Rarest Words

The phrase ‘there’s something about Mary’ may conjure up all sorts of images for you, depending on whether or not you’ve seen the film of that name. But what if Mary’s one of your team, and the thing about her is her unique and rather unpleasant smell?

Tackling a personal hygiene issue at work is never easy. Most people try to ignore it or hope that it’ll miraculously go away. But unfortunately it hasn’t, and it’s getting harder to ignore.

Several other members of your team have commented on it and are now waiting for you to do something. Their own attempts at dropping hints have proved useless and rather expensive - the gift boxes of toiletries have grown bigger with each Christmas and birthday, and yet the smell still lingers.

To be fair, you did try and tackle the subject indirectly during a team meeting. Unfortunately, your request that everyone makes sure they’re always clean and smart for work only succeeded in upsetting the rest of the team, while Mary seemed to remain blissfully unaware that she was the intended target of your comment.

Should you say anything?

Although everyone’s on your case and waiting for you to talk to her, you’re not even sure you have the right to say something - after all, Mary’s very good at her job, and is her BO really that big a problem?

There’s one main reason why people avoid saying anything, and that’s usually their fear of the reaction they’ll get. What if she gets upset or angry? Or what if she walks out? She may well do any or all of these - but then again she may not.

To counteract this, there are three good reasons why you should say something. Firstly, your team are waiting for you to do so. Ok, perhaps they should be tackling issues they have with their colleagues themselves. But they obviously don’t feel confident enough to do it themselves, and they’re waiting for you to show leadership. And if you don’t, perhaps it’ll be the other members of your team that get upset or angry, or start looking for another job.

Problems of this nature can cause huge barriers between colleagues. Although they may actually like Mary, they may end up avoiding having to work closely with her, especially in confined spaces. This is bound to have an impact on everyone’s work.

Which brings me onto the second reason for tackling the issue: BO’s bad for business. What effect is this having on your clients or customers? If Mary only deals with them over the phone, there’s no problem. If on the other hand she regularly meets people, she could be losing you work. Where your clients really have no other choice than to use your organisation (as is often the case in much of the public sector), you might think ‘tough’. Well, if that’s your attitude, you’ve far more to worry about than Mary’s personal hygiene.

The final reason for saying something is Mary herself. If you were Mary, wouldn’t you prefer to be told, than have people whispering about you behind your back? Most people really do prefer to be told about something like this, even though it causes some initial embarrassment. And if Mary is already well aware of the problem, you still need to tackle the issue properly. The hints and endless toiletries are likely to be having a negative effect on her, and might even be taken as a form of bullying.

So, what do you do?

Find somewhere private, where you can talk without being interrupted. You may want to consider somewhere other than your office - if the rest of the team realise what’s going on, the way they watch your door to judge Mary’s reaction as she leaves could make an uncomfortable situation far worse.

Be direct. Beating about the bush will make you both more uncomfortable. You might want to practise an opening phrase beforehand, something like “I’d like to discuss something with you. I’ve noticed you’ve got a body odour problem; we need to talk about it, because it’s affecting the business.”

This ’cause and effect’ structure is very useful - it shows you’re raising the issue for a purpose, rather than just for the sake of it. Of course, it helps if you’ve thought through exactly what effect the problem is causing.

Also, take ownership of what you’re saying - “I’ve noticed” is far better than hiding behind an “everyone’s noticed”.

But what should you do if your initial fear was justified and Mary gets upset or angry? Being told you’ve got BO is obviously not pleasant, so an emotional response is to be expected. Acknowledging her feelings is a good start, and then you need to look at what happens next. You could say something like “You’re clearly upset by this; let’s sort it out.”

In some ways, getting no reaction can be even more difficult. If you just can’t judge how Mary’s feeling, you could try asking, “what do you think about what I’ve just said?” If she says she doesn’t want to discuss it, you need to make it clear that this isn’t an option. Give her time to reflect, setting up a meeting the following day if necessary.

Breaking the news is only part of the story. You can’t assume that now you’ve told her, Mary will be able to do something about it. This could be the case, but she might need your help. Particularly if she already knows she has a problem and hasn’t yet managed to solve it, you’ll need to look at what she’s already tried and then explore other options.

