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Symptoms that meet the criteria for mood episodes are present for a substantial portion of the total active and residual periods of illness 100mg topamax with visa medicine rap song. The disturbance is not due to the direct physiologic effects of a substance (e discount topamax american express treatment in spanish. The bipolar type is diagnosed if the disturbance includes a manic or a mixed episode (or a manic or a mixed episode and major depressive episodes) cheap 100mg topamax medications safe during pregnancy. The depressive type is diagnosed if the disturbance includes only major depressive episodes buy topamax 200mg amex symptoms xanax withdrawal. In the DSM-IV-TR, criterion A for schizophrenia requires two of the following: Disorganized speech (e. Schizoaffective Disorder Criteria Rating ScalesSchizoaffective disorder severity can also be measured using a variety of rating scales. Tools that may help measure the severity of schizoaffective disorder are those typically associated with schizophrenia, bipolar disorder and depression. These tools include:Positive and Negative Symptom Scale for Schizophrenia [PANSS] ??? rates positive symptoms like delusions, negative symptoms like emotional withdrawal and general psychopathology like anxiety Hamilton depression scale ??? rates the severity of depression symptoms like insomnia and agitationYoung mania scale ??? rates the severity of mania symptoms like increased energy and sexual interestCut down, annoyed, guilty, and eye opener (CAGE) questionnaire ??? regarding substance use and abuseSeverity scales are useful as they can plot a starting point when the schizoaffective disorder is first diagnosed and then track improvement throughout treatment. Written by Michael David CrawfordYou may be surprised to hear that I suffer from a devastating and poorly understood mental illness. I want to demonstrate that in fact, friendship with the mentally ill can be a rewarding experience. Read on, and I will tell you how I recovered from schizoaffective disorder - but have not been cured. I will tell you how I learned to live with mental illness every day. We have 2550 guests and 2 members onlineDepression can often be treated quite effectively by drugs called antidepressants. This leads me to another odd experience I have had a number of times. Depression can often be treated quite effectively by drugs called antidepressants. There are many different antidepressants that do this via several different mechanisms, but they all have the effect of boosting one of the neurotransmitters, either norepinephrine or serotonin. It can be hard to keep up hope while waiting for the antidepressant to start working. At first all one feels is the side effects - dry mouth ("cottonmouth"), sedation, difficulty in urinating. But after awhile, the desired effect begins to happen. Instead, when I take antidepressants, other people act differently towards me. I find that people stop avoiding me, and eventually start to look directly at me and talk to me and want to be around me. After months with little or no human contact, complete strangers spontaneously start conversations with me. Women start to flirt with me where before they would have feared me. This, of course, is a wonderful thing and my experience has often been that it is the behavior of others rather than the medicine that lifts my mood. Of course, what really must be happening is that they are reacting to changes in my behavior, but these changes must be subtle indeed. And yet, it truly does seem that when my mood looks up, EVERYthing looks up. One reason people resist taking antidepressants is that they feel they would rather be depressed than to experience artificial happiness from a drug. Being depressed is as much a delusional state as believing oneself to be the Emperor of France. This makes it difficult for nerve signals to be transmitted and has a dampening effect on much of your brain activity. Antidepressants increase the concentration of neurotransmitters back up to their normal levels so that nerve impulses can propagate successfully. What you experience when taking antidepressants is much closer to reality than what you experience while depressed. Auditory hallucinations are a key sign of schizophrenia. Auditory hallucinations are the key sign of schizophrenia. After the summer I was diagnosed, when I related my experience to a fellow UCSC student who studied psychology, he said that the fact that I heard voices by itself made some psychologists consider me schizophrenic. Everyone has an inner voice that they talk to themselves with in their thoughts. Until you come to understand what they are, you cannot distinguish them from someone actually talking to you. Other people hear voices whose words express much more disturbing things. It is common for hallucinations to be harshly critical, to say that one is worthless or deserves to die. Sometimes the voices discuss the inner thoughts of the person who hears them, so they think everyone around can hear their private thoughts discussed aloud. Usually those who hear voices find some way to rationalize why the speech does not have a speaker, for example by believing that the sound is being projected to them over a distance via some kind of radio. For the most part, all my voice ever said was "Mike! When I was brought to Alhambra CPC, I was on a "72 hour hold". Basically I was in for three days of observation, to allow myself to be studied by the staff to determine whether lengthier treatment was warranted. I had the understanding that if I just stayed cool for three days I would be out with no questions asked and so although I was profoundly manic, I stayed calm and behaved myself. Mostly I either watched TV with the other patients or tried to soothe myself by pacing up and down the hall. But when my hold was up and I asked to leave, my psychiatrist came to tell me he wanted me to stay longer. He said something was seriously wrong with me and we needed to deal with it. When I denied it, his response was to ask "Do you ever hear someone call your name, and you turn, and no one is there? I understand some people find what they have to say familiar and comforting, even sweet.

