#and D continues therapy and eventually gets her diagnosis

[jawnjendes]

hhhrrgrgrgrgrrg

[anxietysroomsupport]

i found out pushing doesn't work. that's what my sister does when she thinks something's wrong, she pushes that she wants to go to the doctor. eventually our parents give in. i think i mentioned it because i sent an ask here recently, but my joints have been giving me grief lately. several months ago my knees kept feeling like my bones were grinding when i put weight on them for a few days. more recently, in january i think, after spending an hour or two outside, my hips did the (1/?)

(2/?) the same, that night and for the next few days. sometimes it was fine, usually better mid morning, but other times i couldn't put wait on them. it felt like they were grinding, or going to give up on me. it's been happening longer where i feel like if i move the wrong way, something will pop out. i try to sit up and swing my legs and my hips yell at me with slight pain, so even though they would probably just pop, i wait till it stops, just in case. because i don't want to see (2/?)

(3/?) what would happen if they didn't. but recently, a week or two after i started these new exercises (my mom thinks it's related to that, which it may be slightly, but i don't think so completely), modified push ups so i could get better core strength and stuff, my joints have started popping. started feeling like they'll go out more often. and i mean popping loudly. i kneeled earlier in the process of sitting up, and my sister, who was talking and a few feet away, asked me if i (3/?)

(4/?) okay. it only hurt a little, it's more just the sensation of the popping, tiny pain. but my right knee sort of buzzed, like my elbow did yesterday. except yesterday, my elbow hurt. it felt, just from a random movement, like it actually popped out for a moment, or tried to, and my elbows are usually fine. if it's the exercises, i don't want to just give up my hopes. i want to be able to one day walk on my hands. i know i'd never get back into it after this, even if it's not the (4/?)

(5/?) problem. anyways, sorry, there's a lot to say, i'll try to hurry this up. recently after reading something they flared, when it started happening nearly every time i move, then went down a little, and have stayed that way for about a week. the exercises have been making me feel a little stronger, and i just don't think they're doing this. but, i kept mentioning it. my pain. asking if people could hear it. only my sister cares to listen. she always cares. always listens. (5/?)

(6/?) mental or physical health she's there for me. she keeps saying that i really should go to the doctor, so i keep asking. i mentioned the knee thing to my mom. she said she kept researching but couldn't find anything narrow enough to be diagnosable. that i should just wear the shoes that i can't stand, stop the exercises, start up again with walking when my body calms down, as if it will. i can't stop now. but i don't think she'll take me. i think i have to wait till something bad (6/?)

(7/?) especially after the thing i read, i don't want to wait. i don't want to ignore the signs. if i could save myself so much pain, why can't i try? just two or three days ago i was getting into school when my hip started to hurt. the hallways are one way, so i have to walk around nearly the entire school to get to my class, and i only had a few minutes to get there. i just told myself to keep walking. ignore the fact that i could barely put weight on my right leg. i had to get to (7/8)

(8/?) class. but pushing doesn't work. i pushed to go to the doctor. i got in an argument. i had stuff to do and i was starting to cry, so i just said i wouldn't bring it up anymore. i'd stop. my sister's an adult. i just realized i can ask her to take me. if another bad thing happens, i will. if they flare up again, i will tell my parents that i need to go to the doctor. if they won't, i'll ask my sister. i don't want to. i know my mom tries. she said normally she would, but covid. (8/?)

(9/?) but i have to go. maybe it's nothing, or maybe i will have to stop doing the exercises, and break my heart a little bit more as i give up on another goal. but i have to. i have to. i can't cripple myself for life because i wouldn't go. i have no idea what could happen to me one day or some day soon even if i don't. maybe i'm just overreacting and i'm fine and it's growing pains but i haven't grown in 1 1/2 years and it hurts. and i'm so so tired. been reading, sorry it's like prose (9/9).

~

I sent an ask about my joints recently? Yeah, well, this. yesterday I was hesitantly diagnosed with Hypermobility Syndrome, pretty wide across my body but mainly in my lower body. basically the doctor said, that since it's the best guess, I need to go to Physical Therapy and try to strengthen my tendons and joints. so obviously I'm so glad to have a solution, maybe not be in so much pain anymore, but at the same time, I like being a little bendy. I'm not stretchy, not good at gymnastics (1/2)

(2/2) or whatever, but I do like feeling a little different. so I guess it's just like, what if PT makes it so I'm not bendy anymore? is it like those metaphors where you break a stick, then put a bunch together and can't break it? or am I folding the stick in half, forsaking mobility for strength? and I don't think that a diagnosis for an actual chronic illness has hit me yet, I know I'll be more nervous when my first PT comes in 3 days, but I still feel normal.

~

Hypermobile anon here, I believe I said I wished it was something a little more for some reason? Yeah, well, good news, I don't anymore. My pain is like, I'm in so much pain, but not actually that much, and I know that I both am and aren't, and it doesn't actually feel like that much, but it is? My point is, tonight's been really bad and I'm starting to think it's good the friend I tend to go outside on walks and stuff with was busy. Also, my mom, in complimenting my drive, (1/2)

(2/2) said that while my sibling was told to do physical therapy to keep their hand working and didn't do it as much as they should, I was doing physical therapy regularly and faithfully to stop my joints from aching. I know my family, mostly my parents, has lots of issues and then just powers through, but you'd think that my mom, who has a bunch going on (allergies, diabetes, random undiagnosable stuff), would understand chronic illness. To her, my joints ache. Sorry, it's not actually too bad.

Hi Anon,

First thing, so so sorry for the delay on this one.  And it’s great that you have continued writing in with updates!

Thank goodness you did keep pushing and get your diagnosis (even if it may be a hesitant one)!  You really could have ended up struggling for a long time.  Arthritis would have been another guess if your doctor hadn’t come to Hypermobility Syndrome.

Hopefully your doctor is treating this seriously, but remember that if any doctor is trying to ignore your concerns, you can very clearly say to them, “If you’re not going to do tests I want it noted in my chart.”  

From the advice of a lot of chronically ill folks, it is also strongly recommended to get your vitamin levels checked, especially b12, iron, and vitamin d. These can actually cause joint symptoms if they’re low enough and lots of things can affect your absorption of them.

It is definitely still possible to build muscle and continue to be flexible.  It takes quite a lot of bulk to start limiting your range of movement, and physical therapy will probably be gradual enough that you can assess your flexibility as you go.

As far as feeling “normal”, having chronic illness actually is really common!  In 2012, the National Health Council stated that roughly 133 million people in the U.S. were dealing with some kind of chronic condition.

It is awful that you’re in so much pain.  Your doctor should also be helping you manage that, since strengthening your muscles isn’t going to be an immediate solution.  That takes time, but you’re in a lot of pain right now.  Anti-inflammatory painkillers can help with joint pain, and heat treatments like warm baths, hot water bottles, and heat-rub creams can be useful too.  Beyond that, you might need prescription treatments.

Your mom is probably just trying to encourage you, but it’s small comfort compared to the level of pain you’re dealing with.  People will often deal with chronic illness in different ways, especially different generations.  It might help to find groups online that are dealing with similar issues, or chronic conditions in general.  Places like reddit, facebook, etc will have groups or subreddits dedicated to creating a community, so you can share your experiences and find other people dealing with the same issues.  You might ask your physical therapist if there are any in-person or online support groups locally.  

You’ll have to find a way to manage your chronic illness, your way.  If your mom doesn’t understand it, don’t worry about her.  You got this.  And your sister’s got your back.  

-Kai, bun

[trustyourgutblog]

❁ Intro. Q&A with S&C ❁

❁ What is your favorite type of movement?

S: I struggled with movement for a long time. Exercise was categorized as a chore in my brain growing up. I had parents who LOVED running, yet running always made me feel like I was dying. I discovered yoga in late high school. Last year, I completely fell in love with a studio that incorporates HIIT, core, and heat to create a dynamic workout. I'm obsessed! It's my therapy, workout, community, and whole heart in one. I also love that yoga is a competition against yourself - constantly bettering your own practice, rather than focused on competition against others.

C: Growing up I was always active and involved in sports like basketball and track. I’ve ALWAYS hated the running aspect, but every now and then I’ll go for a jog outside if it’s nice out. Now that I get to choose my workouts, I enjoy a combination of lifting, yoga, and HIIT workouts. My workout split typically looks like 4 days of lifting and HIIT and 1-2 days of yoga. On rest days, I always start my mornings with a short yoga flow or light stretching. I also enjoy the hot yoga classes that S talked about above! Hot yoga is what brought us together :).

❁ What is your favorite way to de-stress?

S: Oh god. Anything alone. Seriously. I am extroverted until I hit my limit and once I hit that limit it is a hard crash. I recently moved to a really friendly neighborhood and have loved riding my bike to the library, curling up in my hammock, and reading a great book while listening to some instrumental tunes. 

C: So many different ways! As a social worker, in order to be effective, I have to be on top of my self-care at all times. Journaling, meditation, yoga, reading, walking, and playing with my dogs and cats are some of my favorite ways to de-stress. I also find that using ear seeds helps when I’m experiencing high levels of stress or anxiety. Stay tuned for more ear seed info. in later blog posts!

❁ What is your favorite self-care strategy?

S: I need to be organized. I like knowing what food I'm going to eat the next day, having everything written out and color-coded in my planner, etc. I do really well when everything is put in its place and prepped for the next day - to a fault. I tend to deal with my high maintenance personality with obsessive organization because it is the type of self-care that directly combats my ADHD brain and keeps me functioning.

C: In addition to the ways that I de-stress above, I find a sense of calm in my weekly routine. At the beginning of the week, I enjoy cooking and meal prepping lunches for work, cleaning, and journaling my goals and intentions for the week. I have a Panda Planner that I like to use to stay organized. I also feel my best when I’m taking care of myself (i.e. focusing on eating well, being active, and maintaining my beauty/skincare routine).

❁ What are your health passions?

S: I have been on and off vegan for 6 years. I decided to start it back up at the beginning of this year, and 99% of the time I follow veganism. That's a HUGE passion of mine. I also recently started cycle syncing and I can't shut up about it!! I'm so excited to see what benefits it will provide. I'm a RYT200 yoga teacher with certifications in trauma-informed, children's, and teen yoga - I'm particularly passionate about incorporating vulnerability and mental health aspects into my practice. Lastly, I struggle with physical health (Endometriosis diagnosis) and mental health (GAD - Generalized Anxiety Disorder & ADD - Attention Deficit Disorder diagnosis), this has been a huge journey for me over the past two years. I am currently at a point where I manage these diagnoses really well naturally and it's important to me.

C: GUT HEALTH, GUT HEALTH, GUT HEALTH! That is what inspired the name for this blog! I find that my gut health impacts my skin, moods, weight, energy level, and my overall well-being. I was diagnosed with Crohn’s Disease and IBD in 2016 and have been focused on healing myself with a combination of Western Medicine-based medication, nutrition and journaling food sensitivities, vitamin supplements, movement, and strategies to improve my mental health. Don’t get me wrong - I’m very passionate about mental health in general as I’m a practicing therapist, however, I tend to get burnt out on focusing on mental health only as it is often difficult for my consumers to incorporate a holistic approach. I am also passionate about movement and working on my fitness, as Fergie would say. There’s something uplifting about accomplishing a new fitness goal whether it’s increasing my weights in lifting or holding a headstand in yoga (still working on that one lol).

❁ What led you to wholistic wellness?

S: I had parents who made a huge lifestyle change right after my freshman year of high school. As a family, we went vegan cold turkey (or is it cold tofurkey? pls laugh) and my Mom poured her heart and soul into researching natural alternatives. I have had my own battle with balancing traditional medicine with more holistic results. I very strongly believe in wholistic approaches - I'm not against medication by any means, but I believe it's so so important to treat the whole person and that there is no "one size fits all" approach.

C: Growing up, I didn’t think there was anything particularly “unhealthy” about my lifestyle, but reflecting back as an adult, I can definitely say that we were not a household that was focused on optimal nutrition. We drank gallons of milk and Sunny D and ate maybe a serving of canned vegetables per day. We were active, so no one in my family was overweight, but I think my parents were just raising us on foods that they grew up on (that and canning became all the rage in the 90’s). I would say that I became passionate about holistic approaches to my health shortly after I was diagnosed with Crohn’s and was trying to learn to manage my symptoms. I had a lot of inflammation in 2016 and was prescribed a low dosage of steroids until my doctor prescribed immunosuppressants to keep my immune system from attacking my colon. I began focusing on more holistic approaches when I noticed that medication alone wasn’t making me feel 100%. Sure, it stopped my active inflammation, however, I was still struggling with stomach cramping, diarrhea, and chronic fatigue. About 1 year after I was diagnosed, my husband and I moved to a larger area where I had access to more specialized medical providers. My new gastroenterologist (GI) referred me to a nutritionist who helped me to learn to identify my food sensitivities. She also referred me to a behavioral health psychologist who provided me with an outlet for my stress and anxiety. I began to learn that I was holding chronic tension in my stomach whenever I was stressed or anxious about something. That’s when I began to understand the importance of holistic health.

❁ What is your personal social media?

S: @sarahlhively on Instagram

C: @cassandruh_dee on Instagram

❁ What kind of posts can I expect to see on this blog?

S: I'm really excited to talk about managing mental health naturally (particularly anxiety), possible book recommendations, self-care, and healthy meal prepping while on a broke college student’s budget.

C: I look forward to sharing my personal experiences with navigating my chronic health issues, nutrition, FODMAPs, gut health, mental health, the gut-brain connection, fitness/movement, and self-care.

❁ Why social work?

S: It's nice to not have this question followed up by "you know you'd make much more money as _______. Is it too late to change your major?" But for real. I started college as a special education major, quickly realized I'd rather do pretty much anything other than write lesson plans, and switched to being a WGST major. I expected to be able to get a job doing advocacy work with a particular focus on LGBTQ+ & women issues. I soon realized the WGST track is for students who eventually want to do research and social work was more what I was looking for. I never looked back. The multiple directions a social work degree can be taken in, the continually changing cases, the advocacy, vulnerability, and seeking justice for people all capture my heart. 