You might want to suggest she visits the doctor, as smells can be symptoms of something else. For example, although you can cover bad breath up with mints, it’s better to tackle the underlying cause, be that gum disease or something else. And talking of underlying medical conditions, be careful about jumping to wrong conclusions. Smelling of alcohol could be the result of drinking, but a similar smell can accompany diabetes.

You should always follow up any action you’ve agreed with ongoing support and encouragement. Tell Mary when you notice improvements, and ask her what’s happening if the problem comes back again.

And finally, avoid falling into the trap of gossiping. If anyone in your team asks what’s going on, let them know you’re dealing with it, but that you won’t say more.

So, when there’s something about Mary (or Martin or Miguel or Meera), you can’t ignore it because it won’t go away. By all means take some time to think through how you want to approach the issue, but in the end you will just have to get on and do it.

Tim Schuler has been a development professional since the mid-1980s and is director of The Development Practice. He has substantial experience of helping people improve their management capability, communication skills and personal effectiveness.

Comments Off

The pain of grieving is there for all losses, whether spouse or lover. A partnership transcends labels and roles and one’s partner is primary when a strong bond exists. Regardless of how the relationship is named, the pain of loss requires healing. In life, we may be exposed to mini losses several times before a major loss presents itself. We “deal with it” and even understand it to a small degree. Yet, we are not schooled in loss or prepared for it in life, so when we experience a larger loss it can feel devastating.

When we love and lose someone, whether that someone is lesbian, homosexual, bisexual or transgender, we are overwhelmed by pain and sorrow. However, when our relationship is out of the mainstream, we might already have been so criticized and saddened, that in this final loss, we find it much more difficult to grieve, heal and move on to a fulfilling new life.
No one can understand totally the pain of another. We can meet at waysides of commonality and share our experiences and progress, and although there is healing in the act of sharing, we still feel alone in our sadness. What touches us in a positive way is when we feel understood. The loneliness of loss and alienation affects us deeply at the level of our souls.
Mourning the loss of a partner within a non-traditional relationship can encompass an additional burden if there is little family or community-at-large support. Such relationships may have had less approval, or in the case of a gay, lesbian, bisexual or transgender partner, even have been kept secret. If the immediate family is not approving of this relationship, they have trouble being supportive. In fact, they may not understand, but may also be angry over the relationship. The reality is that out of the mainstream experiences are harder to understand and accept when they are not “your experience.”

Parents who have accepted their non-mainstream children, who love and support them, don’t have to understand everything. Their love is a support platform. That said, however, joining a traditional support group may not be seen as a viable option because there is no common ground. Parents who are grieving want to meet other parents who are grieving. Grown children who are grieving want a group with others like themselves.

Widows/widowers prefer being with other widows/widowers although there are similarities, there are many differences. People want a good match, the compatibility that comes with shared understanding and similarities. People who are gay do not see a mainstream support group as a major support for themselves because “they will not understand.” People want a match for their experience; they want to know that they can feel understood and loved and not judged or ridiculed. They will drop out of mainstream grief support groups that don’t accept them.

The Lesbian, Gay, Bisexual & Transgender Community Center
Established in 1983, the New York-based Lesbian, Gay, Bisexual & Transgender Community Center has grown to become the largest LGBT multi-service organization on the East Coast and second largest LGBT community center in the world.

Doneley Meris, M.A., C.T. (Masters in Bereavement Counseling; Certified Thanatologist/Death Educator) is their Team Leader for Outreach and Education, Center CARE. Challenges for the LGBT community over grieving and healing are dependent on sensitive and inclusive grief LGBT-focused support groups according to Meris. Major cities have been able to address this concern by facilitating support groups but Middle America still needs to incorporate this unique service to the LGBT community which is a major challenge as religion, morality, and politics often get in the way.
Meris maintains a bereavement psychotherapy practice in New York City where the focus of his work primarily is to meet the challenges of the LGBT bereaved community(ies).

“The LGBT community today continues to face discrimination in more mainstream venues for (bereavement) services,” says Meris. “When you add HIV/AIDS into the mix, the sexual orientation and the stigma attached to AIDS become major barriers to the comfort level, trust, and safety of LGBT individuals who attempt to participate in service programs that are not LGBT identified or sensitive. Secondly, there are many institutions that provide grief services that have not had sufficient and realistic trainings working with the LGBT bereavement population.

“There is sensitivity and humaneness specially required of any service practitioner in order to effectively move the healing process for this unique group of individuals. The big elephant of homophobia and heterosexism even in death has to be dealt with to be effective in providing quality grief services.”

