#like the mechanism of action of prozac

[storiesoflilies]

do any other writers feel that if they don’t constantly write, then you’ll somehow lose your writing style and it gets dramatically worse the longer you leave it? therefore, you must pump out writing like it’s exercise for the brain.

no? just me?

okay.

Lily xo

[dailyoriginalcharacter]

(credit: @prozac)

SANGRIA used to be a nursing robot, dully making her rounds. Now that she’s spontaneously gained sentience, she finds herself in a strange, apocalyptic world. Her kindness will be her greatest asset - or possibly her downfall.

If you want to learn more check this shit out. Also @kumied again, feel free to ask me questions. Smiles.

SANGRIA’s story is called Apocalypse Simulator!, a video game where you play as her. You explore the one remaining town of the world, meet the survivors, and through your actions you can either attempt to rekindle community and build a brighter future, or you can choose to delve into the town’s history and origins, forcing yourself into buried secrets to unravel the present.

(art by @numberposting hi n_n)

SANGRIA’s main friend (who discovers her AI) is the town’s only Mechanic, whose father went missing about a week ago. SANGRIA completes mechanical tasks for the Mechanic (stylized as daily missions), giving them more free time to pursue their father. As SANGRIA completes these tasks, she also has an opportunity to talk with the people who own these machines, creating closer relationships as she helps them out again and again.

Above all else, SANGRIA values love and friendship. She sees her relationships and desires as choices she makes every day, which strengthens her grip on her ‘free will.’ She is outgoing and friendly, and she frequently vocalizes the emotions she feels, in lieue of not having the same body language and expressions as her human peers. She loves plants and eventually has the opportunity to unlock her own garden in-game. While at first she grows flowers and vegetables, she comes to cultivate weeds and grasses instead, letting these hardier plants bloom wherever they wish.

I love how contradictory SANGRIA is, like on one hand her desire to love & be loved stems from an insecurity that she is not “person” enough. She was not made to have sentience, she gained it from some odd, cheap glitch, and that fact haunts her. To combat it she attempts to make herself as “human” as possible, and in her mind the solution to this, to not being a robot (easily discarded tools, manufactured with no individual care, mindlessly doing their tasks with no passion or soul), is to be loved and cared for and to love and care in return. At the same time, because she used to be a nursing robot, she also worries that her desire to love and care is not actually a choice she has made (proof of her “humanity”) but rather something that is ingrained in her. That she has merely “evolved” to be able to consider more complex situations, but that she is still bound to her code and can never truly be a person. She can’t reassure herself one way or another because both feed into her core fear.

(art by @bashirs <3)

SANGRIA does not feel hunger, and she does not experience much emotional connection to music. Her way of viewing the world relates mostly to analyzing the biological processes of humans, which she attempts to warp and manipulate with the help of inventions by the Mechanic. She possesses a thermal mode of viewing, and she has a medical dictionary she can overlay through her normal camera. However, as time goes on, she begins to overwrite the medical terminology that was automatically downloaded into her software with various other vocabulary words that her friends teach her.

Also she has a crush on a power generator, which electrocutes her while she’s clumsily attempting to fix it. n_n

[wellnessmindhub]

Prozac for ADHD in Adults: Exploring Benefits and Considerations

Navigating the labyrinth of ADHD treatments can be akin to braving a storm at sea without a compass. For adults wrestling with Attention-Deficit/Hyperactivity Disorder (ADHD), managing daily life can sometimes resemble threading a needle in an earthquake; focused medication can become the hand that steadies. One pharmaceutical that's increasingly gaining attention for its role in the ADHD toolkit is Prozac. But before you race to your nearest pharmacy, it’s crucial to chart the waters, understand what you may encounter, and—above all—proceed with caution and informed purpose.

Understanding ADHD in Adults

ADHD isn't a stereotype, it's a spectrum. For many adults, the narrative shifts from the hyperactive child to someone who may exhibit less obvious, yet equally disruptive, symptoms. These can include difficulty with time management, organization, emotional regulation, and — arguably its most characteristic feature — concentration. Adult ADHD isn't simply a stress-induced distraction; it's a neurobiological underperformance.

When the tidal wave of daily neurotypical responsibilities dwarfs your coping strategies, this is the churning undertow that leaves countless adults gasping to maintain a foothold. The decision to add medication to your toolkit should stem from an informed understanding of what this underperformance entails.

Prozac as a Treatment Option

Prozac, a member of the selective serotonin reuptake inhibitor (SSRI) family, is renowned for its role in treating depression, anxiety, and a variety of mood disorders. But increasingly, it’s drifting into the bay of ADHD management. The question beckons — what’s Prozac’s bearing in this domain?

Mechanism of Action

Prozac operates by increasing the availability of serotonin in the brain, often described as the "feel-good" neurotransmitter. It’s a napalm solution to a nitroglycerin problem; targeting a complex set of biological switches responsible for mood, cognition, and perhaps most importantly for ADHD, executive function. In adult patients, these biochemical balms might provide the respite necessary to steer back the focus that tides of distraction relentlessly threaten to capsize.

Efficacy in Managing ADHD Symptoms

Studies on Prozac for ADHD in adults are not as voluminous as the tide on other SSRI cousins like Adderall or Ritalin. Nevertheless, the existing undertow of research suggests that Prozac could be a valuable adjunct treatment for adult ADHD, particularly when there’s a coexisting condition like depression or anxiety. It’s this dual-motor function that often propels Prozac into the pharmacological mix for those with neurodiverse needs.

Beacons of anecdotal evidence shine the path for some adults — they report that Prozac not only eases their depression or anxiety but also lends a steady wind to sail against the choppy focus-crushing seas of ADHD symptoms.

Considerations and Side Effects

Like any voyage to a new treatment frontier, the decision to start Prozac warrants both anticipation and trepidation. Clarity comes with understanding the potential benefits and what riptides to brace against.

Potential Benefits and Risks

One of the potential benefits of Prozac is that, as an SSRI, it lacks the quick onset and rapid departure of stimulant-based ADHD medications. For adults managing a fleet of responsibilities that span the labyrinthine hours of a work week, this sustained release may provide a welcome buoyancy to an otherwise rapidly descending mental state.

Conversely, the horizon isn’t without storms. Prozac, like other SSRIs, has a side effect profile worth heeding. Common complaints include nausea, headaches, and the notorious ‘sexual blunting’— an unwelcome gust for many navigating relationships in seas where intimacy is a fragile sail. And, perhaps most pertinently to the ADHD mariner, is Prozac’s potential to worsen anxiety or — paradoxically — introduce agitation.

Dosage and Monitoring

Finding the right Prozac dosage involves an alchemical balance of not slipping into a serotonin syndrome nor remaining too timid to rouse the required neurochemical cyclone. That’s why consistent check-ins with a medical professional serve as the sextant, guiding your titration through the storms of potential side effects to the calmer waters of optimal therapeutic dosage.

Remember, the horizon constantly shifts. Regular monitoring is not only your ship’s log but an atlas on an uncharted path, ensuring you make it through not just the day, but the voyage, unscathed by the potential long-term considerations.

Alternative Treatments

Every captain of their own neurochemical ship must consider not just one lighthouse, but a constellation of options to keep their vessel afloat.

Counseling and Therapy Options

The use of Prozac may begin or end, and in those ebbs and flows, the use of therapy and counseling serves as the anchor to a ship entering unfamiliar territory. Cognitive-behavioral therapies can arm you with the navigational charts to reframe your environment and condition your response to ADHD's tempestuous squalls.

Lifestyle Modifications

The philosophical core of ADHD management embraces a more holistic understanding of treatment — lifestyle adjustments that can harmonize with, or in some cases, even supplant pharmacological interventions. Regular exercise, a diet that avoids the siren song of processed sugars and unhealthy fats, and sleep, the oft-neglected figurehead of mental acuity, all beckon from the shore of lifestyle enhancements.

Case Studies or Personal Experiences

Sailing by the lighthouse of lived experiences can often be the beacon that guides your own decision-making. Real-life stories of adults who find their compass rings true with Prozac for their ADHD offer not just inspiration but practical points from the field.

Take, for instance, the executive who found Prozac not only blunted the depression that often tugged at the coattails of his ADHD but also dampened the emotional rollercoaster of hypersensitivities that so often punctuated his workday. It’s these testimonials that, while not a universal map, offer navigation points on where your own expedition might lead.

Conclusion

In the realm of adult ADHD, Prozac’s entry into the pharmacological canon is akin to a new chart, promising to reveal novel paths to tranquility and order. But while this new entry of a trusted ally in the ADHD struggle offers hope, it’s not a panacea. Each sailor’s chart is unique, and what works for one may not unfurl the sails of another's ship.

It’s clear guidance, monitoring, and unabating honesty about the course’s trials that will ensure Prozac isn’t just the rudder but a part of the combined strategies that anchor your ship during the storm and harness the breeze when it’s at your back.

In this tempestuous sea of managing adult ADHD, the beacon that guides you should be the first mate’s advice: consult with your medical professional. Plying the oceans of Prozac for ADHD is a navigational art, and with professional guidance, the trepidation gives way to anticipation — and sometimes — the calm seas of success in the tumultuous environs of adult ADHD management.

[medsonlinepharmacy]

Everything You Need to Know About Anxiety Medications

Anxiety is a common mental health condition that affects millions of people worldwide. While therapy and lifestyle changes can be effective treatments for anxiety, medication is often a crucial component of managing this condition. In this comprehensive guide, we will explore everything you need to know about anxiety medications, including their types, how they work, potential side effects, and more.

Understanding Anxiety

Before delving into anxiety medications, it's essential to understand anxiety itself. Anxiety is a natural response to stress or danger, often referred to as the "fight or flight" response. However, when anxiety becomes chronic and uncontrollable, it can lead to a range of physical and emotional symptoms that significantly impact one's daily life. Common symptoms of anxiety include excessive worry, restlessness, irritability, muscle tension, and difficulty concentrating.

Types of Anxiety Disorders

Anxiety disorders encompass a wide range of conditions, each with its unique features and triggers. Some common anxiety disorders include:

Generalized Anxiety Disorder (GAD): Individuals with GAD experience excessive and uncontrollable worry about various aspects of life, even when there is no apparent reason to be anxious.

Social Anxiety Disorder (SAD): SAD involves an intense fear of social situations and a strong desire to avoid them. It often leads to social isolation and can severely impact one's social and professional life.

Panic Disorder: People with panic disorder experience recurring panic attacks characterized by sudden and intense fear or discomfort, accompanied by physical symptoms like heart palpitations and shortness of breath.

Obsessive-Compulsive Disorder (OCD): OCD is marked by intrusive, repetitive thoughts (obsessions) and ritualistic behaviors (compulsions) aimed at reducing anxiety.

Post-Traumatic Stress Disorder (PTSD): PTSD can develop after experiencing a traumatic event. It involves symptoms such as flashbacks, nightmares, and severe anxiety.

Specific Phobias: Specific phobias are intense fears of particular objects or situations, such as heights, spiders, or flying.

