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But the nice thing about old age buy sumatriptan 25mg amex, remember cheap sumatriptan 50 mg without a prescription, that your partner also loses his eyesight purchase sumatriptan 25mg visa. But many of the women prefer to have sex in the dark sumatriptan 50 mg without prescription. Many of their partners, men, are much more visually oriented than women and it becomes a problem. Part of it is learning to love your body the way it looks right now. I think sort of in a crisis oriented society, you could see that happening. So I work a lot with women to make them more comfortable by just practical means. MARK POCHAPIN, MD: How do women come to a sexual therapist? I get referrals from all of you, and I also get referrals from my book/video packet, which is a do-it-yourself video packet for sex therapy. Couples start using it, and then they get stuck somewhere and they call me. And the so-called transference has already taken place. You feel safe when you have a friend who says "I know this person, and they make me feel safe. That begins way back, but seems to become more of an issue as someone gets older. And I have the women stand nude in front of a mirror and look at their bodies and draw pictures, as an artist. They may start with their feet or their fingernails, but they slowly have to grow to love it. When does the issue of sex and sexual function come up? Is that something that you bring up with every patient you see? Or is it something that you wait to be addressed with you? PATRICIA BLOOM, MD: I try, as part of the initial assessment, to ascertain whether people are sexually active. That sort of gives them permission to talk about it. They might not want to explore it very much on that visit, but at least it opens the door to communication. But I think having an open door kind of dialogue is helpful. Similarly, I think with, talking about self-esteem, a lot of these issues have to do with communication. There are some interesting relationships that form as a result of that. DAVID KAUFMAN, MD: There has been a sexual revolution, certainly, lately, because of the pharmaceutical. But since the advent of some of the new pharmaceuticals that have come out, of course, Viagra (sildenafil citrate) by Pfizer, where there are now commercials on television with ex-presidential candidates talking about their sexual problems, it really has opened up the door and allowed for people to come and acknowledge that there may or may not be a problem in their lives. When Viagra (sildenafil citrate) hit the pharmacy shelves, my office was inundated with people who are suddenly facing the fact that they do have a problem. And now that they knew that there was something available that was fairly easy to take, a pill, they were really coming out of the woodwork looking for answers. When the news articles hit the stands about the results of that research, I had a tremendous number of women ask me questions about its possible role in their treatment. MARK POCHAPIN, MD: There is a role, possibly, for women using Viagra (sildenafil citrate)? Which is really analogous to what Viagra (sildenafil citrate) does in men, that it improves the quality of the erection. MARK POCHAPIN, MD: The point being that there are now drugs being aimed at older people, for the sole purpose of engaging in sex, is really something that goes along with the fact that we have to start talking about that. Well, I appreciate the three of you on our panel tonight. Older people have a life, and with that life they should enjoy the same pleasures that they did when they were younger. Everything was cut so tight and low, or so high and tight in the case of the tops, that there was nothing appropriate for my little one. For one thing, it would have been impractical, uncomfortable summer wear. This trend is widespread and has been in the news of late. As one 5-year-old girl told ABC News when interviewed on the subject, "I like to look sexy. As the Post reported, in the last few years the clothing of teen-age girls, including teens as young as 12 and 13, has been getting consistently lower and tighter flaunting "breasts, bellies and bottoms" as never before. As one local principal said, skimpy dress "has never been so widespread. Check out reruns of the Brady Bunch, when even young Marcia and Jan were sure wearing some very short styles. Neither does it appear, judging by the fashion trends of even those "sexual revolution" days, did most other girls in their age group. Fast forward to when I was in high school in the early eighties. Today, happily married with four kids, I still like to dress FUN. Again for the record, I just bought a pair of slim fitting, low-waisted but still definitely-above-the-belly-button suede pants. That, apparently, is not the case with way too many teenage girls right now, in both middle and high school. In fact the battles between parents and these girls over modern dressing standards have been dubbed "the whore wars. Why are so many parents waving the white flag when it comes to these wars? Further, are these girls and the adults in their lives really so dopey as to believe these teenagers are not sending an overtly "come-and-get-it" sexual message to boys? The whole POINT of what these girls are doing is to "bother" the boys, and they know it. And finally, why are the feminists silent on all this? Betsy Hart is a frequent commentator on CNN and the Fox News Channel. Dennis Fortenberry, a physician who specializes in adolescent medicine at the Indiana University School of Medicine. A study published in 1999 in the Journal of the American Medical Association examines the definition of sex based on a 1991 random sample of 599 college students from 29 states. Sixty percent said oral-genital contact did not constitute having sex. That, in my mind, makes it a lot different," says Michael Levy, 17, a senior from Owings Mills, Md. What constitutes sex tends to be defined in a culture and varies with the times, Fortenberry says. In Questions Kids Ask About Sex, oral sex is clearly sex. She says a medical panel for the institute determined that oral sex is sex because it places young people at risk for sexually transmitted diseases and infections, puts them at risk for long-term emotional harm and opens the door for other sexual activity. Teenagers say messages from the media make them feel that casual oral sex is normal and suggest that all teens are preoccupied with sex. Last week, the federal government announced $37 million in awards to 63 programs across the country aimed at encouraging young people to abstain from intercourse until marriage.

