By U. Larson. Brown University.
We invite you to call us at 1-888-883-8045 and share your experience with suicide or suicide attempts order mildronate 250mg on line. Rappaport is a child psychiatrist cheap 500 mg mildronate amex, an Assistant Professor of Psychiatry at Harvard Medical School and Director of School Based Programs in Child Psychiatry at the Cambridge Health Alliance in Massachusetts. About 32,000 peoeple take their lives yearly in America. Patricia Gallagher, our guest on the HealthyPlace Mental Health TV Show, talks about her experience when her husband attempted suicide, twice. We invite you to call us at 1-888-883-8045 and share your experience with suicide attempts in the family. He suffered form excruciating headaches, high blood pressure from the stress and weight loss and decided to end his life... Why your circadian clock, circadian rhythm, is the key to good sleep. Sleep is a process needed by the body as much as food or water and yet is not completely understood. While sleep outwardly appears to be exclusively restful, inwardly, sleep is actually a heightened state wherein molecules are constructed from smaller units in the body. This process accentuates the growth and rejuvenation of immune, nervous, skeletal and muscular systems. Sleep is divided into two categories:rapid-eye movement (REM sleep)The American Academy of Sleep Medicine further divides non-REM sleep into stages N1, N2 and N3, N3 being the deepest level of sleep. Sleep usually progresses from N1 to N2 to N3 to N2 to REM sleep. Deep sleep tends to occur earlier in the night and REM sleep occurs just before waking. During N1 sleep, people lose awareness of their physical surroundings and occasionally experience hallucinations or involuntary muscle twitches which may induce wakefulness. Stage N2 sleep is characterized by a complete loss of environmental awareness and this stage occupies 45% - 55% of adult sleep. Stage N3 sleep is the deepest sleep and is when parasomnias (undesirable sleep experiences) like night terrors, bedwetting, sleepwalking and sleep-talking can occur. REM sleep is responsible for almost all dreams and accounts for about 20% - 25% of adult sleep. Muscle paralysis is experienced in this stage of sleep. This is thought to prevent the physical acting out of dreams The disruption of any sleep stage, or the standard progression through the stages of sleep, can indicate a sleep disorder, and specific sleep disorders are typically associated with specific sleep stages. For example, sleep walking, night terrors and the acting out of dreams is associated with REM sleep, whereas sleep paralysis is associated with stage N1 sleep. Medications and other disorders such as depression are also known to affect the sleep cycle in specific ways. In depression, for example, people typically have difficulty in achieving and sustaining stage N3 sleep causing increased fatigue during the day (Read: Depression and Sleep Disorders ). The sleep-wake cycle is controlled by the circadian clock. This clock is an inner time-keeping mechanism that works in tandem with body temperature fluctuations and enzymes to determine the ideal timing of correctly structured and restorative sleep. For example, if a person with correctly structured sleep typically wakes early, they are unlikely to be able to sleep in, even if sleep deprived. Disruption of the circadian clock (circadian rhythm) alters the sleep-wake cycle such that the person is no longer sleepy at night or alert during the day. This disruption can also alter when a person gets hungry. Covers most common types of sleep disorders including snoring and sleep apnea, insomnia, parasomnias, sleep paralysis, circadian rhythm disorders, and narcolepsy. Below, are descriptions of the most common types of sleep disorders. Snoring is typically produced by the vibration of soft tissues in the nose, throat and mouth, caused by the relaxation of sleep. However, sometimes there is more to snoring than just disturbing the sleep of the person next to you. Snoring may also indicate a narrowing upper airway associated with obesity, nasal congestion, a malformation of the area, allergies, asthma, hypothyroidism, adenoid enlargement or a hormonal disorder. Risk factors for this condition include heredity and large neck circumference. This condition is more prevalent in older adults, males and is three times more common in smokers. Physical abnormalities can also cause this condition. While sleep apnea most commonly causes awakening in order to reinstate proper breathing, it may also create a drop in blood oxygen and worsen other disorders such as hypertension, heart failure and diabetes. An additional form of sleep apnea is caused by the brain failing to signal your body to breathe. This rare condition is known as central sleep apnea and primarily appears in individuals with central nervous system conditions or neuromuscular disease but can occasionally occur in healthy individuals at sleep onset.
