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| Fair Fight Guidelines By Tina B. Tessina, Ph.D. Updated: May 11, 2008 Thirty years of marriage counseling and twenty-five years of a second marriage have convinced me that fights are not necessary in a marriage. Married couples need to have discussions, they need to solve problems, and sometimes they need to disagree, but they don't need to squabble, argue, bicker, or fight. Fights are dramatic, which is not helpful to a discussion. If you have enough energy to create drama, you have more than enough to tone it down into a discussion. However, because social expectations and mythology are so strong, many of my clients want guidelines for "fighting fair." I've developed a set of Fair Fight Guidelines you may find helpful. Fair Fight Guidelines  Remember the point of the fight is to reach a solution, not to win, be right, or make your partner wrong.  Don't guess what your partner is thinking or feeling. Instead, ask. "What do you think?" Or "How do you feel about it?" | | |
| Healthy LivingSaturday, May. 10, 2008 Sometimes your guy's attention isn't focused where you want it to be: on you. Maybe he's spent the last month obsessing over the playoffs, and when he wasn't doing that, he was fiddling with his work email on a Blackberry, or simply wondering how the heck he got sucked into digging David Archuleta in his Idol time. No matter what his distractions, they're no excuse for spacing out when you're trying to tell him about your lousy work day or give him the latest update on your sister's fiancé. So how do you make him swivel his neck back into proper position—and keep his attention squarely focused on you? Speak his language. After all, if you can keep him from drifting away, it'll help keep you from drifting apart. Ask him for help up frontGuys know that half the reason you're telling us about your problem is because you need to vent, and that means you need us to just listen. And we respect that. But you can ensure that he'll be more focused on your problem if you tell him from the start, "Honey, I need your help on something." That gives him a task, a challenge, a responsibility. Even if you already know what to do, ask him for his input. It'll make him feel like you're also focused on him, and trust him to see you through whatever's bothering you. Bury the leadIt's an old phrase that journalists use when they wait until the fifth paragraph to tell you the news. You can use the same tactic to keep his attention. Instead of saying that your mom called you today to tell you that Ruffles, the 15-year-old family cat, passed, draw the story out a bit. Tell him your mom called, she sounded sad, she said she didn't want to call, but she needed to, and so on. One of the reasons why guys love sports so much is that they don't know the outcome at the opening kickoff. So start the clock, but don't give away the ending. As Scheherazade taught us, a little suspense can hold a guy's attention for a thousand and one nights. (On night 1002, let him watch basketball.) Wear a baseball hatSorry to say, but guys will be more stimulated conversationally the more stimulated they are physically. And if you look darn good (a woman in a baseball hat does it for some men, for instance), then a guy's senses are going to be heightened, making him more emotionally attentive to his partner as well. Use the right timingNot good times to talk about something important (or even unimportant, but interesting): Calling him at work, right when he leaves for work, right when he comes home from work, when he's watching something on TV that he's been looking forward to, or anytime the kids are around (they need attention, too, especially if they happen to be throwing food or a fit at the time). The best time: When life's slowed down a bit, like on a walk or on a car ride, or when he's winding down for bed. Of course, guys know deep down that they should listen to you whenever you need them, but we're human, and distractible, too. If you can scoot their way a little bit, we're more likely hear it when you talk. Or shout. Or better still, whisper. The other thing you can do: Give him this great article about your major guy annoyances, so that he’s more aware of your triggers. And for a fascinating primer on 50 things men wish women knew, click here. Have other ideas? Please share them with the rest of us here. Want more from David? Subscribe to Men's Health with this special offer: 50% off the cover price. You can also check out "Men, Love & Sex: The Complete User's Guide for Women" and "Eat This Not That" on Yahoo! Shopping. Related: zinczenko, relationships, david zinczenko, dating | | |
| Bipolar Disorder - SymptomsProvided by:  Topic Overview