Therapy may also help the teen adjust to personal generic 50mg sumatriptan free shipping, family buy sumatriptan with visa, and school-related issues or conflicts that emerge 50 mg sumatriptan for sale. Therapy directed specifically at changing homosexual orientation is not recommended and may be harmful for an unwilling teen discount sumatriptan 50mg visa. It may create more confusion and anxiety by reinforcing the negative thoughts and emotions with which the youngster is already struggling. Just as we warn our kids against the dangers of smoking, alcohol and drugs before we discover evidence of such activity, we must take similar precautions and talk to our children about the dangers of gang involvement. That is, making our children aware that gang association of any kind is harmful and will not be tolerated. They need to hear it from you and know where you stand. We must teach them that they should not associate with gang members, communicate with gangs, hang out where gangs congregate, wear gang-related clothing or attend events sponsored by gangs. We must try to make them understand that the dangers here are real and "just saying no" may save their lives. Parents should be alarmed and take appropriate action if a child exhibits one or more of these warning signs. We can assume that a child has some level of involvement with a gang if he/she:admits that they are involved in any manner with a gangis obsessed with a particular clothing colorprefers sagging pants or gang clothingwears jewelry with distinguishing designs or wears it only on one side of the bodyrequest s a particular logo over others such as British Knights (BK) - known as "Blood Killer" in some areasadopts an unusual desire for privacy and secrecyexhibits a change in behavior and conduct and withdraws from the familyis frequently deceitful about their activitiesdeclining grades at schooltruancy and/or being late for schoolbegins keeping late hoursbreaks parental rules repeatedlyis obsessed with gangster music or videosassociates with the "wrong crowd" (changes friends)begins using hand signs with friendshas paint or permanent marker stains on his/her hands or clothes. Or, is in possession of graffiti paraphernalia such as markers, etching tools, spray paint, bug spray and starch cans. Also, it can be detrimental to use these signs as a checklist against which to measure children. Early warning signs are just that, indicators that a child may need our help and guidance. These are behavioral and emotional signs that, when considered in context, can signal a distraught child. Early warning signs allow us to get help for the child before problems escalate. Today parents need to be concerned with both ends of the spectrum regarding weight, health and body image. She finds herself working with younger and younger people these days; kids who have problems with hating their bodies and either not eating enough or resorting to tactics such as vomiting to get rid of unwanted calories for fear of getting fat. She says kids as young as six complain about stomachs that stick out or brag excitedly about having the chicken pox because it means going to bed without dinner which means less calories. Recovered from anorexia nervosa herself, Costin has been helping others in both outpatient and residential settings recover from these disorders for almost 30 years. In her book, "Your Dieting Daughter," written to help anyone raising a child today in this "Thin is In" world, she tries to help people understand the mind set of those with eating disorders. Her own patients helped her develop a list of ten common thought patterns those suffering from eating disorders commonly have. She calls this list "The Thin Commandments" and tells parents they can use this as a checklist to help determine if their daughter (or even son) has a problem. You buy clothes, cut your hair, take laxatives, starve yourself. Thou shall not eat fattening food without punishing yourself afterwards. Thou shall count calories and restrict intake accordingly. Being thin and not eating are signs of true will power and success. Refusal to go to school often begins following a period at home in which the child has become closer to the parent, such as a summer vacation, a holiday break, or a brief illness. It also may follow a stressful occurrence, such as the death of a pet or relative, a change in schools, or a move to a new neighborhood. School refusal is not a formal psychiatric diagnosis. School refusal, school avoidance, or school phobia, are terms used to describe the signs or anxiety a school-aged child has and his/her refusal to go to school. School refusal can be seen in three different types of situations, including the following:Young children going to school for the first timeThis is a normal type of school refusal. This type of fear usually goes away within a few days of the child attending school. Older children may have school phobia based on a real fear of something that may happen to them at school, such as a bully or a teacher being rude. In this situation, it is important to talk with your child to determine what is causing his/her