Our guest tonight is psychologist and developer of The Parent Coaching Cards order mildronate 250 mg line, Dr cheap 500mg mildronate visa. Richfield is a child psychologist, parent/teacher trainer, and has been working in the mental health field since 1980. He is based in Pennsylvania and specializes in the treatment of disruptive behavior disorders and sees families with children diagnosed as having ADD/ADHD, behaviors that are difficult for both child and parent to manage. Parent coaching is a prescriptive type of parenting involving tools and goals to help children develop social and emotional skills. David: What kind of tools and goals are we talking about? Richfield: The tools range from Parent Coaching Cards to other concrete strategies developed by parents and children in a partnership. David: So when you say the word "coaching" are you really referring to "tutoring" in the sense of teaching your child how to deal with various situations that may arise? Richfield: Many skills such as frustration tolerance and other self control skills can be coached. Parents can access the lessons right on the spot or prepare their kids for future challenges David: For instance, what kinds of situations or behaviors is coaching good for? They can use the Coaching Card "Quit The Clowning" to prepare a kid for an event. And at what age can you begin coaching your ADD child? Richfield: Classroom environments, family gatherings, and recess are all coachable places. The Cards target ages 7 - 12 but are used with younger and older kids. Coaching can begin very early - in the preschool years. David: And specifically, how is coaching effective in working with ADD-ADHD children? Richfield: When your kids are younger they require a more personalized approach and parents need to be especially sensitive to their personalities. ADHD kids often do not access internal language - coaching gives them a roadmap to do so. By preparing them for challenges, rehearsing thinking side solutions, you carve out a path of adaptation. One very critical component is the "talk to yourself" message. David: In other words, what you are saying is you simply analyze the behavior or emotional situation the child is or maybe facing (sort of like role playing) and work though that together. So if the situation arises again, the child will be better able to handle it. Richfield: This refers to the content of thought that we are coaching in our ADHD kids that replaces the impulse discharge that so often characterizes their response to a stimulus. Yes, the analysis is compared to a video tape that is rewound and stopped at different points for review. David: On your site, you say "although there are many social and emotional lessons for children to learn, the Parent Coach accepts the fact that they have much to learn as well. Richfield: Also, the child uses the Coaching Cards in a preparatory way - as does the parent - so there is a partnership. The Parent Coach is all of these - coach, authority, friend, confidante - all wrapped up into one. Richfield, is it the "coach, authority figure, friend, and confidante" role that makes it difficult for the ADD child to figure out what the "parent" role is? In order to minimize confusion, the parent is wise to first examine the Coaching Cards and see how they apply to the adult world so that the child understands that learning self control and social skills is a life skill. Coaching comes in when a situation arises that displays a gap between what the environment is asking and what skills the child may lack. Some kids prefer to use the cards without parental help while others will only get comfortable with them by themselves. Richfield: ADD kids are not very good at observational learning - a key component in social skills. Also, their threshold to restrain themselves is lower than the average child. Coaching makes all of this clear and understandable so that they learn how to increase the powers of the thinking side over the reacting side. Pepper48: Does the lack of skills become a fear instilled in these children? Yes, many do recoil from social encounters because they fear rejection and have learned to prefer the company of their video games or other solitary pursuits. David: What is the key component(s) of being able to help your child deal better or more effectively with social and behavioral issues? Richfield: A warm, loving, and goal-oriented relationship that stresses safety, open communication, and clear tools for adaptation. The parent coach must stress that they are on the same side as the child. Too often the child feels like the parent is an adversary - an unfortunate residual effect of family conflict. When a person observes they also must reflect upon those observations and compare them to previous learning and decide what strategies to keep and which to let go of, so observation is only the first step. There is much more cognitive process that goes into the growth of social skills.