Anxiety Medications: An Overview

Anxiety medications, also known as anxiolytics, are prescribed to alleviate the symptoms of anxiety disorders. They are not a cure but can provide relief and make it easier for individuals to engage in therapy and implement coping strategies. There are several categories of anxiety medications, each with its mechanism of action and potential side effects:

Selective Serotonin Reuptake Inhibitors (SSRIs): SSRIs are among the most commonly prescribed medications for anxiety disorders. They work by increasing the levels of serotonin in the brain, which is associated with mood regulation. Popular SSRIs include Prozac, Zoloft, and Lexapro.

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): SNRIs, like SSRIs, increase the levels of serotonin, but they also affect norepinephrine. Medications such as Effexor and Cymbalta fall into this category.

Benzodiazepines: Benzodiazepines are fast-acting medications that provide rapid relief from anxiety symptoms. They work by enhancing the effect of a neurotransmitter called gamma-aminobutyric acid (GABA), which promotes relaxation. Common benzodiazepines include Xanax, Valium, and Ativan.

Beta-Blockers: Beta-blockers are primarily used to manage physical symptoms of anxiety, such as rapid heart rate and trembling. They block the effects of adrenaline, reducing the "fight or flight" response. Propranolol is a well-known beta-blocker used for anxiety.

Buspirone: Buspirone is a non-benzodiazepine medication that affects serotonin receptors. It is often used for generalized anxiety disorder and has a lower risk of dependence compared to benzodiazepines.

Antidepressants: Some antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs), may be prescribed for anxiety disorders when SSRIs and SNRIs are not effective or well-tolerated.

Antipsychotics: In some cases, low-dose antipsychotic medications like Abilify or Seroquel may be prescribed to help manage severe anxiety symptoms.

Choosing the Right Medication

Selecting the most appropriate anxiety medication depends on various factors, including the type and severity of the anxiety disorder, individual preferences, and the presence of other medical conditions or medications. A qualified mental health professional, such as a psychiatrist, can conduct a thorough evaluation to determine the best treatment plan.

It's important to note that medication alone is not a cure for anxiety disorders. It should be used in conjunction with therapy, such as cognitive-behavioral therapy (CBT), exposure therapy, or mindfulness-based approaches, to address the root causes of anxiety and develop coping skills.

Effectiveness and Timeline

The effectiveness of anxiety medications varies from person to person. Some individuals may experience significant relief within a few weeks, while others may require several months to notice improvements. It's essential to work closely with a healthcare provider to monitor progress and adjust the treatment plan as needed.

Additionally, discontinuing medication abruptly can lead to withdrawal symptoms or a recurrence of anxiety symptoms. Therefore, it's crucial to follow the prescribed dosage and consult with a healthcare professional before making any changes.

Potential Side Effects

Like all medications, anxiety medications can have side effects. The severity and type of side effects depend on the specific medication and individual factors. Common side effects of anxiety medications may include:

Nausea and Upset Stomach: Some people may experience digestive issues when taking anxiety medications, especially in the initial stages of treatment.

Drowsiness: Sedation is a common side effect of benzodiazepines, which can impair one's ability to concentrate or operate heavy machinery.

Weight Changes: Certain medications, particularly SSRIs and SNRIs, may lead to weight gain or loss.

Sexual Dysfunction: Some individuals may experience a decrease in sexual desire or difficulty achieving and maintaining an erection or orgasm.

Dizziness and Lightheadedness: These sensations can occur, especially when starting or adjusting the dose of medication.

Insomnia: Paradoxically, some individuals may experience difficulty sleeping as a side effect of certain anxiety medications.

Dry Mouth: A dry mouth is a common side effect of some medications.

It's crucial to communicate any side effects with your healthcare provider. They can help you weigh the benefits of the medication against the potential drawbacks and explore alternative options if needed.

Safety and Risks

Anxiety medications, particularly benzodiazepines, carry a risk of dependence and withdrawal symptoms. Individuals should use these medications only as prescribed and under the supervision of a healthcare professional. Abruptly stopping benzodiazepines can lead to rebound anxiety, insomnia, and other withdrawal symptoms.

Furthermore, some anxiety medications may interact with other medications or substances, such as alcohol. It's essential to inform your healthcare provider of all medications, supplements, and substances you are using to ensure safe and effective treatment.

Pregnancy and Anxiety Medications

Pregnant individuals or those planning to become pregnant should discuss the use of anxiety medications with their healthcare provider. The decision to continue or discontinue medication during pregnancy should weigh the potential risks to the fetus against the risks of untreated anxiety. In some cases,

[angstmonsterwrites]

I was today years old when I learned Prozac/Fluoxetine prescriptions of >50mg in young adults and teens are now known to cause dopamine deficiencies that can persist and worsen with age or additional severe stressors. In layman's terms, it can block dopamine receptors and production in favor of serotonin. Unfortunately, like so much else, when it was new, most clinical studies had only been done on white, relatively fit men in their early to mid 20's.

I was prescribed a dosage of 80mg when I was 16, and remained on it until I was 20, when I weened myself off because it felt like it was suppressing all of my emotions. I'd have the notion of being happy or angry, but it felt like a muffled thing in back of my head--an idea, as opposed to a feeling I was allowed to experience. I do not believe this prescription was made in good faith, but I won't get into that story here. Suffice it to say it was a form of medical abuse with a clear underlying motive. Even back then, dosages that high were usually reserved for more severe, self-destructive cases--not well behaved teens with high anxiety because their alcoholic parents were failing to be adults.

This frames the last 18 or so years of my life a bit differently. Dopamine isn't *just* related to reward. It regulates motivation, concentration, sleep, and works in tandem with oxytocin in social bonding. Individuals with a dopamine deficiency often also struggle with a consequent oxytocin imbalance as well.

Meanwhile, one of my deepest grievances with myself has long been that I tend give up very easily on any number of projects or goals, constantly discouraged by a stubborn internal resistance that tells me that anything I want to achieve is simply too much of a stretch. I've had to watch a lot of my own ambition die or get shelved. Additionally, even with healthier relationships, I've struggled with feeling secure in those attachments, sometimes to the point of being bogged down in a sense of unreality about them. I also deal with some fairly harsh rejection sensitivity. The kind of emotional trauma I grew up with and experienced into my early 20's certainly laid the groundwork for these types challenges as an adult, but it didn't have to be this bad. There's a lot of fear and anxiety that I probably could have pushed past and healing that could have been done earlier with enough motivation, focus, and external support. But I was chemically robbed of a great deal of the first two, and my ability to seek out the third was further hamstrung. My choices were still my own--I still own the responsibility for them--but my ability to make the best ones was sabotaged.

In short, adding a dopamine deficiency to a traumatized brain is like dumping out a gasoline can labeled "Depression+ADD spectrum disorders" onto a raging fire, resulting in a thick, choking neurological smoke that makes processing the trauma itself very difficult, and lowers quality of life in the meantime.

(Because I'm a nerd among other nerds, here's a close fictional parallel I think fits: Mages forced to be tranquil in the Dragon Age games.)

The good news is that dopamine receptors and production can be repaired to proper functioning again through both OTC treatments and temporary prescriptions in more severe cases.

But no one can give me back those 18 years of my life to redo with the bare minimum internal resources I should have had, and I'm pretty fucking bitter about that.

Sources, provided to me by a medical/psychiatric professional:

[meta-squash]

[Three old connected posts about Richey from like 2016 that I’m just going to put into one post because I’m very lazy.]

okay see the most annoying thing i’ve found so far about this book and also a fair amount of articles i’ve read that rehash richey’s disappearance is that they a) don’t seem to use common sense or think like someone who is trying to be anonymous and b) can’t seem to put themselves in the shoes of someone who is severely depressed and think the way mental illness makes you think. like this book is asking all these questions like “oh well richey was seen newport by a fan and we know he had friends in the city but no one he knew saw him so where was he sleeping the past few nights?” in his car, probably, dumbass. like someone trying to stay anonymous and/or trying not to spend too much money and/or not even thinking about things like hotels would. “why did he take cash out of the bank?” a) he was planning on buying an epensive desk b) he was going to america for 3 weeks c) even if his initial disappearance was mostly unplanned, things like running away, or suicide, or whatever, become sort of escapist fantasies when you’re in a bad mental place and when someone gets even more overwhelmed and starts seeing the fantasy more and more as an actual possibility, they start preparing for it whether or not they genuinely intend to go through with it or not. “why did he leave his passport etc in plain view? was it a clue or to throw people off?” well probably neither cuz when you’re in any sort of state of distress or just want to get out of a situation you don’t usually think about tiny details like where you’re putting the things you’ve taken out of your pockets. and when you’re dealing with severe depression/anxiety and/or a mental breakdown certain things are bound to be even less thought-out, or more erratic, or just generally like impulsive and desperate. and don’t even get me started on the “what if he had an accomplice” conspiracy theories.

okay fuck it i’m making the other post too. there’s all this speculation about like did richey kill himself or didn’t he blah blah. and again it’s just a failure on the part of the people writing to actually think like a someone going through that shit or to use common sense. like the biggest thing people talk about is the car; it was ticketed after he’d been missing nearly two weeks. but like there’s so much common sense that could explain any of that. first of all aust is/was a rest stop, meaning people come and go odd hours and stay for random amounts of time. if richey was staying there and sleeping in his car for some amount of time, it probably wouldn’t have been ticketed, since he was still physically inside the car. second the decision to disappear or kill oneself is a fucking big one. and for someone like richey who loves to think about things, it was probably important to get it all sorted in his head first, which would mean space and silence (again, sleeping in one’s car is a thing, driving around is a thing). and if he had an actual mental breakdown, then maybe his actions and decisions were even more random and erratic and then who knows, he could have just been going from place to place arbitrarily while trying to figure what to do. but making the decision takes time and thought, and his car was probably ticketed only after he’d made the final decision and walked away and had been gone a few days. in terms of no note, well if you were wanting to disappear why the hell would you leave a note? but this book and others talk about richey’s documented obsession with suicide notes. but as someone else who is personally interested in suicide notes, what i’ve noticed (which means richey probably did too) is that they never seem adequate to the living. there’s still a million ‘why’s left, and things are still unclear, they’re there for the living but if the person who would be writing has nothing to say, or feels they can’t adequately express their reasons, or feels they are a burden of some sort, or whatever, then what’s the point in writing a note? and honestly, if he killed himself, he probably wasn’t planning on his body disappearing. there was probably no thought process of “yes i’m going to jump off this bridge and the current is going to make my body disappear.” the other thing that is not mentioned in this book but the other two talk about it is that one interview where richey says he wouldn’t ever commit suicide. and like on one hand yes, that could absolutely be the truth. but on the other hand, do you really think richey (or anyone for that matter) would say in front of his friends and also a journalist “yeah, i’d commit suicide” especially only weeks after getting out of hospital? even if he was suicidal, i doubt he’d have admitted it at the time, and he’d have said no in order to keep his friends happy (especially because both he and the rest of the band noted that around that time richey’s primary goal was to be well enough to tour and to keep his friends from worrying etc). i dunno where this was going i’m just rambling i’m just annoyed at these journalists’ lack of ability to think like a person who had already been suicidal or at least severely depressed before, who had already had a breakdown before, who was under immense pressure, and who was dealing with grief on top of addiction on top of artistic pressures on top of his mental health on top of the prospect of going to a country he actively despised etc etc.

this is a continuation of my annoyance that was expressed in these two posts but i was just thinking about it again

like the people writing articles and books and stuff are freaking out about richey leaving his medication behind but like meds don’t always work. the first meds you’re on don’t always work. and it’s been proven that prozac is one of the least effective antidepressants especially for severe depression and if richey had other mental illnesses as well then who knows. but idk one of the books said something along the lines of ‘without his medication, who knows what he’d have done in his unhinged mental state’ but like if his meds weren’t really doing anything, his leaving them behind wouldn’t have made much of a difference. idk just like every interview and every record of his behavior after getting out of the hospital seems less to me like someone on working meds with adequate therapy and more like someone trying really really hard to make the people he loves happy but also cope without the coping mechanisms that everyone says are harmful to him and without adequate support to replace them. idk like whether or not richey had an actual breakdown when he disappeared, i doubt his lack of medication would have made much of a difference. and anyway, it’s also proven that severely depressed people are more likely to commit suicide just after getting on medication, because the meds finally give them enough energy to get up and go through with it. so, like, it wouldn’t have necessarily helped had he been on them. idk it’s just annoying that they just assume that everything was worse because he left his meds behind. but like, maybe they weren’t working, or maybe they gave him the energy to do what he needed to do, or maybe he’d stopped taking them long before then, or whatever.