According to Meris, grief counseling, however, is provided in many venues. “Association for Death Education and Counseling (ADEC) has been very actively engaging and encouraging funeral homes, hospital chaplains, hospices, churches, HIV/AIDS service agencies, and other mental health and community-based organizations to incorporate grief services particularly to LGBT individuals in their service provision. Various websites have sprung up that address the unique grief challenges of the LGBT community.”

Excerpted from THE HEALING POWER OF GRIEF: The Journey Through Loss to Life and Laughter by Gloria Lintermans & Marilyn Stolzman, Ph.D., L.M.F.T., http://www.championpress.com, ISBN 1-932783-48-2

Drawn to the healing aspect of grief counseling, Los Angeles-based Dr. Marilyn Stolzman is a professional counselor specializing in bereavement. Dr. Stolzman created and directs the Southern California bereavement and transition support program, H.O.P.E. UNIT FOUNDATION, which offers a life-affirming two-year support group program.

Los Angeles-based Gloria Lintermans is a former internationally syndicated columnist. She is a freelance writer who has written for national and local magazines and the author of the enormously successful CHEAP CHIC: A Guide to LA’s Resale Boutiques (1990), the “ultimate guide to recycled fashion,” and forerunner of RETRO CHIC: A Guide to Fabulous Vintage and Designer Resale Shopping in North America & Online (Really Great Books, Los Angeles, 2002) and The Newly Divorced Book of Protocol (Barricade Books, New York, 1995).

Comments Off

Everyone wants their lives to be filled with good things and joy. Ideally we all should be able to live in our own utopia. There should be no disappointments, no heartaches, no tragedies, and no disasters. Each day should be nothing but happiness.

Unfortunately, bad things happen. Sometimes very bad things. Bad things don’t discriminate when they strike. They can strike very good people who didn’t do anything to deserve them. They can strike without warning or reason.

The death of a loved one, crime, murder, rape, suicide, disease, wars, and terrorism are among the bad things that happen. Bad things can turn lives upside down and inside out. Their effects can be devastating. When bad things happen there are many more questions than answers.

People who encounter bad things experience emotions they never knew they were capable of. Extreme grief, despair, guilt, anger, and blame are common reactions. People who experience bad things can be changed forever. Their world never appears the same.

Perspectives and priorities are radically altered. There are feelings that one might want to share. But most others won’t understand what they are going through. It feels as if there is no escaping those emotions that one never wanted to experience.

There are unwelcome thoughts and feelings that pop into the mind without warning. Waves of intense emotions can hit unexpectedly. A person can be feeling OK one minute and then the next minute nosedive. There are thoughts of “why me?” “what did I do to deserve this?” or “what does it all mean?”

If you have experienced something bad, you can feel trapped in a waking nightmare. Is there anything you can do? How do you live your life? How do you deal with indescribably intense feelings? Will life ever be normal again?

There is hope and you can and will move forward. You can’t rush or avoid going through your feelings of grief. As extreme as they are, they are real and you do feel them. You need to experience your feelings. It’s all right to do so. If you try to deny them, they will only surface later and can be detrimental to your well being.

Whether you like it or not, a certain amount of time must pass before you are ready to start moving ahead with your life. How much time is needed depends on the circumstances and the individual. There is no appropriate amount of time. Don’t allow other people to tell you what you should or shouldn’t be feeling or what you should or shouldn’t be doing.

You may feel guilt. It’s normal to think that if you only had an opportunity to do things over, or make different decisions, there would have been a better outcome. You can’t turn back the clock. You can’t go back in time even one second. You have to accept what has transpired because it can’t be changed. You shouldn’t feel bad about feeling bad. Your feelings are what they are. There are no right or wrong feelings.

It is extremely helpful to find someone to talk to about your feelings and emotions. Trained professionals and/or support groups of people with similar experiences are good options. Your ultimate goal is to begin living again. You may be changed. There may be feelings that will never totally go away. But you will be able to move forward. Even with these feelings, you will feel happiness again and bring joy to others.

Unless another person has experienced what you have, they don’t have a clue as to what you are going through or experiencing. As well meaning as others’ opinions might be, you have to go through your own grief and healing process in whatever way works for you.

You can strive to be a better and stronger person for what you have endured. If you can use what you have learned from your experiences to help even one other person overcome adversity, then you have squeezed some good from otherwise awful circumstances.

