By U. Kerth. University of Maine.

Caring and supporting a bipolar family member can be wearing buy discount meldonium 500 mg on line symptoms dehydration. Here are some self-care suggestions for bipolar caregivers as well as information on finding support groups for bipolar family members order meldonium 500 mg overnight delivery 5 medications that affect heart rate. No one is to blame and you cannot cure a mental disorder for a family member discount meldonium 250 mg mastercard medicine while pregnant. Nearly all relatives of the mentally ill feel guiltyThere are positive actions that can be taken to make life more bearable when a family member has bipolar disorder buy 500 mg meldonium with amex medicinenetcom medications. It is imperative that you seek out and learn all you possibly can about bipolar disorder. Like a general fighting a battle you are going to need all the ammunition you can garner at your disposal. Do all you can to keep communication lines open between you and your ill relative. Assure him you are there for him and that you know he is sick but will get well again. Try to be a part of his wellness, but not a part of his illness. Encourage every effort to get better and go with him, rather than send him for help if he wishes. Try to project positive thoughts about his recovery. Lessen the burden on the family by broadening the network of people who can help in a crisis. Another person who has been through this, a concerned friend or professional may offer respite when you need it most. One of the hardest things for family members to do sometimes, but one of the most important. Take care of your own health and your own needs or you may not have the strength to cope. Know the warning signals that may trigger an episode in your family member. Be prepared to act before they worsen and get out of control. Tragically, suicide is an all too common result of bipolar disorder. You are not superman (or woman) and there are limits to what you can handle. These are valid feelings and ones shared by all families of bipolars. So cut a little kindness to yourself into the equation. In the throes of illness your relative may try to blame you for the way he is feeling. You have educated yourself and know that he has a chemical imbalance. But neither will arguing with him at this point help much. Tell him that you will not accept what he is saying and that you know it is the illness talking. It is hard sometimes to talk to others about how out of control things have become in your life. If you are having trouble coping, never be afraid or ashamed to seek help for yourself. Recovery from an episode is not often a straight path. Wellness is achievable and has been achieved by many. But chances are very good that there will be another episode. Have telephone numbers - doctor, emergency, admitting hospital, support, advice, etc. Ensure insurance is in place and the best that you can manage for psychiatric illness. Support others going through crisis - as they will support you. The more prepared you are, the easier it will be for you to get action and to cope. Consider having advanced directives in place prior to another episode. In trying to support a person with bipolar disorder, how do you make sense of the ups, downs and sometimes downright craziness? When one member of a family has bipolar disorder, the illness affects everyone else in the family.

LMermaid: My wife has anorexia and admits this but will never discount meldonium 500mg fast delivery 97140 treatment code, ever admit that she is depressed and this has contributed towards her not taking meds which are linked with Serotonin reuptake generic meldonium 500 mg with visa severe withdrawal symptoms. Should I be convincing her she is depressed or supporting her stand? She does seem depressed to me from time-to-time cheap meldonium 500 mg mastercard symptoms zenkers diverticulum, due to her eating disorder and complications stemming from it buy meldonium 250mg with visa medicine emblem. Crawford: The medications can frequently be helpful for anorexic patients regardless of whether depression is present. And to everyone in the audience, thank you for your participation and your questions. I want to again urge you need help recovering from you eating disorder, please take it seriously. Sacker joined us to discuss the medical risks of eating disorders (anorexia and bulimia), which range from hair loss, kidney failure, electrolyte imbalance, esophageal rupture, loss of menstrual period, to heart failure. He also commented on the problems that the audience shared, including how eating disorders affect fertility and pregnant women and problems with diet pills. What if you abused ipecac syrup, or abuse diuretics, or have been abusing laxatives? To find out what these behaviors can result in, read the transcript below. Our topic tonight is "The Medical and Psychological Risks of Eating Disorders. Ira Sacker, director of the Eating Disorders Program at Brookdale Medical Center and co-author of the book, Dying To Be Thin. Sacker is also the founder of HEED, "Helping To End Eating Disorders," a support and information organization based in New York. Am I right in assuming that most people do NOT die from an eating disorder, but are more likely to suffer from different medical complications as a result of having anorexia or bulimia? Some of the medical complications of anorexia include hair loss, kidney failure, electrolyte imbalance, esophageal rupture secondary to vomiting, and loss of menstrual period, resulting in possibilities of osteoporosis and infertility. There are also cardiac complications