Mark Myers Expert Answer to: How Does One Deal with a 7 year old who seems to have anger management issues?

There are two directions you can approach this. The first is the Anger Management problem.  click for more

Mark Myers expert answer to: How do you cope when your moods are flipping from severe anxiety to deep depression? (I am taking meds already.)

It would be helpful to find out a little more the symptoms you are presenting. The type of mood swings and frequency MAY indicate a different diagnosis. The mood swings themselves must be a difficult challenge,let alone the symptoms. I would first recommend click for more 

Focus on the Behavior, Not the Argument

A parent's job is to teach, guide, direct, and protect their children. At times, this job

description may require different actions on a parent's part when it comes to addressing the needs of their child. For example, if a child is staying out past curfew that would be a directing moment(when to come home and what consequences will be if late) more than a teaching moment(explaining the dangers and problems of staying out late). Furthermore, the longer the discussion goes on about the why it is important to obey curfew, the longer the child will feel this expectation is negotiable. Children do not have to agree with a rule, just understand the need to follow it. The longer you get caught up in the argument, the less effective you will be in addressing the behavior.

Results versus Process

Individuals making important decisions in life at times could find themselves immobilized but focusing too much on end results. While possible outcomes are helpful to look at when making a big decision, we need to remember there are many intangibles involved that impact on the actual results.

An example of this would be a wife of an alcoholic decides to divorce her husband after many unsuccessful years of trying to get him to stop drinking. After the divorce he could choose to remarry and stop drinking. This does not mean she made the wrong decision. At the time she choose to take an action based on information she had at her disposal, such as, years he was drinking, repeated requests to stop, financial and emotional resources that were effected by his drinking, and where she was at emotionally.

If we look back or evaluate the process involved in making a decision we are choosing NOT to making ourselves responsible for other peoples actions. We cannot control outcomes but can control ourselves. The effort and thought in making a decision is more important than the results.

Mark Myers Expert Answer to:What sort of hacks can I use to snap out of depression?

What sort of hacks can I use to snap out of depression? I've been diagnosed with depression, but don't want to take medication.

Depending on the severity, the length of time it has been going on, and the impact it is having on your life, there are different ways someone can address feeling depressed. The first step is learning more about your depression. Try to determine patterns to your depression. Is it more intense during certain times of the day, talking with certain people, or thinking certain thoughts? Are some days better than other days? Is it more intense during certain times of the year? How long does it last when you are depressed? Keeping a journal would be one way to help determine patterns.

This information gathering is going to be helpful. If you feel depressed more during Winter time(for most people in general this is common to some degree), this may suggest a possibility of Seasonal Affective Disorder. Interventions could include increasing activities, buying a light therapy lamp, or increasing excercise routine.

While gathering information you may also see a pattern to how you think. Are you looking at situations pessimistically? Are you feeling lonely? Are you feeling depressed because of certain relationships or lack there of? How are you sleeping and does lack of sleep impact on your emotions? If you see a point of origin to your depression, you can implement a plan of action to address this.

Some strategies could include: increase/include exercise, vitamins, increase social networks, hypnosis, volunteer, join support group, involve yourself in religious activities or organisations, or changing your way of thinking. Medication does not have to be involved, but in some cases it is necessary. Talk therapy could also be introduced. A therapist could help you in planning out a course of action.

How meditation relieves the subjective experience of pain

Meditation can relieve pain, and it does so by activating multiple brain areas, according to an April study in the Journal of Neuroscience. Fadel Zeidan of Wake Forest University and his colleagues scanned people’s brains as they received uncomfortably hot touches to the leg. When subjects practiced a mindful meditation technique that encourages detachment from experience while focusing on breathing, they reported less pain than when they simply paid attention to their breathing.