fears. The final type of school phobia is seen in children who are truly distressed about leaving their parent and going to school. Usually, these children enjoy school but are too anxious about leaving their parents to attend. School refusal is the third most common cause of children missing school. Fifty percent of children with school refusal have other behavioral problems. Twenty percent of parents who have a child with school refusal have a psychiatric problem. There is usually a strong bond between the parent and child. School refusal is more common in girls than in boys. Make sure the school officials understand the situation and do not send the child home for the wrong reasons. Allow the child to speak and talk about his/her concerns and fears. Slowly separating the parent from the child in school may also be used. One approach is to have the parent sit with the child in the classroom at first, and then the parent may attend school, but sit in another room. A referral to a child psychologist or psychiatrist may become necessary. American Family Physician, School Refusal in Children and Adolescents, Oct. Finding out that your teen is addicted to drugs is emotionally devastating. Your first reaction may be anger toward your son or daughter. After the anger, though, parents need to find the strength to parent their teen with firmness and support. Whether a teen with drug addiction or chemical dependency is living at home, at a treatment center, or in a therapeutic residential school, parents need to be proactive about the type of parenting their teen requires. Always focus on the goal which is to help your child heal. However, punishing only has short-term, if any, impact. Implement changes that will help your child become the person that you always hoped they would become. The counseling needs to support and help the teen, as well as parents and siblings. One counselor or therapist with the appropriate training and experience might be able to fulfill all the therapeutic needs. Or, there might need to be a combination of therapists and/or support groups to help the whole family. One of the most common issues underlying teens with drug addictions is poor self esteem.

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Armed with these two pieces of information generic 50 mg sumatriptan with mastercard, emotional abuse recovery is possible buy 50 mg sumatriptan with amex. Any of the organizations listed under the emotional abuse help section can point the way to emotional abuse recovery resources purchase 25mg sumatriptan amex. Typically some form of therapy is needed to fully recover from severe emotional abuse purchase sumatriptan toronto. These abusive patterns often become deep-seated and without help, abuse victims may repeat the pattern in other abusive relationships. General counselling, psychotherapy (talk therapy) and cognitive behavioral therapy (CBT) can all have a place in emotional abuse recovery. When someone pictures an emotionally abusive man or woman, they often picture some sort of caricature. They might picture someone of a lower socioeconomic status, a blue collar worker or an uptight housewife. No matter what picture of an emotionally abusive person you have in your head, you are wrong because emotionally abusive men and women run the gamut and no group of people is immune. In fact, if a group of people were to sit in a room, drinking coffee, you would have no way of pointing out which were the emotionally abusive men and women. There are no outward signs of an emotionally abusive person. There may even be no signs when interacting with them, as abusers tend to be able to turn their abusive behavior on and off when convenient. No matter who the emotionally abusive person is, they seek power and control over their victim. Children are the most common victims of emotional abuse for just this reason ??? parents want to completely dominate and control their children into doing what is "right. Emotional abusers seek to have their way irrespective of those around them, assuming that their way is "best," "right," or simply most convenient for them. Ironically, many people who emotionally abuse do so because they themselves are scared of being controlled. Emotionally abusive men and women are of all different types but some common characteristics are found among many of the abusers. Emotional abusers tend to believe they are "owed" by everyone and thus everyone (including their victim) should give them what they want. This makes them feel entitled to give orders, control and abuse in order to get what they want. Similarly, emotionally abusive people tend to be self-centered to the point where they feel they can, and should, tell others what they are thinking and feeling. For men, this may be the idea that men are superior to woman and they believe in stereotyped male and female roles. Other characteristics of emotionally abusive men and women include: Low self-esteem ??? some abusers abuse others to make themselves feel good about themselves, although some people feel that the opposite is true in many cases. Rush into relationships ??? some abusers