Healthy Hearts

Everyday Heart Health Tips If you're not convinced about the need to develop an exercise program for your life, you can at least try following some of these tips in your everyday routine. Take advantage of any opportunity for exercise. Try some today.

 

• Take the stairs instead of an elevator or escalator at school or the mall. Just start with one flight. Soon, you'll be ready for two.
• Park your car at the far end of the parking lot. The short walk to and from the store or school helps your heart.
• If you ride a bus or subway, get off a stop before your destination. Walk the rest of the way.
• If you can, spend a few minutes of your lunch break taking a stroll around the campus grounds. It should help you stay awake after lunch.
• Think of housework as an extra chance to exercise. Vacuuming briskly can be a real workout.
• Mowing the lawn, pulling weeds, and raking leaves are chores that can be done yourself as a chance to exercise.
• If you have a dog, think of the dog as an exercise machine with fur. A brisk walk with the dog is good for both of your hearts. Make it a part of your daily routine.
• If you have a family, schedule an after-dinner walk. Make it quality time.

Fast Food Killing Women's Libido

Changing Food Habits Dampen Desire, say Italian Medics


Never mind slow food; women need more slow sexy food. That's the word from the Italian Society of Gynaecology and Obstetrics (SIGO), who have launched a new book on women's health titled "Food and Sex." The book is a collection of 30 recipes designed to inspire desire and to combat the rising number of Italian women who doctors say are suffering from sexual performance anxiety.

Fast Food Killing Libido

The Mediterranean diet is often hailed as one of the healthiest in the world, with its high proportion of fresh fruit and vegetables and low saturated fats, and it remains the basis of Italian cuisine. Yet lifestyle changes have also brought about significant dietary changes to Mediterranean women.

"The increased pace of life means women who are working in the cities don't have time to prepare fresh food and they are eating more fast food. Many cultural aspects of food are being lost, with consequences for their sexual health and libido," said SIGO President Dr. Giorgio Vittori.

Female Sexual Performance Anxiety

Eleven percent of Italian women reported anxiety about their sexual performance in a recent SIGO study, and a surprising 73% did not acknowledge a link between diet and libido.

To get the message out, and in a twist of marketing genius, doctors are recommending a return to erotic foods.

Top Erotic Foods

Alongside erotic legends like caviar (with zinc for sperm production), chili (for vascular dilation), chocolate and cocoa (with stimulants and anti-depressives pheniletilamine and theobromine), surprise entries in the recommended erotic foods index include asparagus, almonds, honey (recommended by the ancient Ayurvedica culture to newlyweds, hence the word "honey-moon"), avocado, saffron (stimulates erogenous zones) and cloves (one of the most powerful natural aphrodisiacs).

The banana also gets a mention thanks not only to its phallic shape but to its peel, which contains traces of an alkaloid called bufotenin, a powerful toxin usually found in toads that, according to some experts, can act as a relaxant in tiny doses.

Perfect Meal for Passion

"Pre-cooked or pre-packaged food and eating too quickly causes intense cerebral excitement," said Professor Alessandra Graziottin, director of the Centre of Gynaecology at the San Raffaele Resnati Institute of Milan, "but it is paradoxically damaging to libido. In fact, it increases irritability. We need to pay attention not only to what we eat but how."

And the perfect meal for a night of passion according to the "Food and Sex" authors? Crab and avocado "eat me" mousse, "butterflies in my stomach" pasta or "lovers' risotto," "intriguing escalopes" with shavings of truffle and chocolate "kisses" for dessert. Easy on the vino, however, and skip the post-coital cigarette. And whatever you do, go slowly

Mens' and Womens' Sexual Arousal Rates

Do Men & Women Get Excited at the Same Rate?


McGill University's study of sexual arousal rates in men & women revealed that both sexes are turned on to maximal arousal at more or less the same rate. Hard to believe?

This research shows that mens' and women' sexual arousal rates may be more similar than people thought.

Sexual Arousal Rates in Men and Women

The psychology of sexual arousal rates was fascinating long before Alfred Kinsey researched it. Kinsey was the first to make men and women's sexual arousal rates public and acceptable (though how acceptable his research was is debatable!). New research about sexual arousal rates reveal that men and women get excited at the same rate, which seems hard to believe. Don't men think of sex hundreds of times a day, thus increasing their sexual arousal rates?

What McGill's Research Shows About Sexual Arousal Rates

McGill University researchers found that men and women have sexual arousal rates that are more or less equal. However it's important to remember that any time humans or animals are involved in laboratory studies, their responses aren’t quite the same as in “real life.” Researchers do their best to simulate real life situations when they're studying sexual arousal rates in men and women – and they can come really close – but it’s not quite the same. Would these research results about sexual arousal rates be the same if study participants were in their own homes, with their own lovers?

Place Affects Mens' and Womens' Sexual Arousal Rates

The subjects watched a movie with video goggles and other measurements of their sexual response rates. This is much different than having sex at home (or on the train, plane, desk, photocopier, etc). How applicable are the lab findings to "real" sexual arousal situations and sexual arousal rates? It's difficult to say.

Real Life Versus Movies Affects Arousal Rates

With a real-life lover, most men and women (especially women) are affected by their surroundings, who is nearby making noise, how fat they feel, whether they have gas, if birth control is available, how hairy their legs are, how intimate their relationship is, what a colleague said as they were leaving the office, if they're fighting with their sister, and so on… In light of this, do the study’s results about sexual arousal rates in women and men transfer to real-life sexual situations? It may be easier for women to become aroused by watching a movie in a quiet, unpressured research situation than at home with all sorts of real-life distractions.

Study Participants Affect Sexual Arousal Rates

The participants in this study were “healthy subjects”. What does this mean? Were they 21 year old sexually active university students who may experience maximal sexual arousal in minutes? Were they married, gay, straight, parents of small children, overworked lawyers or pastors? In other words, how representative were they of the middle-aged adult population? Whether they're involved in healthy or unstable relationships is another factor that affects sexual arousal rates in men and women.

Definitions of Mens' and Womens' Sexual Arousal Rates

What exactly is “maximal sexual arousal”? In the study, men reached maximal arousal in 664.6 seconds; women in 743 seconds. I’m not sure if this means the same thing in both genders, or if they can even be compared. For men, it probably means full erection. For women, does it mean ready for instant penetration? Maybe. But even when a woman feels aroused, she may not quite be ready for penetration. This may affect the definition of sexual arousal rates in women.

Applying Mens's and Womens' Sexual Arousal Rates to Real Life

Finally, what real-life differences do these sexual arousal results make in the bedroom - or in a healthy relationship? If I don’t get aroused at the same rate as my husband, it doesn’t matter what this or any study reveals about sexual arousal rates in women and men. That said, it is interesting for research purposes. As Dr. Binik states, the results will help treat sexual arousal disorders in women, which is excellent because we could all use a good orgasm now and then!

Feeling connected and intimate with your partner - and not nervous when you're naked - may be more important than sexual arousal rates.

You’re not abnormal or weird - nor is your partner - if your sexual arousal rates aren't the same as the research findings. So, don’t set the timer and expect to be going at full boar after 743 seconds…unless of course you’re watching a sexually arousing movie with special video goggles in a darkened research lab.

Sexual Heath Relationship

These natural tips for healthy physical intimacy will bring you closer to your partner. Your libido will also improve - whether you're male or female - which can help you build a healthy marriage!


"Men should have sex four times a week for optimum health," said Dr Mehmet Oz on the Oprah Winfrey show.

The benefits of physical and emotional intimacy for both men and women include stronger bones and muscles, less stress and depression, better memory and a stronger immune system. Four times a week may be a lot of physical intimacy to ask for even the most loving couple – unless you have a little help.

10 Natural Tips for Healthy Physical Intimacy

Accept your sensuality. Millions of people – both men and women – aren’t comfortable with their libidos, says Dr Marian Dunn of the Center for Human Sexuality. When you’re comfortable with physical intimacy, you can freely admit and explore your full range of desires.

Compromise with your partner. If you crave physical intimacy every night and your partner wants it once a month, you’ll need to meet in the middle. Being happy in your relationship involves openly discussing when and how often physical intimacy happens. This natural tip for a healthy love life requires honest discussion about different views on your libido and physical and emotional intimacy.

Move your body. The more oxygen, fresh air, and movement you give your body during the day (walking, biking, swimming, chasing after your children), the more sensual you’ll feel overall. Physical and emotional intimacy is connected to how active you are during the day. Exercising doesn’t deplete energy, it increases it!

Unwind before you hit the sheets. There’s nothing less sexy than worrying about bills, work, investments, or politics when you’re striving for a healthy sex life. This natural tip for a healthy love life involves de-stressing before you go to bed. Have a bubble bath, snuggle with your partner, or go for a long walk. The less tense you are, the more you’ll enjoy emotional and physical intimacy.

Use protection. If you’re with a new partner, make sure you’re protected against HIV or other diseases. Insist on good protection – or a healthy love life won’t be yours.