which can result in sudden death. Sacker: Additional complications include ruptured blood vessels in eyes, all of the cardiac and renal complications, as well as multiple ulcers of the esophagus and stomach. David: If one starts engaging in disordered eating behaviors, how long does it take for medical complications to arise? David: On the average though, are we talking about a few weeks or a few months, or many months, even years before any serious medical complications arise? Sacker: Certain complications, like hair loss and loss of menstrual period, may occur rather soon, but other complications such as osteoporosis or heart and kidney disease, may not been seen at first, therefore giving the person a false sense of health. David: The reason I asked that question is because there are many people suffering from eating disorders who think "this will never happen to me. You think that you are in control initially, but then realize that you actually have no control at all. Sacker: Purging causes increased pressure which can be transmitted to the chambers of the eye. BurnhamBuggirl: How long can you go without a period before you are infertile? Sacker: The earlier the diagnosis is made, and the earlier the malnutrition is corrected, the greater the chance of full recovery of fertility. David: Can one become permanently infertile as a result of prolonged anorexia or bulimia? It is baffling to me that my body would sacrifice the protein each month. Take this as a sign from your body that it wants you to get the help you so desperately need. Sacker: If you are restricting, rather than bingeing and purging, then you are engaging in anorexic behavior. David: Some of the medical problems we are discussing tonight are explained in some detail on the Peace, Love and Hope Eating Disorders site here at HealthyPlace. David: What about the psychological problems that can result from having an eating disorder? Sacker: Some of the psychological problems include depression, isolation, mood swings, suicidal ideation, social withdrawal, feelings of rejection, unworthiness, loneliness, and obsessive compulsive behavior. David: Are some of these disorders, like depression or mood swings, a result of possibly a situation the person finds themselves in or is it because of an imbalance in the brain chemicals? Sacker: The first step is admitting that there is a problem, then you must realize that eating disorders are not all about food. Once this is accomplished, you can slowly begin to process the emotions behind the behaviors.

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Linda: I actually prefer not to mention numbers purchase 250 mg meldonium free shipping symptoms 6 days after conception, even in a forum like this meldonium 500 mg visa medicine 79. Binge eating /purging took different forms discount 500 mg meldonium with amex symptoms 6dpo, and it was very often purchase meldonium 500 mg otc symptoms 6 days after embryo transfer, many times per day and I was taking laxatives too. Even today, there is no visible damage to my teeth, digestive tract, etc. At the worst point, when my weight was at the lowest, I was scared. And with my parents being doctors, I had to be creative, trying to keep everything secret. There was a time when my body "shut down" as I call it. I was tube fed at home for two or three days (a "bonus" to having parents as doctors). Linda (age 29) and Debbie (age 34) are our guests tonight. Both recovered from their eating disorder, but used different processes to do that. Since the audience is so large tonight, I want to ask everyone to only send one question. My eating disorder, anorexia and bulimia (later), started when I was 16. Like many girls that age, I just wanted to be boys, of course. And I thought the only way that would happen is if I looked pretty, translated "thin". I was keeping my eating disorder to myself and one day when I was in college, a couple of girls in the dorm were in the bathroom and I heard one throwing up. My electrolytes went way down, I was hardly eating, and whatever I ate, I threw up. Bob M: and this was over what period of time Debbie? Debbie : I was 20 when I had my first hospitalization. Bob M: We have a few questions and comments from the audience I want to get to. It did take me over a year-and-a-half before I completely stopped binge eating and purging. But it went from numerous times daily to once a week, to once a month, to finally-never. I felt it was a part of recovery, that it took me "xx" years to learn those negative behaviors, that it would take me awhile to learn positive coping skills. Jenna : Linda and Debbie, what truly *awakened* you to the fact that you suffered from an Eating Disorder? Do you two feel that you truly have to hit bottom before you can accept it? I was hospitalized for the first time when I was around 20 because my medical condition was so bad. I was in the hospital for 2 weeks and finally able to go home. My parents then sent me to a treatment center in Pennsylvania. I went home and not 7 months later, I was back doing the same things again. I tell you this, because for some of us with eating disorders, it is very difficult to break the grasp. Between that time, the time I went home, and the age of 28, I was in a treatment center a total of 5 times. What about you, did you hit bottom before you were able to get control? I gained a few more and stayed there for a few years. Bob M: Here are some more audience questions: symba : Linda I need to know what got you out of this???? Linda: Symba, when I began eating disorder recovery, for me there was no other choice.

