HEART: THE TUBES WHICH GET BLOCKED – THE CORONARY ARTERIES

Posted on April 19, 2011 by admin
When the heart supplies the blood to the aorta (the main artery of the body) it retains two branches for its own supply. The muscles of the heart, which have to contract continuously, need a continuous supply of blood. This blood brings food and oxygen – which gives it power in the form of calories.
The tubes are called coronary tubes, because when they divide and re-divide, they look like a king’s crown. There are two main tubes that form this crown. The one on the right side is called the right coronary artery or RCA, which has a diameter of 5 mm. It has a series of branches as it goes down and circles around the right side of the heart and proceeds as the PDA. This tube can be divided into three parts – proximal third, middle third and distal third.
The branch on the left is called the left main (LM) which immediately divides into two branches.
The first branch, the left anterior descending (LAD), is so named as it artery (supplies to the front (called anterior in medical language) of the heart and goes down (called descending in medical language), supplies blood through numerous branches to the heart muscles. It supplies
blood to some branches in the right, called the septal branches (named as S1 S2, S3 and so on) and some in the left called diagonal branches (D1, D2, D3 and so on). For purpose of easy description, this artery (LAD) can also be divided into three parts – proximal third, middle third and distal third. The LAD is bigger than RCA in size and is more important as it supplies to the main part of the heart ‘chamber 4 or the left ventricle’.
The second branch on the left side of the heart is called the left circumflex (LCx) as it circles down the circumference of the heart on the left side. It is a little smaller than the RCA in size. The circumflex artery branches out to supply all the areas in the back of the left side of the heart. Some of the branches of this tube are called obtuse marginals and are expressed as OM1 OM2, OM3 and so on.
The size of these branches varies from one person to another and there are often minute variations in the branches and supply areas. Seen from angiography (photograph of the heart after injecting radio-opaque dye) the branches look like the following diagram when seen from different angles.
*7/283/5*
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GENESIS OF BACKACHE: THE STUCTURES CAUSING BACKACHE – DISCS

Posted on March 26, 2011 by admin
As mentioned earlier, discs are involved in the genesis of backache in a secondary way most of the time. Primary disc conditions arise out of acute trauma or injury, as in an accident or fall. Discs can degenerate due to age when the blood supply to them gets affected. If the person puts on a lot of weight, the pressure on the discs increases and after some time the sac that contains the gelatinous substance becomes weak in a certain area. This makes the disc bulge with the substance penetrating into the softened area. Just as a stretched balloon becomes easy to blow up, due to loss of elasticity, the discs too can bulge without offering resistance when their walls are stretched and weakened. Once a disc bulges for the first time, it creates a weakness in its walls. It can then bulge again and again in future. This explains why people get recurrent attacks of ‘slipped disc’ if they do not look after their spine. Therefore it is very important to take preventive measures like weight loss, exercises, nutrition etc to manage the spine after the first acute attack.
Sometimes discs rupture due to trauma or other factors that weaken their sacs over a long period of time. The ruptured disc can impinge the nerve and cause permanent backache with a range of neurological symptoms. A ruptured disc is difficult to manage conservatively and often requires surgical intervention. This is the worst type of back problem as the very integrity of an important structure of the back is affected.
*142\330\8*

GENESIS OF BACKACHE: THE STUCTURES CAUSING BACKACHE – DISCSAs mentioned earlier, discs are involved in the genesis of backache in a secondary way most of the time. Primary disc conditions arise out of acute trauma or injury, as in an accident or fall. Discs can degenerate due to age when the blood supply to them gets affected. If the person puts on a lot of weight, the pressure on the discs increases and after some time the sac that contains the gelatinous substance becomes weak in a certain area. This makes the disc bulge with the substance penetrating into the softened area. Just as a stretched balloon becomes easy to blow up, due to loss of elasticity, the discs too can bulge without offering resistance when their walls are stretched and weakened. Once a disc bulges for the first time, it creates a weakness in its walls. It can then bulge again and again in future. This explains why people get recurrent attacks of ‘slipped disc’ if they do not look after their spine. Therefore it is very important to take preventive measures like weight loss, exercises, nutrition etc to manage the spine after the first acute attack.Sometimes discs rupture due to trauma or other factors that weaken their sacs over a long period of time. The ruptured disc can impinge the nerve and cause permanent backache with a range of neurological symptoms. A ruptured disc is difficult to manage conservatively and often requires surgical intervention. This is the worst type of back problem as the very integrity of an important structure of the back is affected.*142\330\8*