Practice being naked. This natural tip involves your self-esteem and self-confidence. If you feel awkward and embarrassed when you’re naked, you won’t enjoy your partner in bed. Repeat to yourself: “I don’t have to look perfect to enjoy love!” Go to a nude beach or change in the dressing room at the pool, and get used to being around people when you’re nude. This will increase the physical and emotional intimacy in your relationship.

Enjoy a healthy diet. Get away from the fast food, soda pop, and processed sugar! Did you see what happened to Morgan in Supersize Me?! Healthy fruits, veggies, grains, beans, and the occasional hunk of meat will make you feel better and more energetic. This natural tip for healthy physical intimacy can help you lose weight, too.

Examine your prescriptions. If you have absolutely no appetite for intimacy, look into the medications you’re taking. Some, such as birth control pills or antidepressants, can inhibit your libido. Talk to your doctor about how your prescriptions are affecting your love life. You may not be able to quit taking your prescription, but your doctor may offer additional tips for healthy intimacy that speak to your specific condition.

Try new things. To fully enjoy physical and emotional intimacy with your partner, stay away from the routine! New toys, lingerie, places, or even foods can help spice up your love life and increase your desire. Physical intimacy at any age can be enhanced with a little variety.

Laugh about it. Sue Johanson of the Sunday Night Sex Show gave George Stroumboulopoulos this advice: Laugh about your sexual escapades with your partner. This natural tip for healthy libidos help reduce the embarrassment or awkwardness you may feel – and laughing with your partner increases feelings of connection.

healthy Relationships

It's been said that no man (or woman, for that matter) is an island. And it's true: good relationships are essential to our happiness and emotional health. Our relationships can affect our physical health as well.


Indeed, one thing researchers know for sure is that our ability to feel love and intimacy is what keeps us well. Study after study has shown that loneliness is a risk factor for disease, and that relationships have a positive effect on everything from heart health to age-related health issues.



Nurture Your Relationships

It's not always easy to keep friendships and family connections strong when you're busy with work, children, and other demands on your time. Here are some tips for keeping those relationships healthy even in tough times:

Visit with friends and family. Simple, but important. Take time to make a phone call, send an email, or write a quick note.

Make new friends. Establishing new contacts with people who have similar lifestyles can help you feel that someone understands your daily challenges.

If you feel too exhausted to talk to or relate with the people important to you, tell them. Explain your feelings to them. This communication can help you both feel better.



5 Ways to Get Closer to Your Mate

For many of us, a spouse, partner or significant other is the most important relationship in our lives. Yet it's easy to grow apart, even when you live together. Here are five tips from the experts for staying close:



1. Listen, With the TV Off.

The experts agree on this point -- listening, truly listening, can reduce conflict, boost trust, and lead to a more satisfying partnership. Listening may sound simple, but it requires more than being in the same room while your better half is speaking. Signal that you care by turning off the television, offering your undivided attention, and making eye contact. And don't forget to follow up on what you hear.

This is particularly important when your partner is upset. If you listen carefully, you are more likely to understand the problem and find a way to help.



2. Focus on the Positives.

"When you first meet someone, you pay attention to all the things you like," says Kate Wachs, PhD, a Chicago psychologist and author of Relationships for Dummies. "As time goes on, you start to take that for granted and instead you focus on what bothers you. If the relationship becomes more negative than positive, you break up."

The solution is to make a conscious effort to focus on the things you like about your partner. "Your partner has many good qualities, as well as things that drive you crazy," Brody says. "Look for [the positives] and drink those in. Jot them down to remember them."

3. Stop Nagging.

Nagging not only creates tension, it usually gets you nowhere. "If you're nagging, your partner will tune you out," Wachs tells WebMD. "If someone isn't giving you what you want, think about what you are doing. It's not working. What can you do instead? Have a dialogue. ... Instead of saying what you don't like, say what you would prefer. Give alternatives."

And remember to balance any criticisms with a heavy dose of positive feedback. When making a request that could be seen as nagging, take the edge off by expressing appreciation for your partner's good qualities.



4. Spend More Time Together.

Putting "couple time" on your calendar reinforces your sense of dedication to each other. "Couples benefit when they feel commitment," Peter A. Wish, PhD, clinical psychologist and author of Don't Stop at Green Lights: Every Woman's Guide to Taking Charge of Her Life and Fulfilling Her Dreams, tells WebMD. "Make these private times special by not including others."

But don't make the mistake of limiting your interaction to designated couple time. Try to enjoy each other's company for at least a few minutes every day, especially first thing in the morning, at the end of the workday, and right before bed. "At those times talk about positive things," Wachs says. "It makes a big impression."

Make a special point of greeting each other at the end of the workday. If you're home first, stop what you're doing when your partner arrives and spend a moment together. "Act like [he or she] is important," Wachs advises, "not just the postman stopping by with the mail."



5. Touch More Often.

Physical communication is as important as emotional communication in a relationship. It relieves tension and shows your partner that you care. "Physically being in contact with your partner breaks through a lot of ice," Wachs says. "Go out of your way to kiss and hug during the day. Always sleep together in the same bed. Just assume you're going to have sex every night. ... It's hard to fight if you're having great sex."

Stress Management

Cut the Stress, Simplify Your Life
Introduction


I went to the woods because I wished to live deliberately, to front only the essential facts of life, and see if I could not learn what it had to teach, and not, when I came to die, discover that I had not lived. I wanted to live deep and suck all the marrow of life. --

OK, it's unlikely you're going to make like Thoreau and move to the woods. Heck, you probably don't even have time for a walk in the woods. If that's the case, though, that may very well mean that it's time to simplify your life. In so doing, you may just save your health -- and your sanity (not to mention actually having time to take that walk).

Erin Bocherer and her husband are doing just that. "Our New Year's resolution was to simplify our life as much as possible to reduce stress," says Bocherer, an advertising account supervisor.

This is what the Bocherers have been doing:

Online banking. "This limits post office drop-offs and reduces the time and money spent on stamps and licking envelopes," says Bocherer. "It also enables me to schedule automatic payments each month, which saves several hours of our time because we no longer need to write out bills and balance the checkbook."

Hiring a cleaning service every three weeks. "We still clean, but they handle the nitty-gritty, time-consuming activities that seemed to fill our weekends," says Bocherer.

Hiring a nanny. Yes, this is expensive, but it saves the Bocherers two hours a day in the car dropping off and picking up their son at daycare. "It enables me to spend more quality time with my son (and with my daughter when she is born in May)," says Bocherer.

Reducing debt. "Debt is one of our biggest stresses that never seems to end," says Bocherer. By creating a strict, yet manageable budget, and focusing on paying off their debt, the Bocherers say they are creating a feeling of accomplishment.

Find a local Psychiatrist in your town

Simplicity Movement Taking Hold

The Bocherers are not alone in their efforts to cut the stress from their life. Browse your favorite newsstand or bookstore and you'll see evidence of an anti-stress movement taking hold in this country. Generally known as "voluntary simplicity," or the "simplicity movement," the need many of us see for a less stressful, more meaningful life is reflected in magazines, books, and web sites devoted to simplifying your life, whether that means "de-cluttering" your home, "downsizing" your career ambitions, or living off the land.

About 5% to 7% of adults in the U.S. are pursuing some form of voluntary simplicity, according to Gerald Celente, director of the Trends Research Institute in New York. The contemporary voluntary simplicity movement began in 1981 with the publication of Duane Elgin's book, Voluntary Simplicity: Toward a Way of Life That is Outwardly Simple, Inwardly Rich. Since then, dozens of books, national magazines, web sites, and grassroots "simplicity circles" have sprung up to offer support and share ideas for those interested in scaling back.

Simplifying your life doesn't necessarily mean doing without. It might, but it doesn't have to. Rather, the prevailing philosophy of today's voluntary simplicity movement is not to live without possessions or to live in frugality, but to slow down and live a more balanced, deliberate, and thoughtful life. And as research increasingly shows, a healthier life as well.

It's no longer news that stress can take its toll on both your physical and mental health. Numerous studies have shown a link between stress and high blood pressure. In one such study, for example, scientists at the University of California at Irvine reported in 1998 in the Journal of Psychosomatic Medicine that men with highly stressful jobs had systolic and diastolic blood pressure readings that were approximately 10 points higher than those with less stressful jobs.

In a study published in 2000 in the journal Social Science & Medicine, researchers from Ohio State University and the University of Alabama found that people with a high ratio of credit card debt to income were in worse physical health than those with less debt.

Too Much 'Stuff' Takes Its Toll

And now, mental health professionals have joined the movement, focusing on how simple living can help alleviate tension-related reactions such as insomnia, nervousness, anxiety, neck and shoulder spasms, chronic fatigue and, says Roderic Gorney, MD, PhD, "our excessive dwelling on 'things.'"