However, there are certain behaviors that you must avoid. Turning to alcohol or illegal drugs only make things worse. They will never help you in a positive manner. You don’t want to engage in self-destructive behavior. You don’t want to lash out at loved ones.

There are people who love you and who depend on you. You may not grasp how much influence you have on others and it’s probably more widespread than you are aware. More people care about you than you realize. Within you lies greater strength to survive and go on than you comprehend. But the strength is there. Have faith in it.

You will get through and survive the bad times. The journey might be hellish but you will emerge. Unfortunately, there is no magic remedy or solution. Life is precious and you must make the most of it. If you can use your experiences to help others dealing with similar circumstances, it will help you and the other person to heal.

Like the grief phase, the healing process also takes time. Helping others can assist the healing process and allow you to focus on something positive. Critical to the healing phase is starting to move forward with your life. Even though you may feel that you will never be or feel the same, continuing with your life is necessary for your well being.

Get through each day. Don’t worry about tomorrow, just deal with today. If it’s too overwhelming to get through an entire day, work on an hour at a time. Find a strategy that works for you. Don’t be concerned about the directives of others telling you how you should feel, what you should do, or how much time you need.

Other people have continued living in spite of bad things. You can and will too.

Copyright 2005 Bryan Golden

Bryan Golden is a self-development and motivational expert, author, and professor. He is the author of “Dare to Live Without Limits,” and writes a nationally syndicated newspaper column. For more information please visit:
http://www.daretolivewithoutlimits.com or
http://www.bryangolden.com

Comments Off

Let us say you put people side by side, one with royal ancestry and one without. Do they perceive the world differently as their DNA is accentuated slightly differently? Interesting question and one many Americans do not wish to address because we all have agreed to live under a doctrine which says; “All Men Are Created Equal” and yet the question remains does a royal lineage change the way you perceive events and experiences? Wow, good questions.

Now then this question came up in an online think tank when one guest member Princess Kristine asked; “What I’m trying to say is would it have some baring on the manner in which you think and how you perceive things??”

Well since I happen to have some royal bloodlines and ancestry I would like to take a crack at this question. And I would say that; Yes of course. For instance if one’s brain is formed a certain way, either thru an adaptation of genetics or certain repetition of use or it was re-formatted by its owner to “think” a certain way (my case), just the fact that it was able to do this would in fact be some Genetics and some nurture. Thus your ancestry and those traits do in fact apply to some degree. The question is to what degree you see?

So indeed the answer would be yes, but partially and perhaps pragmatically. Unfortunately and not politically correct to say in this present period this also dispels a myth; That we are all created equal? Well that simply is not so.

For instance; If a family bloodline carried a genetic flaw, which allowed them to think on a particular subject for long periods of time, rather than jumping around more then it might in this case perhaps allow for greater discovery, innovation and thus propel one further or if in a closer knit group one’s family, corporation, nation, people or self.

Yet by the same token that person caught thinking might have been eaten by a Saber Tooth Tiger for not paying attention to the immediate details of a situation and thus the “superior genes” would be the latter not the former of the genetic flaw. So whether your bloodlines carry genetic flaws or gifts do indeed affect how your brain works and how you think you see? Consider this in 2006.

“Lance Winslow” - Online Think Tank forum board. If you have innovative thoughts and unique perspectives, come think with Lance; http://www.WorldThinkTank.net/wttbbs/

Comments Off

“You’re a bad girl and you’re going to hell for that!”

The words echoed through my eight-year-old head. Squeezing my eyes shut I begged God, once again, not to send me to hell. I tried to choke back the tears, but I had no control over them, as if they had a mind of their own.

With a sniffly nose, I wiped the salty water off of my face with the palms of my hands.

I pictured myself screaming in the middle of red hot flames and coals. I lifted the edge of my white cotton blanket and crawled underneath, curling into a fetal position.

I was a good child. I couldn’t understand what I did so bad all the time to be in danger of hell. This fear transformed into a fear of the end of the world. A fear I’d keep into my early teens.

This is an example of the power of words. Words can build a person up or tear them to shreds. Words have the power to destroy a person’s life; especially the ones coming from those we love and look up to.

I heard damaging words all throughout my childhood. I was told I was going to hell so many times that I absolutely feared death and in turn this turned into a very deep-seated fear of the end of the world.