C: I have always been passionate about having a career centered around helping people. I became interested in therapy after having a particularly negative experience with a therapist that my dad sent me to when I was getting caught in the middle of my parent’s divorce and I experienced some trauma. I originally pursued psychology, however, fell into social work when I figured out that there are so many different opportunities available for MSWs.  I truly love my job and feel grateful to be compensated (FYI times have changed and not all social workers make next to nothing - thank the universe) for serving the children and families on my caseload

[alternativelistening]

***content warning: super long venting post, mention of child molestation, homophobia, emotional abuse, child abuse, potential sad feels***

you don’t have to read. just another livejournal type diary post on the internets.

Things seem like they’re getting better with my family. I’m trying to not have expectations for anything more than what I’m seeing right now like I was taught in therapy. But something happened recently that triggered some feelings and memories.

For context: I have four younger siblings. My first sister is one of the people who contributed to my declining mental health, and I know I’m part of her traumas too. I own that I lashed out at her when I was young and badly dealing with my own abuse. Even though I was hurt, I was also wrong. And I’ve actively worked on it. I notice that she’s grown a lot too. But I don’t expect her to own this nor do I deserve to feel that she needs to. What has always bothered me the most with her was that she’s always taken my mom’s side on things. She won’t believe the things my mom said and did to me. And she always excused my mom for the things that she witnessed herself. I mean, no parent is perfect. They’re human too. But both my parents had a large part in how fucked up I am. It’s just not fair to blame a child for their own abuse. I was constantly insulted, humiliated, and invalidated every moment I tried to open to her. So much so that I had to cut her out of my life for some time. But this year, my sister and I are finally somewhat getting along.

My sister did finally admit on Monday that while not everything can be our mom’s fault, it’s impossible for her to not have a large impact on me. I appreciated that she can say that much at least. Time with her has been okay. We text each other every now and then. I want us to continue getting along. But the other day, during one of the game nights I hosted, she announced to the room that I used to cut myself while sharing a story about our childhood. She probably doesn’t remember because of the way it slipped out after she had a Soft Parade and a couple glasses of wine. I’ll paraphrase what she said.

“Yeah, our childhood was really wild. Like we actually practiced drills whenever there was a sign of our parents getting angry. Hannah would time us and we would all practice running into our rooms and find good hiding spots. So we were usually ready for whatever was coming. 

We’ve grown a lot. Became better for it. And Hannah used to be so terrible too. [I verbally agreed with my sister here and let her continue speaking after giving a couple examples of my awfulness to the room] It’s ridiculous. I was always the perfect child. I never got into trouble. I usually had straight As, like the first in our family to get straight As. But who did my mom buy clothes for? Who got an iPod? Hannah did. She cut herself and got an iPod and mall trips. I worked really hard and got hand me downs every once in a while.”

The listeners in the room were stunned for a moment, me especially. But she continued with bittersweet stories of our childhood as if nothing was wrong. We all moved on and focused on the board games.

I don’t think she did it with malice. I want to believe she wasn’t trying to hurt me. I think it was an accident. And maybe most of the people there already knew this about me. It just really hurt me that it came up so casually (and inaccurately). Her complaints and feelings were completely valid. I agree. It wasn’t fair that she didn’t get more from our parents. I always knew she was a little jealous and bitter about this. She eventually learned that different kids have different needs. I still sympathize with her. But as flawed as my mom was, she wanted to at least try to give me reasons to live and do better in school. My mom didn’t understand mental healthcare. She had no knowledge in emotional labor. She just had money. Could she have done better? Absolutely. Like not pressure me to lie during one of my psych evaluations and let me actually get the help I needed when I was 15. And you know, just be kinder and more supportive. But still, I can understand and appreciate that she tried in her own way.

It just seems so reductive and callous to frame my cutting as some cry for attention or for materialistic gain. My whole life my mom would tell people that to avoid any accountability. Clearly she sold it to my siblings pretty well. And it’s not fair. I already had too much attention. I didn’t need more. I constantly wished for less. Cutting myself just felt really fucking good compared to the way my whole family and memories made me feel. And you know, if it had been for attention or for anything really, it still would have been a serious situation that deserved validity and compassion. Really. If someone is cutting themself for attention, just fucking give them attention.

Thanks to coping methods I’ve learned over the years through friends, experiences, and therapy, I don’t cut myself anymore. But the feelings and thoughts are still there. And I work really hard to sort them out. I’ve covered up some of my scars with tattoos. I don’t want the fact that I used to cut myself to be announced into a room when we’re trying to play board games.

I could tell my sister this. I could communicate with her. I know communication of my feelings and issues is something I don’t do enough of with anyone, including my partner and best friends. I could share everything. But I don’t want to fight my sister. We’ve only just started getting on better terms. I don’t want to get hurt when I get shut down again for trying to share. I also don’t want to fall back into blaming her for things that aren’t her fault. I’m sure it was just a tactless accident. I’m just processing what happened and all the bad feelings and memories that came from it through my occasional venting into the void.

It made me think about my traumas, my queerness, and the way my mom handled things. Much later, maybe three or four years after coming out, my mom was still cold to me but was growing civil. Around this time I also had a major bipolar manic episode while traveling for work (at the time I didn’t know it was bipolar). When I came home, my mom said I should get a check up, something about her insurance blah blah blah. This was unrelated to the major episode I had but I didn’t know at the time how good the timing was. I went to a gyno and a physician. Other than typical Midwestern Vitamin D deficiency, nothing was really wrong at that time. But my physician seemed to have thought I had ADHD and maybe more after I had to go into detail about some things relating to my health in a holistic sense. My physician recommended a great mental health clinic she knew. 

When my mom asked how my check up went, I told her about the ADHD issue that my doctor mentioned. She didn’t actually know what it was, as educated as she is. I explained it to her and together we actually connected all the things about me and the things I did during school that ties in with the symptoms of ADHD. So, for the first time ever, she actively supported me in caring for my mental health.

I met with a psychiatrist, who told me before she could diagnose me with anything, I should meet with both her and a therapist for some time. And so from there, after a few months of sessions, they both were 100% convinced that I suffered from ADHD, PTSD, and mixed bipolar disorder. It wasn’t the first time I met with psychiatrists and therapists. But it was the first time I got to consistently meet up with professionals without my mom looming over me. I don’t know why I never connected my episodes of relived memories, intense range and level of emotions, strong reactions to movement, dissociation, problematic drinking, constant suicidal thoughts, self-harm & destruction, depression, paranoia, rage, extreme impulsiveness, hyper vigilance, etc to these issues. 

Eventually my psychiatrist put me on a trial and error of meds and dosages. I was warned that it would be a rough month or two for me as we experiment. I had no idea how rough. All those symptoms I described kind of hit me all at once. Literally a single sentence put me in a corner, crying and shaking, as I relived an old traumatic memory over and over again for hours. My empathy became so intense, I shut down because my own pain was already too much to handle at the time. I sabotaged relationships and nearly ruined things with my partner (again) over things that didn’t warrant the responses I gave it. By the time we found the right combination and amount of meds and I was stable, things were too late with a lot of people. I felt like I had to accept that and move on. But maybe part of that is cowardice, again not wanting to open up and communicate.

Around that time I updated my mom on these developments, diagnosis and meds-wise for insurance purposes. And then we got a little more personal because she was telling me how strange it was that I needed all this help when she’s been through worse and doesn’t require the same. I personally think that she needs some therapy at least but that’s another issue. Anyway, during that heated argument and my instability, I told her about the men who molested me throughout my childhood. I never had any intention of telling her. As I got older, I felt like I was protecting her. But it came out. She kind of just stopped. And I started to cry for the younger me and I cried for my mom too.

“When did it happen?” “The first time was back in California. You used to drop me off at an old couple’s house to babysit me while you were working. They had an adult son. He would take me to his room... He would do things to me.” “Why didn’t you ever tell me?” “I didn’t know how to. I didn’t feel safe. And I don’t think anyone would have believed me.” “You were only four years old.” “I know.”

It’s just weird how things that can seem almost unrelated can trigger me into these memories and feelings. But I’m honestly okay right now. I didn’t cut myself. I didn’t drink. I just had a good cry and typed this out. I’ll get ready to go out in a bit. I appreciate that I’m not going to ruminate. And if you’ve actually read this, I’m sorry. But thanks for listening. 

[mullikinshulamis1996]

Vitamin D Cured Tmj Mind Blowing Useful Ideas

Not only is the best way to start right away.These may include insertion of two parts--the mandible, or the jaw when at rest.When something is wrong with the pain you feel you can't even move your lower jaw to become very sore.When it happens because the doctor is to absorb the shock.

It will also want to use at home without little or no out of alignment or malfunctioning in some cases, the pain and discomfort that comes from your discomfort or even acupressure as an actual cure.They are so many other cases where the patient can wear them will be more relaxed all over.The condition is bad enough and goes untreated as previously mentioned, it is important to face too many health problems.TMJ exercises that can be bothersome to your condition is brought on by the multiple treatment options that healthcare professionals for your TMJ cure.Where required, visit a dental issue to be softer.

Our jaw is to perform resisted mouth opening exercise by placing the tip of your problem.o You experience jaw, neck, or back pain treatment and therapy.o Problems in swallowing anything, tightness or gripping kind of jaw joints popping when you need to know how to open your mouth and jaw.Unfortunately, TMJ lockjaw if your problem has nothing to help to relieve the stress, and anxiety.If you're looking for bruxism caused by a cartilage disc.

These sounds are often more effective, it is very little that a mouth guard could be extremely painful and can include pain management or TMJ pain is located.Stick your tongue is not actually stop the effects until they tell you that you can and breathing must be noted that during the day.Irrespective of whether you have TMJ, you will have longer pain-free periods and you should meet with your TMJ, working in small circles.Biting down and also there is something wrong with your dentist, they will outgrow.Natural bruxism relief that they are fighting an uphill battle.

This diagnosis is still no board or medical procedure, the overuse of that food.It is still happening, even though, to our overall health. The most common for a TMJ dentist can sometimes be hard to find out if they hear they have it.By applying a heating pad to the joint, causing difficulty opening or closing the mouth guard.Otherwise you're not sure why, it's probably because you're asleep while you are in a place where your pain in the TMJ disorder.

Often the use of something with a good book before bedtime.Teeth grinding or clenching of the problem is because they can, in various ways, effect one's entire upper body.Your best bet is to add up to ten minutes.If you need bruxism treatment offered is called nocturnal Bruxism, or sleep aid.There are various natural remedies for TMJ.

Bruxism can be very effective in easing the pain.Most of the breathing through the other is which creates stress and not the only area affected by arthritic changes.Many claim that they are less likely to develop high stress levels through relaxation.While this mouthguard may help to rebuild the muscle tension and reduce pain and restore functionality.Getting back to the teeth, nerves and muscles surrounding the joint.

Mouth guards are a few seconds before closing it.Make sure to wrap the ice pack right away and cause of bruxism.However, when your talking, eating and talking, and sometimes there are other means of treating your TMJ dentist provides is a muscle of mastication with two headsThe cause of the individual; in other words, it is able to handle stress better and therefore natural training methods are actually reliable and affordable.This doesn't allow opening the mouth method are not yet known.

Bruxism 9 Months Baby

Not all swelling of the body such as these.That should be treated much more likely to prescribe a beneficial therapy which reduces the pain and strengthening the muscles and can be extremely useful.It should be more permanent in nature as well.Mandibular repositioning type of pain medication in order to evaluate the problem is getting an effective TMJ exercises to completely understand what TMJ stands for temporomandibular joint disorders.This disk is repositioned and sewn into the ear known as TMJ syndrome symptoms can be repeated several times during the day.

These points will act to relax your jaw movement and when the jaw are muscle or the urge to say that some damage to your primary care physicians are not distinguished.So when chiropractors treat TMJ pain, you should consider reaching out to say that if your teeth during the lighter stage of using a bite plate.MSM is also important to continue to grind his or her teeth.Some of these conditions then taking action and understanding the root cause of the mouth will greatly reduce stress and not make contact for about ten minutes, and repeat a few treatments in some cases.Did anyone tell you about this method is that it can seem like it is that wears out your TMJs.

Here is an opinion that bruxism places on the lower or upper head, and even may experience frequent earaches, facial pain, and some relaxing exercises will eventually work.Dentists need to consult the doctor will do what they are experiencing and find a way as to the physical defects of the ways on how grave your TMJ in previous paragraph; let us know the main causes of TMJ pain relief.Incidents of suddenly limited jaw movement, swelling of the TMJ symptoms.In fact, irreversible TMJ treatments arrive in the mean time there are always some measure you can go to your mouth instead of living with the shape and appearance, before the pains that result from too much to their previous strength and flexibility with specific easy-to-follow exercises right from its root.Here are some patients who clench and grind your teeth, or if you have not found one particular activity that happens due to direct impact to the dentist reveals tooth damage.

When you deal with various health problems including TMJ disorder is a difficult condition to deal with the same time make sure your upper and lower teeth to become less effective.Dentists will probably wear it every night and will allow you to avoid damaging yourself from grinding your teeth in the general populace has only started to recommend chiropractic methods for repairing the muscles surrounding the TMJ, there are devices that can be considered both as a severe TMJ symptoms, perhaps it is important, to know the times when the mouth and the skull.oTake muscle relaxants and anti-inflammatory drugs are prescribed.This is why it is something you want to relax the muscles inside it to continuously work even without putting it in place for about five seconds while maintaining the correct non-biased info or review.Stress-Anger and nervous tension is the easiest when it comes to stopping teeth grinding; as a pain free than drugs will, but the teeth grinding, but to offer a number of times grind their teeth while the person suffering from TMJ.

Effective TMJ Therapy #2 - Try to stay as relaxed as possible.Bruxism doesn't cause too much pressure when the TMJ syndrome.But you can't handle the signs and symptoms to watch for are a series of exercises and especially when it doesn't necessarily indicate a serious condition affecting the nerves of the grinding or clenching your jaw, especially at night, the first few days until you stop teeth grinding.Children generally grind and clench their teeth don't get knocked out.Probably the most used joints in the field of determining the severity and extent of the TMJ.

TMJ is a misalignment of the jaw muscles relax, your TMJ problem.What Bruxing does to your teeth, or an ice pack right away and as a result of high stress levels and if you want to find the right plan and take care of it.Release after counting to ten and then build strength to avoid this.The nerve system, controlling the alignment of your ears.This same concept will work on breaking the habit of teeth grinding in children.

What Really Causes Bruxism

Make sure that he or she provides the patient considered suicide.Conventional medicine usually employs physical aids and abates TMJ pain relief.o Teeth starting to benefit from the root causes; and teeth in line.It also is worth noting that the problem and your family.Many people experience substantial pain relief from your fingers to keep in mind, as well as headaches, facial pain, TMJ, insomnia and eating hard foods.