enter relationships and claim "love at first sight" very quickly, perhaps fearing being alone. Create isolation ??? an abuser will work to cut off ties to the victim to keep the victim completely centered on the abuser. Use of force during sex ??? acting out scenarios where the victim is helpless may be part of their sex life. Are hypersensitive ??? abusers often take the slightest action as a personal attack. Appear charming to others ??? abusers tend to hide all their abusive behaviors in other scenarios so that the victim is the only one that sees their abusive side making it very difficult for the victim to reach out for help (Information About: Emotional Abuse Help ). And although emotionally abusive people set out to purposefully hurt victims, they often minimize their role and blame the victim for the abuse. It is also known that many emotionally abusive men and women have a type of mental illness known as a personality disorder. Personality disorders are estimated to affect about 10-15% of the population. In the case of a personality disorder, a person develops hurtful and maladaptive patterns of thought and behavior that are consistent throughout their lifetime. Three personality disorders are linked to emotionally abusive behavior are: Narcissistic personality disorder ??? this disorder involves the perception of being grandiose and requiring the admiration of others. People with narcissistic personality disorder exaggerate their own accomplishments, have a sense of entitlement, exploit others, lack empathy, envy others and are arrogant. Antisocial personality disorder ??? this disorder shows a pattern of disregard for the rights of others and the rules of society. People with antisocial personality disorder tend to lie, be aggressive, disregard safety, violate the law and have a lack of remorse. Borderline personality disorder ??? this disorder involves intense and unstable relationships, self-perception and moods. People with borderline personality disorder (BPD) tend to have poor impulse control. People with BPD frantically avoid abandonment, are impulsive, are suicidal or self-harming, feel empty, feel inappropriate anger and may be paranoid. Emotional abuse treatment and therapy is available to help either one or both parties in the abusive situation. Emotional abuse treatment might be sought after experiencing emotional abuse in a personal relationship or even at work. In abusive situations, abusive behavioral and thought patterns tend to become deep-rooted over time and emotional abuse therapy can address this and work to create healthy, functional relationships in the future. Sometimes, the victim is able to coerce the abuser into emotional abuse treatment either in a couple or individual therapy setting. This is rarely helpful and can actually harm the relationship. Most abusers are skilled manipulators and quite capable of getting a therapist, particularly one not specializing in emotional abuse, on their side. The therapist is likely to acknowledge the feelings of the abuser which the abuser will take as a tacit endorsement of their emotionally abusive behavior. Most emotional abusers are not prepared to admit their behavior to a therapist, however. Emotional abuse treatment for the victim has a better chance of being successful but only if the victim is prepared to be as open and honest as possible about the abuse. Many emotional abuse victims hide the abuse or the extent of the abuse, even from therapists, due to their own shame and guilt. An emotional abuse therapist though, can only help when they truly understand the problem. It also works to identify healthy relationship principles such as relationship roles, rights and responsibilities. Therapy for emotional abuse also helps in developing emotional intelligence, learning to set boundaries and modifying behavior. Types of therapy common in treating emotional abuse include: Psychotherapy (talk therapy)Cognitive behavioral therapyHTTP/1. There are typically physical, behavioural and emotional signs of physical abuse. Behaviors are seen both in the abuser and in the victim. Obvious signs of physical abuse are often physical in nature. These may include:Restraint or grip markingsUnusual pattern of injury; repeated trips to the emergency roomAnd while these signs of physical abuse may seem obvious, most victims will try to cover them up so as to hide the abuse due to fear of the abuser or shame about the abuse. While physical violence is never okay, and physical abuse is never the fault of the victim, many victims feel the abuse is their fault. While not strictly physical, many behavioural patterns can also be signs of physical abuse. However, if physical abuse is truly suspected, local authorities should be alerted by contacting the police or your county social services agency. Characterized by a pattern of dominance and control in an intimate relationship, all types of domestic abuse occurs in every imaginable societal and cultural sector. People just like you???from all across the cultural spectrum???can find themselves at risk of sliding into the dangerous cycle of violence in the home.

