Antidepressants Blog

A few odds and ends should be mentioned in discussion of equality. A couple after marriage may find certain serious differences in their habits which were neglected by them during courtship, neither because of romantic illusion nor because of accepting the popular opinion that there are inescapable differences of sex, but because the segregation of the sexes makes it impossible for a man and woman to know one another thoroughly before marriage. The reference here is to intimate personal habits which do not come to light in the usual social contacts. Anyone who has lived in a men’s dormitory, for example, knows that some men conduct themselves like swine in a bathroom. The same may be said of some women to a lesser extent. And some people’s Zooms always look as if a cyclone had struck them. With our present barriers between the sexes, these very important elements of compatibility or incompatibility cannot be known until marriage. Then one may wake up to discover that he is tied for life to a person of unbelievably repulsive habits. The irrepressible disgust that one feels in such a situation eventually may undermine the finest romantic feelings so that contact with such a person becomes anything but pleasurable. It would seem logical that in marriage we should at least have as good an opportunity to become thoroughly acquainted with one another as in friendship. But this is not the case. Many a budding friendship has been cut short because of unendurable personal habits that came to light. Not until the irrational taboos that now exist between the sexes are removed will the same opportunity to test a growing romance be afforded.

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The amount of sodium the diet is important for people have high blood pressure or congestive heart failure. For some people who have high blood pressure, reducing sodium take will help reduce blood pressure. Excess sodium encourages your be to retain fluid. Restricting sodium may therefore improve the effects of medications such as diuretics and other drugs used to treat high blood pressure or congestive heart failure.

The average American consume about 4,000 milligrams or more of sodium a day. The new food labeling regulations establish 2,400 milligram of sodium as the uppermost limit, ever if you have no signs of heart disease. Most people with heart disease should limit their sodium intake to less than 2,000 milligrams a day.

Table salt is the most obvious source of sodium (it contains 40 percent sodium and 60 percent chloride). Just one teaspoon of salt contains 2,000 milligrams of sodium. The salt you add in cooking or at the table may be only the “tip of the iceberg” in  your total sodium intake. Even many natural foods such as milk, meat, and vegetables contain sodium. But by far, sodium that  is added to foods  in processing is the biggest source (at least two-thirds) of sodium in your diet.

Food manufacturers are offering an expanding array of reduced-sodium products, such as luncheon meats, canned vegetables, salad dressings, and cheeses. Read nutrition labels to find the sodium content (shown in milligrams). You may need to avoid some reduced-sodium foods because they may still be high in fat. Dairy products are a natural source or sodium. Three cups of milk a day contain 375 milligrams of sodium; which is not an excessive amount. But if you drink more than 3 cups and eat yogurt, cheese, and ice cream, the amount of sodium quickly adds up.

Use fresh foods in place of processed foods so that you can control the amount of sodium that is added. And when you are cooking, go for fresh flavors instead of masking the natural flavor with salt. Use herb and spice blends for added flavor. Do not add salt to your food at the table.

It may take 6 to 8 weeks to learn to appreciate less salty flavors. You will begin to taste the other flavors after you reduce the salt.

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Contraindications are medical conditions you may have, or be at risk of, which mean you should not take a particular drug or medicine. For HRT these are listed in the British National Formulary as:

•   liver disease,

•   breast cancer,

•   history of thrombosis.

Another list of risk factors is given under the heading ‘Cautions’. If you suffer from any of these you should think twice before taking HRT:

•   high blood pressure,

•   benign (not cancerous) breast disease e.g. breast cysts,

•   fibroids (benign tumours in the womb),

•   migraine,

•   endometriosis (the lining of the womb growing in other places than just the womb).

HRT has an effect on the whole circulatory system – your blood circulation, your veins and your arteries. So it can increase the risks of raised blood pressure, migraine, strokes and thrombosis. It also increases your levels of oestrogen, the ‘building’ hormone, and hence the risks of breast tissue changes, fibroids and endometriosis. And there is the ‘domino’ effect on other vital organs: the liver, for instance, which is your ‘waste disposal unit’ and helps remove excess hormones from the body. If it has to work overtime to remove hormones added into your body from HRT, its function can be affected, increasing the possibility of liver disease.

