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By L. Asaru. Menlo College.

Supporting their loved one can make all the difference - whether it means assuming extra responsibilities around the house during a depressive episode 75 mg plavix visa, or admitting a loved one to the hospital during a severe manic phase buy plavix 75 mg visa. Coping with bipolar disorder is not always easy for family and friends buy discount plavix 75mg line. Luckily, support groups are available for family members and friends of a person with bipolar disorder. Your doctor or mental health professional can give you some information about support groups in your area. Never forget that the person with bipolar disorder does not have control of his or her mood state. Those of us who do not suffer from a mood disorder sometimes expect mood-disorder patients to be able to exert the same control over their emotions and behavior that we ourselves are able to. When we sense that we are letting our emotions get the better of us and we want to exert some control over them, we tell ourselves things like "Snap out of it," "Get a hold of yourself," "Try and pull yourself out of it. But you can only exert self-control if the control mechanisms are working properly, and in people with mood disorders, they are not. Telling a depressed person things like "pull yourself out of it" is cruel and may in fact reinforce the feelings of worthlessness, guilt, and failure already present as symptoms of the illness. Telling a manic person to "slow down and get a hold of yourself" is simply wishful thinking; that person is like a tractor trailer careening down a mountain highway with no brakes. So the first challenge facing family and friends is to change the way they look at behaviors that might be symptoms of bipolar disorder - behaviors like not wanting to get out of bed, being irritable and short-tempered, being "hyper" and reckless or overly critical and pessimistic. Our first reaction to these sorts of behaviors and attitudes is to regard them as laziness, meanness, or immaturity and be critical of them. Now a warning against the other extreme: interpreting every strong emotion in a person with a mood disorder as a symptom. The other extreme is just as important to guard against. A vicious cycle can get going wherein some bold idea or enthusiasm, or even plain old foolishness or stubbornness, is labeled as "getting manic," leading to feelings of anger and resentment in the person with the diagnosis. Communication is the key: honest and open communication. Ask the person with the illness about his or her moods, make observations about behaviors, express concerns in a caring, supportive way. Remember that your goal is to have your family member trust you when he or she feels most vulnerable and fragile. He or she is already dealing with feelings of deep shame, failure, and loss of control related to having a psychiatric illness. Be supportive, and yes, be constructively critical when criticism is warranted. Never forget that bipolar disorder can occassionally precipitate truly dangerous behavior. Kay Jamison writes of the "dark, fierce and damaging energy" of mania, and the even darker specter of suicidal violence haunts those with serious depression. Violence is often a difficult subject to deal with because the idea is deeply imbedded in us from an early age that violence is primitive and uncivilized and represents a kind of failure or breakdown in character. Of course, we recognize that the person in the grip of psychiatric illness is not violent because of some personal failing, and perhaps because of this there is sometimes a hesitation to admit the need for a proper response to a situation that is getting out of control; when there is some threat of violence, toward either self or others. People with bipolar disorder are at much higher risk for suicidal behavior than the general population. Although family members cannot and should not be expected to take the place of psychiatric professionals in evaluating suicide risk, it is important to have some familiarity with the issue. Patients who are starting to have suicidal thoughts are often intensely ashamed of them. They will often hint about "feeling desperate," about "not being able to go on," but may not verbalize actual self-destructive thoughts. But they may need permission and support in order to do so. Remember that the period of recovery from a depressive episode can be one of especially high risk for suicidal behavior. People who have been immobilized by depression sometimes develop a higher risk for hurting themselves as they begin to get better and their energy level and ability to act improve. Patients having mixed symptoms - depressed mood and agitated, restless, hyperactive behavior - may also be at higher risk for self-harm. Another factor that increases risk of suicide is substance abuse, especially alcohol abuse. Alcohol not only worsens mood, it lowers inhibitions. Increased use of alcohol increases the risk of suicidal behaviors and is definitely a worrisome development that needs to be confronted and acted upon. Making peace with the illness is much more difficult than healthy people realize. But the harder lesson is learning that there is no way that anyone can force a person to take responsibility for his or her bipolar disorder treatment. Unless the patient makes the commitment to do so, no amount of love and support, sympathy and understanding, cajoling or even threatening, can make someone take this step. Even family members and friends who understand this at some level may feel guilty, inadequate, and angry at times dealing with this situation. Family members and friends should not be ashamed of these feelings of frustration and anger but rather get help with them. Even when the patient does take responsibility and is trying to stay well, relapses can occur. Family members might then wonder what they did wrong. On the other side of this issue is another set of questions. How much understanding and support for the bipolar person might be too much?

