Most recent international health newscast in addition to examination from our health explore band. » Anti Depressants-Sleeping Aid

WHY YOU CAN’T STAY AWAKE: OTHER TYPES OF DOES – IDIOPATHIC HYPERSOMNIA

admin — Sat, 09 Jul 2011 17:59:30 +0000

“Idiopathic” comes from a Latin word that, in rough translation, means “we don’t know what causes it.” As an example of this poorly defined disorder, let me cite the incident of a patient whose nightly ritual after dinner was to load the dishwasher and take out the garbage. One night before retiring, however, she went to unload the dishwasher—and found the sealed plastic bag of garbage sitting in it, all freshly washed, rinsed, and dried. She found the dinner dishes, of course, in the garbage can. To this day we don’t know what caused her problem.Also called non-REM narcolepsy, idiopathic hypersomnia can make patients feel constantly sleepy without overwhelming them with sleep attacks or cataplexy. Sufferers usually sleep well at night, although their sleep may be prolonged and they may have difficulty rousing. If they take naps, as they often do, the naps are long and unrefreshing. Clinical tests reveal that these patients fall asleep relatively quickly, but REM sleep is not usually present during naps as it is in narcolepsy. In some cases treatment with CNS stimulants or methysergide (Sansert) may help.*165\226\8*

COMMON THEMES IN ALCOHOLISM TREATMENT: GETTING STUCK

admin — Thu, 16 Jun 2011 14:24:22 +0000

Speaking of dependency, anyone working with alcohol-troubled people is bound to hear this one some time: “Sending someone to AA just creates another dependency.” The implication of this is that you are simply moving the dependency from the bottle to AA, and ducking the real issue. That the dependency shifts from alcohol to AA or a counselor for the newcomer is probably true. We think that is a plus. We also think no one should get stuck there. By “there,” we mean in a life-style just as alcohol-centered as before. The only difference is that the center is “not drinking” instead of “how to keep drinking.” Granted, physical health is less threatened, traumatic events are less frequent, and maybe even job and family stability have been established. Nonetheless, it is a recovery rut (maybe even a trench!). That some do get stuck is unfortunately true, but that is no reason to condemn the whole process. After all, weaning takes time, and no one implies it is easy or without the possibility of some setbacks. The infant doesn’t usually go from the breast to the coffee mug in one easy jump.Many factors probably account for the “stuckness.” One might be an “I never had it so good, so I won’t rock the boat” feeling, a real fear of letting go of the life preserver even when safely ashore. Another factor is that some recovering alcoholics, particularly those who began drinking as teenagers, have spent the bulk of their adult lives as active alcoholics. Therefore, they have no baseline of adult healthy behaviors to return to. They are confronted with gaining sobriety, growing up, and functioning as adults simultaneously. This is a tall order that can be an overwhelming prospect. To make it more manageable, it may well be tempting for these recovering alcoholics to keep their world narrowed down to alcoholism recovery. The only thing they now feel really competent to do, the only area where they have had support and a positive sense of self, is in getting sober. Giving up the status of “newcomer” to be replaced by that of “sober responsible adult” may be scary, so a relapse or drinking episode may ensue. They then can justify and ensure that they can keep doing the only thing they feel they do well—being a client, an AA newcomer, a recovering alcoholic.Another factor could be that some counselors (and some AA members) are better equipped to deal with the crisis period of getting sober than with the later issues of growth and true freedom. Time constraints are too often the cause of the counselor’s inability to encourage the letting go—stretching phase. They are quite often overwhelmed with numbers of clients truly in crisis. They simply have no time or energy to put out for the clients who are “getting along okay.” Counselors who are not content with their clients’ just getting by could aid the process by referring them to extra types of therapy and groups that promote personal exploration and growth. This is a delicate situation; the adjunctive treatments are not to be seen as substituting for whatever has worked so far. Rather, they are an addition to it, whether it is AA, individual counseling, or some other regimen.The counselor who does have time and does work with clients on a long-term basis should beware of getting stuck in back-patting behavior. The phrase, “Well, I didn’t do much today, but at least I stayed sober,” is okay once in awhile. When it becomes a client’s standard refrain, over a long period of time, it should be questioned as a satisfactory life-style. Those who work around treatment facilities are all too aware of groups of alcoholics who hang around endlessly, drinking coffee, talking to other alcoholics exclusively, and clearly going nowhere. For some who, for instance, may have suffered brain damage or some other disability, this may be the best that can be hoped for. However, we suspect that many are there simply because they are not being helped and encouraged to proceed any further. These are the alcoholics most clearly visible to the health care professionals; thus, they may be one reason for the low expectations professionals have for recovering alcoholics. They don’t see the ones who are busy, involved, highly functioning individuals. Our contention is that counselors and caregivers can increase the number of the latter and unstick more and more, if they are sensitive to this issue.*107\331\2*