If you are concerned that your child or teen may have bipolar disorder, see the topic Bipolar Disorder in Childhood and Adolescence. What is bipolar disorder?Bipolar disorder (also called manic-depressive disorder) is an illness that causes extreme mood changes that alternate between manic episodes of abnormally high energy and the extreme lows of depression. Bipolar disorder may cause behavior so severe that you may not be able to function at work, in family or social situations, or in relationships with others. Some people with bipolar disorder become suicidal. What causes bipolar disorder?The cause of bipolar disorder is not completely understood, but the disorder runs in families and may also be affected by your living environment or family situation. An imbalance of chemicals in the brain is another possible cause. What are the symptoms?During a manic episode, you may be abnormally happy, energetic, or irritable for a week or more. You may spend a lot of money, get involved in dangerous activities, and sleep very little. After a manic episode, you may return to normal, but your mood may swing in the opposite direction to feelings of sadness, depression, and hopelessness. When you are depressed, you may have trouble concentrating, remembering, and making decisions; have changes in your eating and sleeping habits; and lose interest in things you once enjoyed. The mood changes of bipolar disorder can be mild or extreme. They may develop gradually over several days or weeks, or come on suddenly within minutes or hours. The manic or depressive episodes may only last a few hours or for several months. How is bipolar disorder diagnosed?Because it has many phases and symptoms, bipolar disorder is complex and hard to diagnose. There are no lab tests for bipolar disorder; instead your doctor or therapist will ask detailed questions about what kind of symptoms you have and how long they last. In order to be diagnosed as bipolar, you must have had a manic episode lasting at least a week (less if you had to be hospitalized). During this time, you must have had three or more specific symptoms of mania, such as needing less sleep, being more talkative, behaving wildly or irresponsibly in activities that could have serious outcomes, or feeling as if your thoughts are racing. Your urine and blood may be tested to rule out other problems that could be causing your symptoms. How is it treated?Bipolar disorder is mainly treated with medications to manage manic episodes and periods of depression. Your doctor may try several medications before finding the right combination to manage your symptoms long-term. Medications include mood stabilizers and antipsychotics. Antidepressants are used carefully for episodes of depression, because they cause some people to cycle into a manic phase. Counseling for you and your and family is also an important treatment for bipolar disorder. People with extreme cases of mania may be hospitalized to protect them from risky behaviors, such as driving recklessly or having delusions. During a severe bout of depression, hospitalization may be necessary to prevent the person from committing suicide. Who is affected by bipolar disorder?Over 3 million Americans—about 1% of the population—suffer from bipolar disorder, with similar rates existing in other countries. 1 Bipolar disorder occurs equally among males and females. It often begins between the ages of 15 and 24. 2 Frequently Asked Questions Learning about bipolar disorder: | | Being diagnosed: | | Getting treatment: | | Ongoing concerns: | | Living with bipolar disorder: | |
Health ToolsHealth tools help you make wise health decisions or take action to improve your health. SymptomsBipolar disorder causes extreme mood swings, from feeling overly energetic (mania) to feeling very sad or having low energy (depression). 3 Mania may cause a person to: - Feel extremely happy or very irritable.
- Have a very high opinion of him- or herself (inflated self-esteem).
- Not need as much sleep as usual (may feel rested after 3 hours of sleep).
- Talk more than usual.
- Be more active than usual.
- Have difficulty concentrating due to having too many thoughts at once (racing thoughts).
- Be easily distracted by sights and sounds.
- Act impulsively or do reckless things, such as go on shopping sprees, drive recklessly, get into foolish business ventures, or have frequent, indiscriminate, or unsafe sex.
Depression may cause a person to: - Feel sad or anxious for a significant time.
- Feel hopeless or pessimistic.
- Have slowed thoughts and speech due to low energy.
- Have difficulty concentrating, remembering, and making decisions.
- Have changes in eating and sleeping habits leading to too much or too little eating or sleeping.
- Have decreased interest in usual activities, including sex.
- Have suicidal thoughts.
Types of bipolar disorder- Bipolar I. Considered the classic form of the illness, bipolar I causes recurrent episodes of mania and depression. The depression may last for a short time or for months. You may then go back to feeling normal for a time, or you may go right into a manic episode.
- Bipolar II. If you have bipolar II, you will experience depression just as in bipolar I. However, the episodes of mania are less severe (hypomania). Bipolar II is more common in women. People with bipolar II have more depressive than hypomanic episodes.
- Rapid-cycling bipolar disorder. If you have rapid-cycling bipolar disorder, you will experience at least four episodes of depression, mania, or both within a 12-month period. You may go directly from an episode of depression to an episode of mania, or you may have a short time lapse between the two moods. The mood swings are the same as with other types of bipolar, but the frequency of mood swings distinguishes rapid-cycling bipolar disorder from the other subtypes.