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MALE SEXUAL RESPONSE: THE RESOLUTION PHASE & REFRACTORY PERIOD

Posted on March 21, 2011 by admin
During the resolution phase, there is a quite rapid return to the preexcitement state. The penis will detumefy, or lose its swelling. This loss of erection occurs in two stages; the first happens rapidly, as the cavernous bodies empty, leaving the penis still somewhat enlarged. The second stage occurs more slowly, as the spongy body and glans empty. The duration of this second stage depends somewhat on the man’s activity. If he remains in close body contact with his partner, it often will last longer.
The testicles revert to their usual size and position, as the scrotal sac lowers. Sex flush, if it appeared, now fades; the body may be sweaty. The nipples lose their erection.
An aspect of the sexual response cycle which is believed to be unique to the male is the refractory period, which immediately follows orgasm and extends into the resolution phase. A refractory period, in general biological terms, refers to the time period in which a cell, tissue, or organ may not respond to a second stimulation until a certain period of time has elapsed since the preceding stimulation. In terms of the sexual response cycle, this means that, regardless of the nature and intensity of sexual stimulation, the male will not respond physiologically, that is, he cannot experience erection and orgasm, until the refractory period is over. There is no precise specification for the length of the refractory period; it will vary with situation, age, amount of alcohol in the system, and other factors.
Women presumably do not have such a refractory period, as evidenced by the ability of some women to be multiorgasmic. Some men, especially younger men, report themselves to be capable of multiple orgasms on occasion; as stated above, this is an as yet unexplored area which calls for further research.
Although we utilize the Masters and Johnson model of the sexual response cycle throughout this book, an alternative conceptualization of the physiological sexual process deserves mention — Helen Singer Kaplan’s biphasic model (Kaplan, 1974).
*131\265\8*

MALE SEXUAL RESPONSE: THE RESOLUTION PHASE & REFRACTORY PERIODDuring the resolution phase, there is a quite rapid return to the preexcitement state. The penis will detumefy, or lose its swelling. This loss of erection occurs in two stages; the first happens rapidly, as the cavernous bodies empty, leaving the penis still somewhat enlarged. The second stage occurs more slowly, as the spongy body and glans empty. The duration of this second stage depends somewhat on the man’s activity. If he remains in close body contact with his partner, it often will last longer.The testicles revert to their usual size and position, as the scrotal sac lowers. Sex flush, if it appeared, now fades; the body may be sweaty. The nipples lose their erection.An aspect of the sexual response cycle which is believed to be unique to the male is the refractory period, which immediately follows orgasm and extends into the resolution phase. A refractory period, in general biological terms, refers to the time period in which a cell, tissue, or organ may not respond to a second stimulation until a certain period of time has elapsed since the preceding stimulation. In terms of the sexual response cycle, this means that, regardless of the nature and intensity of sexual stimulation, the male will not respond physiologically, that is, he cannot experience erection and orgasm, until the refractory period is over. There is no precise specification for the length of the refractory period; it will vary with situation, age, amount of alcohol in the system, and other factors.Women presumably do not have such a refractory period, as evidenced by the ability of some women to be multiorgasmic. Some men, especially younger men, report themselves to be capable of multiple orgasms on occasion; as stated above, this is an as yet unexplored area which calls for further research.Although we utilize the Masters and Johnson model of the sexual response cycle throughout this book, an alternative conceptualization of the physiological sexual process deserves mention — Helen Singer Kaplan’s biphasic model (Kaplan, 1974).*131\265\8*

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BACH FLOWER REMEDIES: DR. BACH’S PHILOSOPHY – THE NEGATIVE SIDE OF THE REMEDIES