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However buy generic sumatriptan 50mg online, if the symptoms are severe enough to interfere with your daily routine purchase discount sumatriptan on-line, consult your doctor or a qualified mental health professional purchase cheap sumatriptan. If you answered "yes" to question 10 generic sumatriptan 25mg free shipping, you should seek help immediately, regardless of your answer to any other questions. Interpretation: If you experience five or more of these symptoms for longer than two weeks or if the symptoms are severe enough to interfere with your daily routine, consult your doctor or a qualified mental health professional. If you answered "yes" to question 10, you should seek help immediately, regardless of your answer to any other questions. Note that this inventory can only give results based on the limited number of questions asked in the inventory. It cannot account for the truthfulness of the answers, only for the self-reporting of each participant. The interpretations given are for informational and educational purposes only, and do not constitute or substitute for any psychological and medical evaluations performed by a qualified professional, nor for any psychological or medical treatment. If you need psychological or medical evaluation or treatment, immediately consult a qualified professional. Symptoms of bipolar disorder stem from the episodes of mania and depression (take the bipolar depression test ) caused by this difficult to live with mental illness. The severity of the mood swings, and the way they disrupt normal life activities, distinguish bipolar episodes from ordinary mood changes. These disruptive bipolar symptoms can be managed, however, and effective bipolar treatments do exist. Bipolar disorder involves the cycling of moods from an elevated mood, known as mania or hypomania, to a depressed mood. There are 4 different types of bipolar disorder:bipolar not otherwise specifiedThe nature of bipolar symptoms means bipolar disorder can be difficult to recognize and, many times, it is misdiagnosed as depression. People tend to get help while they are experiencing either extreme high or low symptoms of bipolar. People with bipolar disorder type 2 spend the vast majority of their time depressed. A careful screening by a doctor attempts to look for these symptoms of bipolar disorder. The most severe highs of bipolar disorder are known as manic episodes. The symptoms of bipolar mania often put the person or those around them at physical or emotional risk. Impulsive, irrational or dangerous behavior, aggression, anger and delusions are all symptoms that can hurt the patient or others. Less severe highs, those seen in bipolar 2, are called hypomanic episodes. The symptoms of bipolar hypomanic episodes do not tend to disrupt life to the degree of manic episodes. However either state, if left unchecked, can be dangerous. Bipolar disorder symptoms seen in manic and hypomanic episodes include:Increased physical and mental activity and energy; hyperactivityHeightened mood, exaggerated optimism and self-confidenceFeeling of invincibilityExcessive irritability, aggressive behavior - particularly when grandiose plans are thwartedDecreased need for sleep without experiencing fatigueGrandiose delusions, inflated sense of self-importance - individuals may imagine they have special connections with God, celebrities, or political leadersRacing speech and thoughts; rapidly changing streams of thoughImpulsiveness, poor judgment, distractibilityReckless or risky behavior such as reckless driving, outlandish spending sprees, foolish business investments, or out-of-character sexual behaviorIn the most severe cases, delusions and hallucinationsThe severe lows of bipolar disorder are major depressive episodes. The symptoms of bipolar depression are the same as for unipolar (non-bipolar) depression ( extensive information on unipolar depression ). Bipolar disorder symptoms seen during depressive episodes include:Prolonged sadness or unexplained crying spellsFeeling helpless, hopeless and worthless; feelings of guiltSignificant changes in appetite and sleep patternsIrritability, anger, worry, agitation, anxietyPessimism, indifferenceLoss of energy, persistent lethargyInability to concentrate, indecisivenessInability to take pleasure in former interests, social withdrawalUnexplained aches and painsIf you or someone you know has thoughts of death or suicide, contact a medical professional, clergy member, loved