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Julaine: I hate to say topamax 100 mg amex symptoms stiff neck, but I am in my second childhood now:) Forty-six purchase topamax online from canada medications over the counter. David: I have heard many different stories about how the doctors explain ECT to the patient discount topamax 100mg otc medicine 319 pill. Julaine: I was very sick at the time buy topamax 100 mg free shipping medicine identification, so I cannot tell you all the exact details. However, I remember that they told me enough and I observed other people in the hospital with me getting better, so I consented quickly. David: At that point in your illness with depression and anxiety, did it even matter what the doctor was saying to you? Julaine: I was dying, so to speak, but I could still understand facts. David: How many ECT treatments did you receive and over what period of time? Julaine: At that time period, about twenty, over two trials, separated by about four months. Julaine: During that set of ECTs, I did not experience any sign of memory loss. I did have mild headaches afterwards and drowsiness. David: I think you also mentioned to us that you had delusions. Julaine: Yes, delusions and memory loss were experienced in later trials of ECT treatments. David: So just to clarify, you had a first set of ECT treatments consisting of twenty treatments, in two trials over four months. Then twelve years later you had another set of treatments. Julaine: That is a fairly good estimate of numbers and time. David: Why is it that you needed the second series of treatments? And were you afraid that after receiving shock treatments before that, another round of treatments might result in some permanent damage? Julaine: I had developed hypothyroidism about the time of 1992 and my medication ceased to work. I was tried on all the newer antidepressants at that time, but they did not work. It can also be used to treat mania and so you may hear that some people with bipolar disorder have received ECT. Were you concerned about any permanent brain damage if you underwent another series of ECT? David: How serious was the memory loss that you experienced? Julaine: I saw a lamp post outside the window and I thought it was a human being. Julaine: The delusions were very short in time, perhaps, a week or so. The unreality/reality lasted a few weeks more, and the memory loss of recent time took longer. David: Do you still suffer from depression and anxiety? Julaine: I am recovered and am a grad student in Licensed Counseling today, but I am not cured:) I am looking forward to that day when we find a cure:). The unilateral ECT was not as effective with me since I was so severe. Undiagnosed thyroid disease can cause depression or prevent your medications from working properly. They can originate from schizophrenia type illnesses, or take that form because of possible trauma. David: Here are some Electroconvulsive Therapy experiences, shared by our audience members: RAH: I had six ECTs in April of 1, two bilateral. I have lost two months totally and pieces of my life are gone. I still suffer from severe depression and, of course, I am badgered to get a recharge which I refuse. Tammy_72: I had five ECT treatments and they left me physically very ill, and made me much more depressed than I was before. I experienced aphasia and seizures after my treatments ended. Such memory is lost, that a doctor or lawyer could no longer practice. I would like to try ECT maintenance and see what happens without drugs. Four treatments that were disastrous for me I lost memory for quite some time, I was confused for a long while, and my depression returned within a month. Plus I had to deal with the bad headaches, confusion, memory loss and I returned home more of a mess than when I entered the hospital. We know so little about the brain, and to shock it, I believe, is a dangerous risk. David: Julaine, would you recommend shock therapy to others who might be suffering from treatment resistant depression, based on your experience with it? Julaine: Yes, I would recommend considering ECT, however;First the patient and family must be told the full facts. It would be very helpful to ask exactly who might benefit from ECTs, or who might not, as effectively. Those who suffer from disorders such as trauma or PTSD should especially ask specific questions. David: Here are some more ECT experiences from the audience and some comments: jonzbonz: Two years after I had unilateral ECT, I had a sub-arachnoid hemorrhage of my brain on that side. I suspect strongly that the ECT is responsible for the stroke I had. I have discovered over the years on how to work around them. Anything to allow me to feel, at least partially function, and last but not least, stop me from slipping back into that deep dark hole I was in, works for me. RAH: I feel that I was ill informed about Electroconvulsive Therapy. The days prior to ECT are lost, so I have no idea what was presented to me and no one is talking. For the past two years, I have gone through two trials of nine treatments. In the past eight months, I have had serious memory loss, and am still suicidal.