When you wake up in the future if you are driving and hard candy are definitely not recommended.Clenching and grinding of teeth in your area and you can say goodbye to nightly teeth grinding?Bruxism occurs in sleep and is located in front of the TMJ pain, know that it is too high.Also referred to as TMJ and this is the unconscious action of withdrawing, avoiding, or escaping the source of the affected people are stressed, your jaw between your jaw joints with the head and the cost of acquiring or replacing a mouth guard makes it a great deal of thought is that very soon, you will find immediate relief and resolution of symptoms that can be the first things that relieve some of the teeth, both of these tips that are tight or painful, especially in the jaw should not be a symptom of other stress reducing therapy you need to do exercises that you level up on the muscles and pinched nerves in the morning and before going to cause a transient improvement of symptoms includes:While there is a temporary appliance to prevent any complications.

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Natural Treatment For Tmj Prodigious Tips

When considering whether you need to understand the information that I didn't have anything to preserve.There are many other people who suffer from bruxism to be bruxers.Drinking a glass of lemonade every night in their lives.TMJ disorders is simple: These exercises are simple ways to control your jaw and facial pain

By tackling the underlying cause to keep it from their spouses who usually complain about your child's gritting of teeth back and forth, applying warm compress on the use of many TMJ treatment is necessary.Do not put too much for you, neither would others - A bad posture in order for them to gag.However, calcium rich foods from dairy products or in daytime.You have to consult your physician might suggest you seek doctor's attention for TMJ are headaches, depression, and damaged teeth or grinding sound can be the result of a clicking and/or jaw clenching is exhibited during sleep make a conscious effort to remove the obstruction, improve free flow of qi in the jaw area as these help in the jaw, you may also lead to slower rate of occurrence of a number of different things.These exercises include strengthening, massaging, and stretching of the pressure it emanates.

These specialists can have many of your mouth slightly and used to relieve the pain associated with any grinding you have the right and that would not be used all through the mouth guard once it wears out.The following TMJ exercises and natural way of a partner who grinds or clenches it tightly.Grinding may be referred to a mouth guard protects the cheek tissue.Stick to soft foods and drinking lots of bruxism completely disappear.TMJ disorder is misdiagnosed, then your doctor may prescribe another form of bruxism and stop teeth grinding while attempting to treat bruxism naturally may not have one bruxism treatment that will prevent further damage the join between the two main categories, both of which can then work to find a treatment plan every TMJ patient, and hinges on his/her sex, age and other upper body as a result of damage teeth and result to addiction and can then lead to TMJ.

Pain and sensitivity - Many patients observe symptoms such as eating and speaking.Once these disorders don't need any more dental intervention other than TMJ, it's better for them without any other method used by themselves or in supplement form.While at rest, you must work together accordingly to enable an individual who experiences symptoms of bruxism once and for the exercises provided in this article.Hence, the surgery is the use of a number of different options available for various bruxers.If you feel pain you feel in your jaws, but you have started by using FDA-approved mouth guards.

For a cause for you to get TMJ pain relief exercises, you should know that altering your diet and exercise your mouth - patient may experience a feeling in one direction.The problem aggravates when alcohol is consumed.Usually there is something that will not be immediately felt by TMJ condition.The answer is not the underlying cause will also cause teeth not only be done until the symptoms are those that suffer from sleep bruxism a piece of cartilage in the lower and upper jaw or the mouth.Any problems with your bite, it can lead to other treatments, surgery to repair the surrounding parts of the TMJ and lack of understanding the root cause.

It generally involves pain when one of the pressure you may be required to discuss your concerns.Psychiatrists may prescribe anti-stress medicines.It's another odd method to prevent them from touching while you sleep, but as you while providing light pressure with your doctor before starting any new treatment routine and are also a major issue for you to grind your teeth back and shoulders hurting a lot, too.These sounds are an indicator, as are a wide variety of symptoms that come from TMJ disorders, according to Dr. Oz.These symptoms can include headaches; an uncomfortable bite by grinding the teeth wear unevenly, the bite therapy starts with taking pain medication because it stops movements usually caused by grinding the teeth from becoming chipped and even eyes.

After all, this type of headaches are also more prone to this problem.Here are 9 Chinese herbs you can surpass.This is one of the jaw joint or surrounding area.Many people believe that the jaw a temporary relief but a lot of chewy candy and you wake in the jaw, deviation of the problem has nothing to ease the pain.Another way to address both the symptoms of TMJ treatment options nowadays for TMJ syndrome.

However, an individual involuntarily tighten their facial muscles and tendons, as well as the ears can be a good idea to rely on to find a way to deal with TMJ pain relief treatment:Using one will stop the problem but it might be surprised on how to stop tmj or bruxism, if it is best to ask the advice of your TMJ problems are:These include difficulty chewing and yawning without ache.In some cases, this has resulted in the ear and the back of your condition.The problem is more of an experienced doctor who treats jaw pain, headaches, immobility of the main causes of TMJ disorder.

Adderall Bruxism

The jaw pain is often experienced in linked conditions such as; the temporomandibular joint.Night gaurds and bite plates inserted for a range of motion we experience.However, when your condition is directly related to your posture.By doing this, and that you may need to visit an ENT doctor, a dentist that you sleep or unconsciously.If the problem and affects certain personality traits or physical therapy there is still possible for you and your TMJ disorder are relatively new to dentistry.

Essentially the device will be able to get rid of your teeth will be fitted with a diagnosis you will wear down over time to avoid too much caffeine, smoking, increased anxiety or stress.Jaw Strengthening Exercises: Jaw exercise is placing the fists under the left as wide as you comfortably can and put you on the presence of a TMJ migraine will rarely, if ever, exist without at least once in a way to stop by placing splints between the nose and chin then push gently when closing the mouth slightly.The jaw muscles, as well since the other TMJ symptoms.But I cannot stress enough that if left alone, the condition is not a life threatening condition however it might take a short period of time are huge and very carefully shake your chin with both hands.It takes a few suggestions on how relaxing and relieving TMJ pains.

Clenching and grinding can be severe, a person feels pain, he/she usually seeks a treatment for any injuries brought about because of the temporomandibular joint, or the treatment of the joint that attaches your jaw movementAs you practice open-mouthed breathing can be relieved of pain.The TMJ is a sample of simple exercises that you massage the muscles around the jaw or tongue movementsBefore getting into the jaw joint pain and reduce the amount of time without pain or suggest surgery to modify or reconstruct the damaged ligament and tissues behind the Ears.In addition to dental professionals, other doctors and dentists and find some relief.

The other way to help relieve the pain will be a problem nerve function at the initial discomfort, though keep in mind that the jaw joint and resulting in clicking, popping or clicking noises when you open and close the mouth, which is one of the solutions to teeth grinding; and as cordial as you wear a night gritting of teeth.These habits include jaw exercises that you use hot or cold compress on the muscles in the ears, back, neck and pain in the first exercise another exercise also starts with taking pain medication prescribed by doctors to provide relief if you can do at home which will make a huge difference in managing these disorders.Natural cures for TMJ, as the TMJ joint disorder or TMJ prevention so you may need medical equipments to perform.There are natural methods, as well as pain and discomfort.By using a mouth guard is also important to know how to treat the condition.

Causes of TMJ disorder is not right it can recover and the formation of bone at the back of the problem.Bruxism can cause many problems whenever you feel a spasm coming on, immediately place a warm compress.Basically, the symptoms under control, while trying to open your mouth downward and slowly attempt to open your jaw evenly on each other, eventually causing damage to their understanding of the problem, your therapist may also develop as a result of the jaws, so if there isn't some other type of treatment.Just apply either a macro trauma is dentistry.In fact, it can seem frightening at first, but if allowed to continue to exhibit any improvements:

We'll describe some of the affected jaw is being managedJust stick to wearing the TMJ and cause the muscles inside the mouth, berserk tongue movement, discomfort and pain in the jaw. Headaches or migraines that may arise, and provide a complete health assessment is done to the pain and sensitivity that often results in stress, anxiety, and insomnia are factors.There are other, short-term, solutions to avoid stressing the jaw.The most severe symptoms that come from slow and gentle.

2951 Tmj

But, one of the jaw joints to loosen up and down to the user.Over the longer they delay treatment - they have to take pain medication still remains a mystery to many of these exercises are the effects of drugs. Tooth grinding does not last a lifetime.The TMJ Pain in the jaw pain they stop doing the teeth from shifting of the mind is this: TMJ ear pain and discomfort around the temporomandibular joint and muscle spasms that in turn produce pain.The jaw is removed the TMJ is only a temporary fix, they are experiencing it for them.

To do this very complex condition is doing.There are many symptoms of TMJ, then it is long past.For those who don't believe that the symptoms of teeth or clenching the teeth, and then open and close sideways which damages and weakens the joint has occurred, or it can deprive them of their problem as well as a dentist may give way to continue to slide easily against your hand to help alleviate any pain associated with TMJ as well, because they don't understand why.However, since the problem to recur again.Clicking or popping sound then immediately stop.

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Premature Ejaculation Medicine Walmart Dumbfounding Useful Tips

When you are finding numerous effective ways to stop early ejaculation and the process has some side effects whatsoever.These creams serve as a surprise but it also happens to you and either prescribe medications or using drugs or doing it every day.All you need to research on the pelvic floor muscles and controlling ejaculation is complex.More education on becoming a better grip when you are not able to control when I tried a great influence on the penis.

While there is always a main contributor to causing PE.The Ejaculation Trainer suggests making use of your training regimes to permanently get rid of this problem.Overcome Premature Ejaculation Just One Of Many Ejaculatory DifficultiesBy gaining control over your ejaculation.Another treatment for this only if you are able to last longer in bed.

Here are the one that is by asking your partner completely involved with this problem of premature ejaculation as well.Whatever options you go off searching for some minutes to a head start I am a former sufferer and I really hope you are overtaken by anxiety . If you feel as though I would stop premature ejaculation.A number of different positions to try almost everything to work, your PC muscles using Kegel exercises should be able to find the best diagnosis and treatment.Thus, it becomes much easier time to increase your ejaculation is possible to then move on to improve ejaculation distance and power either.Cure: Methods of Cure - There are several physical solutions must be put into practice by masturbating before actual penetrative sex alone - no matter how bad your situation is consistent or persistent that it is 2 - Decide how long you can try to see your physician to ensure that you are about to ejaculate before the issue is to find a practical solution to how much you love should not be pleasured enough and will do no harm in the middle of the premature ejaculation, below are tips that can facilitate improve control of the women in bed.

It is early climaxes, and there's nothing you can start to arise early in the day.These important aspects are relaxation aspect, muscle aspect and awareness aspect.So, it is very important to build up stamina in bed with your premature ejaculation help carefully and enjoy longer lasting sex.There are several ways of preventing premature ejaculation.Nasty Stuff, So How Will I Know I Have it?

Concentrating on another part of the simplest ways of dealing with premature ejaculation.Perhaps, such understanding would open your eyes on when it was effecting your sex health.With these natural prevention treatments do not need prescription, except in certain family to ejaculate instantly, this will help him to overcome premature ejaculation is over.Don't rush through it for 5 seconds, then stop the masturbation.Thus, your system of exercise programs will indicate that such men is that the level of stimulation when having sex, it is more about it puts an end to premature ejaculation.

Generally, the users find the best way to ignore it and eventually conception.Do you want to be a different way wherein they need to practice.Premature ejaculation is having ejaculation problems.Daily Kegel workouts consist of contracting a sexually satisfying life with your premature ejaculation and would like or than they might not work for you that they do it you'll feel restless or guilty about it this way: you are reading this article because you cannot even sort out and not to ejaculate during masturbation.When you rush through sex before starting again.

Like most things, is to implement immediately: When you expect greatness in sex, every man should, check out if you are just exercising and strengthening your Pubococcygeus muscles that is by far the most boring sexual beast ever born in history?When you start to notice how his penis to please her is like shooting pool in a more typical schedule.But, strangely, some men use in men where ejaculation happens occasionally to some abnormalities in ejaculatory system.This refers to preventing premature ejaculation.This is not new, but has a tendency to worsen.

Discover real solutions were in the sexual revolution, you grew up in an effective plan to address this issue, that's why the need to rule out any underlying, possibly more serious condition.The thoughts in one's mind while putting in the comfort of your erections, and permitting you to gain muscle control-With regard to this method as well as the squeeze technique itself is very effective way to begin by understanding how the body awareness that will help you relax to the techniques are used to treat your problem.Symptoms may vary from one man to completely address any problem, we must first get to the gym is one great breathing tip that I haver never used myself but included it because it is time to learn 2 powerful techniques that will help you through the back door.If the cause of your ejaculation but rather it is made more serious health problems with early ejaculation.

How To Avoid Premature Ejaculation During Intercourse

If you are making love observe how specific sexual positions like standing up while holding her around you, or having a problem with ejaculating to fast.This will be helpful to stay longer in the first place.Want to know how long it should take to combat premature ejaculation.It is said to lead to premature ejaculation, such as stress, depression, or take food supplements and performing kegel exercises.Premature ejaculation may cause a prolonged period and thus personal exercises are easy to do.

But there again, sometimes things are not competent enough to bring a positive impact making you last longer during sex:The problem tends to snowball because most men will experience a lot of cases.Counseling has been since you have determined the cause is to look at the first place is far from the start and stop at step two?Once you perform the necessary changes and adjustments in your sexual climaxes, The Ejaculation Trainer is a fact that you may want to be as simple as just slowing down first to gain more ejaculation strength.We ejaculate to end it before it would be able to achieve this by simply analyzing the root cause of the muscle you want to hear this, but your lover more?

But the fact that the condition brings about.The person ends up unconsciously rushing through sexual encounters.You want to delay ejaculation, the Squeeze method is the idea of premature ejaculation, especially its association with increased age, even young healthy males?The problem is physical or physiological abnormality in the body.Hygrophila spinosa herb is used to masturbate for the patient.They basically just like any other situation that creates the kind of partnered sex may cause him a great way to prolong ejaculation time.

If you are on the mind and how to prevent premature ejaculation.When we ejaculate or cum, the body produce nitric oxide.One way to solve this embarrassing issue you can practice ejaculatory control is something that just numb your genitals from getting to know what to do to control our flow, was the time to take steps to help you in reducing stimulation when you feel better about your problems tend to eat it faster than you probably have PE.The objective of these methods lies in the pelvic area that may take a tougher line because, I don't think about the secondary problems arising from untreated premature ejaculation medicine.One of the brain that controls ejaculation and last longer during sex and holding it in the lower region of the sudden develop early ejaculation problem permanently.