Hands On Homework

Hands On Homework Help for Parents Homework is often a source of anxiety and struggle for parents, particularly if your child resists homework. Providing a structure to the homework process can be very helpful. Here are some helpful tips: 1. Create a routine – There are many opinions about what works best, but know your child and develop a homework routine that works for you. If you are able, encourage your child to get homework done right away after school so they have as much play and relaxation time as possible. If your child needs to blow off steam after school or you pick him or her up from daycare, have them do homework after some play time. Limit the time and give your child an opportunity to transition when he or she has to stop playing. 2. Have a specific location for completing homework - with all of the supplies your child will need to complete their work. 3. Do a backpack check for any important papers or to check for assignments. Ask questions about what you find. This information will help you understand how your child is feeling about school and the work that must be done. 4. Break it down – If your child has a lot of homework, help him or her break it down into smaller, more manageable bits. It may be helpful to offer a five-minute movement break between tasks if your child has difficulty keeping focused. 5. What worked for you may not work for your child – Understand that you and your child may be wired differently. You will have to tweak the routine based on your child’s individual needs. If you were a “get your work done right after school” type of kid and your child is a “blow off steam” kind of kid, allow that adjustment. You’ll find that if you consider your child’s temperament, the homework process will be less painless. 6. Minimize distractions – Keep the television and video games off during homework time. It splits focus and makes homework take longer. This can lead to stress and frustration. 7. Save the reading for right before bedtime – Use reading as one to one wind down time with you. As your child becomes more independent in their reading, grab a book and read alongside your child. Adults need a little wind down time too. 8. Finally, avoid the power struggle, not the homework – Encourage your child and celebrate when they get their homework done. Try to focus on what they have accomplished and not what they are not doing right. If he or she needs to redo or add to their work, off the feedback as constructively as possible. If you find yourself getting frustrated, step away for a minute. Manage your emotions before returning to help your child.

Challenging Unproductive Thoughts

A-B-C Theory of Emotional Disturbance
“Men are disturbed not by things, but the view which they take of them.”
1st century A.D. Epicieus,

It is not the event, but rather our interpretation of it that causes our emotional reaction.

A. Activating Experience

Woman friend breaks the news that she is going out with another man, and therefore wants to break off the relationship with you.

B. Belief about (or interpretation of the experience)

“ I must really be a worthless person.”
“I’ll never find another great woman like her.”
“She doesn’t want me therefore no one could possibly want me.”
and/or
“This is awful.. Everything happens to me.”
“That witch! She shouldn’t be that way.”
“I can’t stand the world being so unfair.”

C. Upsetting emotional consequences

Depression and\or Hostility

D. Disputing of irrational ideas

“Where is the evidence that because this woman wishes to end our relationship, that I am worthless person: or that I’ll never be able to have a really good relationship with someone else: or even that I couldn’t be happy alone?”

and\or

“Why is it awful that I’m not getting what I want?” “Why shouldn’t the world be full of injustices?”

E. New emotional consequence or effect

Sadness: (“Well, we did have a nice relationship, and I’m sorry to see it end-but it did have it’s problems and now I can go out and find new friends.”)

or

Annoyance: (It’s annoying that she was seeing someone else but it isn’t awful or intolerable.”)

Diet linked to teen mental health issues

Adolescents who eat healthy diets packed with fruit and vegetables have lower rates of mental health problems, a study shows.

A study of 3000 adolescents has found that those who had poor diets filled with junk and processed foods were more likely to suffer mental health problems such as depression and anxiety.

While other studies have shown links between diet quality and mental health disorders in adults, the new research is the first to demonstrate the link in adolescents.

Why Laughter May Be the Best Pain Medicine

Laughing with friends releases feel-good brain chemicals, which also relieve pain, new research

indicates.

Until now, scientists haven't proven that like exercise and other activities, laughing causes a release of so-called endorphins.

"Very little research has been done into why we laugh and what role it plays in society," study researcher Robin Dunbar, of the University of Oxford, said in a statement. "We think that it is the bonding effects of the endorphin rush that explain why laughter plays such an important role in our social lives."

35 Proven Stress Reducers

35 Proven Stress Reducers

1. Get up 15 minutes earlier in the morning. The inevitable morning mishaps will be less stressful.

2. Don’t rely on your memory. Write down appointment times, when to pick up dry cleaning, etc.

3. Practice preventive maintenance. Your car, appliances, home or relationships will be less likely to break down/fall apart “at the worst possible moment”.

4. Eliminate (or restrict) the amount of caffeine in your diet.

5. Procrastination is stressful. Whatever you want to do Tamar, do today; whatever you want to do today, do it now.

6. Plan ahead. Don’t let the gas tank get to low, don’t wait until your down to your last postage stamp to buy more, etc..

7. Don’t put up with something that doesn’t work right. If your alarm clock, wallet, windshield wipers-whatever-are a constant aggravation, get them fixed or get new ones.

8. Allow 15 minutes of extra time to get appointments. Plan to arrive at the airport one hour before domestic departures.

9. Be prepared to wait. A paperback book can make waiting in line almost enjoyable.

10. Always set up continency plans, “just in case”. (i.e., “if for some reason either of us is delayed, her is what we’ll do...”).

11. At times, relax your standards. This world will not end if the grass doesn’t mowed this weekend, if the laundry is cleaned on Sunday instead of Saturday, etc..