"The message that we get is that without this complexity of 'things' in our life, we are not lovable and not worthy," says Gorney, clinical professor of psychiatry at UCLA and author of The Human Agenda, who also serves on the board of Seeds of Simplicity, an LA-based program of Cornell University's Center for Religion, Ethics & Social Policy. The organization has recently started a campaign called "Unstuffocate," to help people decide for themselves just how much is enough.

The mental health community's awareness of such dependencies as "consumption addictions" led UCLA's Neuropsychiatric Institute to recently sponsor a conference on "Mental Health and Simple Living: Countering the Compulsion to Consume." The purpose of the conference, says Gorney, was to "help the person shake off the addiction to too much, and with it the distress of excess."

Just acknowledging that you need to simplify your life, however, doesn't solve the problem, although it is a beginning. You may be so crunched for time and energy that you can't even stop to think of ways to simplify your life. Let the experts give you a few suggestions.

It's Time to Disconnect

"Many people feel stressed and overwhelmed because they are 'overconnected,'" says Debra A. Dinnoncenzo, president of ALLearnatives, which specializes in alternative work arrangements. "As a result of the ... never-ending ways that people can access us any time of the day or night, we feel perpetually connected to our work," says Dinnoncenzo, also the author of Dot Calm: The Search for Sanity in a Wired World.

Think about all the technology resources that we now use that weren't commonplace even a few years ago, says Dinnoncenzo. Simplifying your life doesn't mean you have to ditch the cell phone, pager, e-mail, instant messaging, voice mail, call forwarding, and on and on. But it does mean establishing clear boundaries:

Turn off your cell phone when you shouldn't be (or don't want to be) interrupted.

Don't take a cell phone to an appointment or when you are focusing on someone else.

Don't give out your cell phone number. Use it only for outgoing calls.

Screen calls by using caller ID.

Use the "delete" option -- early and often.

Arrange for calls from the office only in cases of emergency.

Maintain your commitment to work-free vacations.

Let voice mail or the answering machine take your calls.

On your voice mail greeting, be clear about when you will and will not be available.

Along with all this technology -- which includes the TV too, by the way -- comes information overload, says Daphne Stevens, PhD, a psychotherapist, life coach and author of the forthcoming book, Watercolor Bedroom: Creating a Soulful Midlife. "Limit the amount of information you expose yourself to," she says. "Being flooded with stimuli is a tremendous source of stress."

Debbie Mandel, MA, a stress management expert and author of Turn On Your Inner Light: Fitness for Body, Mind and Soul, says simplifying your life is like "spring cleaning for the soul."

"Stress is omnipresent," says Mandel. "The trick is to learn to decompress." Mandel's suggestions for simplifying your life include:

Make a list of your activities, prioritize your to-do list, and shed those activities that no longer serve a purpose in your life.

Delegate chores at home and at the office. Don't try to do it all. Ask for help.

Let go of the myth of perfection.

Simplifying your life may also mean more than just getting rid of "stuff." It may mean getting rid of people too, says Daphne Stevens. "Avoid overexposure to negative or toxic people," she suggests. Instead, "nurture the relationships that support you. A quick email or card saying 'I'm thinking of you' can work wonders in keeping a friendship alive when we're too busy to do much else."

However you choose to simplify your life, remember that simplicity is not about poverty or deprivation, according to The Simple Living Network. It is about discovering what is "enough in your life -- based upon thoughtful analysis of your lifestyle and values -- and discarding the rest."

Ear Infections Prevention Tips

Ear Infections

 

Few pains are more excruciating to a young child than an earache. After the common cold, an ear infection is the most frequent childhood illness and three out of four children will experience an ear infection by their third birthday.

 

The ear has three parts: the outer ear, middle ear and inner ear, Rice explains. The outer ear, which collects sound, includes the part outside the head and the ear canal. At the end of the ear canal is the eardrum, a small circle of tissue about the size of a fingertip. Behind the eardrum is the middle ear, which is normally filled with air. When the eardrum vibrates, tiny bones in the middle ear transmit the sound to the inner ear, where nerves relay sound signals to the brain.

 

Causes

 

"Middle ear infections are usually a complication of upper respiratory infection, such as a cold," Rice says. Bacteria travel up the Eustachian tube, a tiny tunnel that connects the back of the nose and throat to the middle ear.

 

When the tube is blocked, fluid builds up in the middle ear, causing the ear to ache and swell. In children, this tube is shorter than in adults and allows germs to reach the ear more easily. Another reason children are more prone to earaches than adults is because their immune systems are not fully developed, Rice adds.

 

Symptoms

 

In babies and young children, symptoms of a middle ear infection include:

 

• Hearing problems
• Unusual irritability
• Tugging at ears
• Fever
• Vomiting
• Ear drainage
• Diarrhea

 

Complications

 

Although rare, complications from untreated ear infections include:

 

• Eardrum rupture
• Infection of the inner ear (labyrinthitis), which causes dizziness and imbalance
• Infection of the skull behind the ear (mastoiditis)
• Infection of the membranes around the brain and spinal cord (meningitis)
• Scarring and thickening of the eardrum
• Facial paralysir
• Permanent hearing loss

 

Treatment

 

"Ear infections, like other infections, are essentially treated with antibiotics," Antibiotic drops may be prescribed if pus is leaking from the ear. If a child has a bulging eardrum and is in severe pain, a surgical incision may be made to the eardrum to release the pus.

 

Prevention

 

"You can avoid middle ear infections by keeping your child away from cigarette smoke and playmates who are sick," says Rice. Studies have shown that children who breathe tobacco smoke have a higher risk of developing health problems, including ear infections.

Diphtheria Prevention Tips

What is it?


Diphtheria is an acute and highly contagious bacterial infection that mainly affects the nose and throat.

Who gets it?

Children under 5 years old and adults over 60 are particularly at risk for contracting diphtheria, as are those living in crowded or unsanitary conditions, the undernourished, and children and adults who do not have up-to-date immunizations.

Diphtheria is rare in the United States and Europe, where health officials have been immunizing children against it for decades. However, it is still common in developing countries where immunizations are not given routinely.

What causes it?

The toxin, or poison, caused by the bacteria can lead to a thick coating in the nose, throat, or airway. This coating is usually fuzzy gray or black and can cause breathing problems and difficulty in swallowing.

What are the symptoms?

In its early stages, diphtheria can be mistaken for a bad sore throat. A low-grade fever and swollen neck glands are the other early symptoms.

In more advanced stages, the patient may have difficulty breathing or swallowing, complain of double vision, have slurred speech, or even show signs of going into shock (pale, cold skin; rapid heartbeat; sweating; and an anxious appearance).

How is it diagnosed?

Children and adults with diphtheria are treated in a hospital.

After a doctor confirms the diagnosis through throat culture and blood counts, the infected person receives a special anti-toxin to neutralize the diphtheria toxin already circulating in the body, as well as antibiotics to kill the remaining diphtheria bacteria. The anti-toxin is given through injections or intravenously. The patient is closely watched while the anti-toxins are given because the solution, which is made from horse serum (blood), may cause an allergic reaction.

What is the treatment?

If the infection is advanced, patients may need mechanical assistance to breathe. In cases where the toxins may have spread to the heart, kidneys, or central nervous system, patients may need intravenous fluids, oxygen, or cardiac medications.

The patient must be isolated. Family members who have not been immunized, or who are very young or elderly, must be protected from contact with the patient.

Your child's doctor will notify the local health department and will take steps to treat everyone in the household who may have been exposed to the bacteria. This will include assessment of immune status, throat cultures, and booster doses of diphtheria vaccine. They will also receive antibiotics as a precaution.

Self Care Tips

Preventing diphtheria depends almost completely on immunizing children with the combined diphtheria/tetanus/pertussis (DTP or DTaP) vaccine and non-immunized adults with the diphtheria/tetanus vaccine (DT). Most cases of diphtheria occur in people who haven't received the vaccine at all or haven't received the entire course.

The immunization schedule calls for DTP or DTaP vaccines at 2, 4, and 6 months of age, with booster doses given at 12 to 18 months and then at 4 to 6 years. Booster shots should be given every 10 years after that to maintain protection.

Diabetes Health Tips

Diabetes - General Information

Artificial Pancreas Safe, Effective in Early Study

An "artificial pancreas" designed to deliver the key blood sugar-regulating hormone insulin to diabetic patients without the need for injections has been found safe and effective in a preliminary study with ten patients.

The device is an insulin reservoir, implanted in the tissue lining the abdominal cavity and connected to a sensor implanted in the jugular vein. The reservoir requires insulin refills every month or so. When the sensor detects an increase in blood glucose, the reservoir delivers the required amount of insulin.



Blood Glucose Testing

Most insurances now pay for diabetics to have blood glucose monitoring equipment in the home. Keeping the machines clean and in good working order are vital for accurate results. Follow the manufacturers' instructions for proper cleaning and maintenance.



Blood Glucose Testing Tip

Be sure hands are clean before performing the test, but don't use alcohol to cleanse your fingertip. It's drying and may cause fingertips to crack. Wash hands with a mild antibacterial soap like Dial.