I want you to think back when you were a child. Do you remember any words spoken to you which had such an impact on your life? Most of us can remember a few instances like this.

Using words to hurt someone is an anger problem, which needs to be controlled. It stems from speaking before you think. Once the words are said, they can not be taken back. Sure you can apologize, but an apology will not magically erase the harsh words already spoken.

There is a well-known experiment from Dr. Masaru Emoto, a creative and visionary Japanese Researcher. He taped different words to bottles of water, in order to determine if words affect something as simple as water. The words actually changed the crystal molecules. Positive words made dirty looking molecules, clear and beautiful. While negative words made a clear, beautiful crystal molecule look muggy, dark and ugly. This provides physical evidence that thoughts, words, music and ideas do affect you at not only an emotional level, but a physical one as well. Our bodies are made up primarily of water; If positive or negative words can have this kind of effect on a single molecule of water, imagine the change it may produce in your own body.

One must not ever forget that words are one of the most powerful tools we have. Use them with caution.

Tracey Wilson is an author on http://www.Writing.Com/
which is a site for Writers. Many of Tracey’s writings can be found at http://www.writing.com/authors/intuey

Comments Off

Hide and Seek is a wonderful game to play with your children. The next time you play this game observe what happens. If you are the person hiding your eyes and counting to 10, feel what happens to your heart as you look for your children.

If you pay attention, my hunch is that your heart and imagination will heighten. Since you cannot see your children in front of you, a movement from the perceptual world to the intuitive world becomes your path into soul. You are, now, being guided from within. In soul, you will feel your heart come alive. You will feel your heart open. And, you will experience your heart become ONE with your children.

1. Feel Your Heart.

Close your eyes and place your attention on your heart. Look at your heart from within using the inner vision of your mind, and not, the ones you use in the material world. This simple act of noticing and placing your attention on your heart enables you to feel your heart.

2. Feel Your Heart Open.

The next time you hug someone you care deeply about, feel how warm and open your heart becomes. It is a similar feeling you get when you receive good news or visit someone you haven’t seen in a long time. An open heart is able to receive the love and attention of another person who wants the same. This mutual receiving and giving love connect hearts as one cohesive unit.

3. A Unified Heart.

A heart in unity with the world, itself, and others around it knows wholeness. Wholeness is the feeling of being ONE with all that is alive and well. It is the feeling of being loved, blessed, known, and cared for. This feeling of being connected to the unified whole called the universe is our ability to identify beyond our own individualized selves. This transcendent state of being creates an awareness of what infuses our heart with eternal love.

Notice what happens when you play Hide and Seek with a small child. The closer you get to finding them, the more you will feel your heart. Your heart will open to a channel of expression and experience where physical eyesight is no longer necessary. This guiding force enabling you to feel your heart, allow your heart to open, and create a path merging two hearts as ONE is the heart of soul.

Samuel Oliver, author of, “What the Dying Teach Us: Lessons on Living” For more information on this author; http://www.soulandspirit.org

Comments Off

The Psychology of Colors in Advertising and Marketing.

© Kurt Geer

Are you stimulating emotions while marketing with your business logo, stationary, business cards, brochures, signs and with your website?

If you know it or not, colors speak very loud to our subconscious and have a positive or negative reaction within 90 seconds. On the web you have less that 30 seconds to make a good first impression.

Are you using the silent language of color to impress, motivate, divert and persuade your prospects to buy from you?

BLACK suggests authority, power, boldness, seriousness, is distinguishing and classic. Business wise it’s great for creating drama and is good for a background color (except on websites, it is very hard on the eyes). It is ideal for text on a light background. Black also implies submission and is associated with evil.

BLUE suggests security, authority, faithfulness and dignity. For business it suggests sanctuary and fiscal responsibility. It is the most popular and the second most powerful color. Blue can also be cold and depressing. People are more productive in blue rooms.

BROWN suggests richness, politeness, helpfulness and effectiveness. In business it suggests less important items. Solid, reliable brown is the color of earth and is abundant in nature. Light brown implies genuineness while dark brown is similar to wood or leather.

GRAY suggests authority, practicality, earnestness and creativity. Business wise it is traditional and conservative.

GREEN suggests health, fertility, freedom, freshness, healing, tranquility and jealousy. Businesses use it to communicate status and wealth. It is the easiest color on the eye and can improve vision. It is a calming, refreshing color.