Note this online depression test is not designed to rule out other disorders such as bipolar disorder order discount plavix, but a professional exam will be able to do so purchase plavix visa. Many people live with the symptoms of depression for years without treatment because they do not realize they have a recognized buy cheap plavix 75 mg, treatable mental illness. Depression facts and statistics reveal the disorder affects 20% of women and 12% of men at some point in their lives and can negatively impact a person both physically and psychologically. The symptoms of depression can drastically affect social, occupational and personal functioning. Depression is a mood disorder characterized by periods of extreme sadness. Depression is defined in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and includes several major classifications. Major depressive disorder (MDD) ??? symptoms of major depression involve a low (or depressed) mood state for two weeks or moreDepression with catatonic or melancholic features ??? includes the standard depression symptoms as well as melancholic symptoms like excessive guilt or catatonic symptoms like mutism Atypical depression ??? atypical depression symptoms include increased appetite and need for sleep Seasonal affective disorder (SAD) ??? depressive symptoms occur according to the time of year (season)The specific set of depression symptoms for each individual varies. Many symptoms of depression can be mild, moderate or severe. For example, the feeling of sadness can occur in a variety of intensities. Depression symptoms can be thought of as mild or moderate if they mildly or moderately affect everyday functioning. Possible mild symptoms of depression include: Sadness or feeling "empty" or easy to tearLoss of interest in pleasurable activities, hobbiesIrritability or frustrationHopelessness, pessimismSlowed thinking and movementsTiredness, loss of energyAny of the above mild symptoms of depression can occur as severe symptoms depending on the individual. When the depression symptoms become severe, they can be crippling and affect everything from personal care to work and home life. Some of the severe symptoms of depression include:Inability to make decisionsObsessive thoughts of death or suicide, suicide plans or suicide attemptPersistent, unexplained physical pain such as headaches, digestive problems, or joint and muscle painInability to feel pleasureDifficulty in thinking and memoryRead more about the symptoms of depression in specific groups:In spite of depression being a mental illness that will affect more than 10% of the population at some point in their lives, the main causes of depression are yet to be pinpointed. Physical and psychological factors appear to cause depression in adults, teens and children. Genetics are also believed to be involved, as depression often runs in families. However, the specific genes that cause depression have not yet been found. It is likely factors combine in many ways to create the actual cause of depression in any given person. There are several biological factors believed to contribute to depression but their exact mechanisms are unclear. In spite of years of research, we only understand that biological differences exist in people with depression, and not how the differences cause depression, specifically. These biological causes of depression are thought to be present in teens and children as well. The biological factors that contribute to depression include: Physical changes to the brain ??? it is known that some part of a depressed brain show less activity than normal when stimulated; some parts of the brain even reduce in volume. Neurotransmitters ??? these chemical messengers in the brain have been implicated in the cause of depression since the 1970s. A central nervous system disruption in serotonin, norepinephrine and dopamine are thought to be a direct cause of depression. Hormones ??? hormone changes may trigger depression. Hormone changes are seen in thyroid problems, menopause and in other conditions. While no single life event is thought to cause depression, stressful events can trigger, or worsen, depression. Some research has shown those with a specific genetic abnormality are at greater risk of depression during stressful life events. Other environmental factors contributing to depression include:One of the causes of teen depression is thought to be a learned feeling of helplessness. Causes of depression in women and men include all of the above, but there are certain risks more common to each gender. An environmental cause of depression in men is more likely to be job-related while an environmental cause of depression in women is more likely to involve their social relationships. Other causes of depression that appear to be gender-related include:Menopause ??? the changes in hormones are thought to be a cause of depression in women. Low testosterone levels ??? men with lower testosterone levels later in life have a greater chance of developing depression. Effective depression treatments are available today and help many people dealing with this serious mental health condition. Depression is a common, treatable mental illness that affects millions of people in the United States every year. Researchers estimate more than 12 million women and 6 million men are affected by depression in any given year. Depression treatment options include: medical, self-help psychotherapeutic and alternative techniques. No one depression treatment is right for everyone, but with treatment, most people experience a significant reduction in depression symptoms. Antidepressants are the most common medication used in depression treatment and are indicated particularly in the treatment of severe depression. One type of antidepressant, selective serotonin reuptake inhibitors (SSRIs), is typically the first-line treatment for moderate-to-severe depression. SSRIs alter a chemical messenger (serotonin) in the brain. SSRIs are generally prescribed first as they are proven effective and carry fewer risks of side effects than other medications for the treatment of depression. Other types of antidepressants include: Tricyclic antidepressants ??? older antidepressants, typically only used if other types have failedTherapy is often the first choice of depression treatment in mild to moderate cases of depression. Several types of therapy have been proven effective in the treatment of depression. They include:Cognitive behavioral therapy (CBT) ??? short-term therapy designed to address faulty and illogical thought patterns contributing to depressionInterpersonal therapy ??? short-term therapy designed to address maladaptive patterns in situations and relationshipsPsychodynamic therapy ??? long-term therapy designed to alleviate deeper issues underlying depressionEye movement desensitization and reprocessing (EMDR) ??? therapy designed to work through traumatic memoriesSelf-help depression treatment can be found in books and online. Depression or other mental health support groups can also offer self-paced treatment for depression. Neurostimulation depression treatments involve the modulation and stimulation of parts of the brain. Neurostimulation is typically accomplished through the use of an electrical current but can also use a strong magnetic field.