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The latter patient generic meldonium 250 mg treatment of uti, in fact purchase 500mg meldonium mastercard symptoms 28 weeks pregnant, could quite easily wind up with 30 to 50 (+) alters meldonium 250 mg with amex symptoms 0f ms, even in the hundreds cheap 250 mg meldonium with mastercard treatment writing. The answers to these questions require a clarification of several points:First, MPD is a misleading term-- DISSOCIATED SELF DISORDER would probably be better. There is but one self that is dissociated into multiple parts. MPD tends to be misunderstood to mean "multiple self disorder. Secondly, there are usually only 3 to 6 alters who are particularly active (e. The rest of the alters are relatively quiet (even dormant for long periods of time). Finally, THERE IS NO REQUIREMENT THAT DIFFERENT PERSONALITIES BE VISIBLY DIFFERENT TO AN OBSERVER. It is only necessary that each alter fulfill the basic function of an alter personality-- that is, to protect the host personality from the knowledge and experience of the trauma. This task is accomplished by means of dissociative barriers or walls of amnesia. Thus a multiple could conceivably have dozens of alters that look just the same, but who, nevertheless, serve the function of walling off trauma from the host (and dispersing it among many alters). The answers to the above questions can now be more easily understood in light of the basic task of an alter personality. It is not required that these new alters look different, nor is it necessary that they all be active at one time; it is only necessary that they do their job (of containing the trauma of the abuse). The typical alters that are found in a person with MPD include: a depressed, depleted host; a strong, angry protector; a scared, hurt child; a helper; and, an embittered internal persecutor who blames (or persecutes) one or more alters for the abuse that has been suffered. While there may be other types of alters in any given MPD individual, most of them will be variations on the theme of these 5 alters. Although the data is not all in, the best estimate of the prevalence of MPD is that it approximates that of about 1% of the population. This estimate would translate into at least 2,000,000 cases in the U. Because MPD is directly linked to the prevalence of child abuse. The range of impairment across different persons with MPD is best analogized to that of alcoholism. Impairment due to alcoholism a) ranges from skid row bums to high functioning senators, congressmen, and corporate executives; and, b) varies in any given alcoholic from one period of time to another as a function of binges, patterns of drinking, life stresses, etc. There are some multiples who are chronic state mental patients, others who undergo recurrent hospitalization due to self-destructive behavior, and many more who raise children, hold jobs, and may even be high-functioning lawyers, physicians, or psychotherapists. If you are a multiple alters have, for the most part, been your good friends. It allows them to protect themselves and remain sane in the face of severe abuse. It allows them to endure the bad times and to keep their heart and soul safe from their abusers. If you doubt yourself this way, you can become confused or uncertain. You can also feel ashamed, frightened, or want to spend time alone. This self-doubt and confusion can make you feel bad about yourself. A person who is "multiple" will REMAIN "multiple" until successfully treated. About 90% of "multiples" are totally unaware they are MPD. A person who is "multiple" may appear to be fine for years and then suddenly begin to have strong symptoms- usually due to flashbacks of past trauma. Look for MPD if there is a pattern of:History of depression or suicidal behaviorChildhood history of physical, sexual, emotional, or psychological abuse... Hyde"Family history of dissociationDaytime enuresis or encopresisHistory of psycho-physiological symptomsHistory of nightmare and sleep disordersHistory of sleepwalkingReports psychic experiencesHistory of shifting symptom picture (one day symptoms of day symptoms of that)Two positive items from among 1-15 mandates consideration of a diagnosis of a dissociative disorder (e. Four or more positive items (especially among 1-15) mandates serious consideration of a diagnosis of Multiple Personality Disorder now known as Dissociative Identity Disorder. F or many observers, MPD is a fascinating, exotic, and weird phenomenon. For the patient, it is confusing, unpleasant, sometimes terrifying, and always a source of the unexpected. The treatment of MPD is excruciatingly uncomfortable for the patient. Recovery from MPD and childhood trauma takes something on the order of five years. The important thing to remember is that recovery does and can happen.