Posted on March 8, 2011 by admin
All great people—world leaders, religious heads, saints— with their own virtuous lives taught their followers to follow such principles as would remove adverse effects of any impediments in the smooth flow of their lives. These virtues are listed as: (1) Love, (2) Sympathy, (3) Mental peace, (4) Firmness, (5) Humidity, (6) Strength, (7) Understanding, (8) Toleration, (9) Wisdom, (10) Forgiveness, (11) Courage, (12) Happiness.   When we develop the above virtues in ourselves, we are assisting in raising the life-style of the human race. We feel, and correctly so, that we are not doing anything for our selfish benefit, and it is good for all men, poor, rich, healthy and handicapped to feel that being a part of God’s creation, they can also play their part without let or hinderance. The above virtues represent the positive side of remedies. Just as the above virtues act as steps to man’s perfection, there are some challenges which obstruct his path, and provide him the occasion to train himself for fighting against odds, and give him added determination to pursue his chosen path. These challenges take the form of disease which affects the mind and appear as disease-symptoms of the body. Flower Remedies provide counter-strength to the mind to offset the effect of these obstructions which are:
(1) Possessiveness, selfishness.
(2) Fear.
(3) Mental pain hidden behind a facade of external peace
(4) Indecision, always in two minds.
(5) Indifference, lack of attention, lack of interest.
(6) Weakness of will; inability to recover after illness.
(7) Doubt, pessimism, depression.
(8) Over-enthusiasm.
(9) Impatience.
(10) Ignorance.
(11) Terror.
(12) Grief.
These remedies can be prescribed for self or others, by anybody, and so long as it corresponds to the mental condition of the patient, it must show its utility.
The above obstructions represent the negative side of the remedies. Sometimes when negative side of the remedy is not clearly shown in the mental state of the patient, the positive side would be available from the virtue of the remedy. The Bach Flower Remedy can be selected on the basis of its positive side.
*28\308\8*

BACH FLOWER REMEDIES: DR. BACH’S PHILOSOPHY – THE NEGATIVE SIDE OF THE REMEDIESAll great people—world leaders, religious heads, saints— with their own virtuous lives taught their followers to follow such principles as would remove adverse effects of any impediments in the smooth flow of their lives. These virtues are listed as: (1) Love, (2) Sympathy, (3) Mental peace, (4) Firmness, (5) Humidity, (6) Strength, (7) Understanding, (8) Toleration, (9) Wisdom, (10) Forgiveness, (11) Courage, (12) Happiness.   When we develop the above virtues in ourselves, we are assisting in raising the life-style of the human race. We feel, and correctly so, that we are not doing anything for our selfish benefit, and it is good for all men, poor, rich, healthy and handicapped to feel that being a part of God’s creation, they can also play their part without let or hinderance. The above virtues represent the positive side of remedies. Just as the above virtues act as steps to man’s perfection, there are some challenges which obstruct his path, and provide him the occasion to train himself for fighting against odds, and give him added determination to pursue his chosen path. These challenges take the form of disease which affects the mind and appear as disease-symptoms of the body. Flower Remedies provide counter-strength to the mind to offset the effect of these obstructions which are:(1) Possessiveness, selfishness.(2) Fear.(3) Mental pain hidden behind a facade of external peace(4) Indecision, always in two minds.(5) Indifference, lack of attention, lack of interest.(6) Weakness of will; inability to recover after illness.(7) Doubt, pessimism, depression.(8) Over-enthusiasm.(9) Impatience.(10) Ignorance.(11) Terror.(12) Grief.These remedies can be prescribed for self or others, by anybody, and so long as it corresponds to the mental condition of the patient, it must show its utility.The above obstructions represent the negative side of the remedies. Sometimes when negative side of the remedy is not clearly shown in the mental state of the patient, the positive side would be available from the virtue of the remedy. The Bach Flower Remedy can be selected on the basis of its positive side.*28\308\8*

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QUICK REFERENCES: SYMPTOMS AND ACTION – FOOD ALLERGY

Posted on February 26, 2011 by admin
1 Collect information.
2 See if your doctor can help.
3 Keep the bowel clean.
4 Avoid junk foods, additives, dairy produce and wheat (even before you have done your sleuthing).
5 Try exclusion or rotation diets.
6 Reactions after eating certain foods:
a) If your mouth swells or you have breathing difficulties, get medical help at once
b) If you experience flushing, palpitations, indigestion, hyperactivity or any symptom which does not need medical help and that you know is associated with what you have eaten, you could try turning the reaction off by taking:
• J teaspoonful of bicarbonate of soda in warm water, or
• one Alka Seltzer in water, or
• 1 gram of vitamin C, preferably in powder form. If you do use vitamin C remember it can be a stimulant.
7 Cool down. Research shows that food allergies are worse when you are hot. Have a cool shower, splash your face and hands with cold water or place a cold cloth on the forehead.
8 Try eating something else. Some people say that if they eat something they have no problems with, it seems to relieve the symptoms.
9 Build up your immune system by looking after your general health and taking supplements; EFAs (essential fatty acids) found in olive oil, fish oils and evening primrose oil can be helpful.
*150\326\8*