Some people may have bipolar disorder with mixed symptoms, in which episodes of depression and mania occur together. Symptoms include sadness, euphoria, and irritability. Other symptoms can include agitation, lack of sleep, appetite changes, and possibly, thoughts of suicide. This makes the disorder challenging to treat and very frustrating for you and for those around you. It can also lead to hospitalization if daily functioning becomes impaired. In addition to changes in moods, some people with bipolar disorder also have symptoms of anxiety, panic attacks, or symptoms of psychosis. Symptoms of bipolar disorder in children can be very different than those of adults and can be confused with other childhood mental disorders, such as depression or attention deficit hyperactivity disorder (ADHD). Bipolar disorder in children significantly interferes with a child's ability to function in school, with friends, and at home. Some other conditions with symptoms similar to bipolar disorder include depression, schizophrenia, and attention deficit hyperactivity disorder (ADHD). People with bipolar disorder—men more frequently than women—may have substance abuse problems, especially during manic episodes. 4 Abusing alcohol or drugs may affect treatment and interfere with taking medications as prescribed. Other disorders that may occur along with bipolar disorder include: 5 These illnesses need to be treated along with the bipolar disorder. CauseThe cause of bipolar disorder is not well understood, although evidence suggests that the disorder runs in families. 3 Your living environment and family situation may also play a role in the disorder. Episodes of depression and mania may be caused by a problem with certain brain chemicals called neurotransmitters. Antidepressant medications can trigger a manic episode in a person who is bipolar. This may occur, however, before someone is diagnosed as bipolar but while he or she is seeking treatment for an episode of depression. Sleep deprivation or substance abuse, including caffeine, can cause a person with bipolar disorder to have a manic episode. What HappensWith bipolar disorder, you alternate between episodes of depression and mania. In between, you may return completely to normal or have some remaining symptoms. The extreme mood changes may come on suddenly or appear more slowly. During a manic episode, you may be abnormally happy, energetic, or very irritable for a week or more. Initially, you may feel incredibly productive or creative. You may feel powerful and seductive and think there is nothing you can't accomplish. But as a manic episode progresses, you may behave wildly and irresponsibly, spending a lot of money, getting involved in dangerous activities, and sleep very little. You may have a hard time functioning in your job and relationships. After a manic episode, you may return to normal or your mood may swing in the opposite direction, and you may feel useless, hopeless, and extremely sad. When you are depressed, you may have trouble concentrating, remembering, and making decisions; have changes in your eating and sleeping habits; and lose interest in things you once enjoyed. Some people become suicidal or harm themselves during episodes of depression. Some feel as if they can't move, care, or think. Men tend to have more manic episodes, while women experience more bouts of depression. Initially, stress may trigger depression or mania. However, as the illness progresses, mood swings may not be caused by any specific event. Without treatment, your bipolar disorder may get worse, causing you to cycle more frequently between mania and depression. What Increases Your RiskBipolar disorder can be passed down through families (genetic risk). If anyone in your family has been diagnosed with bipolar disorder, your risk of developing it is increased. If you have bipolar disorder, changes in sleep or daily routines can increase your risk for a manic episode. Antidepressant medications can trigger a manic episode in someone who is bipolar. 6 This may occur, however, before someone is diagnosed as bipolar but while he or she is seeking treatment for an episode of depression. A stressful event may trigger an episode of mania or depression. Your risk of either a depressive or manic episode is increased if you do not take your medications as prescribed by your doctor. It is common for people to stop taking their medications during a manic phase when they feel good. Even if you are feeling better, you must take your medications regularly to control bipolar disorder. Alcohol or drug use or abuse puts you at a high risk for having a relapse of mood disturbances. 5 When To Call a DoctorIf you have bipolar disorder, call 911 or other emergency services if you: - Think you cannot stop from harming yourself.
- Hear voices.
- Want to commit suicide, or you know someone who has mentioned wanting to commit suicide.
Warning signs of suicide include: - Use of illegal drugs or drinking alcohol heavily.
- Talking, writing, or drawing about death, including writing suicide notes and speaking of items that can cause physical harm, such as pills, guns, or knives.
- Spending long periods of time alone.
- Giving away possessions.
- Aggressive behavior or suddenly appearing calm.