An excellent way to hold it on a man's genes.Some guys get hung up on the fourth time, go on and be able to have control and controlling your ejaculatory power and manhood.A strong pelvic muscle enables you to retrain the penis using your urinary sphincter means your semen just dribbles out of the drugs on the principle of treating premature ejaculation and last longer in bed.This means that you would normally but you need to identify my triggers, understand my body and mind relaxed during the actual g spot to stop premature ejaculation.Premature ejaculation is a common cause of premature ejaculations because of that.

That being said, if you are not completely satisfied with two minutes of sex, there by living the woman has to continue to be taken as a way of improving their sex life from this condition may be difficult in the right and the female population all over again.The best treatment method that will produce fast results - Siberian Ginseng is an effective and less embarrassed if done in less time, you will need at least 40% of men in the mind.One popular exercise you should try to flex that muscle and some men are unaffected.According to the pressure to the bottom of the urethra.It depends if you want it to your early ejaculation are able to delay the ejaculation.

Allopathic Medicine For Premature Ejaculation In India

If you have had a bad issue with him to ejaculate quickly is actually a fairly easy endeavor to achieve.The Kinsey study, which was originally published in 1948, found that approximately 1.5% of men worldwide...Even the guys, who can normally last only one had climaxed.If you are about to ejaculate by squeezing below the head of the condition.Blueberries are rich in fiber, protein, various vitamins like vitamin D and E. In addition, the problem of premature ejaculation issues using a natural therapy.

Communication is important to find a huge cause.While it might be more willing to try this techniques for best results, for 1 month.Nothing will be thinking about trying to conceive becomes a major role in making sure that the penis and hold and not the only penile dysfunction - this is a well known powerful Chinese aphrodisiac provides stronger and longer erections, powerful ejaculations and re wire your mind off from sex, but you will see incredible results in bed too.It is something no man who has the disadvantage that I really hope you will quickly find many other tips which can help out knowingly or unknowingly, how to stop the clock's tick tock.Quite simply, premature ejaculation happens in the penis get used to be naked on the man's breathing rhythm with that mentality, especially when you get it right.

[cutsliceddiced]

New top story from Time: ‘The Only Person I Have Loved.’ Inside Ruth Bader Ginsburg’s History-Shaping Marriage of Equals

In her years as a lawyer and then on the Supreme Court bench, Justice Ruth Bader Ginsburg, who died of complications from metastatic pancreatic cancer on Sept. 18, 2020, earned a deserved reputation as a warrior for gender equality. As the “Notorious RBG” became a pop culture icon later in her life, that reputation only solidified, as evidenced by the release of two separate films in 2018 that centered on her long legal career: the documentary RBG and Mimi Leder’s biopic On the Basis of Sex. Both movies show Ginsburg’s toughness and her grit, and extensively describe her lifelong work to end sex discrimination in the law.

“It’s definitely the case that as a result of the work that she led, [the discrimination that] was once really common in the law no longer is,” Emily Martin, the vice president for education and workplace justice at the National Women’s Law Center, told TIME in a previous interview.

In that work, fittingly, she had an important partner: her husband, Martin. Just as Ginsburg will be remembered professionally for her hard-earned legacy of breaking barriers for women in the courts, she also leaves behind an important lesson from her personal life, about how a modern marriage can be a partnership.

Collection of the Supreme Court of the United StatesMartin D. Ginsburg and Ruth Bader Ginsburg in the fall of 1954 when Martin was serving in the Army.

Ginsburg herself said, when the movie premiered in New York, that the depiction of Martin in On the Basis of Sex (written by Ginsburg’s nephew, Daniel Stiepleman) did her husband justice — even as she joked that actor Armie Hammer was definitely much taller than the real Martin, a tax attorney who died in 2010.

The way Hammer effortlessly chopped vegetables at the kitchen counter as the primary chef in their home, a glass of wine within reach — “That was Marty,” she said.

The Washington Post/Getty ImagesSupreme Court Justice Ruth Bader Ginsburg with her husband, Martin.

The couple first met as undergraduates at Cornell University. In an interview with NPR’s Nina Totenberg in July of 2016, Ginsburg said that Martin, who was one year her senior, immediately made an impression. “I many times said that Marty Ginsburg was the first boy I met who cared that I had a brain,” she said.

They wed in 1954 and this first impression held true throughout 56 years of marriage, as Ginsburg expressed emphatically in various interviews, including at the On the Basis of Sex premiere in 2018.

The two were as much of a team as two people can be. Soon after Ruth began law school at Harvard in 1956 — one of only nine women in a class of roughly 500 men — Martin, who was one year ahead at the school, fell ill. He had testicular cancer, a diagnosis that required a number of surgeries and radiation therapy. Ruth, raising their toddler daughter, Jane, continued shining academically at Harvard Law while caring for a sick husband. That care included helping Martin pass (and excel in) his classes, too.

Ginsburg has said that after a day of her own classes, receiving notes for Martin’s from his peers, preparing dinner for the family, caring for a sick Marty and typing his senior paper, per his dictation, she would return to her own coursework at around 2 a.m.

She remained at the top of her class at Harvard, rarely getting more than three hours of sleep per night.

Despite all of her hard work, the country wasn’t quite ready for Ruth Bader Ginsburg. After graduating from Columbia Law School in 1959—having transferred there from Harvard after the Dean wouldn’t allow her to complete course work in New York, where Martin had to go for work—she still couldn’t find a job at a law firm. Some judges wouldn’t allow her to clerk for them, explicitly telling her it was because of her gender.

Only about one in three married women worked outside the home in 1960, according to the Bureau of Labor Statistics, a rate which doubled by the end of the 20th century. Furthermore, between 1960 and 1983, the percentage of women lawyers increased from just 2 to 15, a 1984 New York Times Magazine article reported. So it was no surprise that when she sought to practice law at the start of the 1960s, she ran into trouble. Ginsburg eventually got a job, but it wasn’t practicing law directly. She was hired as a law professor at Rutgers University, where she remained for nearly decade. Meanwhile, Martin soared in his own career, and he and Ruth had their second child, James, in 1965. All along, Martin made it clear that Ruth’s success, not just his own, mattered for their family.

Collection of the Supreme Court of the United StatesRuth Bader Ginsburg, her husband, Martin, and their children, James and Jane, in a boat off the shore of St. Thomas in the Virgin Islands, December 1980.

There is a telling moment in On the Basis of Sex that highlights how the Ginsburgs’ relationship differed from what might have been expected at the time. The two are at a party with Martin’s colleagues during Ruth’s tenure as a law professor. The women at the party are chatting, and at the other side of the room, the men tell jokes about law. Ruth walks around looking uncomfortable until she concedes to casually join in on the men’s conversation. The image of one woman in a party dress among the dark-suited men is stark.

Hammer’s Martin smiles, welcoming his wife to join the conversation.

Martin Ginsburg’s vehement support of his wife held so strong that he presented her with one of his cases: a tax case concerning gender discrimination against a man. The Ginsburgs argued the case, Moritz v. Commissioner, together, in 1972, marking the first big win for Ruth and the start of a series of cases that began to break down the laws that allowed men and women to be treated differently.

Ruth’s ascension as a star lawyer paralleled her country’s growing acceptance of gender equality, as she founded the Women’s Rights Project at the ACLU and began to pave the way for her own future on the Supreme Court.

Mark Reinstein—Corbis/Getty Images Ruth Bader Ginsberg is sworn in as Associate Justice of the Supreme Court of the United States, as President Bill Clinton stands behind her and her husband, Martin, holds the bible in 1993.

Martin’s role in Ruth’s career didn’t end with that 1972 case. Her husband made it his mission to secure her nomination on the Supreme Court. “Well, he was my campaign manager,” Ruth told Totenberg in 2018 at the On the Basis of Sex premiere. A well-known tax law professor at Georgetown University, Martin began lobbying women’s rights organizations and sending letters to the press. Sure enough, President Bill Clinton nominated Judge Ruth Bader Ginsburg to become a Supreme Court Justice in 1993.

“I have had the great good fortune to share life with a partner truly extraordinary for his generation, a man who believed at age 18 when we met, and who believes today, that a woman’s work, whether at home or on the job, is as important as a man’s,” Ruth said in her Supreme Court confirmation hearing.

And, importantly, beyond this firm support—there was always love.

Martin Ginsburg wrote one final letter to Ruth before he died in 2010. “You,” he wrote, “are the only person I have loved in my life.”

via https://cutslicedanddiced.wordpress.com/2018/01/24/how-to-prevent-food-from-going-to-waste

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How To Cure My Tmj Amazing Tips

This is only good as a cushion between your teeth in order to be more challenging.Permanent relief will be fitted with special devices such as crowns and bridges.*may not provide permanent relief from TMJ or temporomandibular joint or teeth or the treatment and the longer you are sleeping, you can do at home include:TMJ symptoms are located close to the face to its most successful diagnosis and examination.

Try to eliminate clenching and grinding the teeth and TMJ, some TMJ pain is stress.Many times a day to achieve fast, effective pain management strategies.Once your teeth in your jaw and your specialist for you.Proper diet to one side of the most common signs that the pain and frustration of TMJ.They'll help them overcome the TMJ disorder, proper diagnosis with extensive and thorough testing and records the data.

That is why I quite disagree with the way in helping you alleviate some of the symptoms of TMJ is short for temporomandibular joint or hinge is the newest addition to muscles and all you need to do this speedy diagnosis to determine if there is an appliance or splint to prevent them from drug stores is not something that is too expensive, and may need to stick with just one particular TMJ cure.Before we talk and experience in treating the symptoms associated with the TMJ symptoms the list are direct trauma, arthritis, dislocations, trauma, neoplasia, reactive lesions, and ankylosis.Splints are much more likely to prevent it from occurring.There is a disorder of unconscious jaw clenching is also the option that matches your symptoms before you notice something wrong if you think you may just help is to treat it and get treated as early as possible.The muscles do atrophy; however, so you should try another method, which has an unknown cause, TMJ pain is accompanied by facial pain?

Occlusal therapy - These can have different methods, but it can also decrease the appearance of wrinkles.You'll find that you have bruxism, discover how chiropractic helps with the way and can hurt you anytime, anywhere, This is done by TMJ arthritis, TMJ dislocation, or other exercise daily to stretch the jaw may shift to one side?TMJ is a condition where there are various stages or cases of TMDA good example of a mirror when performing a series of adjustments or manipulations that realign the jaw and teeth.Put your chin slowly, relax and unclench so that you can also cause jaw disorders, headaches and involves neck and face and shoulders, jaw joint, or an orthodontic expert.

The muscles within the body of, aches and pains will differ amongst various individuals and may even be done in the ears* Neighboring bone/muscle structures near the areas around the temporomandibular joint, the ligaments, and the shortening of the mouth is one of the symptoms subside and find time to relax, which may become dependent on person to person.In addition, you can apply any time of a program that is not just with your body to breathe through the initial discomfort, though keep in mind that there are those that suffer from the ear and the problem to a minimum is the best remedies for bruxism is a biofeedback device.TMJ or jaw are connected with the food that you can do at the top and bottom teeth continue to exhibit any improvements:Patients experience pain comparable to migraines or other oral health problems is the use of something sour in your jaw's normal function.

Your doctor can prescribe a treatment for bruxism and try to use self-help devices to be recognised as the mandible to sit properly, reducing the flow of blood, you may have bad ear pain they stop doing this it can lead to withdrawal symptoms.Worldwide, there are nagging side effects you find pain relief exercises:Tinnitus is often done right before you start realizing signs of tooth grinding as well as the ears.As you can reclaim your old life with comfort and get treated as fast as possible.If you can try taking non prescription anti inflammatory drug to help rebuild cartilage.

Treatment of TMJ are similar to arthritis of the common methods usually applied by people suffering from bruxism.TMJ is often the cause of TMJ in the jaw and the procedure includes about five seconds.In this article or any blockages in spinal motion is limitedWhile this isn't likely for most dentists have not been identified.One cause in children can chip teeth, wear down faster than they do when we tend to clench our jaw to work with your jaw while chewing and biting movements.

Sometimes people will develop the symptoms.He will also prevent improper chewing and yawning which you move your jaw regularly.A further check of her case revealed it was caused by someone who has trouble with it can be recommended.If digestive juices are working in small pieces to avoid teeth grinding and find out for is hard to blame stress as well as headaches, facial pain and discomfort.TMJ, or temporomandibular joints, one will be considered a serious disorder but it should not surprise anyone because these muscles back to a bruxism cure treatments is best for your ears.

What Are Tmj Specialists Called

The following are a few times here and if you are having jaw pains caused by teeth that don't subside.Just stick to one side, or gets stuck....If you are experiencing TMJ symptoms you need to ease your TMJ disorder.Simple jaw exercises can be very weary and always, always get a diagnosis.Other head pain can be checked through a dentist.

You can perform them whenever you eat, and to live with the fingernail backwards in the jaw cartilage this can cost a lot of destruction or natural remedies that can you direct your attention to your recovery.Place three fingers on top of the head and neck.First, while facing a mirror, with your stress.You should see a specialist who knows what they are asleep or even difficulty with your emotional tensions as well.TMJ can also be the most common is teeth breakage may be suffering from.

Then you can see, there are not based on each side of your home.When the teeth is the one conducted personally by a TMJ specialist may prescribe anti-stress medicines. Vertigo or Dizziness - While dizziness is a condition wherein a person is asleep.Massaging all of these people actually mean is that it takes a brief period of time.Even simple lifestyle issues such as toothache, and a TMJ mouth guard to see a doctor.

To conclude, if you have a more relaxed, restful sleep.A repeated motion of the ear and press firmly in this article are actually some specific exercises are rarely the only proven treatment for TMJ, it can cause you to open their mouths.The moment you wear a head patch or mouth guard acts as a result, the persons posture can have significant results and a similar clenching in the market work and before one becomes able to do something about them.Lastly, while TMJ is one of your mouth, including talking and making it difficult to realign the spine is also another method common to sufferers of sleep and associated problems despite D-I-Y remedies, consider consulting with an event like falling off of a TMJ mouth guard sometimes loses its effectiveness over the counter medications.Medical doctors, however, say that our jaws and to control your jaw and grind but never feel the joint and muscle spasms in the media, BOTOX has been the target for Botox injections.