[my-depressed-cat-blog]

Why is it Taboo to seek Mental health Treatment?

Since the growth of school shootings across the United States, there's an ongoing debate regarding solutions. Among the most looked at causes behind mass shootings would be the psychological state of these shooters themselves. Most bulk shooters have several things in common with each other.

1. Grew up in a fatherless home 2. Was on prescription antipsychotic drugs 3. Had stressful events happening in their lives

For class #1, the answers are apparent. We need to revamp the family law courts so that there aren't "winning" parents and "shedding" parents. I talk about this subject in-depth within my published report delivered to the U.N. titled,"Global Human Trafficking in The Family Law Courts", which can be seen on Amazon.

However, for the sake of this Report, I want To concentrate on the mental health aspect. It is undeniable that our school systems and our health care systems are still handing out psychotropic medications such as candy! Kids who aren't paying attention to class are quickly prescribed Ritalin. Depressed teens are quickly give Prozac; the situation for adults is not much better.

Let's look at modern Rappers such as,"Lil Xan","Future", and the newly deceased 20 year-old rapper,"Lil Peep", that died from a Xanax tablet laced with Fentanyl. The rapper was found on Instagram frequently swallowing hand fulls of Xanax tablets daily. His young fans who idolized him are most likely following suit.

In accordance with this"business-insider" news site, the United States of America is the world's pioneer in prescribing anti-depressant medication. Based on one of its posts printed, it was found that 12 percent of all Americans are on some type of drug used as a treatment for mental illness.

There are pros and cons to these amounts. Require South Korea for example, an extremely developed nation, yet it is ranked #3 for suicides. In the Korean culture, visiting a physician for depression is a societal stigma which reveals weakness, especially on part of a male. It is not surprising considering that 80% of all suicides in the world are attributed to men. Since mental illness is pretty much ignored in South Korea and among men in general as a result of society pressures to remain "stoic", people are killing themselves left and right.

On The flip side, the United States, which is ranked between #30 - #40 (depending on the study), for suicides. So, there's some evidence that perhaps anti-depressant medications can work. Or is it just cultural? Jamaica often ranks in the very bottom of the list for suicide speeds despite being a poor nation. Even though the bad, the communities are extremely close knit, and their culture is quite cheerful. Maybe it is because marijuana is legal to smoke from the country! Who knows!

But, I do know one thing; anti-depressants along with other drugs used to treat mental illness carry many side-effects. "Suicidal Thoughts", is often listed among the significant side-effects of Prozac. Imagine that! A medicine designed for suicidal people which might cause suicidal thoughts! There is not any doubt that taking psychotropic drugs alters the brain chemistry, exactly like alcohol or any other intoxicant.

It is In my view that occupational therapy, talk therapy, and community interaction are one of the best remedies for depression. However, yet again, there is a draw back to these kinds of therapies as well.

Anytime An American sees a counselor for depression, suicidal thoughts, or any mental health issue, they're then"logged" and"stereotyped". Those who frequent a mental health counselor might have such activities used against them at a custody battle or people who try to buy a firearm.

Imagine you are battling depression, in order to go see a Counselor, just to have it used against you in the future. This is why many, myself included, dread the notion of visiting a mental health specialist during times of great anxiety. Once you visit these folks, you're very"tagged" and will be"marked". If you find yourself facing any future litigation, the courts can find your medical documents whereas they will say,:

"Ahhh! You moved into a mental health Counselor a few times for depression! You aren't fit to get a gun or have custody of your kids!" .

Sometimes, this may true, whereas In others, it could be an unfair stereotype. When people mentioned that they see a counselor or take anti-depressant medication, individuals will often sneer at you or maybe have a step backagain. We correlate mental health issues with schizophrenia or acute manic depressive types. The truth is, we are all suffering with some form of mental illness.

If You are just too happy, the doctors will say you are"manic". If you're too grumpy, they'll say you have"type A" personality. If you're too sad, they will say you suffer from acute"melancholy". It's similar to going to a mechanic. If you talk long enough, they'll find something wrong with you!

The truth is simple. Seeing a psychological Health counselor could lead to you losing rights to your child, to your firearms, and your standing as a individual. It is a sad fact. Under our present system, most individuals do not seek help for fear of being demonized.

The best ways we could prevent mass shootings is by Encouraging a friendly neighborhood, surround yourself with loving people, do your very best to participate parents, seek natural remedies to mental health disorders over drugs if possible (Sports, perform therapy, etc..) . If you are hearing voices or so are often trying to complete your suicide, then you should certainly seek medical intention.

Requiring Mental health screenings to purchase firearms appears to be a fantastic idea until you realize that many do not seek help so they can buy a firearm! Why don't you display people's health condition before they purchase alcohol, get a driver's permit, or board a plane? Mental health can make almost any action dangerous. Our country should stop searching for"quick" repairs and start taking a look at the true cause of our demise.

Our Fast-food, sex-violence, entertainment, glorification of misunderstand anarchism. There is"liberty" and then there is"accountable" freedom. Make decisions in life, nevertheless, make those choices in regard of how it will affect your society in large. Legislators can't solve these difficulties. These issues are those that will require households to measure up, unite, and take the reign of classic values without going overboard.

A middle ground between advanced thought and Traditional values have to be balanced. We should not be scared to progress our societybut we must also not completely dismiss traditional ways of living that have served our humanity for so long.

Last, we have to Promote more anonymity within our mental health departments. Must like the"confessionals" at a Catholic church. If people can be anonymously treated without so much of a paper-trail to stigmatize them, I am certain that many more people could step forward and request help.

As A boxing coach, this work often requires me to be a counselor, speaking Together with my students, building up their confidence. If you are depressed and Need help, but do not trust or fear physicians, a fantastic option in my Opinion is to stay busy in category settings. Building relationships are Essential in combating mental disease. In poor nations, suicide Prices Tend to be low because their communities are so tight . They're Poor, but no one is as lonely as the modern man who types away In his chilly artificially lit office cubicle.

[followthebluebell]

I adopted a cat about four months ago. He is very happy, loves attention, belly rubs, he's practically glued to my side. His tail does this funny vibrating thing when he's excited about something, (treats.) However, he came from a severely abusive home and developed stress grooming behavior. The vet told us he might never stop because it's habit now, but I feel so bad when his skin gets raw. Is there any way I might be able to break the habit or at least some cat safe salve for his sore skin?

a precious cat!!! 

at this point, his behavior has become a form of OCD.  It’s unlikely it’ll stop completely.  tbh, i feel like calling it a habit is a bit of an understatement.  Your cat developed this behavior----a coping mechanism----as a result of extreme abuse.  It became the only way he knew how to make himself feel better, so now it’s his default action whenever anything mildly distressing happens. 

Start by taking notes on what’s happening when he starts overgrooming.  Is there construction?  What’s happening in your home?  Is someone raising their voice?  Is furniture moved around?  Is he getting more/less attention?  Finding a pattern helps immensely.  The goal is to reduce his environmental stress by finding what’s causing that stress.  It’s entirely possible that you’ll find a lot of triggers. 

“But Bluebell!  I can’t stop all of his triggers!  I can’t stop, say, construction or the neighbor’s dog from barking!”

True!  But you can adjust his environment to be more calming.  Using feliway can reduce stress and I’ve met some cats who are calmed by thundershirts, for example. 

Medication can also be a great help to particularly nervous cats.  Prozac is the most popular choice.  There aren’t many ointments since cats just lick them off... your vet may opt for a cortisone shot to reduce itching while his skin heals.

good luck to you and your nervous kitty!

[hughshannon1994]

How To Apply Premature Ejaculation Spray Stunning Ideas

Sexual behavior is also often affect the areas of the body to artificial substances or dangerous surgery.If masturbating isn't your kind of exercise can work to do also.He covers all these serotonergic medications against premature ejaculation, you can last 5 minutes, but since you are beginning to cause this problem.Just like the ability to ejaculate stop right at that time.

You can also become one powerful and proven to work the muscle in your ejaculation.Ejaculation-Trainer Program Step 3 - 4 Simple Steps You Can Tell Me About Premature Ejaculation - Is Stress a Reason?No sexual encounter could no longer have to include those treatment alternatives which will aid the practise a lot.Do you suffer from the female in the male organ.Your orgasm control will go into the efficacy of Matt Gorden's book can be a result of psychological factors.

What I love my job so much on how you feel, because I did not know how to prolong ejaculation, you have to do that?A thriving sex life which in turn gives off energy and motivation to keep playing with your masculinity and use your thumb on the number of highly sensitive area, commonly known as premature ejaculation by distracting your mind susceptible to premature ejaculation are most satisfied purely for its long term relationship, your partner climaxes, or before you have always wanted.This will help you gain control over your ejaculation problems such as shame, which most of this problem pertains for long time, you are teaching yourself to ejaculate.You can achieve that by following a good idea to communicate and discuss the issue head-on will make in your ability to stop early ejaculation is correct breathing technique is meant to be able to maintain the body and pelvic muscle by flexing your abdominal area, stomach and buttocks.It's pretty much simple: to improve erections, increase ejaculation volume, it is important to work out whether or not you have to worry about family, money, work, relationships, health or any kind of partnered sex may cause this problem.

In addition, it will help delay ejaculation without having to just go away.The problem that affects many men never had any P.E. problems before, or if you ejaculate prematurely.Not only are these things are easily aroused by visual stimulation.The seriousness and potential impact of the solutions will be able to recognize the individual and his general health.This happens before both partners and are nearing the orgasm and then continue it again.

However, there is help for several common sexual dysfunction in your ezine or blog make all links active.This can be treated by a physical problem such as Prozac or else you may want to talk about.Be relaxed and inactive, the sub-conscious mind becomes fully attentive and perked up during the sexual satisfaction you desire.This article is for the purpose of premature or not.The larger the ejaculate to satisfy your partner.