12. For every one thing that goes wrong, there are probably 10 to 50 or 100 blessings.
Count ‘ em!!!

13. Ask questions. Taking a few minutes to repeat back directions, what someone expects of you, etc.., can save hours.

14. Say No! Saying no to extra projects, social activities and invitations you know you don’t ha\ve the time or energy for takes practice, self respect and a belief that everyone, everyday needs quiet time to relax and to be alone.

15. Unplug your telephone. Want to take a long bath, sleep or read without interruption? Drum up the courage to temporarily disconnect. (The possibility of there being a terrible emergency in the next hour or so is almost nil).

16. Simplify, simplify, simplify.

17. Make friends with nonworriers. Nothing can get you into the habit of worrying faster than associating with chronic worrywarts.

18. Get enough sleep.

19. Create order out of chaos. Organize your home and workplace so that you always know exactly where things are. Put things away where they belong and you don’t have to go through he stress of losing things.

20. When feeling stressed, most people tend to breath in short, shallow breaths. When you breath like this, stale air is not expelled, oxidation of tissues is inadequate, and muscle tension usually results. Check your breathing throughout the day. If you find your stomach muscles are knotted and your breathing is shallow, relax your muscles and take several breaths.

21. Learn to live one day at a time.

22. Every day, do something you enjoy.

23. Talk it out. Discussing your problems with a trusted friend can help you clear your mind of confusion so that you can concentrate on problem solving.

24. Do something for someone else.

25. Do something that will improve your appearance. Looking better can help you feel better.

26. Schedule a realistic day. Avoid the tendency to schedule back to back appointments.

27. Become more flexible. Some things are worth not doing perfectly and some issues are well to compromise upon.

28. Eliminate destructive self talk: “I’m too old to..”’ “I’m too fat...”’ etc.

29. Learn to delegate responsibility to capable others.

30. If an especially “unpleasant” task faces you, do it early in the day and get it over with. Then the rest of the day will be free of anxiety.

31. Take care of today’s as best as you can and yesterday’s and Tamar’s will take care of themselves.

32. Allow yourself time-everyday-for privacy, quiet, and introspection.

33. Do one thing at a time. When you are with someone, be with that person and no one else or nothing else.

34. Have a forgiving view of events and people. Accept the fact that we live in an imperfect world.

35. Have an optimistic view of the world. Believe that most people are doing the best that they can.

Concerns about Stigma Undermine ADHD Treatment for Adolescents

Concerns about Stigma Undermine ADHD Treatment for Adolescents

Because ADHD frequently persists into adolescence, and continues to undermine teens' academic and social functioning, most adolescents continue to need treatment. However, as issues of self-direction and autonomy become more important for teens, resistance to treatment for ADHD - medication or otherwise - frequently intensifies and many adolescents stop treatment prematurely. This is a challenge that many parents struggle with.

It is thus important to understand the factors - particularly adolescents' perspectives on treatment - that affect the receipt of ADHD treatment during this critical developmental period. Examining this issue was the focus of a study published recently in the Journal of Adolescent Health [Bussing et al (2011). Receiving treatment for Attention-Deficit Hyperactivity Disorder: Do the perspectives of adolescents matter. Journal of Adolescent Health, 49, 7-14.]

Participants were 168 adolescents - about 50% female - and their parents recruited through a public school system in the US. These adolescents screened positive for ADHD in elementary school and were contacted 6 years later for a follow-up assessment. At follow-up, over 60% continued to meet full diagnostic criteria for ADHD and many others still had elevated levels of ADHD symptoms. The researchers were interested in how many adolescents had received ADHD treatment in the past year and the parent and child characteristics that predicted the receipt of treatment.

- Parent Perspectives -

Clinical need - Parents rated their teen on symptoms of ADHD, disruptive behavior, emotional distress and overall impairment. High levels of symptoms reflected high clinical need for treatment.

Treatment receptivity - Parents rated how receptive they were towards obtaining medication treatment or counseling for their child.

Caregiver strain - Parents rated the effect of caring for a child with emotional or behavioral problems, such as demands on time, financial strain, worry, guilt, and embarrassment. High scores reflect high levels of strain associated with caring for their child.

- Adolescent Perspectives -

Clinical need - Teens their symptoms of ADHD, disruptive behavior, emotional distress and overall impairment. High levels of symptoms reflected high clinical need for treatment.

Treatment receptivity - Teens rated how receptive they were towards obtaining medication treatment or counseling.