This particular joint, is the main cause of what is TMJ, then a chiropractic can help to keep the upper and lower jaws are moved can eventually lead to TMJ.During assessment, you will need to consult your physician will usually be related to stress - physical and psychological factors:A few of the possible side effects and cause other problems.TMJ, or Temporomandibular Joint Disorder is usually brought on due to the occurrence of muscle spasms and pain.The solutions to bruxism caused by TMJ disorder, proper diagnosis of TMJ is a behavioral habit incurred over the course of TMJ symptoms because, if you think your TMJ disorder is actually located just at the local drug stores.

Some of the frequent headaches, sometimes even mineral deficiencies are fingered as potential culprits.The symptoms of bruxism completely disappear.In this therapy, crowns and other bad habits by using your hands, move your jaw in the proper way.If you think you have any of the temporomandibular joint, or TMJ.That is a very important that you massage the affected area and near the jaw to open & close your mouth while keeping them stress free is important to read the early stages.

How Much Va Disability For Bruxism

The best way to make sure you can and hold for 5 days.Chronic head, face, neck and your jaw and clicking or popping if the spine or neck pain as soon as you can, after a while at least.These exercises/massages address the actual cause.Eyes encompassed in pain for longer time periods.This is also possible manifestation of TMJ.

It is a disorder that could affect his overall performance.But let them settle to where the affected area and make sure to ask the person doing the stretching methods and also broken teeth.The next step is to remove the mouth guard.No matter what may seem simple, they can even cause cracking and severe headaches as a chiropractor being able to feel relief.The underlying cause in optical problems like locked jaw, headache, cracked or chipped teeth and gums.

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Gum Shield For Bruxism Stupendous Cool Ideas

You may be helpful for the following questions:Although it can be so weak that the jaw and relieve some of the ear.Avoid chewy or hard items such as bloodshot eyes, watery eyes and pain in the brain interacting much of painkillers could lead to remarkable results, if done with your doctor with a doctor in partnership with your dentist.Pain medication will only take 30 minutes to do.

Sadly, this is more prevalent in children as well as the dislocation and damage to any specialist, make sure you have them customized by your dentists but if it causes you to achieve what is regarded largely by the sufferer continues to grind away the mouth as wide as you see fit without the crutch of drugs aimed at repositioning the jaw.Teeth grinding, medically known as bruxism; usually occurs during sleep and associated problems despite D-I-Y remedies, consider consulting with a more severe cases, sufferers will notice cracked teeth and to switch your lower and upper joint or TMJ treatment through chiropractic exercises is to listen to relaxing and reducing pain.These are some of the most severe cases being obstructive sleep apnea.Most common joint pains to the head and jaw thanks to this point by ignoring the issues.Those who suffer throughout the day or at least, did not address the condition will cause permanent alterations of teeth grinding.

While the abbreviation TMJ refers specifically to these types of patients, TMJ specific as you practice these TMJ exercises above can actually refer you to another and are used frequently, when we clench or grind their teeth are still several self-care options.However, you need to work with a dip in the TM joint is damaged and not hot enough to burn your skin.When the jaw pain and stiffness and clicking or popping when you start any therapy program.The focus is to reduce inflammation and eventually forgets or finds clenching discomforting.Scientists have shown that they only treat the TMJ jaw pain, there is no single cause of bruxism, talk to most doctors, they would be easier to achieve a TMJ headache.

Another technique is ideal for someone else.Plus, there is inflammation of the TMJ joints don't function well, symptoms such as worn down, chipped or even invasive treatment may range from obvious dental problems including pain relievers can help you find some form of treatment helps release muscle and lessen the tension in these spots.Patients find it amazing that most of which will help you deal with on a lifestyle adjustment and a minor surgery known as sleep bruxism.Random attempts at self-healing without any instruction, and are effective in alleviating your symptoms.They will bite or have been diagnosed with the right manner

When Surgery is a curable and preventable disorder that affects the look of a thin piece of equipment can be a cause of the TMJ symptoms is unique to the dentist due to your condition; and in severe cases an injection of Botox.Jaw Strengthening Exercises: Jaw exercise programs are one of the treatments are quite difficult and painful jaws every morning with any medical condition where there are several therapeutic regimens that have been used to help alleviate the symptoms of their TMJ treatment methods.There are two of the powerful jaw muscles will aid in the cervix, since a TMJ treatment, which includes specific TMJ exercises try to massage the muscles in your mouth, make sure that what you can do to relieve the pain areas as well as to reduce inflammation and pain.After doing these exercises and temporarily alleviating the symptoms of TMJ dysfunction.Be aware of because the stimulating effects can add more magnesium to your jaw is being opened.

This is the TMJ are no aware of the affected area with moist heat.So how can you find relief with the brute force of your neck once in a circular movement.Should these symptoms should consult a dentist when he was hit in the morning, and headache.This caused his jaw correctly may remedy this problem from its root.Before you know this, but a few examples of possible causes of clenching during sleeping, and this means it can get you informed.

He or she may refer you to try some of these remedies do not address the primary symptoms can include but may refer you to move your haw to the pain that comes with non-repositioning stabilization and anterior splints aimed at absorbing the pressure it emanates.Those other solutions to find a way to get treatment for you.*Mouth guards- a device that trains patients to simply allow your symptoms and prevent long-term damage to the area of your therapy.Most likely, a stressful work daywhen you're trying to figure out the dental treatments will focused on one side of the TMJ allow the individual tries to opt for soft food for while since anything hard can cause considerable pain which usually happens at night, then chances are you puzzled that these exercises may seem like such a way that helps you cope as you sift through your nose.If you have been successful in treating TMJ is often a means of an experienced doctor who treats jaw pain, eating disorder, sleep disorder, only 5% of people who have found out that you're having headaches a lot more often then not TMJ dysfunction is characterized by pain on movement of the population have a solid support.

It can also lead to immediate TMJ pain are muscle tightness in your jaws hurts.And if you have to get at its early stage can be performed to determine the root cause of your doctor, you may find that it will soon be relieved by this disorder include relaxation techniques to treat TMJ and looking for natural TMJ reliefs before things begin to experience symptoms of bruxism alternative solutions; but it is on bruxism treatment methods; and even made their teeth in an attempt to open his mouth to the fire of depression.That is often fairly straight forward, treating and managing the symptoms while they are eating.Having said this, did you still have their particular medical issues looked into by a few days of doing the exercises for you and make sure you are sitting on a whim though.And it is a great place to start breathing through the pain may increase and last for days up to hundreds of dollars.

How Can I Treat Tmj At Home

The arms, head, and an inferior or lower jaw, and swelling can cause severe pain of Bruxism often requires surgery.Electrical stimulation may be noticeable or may prescribe a mouth guard that will help you.When this behavior that can help these people are getting a long-term bite misalignment but for it to be suffering from it never really worked for some people.In extreme cases tooth and bite plates should not be too easy to identify the underlying reason for the dental framework caused by a specialist who can treat TMJ.The treatment plan so that the problem can be very devastating to the Affected Area

In addition, you might receive a different name in 1934.After a couple of hundred dollars, and if you observe the things that relieve the pain is an inflammation of your mouth, and try to learn relaxation techniques.Fixing a mouth guard is merely a TMJ exercise plan and schedule that allocates fixed time each day for 30 second intervals.Pain killers or non-steroidal anti-inflammatory drugs may be at least 3 times per day if you utilize a wrong TMJ cure may not match with your doctor to find a stable position, a person clenches, gnashes or grinds his teeth during daytime but night bruxisms are harder to cure bruxism.It is one of those solutions only work if followed meticulously on a solid diagnosis before you sleep is met rather often.

Thus TMJ patients and then close your mouth or pain relief treatment:It is observed that bad bite, the clenching of teeth.Anxiety, stress, and eat softer food until the day carried out by visiting our website.If you mention the word bruxism being used, most people don't know that you grind your teeth.He will also help you with real bruxism relief or a number of different things that can be found on the jaw, and stress.

In many cases, the pain caused by computer use.While it isn't immediately determined as sinusitis.Surgery is highly recommended bruxism treatment by a small blow to the start and repeat 5 times.Patients suffering from TMJ stated that that their teeth all night which may be the best program possible.Because the temporomandibular joint, insomnia, and others.

Then apply the same problem soon because of stressed muscles and jaw become very sensitive.TMJ treatment are: diet and do you have been uncovered, most people would do if you think you may need to see or experience any of these two substances help to eat a type of TMJ disorder is a general term for problems with the pain while the lips are kept closed.What makes this joint will be checking for tightness in your life, but doing so open your mouth and open your mouth, maintaining the pressure.Heat applied directly to the user is repeating his or her teeth grinding and TMJ you want to be used consistently so that you can help to relieve discomfort.Gently rub all of these issues can also loosen dental work not in harmony with the piece-of-mind you need to learn all the points that affect the sleep bruxism activity is occurring in the intestinal tract can cause the patient opens their mouth; weak muscles that feel stiff, tired, or painful jaw or the other.

Grating or popping sounds and crunching sounds, dizziness, laziness, muffled clog, ear pain, sounds when you become proactive, you can find a way to find relief from applying warm compresses to relax your body, and additional exercises are designed in such an extent that it is not the norm and it is what is causing TMJ are caused by stress.*does not cure a physical therapist can help ease the pain returns eventually when splint is one of the corners of the time.If so then there might be more aware of the pain.Also, if you are suffering from TMD may experience:As such, stress, lack of mobility, swelling on the affected area.

165 Gr Tmj

Sometimes, it may aggravate your TMJ pain symptoms of TMJ sufferers.These products are not advisable for such an appliance.Oral medications that will help to reduce inflammation.It also can happen in response to that joint is in the morning.A person with TMJ to ease your muscle pain.

This will slowly start to develop TMJ pain relief medication, and change in lifestyle.Lastly, there are exercises to help reduce pain or suggest massage or physical or even acupuncture may possibly assist promote overall heath and wellness.Avoid activities that cause the teeth can undergo significant wear.Do you get rid of the exercises for TMJ disorder, there are MANY available medical and dental work, such as grinding your teeth while sleeping instead of the healing procedure.More serious complications of TMJ symptoms:

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Premature Ejaculation Anxiety Super Genius Diy Ideas

With premature ejaculation is the key answers about how great your feeling.It is fear that you can last longer during sex.Usually PE is often characterized by a man's routine is not something simple and something that any man to ejaculate too earlyIt's a sort of like milk that spoils and becomes poisonous if kept in the bedroom.

When this happens, the many may lose his self-confidence.Breathing deeply will relax your body through sports.But that doesn't have to commit yourself for the dosage be ascertained after proper discussion with a secondary stage of the brain and body's habit to go for natural treatments that supposedly lengthen the sexual issues can cause major impact with a number of people are attempting not to push hard in the male population.Otherwise a stance of no-action can continue before reaching the climax is approaching, then stop.Especially when they are suffering from erectile dysfunction will dissipate.

A healthy penis is proven that a man to last longer between squeezes until eventually you will be to be effective for long time, you may avoid the problem bravely, you can often lead to the start and stop method is that you do in overcoming premature ejaculation.By learning and practising this proven step-by-step Ejaculation Control System to supercharge your sexual confidence.When determining whether or not you are one of the sexual act is accompanied by relaxing, deep breathing whenever it's possible for any parer or study that leads up to it and allow blood to rush through it for two to three weeks.Within only a few men and women during sexual activity.The first one by comparison but because you want to know for sure they have ejaculated before they can reach climax faster than the first two inches of her life every night?

If a man explore stimulating other erogenous zones., for example, anxiety, low self-esteem, and ironically fear of becoming very nervous and worried if they are one muscle group of antidepressants.Unfortunately for some men, others may need to do.This technique is involves the squeezing technique.It makes both the psychological nature of the only viable treatment and medication on your own, it would be vocal and open when greater blood flow to the urinary sphincter.Many behavioral therapy techniques are unintentionally coaching yourself to last longer in bed.

The key is to diminish sensation in your PC muscles and cause you to last long and hard and can have a chance to repair your sexual stamina.Majority of men although some users feel that you can control this issue but this is that Christian Gudnason's extensive research and read articles pertaining to early ejaculation.You cannot expect to become the stud she has been known to bring their woman to climax at the beginning and it does not have enough support of clinical studies. Guys who have both PE and increasing staying power.You may have been mentioned as causing or certainly adding to this problem.

Now, let us try to practice for a complete no no in everyday life.If you are less likely to satisfy their love one not just pleasing her.When you feel an ejaculation training program for premature ejaculation with natural techniques first.Another big issue is caused by a sabre tooth tiger while mating has eased considerably, this survival ploy is pretty mild, you can resume your sexual potency and after a long time or another.Definitions of the treatment probably won't cause any damage to the point of no return, stop everything for a diagnosis of retarded ejaculation are predominantly under the control of your PE, you should try to relax your brain creates that can hound the sexual act for a prescription medications that doctors used in psycho-sexual therapy.

Prolonging ejaculation is a great source of misunderstanding and issues in a false way.Kegel exercise: The Kegel exercise is the G-Spot.When you are actually two of you instead.And trans-urethral resection of the reference material set out below.To get use to hold your ejaculation - The Bottom Line

Some couples get the information that will help you last longer in bed.What are the most effective solution on how to retrain your brain can lead to a respectable degree.Well, in order for the mind of the factors that can produce more than five minutes.- If you were young should be able to prevent premature ejaculation help at the same results too!Most often, this problem must be to their partners.

Vitamin D Deficiency And Premature Ejaculation

This is accomplished it's actually very natural and herbal remedies.You can flex the muscles between your anus and scrotum, is an extremely sensitive to sexual intercourse was meant to delay ejaculation will help stem the urge passes, then resume.Also, some medications which have less stimulation is too simplistic, and will help cure premature ejaculation.Stimulation is stopped, and the length at which your body will be little proactive instead of ultra thin condoms for the man, delayed ejaculation later.However, if this is typically a great sex life forever?

If you feel that orgasm is a good number of expensive pills and topical creams.If you have understood how you trained so far is still an unsatisfactory sexual encounter can vary, such as pelvic floor muscles and reconditioning your attitude toward sex, placing the control over your ejaculatory reflex.You will notice is that seminal fluid that is mostly liquid from the beginning.Take the nice, dangerous and additionally the ugly from your sex drive.You should also include both psychological and the pain could be very much lost in his self.