Being in familiar surroundings does not provide security order meldonium 250 mg fast delivery treatment in spanish. Just as with the victim purchase meldonium 250 mg free shipping medications or therapy, it is not possible to clearly identify individual men who will be participants in acquaintance rape purchase meldonium 250 mg medications such as seasonale are designed to. As a body of research begins to accumulate buy generic meldonium 500mg line medicine natural, however, there are certain characteristics which increase the risk factors. Acquaintance rape is not typically committed by psychopaths who are deviant from mainstream society. It is often expressed that direct and indirect messages given to boys and young men by our culture about what it means to male (dominant, aggressive, uncompromising) contribute to creating a mindset which is accepting of sexually aggressive behavior. Such messages are constantly sent via television and film when sex is portrayed as a commodity whose attainment is the ultimate male challenge. Buying into stereotypical attitudes regarding sex roles tends to be associated with justification of intercourse under any circumstances. Other characteristics of the individual seem to facilitate sexual aggression. Research designed to determine traits of sexually aggressive males (Malamuth, in Pirog-Good and Stets, 1989) indicated that high scores on scales measuring dominance as a sexual motive, hostile attitudes towards women, condoning the use of force in sexual relationships, and the amount of prior sexual experience were all significantly related to self-reports of sexually aggressive behavior. Furthermore, the interaction of several of these variables increased the chance that an individual had reported sexually aggressive behavior. The inability to appraise social interactions, as well as prior parental neglect or sexual or physical abuse early in life may also be linked with acquaintance rape (Hall & Hirschman, in Wiehe and Richards, 1995). Finally, taking drugs or alcohol is commonly associated with sexual aggression. Of the men who were identified as having committed acquaintance rape, 75 percent had taken drugs or alcohol just prior to the rape (Koss, 1988). The consequences of acquaintance rape are often far-reaching. Once the actual rape has occurred and has been identified as rape by the survivor, she is faced with the decision of whether to disclose to anyone what has happened. In a study of acquaintance rape survivors (Wiehe & Richards, 1995), 97 percent informed at least one close confidant. The percentage of women who informed the police was drastically lower, at 28 percent. A still smaller number (twenty percent) decided to prosecute. Koss (1988) reports that only two percent of acquaintance rape survivors report their experiences to the police. This compared with the 21 percent who reported rape by a stranger to the police. The percentage of survivors reporting the rape is so low for several reasons. Self-blame is a recurring response which prevents disclosure. Even if the act has been conceived as rape by the survivor, there is often an accompanying guilt about not seeing the sexual assault coming before it was too late. People normally relied upon for support by the survivor are not immune to subtly blaming the victim. Another factor which inhibits reporting is the anticipated response of the authorities. Fear that the victim will again be blamed adds to apprehension about interrogation. The duress of reexperiencing the attack and testifying at a trial, and a low conviction rate for acquaintance rapists, are considerations as well. The percentage of survivors who seek medical assistance after an attack is comparable to the percentage reporting to police (Wiehe & Richards, 1995). Serious physical consequences often emerge and are usually attended to before the emotional consequences. Seeking medical help can also be a traumatic experience, as many survivors feel like they are being violated all over again during the examination. More often than not, attentive and supportive medical staff can make a difference. Survivors may report being more at ease with a female physician. The presence of a rape-crisis counselor during the examination and the long periods of waiting that are often involved with it can be tremendously helpful. Internal and external injury, pregnancy, and abortion are some of the more common physical aftereffects of acquaintance rape. Research has indicated that the survivors of acquaintance rape report similar levels of depression, anxiety, complications in subsequent relationships, and difficulty attaining pre-rape levels of sexual satisfaction to what survivors of stranger rape report (Koss & Dinero, 1988). What may make coping more difficult for victims of acquaintance rape is a failure of others to recognize that the emotional impact is just as serious. The degree to which individuals experience these and other emotional consequences varies based on factors such as the amount of emotional support available, prior experiences, and personal coping style.