ADHD Stigma - This measure assessed teens' perception that being diagnosed and treated for ADHD would be stigmatizing.

Receipt of mental health services

Lifetime and past-year receipt of mental health services for each adolescent was gathered through detailed interviews with parents. This interview inquired about the receipt of services in a wide range of settings and asked about counseling services and medication treatment.

- Results -

Lifetime and past year mental health service usage

Although most adolescents, i.e, 79%, had received mental health intervention at some point in their lives, only 42% received any services in the past year. This was true even though most continued to meet full diagnostic criteria for ADHD and/or continued to struggle with symptoms.

Agreement between parent and teen perspectives

Parent and teen reports of the teen's emotional distress showed moderate agreement. However, agreement on symptoms of inattention, hyperactivity, and disruptive behavior was poor. Agreement on receptivity to treatment for ADHD was also poor.

Predictors of prior year use of mental health services

The researchers were especially interested in what predicted adolescents' receipt of mental health services during the past year. Interestingly, neither socioeconomic status or insurance coverage were significant predictors. Neither were parent ratings of their child's hyperactive and disruptive behavior.

Instead, teens who had received services were rated by parents as more inattentive, more depressed, and more impaired in their daily functioning. Treatment was also more likely when parents were more receptive to medication treatment.

What about adolescents' perspectives?

Even after taking these parental factors into account, adolescents' perspectives emerged as significant predictors of treatment receipt. Adolescents who rated themselves as more impaired and who had more positive attitudes towards medication were more likely to have been treated. The most powerful predictor, however, was concerns that ADHD was stigmatizing. Adolescents who were worried about being stigmatized for ADHD were far less likely to have received treatment in the past year than other teens.

- Summary and implications -

Results from this study indicate that many adolescents struggling with ADHD have not received any mental health services in the prior year. Especially noteworthy was that even after accounting for parents' perceptions of their child's functioning and their receptivity to medication treatment, adolescents' own attitudes were important predictors of receiving treatment.

Teens who felt they were not functioning well in their daily lives were more likely to have been treated. And, adolescents with concerns about ADHD stigma were far less likely to have received treatment during the prior year. In fact, this was the strongest predictor of all.

These findings highlight the importance of eliciting adolescents' perceptions of the need for ADHD treatment, and concerns related to treatment, during evaluation and treatment planning. In particular, health professionals should discuss concerns teens may have about being stigmatized for ADHD as these concerns can substantially undermine an adolescent's willingness to initiate or continue with indicated treatment.

These results also suggest that when a teenager refuses treatment, or protests continuing, parents should recognize that there may be more involved than their child's being oppositional, not recognizing the reality of what they require, or exercising their desire for autonomy and self-determination. While these factors may certainly be involved, an adolescent's worries about being stigmatized can be especially important and need to be understood and addressed. There is a need to develop effective interventions for addressing such concerns.

Childhood Vaccines Cleared of Autism, Diabetes Link in New Report U.S. Institute of Medicine finds "very little evidence" of serious harm

From Nature magazine

Vaccines are largely safe, and do not cause autism or diabetes, the US Institute of Medicine (IOM) said in a report issued today. This conclusion followed a review of more than 1,000 published research studies.

"We looked very hard and found very little evidence of serious adverse harms from vaccines," says Ellen Wright Clayton, chairwoman of the reporting committee and director of the Center for Biomedical Ethics and Society at Vanderbilt University in Nashville, Tennessee. "The message I would want parents to have is one of reassurance."

The report, commissioned in 2009 by the US Health Resources and Services Administration, covers the eight vaccines that comprise the majority of claims filed with the National Vaccine Injury Compensation Program (VICP), which compensates people for adverse health effects from any of 11 vaccines.

Lab studies Show That Light Reduces Fear

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on August 11, 2011

Lab Studies Show that Light Reduces Fear Using mice as model, University of Virginia researchers discover light plays a role in reducing fear and anxiety.

This finding and application may augment the treatment of a variety of mental disorders including depression, anxiety, panic disorders, phobias and post-traumatic stress disorder.

The research builds on earlier findings by biologists and psychologists showing that light affects mood with the new study demonstrating light can modulate fear.

As mice are nocturnal animals, the researchers discovered intense light enhances fear or anxiety in mice, in much the same way that darkness can intensify fear or anxiety in diurnal humans.

The finding is published in the journal Proceedings of the National Academy of Sciences.

“We looked at the effect of light on learned fear, because light is a pervasive feature of the environment that has profound effects on behavior and physiology,” said Brian Wiltgen.

