Death by Dr. Carl Jung, MD

https://www.youtube.com/watch?v=LOxlZm2AU4o&ebc=ANyPxKrzF3QWbfMhvuEm4dq862_GXG-exIs0PRZRjqyziDuirv3nZaVSpJYpmB6-Fgvz_xxnM3dhFO_R9SYFGerHjm87OPl9hg

An Examination of Death from Dr. Carl Jung, MD on the direction 

towards to Death. Think on the line of Nature According the 

Honorable Doctor .

Pre-Anticiptoray Care toward Cancer

For people diagnosed with cancer, the risk of cancer death falls as physical activity rises, according to a new analysis of more than 70 existing studies.

Researchers found the same holds true for everyone - supporting the current World Health Organization recommendation of moderate physical activity to combat the risk of chronic disease, they write in the British Journal of Sports Medicine.

The WHO recommends two and a half hours of moderate exercise per week for some health benefit and five hours of moderate exercise per week for additional benefit. Half as much time per week of vigorous physical activity, like running, may confer the same benefits.

There are no specific recommendations for physical activity levels to combat cancer risk, although more activity has been tied to lower risk of death from breast, colorectal and prostate cancers, the authors note.

"Our results might help to update the recommendation concerning the advisable amount of physical activity to reduce cancer mortality," said senior author Dr. Li Liu of Huazhong University of Science and Technology in China.

Doctors could start to incorporate physical activity into cancer treatments, Liu told Reuters Health by email.

More on this..    

The researchers included 71 studies of physical activity and cancer death risk in the general population or among cancer survivors.

When they pooled these results, people in the general population who got at least two and half hours of moderate activity like brisk walking, per week, were 13 percent less likely to die from cancer than those with the lowest activity levels.

They also looked at data in terms of MET-hours, a measure of the relative amounts of energy expended in given activities and time spent doing them. Resting represents 1 MET, while a 4-MET activity like brisk walking uses four times as much energy, according to the U.S. Office of Disease Prevention and Health Promotion. Doing a 4-MET activity for 30 minutes equals 2 MET-hours.

Cancer survivors who completed at least 15 MET hours per week of physical activity were 27 percent less likely to die from cancer.

Exercise after cancer diagnosis reduced cancer death risk more than prediagnosis exercise, the study team notes.

Exercise may change the body's response to cancer, and those who exercise more may live healthier lifestyles in other ways as well, Liu said.

But many of the high-quality studies included in this analysis accounted for other healthy-lifestyle factors that may have played a role, Liu noted.

"Physical activity, mostly before diagnosis, and breast cancer mortality has been studied for decades, but only in the last 10 years or so have we been studying physical activity after diagnosis," said Patrick T. Bradshaw of the University of California, Berkeley, who was not part of the new study.

"Other cancers (e.g. colorectal, ovarian) have been studied much less than breast cancer, but some researchers there have also found a reduction in mortality associated with increasing physical activity levels," Bradshaw told Reuters Health by email.

So far, most studies have not been able to address which types of physical activity are most beneficial, he said.

Leisure time physical activity or recreational physical activity, but not occupational activity, is protective against cancer according to most research, Liu said.

"The take-home message here is encouraging - exercise may be beneficial even if started after diagnosis," Bradshaw said.

"Based on huge evidence of the inverse association between physical activity and cancer mortality, there is no doubt that cancer patients should be physically active," Liu said. "We suggest that cancer patients to consult their doctors about a personalized physical activity plan, including exercise time, exercise frequency, exercise mode and so on, which may help to promote the survival of patients without bringing too much physical burden."

What Every Woman Should Know - Cultural Considerations

Major depression and dysthymia affect twice as many women as men. This two-to-one ratio exists regardless of racial and ethnic background or economic status. The same ratio has been reported in ten other countries all over the world. Men and women have about the same rate of bipolar disorder (manic-depression), though its course in women typically has more depressive and fewer manic episodes. Also, a greater number of women have the rapid cycling form of bipolar disorder, which may be more resistant to standard treatments.
A variety of factors unique to women's lives are suspected to play a role in developing depression. Research is focused on understanding these, including: reproductive, hormonal, genetic or other biological factors; abuse and oppression; interpersonal factors; and certain psychological and personality characteristics. And yet, the specific causes of depression in women remain unclear; many women exposed to these factors do not develop depression. What is clear is that regardless of the contributing factors, depression is a highly treatable illness.