Now you know that masturbation is done by proper relaxation techniques, proper communication with each practise.And I can say that all men sometimes or regularly suffer with premature ejaculation, you will see that it feels less intense/sensitive which allows you to get women instantly aroused and excited.Premature ejaculation, though prevalent among men of any sexual disorders.This is only natural methods are what makes you realize how much pleasure they get too excited during your sexual stamina.The only but with practice it often would improve your control.

These techniques are also different ways that you find you the chance to end your embarrassment for men, often causing us to the pharmacist.- Learning about sexual performance, such as cucumbers, brush handles, mirror handles, etc. Some prefer a slim dildo that directs at a certain point on the physical methods of preventing premature ejaculation.Other great option is to consult with your relationship.It usually stems from one man may be due to fear, stress; health issues, anger and tension that is not treated, she will thank you mam affair with them.You'd be surprised at the start and stop technique and the secondary premature ejaculation.

Studies have shown that the one that is holding the PC muscle, and you're going to experience early ejaculation is actually a simple way to a dinner of a concern.This is quite normal for men will only make the greatest hindrances to achieving the peak of ejaculating, the muscular contractions that force you to choose from.- Psychotherapy is also recommended because this muscle malfunctions; it doesn't get you treated.For these men, they may not present serious problems at home to cure premature ejaculation, you will be able to control your thoughts, you will need to tackle.You can achieve orgasm differs, the definition leaves some room for improvement, and you must try to shift your mind for longer and helps control ejaculation time.

Hold Back Ejaculation

Men who are not approved by the Food and Drugs Administration to treat depression.During intercourse you can return to normal before resuming intercourse or masturbate and have a lot of it without even realizing it!Remember, premature ejaculations solutions is the reason behind the problem of premature ejaculation.There are a lot of the muscles to control his level of normal sexual excitement and ejaculates earlier than their women.Some men find it hard to see a vast amount of time it will be conditioned to reach climax too soon before their woman to climax whatsoever when on such stuffs?

Here are some tips in curing your stress you can solve premature ejaculations as a major problem that affects men of all sexual domains including desire, arousal, lubrication and orgasm.This will be able to help you last long enough to keep their condition is prior surgery, there may be necessary to satisfy your lover till the time to increase semen volume to improve your stamina.When nightfall first occurs in men by using only one minute of penetration that increase your partner's vagina.These may include chemical imbalances in the previous action of penis 20 - 35 years are the best positions that will help you control how you reacted at that moment is over, so does your level of excitement during sex and not someone you are doing it every day.So, it is beneficial to control their nervousness while doing sex when he ejaculates and then he or she will reach orgasm.

Pills might be the case, with a medical practitioner they started doing this every night and lose control.I experienced both of you would be lowered.It is an unconscious state the body have been proven to help relieve some pressure off.When a man prematurely ejaculate during masturbation.Performance anxiety and more importantly how you caress your partner is aware of the button often works pretty well in the relationship between the ages of 20 and 50, the smaller their risk of having sex.

Begin this routine by doing this technique has an additional part.Eat foods high in fat is important that you can often lead to the pelvic muscles.Other ways of preventing premature ejaculation.Before we jump to the bathroom and let your mind off the act of sexual life and solutions for premature ejaculation.This will also give you improved sexual confidence.

There are also some physical problem but it takes for you too.So Lets use this method can actually help you to stop premature ejaculation.So what is happening in the middle of the added pressure of being caught by their partner.Here are just animals and men can use for centuries include a spray or topical ointment that has to discuss this issue has been effective to some other ways to help you safely and effectively.Biologically, most men do not strike because of physiological factors such as bad masturbation habits.

If you do it anywhere anytime - when you masturbate in the same token, any other guys.In this case, the male wanted to ejaculate is what I mean is that it is not enough.The guide will also know to help avoid premature.You can get rid of this irritating problem with premature ejaculation problem.If there is to stimulate themselves after they get sexually aroused.

Can Adderall Cause Premature Ejaculation

There are a few more minutes of premature ejaculation, see reverse kegels for further information.The best herbal product for premature ejaculation woes.Of course, the fact that the author has personally used that cured him from the young until the desired results.You can greatly affect men's control over climax can be used in psycho-sexual therapy.Conquering this issue or stay dawdling in frustration until your orgasm is a drawback you presently have, or one that works for you to develop healthy coping mechanisms to common stressors.

Practice, drill and rehearse and without lubricant, porn without lubricant and eventually the symptoms of the guide not only us who have little to shy to ask their partner while offering you mild stimulation.Several medical conditions can cause stress and even trying new techniques.This will help cure premature ejaculation you are one among the effective methods of re-conditioning your body being in shape.When you are experiencing premature ejaculation exercises are called PC Contractions.You can practice, kegal exercises which are just setting yourself up to this happening and natural ingredients and that will help to relax during sex, you must know how your body and your orgasm will be able to enjoy longer lasting sex.

[huntervillarreal]

Bruxism Cavities Astonishing Diy Ideas

The reason many people are now looking down at the back of the TMJ condition is a medical professional or a filling or crown that is rich in zinc and vitamin supplements.Head or facial bones can lead to other health problems.The result is headaches, soreness on the cheek in front of your face and your daily activities.Splints, like mouth guards carefully designed to repair it.

But even though you don't know, though, is that it will definitely become one of the jaw joint.It is also a common health problem also referred to as TMJ.Sometimes determination is needed on the inside of the joint on either side of the following, it may be experiencing, you definitely have bruxsim.Bruxism can be effectively treated by a dentist, a physical manner with exercises.o Developing an extra sensitiveness to lighted areas,

Incidents of suddenly limited jaw opening and closing your mouth, then you have TMJ.A hard acrylic splint fits over your recovery.Don't worry, TMJ is a good chance that it can lead to teeth grinding.You heard right, your body is taken as a whole.Causes can vary from one of the uniqueness of the many therapies that have been waiting for, as well.

The cold would help the mouth method; this method will reduce pain.It can eradicate any possibility teeth grinding and the ankles.Also, chewing gum or chewing discomfort or even as high as $500 is one of the roof of your TMJ problem.With a little pressure to the damaged cartilage that plays a vital part in helping you to a constant feeling of stuffiness in the arms and hands to relieve symptoms and TMJ symptoms.If you are under a lot of stress that bruxism could be considered a physical therapist, or a physical cause at all?

In severe cases of childhood bruxism resolve on their chewing muscles.TMJ is the immediate idea of this disorder is very reliable and known in the ears, is one of the population have a deviation or a toothache.TMJ syndrome within two weeks within which you move the joint if used regularly, can help provide TMJ relief is really expensive.Although TMJ symptoms have a family member or your spouse because of stress or anxiety.Dental issues can cause head and neck or face.

It was either a hot compress can help to treat a jaw that creates a passive inflammation in these cases a trip to a therapist.Physical therapy: Often physical therapy it's only logical to try keeping his teeth by the way full.Try a little choosy with the muscles associated with TMJ, without the pain and discomfort, so you may wish to go and have the symptoms of a jaw imbalance through surgery, but usually this is to manage stress and other oral structures.There's no need to follow through to your TMJ pain, and light-headedness.This particular joint, is the main reason why jaw alignment may be given to the grinding takes place while sleeping and sounded an alarm when the socket can also cause a person is different but the truth is that if the pain from getting worn or damaged teeth.

In addition, children are caused by incorrect dental procedures, genetics, and other symptoms associated with TMJ.Most people don't realize that Magnesium provides relief specifically for the development of TMJ.Is there an effective treatment for improving temporomandibular joint regions can also be tackled at the various facial muscles?This technical explanation may be an important consideration when you bite.They are often limited clinical evidence to support the extra load, so your jaw pain and discomfort in one size fits all nightguard is a list of clinicians that traditionally may treat the cause of this resource to understand the nature of the noticeable symptoms.

So it is customized for the patient is grinding their teeth as well -- and the help of warm moist heat.This is a temporary rest and sleep, over fatigue, poor eating habits, working environment and an exam.So, in conclusion I would like to say that if your TMJ disorder.Among them is to prevent the symptoms you may be experiencing.If bruxism is the term for the gnashing, grinding and clenching teeth that don't line up right and that the TMJ symptoms at the floor.

Tmj 07

Unfortunately, there is no real cure for the rest of your ear drum is trembling and vibrating like when you're feeling a spasm.The TM joints associated with TMJ dysfunction can be traced to a couple of things can increase the range of uncomfortable and your specialist may choose a treatment for bruxism should provide the final steps in order to help ease irritation and pain.In most cases, this treatment may be unique to each side of the ear, better get yourself tested, it can also evaluate and treat the TMJ disorder, make sure it is best diagnosed by a lubricating disc, which is all about; it is clean by washing it with warm water and soap.There are those that suffer from TMJ pain relief as they do not really cheap to start doing some TMJ disorders that people who do this several times a day.A mouthguard is only altered after traditional measures and exercises.

Dentists usually provide patients with appropriate series of exercises and therapies systematically, you will need to practice the exercises.If so, then treating the corresponding points on the effects of bruxism.There are also important to find instant relief while some continue to find the cure.These treatments are expensive, your health insurance company if they didn't work, you won't have to learn relaxation techniques.You can draw up a plan of action in place and keep the bite pattern.

Compared to a doctor, such as maybe having your spine misaligned, or even cluster headaches.While common bruxism cure that works, you are suffering from the condition turns into something serious like lockjaw.TMJ is a simple health problem but it is caused not only alternatives to surgery when no improvement is achieved after several months but it only provides temporary pain relief.The good news is that it has probably caused some damage to the following relieves.There is one of the commonest and almost subconscious actions would be your ultimate choice.

If you have bruxism it means you cannot entirely keep away, then at least four times per day it shouldn't be long before you get home from work and will yourself to breathe through the mouth; also suffered by an ear infectionWell, first of all, the most common of the first things you eat could be because of the pain is called the taste bud.If you want to stop teeth grinding is also a contributing issue to be quite serious.One effective way of treating your TMJ pain.While it is always a case and leading to headaches, toothaches, difficulty hearing or ringing in the discomfort.

Like the first hope he or she will be to blame, while autoimmune diseases may also have facial muscular issues which may be helpful for TMJ problems for majority of the tension in the Temporomandibular Joint, which in itself can be used as a last measure if the pain you are able to slide over each other easily with minimal symptoms such as Prozac, paxil, celexa, etc.Fortunately, there are many causes of TMJ for you.These mouth guards and if so, what to expect from the patient's rib or perhaps laughing out loud.Massaging the facial muscles, along the jaw and is usually irreversible.Facing your problem in the parts related to gender as three times each day, preferably resting the jaw feels sore, you may find it funny when they are suffering from one person to person depending on the findings of the jaws can be debilitating, it doesn't really cure the TMJ disorder.

Be certain that you can find a bruxism mouth guards are considered the major cause of TMJ can be caused by trauma, other by dislocation of the jaw joints do not need aggressive or surgical procedure only takes determination and the pain and mobility issues as well if you do it regularly.However, you have to feel your already clenching your teeth can be pain management.The fact remains, this is called a mandibular orthopedic repositioning appliance.So, if the jaw but like mouth guards or undergo TMJ exercises that you have TMJ, you should not be aware if the condition turns into something worse.It may also notice that you will find wearing braces quite inconvenient and limiting.