QUICK REFERENCES: SYMPTOMS AND ACTION – FOOD ALLERGY1 Collect information.2 See if your doctor can help.3 Keep the bowel clean.4 Avoid junk foods, additives, dairy produce and wheat (even before you have done your sleuthing).5 Try exclusion or rotation diets.6 Reactions after eating certain foods:a) If your mouth swells or you have breathing difficulties, get medical help at onceb) If you experience flushing, palpitations, indigestion, hyperactivity or any symptom which does not need medical help and that you know is associated with what you have eaten, you could try turning the reaction off by taking:• J teaspoonful of bicarbonate of soda in warm water, or• one Alka Seltzer in water, or• 1 gram of vitamin C, preferably in powder form. If you do use vitamin C remember it can be a stimulant.7 Cool down. Research shows that food allergies are worse when you are hot. Have a cool shower, splash your face and hands with cold water or place a cold cloth on the forehead.8 Try eating something else. Some people say that if they eat something they have no problems with, it seems to relieve the symptoms.9 Build up your immune system by looking after your general health and taking supplements; EFAs (essential fatty acids) found in olive oil, fish oils and evening primrose oil can be helpful.*150\326\8*

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SURGICAL APPROACHES TO EPILEPSY: SURGERY SHOULD ONLY BE PERFORMED AFTER CAREFUL EVALUATION

Posted on February 21, 2011 by admin
Surgery should only be performed after careful evaluation in an epilepsy center with full capabilities for both evaluation and surgery, and then only after careful consideration of the alternatives.
Three major types of epilepsy surgery are currently performed: “focal excision,” which removes the epileptic area thought to be triggering the seizures; “hemispherectomy,” or partial hemispherectomy, which removes all or much of one side of the brain when large areas are electrically and functionally abnormal; and “corpus callosum sectioning,” an operation cutting the tissue connecting the two hemispheres, thus preventing the spread of the seizures to the other side of the brain. Although modifications of these and other procedures may be devised for specific patients and specific problems, we discuss here only these three more commonly performed procedures. Each is appropriate only for specific seizure problems, and each has its own risks and benefits.
*152\208\8*

SURGICAL APPROACHES TO EPILEPSY: SURGERY SHOULD ONLY BE PERFORMED AFTER CAREFUL EVALUATIONSurgery should only be performed after careful evaluation in an epilepsy center with full capabilities for both evaluation and surgery, and then only after careful consideration of the alternatives.Three major types of epilepsy surgery are currently performed: “focal excision,” which removes the epileptic area thought to be triggering the seizures; “hemispherectomy,” or partial hemispherectomy, which removes all or much of one side of the brain when large areas are electrically and functionally abnormal; and “corpus callosum sectioning,” an operation cutting the tissue connecting the two hemispheres, thus preventing the spread of the seizures to the other side of the brain. Although modifications of these and other procedures may be devised for specific patients and specific problems, we discuss here only these three more commonly performed procedures. Each is appropriate only for specific seizure problems, and each has its own risks and benefits.*152\208\8*

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SUMMARY OF INTENSIVE MANAGEMENT OF TYPE 1 DIABETES: GUIDELINES FOR CARE & NEPHROPATHY

Posted on February 11, 2011 by admin
Guidelines for Care
A compelling rationale is to have a goal of achieving normal levels of key clinical and biochemical markers. Fortunately, this goal of “normalcy” can be defended on the basis of large-scale, prospective clinical trials. In some systems, an action level is set, which is typically modestly greater than the normal goal. Although some may find this useful, others simply want to know the goal to strive for, with recognition that it may not always be possible to achieve. In diabetes, this is particularly true in the case of glycemic regulation, in which severe hypoglycemia (requiring the assistance of others) may be a serious limiting factor. This is particularly true for type 1 diabetes and is the major reason that the HbA1 c goal is set at < 7%, instead of at the top normal for most laboratories of 6%.
Nephropathy
Microalbuminuria (> 30 mg/24 hours) is the first sensitive clinical indicator of diabetic nephropathy. Progression to clinical albuminuria (> 300 mg albumin/24 hours) is delayed or prevented by intensive glucose management and control of blood pressure to the goal of < 130/80 mmHg. ACE inhibitors and/or angiotensin receptor blockers are the agents of first choice and delay progression to end stage renal disease in patients with clinical proteinuria and elevated serum creatinine levels.
*231\357\8*