Diabetes Test After Heart Attack Shows Future Risk

Testing patients who have had heart attacks for signs of diabetes before they leave the hospital may identify those with the highest risk of future heart attacks. Many people hospitalized for a heart attack have undiagnosed diabetes or prediabetes, a term coined to describe the millions of overweight and obese people who have blood sugar levels suggesting an elevated risk of full-blown diabetes. Medications, exercise and diet changes, all of which can restore normal glucose levels, may reduce the risk of heart attacks in patients who have already had a heart attack.



Diabetic Dental Care

Immaculate mouth care is a must. Diabetics are much more prone to gum disease. More frequent dental visits may be needed and careful brushing and flossing are a necessity. Avoid ill-fitting dentures that may cause mouth sores.



Diabetic Eye Care

If you're a diabetic, regular visits to your eye care professional are a must to prevent problems that could lead to blindness.



Diabetic Foot Care Tips

* Take the pressure off your feet by losing weight if you are obese.

* Inspect your feet at least once per day. If you can't see well, ask someone to do it for you.

* Wash feet with mild soap and lukewarm water daily.

* Wear white cotton socks rather than synthetic ones with dyes.

* Don't go barefoot or wear ill-fitting shoes.

* See a podiatrist regularly for toenail trims and other routine maintenance.



Diabetics Are Prone to Foot Problems

Diabetics have decreased sensation and circulation in their feet making them prone to foot infections/wounds that could eventually lead to amputation.



Drug Could Delay Diabetes

Acarbose, a drug that blocks the digestion of starch, could prevent or delay the development of the most common form of diabetes in those with slightly high blood sugar.



Exercises to Avoid

Diabetics should avoid exercises that involve pushing or pulling heavy objects and lifting weights. Blood sugar levels and blood pressure are raised during this kind of exercise.



FDA Approves New Sweetener Neotame

A non-nutritive sweetener said to be 7,000 to 13,000 times sweeter than sugar received approval from the U.S. Food and Drug Administration to be marketed as an additive in candies, soft drinks and various other products.

Like other familiar sweeteners, Neotame is a white crystalline powder that dissolves in water. It is made by Monsanto, which also makes NutraSweet's sweetener Equal. Neotame is approved for use in baked goods, nonalcoholic beverages, chewing gum, confections, frozen desserts, gelatins and puddings, jams, jellies, fruit, juices, toppings and syrups.

The FDA declared the product to be safe for consumption after reviewing more than 113 animal and human studies, some of which looked at any possible links with cancer-causing or neurological side effects.


Inhaled Insulin

Inhaled insulin may soon offer an alternative to needles for people with diabetes.

Novo Nordisk, a Denmark-based company, has ongoing clinical trials to test the safety and effectiveness of an electronic pulmonary insulin system. They say it may be available in the United States and Europe within a few years.

This is the first electronic pulmonary insulin system currently being tested in clinical trials. It works by converting a special liquid insulin into aerosol particles, which are inhaled into the lungs.

Regular Exercise Is a Must

Exercise is extremely important for diabetics as it strengthens the cardiovascular system, increases circulation to the arms and legs and helps control blood sugar levels. Walking, jogging, rowing and swimming are best.

Shoes for Diabetics

* Avoid plastic shoes and waterproof shoes. They encourage perspiration and fungal growth.

* Avoid tight or unventilated footwear.

* Don't wear boots all day.

* Choose cotton or leather shoes.

* Wear sandals as much as possible in the summer.

* Don't wear the same shoes two days in a row.

* Air shoes in the sun to inhibit fungal growth.


Small, Frequent Meals

Diabetics should follow their American Diabetic Association diet and eat small meals more frequently such as three small meals with one or two healthful snacks between meals. This helps maintain a more stable blood sugar level.

Treatment of Hyperglycemia

Some symptoms of hyperglycemia (high blood sugar) are: excessive urination, weight loss, excessive hunger and thirst. If you are experiencing any of these symptoms, you should see your doctor.

Treatment of Hypoglycemia

Some symptoms of hypoglycemia (low blood sugar) are: cool, clammy skin, numbness of the mouth, a fluttering in your chest, hunger and feeling faint. Emergency treatment includes ingesting something containing sugar like orange juice, a candy bar, or sugared soda pop. Follow that with some cheese or peanut butter crackers to sustain your blood sugar level.
What's an Exchange?

In an exchange diet, foods that are similar are grouped together. Serving sizes are well defined so that each will have the same amount of carbohydrate, fat, and protein as any other. Foods can be "exchanged" or traded with others in a category while still meeting the desired overall goals. Exchanges can be applied to most any eating situation and may make it easier to follow a prescribed diet. For example, if a nutrition plan calls for one starch exchange a person could choose 1/2 cup of cooked pasta, OR one slice of bread, OR a small (3 oz.) baked potato.

Rest

Having diarrhea for more than a couple of days can be very exhausting. If you have lost a lot of fluid you are bound to feel very tired and weak. So it's very important to let your body rest when you can.


Ask family and friends to help you with things like cooking, cleaning the house, shopping and collecting the kids from school. They really won’t mind so don’t be afraid to ask. It’s important you get all the help and rest you need.

Being prepared when you go out

One of the hardest things about having diarrhea is that it can sometimes happen so suddenly. You will probably want to be close to a toilet at all times to avoid accidents.

 

If an accident does happen it is very natural to feel embarrassed and upset, even if no one else knows about it. You may worry that people will smell it. This is very hard to cope with so try not to be too hard on yourself. Your close family and friends will understand and will only want to make things as easy as possible for you.

 

To avoid accidents when you go out, you can help to prepare yourself

 

• Know exactly where the toilets are in the place you are going
• Don’t go on long car, train or bus trips
• Take spare underwear, pads, soothing creams and a plastic bag with you, just in case. You can always rinse out underwear you have on in the bathroom sink and put it in the bag to take home. No one needs to know about this
• Wearing a pad can help protect your underwear and make you feel a bit safer
• If you have a colostomy take a spare colostomy bag with you. There are products on the market that can help mask the smell from a colostomy so ask your stoma nurse about these.

 

And also when you are at home, try to

 

• Protect your mattress - put a large pad or towel on your bed if you are worried about having an accident during the night
• Leave a night light on near your bed, in the hallway and bathroom so that you can see where you are going and get to the toilet quickly

 

There are disposable waterproof bed pads on the market that are made for toddlers during toilet training. These can be very handy and help you to feel more secure. You can buy these in supermarkets. Or your nurse may be able to give you some from the hospital, as they use a similar product.

 

If you aren’t able to move quickly, you may feel safer with a commode by the bed. Your nurse can help you arrange to borrow a commode for as long as you need it.

 

Even if it is embarrassing, it is important to let your doctor know if you are having accidents. They may be able to change your anti-diarrhoeal drugs

Looking after the skin around your anus

Looking after the skin around your anus


The skin around your back passage (anus) can become very sore and may even break down if you are having severe diarrhea.

These tips may help

Use unscented baby wipes instead of toilet paper to wipe yourself after you’ve been to the toilet

Have a warm bath to help soothe pain and help with healing. Do this a few times a day if necessary

Pat the area dry with a soft towel after a shower or bath - don’t rub

Ask your doctor or nurse about soothing creams to apply around your anus

Avoid wearing tight trousers or underwear

Cotton underwear will help to keep the area ventilated – nylon can make you sweat and cause even more soreness

Drinking plenty

You lose a lot of fluid if you have diarrhea so it is important to replace this to prevent dehydration. Drink as often as you can, even if it is just small sips. And avoid alcoholic drinks, as they make you lose fluid, rather than replacing it.


The best types of fluids to drink include

Water

Herbal teas

Clear soups

Non fizzy drinks

Electrolyte replacement drinks such as Dioralyte

Soy milk

Managing your diet

Although it is usually better for us to eat a diet high in fiber, this makes diarrhea worse. So if you have diarrhea you will need to break the rules for a while and eat foods that don’t contain too much fiber. It’s best to check with your doctor how long you should do this for.


Foods high in fiber include

High fiber cereals such as bran

Wholegrain breads

Dried and fresh fruit

Nuts

Vegetables such as broccoli, cabbage, cauliflower and beans

Other foods that tend to make diarrhea worse include

Greasy, fatty and fried foods

Foods with caffeine in them – chocolate and coffee

Dairy foods such as milk, yogurt, cheese, butter and cream

Some foods tend to make your stools firmer so try these instead

Rice and pasta

Potatoes without the skin

Dry cracker biscuits

Baked foods

White bread

Pretzels

Bananas

Chicken, beef or fish

Avoid pickled and spicy foods as these irritate the digestive tract and can make diarrhea worse. Eating several small meals a day instead of 3 large ones can help you feel less bloated.

Diarrhea Prevention Tips

Tips on how to cope with diarrhea


This page has some suggestions for ways to cope with diarrhea. As well as taking any medication from your doctor, it’s possible to make small lifestyle changes to help you cope better. These include

Psychological Treatment

There are a wide range of psychological treatments for depression.