Print and take this quiz order plavix toronto, along with your answers purchase plavix master card, and discuss the outcome with your health professional order plavix 75mg on line. Answering more than three questions with "maybe" or "often" should also be discussed with a health professional. Those answers indicate you may have an eating disorder or be at risk for developing an eating disorder. There are almost as many types of treatment for eating disorders as there are types of eating disorders themselves. This is because different eating disorders require different approaches and the severity of the eating disorder may dictate the treatment method chosen. The key lies in finding the right type of eating disorder treatment that works best for the individual. Help for anorexia and bulimia is generally available at medical care facilities, through private practitioners and through community or faith-based groups. Treatment types include:Acute, medical care, typically through a hospitalOngoing psychiatric care, possibly including medicationInpatient or outpatient programs, typically eating disorder specializedNutritional counselingPsychological counselingGroup therapy / Self-pacedMedical treatment for eating disorders, particularly acute, inpatient admission, is not generally required. The exception is when an eating disorder is so severe that the physical damage must be handled immediately, as in the case of an esophageal tear in a bulimic ( bulimia side effects ) or in the case of severe starvation in an anorexic ( anorexia health problems ). Medical treatment of an eating disorder that includes prescription medication is needed more frequently. In this case, medications are prescribed, generally by a psychiatrist and may be intended to help treat the eating disorder itself or any possible co-occurring mental illnesses, such as depression, which is common in those with anorexia or bulimia. Medications used in the treatment of eating disorders typically include:Selective serotonin reuptake inhibitors (SSRIs) - the preferred type of antidepressant; thought to help decrease the depressive symptoms often associated with some eating disorders. Fluoxetine (Prozac)Tricyclics (TCAs) - another type of antidepressant thought to help with depression and body image. TCAs are generally only used if SSRIs treatments fail. Desipramine (Norpramin)Antiemetics - drugs specifically designed to suppress nausea or vomiting. Ondansetron (Zofran)The type of program that is chosen depends on the severity and duration of the eating disorder. For those with a severe, long-standing eating disorder, inpatient treatment may be required. Inpatient care is full-time and generally done in an eating disorder treatment center or in a dedicated wing of a hospital. Outpatient treatments for anorexia or bulimia are similar to inpatient care, but are only provided during the day. Outpatient (or daytime) eating disorder treatment is most appropriate for those who have a safe and supportive home to go to each night. Eating disorders are mental illnesses and so, like any other mental illness, treatment for eating disorders often includes psychological counseling. This type of therapy for eating disorders may focus on building life or psychological skills, or analyzing the cause of the eating disorder. Types of counseling used include:Talk therapy - for psychological issues behind the eating disorderCognitive behavioral therapy (CBT) - to challenge the thought patterns and actions surrounding eating behaviorsGroup therapy - professionally-led group therapy can be used as part of CBT, as support and as a learning environmentNutritional counseling may be used in conjunction with any of the other treatments - either initially or on an ongoing basis. Support groups and self-paced therapies can also be part of successful eating disorder treatment. Support groups may contain a mental health professional, but are often run by peers. Some groups are part of a structured treatment program, while others are more supportive in nature. Support groups can help a person get through treatment by meeting others who personally understand eating issues. Many people do not need medications for eating disorders during treatment, but eating disorder medications are needed in some cases. Patients also need to be aware that all eating disorder medications come with side effects and the risks of the drug needs to be evaluated against the potential benefit. These medications are primarily prescribed to stabilize the patient both mentally and physically. Without the proper electrolyte balance, there can be emergency eating disorder health problems and complications involving the heart and brain. Only one psychiatric medication has been FDA approved to treat eating disorders: fluoxetine (Prozac ) is approved for the treatment of bulimia. However, other psychiatric medications may be used in treatment for any eating disorder. Because of depression, anxiety, impulse and obsessive disorders commonly seen in patients with anorexia or bulimia, the patient may receive antidepressants or mood stabilizers. Common psychiatric eating disorder medications include the following types:Selective serotonin reuptake inhibitors (SSRI): these antidepressants have the strongest evidence as eating disorder medications with the fewest side effects. In addition to fluoxetine, examples of SSRIs include sertraline ( Zoloft ) and fluvoxamine ( Luvox ). Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs): These older antidepressants have some evidence as being effective in eating disorders treatment; however, they have more side effects than SSRIs. Other antidepressants: Other antidepressants are also used in the treatment process. Examples are bupropion ( Wellbutrin ) and trazodone ( Desyrel )Mood stabilizers: There is some evidence for using mood stabilizers to treat eating disorder patients. Because mood stabilizers can have adverse effects such as weight loss, mood stabilizers are not a first choice for eating disorder medications. Examples of mood stabilizers are: topiramate ( Topiramate ) and lithium. Even if medications for eating disorders are not indicated, the patient may have other medical conditions that need to be managed with medication. Psychiatric disorders like depression, bipolar, anxiety, substance abuse, ocd and ADHD are extremely common in patients with an eating disorder. Medications for eating disorders may also be prescribed to manage the physical damage done by the eating disorder. Examples of other medications for eating disorders and co-existing conditions include:Orlistat (Xenical): an anti-obesity drugEphedrine and caffeine: stimulants; energizing drugs Methylphenidate: typically used when attention deficit hyperactivity disorder accompanies the eating disorderEating disorder recovery can seem like an impossible goal to some, but with professional help, eating disorders can be successfully treated. Successfully recovering from an eating disorder requires various types of treatment depending on individual circumstances. Therapy, medication, support groups are all part of a treatment program.

Over a 4 to 6 week period order plavix once a day, you may find some side effects less troublesome (nausea and dizziness discount plavix 75mg mastercard, for example) than others (dry mouth purchase 75mg plavix mastercard, drowsiness, and weakness). More common side effects may include: Abnormal ejaculation, abnormal orgasm, constipation, decreased appetite, decreased sex drive, diarrhea, dizziness, drowsiness, dry mouth, gas, impotence, male and female genital disorders, nausea, nervousness, sleeplessness, sweating, tremor, weakness, vertigoLess common side effects of Paxil may include: Abdominal pain, abnormal dreams, abnormal vision, agitation, altered taste sensation, blurred vision, burning or tingling sensation, drugged feeling, emotional instability, headache, increased appetite, infection, itching, joint pain, muscle tenderness or weakness, pounding heartbeat, rash, ringing in ears, sinus inflammation, tightness in throat, twitching, upset stomach, urinary disorders, vomiting, weight gain, vertigo, yawningRare side effects may include: Abnormal thinking, acne, alcohol abuse, allergic reaction, asthma, belching, blood and lymph abnormalities, breast pain, bronchitis, chills, colitis, difficulty swallowing, dry skin, ear pain, exaggerated sense of well-being, eye pain or inflammation, face swelling, fainting, generally ill feeling, hair loss, hallucinations, heart and circulation problems, high blood pressure, hostility, hyperventilation, increased salivation, increased sex drive, inflamed gums, inflamed mouth or tongue, lack of emotions, menstrual problems, migraine, movement disorders, neck pain, nosebleeds, paranoid and manic reactions, poor coordination, respiratory infections, sensation disorders, shortness of breath, skin disorders, stomach inflammation, swelling, teeth grinding, thirst, urinary disorders, vaginal inflammation, vision problems, weight lossDangerous and even fatal reactions are possible when Paxil is combined with thioridazine (Mellaril) or drugs classified as monoamine oxidase (MAO) inhibitors, such as the antidepressants Nardil and Parnate. Never take Paxil with any of these medications, or within 2 weeks of starting or stopping use of an MAO inhibitor. Paxil should be used cautiously by people with a history of manic disorders and those with high pressure in the eyes (glaucoma). If you have a history of seizures, make sure your doctor knows about it. Paxil should be used with caution in this situation. If you develop seizures once therapy has begun, the drug