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But the harder lesson is learning that there is no way that anyone can force a person to take responsibility for his or her bipolar disorder treatment discount topamax 200 mg overnight delivery medications in mexico. Unless the patient makes the commitment to do so cheap topamax 100mg without prescription treatment 3 phases malnourished children, no amount of love and support buy topamax 100mg mastercard medicine 44175, sympathy and understanding order topamax american express treatment, cajoling or even threatening, can make someone take this step. Even family members and friends who understand this at some level may feel guilty, inadequate, and angry at times dealing with this situation. Family members and friends should not be ashamed of these feelings of frustration and anger but rather get help with them. Even when the patient does take responsibility and is trying to stay well, relapses can occur. Family members might then wonder what they did wrong. On the other side of this issue is another set of questions. How much understanding and support for the bipolar person might be too much? Should you pay off credit card debts from hypomanic spending sprees caused by dropping out of treatment? What actions constitute helping a sick person, and what actions are helping a person to be sick? These are thorny, complex questions that have no easy answers. Like many chronic illnesses, bipolar disorder afflicts one but affects many in the family. Where mood swings are mild, the family will experience many forms of distress but, over time, may adapt well enough to the demands of the illness. They may experience anger if they see the individual as malingering or manipulative. Anger can also be directed at the "helping" professionals who are unsuccessful in curing the illness "once and for all". Anger may be directed at other family members, friends or God. Typically, these same family members experience feelings of extreme guilt (read Bipolar Guilt ) after the individual has been diagnosed. They are concerned about having had angry or hateful thoughts and may wonder whether they somehow caused the illness by being unsupportive or short-tempered (read about causes of bipolar disorder ). Moreover, much literature and other media of the past few decades have largely supported (erroneously) a common notion that parents are somehow always responsible for producing mental illness in children. And so, parents and to a lesser degree, other family members may find that feelings of guilt and the wish to compensate for any wrongdoings prevent them from effectively setting limits and developing realistic expectations. Equally painful is the sense of loss that is associated with the growing awareness that, in severe cases of recurrent manic-depressive illness, an individual may never be quite the same person the family knew before the illness. The mourning process is usually marked with periods of resignation and acceptance and intermittent periods of renewed grief stimulated perhaps, by the accomplishment of a peer, a family celebration or some other seemingly minor event. Eventually, as with any other loss, whether the end of a marriage, the death of a loved one, or the loss of ability through illness or accident, what is needed is a careful re-evaluation of goals and an adjustment of expectations. Related here, may be some feelings of shame associated with unfulfilled expectations and with the stigma of mental illness. It may be interesting for family members to realize that one of the reasons that mental illness carries with it such a stigma is that mental illness is often associated with decreased productivity. The value of productivity and the notion of "the bigger the better," have long formed a mainstay of North American culture. The family may have to grapple with whether they want to place such emphasis on these values. Shifting emphasis on to values related to family, spirituality or other focus may help to diminish any unnecessary suffering due to feelings of shame. Finally, anxiety may be ever present as family members grow to continually anticipate a change of mood, a return of bipolar symptoms. Families may find planning events fraught with worries of whether the ill relative will present any problems at the event. There may be fear that unprovoked conflicts will arise at any time, that other family members may suffer. Children may fear that they will inherit the illness, they fear that they may have to manage the care of their ill relative as well as manage their own lives when the primary caretakers can no longer do the job. To cope with such consuming anxiety, some family members learn to distance themselves (both physically and emotionally) from the family, while others may put their personal goals on hold in anticipation of the next crisis. In any event, families need support to learn to manage anxiety and to lead as fulfilling lives as possible. Attending bipolar family support groups can help to relieve the pressure experienced by families caught in their stressful situations. In severe cases of manic-depressive illness, families typically find that their social network starts shrinking in size for several reasons. The family is often embarrassed by the varied symptoms of an ill relative whether these symptoms have to do with poor self-care skills or belligerent behavior. Visitors may feel awkward about what to say or how to help the family. Usually they say nothing at all and soon both family and friends find themselves participating in a conspiracy of silence. Going to a bipolar disorder support group is one way to help reduce the sense of isolation a family often faces. Through the practice of self-disclosure and the development of a vocabulary to use and the self-confidence to use it, a family can gradually learn how to communicate with extended family members and friends. Family members often feel exhausted because of the time and energy spent on issues related to the illness. There is little energy left to invest in other potentially satisfying relationships or rewarding activities. Increased tension leads to risk of marital dissolution and stress-related physical symptoms. To deal with feelings of resentment and guilt, siblings spend more time away from the family. When the ill member is a parent who cannot meet the emotional needs of his or her spouse, a child may assume the role of confidante with the well parent and may sacrifice some of his or her own personal development as an independent individual. In general, the emotional welfare of all family members is at risk because of the ongoing stress. It is important for the family to be aware of these risks and to take appropriate measures (for instance, getting support from outside sources) in order to minimize the risks. Regardless of which family member is ill, role relationships often shift in response to the illness. If, for instance, a father is unable to provide financial and emotional support, the mother may have to take on additional responsibilities in both spheres in order to compensate. She may find herself in the position of a single parent but without the freedom of decision-making afforded by single parenting. Added to this, the wife may find herself parenting her ill husband as she monitors his symptoms, his medications and deals with his hospitalizations.