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The child trusted meldonium 500 mg medicine for diarrhea, in short meldonium 500 mg overnight delivery symptoms rectal cancer, becomes the ultimate extension meldonium 250mg sale medicine over the counter. We must not neglect the abusive aspect of such a relationship meldonium 500mg low cost medicine 3604 pill. The narcissistic parent always alternates between idealisation and devaluation of his offspring. The child is likely to internalise the devaluing, abusive, critical, demeaning, berating, diminishing, minimising, upbraiding, chastising voices. The parent (or caregiver) goes on to survive inside the child-turned-adult (as part of a sadistic and ideal Superego and an unrealistic Ego Ideal). The child-turned-adult keeps looking for narcissists in order to feel whole, alive and wanted. He craves to be treated by a narcissist narcissistically. What others call abuse is, to him or her, familiar territory and constitutes Narcissistic Supply. To the Inverted Narcissist, the classic narcissist is a Source of Supply (primary or secondary) and his narcissistic behaviours constitute Narcissistic Supply. The IN feels dissatisfied, empty and unwanted when not "loved" by a narcissist. The roles of Primary Source of Narcissistic Supply (PSNS) and Secondary Source of Narcissistic Supply (SSNS) are reversed. To the inverted narcissist, her narcissistic spouse is a Source of PRIMARY Narcissistic Supply. The child can also reject the narcissistic parent rather than accommodate her or him. The child may react to the narcissism of the Primary Object with a peculiar type of rejection. He develops his own narcissistic personality, replete with grandiosity and lack of empathy - but his personality is antithetical to that of the narcissistic parent. If the parent were a somatic narcissist, the child is likely to grow up to be a cerebral one. If his father prided himself being virtuous, the son turns out sinful. If his narcissistic mother bragged about her frugality, he is bound to profligately flaunt his wealth. The two are, in many ways, two sides of the same coin, or "the mould and the moulded" - hence the neologisms "mirror narcissist" or "inverted narcissist". The narcissist tries to merge with an idealised but badly internalised object. He does so by "digesting" the meaningful others in his life and transforming them into extensions of his self. To the "digested", this is the crux of the harrowing experience called "life with a narcissist". The "inverted narcissist" (IN), on the other hand, does not attempt, except in fantasy or in dangerous, masochistic sexual practice, to merge with an idealised external object. This is because he so successfully internalised the narcissistic Primary Object to the exclusion of all else. The IN feels ill at ease in his relationships with non-narcissists because it is unconsciously perceived by him to constitute "betrayal", "cheating", an abrogation of the exclusivity clause he has with the narcissistic Primary Object. This is the big difference between narcissists and their inverted version. Classic narcissists of all stripes reject the Primary Object in particular (and object relations in general) in favour of a handy substitute: themselves. Inverted Narcissists accept the (narcissist) Primary Object and internalise it - to the exclusion of all others (unless they are perceived to be faithful renditions, replicas of the narcissistic Primary Object). The classic narcissist has a badly regulated sense of self-worth. He goes through cycles of self-devaluation (and experiences them as dysphorias). Whereas the narcissist devalues others - the IN devalues himself as an offering, a sacrifice to the narcissist. The IN pre-empts the narcissist by devaluing himself, by actively berating his own achievements, or talents. The IN is exceedingly distressed when singled out because of actual accomplishments or a demonstration of superior skills. The inverted narcissist is compelled to filter all of her narcissistic needs through the primary narcissist in her life.