 

Some of the main ones are:

 

• Cognitive Behavior Therapy (CBT)
• Interpersonal Therapy (IPT)
• Psychotherapies
• Counseling
• Narrative Therapy

 

CBT, IPT, psychotherapy and counselling all provide either an alternative to medication or work alongside medication. As always, a thorough assessment of the person is needed in order to decide on the best set of approaches.

 

Cognitive Behaviour Therapy (CBT)

 

People suffering from depression - particularly 'non-melancholic depression' - will often have an ongoing negative view about themselves and the world around them. This negative way of thinking is often not confined to depression, but is an ongoing part of how the person thinks about life. Many or all of their experiences are distorted through a negative filter and their thinking patterns become so entrenched that they don't even notice the errors of judgement caused by thinking irrationally.

 

Cognitive behaviour therapy aims to show people how their thinking affects their mood and to teach them to think in a less negative way about life and themselves. It is based on the understanding that thinking negatively is a habit, and, like any other bad habit, it can be broken.

 

CBT is conducted by trained therapists either in one-on-one therapy sessions or in small groups. People are trained to look logically at the evidence for their negative thoughts, and to adjust the way they view the world around them. The therapist will provide 'homework' for between sessions. Between 6-10 sessions can be required but the number will vary from person to person.

 

CBT can be very beneficial for some individuals who have depression but there will be others for whom it is irrelevant.

 

Interpersonal Therapy (IPT)

 

The causes of depression, or our vulnerabilities to developing depression, can often be traced to aspects of social functioning (work, relationships, social roles) and personality .

 

Therefore, the underlying assumption with interpersonal therapy is that depression and interpersonal problems are interrelated.

 

The goal of interpersonal therapy is to help the person understand how these factors are operating in the person's current life situation to lead them to become depressed and put them at risk to future depression.

 

The therapy occurs in three main phases:

 

an evaluation of the patient's history

 

an exploration of the patient's interpersonal problem area and a contract for treatment

 

recognition and consolidation by the patient of what has been learnt and developing ways of identifying and countering depressive symptoms in the future.

 

Usually 12-16 sessions of IPT will be required.

 

Psychotherapies

 

Psychotherapy is an extended treatment (months to years) in which a relationship is built up between the therapist and the patient. The relationship is then used to explore aspects of the person's past in great depth and to show how these have led to the current depression. Understanding this link between past and present - insight - is thought to resolve the depression and make the person less vulnerable to becoming depressed again.

 

Counselling

 

Counselling encompasses a broad set of approaches and goals that are essentially aimed at helping an individual with problem solving - solving long-standing problems in the family or at work; or solving sudden major problems (crisis counselling).

 

Narrative Therapy

 

Narrative Therapy is a form of counselling based on understanding the 'stories' that people use to describe their lives. The therapist listens to how people describe their problems as stories and helps the person to consider how the stories may restrict them from overcoming their present difficulties. It sees problems as being separate from people and assists the individual to recognise the range of skills, beliefs and abilities that they already have (but may not recognise) and that they can apply to the problems in their lives.

 

Narrative Therapy differs from many therapies in that it puts a major emphasis on identifying people's strengths, particularly as they have mastered situations in the past and therefore seeks to build on their resilience rather than focus on their negatives.

Physical Treatment

The main physical treatments for depression comprise


Drug treatments

Electroconvulsive therapy

A third physical treatment with as yet narrow application is

Transcranial magnetic stimulation.

Drug Treatments

There are three groups of drugs most likely to be used for depression:

Antidepressants

Tranquillisers

Anti-manic drugs or mood stabilisers

Antidepressants

There is a large number of antidepressants - they have a role in many types of depression and vary in their effectiveness across the more biological depressive conditions.

Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclics (TCAs) and Irreversible Monoamine Oxidase Inhibitors (MAOIs) are three common classes of antidepressants. They each work in different ways and have different applications.

At the Institute we believe that they are not, however, equally effective and that it is necessary to find the right antidepressant for each person.

If the first antidepressant does not work, it is sensible to move to a different kind of antidepressant. For the biological depressive disorders, more broad action antidepressants are usually more effective.

A well-informed health provider should be able to use their assessment of the type of depression, its likely causes and their understanding of the person to identify the medication most likely to benefit.

Finally, being able to decide not to use medication is important too.

Tranquillisers

These medications are usually called 'minor' or 'major' tranquillisers.

Minor tranquillisers (typically benzodiazepines) are not helpful in depression; they are addictive and can make the depression worse.

Major tranquillisers are very useful in people with a psychotic depression and in melancholia where the person is not being helped by other medications.

'Anti-manic' drugs or 'mood stabilisers'

These drugs are of great importance in bipolar disorder.

Their use in treating mania makes them 'anti-manic', while their ability to reduce the severity and frequency of mood swings makes them 'mood stabilisers'.

Lithium, valproate and carbamazepine are the most common.

It is important to remember that the anti-depressants and mood stabilisers are often necessary both to treat the depression that is occurring now, and to make a relapse in the future less likely. So people sometimes need to continue taking medication for some time after they are better.

Electroconvulsive Therapy (ECT)

Because of its controversial past many people feel the need to think carefully before having ECT or allowing it to be given to relatives.

Clinicians at the Institute firmly believe that ECT has a small but important role in treatment, particularly in cases of

Psychotic depression

Severe melancholia where there is a high risk of suicide or the patient is too ill to eat, drink or take medications

Life-threatening mania

Severe post-natal depression.

While there are some short-term side-effects, ECT is a relatively safe and, because an anaesthetic is used, not too unpleasant.

Transcranial magnetic stimulation (TMS)

A possible alternative to ECT is transcranial magnetic stimulation (TMS).

Transcranial magnetic stimulation is a procedure used by neurologists, both as a treatment and as diagnostic procedure. A coil is held next to the patient's head and a magnetic field created to stimulate relevant parts of the brain. Unlike ECT, there is no need for a general anaesthetic nor is a convulsion induced.

In our view, the evidence in favour of this treatment is not yet in, but it is a major area of research at the Institute and elsewhere. If TMS is shown to be as effective as ECT this would be a distinct advance in the treatment of many mood disorders. No clear evidence about its utility is expected for a number of years.

Treatments

A large number of different treatments are available for depression.

 

New treatments (particularly medications) appear regularly. Continuing research means that the evidence for how well a treatment works is always changing too. We have chosen to give only a brief summary of treatments and instead direct you to other sites which provide more comprehensive details.

 

Key points about treatments for depression

 

• We believe that different types of depression respond best to different sorts of treatments (see below).
• It's important that a thorough and thoughtful assessment be carried out before any treatment is prescribed.
• Treatments for depression include physical and psychological treatments.
• Depression can sometimes go away of its own accord but, left untreated, it may last for many months. Allow yourself to seek help.
• Depending on the nature of your depression, self-help and alternate therapies can also be helpful, either alone or in conjunction with physical and psychological treatments.

 

Different types of depression need to be treated differently

 

At the Institute we believe there are different types of depression, falling into the following three principal classes:

 

• Melancholic depression
• Non-melancholic depression
• Psychotic depression.

 

Those types of depression that are more biological in their origins (melancholic depression and psychotic melancholia) are more likely to need physical treatments and less likely to be resolved with psychological treatments alone.

 

We believe non-melancholic depression can be treated equally effectively with physical treatments (antidepressants) or with psychological treatments.

Causes of depression

While researchers often talk about ‘finding the cause’ of some disease or disorder this often obscures the fact that only part of the story is known.


Some causes are pretty straightforward. We know that a broken leg is usually the result of some kind of pressure or strain being applied. Moreover, if you have a broken leg you typically know when it happened (leg was fine yesterday, today it is broken) and how it happened (this morning you went skiing).

Things are not so simple with depression. We have good ideas about what some of the ‘pressures or strains’ that result in depression are – but they are not all agreed upon and there might be others.

For any one person there could be many ‘pressures’ in their life. It is often unclear when the depression started – much of the time it gradually has an effect.

We can see another complication by going back to the broken leg example. Some people suffer from osteoporosis which makes their bones more fragile (more vulnerable). If you only had a minor accident when you went skiing, your osteoporosis was probably as much the cause of your broken leg, since it made your leg more vulnerable to the effects of pressure. If you have a major accident, however, the leg will probably break, osteoporosis or not.

In other words, the causes of depression are some mixture of ‘pressure’ (mild to severe) combined with a vulnerability to depression (as a sort of ‘psychological osteoporosis’) which too can range from mild to severe.

As noted earlier, for each ‘type’ of depression, differing ‘mixtures of causes’ have differential relevance. Thus, for psychotic or melancholic depression physical and biological factors are generally more relevant. By contrast, for non-melancholic depression, the role of personality (osteoporosis) and life-event stressors (accident) are generally far more relevant.

Types of Depression

At the Institute we believe that there are three broadly different types of depression:

 

• Melancholic depression
• Non-melancholic depression
• Psychotic depression

 

each with their own features and causes.