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Try these tips for handling this type of situation:Start the conversation by stating this situation is very difficult to talk about cheap topamax online american express medicine prices, which will let your partner know you feel vulnerable buy topamax with a mastercard medicine 2 times a day. Talk about ways to handle a bowel or bladder accident during sex buy topamax canada medicine measurements. State that you typically try to empty your bladder and bowels prior to sexual activity order generic topamax online medications not to take before surgery, but that you also keep towels, urinals, bedpans and handi-wipes nearby. Diffuse your conversation about this difficult topic with a little humor -- it will put you both at ease.. Given that our bodies can look very different from what the media tells us is attractive, we often feel we will be rejected when our partners see our bodies. Even though many people with disabilities do feel comfortable with the appearance of their bodies, many others do not. Many people will go to great lengths to hide their bodies, such as wearing clothing that covers up their arms and legs or only undressing in the dark. While it can be hard to manage these personal feelings, there are some ways to deal with these issues in yourself and with your partner. Look at yourself in the mirror, and get to know what your body looks like. If you wear a prosthetic, look at your body with it on and off. Aim to get more comfortable with the way that you look. When you become more comfortable with your body, your partner will also feel this same sense of ease.. He or she may wonder why you feel uncomfortable -- your partner may be more accepting of yourself than you are! When your partner gives a favorable reaction (as will surely be the case), you may feel increased comfort with taking more off! People often end up feeling better about their bodies when they realize their partner finds them incredibly attractive. People who are deaf or who having hearing impairments require light to lip read and view sign language. Given this necessity, lights need to be on during sexual activity, unless both partners choose not to communicate with words during sex play. Even though keeping the lights on may seem obvious, it may be helpful to communicate this information directly to your partner prior to sexual play. Having sex with the lights on can be erotic and exciting, but very different for those people who are not used to engaging in sex in this manner. The need for this discussion may not be as critical if you are being sexual with a partner who is also deaf or hearing impaired. That is, your common experiences may create an understanding in which this does not need to be discussed. However, if you do need to have this talk, consider the following::Find a way that feels right to you to launch this discussion. If it is important to you, talk about the fact that you like to communicate during sex and that leaving the lights on is the only way this can be accomplished. Use humor -- you may want to lead with, "You know, those of us who lip read do it with the lights on! The more comfortable you are, the more comfortable your partner will be. Linda Mona, a licensed clinical psychologist specializing in disability and sexuality issues and a disabled woman living with a mobility impairment. President, Couples Learning Center Philadelphia, PAA: I think the first thing you need to do is ask yourself what is the evidence? Has your daughter come to you asking about your gynecologist? A boyfriend, girlfriend, or your child asking you questions about sex is not enough evidence for you as the parent to be questioning your child. If you do have enough evidence to believe your child is sexually active, there are a few rules to remember: Look your child directly in the eyes and talk, do not scream at them. If you are embarrassed to talk about sex, practice in front of a mirror first. This may be the time to talk about real choices--such as what type of birth control they are going to use. It is also fine to let them know you are not pleased with their decision to have sex and encourage them to wait. Chances are that a child who is having sex at 16 is probably going to end up getting hurt. Kids need parents to talk openly and honestly with them from a very young age. This is not a pre-AIDS society that can pretend to be separate from the rest of the world. Kids need to be comfortable with their selves and their sexuality long before they practice it. Teenagers are the fastest rising risk group for AIDS. We need to confront our own fears about AIDS and stop projecting them on our children. Children must be lovingly approached and taught the beautiful and ugly sides of human sexuality. They must know the responsibilities that go along with sexual relations before they have children themselves. We must face it with the utmost courage and honesty. Kathryn Christensen, 16 Apple Valley, MNI would sit them down and have a nice little heart-to-heart. Then I would talk about emotional risks like where they thought the relationship was going. I know kids because I am a kid and I know that, if they want to have sex, they will. Lectures are stupid and when they are given, kids usually end up doing the opposite anyway! Johnson, MSW, Planned Parenthood Federation of America New York, NYI would say that I hoped that it was planned, consensual, non-exploitive, and protected. I would express regret that he/she did not wait until he/she was older, surer, wiser.

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