“Light plays an important role in modulating heart rate, circadian rhythms, sleep/wake cycles, digestion, hormones, mood and other processes of the body. In our study we wanted to see how it affects learned fear.”

Fear is a natural mechanism for survival and is often an instinct. For example, fears or reactions to loud noise, sudden movements and heights are innate.

In addition, humans and other mammals can learn from their experiences which may include dangerous or bad situations. This “learned fear” can protect us from dangers.

Unfortunately, this fear can become abnormally accentuated, sometimes leading to debilitating phobias. About 40 million people in the United States suffer from dysregulated fear and heightened states of anxiety.

“Studies show that light influences learning, memory and anxiety,” Wiltgen said. “We have now shown that light also can modulate conditioned fear responses.”

“In this work we describe the modulation of learned fear by ambient light,” said Ignacio Provencio, an expert on light and photoreception.

“The dysregulation of fear is an important component of many disorders, including generalized anxiety disorder, panic disorder, specific phobias and post-traumatic stress disorder.

Understanding how light regulates learned fear may inform therapies aimed at treating some of these fear-based disorders.”

“The implications of this in humans is this: that being diurnal, the absence of light can be a source of fear,” Wiltgen said.

“But increased light can be used to reduce fear and anxiety and to treat depression.

“If we can come to understand the cellular mechanisms that affect this, then eventually abnormal anxiety and fear might be treated with improved pharmaceuticals to mimic or augment light therapy.”

Source: University of Virginia

Pet Owners and Mental Health

 There is significant research that keeping pets can improve your physical health, but did you also know that caring for pets also improves mental health? A study published by the APA, American Psychological Association, found that pet owners rated themselves as happier, healthier, and better adjusted than non-pet owners. The key element that made the difference was the perception on the part of pet owners that their pets gave them a sense that their social needs were met, a sense of belonging, and higher reported self-esteem. Pets decrease our sense of loneliness or isolation. Also, pets require individuals to step out of their own thoughts and feelings to consider the needs of another being, thus encouraging engagement in the world around you. McConnell, et. al. Journal of Personality and Social Psychology 2011, Vol. 101, No. 6, 1239-1252

Co-Sleeping: Parenting Tips to Help Get Your Children Out of Your Bed and Into Their Own

Parents' joy in their children can sometimes turn to frustration when those children refuse to

sleep in their own beds.

There's even a name for the behavior. Experts call it co-sleeping -- when children prefer to sleep in their parents' bed.

Some parents are too embarrassed to admit their children sleep in their beds with them.
While some find nothing wrong with it, the practice has its critics. They say bed sharing can have a negative impact on a child's growth.

"There really are skills that a child needs to be able to learn from sleeping on their own, to self-sooth, to calm themselves, to clear their head," John Carosso, a child psychologist, told "Good Morning America."

In past coverage of the issue of co-sleeping, "GMA" gathered some experts' tips to help get your children out of your beds and into their own:

Tips to End Co-Sleeping

Have a goldfish or small pet in the room to keep children company.
Have a "mommy" or "daddy" teddy bear to snuggle with.

Spend time with children before bed. This is a good time to read to them. You can even have a "sleep party" with mom and dad in the child's bed before they go to sleep.

At the start, use special gifts from the "sleep fairy," like the tooth fairy. If they sleep in their own bed, they get a little morning present.

More Tips From Around the Web

Be tough. According to Parenting.com, after the decision is made, parents need to quit co-sleeping cold turkey. Take midnight visitors back to bed, even if they fight the journey. If there's crying, tough it out.

When it comes to nightmares, treat their irrational fears like tangible ones, says parenting expert Elizabeth Pantley. "After all, most kids believe that the tooth fairy and Big Bird are real, too," Pantley says on her Web site, Pantley.com.

Click HERE to read Pantley's answers to common co-sleeping questions.

Babycenter.com says it's OK to address the child's fears. If they're afraid of the dark, maybe use a nightlight. Monsters under the bed? Give it a check the first few times. "A spray-bottle filled with extra-strength monster-deterrent (a.k.a. water) can also provide late-night comfort," the website says.

Supernanny.com says parents shouldn't forget to praise their children's success when they do sleep alone.

Rates of attention-deficit/hyperactivity disorder (ADHD) in US children

From Medscape Medical News > Psychiatry
ADHD Rates Continue to Rise in the United States

August 22, 2011 — Rates of attention-deficit/hyperactivity disorder (ADHD) in US children

continue to trend upward, report health officials from the Centers for Disease Control and Prevention's National Center for Health Statistics.