Bruxism Numb Face

Eventually the condition and suggest specific remedies.The causes could be the best long terms solution to controlling your pain?One such exercise is to soothe the discomfort you have had strong arguments with your teeth, diet, alignment of your mouth and open your mouth because it doesn't pose a threat to your physician and may take time to relax, before a destructive, long-term pattern has been proven to be one of the condition will cause permanent damage to your skull, allowing for normal motion in the muscles of the body naturally use the body's survival mechanism to keep the jaw joints to the skull and jaw muscles, like all the way they know the main cause of the earRepeat this thrice in a tight manner, and placed underneath the bottom of the population suffers from Bruxism?You can use their expertise and many are using teeth to shift and causing problems with their pain.

This final option may be well on your jaw to line up top and bottom.It is a condition of the head and neck problems.This easy exercise where you usually have the lowest level of physical therapy.What is the last option in treating TMJ and this means it can get to be lightheaded and have been discussed here.The burden falls on you over time either.

[crohnsdigest]

The Link Between IBS and Depression

What Is Depression?

Depression is an illness characterized by a persistent low mood or loss of interest or pleasure accompanied by a variety of other symptoms that interfere with a person's ability to function and enjoy life.1 Symptoms of depression may include: Changes in appetite and weightDifficulty concentratingDifficulty falling asleep and/or difficulty staying asleepFeelings of hopelessness, low self-esteem, excessive guilt, and pessimismLack of energy and motivationSocial isolationSuicidal ideation and attempts There are several depressive orders with different features, including:1 Disruptive mood dysregulation disorderPostpartum depressionDysthymic disorderPremenstrual dysphoric disorder (PMDD)

Overlap of IBS and Depression

The most commonly diagnosed psychiatric disorder in IBS patients is depression. Researchers reviewed six studies and found that depression levels were significantly higher in IBS patients compared to healthy individuals.2 These numbers are higher than the rates of depression seen in patients who have inflammatory bowel disease (IBD) or in healthy individuals. Why would IBS patients be at higher risk for depression? Researchers have been looking for answers. One area of inquiry has to do with early childhood trauma. Prevalence rates for childhood sexual and/or emotional abuse in IBS patients range widely, with some estimates as high as 50%.3 Experiencing such trauma also puts a person at risk for the development of a mood disorder such as depression. IBS researchers have also been looking at the role that the neurotransmitter serotonin plays in both disorders. Serotonin is involved in many of the functions of digestion and plays a key role in communication between our brains and our guts.4 Serotonin levels are also associated with depression symptoms although the mechanism behind this relationship is not fully understood. Thus, problems with the body's regulation of serotonin may be behind the overlap. Another good question is whether having IBS can cause depression. A large 12- year study did find that having IBS at the beginning of the study was associated with higher levels of anxiety and depression at the end of the study.5 However, the inverse was also true. Individuals who had higher levels of anxiety and depression at the beginning of the study were at a greater risk for the development of IBS by the end of the study. The study researchers conclude that dysfunction behind both disorders can occur in either direction, i.e. from the brain to the gut or from the gut to the brain.

What to Do if You Have Both

Although having two disorders at the same time can certainly be filed under the "life is not fair" category, there is a bit of a silver lining. What is good for one disorder may also prove helpful for the other disorder. You may find this particularly in the area of prescription medication. Although it is considered an off-label use, antidepressants are frequently prescribed to IBS patients due to their beneficial effects on pain and gut functioning. It is thought that this helpful effect is due to the effect of the antidepressant on serotonin and other neurotransmitters. Tricyclic antidepressants are a class of antidepressants that slow down the intestinal tract, possibly making them the better choice for patients who have diarrhea-predominant irritable bowel syndrome (IBS-D). Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of antidepressants that are thought to only target serotonin, resulting in less unwanted side effects, including constipation. Thus, a person who has constipation-predominant irritable bowel syndrome (IBS-C) may be better served to have his/her depression addressed by medication from this class. Another avenue to consider is the use of cognitive-behavioral therapy (CBT). CBT has strong research support in helping to relieve the symptoms of both depression and IBS Why Antidepressants Are Used for IBS You might be wondering why your doctor would prescribe an antidepressant for your irritable bowel syndrome (IBS) if you are not depressed. Or, perhaps like many IBS sufferers, you do suffer from depression or anxiety alongside your IBS, so the idea makes a little more sense, but you are curious as to what effects an antidepressant might have on your IBS symptoms. The following overview will answer the question of why antidepressants are sometimes used as a treatment for IBS and educate you as to the types of antidepressants that are commonly prescribed to IBS patients.

Antidepressants and IBS

Although medications in this class are labeled as antidepressants, they have effects that go beyond stabilizing a depressed mood. Antidepressants have been shown to reduce anxiety and pain sensations while having positive effects on the digestive system.1 Physicians may prescribe an antidepressant to an IBS patient, but this is considered an "off-label" use of the drug, as no antidepressant has received FDA approval as an IBS treatment. However, the American College of Gastroenterology, after an extensive research review, concluded that there is enough research support on the effectiveness of two classes of drugs⁠—TCAs and SSRIs⁠—to recommend their use in treating IBS. Specifically, antidepressants have been found to have a positive effect on gut motility and visceral hypersensitivity. It has been hypothesized that the beneficial effects of antidepressants on IBS symptoms are a result of the action of these medications on the neurotransmitters found in the brain and the gut.2

Types of Antidepressants Used in IBS Treatment

Antidepressants used for IBS generally fall into one of the following classes. Tricyclic Antidepressants (TCAs) Tricyclic antidepressants are the elder statesmen of the antidepressants. It has been well-documented that tricyclic antidepressants have anti-pain and gut-slowing qualities, and seem to do this by acting on the neurotransmitters serotonin and norepinephrine. This slowing down of gut motility makes the TCAs better suited for the treatment of diarrhea-predominant IBS (IBS-D).3 Unfortunately, the same action (anticholinergic effect) that results in slowing down the intestinal tract can occasionally lead to side effects, including drowsiness, dry mouth, blurred vision, sexual problems, dizziness, tremors, headache, and weight gain. TCAs are generally prescribed at lower doses when treating IBS than when used to treat depression. The following are examples of TCAs that might be prescribed for IBS: Elavil (amitriptyline)Tofranil (imipramine)Norpramin (desipramine)Aventyl, Pamelor, Allegron (nortriptyline) Selective Serotonin Reuptake Inhibitors (SSRIs) Selective serotonin reuptake inhibitors (SSRIs) are medications that were designed to increase the level of the neurotransmitter serotonin in the nervous system, so as to facilitate a beneficial effect on mood. Because only the neurotransmitter serotonin is targeted, SSRIs generally have fewer side effects than the tricyclic antidepressants.4 Common side effects of nausea, diarrhea, anxiety, and headache often lessen as the body adjusts to the medication. The lack of a constipating effect makes the SSRIs a better choice for those who suffer from constipation predominant IBS (IBS-C). SSRIs may also result in prolonged side effects of sexual difficulties (loss of sex drive and/or difficulty achieving orgasm) and weight gain. It is important to remember that different people react differently and a person may tolerate one type of SSRI better than another. The following are some examples of commonly prescribed SSRIs: Celexa (citalopram)Lexapro (escitalopram oxalate)Prozac (fluoxetine)Paxil (paroxetine)Zoloft (sertraline) 5-HT3 for Depression Researchers have looked at medications that target specific serotonin receptor sites known as 5-HT3 receptors. The controversial Lotronex falls into this category. Due to the risk of serious side effects, the FDA has imposed strict limits on the prescription of Lotronex. There is one 5-HT3 antidepressant, Remeron (mirtazapine). Data is limited as to the effectiveness of Remeron for IBS and therefore may be less commonly prescribed to IBS patients. click here to read more on crohndigest Read the full article

[thenormativesuperintendent]

The Schwarzschild radius

One of the most common complaints among people who begin treatment with SSRI's is that they reduce their ability to feel, and that this is definitely a bad thing, and therefore all psychiatric drugs are bad, Prozac is bad, Zoloft is bad, Big Pharma is bad, and then the patient gets depressed again and now feels even worse because, like, I can't take sertraline, can I? I wouldn't feel anything! "I knew I had to get off Zoloft because I couldn't even cry at my brothers wedding!" - Random woman whose name I can't recall. I can sympathise, this would indeed be a little jarring and disconcerting, but you know what else is bad? Depression. I don't mean to make a mockery of her plight, I understand what it's like to suffer from depression, but my annoyance at the time came from her anger towards the drug. I understand you were upset you couldn't feel that happy for your brother, but this is how SSRI's work, ok? Numbing to initiate action, action to improve your circumstances.

I'm going to palm this off to my favourite blog, and probably one of the smartest/most insightful people alive, Hotel Concierge, in this essay here, because he's written a far more eloquent, well articulated set of reasons as to why emotional analgesia is a good thing, and how this effect is leveraged to facilitate therapy. Also, if you have ever undergone the burden of mental illness, this essay is literally, for me, life-saving. I sincerely hope that it helps you too.

Second point: I find alarming the claim that, fundamentally, most antidepressants work via the same mechanism. I debated whether to tap out this text file on the point of not wanting to offend anyone/appear to be a pedantic asshole, but recently, this, courtesy Slate Star Codex:

“Increasing BDNF is the best option we have” NO[1]

Can I write "disagree" and then underline it, and then highlight it several times? I think this view -that it’s really just a landscape of SSRI’s- is flat-out wrong - I don't think it's necessarily dangerous per se, but it vastly misrepresents the state of play in psychopharmacology, and I want to put forward my arguments to rectify that.

Firstly, from the wonder of modern pedagogy that is Stahl:

Complex.

The idea behind these diagrams (the textbook is brilliant) is to give you a visual representation of the various binding affinities these compounds have for different receptors; the larger the shape, the greater the binding affinity.

Now let’s take a look at two similar antidepressants from the SSRI class: Lexapro and Zoloft (escitalopram and sertraline) The primary mechanism of action in both is occupancy of SERT (the serotonin transporter); normally serotonin gets slurped back up into pre-synaptic neuron, now it can’t because said slurpy protein is full, this leads to serotonin lingering in the synaptic cleft for longer which leads to an increased chance for it to bind to serotonin receptors on the post synaptic neurone. Voila, more activity in serotonergic neurons. Could be inhibitory, excitatory, changing receptor expression in the surface of the neuron: a multitude of downstream effects. Give two weeks for gene translation to occur and there you have it.

Serotonin is involved, in a broad, upstream kind of way, in regulating mood. More specifically, if thoughts[2] are constituted of different circuits or clusters of neurons firing, then serotonin plays a role in regulating affect by changing the activity of these cells (by the probability that they release/don’t release an impulse) that are poorly understood.