 

A possible fourth type of depression is

• Atypical depression.

 

Why is this important? We believe that, as with any illness, the person suffering from it can’t be properly treated unless the specifics of their illness are understood.

 

We therefore believe that people who are depressed should receive a sophisticated assessment identifying their particular type of depression and its broad causes, whether biological, psychological or other.

 

 

 

Treatments should be selected according to the specific type of depression experienced by an individual, and its causes.

 

A description of the different types of depression follows.

 

Melancholic depression

 

Melancholic depression is the classic form of biological depression. Its defining features are:

 

a more severe depression than is the case with non-melancholic depression

 

psychomotor disturbance

 

Melancholic depression is a relatively uncommon type of depression. It affects only 1-2 per cent of Western populations. The numbers affected are roughly the same for men and women.

 

Melancholic depression has a low spontaneous remission rate. It responds best to physical treatments (for example antidepressant drugs) and only minimally (at best) to non-physical treatments such as counseling or psychotherapy.

 

Non-melancholic depression

 

‘Non-melancholic depression’ essentially means that the depression is not melancholic, or, put simply, not primarily biological. Instead, it has to do with psychological causes, and is very often linked to stressful events in a person’s life, alone, or in conjunction with the individual’s personality style.

 

Non-melancholic depression is the most common of the three types of depression. It affects one in four women and one in six men in the Western world over their lifetime.

 

Non-melancholic depression can be hard to accurately diagnose because it lacks the defining characteristics of the other 2 depressive types (viz psychomotor disturbance or psychotic features). Also in contrast to the other 2 depressive types, people with non-melancholic depression can usually be cheered up to some degree.

 

 

 

People with non-melancholic depression experience

 

a depressed mood more than two weeks

 

social impairment (for example, difficulty in dealing with work or relationships).

 

In contrast to the other types of depression, non-melancholic depression has a high rate of spontaneous remission. This is because it is often linked to stressful events in a person’s life, which, when resolved, tend to see the depression also lifting.

 

Non-melancholic depression responds well to different sorts of treatments (such as psychotherapies, antidepressants and counselling), but the treatment selected should respect the cause (e.g. stress, personality style).

 

Psychotic depression

 

Psychotic depression is a less common type of depression than either melancholic or non-melancholic depression.

 

The defining features of psychotic depression are:

 

an even more severely depressed mood than is the case with either melancholic or non-melancholic depression

 

more severe psychomotor disturbance than is the case with melancholic depression

 

psychotic symptoms (either delusions or hallucinations, with delusions being more common) and over-valued guilt ruminations.

 

Psychotic depression has a very low spontaneous remission rate. It responds only to physical treatments (such as antidepressant drugs).

 

Atypical depression

 

Atypical depression is a name that has been given to expressions of depression that contrast with the usual characteristics of non-melancholic depression. For example, rather than experiencing appetite loss the person instead experiences appetite increase; and sleepiness rather than insomnia. Someone with atypical depression is also likely to have a personality style of interpersonal hypersensitivity (that is, expecting that others will not like or approve of them).

 

The features of atypical depression include:

 

The individual can be cheered up by pleasant events

 

Significant weight gain or increase in appetite (especially to comfort foods)

 

Excessive sleeping (hypersomnia)

 

Arms and legs feeling heavy and leaden

 

A long-standing sensitivity to interpersonal rejection —the individual is quick to feel that others are rejecting of them.

FAQ

What are the signs of depression?

 

How depressed should I be before I seek help?

 

What should I do if I'm feeling (or someone close to me is feeling) suicidal?

 

Am I always going to feel like this?

 

How long does depression last?

 

How is depression treated?

 

Where can I get help for depression?

 

How should I behave with someone who is depressed?

 

1. What are the signs of depression?

 

The following are a list of the features that may be experienced by someone with depression.

 

Lowered self-esteem

 

Change in sleep patterns

 

Change in mood control

 

Varying emotions throughout the day

 

Change in appetite and weight

 

Reduced ability to enjoy things

 

Reduced ability to tolerate pain

 

Reduced sex drive

 

Suicidal thoughts

 

Impaired concentration and memory

 

Loss of motivation and drive

 

Increase in fatigue

 

Change in movement

 

Being out of touch with reality.

 

Note that, having one or other of these features, by themselves, is unlikely to indicate that someone is clinically depressed. Also, having these features for only a short period (of less than two weeks) is unlikely to indicate clinical depression. It's also important to know that many of the above features could be caused by or related to other things, such as a physical illness, the effects of medications, or stress. Help in coming to such decisions should be assisted by a proper assessment by a trained professional.

 

2. How depressed should I be before I seek help?

 

Everybody feels down or sad at times. But it's important to be able to recognise when depression has become more than a temporary thing, and when to seek help.

 

As a general rule of thumb, if your feelings of depression persist for most of every day for two weeks or longer, and interfere with your ability to manage at home and at work or school, then a depression of such intensity and duration may require treatment, and should certainly benefit from assessment by a skilled professional.

 

3. What should I do if I'm feeling (or someone close to me is feeling) suicidal?

 

See the list of emergency contact numbers (and add the numbers of your General Practitioner and your local Community Mental Health Service) and keep a copy handy somewhere. Don't hesitate to call one of them if in need of help.

 

Recognise that having suicidal thoughts is one of the features of depression, and seek help, either from your General Practitioner or another mental health professional such as a psychologist or a counsellor. Make sure you tell them you have been having suicidal thoughts.

 

If you have already received treatment for depression, and you are having suicidal thoughts, contact the person who has been giving you the treatment, or a close friend who you trust, and tell them you are feeling suicidal.

 

If someone close to you is suicidal or unsafe, talk to them about it and encourage them to seek help. Help the person to develop an action plan, involving him or her and trusted close friends or family members, to keep him or her safe in times of emergency

 

Take away risks (e.g. remove guns or other dangerous weapons and hold the keys of the car if the depressed person is angry, out of control and wanting to drive off into the night).

 

4. Am I always going to feel like this?

 

This is a common fear. It's important to know that depression can be successfully treated and that you will feel better in time and with the right treatment.

 

5. How long does depression last

 

Sometimes depression goes away of its own accord, but, depending on the nature and type of the depression, it may take many months and possibly considerable suffering and disruption if left untreated. Allow yourself to seek help in the same way you might if you had a physical illness.

 

6. How is depression treated?

 

There are a large number of different treatments for depression. At the Black Dog Institute we believe that different types of depression respond best to different treatments and it is therefore important that a thorough and thoughtful assessment be carried out before any treatment is prescribed.

 

Treatments can fall into the following categories:

 

Physical treatments, comprising :

 

drug treatments, of which there are three main groups: antidepressants, tranquillisers, and mood stabilizers.

 

electroconvulsive therapy (ECT) - a physical therapy that may be relevant in a minority of cases of psychotic depression, severe melancholia or life-threatening mania.

 

transcranial magnetic stimulation - a treatment that is still under development, but which involves holding a coil near to a patient's head and creating a magnetic field to stimulate relevant parts of the brain.

 

Psychological treatments, the most common ones being:

 

• Cognitive Behaviour Therapy - a form of therapy that aims to show people how their thinking affects their mood and to teach them to think in a less negative (and more 'realistic') way about life and themselves.
• Interpersonal Therapy - a therapy that aims to help people understand how social functioning (work, relationships and social roles) and personality operate in their lives to affect their mood.
• Psychotherapy - an extended treatment aimed at exploring aspects of the person's past in great depth to identify links to the current depression.
• Counselling - a broad set of approaches and goals that provide problem solving and learning skills to cope with difficult life circumstances.

 

7. Where can I get help for depression?

 

A good first place to start in getting help is to visit your local General Practitioner. Let him or her know if you think you might have depression. Your General Practitioner will either conduct an assessment of you to find out whether you have depression, or refer you to someone else, such as a psychiatrist or a psychologist.

 

Depending on the nature of your depression, your General Practitioner may recommend some psychological intervention, such as cognitive behaviour therapy or interpersonal therapy, and might prescribe antidepressant medication to relieve some of the symptoms of depression.

 

Because depression is a common experience these days, many General Practitioners are used to dealing with depression and other mental health problems. Some General Practitioners take a special interest in mental health issues and undergo additional training in the area. If you don't feel comfortable talking to your own doctor, find another one with whom you do feel comfortable. It is important that you feel comfortable talking about how you are feeling with your doctor so they have as much information to help you as possible.

 

If you are having trouble tracking down such a General Practitioner, you could telephone general practices in your area to find out whether any doctors in that practice have a particularly strong interest in mental health and, if so, whether they are taking on new patients.

 

8. How should I behave with someone who is depressed?

 

Someone with a depressive illness is like anyone with an illness - they require our care. You can provide better care if you are able to:

 

• Understand something about the illness
• Understand what the treatment is, why it is being given, and how long the person is expected to take to recover.