Watchful WaitingWatchful waiting may be enough if a mood episode has just started and you are taking proper medications. If your mood episode has not improved within 2 weeks, call your doctor. If you have a loved one who is experiencing a manic episode and is behaving irrationally, help the person seek treatment. Who To SeeBipolar disorder is complex and hard to diagnose because it has many phases and symptoms. Sometimes it is misdiagnosed as only depression (unipolar depression) because people are more likely to seek treatment during a period of depression. Once you are diagnosed with bipolar disorder, it is important to keep a long-term relationship with your doctor or therapist to make sure your treatment is consistent and that your medications can be adjusted as needed. Although other health professionals can diagnose bipolar disorder, you will probably be referred to a psychiatrist who specializes in treating such disorders and can prescribe medications and provide counseling. Other health professionals who can diagnose bipolar disorder include: Counseling can help you deal with mood changes and the impact bipolar disorder can have on your work and family relationships. In addition to psychiatrists, health professionals who can provide counseling include: Family member supportIf a loved one has bipolar disorder, it may be helpful for you to get counseling to deal with its impact on your own life. Manic episodes can be particularly difficult. Consult a psychiatrist, psychologist, social worker, or licensed professional counselor for your own therapy. Therapy can also be helpful for a child who has a bipolar parent. The parent's mood swings may negatively affect the child, causing tearfulness, anger, depression, or rebellious behavior. To prepare for your appointment, see the topic Making the Most of Your Appointment. Exams and TestsThere are no lab tests for bipolar disorder; instead your doctor will ask detailed questions about your symptoms, including how long they last and how often you have them. He or she will discuss your family history and may do a mental health assessment. A mental health assessment tests your emotional functioning and your ability to think, reason, and remember. It includes an interview with a health professional, a physical examination, and written or verbal tests. During the interview, the health professional assesses your appearance, mood, behavior, thinking, reasoning, memory, ability to express yourself, and your ability to maintain personal relationships. Blood and urine tests, such as a toxicology screen, may be done to rule out other causes of your symptoms. A toxicology screen examines blood, urine, or hair for the presence of drugs. Early DetectionThe earlier bipolar disorder is diagnosed and treated, the better your chances of getting the illness under control and improving the quality of your life. Early detection and treatment can help reduce your risk of complications, such as alcohol and drug abuse or suicide. About 10% to 15% of people with bipolar disorder will die from suicide. 3 Up to 60% of those with bipolar disorder develop drug and alcohol abuse problems, which interferes with successful treatment of their disorder. 7 PreventionBipolar disorder cannot be prevented, but often the mood swings can be controlled with medications, if you take them regularly as prescribed by your doctor. About 1 in 3 people will remain completely free of symptoms of bipolar disorder by taking mood stabilizer medications, such as carbamazepine or lithium, for life. 5 Other ways to help prevent a depressive or manic mood episode include: - Eating a balanced diet.
- Exercising daily.
- Avoiding extensive travel into other time zones.
- Getting approximately the same number of hours of sleep every night.
- Avoiding alcohol or drugs.
- Reducing stress at work and at home.
- Seeking treatment as soon as you notice symptoms of a depressive or manic episode coming on.
Changes in your sleep patterns can sometimes trigger a manic or depressive mood episode. If you plan extensive travel into other time zones, you may want to call your doctor before you leave to discuss whether you should make any changes in your medications, and what to do if you have a manic or depressive episode while you are away. Home TreatmentHome treatment is important in bipolar disorder. In addition to taking your medications every day as prescribed, you can help control mood swings by: - Getting enough exercise. Try moderate activity for at least 30 minutes a day, every day, if possible. Moderate activity is activity equal to a brisk walk.For more information, see the topic Fitness.
- Getting enough sleep. Keep your room dark and quiet, and try to go to bed at the same time every night.
- Eating a healthy, balanced diet. A balanced diet includes foods from different food groups, including whole grains, dairy, fruits and vegetables, and protein. Eat a variety of foods within each group (for example, eat different fruits from the fruit group instead of only apples). A varied diet helps you get all the nutrients you need, since no single food provides every nutrient. Eat a little of everything but nothing in excess. All foods can fit in a healthy diet if you eat everything in moderation. For more information, see the topic Healthy Eating.
- Control the amount of stress in your life. Manage your time and commitments, establish a strong system of social support and effective coping strategies, and lead a healthy lifestyle. Techniques to relieve stress include physical activity and exercise, breathing exercises, muscle relaxation, and massage. For more information, see the topic Stress Management.
- Avoid alcohol or drugs.