ORANGE suggests pleasure, cool, excitement, cheer, endurance, strength and ambition. For business it is good for highlighting information on charts and graphs.

PINK suggests femininity, gentleness, well being and innocence. For business you must be aware of it’s feminine links and implications.

PURPLE suggests spirituality, royalty, luxury, wealth, sophistication, authority and mournfulness. In business it is upscale and works with artistic types. It is also feminine and romantic. However, because it is rare in nature, purple can appear artificial.

RED suggests excitement, strength, sex, passion, vitality, aggressiveness and commands attention. Business wise it associated with debt, is great for boldness and accents. The most emotionally intense color, red stimulates a faster heartbeat and breathing.

WHITE suggests refined, purity, devotion, contemporary and truthfulness. For business it can be sterile and refreshing. The best color on the web for a background color. Doctors and nurses wear white to imply sterility.

YELLOW suggests warmth, sunshine, cheer, happiness, jealousy deceit and cowardice. Business wise it appeals to the intellectual types and is a good accent. Yellow enhances concentration, hence its use for legal pads. It also speeds metabolism. It is the most difficult color for the eye to take in, so it can be overpowering if overused.

Green, brown, and red are the most popular food colors. Red is often used in restaurant decorating schemes because it is an appetite stimulant.

People respond more to non verbal cues than verbal ones. Make sure you use the psychology of colors in all your marketing, especially when you can’t be face to face.

Comments Off

Coming to the United States 3 months ago I had an opportunity to observe day-to-day life and make a brief psychological analyze of immigrants, trying to answer questions I was asked. Many American people are wondering why do foreign people come to United States? Who they are and where is their patriotism? Aren’t they homesick? What is the main reason they come to a foreign country and make all the efforts to study foreign language?

Many people come to the United States in hope to find freedom, which they did not have before in their motherland. However, the word “freedom” can be understood in different ways - for some people it’s freedom to buy a lot of food, household items or clothes. Having a lack of opportunity to buy goods in their homeland due to high prices, unemployment and low salaries, these people become “happy” very soon, since they are able now to buy almost everything they think they want.

But for others freedom means possibility to grow personally and professionally, to make contribution to the society, being able to study, gain scholarships or assistantships, make scientific research in spite of difficulties with foreign language, expensive education, and absolutely unfamiliar environment. This type of immigrants becomes good professionals in various fields such as medicine, mathematics, physics, construction, psychiatry and so on. They realize themselves personally, making contribution to the society where they live and increase their level of psychological self-actualization. This is not an easy way for immigrants, but the American society also has a lot of benefits for them and their children. Even the possibility to work, be valued and fairly paid is part of freedom, sought by people around the world.

Most of immigrants are homesick, have difficulties in understanding foreign language and it is not easy for them to realize all the rules and laws of the new country. That is the reason why immigrants often get very confused during their first several years in the United States, causing depressions, frustrations and even break-ups of families. Very often recently immigrated parents misunderstand their children who get used to the new life-style very quickly.

However, in spite of all obstacles many immigrants do achieve success. I have tried to understand what is they key to success, talking with people from Russia, Ukraine, Afghanistan, Puerto-Rico, Ethiopia, and Uzbekistan. Together we understand, that the most important way to succeed for immigrants is to realize their goals from first days in United States. Immigrants should ask themselves: Why did I move to this country? What am I expected to do here? And how can I contribute to the society? It is important to have life orientations and values directed to contribution to the society. It is also important to learn more about history and laws of the country, have friendly attitude and some day the American society will reward and treat you with respect you deserve.

Original Article URL

Comments Off

How do we treat bipolar disorder? Specifically, how do we treat mania or depression associated with bipolar disorder? The treatment of these two clinical states is not the same.

The treatment of mania is dependent upon its severity and acuity. For mild to moderate mania, mood stabilizers such as lithium and valproic acid (Valproate) are still the standard of treatment and may be sufficient to contain the symptoms. Lithium starts to work after 10 to 14 days while valproic acid, about 7 to 10 days.

Also, recent studies have shown the effectiveness of atypical antipsychotics such as risperidone, olanzapine, and quetiapine even when used alone to treat the acute phase of bipolar disorder.