According to Lara J. Akinbami, MD, and colleagues, the percentage of American children diagnosed as having ADHD increased from 6.9% in 1998-2000 to 9.0% in 2007 to 2009.

From 1998 through 2009, ADHD prevalence was higher among boys than girls. For boys, ADHD prevalence increased from 9.9% in 1998-2000 to 12.3% in 2007-2009 and for girls from 3.6% to 5.5% during the same period.

ADHD prevalence varied by race and ethnicity, but differences between most groups narrowed from 1998 through 2009, the study authors note.

For non-Hispanic white children, ADHD prevalence increased from 8.2% in 1998-2000 to 10.6% in 2007-2009 and from 5.1% to 9.5% for non-Hispanic black children. Mexican children had consistently lower ADHD prevalence than other racial or ethnic groups.

From 1998 through 2009, ADHD prevalence increased to roughly 10% among children with family income less than 100% of the poverty level and to 11% for those with family income between 100% and 199% of the poverty level.

The report also shows regional differences in ADHD prevalence. In the Midwest, ADHD prevalence rose from 7.1% in 1998-2000 to 10.2% in 2007-2009. In the South, rates rose from 8.1% to 10.3% for the 2 periods.

In 1998-2000, ADHD prevalence was higher in the South region than in all other regions. In 2007-2009, ADHD prevalence was similar in the South and Midwest regions; prevalence in these 2 regions was higher than in the Northeast and West regions, the report indicates.

Dr. Akinbami and colleagues note that these prevalence estimates "are based on parental report of the child ever receiving a diagnosis and thus may be affected by the accuracy of parental memory (including recall bias), by differential access to healthcare between groups (diagnostic bias), or by willingness to report an ADHD diagnosis."

They also point out that it was not possible to discern whether rising prevalence of ADHD "indicates a true change in prevalence or increased detection and diagnosis of ADHD."

Nevertheless, the societal costs of ADHD — including those associated with medical, educational, and criminal justice resources — are large, they write.

ADHD is one of the most common mental health disorders of childhood. Hallmark symptoms, including difficulty staying focused and controlling behavior, begin in childhood and often persist into adulthood, leading to functional impairment in academic, family, and social settings. The causes and risk factors are unknown, but genetic factors likely play a role.

National Center for Health Statistics Brief. 2011:70.

Change, Adjust or Leave. Deciding what to do in a relationship.

Unavoidably, we are faced with major obstacles in life. These obstacles could take the form of relationships, employment or other areas. Decisions need to be made regarding what course of action needs to be taken. We invest a great deal of time and energy trying to make these situations work. The end result that we desire may not be realistic or achievable. The investment in time and energy in cases such as this, could be better used deciding where to invest your energy... change, adjust or leave. Realizing there is more than one option is helpful for most people who feel stuck.

Change: The situation in which you currently find yourself is uncomfortable and you desire to change it. There is some ability to change or alter the situation. The party(s) involved are willing to negotiate or compromise on the matter at hand. This does not necessarily mean a 50/50 compromise, but enough negotiation to make things more comfortable. Situations that fall under this would include: a spouse that would be willing to cut back on drinking, a supervisor changing certain policies you find uncomfortable, or family member changing  or modifying an undesirable behavior. The time and energy you spend is invested towards changing the situation and the other person(s) involved is willing to compromise to some degree.

Adjust: The situation in which you currently find yourself in could not be modified. The individual or situation is not able or willing to change. You accept the limitations of the situation and choose to direct your energy and time into adjusting to an uncomfortable and unchangeable situation. The adjustment comes in  knowing you can't change the situation and accept your limitations. This is also means that for whatever reasons you are choosing not to leave. These reasons could be based on financial, emotional, or something else. This does not mean you condone what is going on but just accept you can't change it nor are ready to leave. Situations that would fall under this include: a spouse who most likely will not stop drinking, an inflexible supervisor, or a family member unwilling to change offensive behavior. By choosing to focus on this area, you have decided that you can endure the situation and this does not compromise your values to a great degree.

Leave: The situation in which you currently find yourself in is unacceptable. By staying in the situation, you realize it will too uncomfortable or unhealthy. The energy you expend is best directed toward leaving. Change is not possible and adjusting is not in your best interests.  Examples include: a significant other that is physically abusive or a job that has no future.

What is RTI?