 

An important part of caring is to help the treatment process:

 

• If medication is prescribed encourage the person to persist with treatment (especially when there are side effects)
• Counselling or psychotherapy often results in the depressed person 'thinking over' their life and relationships. While this can be difficult for all concerned, you should not try and steer the person away from these issues.
• A resolving depression sometimes sees strong emotions released which may be hard on the carer. The first step in dealing with these fairly is to sort out which emotions really refer to the carer and which refer to other people or to the person themselves.
• Treatment has a positive time as well - when the person starts to re-engage with the good things in life and carers can have their needs met as well.

 

Don't forget that as a carer you too are likely to be under stress. Depression and hopelessness have a way of affecting the people around them. Therapy can release difficult thoughts and emotions in carers too. So part of caring is to care for your own self - preventing physical run-down and dealing with the thoughts and emotions within yourself.

Depression Prevention Tips

Depression explained

 

Depression is a common experience. We have all felt 'depressed' about a friend's cold shoulder, misunderstandings in our marriage, tussles with teenage children - sometimes we feel 'down' for no reason at all.

 

However, depression can become an illness when:

 

• The mood state is severe;
• It lasts for 2 weeks or more; and
• It interferes with our ability to function at home or at work.

 

Signs of a depressed mood include:

 

• Lowered self-esteem (or self-worth)
• Change in sleep patterns, that is, insomnia or broken sleep
• Changes in appetite or weight
• Less ability to control emotions such as pessimism, anger, guilt, irritability and anxiety
• Varying emotions throughout the day, for example, feeling worse in the morning and better as the day progresses
• Reduced capacity to experience pleasure: you can't enjoy what's happening now, nor look forward to anything with pleasure. Hobbies and interests drop off.
• Reduced pain tolerance: you are less able to tolerate aches and pains and may have a host of new ailments
• Changed sex drive: absent or reduced
• Poor concentration and memory: some people are so impaired that they think that they are going demented
• Reduced motivation: it doesn't seem worth the effort to do anything, things seem meaningless
• Lowered energy levels.

 

If you have such feelings and they persist for most of every day for two weeks or longer, and interfere with your ability to manage at home and at work, then you might benefit from getting an assessment by a skilled professional.

 

Having one or other of these features, by themselves, is unlikely to indicate depression, however there could be other causes which may warrant medical assessment.

 

If you are feeling suicidal it is very important to seek immediate help, preferably by a mental health practitioner.

Tooth Bleaching

Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day.


Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth has become popular in today's society and tooth bleaching can be the answer.

Tooth bleaching safely lightens the color of the teeth and can last for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.

Is bleaching for you?

Generally, bleaching is successful in at least 90 percent of patients, although it may not be an option for everyone.

Tooth bleaching is effective for teeth darkened from extrinsic stains such as aging, coffee, tea or smoking. Teeth darkened by intrinsic stains caused by fluorosis, tetracycline, or other medications and by congenital abnormalities won't respond well to bleaching.

Teeth darkened with the color of yellow, brown or orange respond better to lightening than gray staining. If you have very sensitive teeth, periodontal disease or teeth with worn enamel, your dentist may discourage bleaching.

What's involved?

First, the dentist must determine whether you are a candidate for tooth bleaching and what type of bleaching system would give you the best results.

If you're in a hurry for whiter teeth, you may decide to have your teeth whitened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair.

However, most patients choose dentist-supervised, at-home bleaching, which is more economical and provides the same results.

At the next appointment, if you don't choose laser bleaching, the dentist or hygienist will make impressions of your teeth to fabricate a mouth guard appliance for you. (The mouth guard is used to hold the bleaching solution against your teeth.)

The mouth guard is custom-made for your mouth. It can be worn comfortably while you are awake or sleeping.

The mouth guard is so thin that you should even be able to talk and work while wearing it. Along with the mouth guard, you'll receive the bleaching solution and instructions on how to wear the mouth guard.

Some bleaching systems recommend bleaching your teeth from two to four hours a day. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days completing.

How long does it last?

Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee or tea. At this point you may choose to get a touch-up. This procedure may not be as costly because you can probably still use the same mouth guard. The treatment time also is much shorter than the original treatment time.

How does it work?

The active ingredient in most of the whitening agents is 10 percent carbamide peroxide, also known as urea peroxide. When water contacts this white crystal, the release of hydrogen peroxide lightens the teeth, bleaching out the porous surface of the enamel.

The higher the strength of carbamide peroxide and the quicker the bleaching process is carried out, the greater the chances for sensitivity.

Is it safe?

Several studies during the past five years have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth-bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.

What are realistic expectations?

No one can really predict how much lighter your teeth will become, but the key is to have a realistic expectation before starting the process. Every case is different.

Typically, there is a two-shade improvement as seen on a dentist shade guide. The success rate depends on the type of stain involved and your compliance. Bleaching can only provide a shift in color, from gray to a lighter shade of gray, for example.

Bleaching does not lighten artificial materials, such as white fillings (resins) or porcelains. So if you are considering bleaching, it would be best to bleach before resin fillings or porcelain crowns, onlays or inlays are placed, to allow for the shade to be matched.

Temporomandibular Disorder Affects Jaw Muscles, Joints & Nerves

What is the temporomandibular joint?


The TMJ is a joint that slides and rotates just in front of your ear, consisting of the temporal bone (side and base of the skull) and the mandible (lower jaw). Mastication (chewing) muscles connect the lower jaw to the skull, allowing you to move your jaw forward, sideways, and open and close.

The joint works properly when the lower jaw and its joint (both the right and left) are synchronized during movement. Temporomandibular disorder, or TMD, may occur when the jaw twists during opening, closing or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

TMD describes a variety of conditions that affect jaw muscles, temporomandibular joints, and nerves associated with chronic facial pain. Symptoms may occur on one or both sides of the face, head or jaw, or develop after injury. TMD affects more than twice as many women than men and is the most common non-dental-related chronic orofacial pain.

What causes TMD?

Normal function for this muscle group includes chewing, swallowing, speech and communication. Most experts suggest that certain tasks, mental or physical, cause or aggravate TMD, such as strenuous physical tasks or stressful situations. Most discomfort is caused from overuse of the muscles, specifically clenching or grinding teeth (bruxism).

These excessive habits tire the jaw muscles and lead to discomfort, such as headaches or neck pain. Additionally, abnormal function can lead to worn or sensitive teeth, traumatized soft tissues, muscle soreness, jaw discomfort when eating, and temporal (side) headaches.

What TMD symptoms can I experience?

An earache without an infection

Jaw pain or soreness that is more prevalent in the morning or late afternoon

Jaw clicking or popping when opening and closing your mouth

Difficulty opening and closing your mouth

Locked or stiff jaw when you talk, yawn or eat

Sensitive teeth when no dental problems can be found

What can I do to treat TMD?

In my experience, the majority of cases can be treated by patient education, unloading (resting) the joint with a custom-fit mouth guard from your dentist, taking an anti-inflammatory, eating a soft diet, applying moist heat and in some severe cases using muscle relaxants.

Benefits from conservative treatment are not quick and require application over time.

Even though you treat the symptoms, the cause of the problem also needs to be addressed with stress management and relaxation techniques. It's important to break bad habits to ease the symptoms. Each TMD case is unique, and a course of treatment should be initiated only after consultation with a dentist.

Most treatment for TMD is simple, often can be done at home, and does not need surgery. For example, control clenching or grinding during the day by sticking your tongue between your teeth. If you still experience pain, you may be grinding or clenching your teeth at night. See your dentist for a nighttime mouth guard.

Most people will experience relief with minor treatment. More severe cases may be treated with physical therapy, ice and hot packs, posture training, and orthopedic-appliance therapy (splint). Eating soft foods and avoiding chewing gum also help relax the muscles.

Some severe cases of TMD require surgery to correct the underlying cause that conservative treatment will not help. Generally, a referral to an oral surgeon for evaluation and an extensive radiographic series is needed to make this determination.

Is TMD permanent?

The condition is often cyclical and may recur during times of stress, good or bad. As the patient, you should be active in your treatment by being aware of the causes of your jaw problems after seeing a dentist for a diagnosis regime. Make routine dental appointments, so your doctor can check TMD on a regular basis.

Smokeless Tobacco & Oral Health

Smokeless tobacco products such as chew or snuff are not safe alternatives to smoking.

 

The oral health problems that result are plentiful and include bad breath, tooth discoloration and decay, recession, disease of the gums, diminished sense of taste/smell, and white patches and red sores that can lead to oral cancer.

 

Smokeless tobacco contains nicotine that is very addictive. After using tobacco for a short period of time, you will need another dip every 20 to 30 minutes to keep the buzz from ending. You may become dizzy and shaky when trying to quit.

 

Nicotine in tobacco can cause your heart to beat faster and is also linked to hypertension.

 

Tobacco juices can damage your gums, expose the roots of your teeth, lead to sensitive teeth or tooth loss, or cause worn surfaces on tooth enamel. If tobacco juice is swallowed, it can produce stomach ulcers.