SECOND STAGE OF STRESS BREAKDOWN: WILL-POWER, EMOTIONAL CONTROL AND THE SELF-STARTER FUNCTION

admin — Wed, 05 Jan 2011 16:50:06 +0000

The ability to keep our emotions under control is a necessary pre-condition for any organized, civilized society. Mutual cooperation and teamwork are only possible when people can delay demands for gratification of their needs and desires, and are able to inhibit the outward display of feelings of resentment or anger. It is important for human beings to be able to control their emotions in situations of emergency and unexpected threat, because the ability to survive such crises usually involves teamwork and co-operation.
In emergency situations we are usually able to call on reserves of will-power to control our emotions enough to cope with the immediate problems which present themselves. Many people have experienced calm in the midst of a crisis, which has enabled them to take clear and decisive action. When the immediate danger has passed, they begin then to experience the fear that was appropriate to the situation.
The inhibitory reserves which allow us to delay the experience of fear and anxiety in crisis situations are only meant to operate in an emergency. However, we know that people under stress and beginning to experience anxiety symptoms from overload can, for a time, use their emergency inhibitory reserves to ignore the nervous system’s alarm signal, that is, the symptoms of anxiety. When these reserves are exhausted, the ability to dampen down unwanted or inconvenient emotions is lost. As a result the person becomes emotionally labile, that is, his or her emotional display can change very rapidly from tears to laughter and back.
Our will-power mechanism also gives us the ability to force ourselves to do things which are not in themselves enjoyable. However, our ability to continue forcing ourselves into unenjoyable tasks has a definite limit. In stage two stress breakdown, the symptom of loss of the ability to motivate oneself to adapt to changing circumstances is caused by the self-starter mechanism running out of energy, like a car battery running out of electric charge. People who experience second stage stress breakdown symptoms will report that they are utterly incapable of forcing themselves to do anything. They seem to have run out of the energy they need to psych themselves into doing things.
Some people, who are beginning to experience stage two, find that whereas they cannot force themselves into tidying up the house, they can do it if they don’t try to do it. Listening to the radio and wandering about tidying up things which happen to be in the vicinity while concentrating on the radio programme, is a method used by some people. Others find they have the ability to help someone else, but don’t have the psychic energy to plan to do the tasks themselves.

*16/129/5*

SIGNS OF DEPRESSION: RUNNING ON EMPTY

admin — Wed, 29 Apr 2009 08:46:02 +0000

Not long ago the newspapers reported that the president of Harvard University was unable to return to work. Amid speculations as to what might be wrong with him, his doctor issued a bulletin saying that he was exhausted from overwork. He was ‘running on empty’. Well, you don’t have to be the president of Harvard University to know how that feels. I have encountered this symptom in depressed patients I have treated from all walks of life. I recall a highly skilled psychotherapist who was in such great demand because of his expertise that he received many more referrals than he could comfortably handle. Unfortunately he was much more skilful at taking care of his patients than of himself, and had a hard time disappointing his referral sources. He seriously overbooked his schedule, leaving much too little time for rest, exercise and recreation. As a result, his depression was extremely difficult to treat. No matter what anti-depressants I gave him, he always seemed to be running on empty.

Population studies suggest that depression is becoming more common with each successive generation, our youngest people being most frequently affected. No one knows why this should be happening. One possible reason is that it is a cost of upward mobility. As we become an increasingly sophisticated technological society, the newly created opportunities carry with them certain risks and hazards. Increasingly, there are businesses that stay open until all hours of the night. People take their computers on holiday with them so that they can plug into their e-mail and connect to the Internet from the most remote places. They carry cellular phones and are always on-call, wired in and connected to their business associates and customers. And businesses themselves, in an attempt to become more competitive, squeeze the most they can out of each employee. One patient of mine, a chemist who supervised several pharmacies, kept being given more and more shops to supervise. Just as with the psychotherapist I mentioned, her depression was very hard to treat and only responded, finally and completely, when she quit her job.

The curious thing about depression, though, is that you can end up running on empty regardless of how great your burdens are in any objective sense. Each of us has our comfort zone in which we can function happily and efficiently, and each has our limit beyond which our capacity to function breaks down. When someone becomes depressed, that breaking point has been exceeded. It does no good to debate whether or not you should be able to handle the level of stress. Regardless of the objective level of stress that you are currently under, if your capacity for handling that stress has been exceeded, you will feel as though you are running on empty and that may be an indication that you are clinically depressed, especially when it is combined with some of the other tell-tale signs of depression.

One of the hardest things to do when you are running on empty is to start new projects. New initiatives invariably require a new burst of energy, which is especially difficult to muster when you are down.

It is also important to remember that running on empty may be a symptom of other illnesses. Chronic infections, such as glandular fever, may strip you of energy, as may many other medical disorders. Chronic fatigue syndrome (CFS; also known as ME) is a particularly vexing condition, in which low energy level is the cardinal and sometimes the only symptom. Low thyroid function and other hormonal conditions may also result in fatigue and low energy levels. These can generally be diagnosed by simple blood tests. This is one reason why, in the best of all possible worlds, you should get a medical evaluation before reaching a definitive diagnosis of depression. Or, if you don’t choose to do that, to re-evaluate the situation if you try to treat your depression and it hasn’t improved substantially within a month or two.

If you have been running on empty for more than a few weeks, consider the possibility that you may be clinically depressed.

*52\75\2*