should be discontinued. If you have a disease or condition that affects your metabolism or blood circulation, make sure your doctor is aware of it. Paxil may impair your judgment, thinking, or motor skills. Do not drive, operate dangerous machinery, or participate in any hazardous activity that requires full mental alertness until you are sure the medication is not affecting you in this way. It can lead to symptoms such as dizziness, abnormal dreams, and tingling sensations. To prevent such problems, your doctor will reduce your dose gradually. Remember that Paxil must never be combined with Mellaril or MAO inhibitors such as Nardil and Parnate. If Paxil is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Paxil with any of the following:Alcohol Antidepressants such as Elavil, Tofranil, Norpramin, Pamelor, ProzacPhenobarbital Phenytoin (Dilantin)Propranolol (Inderal, Inderide)The effects of Paxil during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. Paxil appears in breast milk and could affect a nursing infant. If this medication is essential to your health, your doctor may advise you to discontinue breastfeeding until your treatment with Paxil is finished. The usual starting dose is 20 milligrams a day, taken as a single dose, usually in the morning. At intervals of at least 1 week, your physician may increase your dosage by 10 milligrams a day, up to a maximum of 50 milligrams a day. The usual starting dose is 20 milligrams a day, typically taken in the morning. At intervals of at least 1 week, your doctor may increase the dosage by 10 milligrams a day. The recommended long-term dosage is 40 milligrams daily. The usual starting dose is 10 milligrams a day, taken in the morning. At intervals of 1 week or more, the doctor may increase the dose by 10 milligrams a day. The target dose is 40 milligrams daily; dosage should never exceed 60 milligrams. The recommended dose is 20 milligrams taken once a day, usually in the morning. The recommended dose is 20 milligrams taken once a day, usually in the morning. For older adults, the weak, and those with severe kidney or liver disease, starting doses are reduced to 10 milligrams daily, and later doses are limited to no more than 40 milligrams a day. Safety and effectiveness in children have not been established. The symptoms of Paxil overdose may include: Coma, dizziness, drowsiness, facial flushing, nausea, sweating, tremor, vomitingWritten by Oloruntoba Jacob Oluboka, MB, BS Emmanuel Persad, MB, BSSometimes antidepressants lose their effect. Pharmacologic intervention in an individual with depression poses a number of challenges to the clinician, including tolerability of an antidepressant and resistance or refractoriness to the antidepressant drug. To this list we wish to add loss of antidepressant effect. Such loss of efficacy will be discussed here within the context of the continuation and maintenance treatment phases after an apparently satisfactory clinical response to the acute phase of treatment. The loss of therapeutic effects of antidepressants has been observed with amoxapine, tricyclic and tetracyclic antidepressants, monoamine-oxidase inhibitors (MAOIs) and the selective serotonin reuptake inhibitors (SSRIs). Zetin et al reported an initial, rapid "amphetamine-like", stimulant and euphoriant clinical response to amoxapine, followed by breakthrough depression refractory to dose adjustment. All eight patients reported by these authors experienced loss of antidepressant effect within one to three months. Cohen and Baldessarini4 reported six cases of patients with chronic or frequently recurrent unipolar major depression who also illustrated the apparent development of tolerance during the course of therapy. Four of the six cases developed tolerance to tricyclic antidepressants (imipramine and amitriptyline), one to maprotiline and one to the MAOI phenelzine. Mann observed that after a good initial clinical response there was a marked deterioration, despite maintaining the MAOI (phenelzine or tranylcypromine) dosage, even though no loss of inhibition of platelet monoamine oxidase was noted. The author suggested two possibilities for the loss of the antidepressant effect. The first was a fall in the level of brain amines such as norepinephrine or 5-hydroxy- tryptamine due to end point inhibition of synthesis, and the second was post-synaptic receptor adaptation, such as the down regulation of a serotonin-1 receptor. Donaldson reported 3 patients with major depression superimposed on dysthymia who initially responded to phenelzine but later developed a major depressive episode that was refractory to MAOIs and other treatments. He postulated that overmedication due to parent and metabolite accumulation with fluoxetine could appear as response failure.

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