 

Many people ignore the warning signs about the serious long-term health problems related to chewing and smoking. They can better relate to bad breath, stained teeth and financial drain on their wallets.

 

If you quit using tobacco products, many of the gum changes and side effects will disappear, foods will taste better and you will significantly decrease your risk of developing oral cancer.

 

If you are concerned about your oral health, do not wait until it's too late. A family dentist can counsel tobacco users regarding the risks of using tobacco products and help plan a sensible tobacco-cessation program.

 

In addition, if you use smokeless tobacco, or have in the past, you should be on the lookout for some of these early signs of oral cancer:

 

• A sore that does not heal.
• A lump or white patch.
• A prolonged sore throat.
• Difficulty chewing/swallowing.
• A movement of the tongue or jaws.
• A feeling of something in the throat.

 

Pain is rarely an early symptom. For this reason all tobacco users need regular dental check-ups.

Oral Piercing

It's not a surprise these days to see some people sporting pierced tongues, lips or cheeks. The surprise for some of these folks, however, is that piercing can be dangerous.

 

Visits to the emergency room or doctor's office are not usually on the minds of those who are electing to have piercing. There are some things that should be considered, however. The human mouth contains millions of bacteria, and infection is a common complication of oral piercing. Other side effects include pain and swelling.

 

The most popular piercing site, the tongue, could swell enough to close off an airway. Regardless of how "experienced" the person doing the piercing claims to be, piercing can cause uncontrollable bleeding and nerve damage.

 

Piercing can be extremely painful and result in swelling and increased saliva flow and even drooling. Healing may take six weeks or longer, especially if there are complications.

 

Even if the piercing injury doesn't cause any trouble, you should be aware of the potential hazards that mouth jewelry presents:

 

• You can easily choke on any studs, barbells or hoops that come loose in your mouth.
• The jewelry can chip or crack your teeth.
• Jewelry worn in the mouth can hinder your ability to eat, not to mention your speech. It's hard to be cool when you can't pronounce your words or when pieces of your lunch are stuck to that tiny barbell.

 

Piercing is a fashion statement that involves more than just deciding what jewelry will be attached to the body and where. This decision could have major consequences for your oral health, too.

Oral Cancer

While the rates of oral cancer have dropped in the past 20 years, health agencies still anticipate that it will be diagnosed in more than 30,000 Americans this year.

 

Knowing the risk factors as well as the signs of oral cancer can go a long way toward limiting the influence this disease can have on your life.

 

Know what to look for

 

As with many forms of cancer, early detection of oral cancerous lesions can improve the chances of successful treatment. You can take an active role in detecting signs of oral cancer early by checking your oral tissues periodically. Take a few minutes to examine your lips, gums, cheek lining and tongue, as well as the floor and roof of your mouth.

 

You'll want to make note of the following:

 

• A color change in the oral tissues (whitish or red spots, for example).
• A lump, thickening, rough or crusted spots, or small eroded areas.
• A sore that bleeds easily or does not heal.
• Pain, tenderness or numbness anywhere in the mouth or on the lips.
• Difficulty in chewing, swallowing, speaking or moving the jaw or tongue.
• Changes in the voice.
• A change in the way your teeth fit together.

 

In addition, watch for changes beyond the mouth that could signify oral cancer:

 

• Drastic weight loss.
• Lump or mass in your neck.

 

If any of these conditions persists, contact your dentist for an examination.

 

Minimize the risk

 

You can take steps to reduce your risk of developing oral cancer by avoiding behaviors that researchers have identified as being strongly associated with the development of oral cancer.

 

The use of any kind of tobacco products (cigarettes, pipe tobacco, cigars or smokeless tobacco), particularly combined with heavy alcohol consumption, has been identified as the major risk factor for oral cancers in the United States.

 

The importance of professional dental care

 

Regular visits to your dentist are important in protecting yourself from the effects of oral cancer. As part of your regular dental examination, your dentist can quickly and easily check the oral tissues for signs of cancerous and pre-cancerous lesions.

 

Detecting and treating cancerous tissues as early as possible is critical in helping you beat a potentially deadly disease.

Fluoride

Fluoride is a mineral that is essential to the prevention of decay in teeth. It helps strengthen the tooth enamel to make it more resistant to the acid that is produced by the bacteria in our mouths.


There are several common sources of fluoride that are easily available in any part of the country.

The most readily attainable source is something you consume and use every day—water. The optimum level of fluoride in water is one part fluoride per million parts water.

If you would like to know if your water system contains fluoride, ask your dentist, local health department or water treatment department.

Water fluoridation has been shown to be very effective against cavities. In fact, nearly two thirds of cavities can be prevented in children who drink fluoridated water from birth. If you have your water tested and it is not fluoridated, a physician or dentist can prescribe fluoride supplements in the form of drops, tablets or mouth rinses.

Drops are best for infants. Gradually work from drops into tablets as the child gets older. In addition to water fluoridation, many school systems offer a fluoride program to provide rinses to the children at school.

During routine dental visits, the child will receive a topical application of fluoride gel, usually in soft foam mouthpiece trays. If the child has a high rate of decay or the present decay is extensive, the dentist may prescribe home rinses or prescription-strength fluoride toothpaste.

Another source of fluoride is in our daily diets. Dark green vegetables contain fluoride and can help supplement our attempt to be cavity-free.

Everyone should use fluoride toothpaste for extra protection against cavities. When purchasing toothpaste, read the label to make sure it contains fluoride. There are still toothpastes out on the market that don't contain fluoride.

Fluoride alone will not prevent cavities, but it greatly decreases the chance of them developing. Good tooth brushing, flossing, eating healthy foods, and seeing your dentist and hygienist regularly are all factors involved in preventing tooth decay.

Flosses & Water picks

Plaque is a sticky layer of material containing germs that accumulates on teeth, including places where toothbrushes can't reach.


This can lead to gum disease. The best way to get rid of plaque is to brush and floss your teeth carefully every day.

The toothbrush cleans the tops and sides of your teeth. Dental floss cleans in between them. Some people use water picks, but floss is the best choice.

Should I floss?

Yes. Floss removes plaque and debris that adhere to teeth and gums in between teeth, polishes tooth surfaces, and controls bad breath. Floss is the single most important weapon against plaque, perhaps more important than the toothbrush. Many people just don't spend enough time flossing or brushing and many have never been taught to floss or brush properly. When you visit your dentist or hygienist, ask to be shown.

Why should I floss?

Flossing is the one most important step in oral care that people forget to do or claim they don't have time for. By flossing your teeth daily, you increase the chances of keeping your teeth a lifetime and decrease your chance of having periodontal or gum disease. Flossing cleans away the plaque from between your teeth, decreases the chance of interproximal decay and increases blood circulation in the gums.

Which type of floss should I use?

Dental floss comes in many forms: waxed and unwaxed, flavored and unflavored, wide and regular. Wide floss, or dental tape, may be helpful for people with a lot of bridgework. Tapes are usually recommended when the spaces between teeth are wide. They all clean and remove plaque about the same. Waxed floss might be easier to slide between tight teeth or tight restorations. However, the unwaxed floss makes a squeaking sound to let you know your teeth are clean. Bonded unwaxed floss does not fray as easily as regular unwaxed floss, but does tear more than waxed floss.

How should I floss?

There are two flossing methods: the spool method and the loop method. The spool method is suited for those with manual dexterity. Take an 18-inch piece of floss and wind the bulk of the floss lightly around the middle finger. (Don't cut off your finger's circulation!) Wind the rest of the floss similarly around the same finger of the opposite hand. This finger takes up the floss as it becomes soiled or frayed. Maneuver the floss between teeth with your index fingers and thumbs. Don't pull it down hard against your gums or you will hurt them. Don't rub it side-to-side as if you're shining shoes. Bring the floss up and down several times forming a "C" shape around the tooth, being sure to go below the gum line. The loop method is suited for children or adults with less nimble hands, poor muscular coordination or arthritis. Take an 18-inch piece of floss and make it into a circle. Tie it securely with three knots. Place all of the fingers, except the thumb, within the loop. Use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, going below the gum line forming a "C" on the side of the tooth.

How often should I floss?

At least once a day. To give your teeth a good flossing, spend at least two or three minutes.

What are floss holders?

You may prefer a pre-threaded flosser or floss holder, which often looks like a little hacksaw. Flossers are handy for people with limited dexterity, for those who are just beginning to floss, or for caretakers who are flossing someone else's teeth.

Is it safe to use toothpicks?

In a pinch, toothpicks are effective at removing food between teeth, but for daily cleaning of plaque between teeth, floss is recommended. Toothpicks come round and flat, narrow and thick. When you use a toothpick, don't press too hard as you can break off the end and lodge it in your gums.

Do I need a water pick (irrigating device)?

Don't use water picks as a substitute for brushing and flossing. They are effective around orthodontic braces that retain food in areas a toothbrush cannot reach. However, they do not remove plaque. Water picks are frequently recommended for persons with gum disease.