one, friend or hospital emergency room or call 911 immediately. Only a properly trained health professional can diagnose a mental illness. Our online bipolar tests or this bipolar screening test can help you communicate your symptoms to your health care professional. Any suspected symptoms of bipolar disorder should be discussed with a professional health care provider. Bipolar disorder symptoms are only defined in adults. The diagnosis of bipolar disorder in children may be made by a medical professional by looking for similar moods as seen in adults with bipolar. Both men and women can have any type of bipolar disorder; however, the prevalence of bipolar in men and bipolar in women differ slightly. Signs of bipolar mania in women may improve more quickly than in men, but bipolar symptoms in women are more likely to include depression. Bipolar signs in men share most of the same signs of bipolar in women. However, certain types of jobs are linked to bipolar disorder and many of these jobs are common for men. Signs of bipolar in men are often around:High-pressured, executive jobs (these roles are still predominantly held by men)Emergency worker positions such as being a police officerSeasonal employment such as laborers (workers may be manic during the working season and then become depressed during the slow season)Hormonal changes can play a role in the signs of bipolar in women and can become a concern surrounding childbirth. As pregnancy, delivery and motherhood drastically affect the woman both physically and psychologically, signs of post-partum bipolar depression and signs of bipolar psychosis can occur. Bipolar symptoms in women may also appear in the few days leading up to menstruation. One recent study found bipolar women taking oral contraceptives had much less cycling during the entire month than bipolar women not receiving oral contraceptives. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association; 2000. Guide to Depression and Manic-Depression [brochure]. Chicago, Ill: Depression and Bipolar Support Alliance; 2001. There may be no single cause of bipolar disorder (aka manic depression ). Instead, research indicates the causes of bipolar disorder are probably a combination of biochemical, genetic and environmental factors that may trigger and perpetuate the chemical imbalances in the brain. In trying to uncover the causes of bipolar disorder, scientists have used brain imaging scans and other tests. Researchers have discovered that some people with bipolar disorder have:biochemical imbalances of hormones and certain neurotransmitters in the brain; especially dopamine, serotonin, norepinephrine, and acetylcholine. Sleep abnormalities have been linked to triggering symptoms of bipolar depression and bipolar mania. In searching for the answer to what causes bipolar disorder, scientists report genetics may be one of the key culprits, as bipolar disorder seems to run in families. First-degree relatives of people with bipolar disorder type 1 are seven times more likely to develop bipolar 1 over the regular population. Children of a parent with bipolar disorder have a 50% chance of having a major psychiatric illness. Children remain at an increased risk even if they are raised in the home of parents without the illness. Identical twin studies show if one twin has bipolar 1, the other twin has between a 33% - 90% chance of also having bipolar type 1. Multiple genes, involving several chromosomes, have been linked to the development of bipolar disorder. What causes bipolar disorder may also be involved in schizoaffective disorder. Researchers have been investigating whether common biologic factors are involved in the cause of bipolar disorder and schizophrenia, schizoaffective and manic syndromes, as schizophrenic and bipolar disorder are similar in many respects. They share: Worldwide distributionGenetic susceptibilityScientists are also identifying a number of common genetic and biologic pathways shared by both schizoaffective and bipolar disorders. Commonalities between disorders include:Genetic abnormalities have been found in the genes for specific brain cells (oligodendrocyte-myelin-related) (also present with major depression)Abnormalities in the white matter in parts of the brain (also present with major depression )Genetic abnormalities for both diseases appear on many of the same chromosomes. Pathways of the neurotransmitter dopamine appear to be important in both illnesses.

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