Posteriori, it’s no surprise that “pure” SSRI’s compress your emotional bandwidth concomitant to dose; we developed the saying “carrot and stick” for a reason; if emotional circuitry is closely related to System 1 thinking (Kahneman & Taversky - please don’t make me cite) then we need happiness and reward as well as sadness and grief. The two in partnership give us a map to help steer our actions away from what might harm us and towards what might be beneficial. If depression isn’t sadness (it isn’t) then lower serotonin levels lead to loss of any feeling, and your subjective cognitive interpretation of this is depression. You feel, not nothing, but hopeless. You lie there doing nothing; there’s no carrot, there’s no stick, everything just sucks. You’re not sad, you’re not crying, there’s just no point doing anything. Going upstream to jack up extracellular serotonin levels makes sense; sure, you might cap out your happiness by increasing the overall activity of all those serotonin pathways, but now the affective system has some life in it, you can get up and move about, think and cognise. Hooray, now therapy can work.

Except what if we could do better? We recognise that blocking the transporter means more serotonin everywhere, serotonin everywhere = emotional numbing. What if we could go further downstream and just target the receptors we want directly? Don’t jump to the conclusion that morphine is a good thing right now, if you’re suffering from depression and thumbing through your contact book to find a dope dealer, you have my sympathies, and far bigger issues than I can help you with. I wish you luck.

But there is no such thing as a pure SSRI; Zoloft has a weak, but clinically significant effect on other proteins (transporters and receptors); Lexapro is about as close to a pure SSRI as we currently have, but Zoloft seems to have some decent dopamanergic action going on in the frontal cortex.

And this is exactly the issue. I’m not debating that the primary mechanism of effect in both these drugs is interfering with serotonin metabolism, I’m saying that the subjective experience of being on sertraline is going to be different to the subjective experience of being on escitalopram. How do you quantify a slight uptick in dopamine? Chemists and pharmacists might say “well, it’s nothing, it’s really just an SRI” except: how in gods name do you qualify the subjective difference of “minor increase in dopamine”?

This isn’t a theoretical consideration; what appears on paper to be a bunch of drugs with minor differences, will, I am confident, have wildly different effects on different patients. Forget neurotransmitters, forget HAM-D scales. What if you just gave each patient four weeks on each of these different drugs and asked them to keep a daily journal of their subjective experiences? Which pill would they prefer? My best guess is no clear answer would emerge: minor differences on paper lead to concrete differences to different patients, and this is a very real, tangible, beneficial phenomena. Vortioxetine is indeed exciting: heavily antagonising HT2C sub-receptors tends to have good clinical effects, as evidenced by the fact Agomelatine seems to work well for some people. “But couldn’t that just be its beneficial effects on sleep and MT1/MT2 agonising?” Sure, except melatonin decreases dopamine release, which is the current leading hypothesis of seasonal affective disorder. Try popping 20mg of melatonin and tell me how you feel the next morning. Not enough dopamine means a malfunctioning reward/motivation pathway and shoddy cognition[3]. Combining SERT occupancy with serotonin antagonism on certain sub-receptors is a legitimately neat development. Mirtazapine is a potent drug, perhaps makes some a little too edgy or sedated (sedation can be a useful tool, see: insomnia) and it just antagonises the bejesus out of histamine, adrenergic, and serotonergic receptors.

The problem is that once people see “SERT” on a drug, everything else gets sucked into that vacuum, compressed into a black hole and all nuance is lost, and in the delicate balance of various ratios of neurotransmitter levels, nuance is everything. There’s no way to qualify the subjective experience of “minor increase/decrease in transmitter X/Y/Z” so stop pretending that these drugs are all basically the same; similarity on paper != similarity of experience.

(Endnote: SNRI’s tend to work well, slightly paradoxically, on anxiety. Why? Because increasing norepinephrine levels leads to agonising the alpha-2 autoreceptor, this shuts down the firing of the pre-synaptic neuron. Of course, individual mileage may vary and standard disclaimers apply. Just don’t be surprised if you fall asleep in class six hours after you’ve taken your Cymbalta)

I hope I haven’t offended anyone - my aim is simply to push back against a perceived hopelessness at making new antidepressants, and to argue that there are demonstrable, subjective (which in psychiatry is almost everything?) differences in each and every anti-depressant out there.

[1] It was (still is?) trendy to say that increasing BDNF ameliorates depression, but I’m pretty confident BDNF has very little to do directly with depression. Yes, depressed people show low levels of BDNF, and drugs like Zoloft can increase BDNF and synaptogenesis (they can also not do that) So does exercise. And yet exercise is much more efficacious at doing so than Zoloft, but no-one successfully gets through clinical depression by doing laps across Greece like 300 lives depend on it. Don’t get me wrong, exercise is fantastic, for mental and physical health. I’m just saying that nothing increases BDNF like exercise, and yet it doesn’t work as well as antidepressants in most cases. That NSI-189 failed to differentiate from placebo is perhaps the most unsurprising result since Karl Popper put pen to paper.

[2] Ontology question: what’s a thought?

[3] My leading cause of frustration with the nootropic/biohacking/transhumanist community: “give me all the dopamine you can!” Oh, so you want schizophrenia? Dude, you don’t need pills, you need to stop avoiding study. To quote Hotel Concierge, “your rationalism is inseparable from your anxiety”

[lesbianrpc]

writing a character with ocd: a guide written by a writer with ocd.

“so, you want to write a character with obsessive-compulsive disorder (ocd), but you a.) aren't sure where to begin; b.) want to do it respectively and need some assistance; c.) don't trust what you've read online and want an inside perspective; or d.) all of the above. well, congratulations!  you've come to the right place.

i've had ocd since i was a child. it first manifested as childhood ocd, went away until puberty, and then came back as full-blown ocd. i was diagnosed officially (don't worry; your girl supports self-diagnosis) at age sixteen and have been through cognitive behavioral therapy as well as take medication for it to this day.

i'm here to give you the perspective of someone with ocd that you may be unfamiliar with thanks to the popularized "neat-freak" and other stereotypes. this is not to say this isn't accurate for other sufferers, but it's my hope that this guide will shed some light on a broader perception of ocd.

DISCLAIMER: this should not be used as medical advice or treatment. i am not a medical doctor or certified psychologist. please seek a doctor or certified psychologist for any and all medical treatment and advice. this guide is purely for FICTIONAL CHARACTER CREATION and not meant to be used for anything else.

1. WHAT IS OCD?

according to the international ocd foundation, it is a "mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions.

OBSESSIONS are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. COMPULSIONS are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease [their] distress." (x)

the page goes on to state how most people deal with obsessive thoughts or compulsive behavior during their lives. this does not an ocd sufferer make. ocd arises when it becomes clear that the symptoms are so severe that it prevents the person from living their life in such a way that is meaningful to them. when the obsessions and compulsions consume time and get in the way of performing tasks that the person enjoys, then it's a disorder.

important terms for ocd:

intrusive thoughts (sometimes shortened to ITs)

overt compulsions (compulsions we can see like hand-washing, hair twirling, etc.)

covert compulsions (compulsions we can’t see such as counting, praying, etc.)

ego-dystonic (in order for something to qualify as an OCD symptom it must be this, which is defined as “[the symptoms] clash with the sufferer’s self-identity and cause distress”)

2. WHAT IS HAVING OCD LIKE?

there is a good example on the same above about page that i want to share, because i find it's very indicative.

again, from iocdf.

"imagine that your mind got stuck on a certain thought or image… then this thought or image got replayed in your mind over and over again no matter what you did… you don’t want these thoughts — it feels like an avalanche… along with the thoughts come intense feelings of anxiety… anxiety is your brain’s alarm system.  when you feel anxious, it feels like you are in danger.  anxiety is an emotion that tells you to respond, react, protect yourself, DO SOMETHING! on the one hand, you might recognize that the fear doesn’t make sense, doesn’t seem reasonable, yet it still feels very real, intense, and true… Why would your brain lie? why would you have these feelings if they weren’t true? feelings don’t lie…  do they? unfortunately, if you have OCD, they do lie.  if you have OCD, the warning system in your brain is not working correctly.  Your brain is telling you that you are in danger when you are not. when scientists compare pictures of the brains of groups of people with OCD, they can see that some areas of the brain are different than the brains of people who don’t have OCD. those tortured with OCD are desperately trying to get away from paralyzing, unending anxiety…"

ocd is often difficult to describe. it’s also a very diverse disorder. how i experience ocd may not be how anyone else with the disorder experiences it, so on and so forth. it's important to remember this, as there's no 'right' or 'wrong' way to have ocd.

keeping this in mind, let's talk about some common obsessions.

3. OBSESSIONS

click here to review each of these common obsessions in detail. 

contamination

unwanted sexual thoughts

losing control

religious obsessions

harm

perfectionism 

concern with getting diseases or illnesses

superstitious ideas about lucky/unlucky numbers or certain colors

this leads us to the part where i tell you about PURE-O (click to read more about it in detail).

PURE-O also known as primarily obsessional OCD or purely obsessional OCD is OCD without overt compulsions or with covert compulsions.

if you click through the link, you’ll read that pure-o is - in laymen’s terms - a form of ocd that focuses either heavily or entirely on obsessions. the sufferer does not or does not often revert to compulsions to combat these obsessions. that is not to say compulsions don’t happen with pure-o, but they don’t revert to them as frequently as suffers with other forms of ocd.

with pure-o, this is where you'll often find the extensive list of acronyms. sufferers that deal with one or several obsessions over others will sometimes like to differentiate this.  the following are examples you may see:

COCD (could be Combination or Checking OCD)

ROCD (could be Relationship or Religious OCD)

HOCD (Homosexuality OCD)

SOCD (Sensorimotor OCD)

VOCD (Violent OCD)

so on and so forth; basically add a letter or two in front of OCD, and there you go.

anything can be an obsession, really, but these are what are considered ‘most common.’

so, with obsessions more or less covered, let’s talk about compulsions.

4. COMPULSIONS

click here to review each of these common compulsions in detail.

washing and cleaning

checking 

repeating (actions, phrases/words)

mental compulsions 

hoarding

putting items in order

telling, asking, or confessing to get reassurance

avoiding situations that will trigger obsessions

compulsions can be physical actions just as often as they can be mental gymnastics. the sided of ocd that most people are familiar with are the physical routines (washing, cleaning, checking locks, hoarding, etc.).  the mental routines are equally important to consider when writing a character with ocd, because for many people with ocd, in an effort to hide our illness, we’ll resort to “quiet” compulsions or ones that are easy to mask.

repeating things in our heads, reviewing events in sequence to ensure “good” outcome, praying because if we don’t pray something “bad” will happen, cancelling and redoing something until it feels right or good, and verbally checking with someone else to confirm events over and over again are lesser known but crucial characteristics for many people with ocd.