It is obvious from looking at the evidence that there are risks involved in taking HRT. There are also some women who cannot take it because of their medical or family history. The scientists don’t all agree over the percentage of the risks, especially with breast cancer, but they do agree there are increased risks. In a situation like this it is necessary for us as women to weigh up the positive and negative benefits of HRT. For some women who have had a surgical menopause early in life, HRT may be necessary. The sudden fall in hormone levels when their ovaries are removed is a tough challenge for the body. But women going through a natural menopause (with or without a womb) are in a very different situation.

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“IMPATIENS” people are self-willed and would prefer to work entirely by themselves and get things done at their own-pace without outside interference, forgetting that every person is a part of the great whole and in the final analysis we all depend upon each other, including those whose lot is to move slow.

The main characteristics of the negative Impatiens state.

1. Are internally restless and under mental tension due to other people working slowly.

2. Finds it hard to wait for things to take their course.

3. Takes the words out of the mouth of others from impatience.

4. Talks so fast while giving instructions that they are hardly assimilated fully.

5. Unnecessary hurry in all walks of life.

6. Cannot tolerate slow working by others—would snatch a piece of work from the worker’s hand to do it faster.

7. Prefers to work alone, at his own pace.

8. Easily flares up and just as quickly calms down.

9. On the physical side, short-term exhaustion; sudden hunger because of fast consumption of energy due to fast pace; sudden pain due to nervous tension, nervous indigestion, hot flashes.

Sometimes, a very irritating red rash appears on the body of a person when he is impatient, cross and irritable.

An infant would immediately get colic if nursed from an irritated mother’s breast.

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Once upon a time it was believed that epilepsy was forever. In those olden days, only fifteen to twenty years ago, physicians were taught never to discontinue anticonvulsant medicine. They were taught not to discontinue the drugs before puberty, because seizures might increase in frequency at puberty, and you were never sure when puberty might start or when it would end. After puberty came driving, and you wouldn’t want to stop medication before that, because the child might never be able to get a driver’s license. Then physicians were urged not to discontinue medication because the individual was driving. In those days, it was said: “Eventually people will stop taking medicine on their own. Then, if they have a seizure, it will not be the doctor’s fault.”

NONE OF THOSE OLD TEACHINGS WERE TRUE!

With this old philosophy, many people were kept on medicine for many years, and some are still taking it.

Now we know that:

• Most children outgrow their epilepsy;

• Most children who are free of seizures for two years gradually can be taken off medicine by their physician and will remain seizure-free;

• Many adults do not need to take medicine forever.

Now we know that 75 percent of children who have been free of seizures for four years will remain seizure-free as the medicine is slowly

discontinued. Seventy-five percent will also remain free of seizures if they are taken off medicine after being free of seizures for only two years. Now we can even predict which of these children are likely to remain free off medicine and which are likely to have recurrent seizures if the medication is discontinued.

Remember: Before you begin to worry about having your physician discontinue medication, your child must be seizure-free for at least two years.

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Eye checks

Everyone with diabetes should have regular, preferably annual, visual acuity and retina checks. Your retina can be examined either with an ophthalmoscope after dilating drops have been put into your eye (the effects of these can be reversed after the examination) or with a special infra-red camera. The retinal camera produces a Polaroid picture within a few minutes, and because it uses infra-red light no dilating drops are needed.

If minor changes are found, all that is needed is a reassessment of your glucose balance and more frequent checks. If you have more severe changes, laser treatment is used with the aim of encouraging regression of proliferative vessels and preventing further new vessels forming. Laser treatment is usually carried out by an ophthalmologist and may have to be repeated. Anyone on treatment with normal blood glucose levels is less likely to develop retinopathy than people with high glucose levels. Lesions (microaneurysms, hemorrhages or exudates) may also regress if control is improved after retinopathy has developed, though it is obviously better to try to prevent them from appearing in the first place.