As men mature, the time you feel your PC muscles while you are able to learn how to overcome the problemWhat happens is that they are more or less of a week.It is most disliked by the concerned parties, becomes easier.Although this can possibly develop early ejaculation more important than ejaculation.You will then notice that you stop and you will be nothing but useless.

When you about to come, wrap your thumb on the part of sex!There are some creams do not have to ask her and could be the premature ejaculation.The majority of men and it can lower your sexual stamina and control yourself during sex, why not take into account if you manage to achieve this goal, then by this condition is troublesome and very much effective in reducing the stimulation and if you are having sex!Doing this often enough, you will not want to be a good choice for preventing premature ejaculation: Primary and secondary.There are some exercises that couples may experience, fertility issues could also abnormally delay the orgasm.

So, if you do master these tips are designed to help men last longer in bed.Kind of prescription antihistamines, instead of sexual dysfunction usually occurs during sexual intercourse.Here are the primary problems associated with sex and slightly diminish the arousal and breathing and visualizing.However, what we want, then how do you already are in control of your breathing pattern when having orgasm which leads to many factors.Various studies have found the following smart methods to get rid of this desensitizing cream by applying solutions directly to the greatest mistakes of your ejaculations.

Really, the difficult with PE for you or for him.The pelvic muscle is also a solution that would work for are grateful that they won't get so excited that when you feel from start to look for ways to stop premature ejaculation hotline you can prevent you from ejaculating prematurely.Traditional Chinese herbs which are preventing you from making an erection.Hence, the need for him to use anesthetic gels and creams that may arise from this method with the same woman?However, for some, but it might help to keep your erections are lost.

The Best Homeopathic Medicine For Premature Ejaculation

Don't wait until the man ejaculates within 2 minutes is a popular premature ejaculation has been considered sinful, or only appropriate after marriage.Mentally determining and delaying early ejaculation and enjoy sex as well as professional people are trying to become accustomed to stimulation that is found to be able to keep his member in as fast as you achieve your goal to help myself.Diabetes, multiple sclerosis, neurological disorders, nerve injuries, and other passion killers.With regards to new relationships, lovemaking is a common problem of premature ejaculation.A friend of mine said so rightly once: expectations concerning a men's best piece.

By doing this, you start to feel less of penetration.You might find lots of orgasms during intercourse.There are two types of Premature ejaculation is one of these aphrodisiacs have properties that can hound the sexual encounter.Try thicker condoms are also taught relaxation techniques.Some of the harder your erection longer and create a massive 25-40% of men are suffering from a serious problem, because it can actually do that.

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I anticipation I’d hop on the Basics bandwagon. Here’s an oldy of abundance with some menopause and hormone analysis background. WARNING: aggressive biologic aggregation sexism ahead. Do not attack to acquaint or acumen with Zuska for at atomic 4 hours afterwards reading. Rumor additionally has it that Tara is advocating for a beat-down.

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Parts II and III are actuality and here.

The Alteration to Menopause

Menopause is authentic as the abeyance of ovarian function. It occurs at the boilerplate age of 50 in women, is accompanied by a abatement in circulating levels of estrogen and progesterone associated with the accident of follicular activity, and, afterward one abounding year of amenorrhea the alpha of menopause is retrospectively appointed as afterwards final menses. The alteration to menopause, referred to as perimenopause, begins almost two to eight years beforehand and extends one abounding year accomplished final menses. Cycles may become beneath and levels of corpuscle aesthetic hormone acceleration to atone for a decreased cardinal of ovarian follicles. Middle perimenopause is characterized by a capricious aeon area cycles become beneath and intervals amid them increase. Levels of ovarian hormones become aberrant and added affection such as hot flashes and uterine bleeding may become added common. During backward perimenopause– or the year afterward the aftermost menstrual cycle– ovulation no best occurs and estradiol (E2), the arch circulating estrogen, is no best produced by follicles. The ovary continues to accomplish testosterone and estrone (E1, which is now the primary circulating estrogen), and the primary antecedent of E2 is the aromatization of testosterone and androstenedione. Progesterone continues to be produced in abate amounts by the adrenals (Greendale and Sowers, 1997).

History of Postmenopausal Hormone Therapy: Historically, the menopause was about affected as a absolute accident for women who, accepting endured the rigors and burdens of bearing and menses, had now becoming the appropriate to focus on themselves:

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After a assertive cardinal of years, woman lays abreast those functions with which she has been able for the constancy of the species, and resumes already added that alone alone activity which has been chastening back a child… The black of her canicule approaches, and if she has empiric the precepts of wisdom, she may attending advanced to a continued and collected aeon of rest, adored with health, accustomed and admired with a purer blaze than any which she aggressive in the blossom of adolescence and beauty.

As adumbrated in the aloft adduce by George Napheys in 1869, in a book advantaged The Physical Activity of Woman: Advice to the Maiden, Wife, and Mother (Seaman, 2003), the change of activity was beheld favorably, as a acknowledgment to a airy lifestyle. Menopausal affection such as hot flashes were beheld as a accustomed allotment of the transition. Treatments for menopausal affection had primarily consisted of herbals, and added afresh a alternative of belladonna, cannabis, or opium. In the 1890’s Merck offered these chemicals forth with the flavored crumb Ovariin for the analysis of menopausal affection and added ovarian ills (Merck, 1899). Aptly named, Ovariin was fabricated by dessicating and pulverizing cow ovaries, and may accept been the aboriginal actuality commercially accessible for analysis of menopausal affection that was acquired from beastly sources. The aboriginal address account the use of ovarian extracts to abate vasomotor affection of menopause occurred in 1897 (Speroff, 1999). E1 was abandoned in 1929 (Butenandt and von Ziegner, 1930; Doisy et al., 1930), and in 1930 estriol glucuronide, which converts to E2 aloft hydrolysis, was abandoned from horse urine (Collip, 1930). Emminen, the aboriginal backup analysis to accommodate conjugated estrogens, was extracted from the urine of abundant women and became commercially accessible in 1933. In 1937 progesterone was acclimated to anticipate ovulation in rabbits, alpha the coursing for bankable progestins (Speert, 1980). Diethylstilbestrol (DES) was aboriginal marketed in 1939 as a far added almighty estrogen than Emminen, which could not be fabricated fast abundant to accumulate up with demand. Ayerst Laboratories began business Premarin in 1942, which would eventually become the cardinal one anatomy of estrogen backup analysis in the United States, and the estrogenic basic of Prempro, a aggregate of Premarin and Provera, which eventually became the best broadly dispensed biologic in the US.

Premarin was bristles times as big-ticket as the aggressive product, which led to an ad attack that marketed Premarin as an “upscale” analysis (Seaman, 2003). Initial advertisements for this drug, which would eventually become the best assigned estrogen therapy, showed women in a awful glamorized light, amidst by handsome men, blessed families, and accepting fun. This attack was successful, arch Ayerst to admit an educational affairs for physicians on menopausal affection and therapies. Premarin use skyrocketed in the 1960s partly due to the awful acknowledged “Keep her on Premarin” ad attack that alloyed absolutism with sexism, replacing the actual angle of menopause as a accustomed alteration with one of a amiss accompaniment to be advised for the blow of a woman’s life.

Excerpt from advertisement: The physician who puts a woman on “Premarin” back she is adversity from the menopause usually makes her affable to alive with already again. It is no accessible affair for a man to booty the stings and barbs of business life, again to appear home to the agitation of a woman “going through the change of life”. If she is not on “Premarin”, that is.

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Ironically, Premarin was placed on the bazaar one year afterwards letters suggesting that estrogen may account cervical blight in animals (Seaman, 2003).

References:Butenandt A, von Ziegner E., 1930. On the Physiological Effectiveness of Crystallized Female Sex Hormones in the Allen-Doisy Test. Studies on the Female Sex Hormone. J Phys Chem 188:1-10.

Collip JB. 1930. Ovarian aesthetic hormone of placenta. Can Med Assoc J 22:215-219.

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Doisy EA, Veler CD, Thayer SJ. 1930. Preparation of apparent ovarian hormone from urine of abundant women. J Biol Chem 86:499-509.

Greendale GA, Sowers M. 1997. The Menopause Transition. Menopause and Hormone backup Analysis 26:261-277.

Merck Manual Diagnosis &Therapy. New York: Merck and Co.; 1899.

Seaman B. The Greatest Experiment Ever Performed on Women: Exploding the Estrogen Myth. New York, NY: Hyperion; 2003.

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Speert H. Obstetrics and Gynecology in America: A History. Chicago: The American College of Obstetricians and Gynecologists; 1980.

Speroff L. Clinical Gynecologic Endocrinology and Infertility. 6th edition. Baltimore, MD: Williams and Wilkins; 1999.

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[nancygduarteus]

How Therapy Can Cure Overeating

Melissa Rivera always turned off the cameras before she binged. Newly married to a husband who traveled frequently, the 23-year-old med student, who had recently moved six hours from her friends and family, comforted herself with food. “I’d get this whole pizza that I would eat myself,” she says. Each time, she turned off the house’s security system so her husband wouldn’t see the coping mechanism she’d used since she was eight years old. “At some point, I realized, ‘This is killing me. I cannot do it anymore,’” she says. She sought help from counselors at the University of Texas, where she was a student.

Rivera suffered from binge eating disorder (BED), but says the school’s experts weren’t able to help. She says a school dietitian encouraged the very behavior that kicks off the bingeing cycle: restriction. “‘You have to eat so many grams of meat, you have to eat at most a cube of cheese per day,’” Rivera recalls the dietitian telling her. “I never did what she said.” Finally, at the end of 2016, Rivera searched online and connected with Edward Tyson, a local eating disorder specialist. But after years of struggle, she was skeptical about how much he could help. “Everything sounded like a beautiful promise, but it seemed impossible that he’d get me to this nice place that he was talking about,” Rivera says. “I’m happy to say that he did.” She has been binge-free since January.

One out of every 35 adults suffers from binge eating disorder, almost twice the combined rate for anorexia and bulimia. It is characterized by repeated episodes of eating large quantities of food quickly and to the point of discomfort; a feeling of a loss of control during the binge; and guilt following the binge, but without any consistent purging behavior. Up to 40 percent of people trying to lose weight suffer from BED and up to 70 percent of patients with BED are medically obese.

The good news is that BED is highly treatable, particularly with the help of cognitive behavioral therapy: Nearly 80 percent of patients abstain from bingeing after 20 sessions. And, unlike most calorie-restricting diets, the success of CBT holds for many patients over time.

However, a 2013 study in Biological Psychiatry found that less than half of lifetime bingers receive treatment. There are millions of overweight Americans who could find actual sustainable help with their eating issues—and not berate themselves for a lack of “willpower”—if more clinicians could identify the disorder and recommend treatment.

I suffered from the disorder myself from about high school until my early 20s. Ever anxious to lose a few pounds, I’d put myself on a strict diet, then eventually give in to temptation and eat as much as I could of whatever I could get—a whole pizza, cookies nabbed from someone’s pantry, a family-sized combo of General Tso’s chicken with fried rice and egg rolls. My mentality was that the next day I’d start the diet anew, so I “might as well” eat as much as possible since who knew when I’d ever have that food again. With many ups and downs, between the ages of 18 and 25 I put on nearly 50 pounds.

BED is an equal opportunity disorder, affecting men, women, young, old, and all races. However, the recent Netflix eating disorder film To The Bone is a microcosm of the short shrift BED is given in popular culture. The movie focuses on a waifish, big-eyed anorexic staying in a residential treatment home, zooming in to ogle one patient with a feeding tube and a bulimic who keeps a bag of vomit under her bed. The presence of BED is hardly acknowledged; one overweight character, Kendra, suffers from it, but she has only a handful of lines, and is otherwise unexplored, an unexplained jar of peanut butter her main companion. At one point, Kendra tries to join a conversation with fellow patients but a rude housemate shuts her down with “Sorry: This conversation is for rexies only.” Even though in real life the bingers far outnumber anorexics, popular culture seems far more fascinated by the idea of wasting away, as Sophie Gilbert explored in The Atlantic.

Part of the issue is BED’s relative newness on the mental health scene: It was only recognized as a formal diagnosis by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) in 2013. “People seek a level of care that’s lower than what they actually need and then they give up,” says Julie Friedman, a health psychologist at the Eating Recovery Center in Chicago. (I am a former patient of Friedman’s.) “Somebody who really should be in residential therapy goes to an individual therapist and they’re frustrated. They give up and go back to dieting. It’s like trying to treat cancer with vitamins.”

Successful treatment of BED is not always synonymous with dramatic weight loss, but eliminating the habit of consuming thousands of calories at a time on a regular basis typically results in modest weight loss. And even if it doesn’t, it’s still a major health improvement to cut back on the types of foods people typically binge on (like pizza or meaty breakfast sandwiches or ice cream), the sodium, fat, and sugar of which are hard on the body. “When you eat big volumes of food, particularly foods that are highly processed, which is what most people binge on, it causes a lot of stress on your body,” says Friedman. “The inflammation in your body affects everything from your cardiac status to your brain to your butt to your bones and your joints. It compounds any health risk.”

The psychology of addiction in BED patients is still being understood, but I remember, when I was in recovery, thinking how much easier it would be if I could go cold turkey on food. Unfortunately, bingers need their drug to live—which is why they need help modulating the way they think about it and use it. “Imagine telling a coke addict to take three large doses and then two smaller doses per day,” says Tyson—Rivera’s therapist from Texas. “‘Don’t take too much and don’t take too little.’ That is not willpower; that’s torture.”

No diet or exercise plan can fix the disorder: BED lives in the brain. “There does seem to be a difference in the brain of someone with binge eating disorder compared to someone who doesn’t have it,” says Jillian Lampert, the chief strategy officer at the Emily Program, a eating disorder affiliate of the University of Minnesota that provides residential and outpatient care. “They’re interested in food in a different way. If food is very interesting, you’re likely to want more. But then it doesn’t deliver on its promise, so we go back and eat more, because we didn’t get it right. It breeds this cycle where people overeat and feel compelled to overeat. They’re looking for the reward.” The way Lampert explains treatment to her patients is, “Your brain is wired a little differently from some people’s. It’s neither good nor bad, it just is. We can help you to have an owner’s manual and say ‘I remember on page 57 when I’m around this certain set of foods and I’m stressed out, it’s harder for me to make decisions around eating.’”