These drugs are relatively safe but they don’t come without side effects. Nausea, vomiting, tremors, and dizziness during the initial phase of treatment are commonly experienced. The more serious side effects such as renal and thyroid problem from lithium, liver dysfunction and pancreatitis from valproic acid, and increased risk of diabetes and high cholesterol from atypical antipsychotics are uncommon. However, regular blood tests are required to monitor any abnormalities.

For moderate to severe cases, atypical antipsychotics such as risperidone and quetiapine should be added to the mood stabilizers during the acute phase. Once the illness has stabilized and the symptoms have subsided, then the atypical neuroleptics can be gradually tapered off. But the mood stabilizers should continue. Regardless of severity, patients usually do well on a combination of mood stabilizer and atypical antipsychotic during the acute phase.

What is the treatment for bipolar depression? In general, the mood stabilizers’ dosage should be optimized or if the patient is not on any medication yet, a mood stabilizer such as lithium should be started. Physicians should make sure that the medication maintains a “therapeutic level.” If not, the dosage should be adjusted. Moreover, possible precipitants such as stresses at home should be addressed.

If these measures don’t help and the depression is so severe, an antidepressant with the least risk to induce mania such as bupropion should be added to the mood stabilizer. When the depression is resolved, then the antidepressant can be gradually tapered off because its prolonged use even in the presence of mood stabilizer can still induce mania.

When should the medication be discontinued? Bipolar patients have to continue taking the medication for several months even after they become normal. High relapse rate is common if medications are prematurely stopped. Also, for patients with multiple or difficult-to-treat episodes, they may need to take the medication for years or even for life to prevent recurrence.

Patients and their physicians should thoroughly discuss the risk and benefits of any treatment intervention. Knowledge about the drug’s indication, side effects, and prognosis with or without treatment is a must.

Furthermore, it is crucial that bipolar patients should also receive individual psychotherapy to help them deal with the many personal and psychosocial issues they face on a daily basis. As you know, medication alone won’t suffice to address financial problems, marital conflict, work issues, and prior abuse.

In summary, the combination of medication and psychotherapy is the best treatment for bipolar disorder.

Copyright © 2004. Dr. Michael G. Rayel - author (First Aid to Mental Illness-Finalist, Reader’s Preference Choice Award 2002) psychiatrist, and inventor of Oikos Game: An Emotional Intelligence Game. For info, visit http://www.oikosgame.com and http://www.soardime.com.

Comments Off

The most recent models that attempt to describe what is happening in the brains of people with Attention Deficit Hyperactivity Disorder suggest that several areas of the brain may be affected by the disorder. They include the frontal lobes, the inhibitory mechanisms of the cortex, the limbic system, and the reticular activating system. Each of these areas of the brain is associated with various neurological functions.

There are several areas of the brain potentially impacted, and there are several possible “types” of ADHD. Daniel Amen, a medical doctor using SPECT scans as identified six different types of ADHD, each with its own set of problems, and each different from the other “types.”In our practice we used five different “types” of ADHD, identifying each “type” with a character from the Winnie the Pooh stories (Pooh is inattentive, Tigger is hyperactive, Eeyore is depressive, and so on).

The frontal lobes help us to pay attention to tasks, focus concentration, make good decisions, plan ahead, learn and remember what we have learned, and behave appropriately for the situation. The inhibitory mechanisms of the cortex keep us from being hyperactive, from saying things out of turn, and from getting mad at inappropriate times, for examples. They help us to “inhibit” our behaviors. It has been said that 70% of the brain is there to inhibit the other 30%.

When the inhibitory mechanisms of the brain aren’t working as hard as they ought to, then we can see results of what are sometimes called “dis-inhibition disorders” which allow for impulsive behaviors, quick temper, poor decision making, hyperactivity, and so on.

The limbic system is the base of our emotions and our highly vigilant look-out tower. If over-activated, a person might have wide mood swings, or quick temper outbursts. He might also be “over-aroused,” quick to startle, touching everything around him, hyper-vigilant. A normally functioning limbic system would provide for normal emotional changes, normal levels of energy, normal sleep routines, and normal levels of coping with stress. A dysfunctional limbic system results in problems with those areas.

The Attention Deficit Hyperactivity Disorder might affect one, two, or all three of these areas, resulting in several different “styles” or “profiles” of children (and adults) with ADD ADHD.

Learn more about the impact of ADHD on children and teens, treatment options for ADHD, and much more at the ADHD Information Library.

Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library’s family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.

Comments Off