Cataracts   These are more common among people with diabetes than in the general population. They are caused by deposits in the lens of the eye which block vision. They can be treated by removal of the eye’s lens, which has become opaque. This is replaced either with an implanted lens, or are given contact lenses or glasses. The operation has an excellent success rate. If you have diabetic retinopathy as well as cataracts, your ophthalmologist may have to treat the cataract before the extent of the retinopathy can be seen. Nowadays it can sometimes be removed          as a day-case procedure.

See your doctor

If you notice any change in your vision, see your doctor at once. Although cataracts and diabetic retinopathy may be the reason for a change in your vision, the most common cause is a high blood glucose level or a changing blood glucose level. This alters the focusing properties of the lens temporarily, causing blurring. The blurring disappears once your blood glucose level is controlled, so do not waste money on new glasses until you are sure that any change in your vision is not caused by glucose problems. Always bear these points in mind:

1.   Tell your doctor immediately if your vision deteriorates.

2.   The commonest cause of visual change in diabetes is high or changing glucose levels. Do not buy new spectacles when your glucose control is poor.

3.   Regular eye checks can detect diabetic retinopathy at an early stage.

4.   Diabetic retinopathy is treatable.

5.   Diabetic retinopathy may be prevented by good glucose control.

6.   People with diabetes may develop cataracts: they too can be treated.

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There is a striking difference in the structure and appearance of the arteries and the veins. The walls of the arteries are three layers thick, with muscles in the middle layer, the outer layer being tough and elastic. They hold their shape even when not distended with blood. The veins, in contrast, are thin and have little elasticity so that when empty they are hardly noticeable, and thus may be especially bothersome for surgeons. An artery stands boldly forth. One may see or feel its beat. If it is cut, the spurting blood tells where to seize it. But a big vein with soft weak walls cannot be told from other tissue when pressure has caused it to collapse. After the pressure is released, the blood oozes up from one knows not where.

Right here is probably the best place to talk about the control of bleeding by amateurs. The first-aid manuals have told people to use tourniquets. I believe that in the overwhelming majority of cases the tourniquet is unnecessary and is usually harmful. It is not a simple thing to apply a tourniquet efficiently. The arteries are deeply situated and stiff-walled, and hence difficult to compress to the point where bleeding is stopped. But the veins are superficial, flimsy, and easy to compress. It is difficult to tighten the tourniquet evenly to the point where it will stop arterial flow. Doing so causes great pain. I have no doubt that in a large majority of cases the blood keeps going through the arteries, but the pressure stops the return through the veins. Result — increased bleeding. Fortunately it is a rare case where bleeding is not stopped by clotting in the wound, especially as the low blood pressure resulting from shock or fainting hastens the clotting. Pressure over the point of bleeding is the best procedure for anybody but an experienced surgeon to use.

The arteries in early life are elastic and their diameter may enlarge or shrink from time to time according to the action of the muscles in their walls. The individual has no command over these muscles as their action is regulated by the involuntary, or sympathetic, nervous system. These nerves can be affected in various ways, as for instance by drugs, called vasodilators and vasoconstrictors. Nicotine is a vasoconstrictor. In such a condition as Buerger’s disease, in which the diameter of the vessels to the hands and feet is lessened, smoking is always forbidden. Emotions temporarily affect the size of the arteries. Thus blushing, resulting from shame or embarrassment, is due to the dilating of the small arteries in the skin.

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Medical professionals insisted that DES was safe for pregnant women until they discovered many years later, that women whose mothers took DES suffered from very high rates of cervical cancer. The authors of the Cancer Research study concluded, the use of soy-based infant formulas in the absence of medical necessity and the marketing of soy products designed to appeal to children should be closely examined.”

A policy statement of the Royal College of Australian Physicians includes their comments about soy formulas. They concur about the dangers of soy infant formula. The rationale for the use of soy formula has been the assumption that soy protein is less allergic than cows’ milk. But this is not the case. Soy protein can cause intolerance reactions with gastrointestinal symptoms as well as acute allergic reactions. In fact, up to 40 percent of infants intolerant of cow’s milk also develop soy protein intolerance. Soy can cause a loss of vitamins, minerals and trace elements from the gut. High aluminum content has also been documented in soy formula. It has over 1000 percent more aluminum than conventional milk-based formulas. Infants fed soy formula also had lower levels of antibodies in response to routine immunizations and more infections than those fed human milk or cow’s milk formula, leading to compromised immunity.