SUMMARY OF INTENSIVE MANAGEMENT OF TYPE 1 DIABETES: GUIDELINES FOR CARE & NEPHROPATHYGuidelines for CareA compelling rationale is to have a goal of achieving normal levels of key clinical and biochemical markers. Fortunately, this goal of “normalcy” can be defended on the basis of large-scale, prospective clinical trials. In some systems, an action level is set, which is typically modestly greater than the normal goal. Although some may find this useful, others simply want to know the goal to strive for, with recognition that it may not always be possible to achieve. In diabetes, this is particularly true in the case of glycemic regulation, in which severe hypoglycemia (requiring the assistance of others) may be a serious limiting factor. This is particularly true for type 1 diabetes and is the major reason that the HbA1 c goal is set at < 7%, instead of at the top normal for most laboratories of 6%. NephropathyMicroalbuminuria (> 30 mg/24 hours) is the first sensitive clinical indicator of diabetic nephropathy. Progression to clinical albuminuria (> 300 mg albumin/24 hours) is delayed or prevented by intensive glucose management and control of blood pressure to the goal of < 130/80 mmHg. ACE inhibitors and/or angiotensin receptor blockers are the agents of first choice and delay progression to end stage renal disease in patients with clinical proteinuria and elevated serum creatinine levels.*231\357\8*

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UNMODIFIED RISK FACTORS OF CORONARY ARTERY DISEASE: HEREDITY

Posted on January 21, 2011 by admin
Risk factors for heart disease that cannot be changed are heredity (family history), age, and sex. Your risk of coronary artery disease is higher if you have a close relative (mother, father, brother, or sister) who developed coronary artery disease before age 55. Your risk also increases as you age. Women in general have a lower risk than men, at least until menopause, but as they get older, their risk increases. Women who smoke lose much of this advantage and have a risk of coronary artery disease similar to that in men.
Heredity
If one or both of your parents or another close blood relative had a heart attack at a young age, your risk for the development of coronary artery disease is higher than someone whose family has no members with heart disease. Even if you have eliminated risks that were not so well known a generation ago, such as smoking or high blood cholesterol, the fact that your father, for example, died of a heart attack at age 50 makes your risk somewhat higher than the risk for someone who does not have this family history.
The greatest inherited risk is in people with familial hypercholesterolemia (a genetic predisposition to have dangerously high cholesterol levels). Other genetic factors passed on from parents to children may promote the development of moderately high cholesterol levels, high blood pressure, diabetes, or obesity. There is also a genetic link for a disorder known as idiopathic dilated cardiomyopathy. A Mayo Clinic study of 59 patients with this form of cardiomyopathy and 315 of their relatives found up to 20 percent of the families had additional family members who showed signs of the disease.
Families pass on more than genes. The types of food you eat, your exercise habits, and whether you smoke are often strongly influenced by your family. Exposure to tobacco smoke in the home, even if you do not smoke, is an additional health risk.
Your genes neither doom you to nor fully protect you from the risk of heart disease. You can make a big difference by evaluating and controlling other risk factors, especially smoking, high blood pressure, and high blood cholesterol. Being aware of your history can be an extra incentive to develop more healthful habits.
*223\252\8*

UNMODIFIED RISK FACTORS OF CORONARY ARTERY DISEASE: HEREDITYRisk factors for heart disease that cannot be changed are heredity (family history), age, and sex. Your risk of coronary artery disease is higher if you have a close relative (mother, father, brother, or sister) who developed coronary artery disease before age 55. Your risk also increases as you age. Women in general have a lower risk than men, at least until menopause, but as they get older, their risk increases. Women who smoke lose much of this advantage and have a risk of coronary artery disease similar to that in men.HeredityIf one or both of your parents or another close blood relative had a heart attack at a young age, your risk for the development of coronary artery disease is higher than someone whose family has no members with heart disease. Even if you have eliminated risks that were not so well known a generation ago, such as smoking or high blood cholesterol, the fact that your father, for example, died of a heart attack at age 50 makes your risk somewhat higher than the risk for someone who does not have this family history.The greatest inherited risk is in people with familial hypercholesterolemia (a genetic predisposition to have dangerously high cholesterol levels). Other genetic factors passed on from parents to children may promote the development of moderately high cholesterol levels, high blood pressure, diabetes, or obesity. There is also a genetic link for a disorder known as idiopathic dilated cardiomyopathy. A Mayo Clinic study of 59 patients with this form of cardiomyopathy and 315 of their relatives found up to 20 percent of the families had additional family members who showed signs of the disease.Families pass on more than genes. The types of food you eat, your exercise habits, and whether you smoke are often strongly influenced by your family. Exposure to tobacco smoke in the home, even if you do not smoke, is an additional health risk.Your genes neither doom you to nor fully protect you from the risk of heart disease. You can make a big difference by evaluating and controlling other risk factors, especially smoking, high blood pressure, and high blood cholesterol. Being aware of your history can be an extra incentive to develop more healthful habits.*223\252\8*