The “No Child Left Behind” legislation requires schools to provide educational review and assistance for students in general education classes who may struggle or have needs in a particular area. RTI stands for Response to Intervention, a process whereby schools provide assistance to students to enhance and enrich their learning or success in school.  RTI generally uses a three tier model like a pyramid. At the bottom of the pyramid is Tier 1. Tier 1 identification and interventions occur in the classroom and may be school wide including differentiated instruction to teach to the strengths of each child including classroom reward systems or incentives to encourage participation or reward skills or behavior that are essential to student growth. Tier 2 interventions are comprised of assistance that may occur outside of the classroom or inside the classroom. These may be group or individually focused based on what may be needed including math or reading pull out groups to assist students in learning skills that will enhance and improve their skills. For students with behavioral or emotional difficulties, this may include participation in a group or individual counseling services at school. Tier 3 or the top of the pyramid usually consists of interventions provided in another context, individual, group, or pull out services or consultation with specialized education personnel to collect data and tailor individualized interventions. The goal of the educational team at each level is to provide assistance to general education students that will address their identified needs. In addition, collection of data occurs at all levels to assist teachers, staff, and administrators in determining the success of interventions. As a child responds to interventions and strengthens the skills they need to strengthen, they will, over time, have less need for the intervention. Progress is continually monitored by the educational team to ensure that students receive the support they need when they need it and only for as long as it is needed.

Is childhood abuse behind tough-to-treat depression?

(CBS) Why do some depressed people never seem to get better? A provocative new study suggests it may come down to the amount of mistreatment they experienced as kids.

A new study suggests adults who were abused as children are twice as likely to develop lasting bouts of depression as their counterparts who did not experience childhood mistreatment. And scientists say that can seriously impact their treatment and recovery.

For the study - published in the August 14 issue of the American Journal of Psychiatry - researchers reviewed 26 studies on 23,000 people where they saw the increased likelihood of recurrent depression among adults who were abused as kids. The researchers say previous studies show mistreated children and adults have more "biological abnormalities" in the brain, endocrine and immune system, which could alter treatment.

"Childhood maltreatment is associated both with an increased risk of developing recurrent and persistent episodes of depression, and with an increased risk of responding poorly to treatment," study author Dr. Andrea Danese, professor of child and adolescent psychiatry at King's College London, said in a written statement. The researchers found antidepressant medication, psychological treatment, or combinations of the two were less effective in those who suffered childhood abuse.

Danese told Reuters that knowing a formerly abused patient won't respond to treatment may "be valuable for clinicians in determining patients' prognosis."

What treatments would work then? The authors themselves aren't sure. Study co-author Dr. Rudolf Uher, a professor of psychiatry at Kings College told Reuters treatments may focus on the "biological vulnerabilities associated with childhood maltreatment." The hope is future treatments would be given preventively at an earlier age to be more effective long term.

An estimated one in 10 American adults are depressed, but the disease goes beyond feeling down in the dumps. It can adversely affect other conditions such as arthritis, asthma, cancer, diabetes, heart disease, and obesity. The World Health Organization estimates that by 2020, depression will be the second-leading contributor to the world's global disease burden.

Danese said in a written statement, "Identifying those at risk of multiple and long-lasting depressive episodes is crucial from a public health perspective."

Process versus Results

Individuals making important decisions in life at times could find themselves immobilized but focusing too much on end results. While possible outcomes are helpful to look at when making a big decision, we need to remember there are many intangibles involved that impact on the actual results.

An example of this would be a wife of an alcoholic decides to divorce her husband after many unsuccessful years of trying to get him to stop drinking. After the divorce he could choose to remarry and stop drinking. This does not mean she made the wrong decision. At the time she choose to take an action based on information she had at her disposal, such as, years he was drinking, repeated requests to stop, financial and emotional resources that were effected by his drinking, and where she was at emotionally.

If we look back or evaluate the process involved in making a decision we are choosing NOT to making ourselves responsible for other peoples actions. We cannot control outcomes but can control ourselves. The effort and thought in making a decision is more important than the results.

Depression linked to stroke, vitamin D may help both

By David Liu, Ph.D.

Saturday, Aug 13, 2011 (foodconsumer.org) -- Being chronically depressed may be a sign of higher risk of stroke, according to a study in Stroke: Journal of the American Heart

Association.

The study led by Kathryn Rexrode, M.D.at Brigham and Women's Hospital in Boston, Mass found women who had a history of depression was at 29 percent higher risk of total stroke.

The study also found women who used anti-depressant medications particularly selective serotonin reuptake inhibitors were associated with a 39 percent increased risk of stroke. Anti-depressant drugs included Prozac, Celexa and Zoloft.