This information is generalized and is not intended as specific medical advice order mildronate 500 mg online. If you have questions about the medicines you are taking or would like more information mildronate 250mg with amex, check with your doctor, pharmacist, or nurse. Generic name: GlimepirideAmaryl is an oral medication used to treat type 2 (non-insulin-dependent) diabetes when diet and exercise alone fail to control abnormally high levels of blood sugar. Like other diabetes drugs classified as sulfonylureas, Amaryl lowers blood sugar by stimulating the pancreas to produce more insulin. Amaryl is often prescribed along with the insulin-boosting drug Glucophage. It may also be used in conjunction with insulin and other diabetes drugs. Always remember that Amaryl is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan may diminish the results of Amaryl and can lead to serious complications such as dangerously high or low blood sugar levels. Remember, too, that Amaryl is not an oral form of insulin, and cannot be used in place of insulin. Do not take more or less of Amaryl than directed by your doctor. Amaryl should be taken with breakfast or the first main meal. If it is almost time for the next dose, skip the one you missed and go back to your regular schedule. Amaryl should be stored at room temperature in a well-closed container. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Amaryl. Anemia and other blood disorders, blurred vision, diarrhea, dizziness, headache, itching, liver problems and jaundice, muscle weakness, nausea, sensitivity to light, skin rash and eruptions, stomach and intestinal pain, vomitingAmaryl, like all oral antidiabetics, can result in hypoglycemia (low blood sugar). The risk of hypoglycemia can be increased by missed meals, alcohol, fever, injury, infection, surgery, excessive exercise, and the addition of other medications such as Glucophage or insulin. To avoid hypoglycemia, closely follow the dietary and exercise regimen suggested by your doctor. Symptoms of mild low blood sugar may include:Blurred vision, cold sweats, dizziness, fast heartbeat, fatigue, headache, hunger, light-headedness, nausea, nervousnessSymptoms of more severe low blood sugar may include:Coma, disorientation, pale skin, seizures, shallow breathingAsk your doctor what steps you should take if you experience mild hypoglycemia. If symptoms of severe low blood sugar occur, contact your doctor immediately; severe hypoglycemia is a medical emergency. Avoid Amaryl if you have ever had an allergic reaction to it. Do not take Amaryl to correct diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, and fruity breath). If you have a heart condition, you may want to discuss this with your doctor. When taking Amaryl, you should check your blood and urine regularly for abnormally high sugar (glucose) levels. The effectiveness of any oral antidiabetic, including Amaryl, may decrease with time. This may occur because of either a diminished responsiveness to the medication or a worsening of the diabetes. Even people with well-controlled diabetes may find that stress such as injury, infection, surgery, or fever triggers a loss of control. If this happens, your doctor may recommend that you add insulin to your treatment with Amaryl or that you temporarily stop taking Amaryl and use insulin instead. If Amaryl is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Amaryl with the following:Airway-opening drugs such as albuterol sulfateAspirin and other salicylate medicationsCorticosteroids such as prednisoneDiuretics such as hydrochlorothiazide and chlorothiazideEstrogens such as conjugated estrogensHeart and blood pressure medications called beta blockers, including atenolol, metoprolol tartrate, and propranolol hydrochlorideMajor tranquilizers such as thioridazine hydrochlorideMAO inhibitors (antidepressants such as phenelzine sulfate and tranylcypromine sulfate)Nonsteroidal anti-inflammatory drugs such as diclofenac sodium, ibuprofen, mefenamic acid, and naproxenSulfa drugs such as sulfamethoxazole and trimethoprimThyroid medications such as levothyroxineUse alcohol with care; excessive alcohol intake can cause low blood sugar. Since studies suggest the importance of maintaining normal blood sugar levels during pregnancy, your doctor may prescribe injected insulin instead. Drugs similar to Amaryl do appear in breast milk and may cause low blood sugar in nursing infants. If diet alone does not control your sugar levels, your doctor may prescribe injected insulin. The usual starting dose is 1 to 2 milligrams taken once daily with breakfast or the first main meal. If necessary, your doctor will gradually increase the dose 1 or 2 milligrams at a time every 1 or 2 weeks. Your diabetes will probably be controlled on 1 to 4 milligrams a day; the most you should take in a day is 8 milligrams. If the maximum dose fails to do the job, your doctor may add Glucophage to your regimen. Weakened or malnourished people and those with adrenal, pituitary, kidney, or liver disorders are particularly sensitive to hypoglycemic drugs such as Amaryl and should start at 1 milligram once daily. Your doctor will increase your medication based on your response to the drug. Safety and effectiveness in children have not been established.
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