secondary personality may exhibit the phenomenon of co-consciousness and be aware of events even when another personality is dominant buy cheap lady era 100 mg menstruation and ovulation pro. Generally the original personality is rather reserved and depleted of affect. The secondary personalities usually express affects or impulses unacceptable to the primary personality such as anger, depression, or sexuality. Differences between personalities may be quite subtle or quite striking. Personalities may be of different age, race, sex, sexual orientation, or parentage from the original. Most often the personalities have chosen proper names for themselves. Psychophysiologic symptoms are extremely frequent in multiple personality. Headaches are extremely common as are hysterical conversion symptoms and symptoms of sexual dysfunction [3, 10]. Transient psychotic episodes may occur in multiple personality. Hallucinations during such episodes are usually of a complex visual nature indicating an hysterical type of psychosis. Sometimes a personality will hear the voices of other personalities. These voices, which occasionally are of a command type, appear to come from inside the head, and should not be confused with the auditory hallucinations of the schizophrenic which usually come from outside the head. Most often stressprecipitates the transition between personalities. In a clinical situation the transition may be facilitated by asking to speak to a particular personality or by the use of hypnosis. The switching process usually takes several seconds while the patient closes the eyes or appears to look blank, as if in a trance. The onset of multiple personality generally occurs in childhood, although the condition is not usually diagnosed until adolescence or early adulthood. This increased incidence of multiple personality in women may occur because sexual abuse and incest, which are strongly associated with multiple personality, occur predominantly in female children and adolescents. The degree of impairment in multiple personality may vary from mild to severe. Although multiple personality was thought to be quite rare, recently it has been reported to be more common. Trauma has long been recognized as an essential criterion for the production of dissociative disorders including multiple personality. The various types of trauma include childhood physical and sexual abuse. As early as 1896, Freud recognized that early childhood seduction experiences were responsible for 18 female cases of hysteria, a condition closely associated with dissociative disorders. It was not until the publication of Sybil in 1973 that childhood physical and sexual abuse became widely recognized as precipitants of multiple personality. Since 1973 numerous investigators have confirmed the high incidence of physical and sexual abuse in multiple personality [6, 18, 19]. In 100 cases Putnam found an 83% incidence of sexual abuse, 75% incidence of physical abuse, 61% incidence of extreme neglect or abandonment. The types of child abuse experienced by victims of multiple personality are quite varied. Sexual abuses include incest, rape, sexual molestation. The abuse in multiple personality is usually severe, prolonged. In only one instance was the abuser not a family member. No cases of childhood multiple personality disorder were reported between 1840 and 1984. In 1840 Despine Pete reported the first case of childhood multiple personality in an Il-year-old girl. Since 1984 at least seven cases of childhood multiple personality disorder have appeared in the literature [24-27]. From these first few reported cases the symptoms characteristic of childhood multiple personality begin to emerge and reveal some marked differences when compared to adults. In the childhood form of multiple personality the difference between personalities are quite subtle. So far an average of 4 (range 2-6) personalities have been reported in children. Symptoms of depression and somatic complaints are less common in children but the symptoms of amnesia and inner voices are not decreased. Perhaps most importantly, the therapy of children with multiple personality is usually brief and marked by steady improvement. In adults therapy may last anywhere from 2 to over 10 years. Kluft believes this shorter therapy time is due to the lack of narcissistic investment in separateness. Kluft and Putnam have derived a list of symptoms characteristic of childhood multiple personality disorder. The main characteristics include the following:A history of repeated child abuse. Subtle alternating personality changes such as a shy child with depressed. Amnesia of abuse and/or other recent events such as schoolwork. Relatively little is known about multiple personality parents who abuse their children. Most of the multiple personality parents in this series tried to be very good parents in order to insure that their children did not suffer child abuse as they had. In another reported case an 18-month-old girl was physically abused by her stepfather who was a multiple personality. The abuse ceased when the parents divorced subsequent to the episode of physical abuse which left the child in a transient coma and a retinal hemorrhage. The management of parents with multiple personality who abuse their children should be handled like any other case of child abuse. The child abuse should be reported to the appropriate child protective services and the child should be removed from the home if necessary. Obviously the parent with multiple personality should be in therapy and attempts to help the abusive personality should be of paramount importance. Management should then proceed on a case by case bases [30, 31].

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