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HOW OFTEN SHOULD YOU MEET WITH TEACHERS OF YOUR CHILD WITH ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER)

Posted on January 7, 2011 by admin
Q: How often should my wife and I meet with our son’s teachers? Is twice a year sufficient?
A: I’d suggest a more frequent schedule, perhaps every month or two if possible. The important thing is to stay in close contact with your son’s teachers so that everyone is kept well informed.
Parents should use these regular conferences to notify teachers of any changes in a child’s treatment, medication, or home life, as well as any difficulties in getting the child to do his homework. Teachers can use the time to inform parents of any changes—good or bad—in the child’s classroom behavior, learning skills, or social situation.
Unfortunately, many parents find it difficult working so closely with their child’s teacher. They may feel intimidated or put off by the instructor, who is often forced to do a massive job under extremely difficult circumstances.
Teachers, too, may feel uncomfortable with this relationship. They may feel intruded upon or intimidated, especially if parents are overly strident in their efforts to make sure that their child is receiving everything to which he is entitled.
This is a sensitive alliance that works best when developed and nurtured at the beginning of every school year. The more parents can get a teacher to understand their child, the better off the child will be. But everyone must take into consideration the feelings and opinions of others. Remember: You’re a team working toward the same goal. As such, compromise and understanding make up half the battle.
*116\173\2*

HOW OFTEN SHOULD YOU MEET WITH TEACHERS OF YOUR CHILD WITH ADHD (ATTENTION DEFICIT HYPERACTIVITY DISORDER)Q: How often should my wife and I meet with our son’s teachers? Is twice a year sufficient?A: I’d suggest a more frequent schedule, perhaps every month or two if possible. The important thing is to stay in close contact with your son’s teachers so that everyone is kept well informed.Parents should use these regular conferences to notify teachers of any changes in a child’s treatment, medication, or home life, as well as any difficulties in getting the child to do his homework. Teachers can use the time to inform parents of any changes—good or bad—in the child’s classroom behavior, learning skills, or social situation.Unfortunately, many parents find it difficult working so closely with their child’s teacher. They may feel intimidated or put off by the instructor, who is often forced to do a massive job under extremely difficult circumstances.Teachers, too, may feel uncomfortable with this relationship. They may feel intruded upon or intimidated, especially if parents are overly strident in their efforts to make sure that their child is receiving everything to which he is entitled.This is a sensitive alliance that works best when developed and nurtured at the beginning of every school year. The more parents can get a teacher to understand their child, the better off the child will be. But everyone must take into consideration the feelings and opinions of others. Remember: You’re a team working toward the same goal. As such, compromise and understanding make up half the battle.*116\173\2*

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THINGS PEOPLE SAY WHEN THEY ARE MOVING FORWARD AND SELF HELP GROUPS FOR DEPRESSION.

Posted on December 30, 2010 by admin

THINGS PEOPLE SAY WHEN THEY ARE ‘MOVING FORWARD’ AND SELF-HELP GROUPS FOR DEPRESSION

 

‘For the first time I could feel the effect my depression was having on my wife/children/secretary’, etc.
‘My facial muscles felt strange—then I realized that I was smiling at a baby’.
‘I woke up thinking pleasurably about a cup of coffee instead of how I would get through the day.’
‘I bought a packet of seeds. For the first time I was thinking beyond the gloomy moment.’
‘I was halfway through a board meeting/the ironing/the weekly shopping, when I realized that I was not resenting every minute of it.’
‘I actually started a conversation.’
Self-Help Groups For Depression
Working in a group towards health can be of great benefit. See if there is a depression self-help group in your area. Guard against an exchange of symptoms without a positive approach and be prepared to accept that someone close to you may feel threatened when they see you changing. They may feel safe when you are
‘I forced myself to tidy the shed, then was astonished to
find, when I went indoors, that two hours had passed’.
‘I realized that the birds had not stopped singing. I had shut my ears to them.’
‘For the first time in years my regular business trips to the States seemed like a normal thing to do.’
‘I bought a book at the airport and did not feel thoroughly irritated when a child dropped ice cream on my shoe. They may seem small things, but I feel really free’.

*38\49\8*

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