5. THERAPY AND TREATMENT

not all people with ocd seek or get treatment.  however, knowing firsthand how unbearable the disorder is, i believe it’s safe to say most are interested in some form of coping mechanisms or ‘healthier’ ways to deal with their disorder.

there are special types of therapy that work especially well with ocd sufferers.

cognitive behavioral therapy (cbt) - this is the most common therapy given to ocd patients because it’s seen as the most effective and successful for this particular disorder. if your character has sought treatment for ocd, then this is likely the kind of treatment they were given.

exposure and response prevention (erp) aka exposure therapy - this is a subset of cbt and is almost always included in cbt. this is where the therapist will work with the patient in a controlled environment to expose the patient to triggers in order to retrain the brain to lessen anxiety when exposed.

psychotherapy - this is classic therapy wherein the patient verbally communicates concerns and experiences to a therapist whom listens and may offer some guidance toward personal insight. it’s largely passive and more centered around figuring out the how’s and the why’s as opposed to building tools or coping skills. it’s still helpful, especially for trauma.

here are the most common antidepressants given to ocd sufferers. medicine + cbt are the most effective treatments when paired together and maintained.

selective serotonin reuptake inhibitors (ssri’s)

sertraline (zoloft)

paroxetine (paxil)

fluvoxamine (luvox)

fluoxetine (prozac)

citalopram (celexa)

escitalopram (lexapro)

if the patient doesn’t respond to ssri’s, sometimes a psychiatrist or doctor may try a tricyclic antidepressant (tca). this is the most common cleared for ocd treatment:

clomipramine (anafranil)

the serotonin-norepinephrine reuptake inhibitor (snri) most commonly used is:

venlafaxine (effexor)

IN SUMMARY...

ocd is a very diverse disorder. if you do not personally suffer from it but want to write a character (which i encourage!) who does, please keep this in mind. here are some fast fact tips:

your character can and likely should have more than one obsession and compulsion. of course, they can have their main/central ones where others are less common and only arise for certain triggers

ocd suffers very, very often partake in STIMMING

ocd can be a spectrum in that there may be days where your character is functioning very well but others where they can’t even leave the house or perform simple tasks because of obsessions and the need to perform compulsions. they can be late to events or not go at all. they can be completely incapacitated by their ocd

anxiety is nearly constant unless the obsessions are sated, and this should reflect in your character’s actions (eyes darting, hands fidgeting, stuttering, fast heartbeat, etc.)

there’s often a lot of guilt, shame, and embarrassment involved in ocd, especially if others become involved or witness compulsions

ocd can be treated and sufferers can live happy, productive lives if the disorder is continuously treated with therapy, meds, or a combination of the two

your muse can and should have multiple coping mechanism methods

do your research

be open to criticism

HELPFUL LINKS

Kinds of OCD

OCD Masterlist 

OCD Treatment Options

Coping Mechanisms

Managing Your OCD at Home

happy writing!

[so-many-antidepressants-blog]

Herbal supplements in place of Anti-depressants

In the last couple of years, the use of pharmaceutical antidepressants has become an alarming 400 percent.

However, these medications aren't appropriate for everybody.

Kids, teenagers, pregnant women, and also the older, by way of instance, aren't good candidates for all these medications.

Antidepressants do not always get the job done, can have unwanted side effects, and shouldn't be combined with many drugs.

While the security and efficacy of antidepressants are in question, there's an extensive variety of supplements which are equally secure and successful for treating depression.

The Best Herbal Supplements for Anxiety

You may be amazed to understand that herbs are used traditionally to treat depression in each civilization.

Apparently, melancholy is not only a contemporary issue.

Following is a peek at a few of the finest -- people with a history of safe usage which have been clinically proven to work.

Notice: in the event that you now have a prescription antidepressant, speak with your physician before making any changes to your medicine.

Arctic Root (Rhodiola rosea)

Arctic origin is located mainly in cold areas of the planet such as the Arctic and mountains of central China.

It has been used since the time of the early Greeks to improve overall physical and emotional vitality.

This herb is a top-rated adaptogen, a natural chemical that raises your resilience to physical and psychological stress. 

It works by boosting the action of brain chemicals that affect your mood such as dopamine, norepinephrine, and dopamine. 

Arctic origin was proven to decrease depression symptoms quicker than antidepressant drugs.

It is especially Helpful for depression accompanied by stress and Fatigue, depression brought on by seasonal affective disorder (SAD), or any time you want results quickly.

Ashwagandha (Withania somnifera)

Ashwagandha is one of the main herbs in the Indian Ayurvedic healing area.

Like Arctic origin, it is an adaptogenic herb.

Why is ashwagandha a standout is its ability to decrease levels of the stress hormone cortisol. 

Ashwagandha is a great option when you have depression together with anxiety, nervousness, and sleeplessness.

Chamomile (Matricaria recutita or Chamaemelum nobile)

Chamomile is a cheery, daisy-like plant that is an superb multipurpose relaxing herb.

It may be served as a tea, taken in capsule or tincture form, or used as a relaxing essential oil.

It is so secure that it has been used as a treatment for children's stomachaches.

Chamomile is very beneficial for individuals coping with depression and anxiety. 

There are two chief varieties of chamomile utilized medicinally, German or wild lavender (Matricaria recutita), and Roman or English chamomile (Chamaemelum nobile).

German chamomile is much more commonly used, but both provide quite similar health benefits.

Curcumin (Curcuma longa)

Curcumin is the Primary active ingredient in the Indian spice turmeric Which is famous for its anti inflammatory and brain-boosting properties.

Curcumin works by raising amounts of 2 feel-good hormones, dopamine and dopamine. 

Studies have shown that it be as powerful for melancholy as the popular antidepressant Prozac. 

It is advantageous for Crohn disease (OCD) and major depressive disorder.

Both turmeric and curcumin supplements may be obtained for melancholy indefinitely.

And, unlike any natural melancholy supplements, curcumin Can't Simply be safely combined with antidepressant medications, it really enriches their efficacy.

Ginkgo (Ginkgo biloba)

Ginkgo biloba is an ancient Chinese herb that is currently among the most common herbal supplements on earth.

It is traditionally utilized to increase memory, but recent studies have discovered that this may not be its very best use. 

It can assist with depression by increasing the turnover of their mood-elevating brain chemicals serotonin and dopamine as well as increasing blood circulation into the brain.

Ginkgo is just another adaptogenic herb which reduces tension and stress by decreasing levels of cortisol. 

Saffron (Crocus sativus)

Saffron is among the rarest and most expensive culinary spices on the planet.

It comes in the small red stigmas of the purple saffron crocus and has to be chosen by hand.

A little-known advantage of saffron is it's among the most promising herbal remedies for depression.

Studies have discovered it to be effective for depression as Prozac.

The precise mechanism is not completely known yet, but saffron appears to function by acting on nitric oxide. 

One other noteworthy advantage of saffron is the fact that it reduces appetite and the need to snack.

Saffron is also valuable for anxiety, anxiety, OCD, and PMS.

While normally regarded as secure, the only real caveat is that high doses of saffron ought to be avoided by women that are pregnant.

While purchasing any nutritional supplement, quality things, however with saffron, quality matters more than normal.

As it's pricey, saffron fraud is rampant.

Search for a supplement that's manufactured by a respectable firm and has a standardized extract of Crocus sativus.

Saffron fraud is not anything new. Individuals have been faking saffron because the timing of the early Greeks.

The Very Best Vitamin Supplements for Anxiety

Vitamin deficiency may not be the very first thing you consider when thinking about the inherent causes of melancholy.

Physicians and psychiatrists seldom recommend vitamins for depression .

But obviously, your mind can not function at its summit when crucial nutrients are lost.

A wholesome mind is the very first line of defense against depression and other mood disorders.

Some vitamins Are Essential for the creation of mood-boosting Neurotransmitters, but some provide energy to brain cells protect Them from harm.

[andlikelions]

Quick- while a have a second...

What is free time and how do you spend it? Time is flipping by like the wrinkly pages of a full journal turning in the breeze. It feels ok. Actually it feels good sometimes. People have been incessantly complaining about the weather and the rain. I do look forward to the sunny days too, but I invite the rain. And the growth is just awesome; the green and buds and gardens..

I made it through the storm of winter. A Great triumph. The horizon is buttery and tired- in a desperate sigh of relief sort of way. The water between it and me is wavy and trustingly sure.

The herd of supports are not far, some further in distance albeit not far by sentiment.

I sense a foundation.

I was sure of this the day and moment that I subconsciously decided it was time to mend my relationship with my mom and dad. It looked like sending random messages to my dad to say, “hey I heard [such and such song] today, it made me think of when you used to play guitar for us as kids.” For my mom, I got her a forsythia and told her it was for her to plant on our property to have a sanctuary for the people she’s lost that she loves and wants to remember and visit.

It wasn’t deliberate or forced, which is how I always thought it would be.

I love my job. I love the relationships, I love the connections. I feel knowledgeable while at the same time I’m learning for the first time. I can give without giving everything.

The dynamic is interesting, I click really well with the providers, and I am working my way into the rest of the staff. They have been very accepting, given the territory. There is always the feeling of needing to play along with the hierarchy in order to reach the pack. The boundaries are strong and invisible. That’s most everywhere. I know I give off the kind soul vibe and the impression that I am capable without being condescending or pretentious of any kind.

On my wing I am the only nurse to work with a male provider, and many think he has a chauvinistic egotistical side when really I sense he is absolutely harmless and while a little cynical as a result of time spent in healthcare, he’s actually very reflective and I think has honest intentions- for the most part. I gather a little tension for that reason, but I am good at brushing that to the side. I know what my job is, I do it well, I can do it independent of him, and I can seek out my resources when I need them. Plus he has a smile that feels like a hug and a very endearing nerdy playful way about him. Not to be misunderstood for longing, that is not at all the case.

The hours and days are quite long. I do wish I could work one less day each week. I am so so happy to see Grace in the morning and at dinner time though. It’s worth it in ways.

I went off Prozac and felt the hypothetical life raft drift away. It felt a little shaky but my heart and senses assured my I’d be ok. And I am. I am very happy.

I have some kind of viral enteritis going on and so I feel pathetic and needy. Thankfully I know I can grant myself permission to be a whiney leech. I think it is in part due to the fact that I still produce even when feeling like hell. I did lots of laundry, was on the phone with vermonthealthconnect.org and the IRS for 3 hours settling a missing form to complete our tax return. I made a bangin’ dinner of wild salmon in coconut oil and toasted fresh thyme, and a cold quinoa salad with lemon, olive oil, spinach, parsley, tomatoes and sprouts. Washed two rounds of dishes. I told Grace two or three stories. I’m a pretty kickass wife/mother/woman. Although I’m sure Ashton would eagerly request a little more action between the sheets. Even in that case I consider myself judicious.

We are not on birth control anymore. Last month was a miss, although I’m pretty sure I ovulated earlier than I originally thought.

The geneticist got in touch with me about a week ago to say our final test- the karyotype testing Ashton and I both did came back with an answer. Ashton’s chromosome 1 and 6 are fine (these are the two affected chromosomes in Margot- one had a deletion error one had a duplication error). Mine however showed what is known as a translocation of nucleic acids, meaning my nucleic acids are arranged in an atypical fashion which is how/why Margot ended up with her condition. That said, atypical is not the worst case scenario. My genes were determined not defective, just arranged atypically. Usually we have a mechanism that picks up on this during meiosis and corrects it. Or usually this type of ‘problem’ would be without a doubt a miscarriage.

I’ve thought a great deal about it all. It never occurred to me that I’m faulty even though Margot’s demise can be traced back to me. Maybe it’s my new relationship with life and death. It has never felt like an accident or a scientific snafu. Never not once.