Michael Meginness didn’t acknowledge his BED until he had been at at Chicago’s Eating Recovery Center for over a week. The 35-year-old Ohio father of four figured that he was eating three meals a day, so he was perfectly fine. Except that his typical breakfast included two meaty breakfast sandwiches and a bowl of cereal. “My brain’s telling me ‘I’m eating three meals’ but in actuality I’m eating three meals per meal,” he says. Finally, he went to treatment after his wife gave him an ultimatum. After working with Friedman, he says, “I had a realization that maybe I do have an eating disorder. Going through the treatment was a new start.”

When Rivera met Tyson’s dietitian, she requested the structure she had been given at UT. “If you can give me a meal plan, that’s what I’m going to follow.” Instead, Rivera recalls, “She laughed and said, ‘That’s not the approach we’re going to take.’” For the first time, all foods were “legalized” for her—the only rule was to eat three meals a day and three snacks. “[The dietitian] encouraged me to eat protein, fat, and carbs every meal. ‘If you’re going to eat a donut and a sausage, I’m cool with that.’” De-restricting meals was a step toward stopping the restrict-and-binge cycle.

In therapy, Meginness worked on a strategy called “catching your thoughts,” he says. “When you have a thought, those are just thoughts. It’s what you do after that helps makes those decisions. I can treat it as the truth or treat it as the lie. Am I that hungry? No, I ate, I’m fulfilled. I don’t need to act on that, I can throw [that thought] out and move on.”

In therapy Meginness also addressed the difficulties in his marriage. “I had to prepare myself that when I was released, my wife might not stay with me and the kids. Could I accept that, and continue with recovery? It was really tough. [Friedman] was like, ‘You need to make the choice: Are you going to do this for yourself whether or not you go home to a family?’” Once he decided to pursue treatment no matter what, his wife recognized that he was choosing to treat his disorder. “Actually now we’re in a thriving marriage.”

Body acceptance is also a major part of BED treatment, says Lampert, especially in a culture that prizes the big reveal of “Half Their Size!” features in magazines. Her patients often say, “I don’t feel like I’ll ever be enough, so what’s the point.” But Lampert says, “You can accept your body and delight in what it does while you work on making it feel better. ‘I can take care of myself today: I don’t have to wait until I lose weight.’ Those small wins can accumulate into a mastery of ‘I can do this.’” Rivera inexplicably began to gain weight after she was in treatment with Tyson; eventually she was diagnosed with polycystic ovary syndrome, a hormonal disorder that can cause weight gain. Once that was under control, she started to lose weight again. If it wasn’t for the mental health foundation she had established earlier, she says, she may have given up. “Even though my body was changing to what I considered a negative, just being able to keep up with legalizing food and going to treatment gave me a lot of strength,” she says.

According to Tyson, a binger who stops the cycle will lose about 10 percent of their body weight. That’s not sexy enough for a reality TV show reveal, but it’s a significant health improvement, which can improve blood pressure and heart health. “It’s not a rapid 100 pounds, but what I tell patients is that the goal here is to feel in control. If you’re not eating 1200 calories three times a day during binges, will that drop your weight? Sure, but it’s not sudden.” For many bingers, weight loss is simply a nice bonus that comes with improving mental health. I may have lost 50 pounds since I first sought treatment for BED, but for me the major victory was being able to eat a cookie, or three, or seven, and let it just be that. It doesn’t mean I don’t deserve to exercise, or to eat healthily, to be loved or to love myself the next day.

So why isn’t therapy given the same amount of press as a weight loss tool that Whole30 and CrossFit receive?

First, says Tyson, clinicians need to catch up on BED in order to be the first line of defense for their patients. “If people know they’re not going to be treated like ‘Oh, another obese patient who is not going to do what I want them to do,’ that will decrease the shame,” he says. The poor success rate of calorie-restricting diets has been well-documented, and he is frustrated by physicians who continue to recommend them to their patients. He says that the arrival of the binge-cessation drug Vyvanse, a stimulant also prescribed for ADHD that Friedman says helps some bingers manage eating-related impulsivity, has helped raised the profile of BED (Tyson is on the drugmaker’s board), but he warns that clinicians must not recommend the drug alone. “As long as you also recommend the therapy and the dietitian, then they stay in treatment and they’ll see success.”

“In a perfect world we’d be screening people for their eating behaviors and not so much about their weight,” says Lampert. “Their behaviors would tell us more about the place where we make change.”

It doesn’t help that overeating isn’t always seen as a disorder. When I first began treatment I felt ridiculous admitting that I, a functional adult, could let my whole week be dictated by a bowl of tortilla chips and a pitcher of margaritas. Friedman frequently hears reluctant patients says things like “I don’t fit in—I won’t even fit into the chairs.” She says, “The issue is that people don’t associate people struggling with their weight with eating-disorder treatment. Their perception is really antiquated, all these anorexics needing to be fed.”

Sufferers of BED tend to be high achievers who can’t accept that they can’t just force themselves to stop through sheer willpower, which Tyson says is ironic. “These are patients who have done incredibly difficult things—philanthropic work, mission work, endured very difficult circumstances—so to say that it’s something about lack of willpower, that’s just not the profile of these people.”

The high functionality of most bingers points to another reason more people with BED don’t get the help they need: insurance. Friedman notes that she fights with insurance companies “every day” over patients insurers see as being too functional to receive psychiatric care. “They go to work every day, but then they come home Friday at 5 and spend all weekend binge eating, with no quality of life, no social support. When you’ve got an 18-year-old who can’t finish her first year of college—that gets authorized easily. But if you have someone who is suffering on their own time, that makes it really hard to get authorization for care.”

Lampert says that it takes a minimum of 12 sessions of CBT for a patient to see results, with the average length of stay at the Emily Program lasting a year to a year and a half. But that kind of help is not always accessible. Rivera had to pay out of pocket for her work with Tyson, which included medication for depression and ADD. She was paying $250 a month at one point for her prescriptions. Fortunately, her husband is an ER doctor. “If I didn’t have his support, I would never be able to afford treatment. I’m so grateful that I was able to get to this place but then I think how many people are there and they can’t afford it. They’re just being told how much self-control they’re lacking.”

Sometimes that stigma comes from the insurance companies themselves. “Usually when I’m asking for more intensive treatment, I’m told, ‘This patient can go to Weight Watchers,’” says Friedman, who notes that the current level of care criteria that insurers use are based on anorexia or bulimia. Insurers then say, “They haven’t lost weight, they haven’t thrown up, so they don’t need treatment.” She says therapists have been working to create a new criteria of care that addresses functional impairment and distress over weight.

I reached out to two insurers with whom Friedman and Lampert frequently work and both said that they cover CBT for eating disorders. A spokesperson for Optum said that binge eating disorder is included in that “when it is appropriate to meet [patients’] clinical needs and goals,” and a spokesperson for Health Care Service Corporation (which runs several Blue Cross Blue Shield plans) said “CBT is among the most common therapies for eating disorders and is supported by our Behavioral Health Program.”

Tyson hopes to hear more noise from groups like the Eating Disorders Coalition and the Academy for Eating Disorders to call for conferences to discuss better coverage. Friedman says that sufferers of BED should get comfortable advocating with their insurance companies for adequate care. “Patients will call and say ‘it’s not right that I’m not getting this care’ and insurance will listen to a patient a lot faster and more effectively.”

America also has a long way to come in terms of its indecisive attitudes toward diet and food. Don’t be fat, but also don’t act like you care about your weight too much. Meginness says that after treatment, he felt extra pressure managing his eating as a man. “Guys are expected to enjoy tailgates and all this man food and meats and not worry about portions.” When he goes to social occasions, he plans ahead what he’s going to eat, but he says, “It’s hard, seeing these other guys filling their plates two to three times. It makes me want to be like ‘Oh well, let’s just do it.’”

Without even going into weight management, Meginness lost 65 pounds by addressing his bingeing in therapy. Now, when he feels stress triggers at his IT job, he plays games on his phone or goes and plays with his kids. However, to him the weight is secondary to the biggest change in his life since he got treatment. “I used to yell and scream at my kids a lot. I wasn’t a very nice person. Now I’m more joyful, and I see that,” he says. When it comes to people like him and Rivera and me and everybody else like us, he says, “That’s what society doesn’t understand—they want a quick fix and get the instant gratification. If you find the root cause you don’t need Nutrisystem, AdvoCare, or any of the rest.”

from Health News And Updates https://www.theatlantic.com/health/archive/2017/08/how-therapy-can-cure-overeating/537537/?utm_source=feed

[ionecoffman]

How Therapy Can Cure Overeating

Melissa Rivera always turned off the cameras before she binged. Newly married to a husband who traveled frequently, the 23-year-old med student, who had recently moved six hours from her friends and family, comforted herself with food. “I’d get this whole pizza that I would eat myself,” she says. Each time, she turned off the house’s security system so her husband wouldn’t see the coping mechanism she’d used since she was eight years old. “At some point, I realized, ‘This is killing me. I cannot do it anymore,’” she says. She sought help from counselors at the University of Texas, where she was a student.

Rivera suffered from binge eating disorder (BED), but says the school’s experts weren’t able to help. She says a school dietitian encouraged the very behavior that kicks off the bingeing cycle: restriction. “‘You have to eat so many grams of meat, you have to eat at most a cube of cheese per day,’” Rivera recalls the dietitian telling her. “I never did what she said.” Finally, at the end of 2016, Rivera searched online and connected with Edward Tyson, a local eating disorder specialist. But after years of struggle, she was skeptical about how much he could help. “Everything sounded like a beautiful promise, but it seemed impossible that he’d get me to this nice place that he was talking about,” Rivera says. “I’m happy to say that he did.” She has been binge-free since January.

One out of every 35 adults suffers from binge eating disorder, almost twice the combined rate for anorexia and bulimia. It is characterized by repeated episodes of eating large quantities of food quickly and to the point of discomfort; a feeling of a loss of control during the binge; and guilt following the binge, but without any consistent purging behavior. Up to 40 percent of people trying to lose weight suffer from BED and up to 70 percent of patients with BED are medically obese.

The good news is that BED is highly treatable, particularly with the help of cognitive behavioral therapy: Nearly 80 percent of patients abstain from bingeing after 20 sessions. And, unlike most calorie-restricting diets, the success of CBT holds for many patients over time.

However, a 2013 study in Biological Psychiatry found that less than half of lifetime bingers receive treatment. There are millions of overweight Americans who could find actual sustainable help with their eating issues—and not berate themselves for a lack of “willpower”—if more clinicians could identify the disorder and recommend treatment.

I suffered from the disorder myself from about high school until my early 20s. Ever anxious to lose a few pounds, I’d put myself on a strict diet, then eventually give in to temptation and eat as much as I could of whatever I could get—a whole pizza, cookies nabbed from someone’s pantry, a family-sized combo of General Tso’s chicken with fried rice and egg rolls. My mentality was that the next day I’d start the diet anew, so I “might as well” eat as much as possible since who knew when I’d ever have that food again. With many ups and downs, between the ages of 18 and 25 I put on nearly 50 pounds.

BED is an equal opportunity disorder, affecting men, women, young, old, and all races. However, the recent Netflix eating disorder film To The Bone is a microcosm of the short shrift BED is given in popular culture. The movie focuses on a waifish, big-eyed anorexic staying in a residential treatment home, zooming in to ogle one patient with a feeding tube and a bulimic who keeps a bag of vomit under her bed. The presence of BED is hardly acknowledged; one overweight character, Kendra, suffers from it, but she has only a handful of lines, and is otherwise unexplored, an unexplained jar of peanut butter her main companion. At one point, Kendra tries to join a conversation with fellow patients but a rude housemate shuts her down with “Sorry: This conversation is for rexies only.” Even though in real life the bingers far outnumber anorexics, popular culture seems far more fascinated by the idea of wasting away, as Sophie Gilbert explored in The Atlantic.

Part of the issue is BED’s relative newness on the mental health scene: It was only recognized as a formal diagnosis by the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) in 2013. “People seek a level of care that’s lower than what they actually need and then they give up,” says Julie Friedman, a health psychologist at the Eating Recovery Center in Chicago. (I am a former patient of Friedman’s.) “Somebody who really should be in residential therapy goes to an individual therapist and they’re frustrated. They give up and go back to dieting. It’s like trying to treat cancer with vitamins.”

Successful treatment of BED is not always synonymous with dramatic weight loss, but eliminating the habit of consuming thousands of calories at a time on a regular basis typically results in modest weight loss. And even if it doesn’t, it’s still a major health improvement to cut back on the types of foods people typically binge on (like pizza or meaty breakfast sandwiches or ice cream), the sodium, fat, and sugar of which are hard on the body. “When you eat big volumes of food, particularly foods that are highly processed, which is what most people binge on, it causes a lot of stress on your body,” says Friedman. “The inflammation in your body affects everything from your cardiac status to your brain to your butt to your bones and your joints. It compounds any health risk.”

The psychology of addiction in BED patients is still being understood, but I remember, when I was in recovery, thinking how much easier it would be if I could go cold turkey on food. Unfortunately, bingers need their drug to live—which is why they need help modulating the way they think about it and use it. “Imagine telling a coke addict to take three large doses and then two smaller doses per day,” says Tyson—Rivera’s therapist from Texas. “‘Don’t take too much and don’t take too little.’ That is not willpower; that’s torture.”

No diet or exercise plan can fix the disorder: BED lives in the brain. “There does seem to be a difference in the brain of someone with binge eating disorder compared to someone who doesn’t have it,” says Jillian Lampert, the chief strategy officer at the Emily Program, a eating disorder affiliate of the University of Minnesota that provides residential and outpatient care. “They’re interested in food in a different way. If food is very interesting, you’re likely to want more. But then it doesn’t deliver on its promise, so we go back and eat more, because we didn’t get it right. It breeds this cycle where people overeat and feel compelled to overeat. They’re looking for the reward.” The way Lampert explains treatment to her patients is, “Your brain is wired a little differently from some people’s. It’s neither good nor bad, it just is. We can help you to have an owner’s manual and say ‘I remember on page 57 when I’m around this certain set of foods and I’m stressed out, it’s harder for me to make decisions around eating.’”