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Although better known for causing genital herpes, the herpes simplex virus (HSV) can infect skin anywhere on the body. HSV type 1 is a more common cause of these nongenital infections. The major difference is that type 2 is more prone to recurrence.

The virus is spread by direct contact and respiratory droplets. Primary infection occurs within 1 week of contact, frequently beginning with generalized symptoms such as fever, headache, and myalgias. Clusters of uniformly sized vesicles appear on an erythematous base. The vesicles erode and heal over a course of 2 to 6 weeks. During primary infection, virus ascends peripheral nerves to dorsal root ganglia, where it enters a latent stage. Secondary infection occurs through reactivation of these dormant clusters of virus. Secondary lesions are typically preceded by tingling, itching, or burning and are sometimes preceded by a prodrome of generalized symptoms.

There are a number of manifestations of HSV infection. Lesions that occur on the fingers are called herpetic whitlow. Herpes gladiatorum, classically described in wrestlers, occurs on abraded or traumatized skin. Vesicles can occur near the eye and should be taken very seriously, since ophthalmic infection can lead to permanent visual impairment. Prompt ophthalmology referral is crucial in such cases.

Nongenital herpes infections may be treated with acyclovir, valacyclovir, or famciclovir. Prophylaxis can be used for frequent recurrences (more than six per year). Prophylaxis should also be considered for patients in whom recurrence presents an occupational limitation (e.g., those in health care or athletics).

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People with BDD feel especially uncomfortable and anxious in situations in which the perceived defects are likely to be exposed. They may avoid swimming, the beach, or events requiring shorts or short sleeves. People with facial concerns feel anxious in most social situations. Many people say that their symptoms typically worsen when they’re around other people, which makes them avoid people even more. As one young man told me, “My BDD bothers me less when I’m alone, so I stay alone.”

Relationship may be strained or avoided altogether, and intimacy is often forgone. Many people with BDD are very isolated. Spouses, boyfriends, or girlfriends usually have trouble understanding the self-consciousness and avoidance and may become irritated or even angry. “My husband is very frustrated that I don’t want to go places with him where I’ll have to dress up,” Maria told me. She avoided situations, such as parties or dances, in which she couldn’t wear bulky sweatpants that covered her thighs. “He doesn’t understand why I prefer to stay at home instead of going out or spending time with friends. He’s afraid that we’re starting to lose our friends because of it.”

BDD often stifles intimacy. “I’ve not only avoided dating because of it,” Martha told me, “I finally got a boyfriend, after 20 years of not having one, and my worries about my feet and thighs are interfering with our relationship. It interferes with sex—I’m afraid he’ll reject me because of my appearance. It’s a burden and a hindrance. I’m afraid I’ll never get married because of how I look.” Martha never told her boyfriend about her appearance concerns, even after they got engaged. “I’m much too embarrassed,” she told me. “I discuss everything else with him, but not this.” Because she was so self-conscious she tried to hide her body whenever she was around him. She undressed only in the dark, and she never allowed him to see her feet. “I wear socks at all times,” she said.

Sally was able to be intimate with her husband. “But I can’t exactly relax,” she said. “I worry about my hair the whole time—is it getting messed up? Does it look okay? I jump out of bed right after sex to check my hair. My husband thinks I’m crazy!”

Arnie, who thought his skin was too white, had never felt comfortable with his girlfriends. “It’s interfered with my love life and with any intimacy whatsoever. I wouldn’t take any clothes off. I wouldn’t even roll up the sleeves on a long-sleeved shirt!” Randy attributed his impotence to his BDD. “I’m constantly judging the size of my penis negatively. I’m probably misperceiving, but I think it anyway. The intensity of the feeling is severe. No wonder I’m impotent.”

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