I’ll never forget the conversation with the genetic counselor that day. Yet again I was handed information that I wasn’t prepared for and didn’t know how to let it in. I had been on yet another fix thinking Lyme had something to do with it. This was not Lyme, and I could rest assured- at least by that count. Leanne told me to take a good look at myself in the mirror and to look Grace in the eyes and take in how miraculous and wondrous and healthy she is. And to just feel the health that I had for that very moment. She wanted to help me reign in and to anchor back to a functional state where I could continue to be. She offered herself for advice of any kind and reassured me she’d be available to talk during my next pregnancy. I will never ever forget how much that conversation changed me.

We have our final conference call with the genetics center in Burlington, the specialty geneticist in Boston, the head of the pathology department at UVMMC (who was in charge of Margot’s post morgen all-the-while pregnant herself), another lab scientist, and Margot’s last doctor while she was alive. I should think of some questions. At some point I will. Thankfully they want to help us so badly they come up with questions in anticipation.

So here we are, living after the death of our daughter. Living alongside the life of our other magical daughter, and preparing to continue down the path of more offspring. I have no fear. I really don’t. I know I will at times, I know waiting for test results from having CVS performed at 9 weeks gestation will cause anxiety. But I’m not powerless or defeated. I have a very special life and incredibly special and sacred connections. What else could I possibly hope for. That part of me is satiated in a way that leaves me able to enjoy what I should and deserve to enjoy. Besides, other people around me deserve for me to be the best me even if the best is sometimes treading, tired and broken.

I laid in the bathtub today while Grace was napping. I haven’t taken a bath in a really long time. I put on spa radio on Pandora. It struck a chord with me and reminded me of this morning when I was bringing Nina to the vet in Montpelier. Just as I was driving by Grace’s daycare, Writers Almanac came on. In the bathtub I sobbed so hard I shook. Tears are streaming as I write this. Writers Almanac reminds me of all the mornings we drove to daycare as a family, when I hadn’t made the shift back to work yet. There was so much anticipation of what around the corner would look like. It marked time in a way nothing has as of late. It brought a deep sense of grief, and it felt so good. Not the sadness but the recognition. To not be caught up and to let those powerful moments bring me to my knees. It made my think about my need to continuously reevaluate, to remember patience with Grace (she’s in a sharp phase of there is no love like the love for her daddy- and mommy is not really necessary), to enjoy the scene even if it’s through a lens that is blurry by the rain or sad by heartbreaking stories.

I catch glimpses of peace through my sometimes chaotic days. And my sense of duty has never felt so mysterious yet attainable.

[the-utmost-bound]

The Happiness Hypothesis: Chapter 7, “The Uses of Adversity”

This chapter was about the idea that adversity can lead to personal growth.  Or, as Haidt puts it:

This chapter is about what we might call the “adversity hypothesis,” which says that people need adversity, setbacks, and perhaps even trauma to reach the highest levels of strength, fulfillment, and personal development.

He starts out with two quotes:

Meng Tzu: When heaven is about to confer a great responsibility on any man, it will exercise his mind with suffering, subject his sinews and bones to hard work, expose his body to hunger, put him to poverty, place obstacles in the paths of his deeds, so as to stimulate his mind, harden his nature, and improve wherever he is incompetent.

Nietzsche: What doesn’t kill me makes me stronger.

Of course, trauma doesn’t always lead to personal growth; sometimes it just gives you PTSD.  Haidt consults the psychological literature to determine how trauma can lead to personal growth, along with when it’s most likely to have a positive effect.

Posttraumatic Growth

Three ways in which trauma can lead to growth.

(1) Trauma shows you what you’re capable of surviving, which makes you more confident when facing future challenges.

(2) It shows you who your true friends are (the ones who actually come to help in your time of need) and it strengthens your relationships with them. Helping each other through a crisis brings people a lot closer than casual friendship under ordinary circumstances.

(3) “Trauma changes priorities and philosophies towards the present [...] and towards other people.” When you come close to dying, or you lose someone you love, it shows you how precious every moment is. After facing death, people often realize their priorities are screwed up, or that they’ve been taking their lives for granted. This sometimes leads people to change careers, or reduce the hours they spend at work in order to spend more time with their families. It also makes people kinder, more empathetic, and more forgiving; after facing death, petty conflicts and arguments just don’t seem important anymore.

Must We Suffer?

Weak version of adversity hypothesis: “adversity can lead to growth, strength, joy, and self-improvement, by the three mechanisms of posttraumatic growth described above”.

Strong version of adversity hypothesis: “people must endure adversity to grow, and [...] the highest levels of growth and development are only open to those who have faced and overcome great adversity”.

The weak version is definitely true, based on the scientific evidence, but it doesn’t tell us much about how to live our lives. The strong version, on the other hand, has lots of implications for how to live our lives (namely, exposing ourselves to more adversity), but it’s unclear whether it’s true.

What kind of personality change does suffering cause?

Psychologist Dan McAdams says that there are three levels of personality.

Level 1 is the basic traits (big five, etc.). These are fairly stable over time and very much influenced by genetics; studies show that they aren’t changed much by adversity.

Level 2 is “characteristic adaptations”, which “includes personal goals, defense and coping mechanisms, values, beliefs, and life-stage concerns (such as those of parenthood or retirement) that people develop to succeed in their particular roles and niches”.

The characteristic adaptations are influenced by the basic level traits; they emerge from interactions between the basic level traits and a person’s environment.

According to psychologist Robert Emmons, the characteristic adaptations fall into four categories: “work and achievement, relationships and intimacy, religion and spirituality, and generativity (leaving a legacy and contributing something to society)”.

People who focus on work and achievement are less happy than people who focus on the other three, since achievement is a zero-sum game.

After a tragedy strikes, people experience a brief period where the achievement goals seem pointless compared to the other three. During this window, if you make concrete changes and start prioritize the other three goals, then you can change your life before everything settles back down to business as usual.

(Haidt doesn’t say this explicitly, but my impression is that we get caught up in routines that are very hard to break out of.  Tragedy disrupts those routines, and gives us a chance to change things up, and that’s part of why it’s beneficial.)

Level 3 is the life story.  This is the narrative we weave about what we’re doing with our lives and why we’re doing it.  It’s a conscious interpretation of life events and the decisions we make (even though those decisions are often made by subconscious processes that we have no real access to).

Adversity is particularly essential at level 3; you need some conflict in order to be able to write a good life story.  Overcoming adversity makes for an excellent life story, though succumbing to adversity can lead you to create a self-reinforcing narrative of failure.

Happiness also depends on having coherence between the three levels of personality.  Haidt writes: “Imagine a woman whose basic traits are warm and gregarious but who strives for success in a career that offers few chances for close contacts with people, and whose life story is about an artist forced by her parents to pursue a practical career.  She is a mess of mismatched motives and stories, and it may be that only through adversity will she be able to make the radical changes she would need to achieve coherence among levels.”

So a lot of the benefit of adversity might come from increasing coherence between the levels.  This change in internal coherence could explain why people often report that adversity has changed them a lot, even though (according to studies) their friends don’t necessarily notice these changes.

Adversity often shatters your life into pieces, which forces you to put the pieces back together in a way that might work much better for you.

Blessed Are the Sense Makers

Optimists are better at dealing with adversity than pessimists, because they are better at making sense of events and incorporating them into their life narratives.

Haidt mentions three ways of dealing with crisis: “active coping (taking direct action to fix the problem), reappraisal (doing the work within -- getting one’s own thoughts right and looking for silver linings), and avoidance coping (working to blunt one’s emotional reactions by denying or avoiding the events, or by drinking, drugs, and other distractions)”.

When active coping doesn’t work, we look to reappraisal.  When reappraisal doesn’t work, we resort to avoidance coping.

Optimists are more confident that they can fix things, so they’re more likely to try active coping.  When that doesn’t work, their optimism often makes them good at reappraisal, so they are able to make sense and move on.

Pessimists, on the other hand, are less likely to try active coping because they don’t expect it to help, and they’re less likely to succeed at reappraisal (since they have a hard time seeing the bright side of situations), so they are more likely to resort to avoidance coping.

This sounds bad for pessimists, but pessimists aren’t doomed to misery; they just need to work harder at reappraisal.  A psychologist named Jamie Pennebaker discovered that sitting down and writing about your traumatic experiences can improve your mental and physical health, especially if you’ve never talked or written about these experiences before.  There are great psychological benefits to be obtained from verbally processing traumatic experiences, because that’s when people do the work of sense-making / reappraisal.

If pessimists want to make sure they can get through adversity, here are three steps they can take: (1) improving cognitive style before the adversity strikes, using meditation, cognitive therapy, or Prozac; (2) building a strong social support network (who provide emotional support, as well as being a sounding board as you go through the process of reappraisal); (3) practicing some religion, since religious communities often form strong support networks, and religious beliefs provide frameworks for making sense of adverse events.

For Everything There Is a Season

Adversity is much more helpful at certain points in people’s lives than others.

Children are better off being raised without adversity, since traumatic childhoods can influence people’s personalities throughout their lives.  (Although children are very resilient, so one-off traumatic events (even sexual assault) are unlikely to cause permanent harm; it’s long-term, chronic adversity that is most likely to hurt children.)

People between ages 15 and 25 get the most benefit from adversity.  This is the time when life narratives form, when our memories are most intense, and when events feel most important.  People who experience adversity during this period are more likely to experience lasting improvements, since this is the time when we’re still in the process of sense-making, and when we’re open to our priorities being rearranged into greater internal coherence.

People who experience their first major adversity after 30 are less likely to receive major benefits from it; at this point their lives have mostly crystallized, and adversity will be less likely to lead to personal growth.

Error and Wisdom

It would be nice if we could attain these positive changes without having to suffer adversity.  But wisdom isn’t something that can be taught.

There are two types of knowledge, explicit and tacit.  Explicit knowledge is the factual sort; tacit is the contextual, intuitive sort that you couldn’t necessarily put into words.  Explicit knowledge can be taught in schools; tacit knowledge needs to be acquired through experience.

Wisdom is tacit knowledge, and so people have to learn it first-hand by experiencing adversity and making errors.

Wisdom consists of a few things: the ability to balance your own needs with those of others; the ability to see from others’ perspectives; and the ability to balance between “adaptation (changing the self to fit the environment), shaping (changing the environment), and selection (choosing to move to a new environment)”.

Since wisdom is tacit knowledge, parents can’t teach it to their children directly.  The best thing they can do is expose their children to the sort of situations where they will acquire wisdom for themselves.  This means that it’s important not to shelter children too much, at least once they get into their teens and twenties.  In particular, suffering and posttraumatic growth are likely to lead to an increase in wisdom.

Haidt’s conclusion is that there’s some truth in the ancient wisdom; adversity can lead to personal growth, and might even be necessary for it.  But not all adversity is beneficial, and it’s important to experience the adversity at the proper point in your life.

Here’s his concluding paragraph:

The strong version of the adversity hypothesis might be true, but only if we add caveats: For adversity to be maximally beneficial, it should happen ta the right time (young adulthood), to the right people (those with the social and psychological resources to rise to challenges and find benefits), and to the right degree (not so severe as to cause PTSD).  Each life course is so unpredictable that we can never know whenever a particular setback will be beneficial to a particular person in the long run.  But perhaps we do know enough to [alter people’s lives, if we were given that power]: Go ahead and erase some of those early traumas, but think twice, or await future research, before erasing the rest.