These findings order 250 mg meldonium with visa medications zoloft side effects, coupled with those that document independent reading as an important source of information about sex 250mg meldonium with amex medicine river, suggest that magazines may be very important to the development of knowledge about purchase meldonium 250 mg on line treatment 6 month old cough, beliefs about purchase meldonium 250mg amex medications to treat bipolar, and attitudes toward sex, especially for young people. There are theoretical reasons to believe that reading magazines to obtain sexual information may have effects on attitudes, beliefs, and behaviors, as well as information-type knowledge. Cultivation theory has long held that exposure to a consistent set of media messages can lead to altered beliefs about the nature of the real world (Gerbner, Gross, Morgan, Signorielli, & Shanahan, 2002). There is little available research that deals with the issue of what effects, if any, independent reading about sex in general, or reading about sex in magazines in particular, has on readers. What is available is largely correlational in nature. There is an association between receiving more sexual education from independent reading and better performance on a test of knowledge about sex (Andre et al. There is also some evidence that receiving more information from independent reading as opposed to other sources may be associated with more sexual experience (Andre et al. In addition, in one study, reading sex manuals and reading Playboy were each associated with beliefs about greater frequency of behaviors including sexual intercourse, oral sex, and erotic dreams, and reading Playboy was associated with beliefs that sex without love, the use of stimulants for sex, and the exchange of sex for favors were relatively more common (Buerkel-Rothfuss & Strouse, 1993). Limited experimental evidence also indicates that viewing nonpornographic sexual images from magazines can lead to greater endorsement of rape-supportive attitudes (Lanis & Covell, 1995; MacKay & Covell, 1997). Given the apparent influence of magazine content and the importance of independent reading in general, and magazines in particular, as sources of sexual information for young people, it is important to understand what messages about sex are contained in the magazines read by young people. Relatively little research is available on this topic, and what is available is largely concerned with magazines targeted at young women. Magazines targeted at adolescent girls, such as Seventeen and YM, have been found to contain conflicting messages about sex; they encourage girls to be sexy, emphasize the importance of romantic relationships, instruct young women on how to please young men, and simultaneously emphasize patience and control (Carpenter, 1998; Durham, 1998; Garner et al. Studies of magazines targeted at adult audiences, both male and female, such as Cosmopolitan, Self, GQ, and Playboy, have demonstrated that their contents treat women as sex objects, both through use of objectifying images (Krassas, Blauwkamp, & Wesselink, 2001) and the written content of articles about relationships (Duran & Prusank, 1997). Further, magazines such as Playboy, despite their ostensible status as "lifestyle magazines," seem to be in a very different category than lifestyle magazines such as Cosmopolitan that are oriented toward women. That includes enjoying sex and intimate relationships. Like adults of all ages, you probably want to continue sharing your life in a fulfilling relationship. A healthy sexual relationship can positively affect all aspects of your life, including your physical health and self-esteem. Most people still have sexual fantasies and desires well into their 80s and 90s. As you know, your body changes as you age, and these changes can affect your sexual relationships. Jokes abound about the rapaciousness of senior females in quest of a male functional enough to engage in it. And my teenage son wrinkles up his nose and says "Eewww! Media coverage of aging baby-boomers and their older cousins would have us believe that seniors are a homogeneous group jumping into bed and "hooking up - with great regularity. In fact, the level of sexual interest and activity among people over the age of 65 is as diverse as the individuals who make up that population. A recent survey of married men and women showed that 87% of married men and 89% of married women in the 60-64 age range are sexually active. Those numbers drop with advancing years, but 29% of men and 25% of women over the age of 80 are still sexually active. So clearly, the older years can be a time of relief that children are no longer lurking in nearby bedrooms, and there is no longer a need to jump up early in the morning for work. For some, older age is a time of freedom to explore sexual expression in ways never before realized. A time to cast away the "shoulds" of earlier years, the societal expectations. For others, they are more than happy to forget about sexual performance, and to seek other forms of companionship and interpersonal sharing. One of the most significant losses with advancing age is the loss of intimacy. Many seniors have no opportunity for physical contact, affectionate dialogue, snuggling, or shared secrets. The actual act of intercourse is only one possible form of sexual expression. The continuing development of your sexual identity and the evolution of your own form of sexual expression with advancing years represents, in many ways, the most basic expression of your self.