Michael Meginness didn’t acknowledge his BED until he had been at at Chicago’s Eating Recovery Center for over a week. The 35-year-old Ohio father of four figured that he was eating three meals a day, so he was perfectly fine. Except that his typical breakfast included two meaty breakfast sandwiches and a bowl of cereal. “My brain’s telling me ‘I’m eating three meals’ but in actuality I’m eating three meals per meal,” he says. Finally, he went to treatment after his wife gave him an ultimatum. After working with Friedman, he says, “I had a realization that maybe I do have an eating disorder. Going through the treatment was a new start.”

When Rivera met Tyson’s dietitian, she requested the structure she had been given at UT. “If you can give me a meal plan, that’s what I’m going to follow.” Instead, Rivera recalls, “She laughed and said, ‘That’s not the approach we’re going to take.’” For the first time, all foods were “legalized” for her—the only rule was to eat three meals a day and three snacks. “[The dietitian] encouraged me to eat protein, fat, and carbs every meal. ‘If you’re going to eat a donut and a sausage, I’m cool with that.’” De-restricting meals was a step toward stopping the restrict-and-binge cycle.

In therapy, Meginness worked on a strategy called “catching your thoughts,” he says. “When you have a thought, those are just thoughts. It’s what you do after that helps makes those decisions. I can treat it as the truth or treat it as the lie. Am I that hungry? No, I ate, I’m fulfilled. I don’t need to act on that, I can throw [that thought] out and move on.”

In therapy Meginness also addressed the difficulties in his marriage. “I had to prepare myself that when I was released, my wife might not stay with me and the kids. Could I accept that, and continue with recovery? It was really tough. [Friedman] was like, ‘You need to make the choice: Are you going to do this for yourself whether or not you go home to a family?’” Once he decided to pursue treatment no matter what, his wife recognized that he was choosing to treat his disorder. “Actually now we’re in a thriving marriage.”

Body acceptance is also a major part of BED treatment, says Lampert, especially in a culture that prizes the big reveal of “Half Their Size!” features in magazines. Her patients often say, “I don’t feel like I’ll ever be enough, so what’s the point.” But Lampert says, “You can accept your body and delight in what it does while you work on making it feel better. ‘I can take care of myself today: I don’t have to wait until I lose weight.’ Those small wins can accumulate into a mastery of ‘I can do this.’” Rivera inexplicably began to gain weight after she was in treatment with Tyson; eventually she was diagnosed with polycystic ovary syndrome, a hormonal disorder that can cause weight gain. Once that was under control, she started to lose weight again. If it wasn’t for the mental health foundation she had established earlier, she says, she may have given up. “Even though my body was changing to what I considered a negative, just being able to keep up with legalizing food and going to treatment gave me a lot of strength,” she says.

According to Tyson, a binger who stops the cycle will lose about 10 percent of their body weight. That’s not sexy enough for a reality TV show reveal, but it’s a significant health improvement, which can improve blood pressure and heart health. “It’s not a rapid 100 pounds, but what I tell patients is that the goal here is to feel in control. If you’re not eating 1200 calories three times a day during binges, will that drop your weight? Sure, but it’s not sudden.” For many bingers, weight loss is simply a nice bonus that comes with improving mental health. I may have lost 50 pounds since I first sought treatment for BED, but for me the major victory was being able to eat a cookie, or three, or seven, and let it just be that. It doesn’t mean I don’t deserve to exercise, or to eat healthily, to be loved or to love myself the next day.

So why isn’t therapy given the same amount of press as a weight loss tool that Whole30 and CrossFit receive?

First, says Tyson, clinicians need to catch up on BED in order to be the first line of defense for their patients. “If people know they’re not going to be treated like ‘Oh, another obese patient who is not going to do what I want them to do,’ that will decrease the shame,” he says. The poor success rate of calorie-restricting diets has been well-documented, and he is frustrated by physicians who continue to recommend them to their patients. He says that the arrival of the binge-cessation drug Vyvanse, a stimulant also prescribed for ADHD that Friedman says helps some bingers manage eating-related impulsivity, has helped raised the profile of BED (Tyson is on the drugmaker’s board), but he warns that clinicians must not recommend the drug alone. “As long as you also recommend the therapy and the dietitian, then they stay in treatment and they’ll see success.”

“In a perfect world we’d be screening people for their eating behaviors and not so much about their weight,” says Lampert. “Their behaviors would tell us more about the place where we make change.”

It doesn’t help that overeating isn’t always seen as a disorder. When I first began treatment I felt ridiculous admitting that I, a functional adult, could let my whole week be dictated by a bowl of tortilla chips and a pitcher of margaritas. Friedman frequently hears reluctant patients says things like “I don’t fit in—I won’t even fit into the chairs.” She says, “The issue is that people don’t associate people struggling with their weight with eating-disorder treatment. Their perception is really antiquated, all these anorexics needing to be fed.”

Sufferers of BED tend to be high achievers who can’t accept that they can’t just force themselves to stop through sheer willpower, which Tyson says is ironic. “These are patients who have done incredibly difficult things—philanthropic work, mission work, endured very difficult circumstances—so to say that it’s something about lack of willpower, that’s just not the profile of these people.”

The high functionality of most bingers points to another reason more people with BED don’t get the help they need: insurance. Friedman notes that she fights with insurance companies “every day” over patients insurers see as being too functional to receive psychiatric care. “They go to work every day, but then they come home Friday at 5 and spend all weekend binge eating, with no quality of life, no social support. When you’ve got an 18-year-old who can’t finish her first year of college—that gets authorized easily. But if you have someone who is suffering on their own time, that makes it really hard to get authorization for care.”

Lampert says that it takes a minimum of 12 sessions of CBT for a patient to see results, with the average length of stay at the Emily Program lasting a year to a year and a half. But that kind of help is not always accessible. Rivera had to pay out of pocket for her work with Tyson, which included medication for depression and ADD. She was paying $250 a month at one point for her prescriptions. Fortunately, her husband is an ER doctor. “If I didn’t have his support, I would never be able to afford treatment. I’m so grateful that I was able to get to this place but then I think how many people are there and they can’t afford it. They’re just being told how much self-control they’re lacking.”

Sometimes that stigma comes from the insurance companies themselves. “Usually when I’m asking for more intensive treatment, I’m told, ‘This patient can go to Weight Watchers,’” says Friedman, who notes that the current level of care criteria that insurers use are based on anorexia or bulimia. Insurers then say, “They haven’t lost weight, they haven’t thrown up, so they don’t need treatment.” She says therapists have been working to create a new criteria of care that addresses functional impairment and distress over weight.

I reached out to two insurers with whom Friedman and Lampert frequently work and both said that they cover CBT for eating disorders. A spokesperson for Optum said that binge eating disorder is included in that “when it is appropriate to meet [patients’] clinical needs and goals,” and a spokesperson for Health Care Service Corporation (which runs several Blue Cross Blue Shield plans) said “CBT is among the most common therapies for eating disorders and is supported by our Behavioral Health Program.”

Tyson hopes to hear more noise from groups like the Eating Disorders Coalition and the Academy for Eating Disorders to call for conferences to discuss better coverage. Friedman says that sufferers of BED should get comfortable advocating with their insurance companies for adequate care. “Patients will call and say ‘it’s not right that I’m not getting this care’ and insurance will listen to a patient a lot faster and more effectively.”

America also has a long way to come in terms of its indecisive attitudes toward diet and food. Don’t be fat, but also don’t act like you care about your weight too much. Meginness says that after treatment, he felt extra pressure managing his eating as a man. “Guys are expected to enjoy tailgates and all this man food and meats and not worry about portions.” When he goes to social occasions, he plans ahead what he’s going to eat, but he says, “It’s hard, seeing these other guys filling their plates two to three times. It makes me want to be like ‘Oh well, let’s just do it.’”

Without even going into weight management, Meginness lost 65 pounds by addressing his bingeing in therapy. Now, when he feels stress triggers at his IT job, he plays games on his phone or goes and plays with his kids. However, to him the weight is secondary to the biggest change in his life since he got treatment. “I used to yell and scream at my kids a lot. I wasn’t a very nice person. Now I’m more joyful, and I see that,” he says. When it comes to people like him and Rivera and me and everybody else like us, he says, “That’s what society doesn’t understand—they want a quick fix and get the instant gratification. If you find the root cause you don’t need Nutrisystem, AdvoCare, or any of the rest.”

Article source here:The Atlantic

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Kids with Diabetes Can Be Depressed, Too

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Kids with Diabetes Can Be Depressed, Too

We're in the final days of May — National Mental Health Awareness Month — and earlier this month, I shared my own personal struggles in dealing with depression and diabetes. But that was through my lens as an adult with diabetes. What about children and adolescent PWDs?

We all know that being a teenager is no picnic, and adding diabetes to the mix can sometimes be a recipe for disaster. And depression.

Studies show that adults with diabetes are at nearly double the risk for depression, and that nearly 30% of all PWDs also have depression. Nearly one in seven children with diabetes self-report having depressive symptoms, a stat that's nearly double the incidence in non-diabetic kids.

Raising children with diabetes is already a huge challenge, and we wondered about the added nuances of dealing with depression in a child or youth as opposed to in adults. So we reached out to two experts in the field: Sarah Jaser, a research scientist from the Yale School of Nursing; and Debbie Butler, a psychologist at Joslin Diabetes Center. Both offered some great advice and confirmed that depression in adults or children isn't really all that different than in older folks.

Although, sometimes depression can look like garden-variety irritation in those adolescent years, which makes the whole thing... even more difficult for parents trying to raise a child or teen with diabetes.

Depression > Diabetes > Attitude

We're all pretty familiar with the "vicious cycle" here: Not only can diabetes increase the risk of depression, but depression can also increase a variety of risks with diabetes. When diabetes management goes downhill, that can lead to hospitalizations from DKA or eventual D-complications, no matter what your age.

"It's important for parents to know that depression in youth with type 1 diabetes can have important medical complications," says Sarah Jaser at Yale.

Jaser is currently studying a group of adolescents with type 1 diabetes and their mothers to examine the relationship between diabetes and depression. In her study, adolescents who were able to cope with diabetes in a healthy way, such as using problem-solving strategies, have fewer depressive symptoms. But adolescents who use avoidance or wishful thinking in their diabetes have more depressive symptoms.

So what it boils down to is that denial doesn't work; what helps is having a proactive attitude about coping with bad days and setbacks.

Not Just 'The Blues'

How do you know if your child is suffering from true depression? Differentiating between "the blues" and clinical depression can be tough. Although diabetes management factors — like a high A1c — can indicate depression, there are plenty of other typical signs of depression that show in both kids and adults, including:

- Feelings of sadness, hopelessness, excessive crying or outbursts

- Losing interest in activities they enjoy, like sports or spending time with friends

- Low energy or exhaustion

- Having trouble sleeping or excessive sleepiness

- Changes in appetite, like eating more than usual or eating less

- Decrease in productiveness, like a drop in grades, cutting class or missing school

"It's also important to note that, in children, depression can show up as irritability rather than sadness," Jaser says.

Screening & Getting Help

Children, especially teenagers, are not necessarily the most forthcoming about asking for help. So what are some strategies for getting to the root of the problem with your adolescent?

Yale researcher Jaser suggests parents talk to the child about what they've noticed, in an interested but non-judgmental tone, i.e. "You've been in your room a lot lately, crying more than usual, not spending as much time with friends, etc." Hopefully this can open the door for the child to talk about how he or she is feeling without being put on the spot.

Somewhat surprisingly, the American Diabetes Association recommends screening for depression once a year, starting at age 10 (!) This isn't exactly new, as the ADA released this statement in a 2005 issue of Diabetes Care (along with many other recommendations for children with diabetes, if you're curious).

Jaser says that screenings should be done by a social worker or psychologist (folks who are professionally trained), but nurses or health care providers can also do the screening. It's obviously not the only way to catch depression, though. Thankfully many PWDs come forward to seek out a therapist on their own, like I did before being diagnosed with depression.

"Talk Therapy" Helps

Although medication can work for children with depression, both of our experts believe that counseling, or "talk therapy," is the best first step. They say the family is often very important in making the therapy successful, as well.

"I'm a firm believer in trying counseling first, and that if someone does go on medication, that they should continue to stay in counseling," Butler from Joslin says. "Even if medication works, you still have to cope with the same problems."

Professional diagnosis and treatment is always crucial when dealing with depression, in other words, the success rate is very low for people who just try to "deal with it on their own." And therapy treatments and medication are certainly not one-size-fits-all; they have to handled on a case-by-case basis depending on the severity of the depression.

There are also some good "non-clinical" ways to get emotional support for a child dealing with diabetes, like connecting and sharing feelings with peers. Nicole, a mom of a 13-year-old with diabetes who's had bouts of depression, wrote on the ChildrenwithDiabetes.com forum that one of the best treatments for her daughter came from friends with diabetes.

She wrote, "Try as I might, it will never be possible for me to understand what it is like to have type 1. This is where camp was a huge blessing for us... she was able to meet other kids her age going through the same things, experiencing the same feelings... and she learned that she will be okay."

D-Parents: Try Easing Up

For awhile now, psychologists and PWDs themselves have been advising parents not to be too hard on their kids and teens, and now the Yale group has evidence to support that.

"Our results suggest that parenting is related to depressive symptoms in adolescents — when mothers use a lot of lecturing or nagging in their interactions, adolescents report more depressive symptoms," Jaser explains. "Warm, supportive parenting is linked with better outcomes, but it can sometimes be hard to describe. The easiest thing for parents to do is to make an effort to praise what the child is doing well (e.g., 'you're doing a great job checking your blood sugar before dinner')."

In Butler's practice at Joslin, she's found that working with adolescents to find out what exactly they need help with can sometimes do the job when teens are feeling burned out. She says that other researchers have confirmed that parents "mean well, but the support often comes out in the wrong way."

"So (support style) is what a counselor can really help with," Debbie says. "It's a different formula for every patient, family and situation."

Jaser believes that it's important to make sure diabetes isn't always the focus of your interactions with your child. "I hear from a lot of kids and parents that the first questions parents ask when kids come home from school are about diabetes management, but kids don't want to talk about and think about diabetes all the time. If parents lead with questions about the child's interests (e.g., sports, music, theater, video games), then kids may be more receptive to later questions about diabetes management," she says.

No one likes to think about the possibility of complications impacting our lives at any point. It's, well... depressing! But clearly, clinical depression is one effect of diabetes that can hit us in the here and now and needs to be addressed. Kids aren't immune, and as the experts and PWDs like myself say, sharing is often the first step in addressing depression. So, if you've dealt with depression in your adolescent (or yourself) we would love to hear your experiences and advice for others!

Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

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