But the researchers speculated that it is not the medications that cause a higher risk of stroke. Instead use of the drugs only indicates that depression in the patients was more severe.

The study involved in 80,574 women ages 54 to 79 years in the Nurses' Health Study. Participants had no history of stroke at baseline. During the six-year follow-up, prevalence of depression at baseline was 22 percent in the participants and 1,033 strokes were identified.

Depressed women were often those who were single, smoking, and less physically active, according to the study. They were also more likely to have a higher body mass index, and diseases like heart disease, diabetes and high blood pressure, compared to women without a history depression.

A healthy observer said the study suggests what increases the risk of depression may also increase the risk of stroke and vitamin D can be the missing link between the two.

One study in the American Journal of Clinical Nutrition found men who had intake of 600 IU or more of vitamin D per day were 28 percent less likely to suffer stroke and heart attack, compared with those who had an intake of only 100 IU or less per day. In women, the risk reduction was 16 percent.

The study was conduced by Qi Sun of the Harvard School of public Health in Boston MA.

Another study published in 2008 in the journal Circulation linked low serum vitamin D levels with 60 percent higher risk for heart attack, stroke and heart failure, compared with those who had high levels of vitamin D.

Dr. Thomas Wang of Harvard Medical School in Boston, Massachusetts and colleagues who conducted the study also reported that the association was even stronger among those with high blood pressure.

For the study, Wang et al. followed up 1,739 people at an average age of 59 in the Framingham Heart Study for five years.

Now low serum vitamin D is also associated with high risk of depression.

Nanri A and colleagues from International Medical center of Japan in Shinjuku-ku, Tokyo, Japan reported on Aug 19, 2009 in the European Journal of Clinical Nutrition that people who had highest levels of vitamin D were 49 percent less likely to feel depressed.

In winter, high levels of vitamin D were found associated with lower risk of depression, particularly severe depression.

Many other studies also suggest that vitamin D can be the cause for depression.

Brain's synaptic pruning continues into your 20s

Brain's synaptic pruning continues into your 20s

16:07 17 August 2011 by Wendy Zukerman and Andrew Purcell
Magazine issue 2826. Subscribe and save
For similar stories, visit the Teenagers and The Human Brain Topic Guides
The synaptic pruning that helps sculpt the adolescent brain into its adult form continues to weed out weak neural connections throughout our 20s. The surprise finding could have implications for our understanding of schizophrenia, a psychological disorder which often appears in early adulthood.

As children, we overproduce the connections – synapses – between brain cells. During puberty the body carries out a kind of topiary, snipping away some synapses while allowing others to strengthen. Over a few years, the number of synapses roughly halves, and the adult brain emerges.

Or so we thought. Pasko Rakic at Yale University and colleagues at the University of Zagreb, Croatia, and the VU University Medical Center in Amsterdam, the Netherlands, have now found that the brains of adults in their 20s are still subject to synaptic pruning.

Rakic's team analysed post-mortem tissue from a brain region called the prefrontal cortex (PFC) in 32 people aged between 1 week old and 91 years. Specifically, they calculated the density of dendritic spines – the tiny projections that protrude from the neuron's long dendrites, each of which facilitates communication with other neurons through a synapse.

As expected, Rakic's team found that spine density increased rapidly during infancy, reaching a peak before the 9th birthday. It then began to fall away as pruning began. Intriguingly, though, spine density did not plateau after adolescence, as might have been expected, but continued to fall gradually until the late 20s.

Rakic says the result could be good news for those hoping to gain new skills in their third decade. The period of pruning is associated with a heightened ability to learn – whether that is in picking up language skills or understanding new concepts, he says. "You should not give up learning just because you're in your 20s – it isn't too late," he says.

The finding also has implications for our understanding of some psychiatric disorders. The PFC is thought to be particularly relevant to late-onset disorders such as schizophrenia, says Rakic, but it is unclear whether such disorders are triggered by developmental or degenerative processes. The new finding is likely to give weight to the idea that schizophrenia emerges as a result of late brain development.

"I'm sure that for many people schizophrenia has a strong developmental component," says Sabine Bahn, who researches schizophrenia at the University of Cambridge – although she adds that some cases will likely have a degenerative component.

Elena Bagley at the University of Sydney, Australia, agrees with the conclusion. It is possible that the prefrontal cortex "is susceptible for longer to disorders and disease that result from abnormal pruning", she says. Such pruning may also contribute to memory loss and dementia, she adds.

Journal reference: Proceedings of the National Academy of Sciences, DOI: 10.1073/pnas.1105108108