- Learn to recognize the early warning signs of your manic and depressive mood episodes.
- Ask for help from friends and family when needed. You may need help with daily activities if you are depressed or support to control high energy levels if you are experiencing mania. For more information, see:
- Managing a manic episode.
Family members often feel helpless when a loved one is depressed or manic. Family members and friends can help by: - Encouraging the person to take his or her medications regularly, even when feeling good.
- Learning the warning signs for suicide, which include:
- Drinking heavily or taking illegal drugs.
- Talking, writing, or drawing about death, including writing suicide notes.
- Talking about harmful things, such as pills, guns, or knives.
- Spending long periods of time alone.
- Giving away possessions.
- Aggressive behavior or suddenly appearing calm.
- Recognizing a lapse into a manic or depressive episode, and helping the person cope and get treatment.
- Allowing your loved one to take enough time to feel better and get back into daily activities.
- Learning the difference between hypomania and when he or she is just having a good day. Hypomania is an elevated or irritable mood that is clearly different from a regular nondepressed mood and can last for a week or more.
- Encouraging your loved one to go to counseling and join a support group, and joining one yourself if needed.
To learn more about how you can help your loved one through mood swings, see: MedicationsMedications, when taken regularly as prescribed, can help control bipolar mood swings. Although your family doctor can prescribe medications to treat bipolar disorder, you will probably be referred to a psychiatrist, who is trained specifically in the medications used to treat mental disorders. Mood stabilizers, such as lithium, are usually prescribed first to treat mania and to prevent the return of both manic and depressive episodes. You may need to take a mood stabilizer for several years, or even for the rest of your life, to manage the illness. Your doctor may prescribe additional medications—typically antipsychotics—to better control your symptoms. Your doctor will vary the amounts and combinations of your medications according to your symptoms, which type of bipolar disorder you have (bipolar I or II, rapid cycling, or bipolar with mixed symptoms), and how you respond to the medications. Medication ChoicesSeveral medications are used to treat bipolar disorder. It may take time and several attempts at using different medications to find the treatment that works best for you. The most common medications used to treat bipolar disorder are: - Mood stabilizers, such as lithium carbonate (Eskalith, Lithane, and Lithobid). Experts believe lithium may affect certain brain chemicals (neurotransmitters) that cause mood changes, but how the medication works is not completely understood. A mood stabilizer and an antipsychotic are recommended as the first medications for acute manic episodes. Anticonvulsants, such as valproate sodium (Depakene Syrup), divalproex (Depakote), and carbamazepine (Tegretol) are also considered mood stabilizers. Valproate and divalproex are used to treat manic episodes. The anticonvulsant lamotrigine was recently approved for the long-term maintenance treatment of bipolar I disorder and may be helpful for depression. Anticonvulsants can be helpful in hard-to-treat bipolar episodes.
- Atypical antipsychotics, such as olanzapine (Zyprexa), risperidone (Risperdal), ziprasidone (Geodon), or quetiapine (Seroquel). Antipsychotics quickly improve manic episodes. Olanzapine may be used in combination with mood stabilizers and anticonvulsants.
- Benzodiazepines, such as diazepam (Valium), may be used instead of antipsychotics or as an additional medication during a manic phase.
What To Think AboutAntidepressants, such as fluoxetine (Prozac), are used very carefully to treat depression because they can trigger a manic episode. Experts now recommend that antidepressants only be used for short periods of time during severe episodes of depression and that they be combined with mood stabilizers. 8 If you are prescribed lithium carbonate or valproate, you will need regular blood tests to monitor the amount of medicine in your blood. Too much lithium in your bloodstream may lead to serious high lithium carbonate side effects. Your doctor may want you to have blood tests for other medications, such as valproate, to check whether the medication is affecting your liver. During your doctor's appointment, ask about: - The side effects of each medication.
- How often you will need to take the medications.
- How the medications may interact with other medications you're taking.
- Whether it's important that you take the medications at the same time every day.
FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory to patients, families, and health care providers to closely monitor adults and children taking antidepressants for signs of suicide. This is especially important at the beginning of treatment or when doses are changed. The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children who may be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicidal impulses. The FDA has not recommended that people stop using antidepressants, but simply to monitor those taking the medications and, if concerns arise, to contact a health professional. | | |
| This is the last and final....
Hopefully I could make a sense out of myself.... Hmm, where to begin. | | |
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