The Many Dimensions of Depression in Women

Investigators are focusing on the following areas in their study of depression in women:

The Issues of Adolescence

Before adolescence, there is little difference in the rate of depression in boys and girls. But between the ages of 11 and 13 there is a precipitous rise in depression rates for girls. By the age of 15, females are twice as likely to have experienced a major depressive episode as males. This comes at a time in adolescence when roles and expectations change dramatically. The stresses of adolescence include forming an identity, emerging sexuality, separating from parents, and making decisions for the first time, along with other physical, intellectual, and hormonal changes. These stresses are generally different for boys and girls, and may be associated more often with depression in females. Studies show that female high school students have significantly higher rates of depression, anxiety disorders, eating disorders, and adjustment disorders than male students, who have higher rates of disruptive behavior disorders.

Adulthood: Relationships and Work Roles

Stress in general can contribute to depression in persons biologically vulnerable to the illness. Some have theorized that higher incidence of depression in women is not due to greater vulnerability, but to the particular stresses that many women face. These stresses include major responsibilities at home and work, single parenthood, and caring for children and aging parents. How these factors may uniquely affect women is not yet fully understood.
For both women and men, rates of major depression are highest among the separated and divorced, and lowest among the married, while remaining always higher for women than for men. The quality of a marriage, however, may contribute significantly to depression. Lack of an intimate, confiding relationship, as well as overt marital disputes, have been shown to be related to depression in women. In fact, rates of depression were shown to be highest among unhappily married women.

Reproductive Events

Women's reproductive events include the menstrual cycle, pregnancy, the postpregnancy period, infertility, menopause, and sometimes, the decision not to have children. These events bring fluctuations in mood that for some women include depression. Researchers have confirmed that hormones have an effect on the brain chemistry that controls emotions and mood; a specific biological mechanism explaining hormonal involvement is not known, however.
Many women experience certain behavioral and physical changes associated with phases of their menstrual cycles. In some women, these changes are severe, occur regularly, and include depressed feelings, irritability, and other emotional and physical changes. Called premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), the changes typically begin after ovulation and become gradually worse until menstruation starts. Scientists are exploring how the cyclical rise and fall of estrogen and other hormones may affect the brain chemistry that is associated with depressive illness.
Postpartum mood changes can range from transient "baby blues" immediately following childbirth to an episode of major depression to severe, incapacitating, psychotic depression. Studies suggest that women who experience major depression after childbirth very often have had prior depressive episodes even though they may not have been diagnosed and treated.
Pregnancy (if it is desired) seldom contributes to depression, and having an abortion does not appear to lead to a higher incidence of depression. Women with infertility problems may be subject to extreme anxiety or sadness, though it is unclear if this contributes to a higher rate of depressive illness. In addition, motherhood may be a time of heightened risk for depression because of the stress and demands it imposes.
Menopause, in general, is not asssociated with an increased risk of depression. In fact, while once considered a unique disorder, research has shown that depressive illness at menopause is no different than at other ages. The women more vulnerable to change-of-life depression are those with a history of past depressive episodes.

Specific Cultural Considerations

As for depression in general, the prevalence rate of depression in African American and Hispanic women remains about twice that of men. There is some indication, however, that major depression and dysthymia may be diagnosed less frequently in African American and slightly more frequently in Hispanic than in Caucasian women. Prevalence information for other racial and ethnic groups is not definitive.
Possible differences in symptom presentation may affect the way depression is recognized and diagnosed among minorities. For example, African Americans are more likely to report somatic symptoms, such as appetite change and body aches and pains. In addition, people from various cultural backgrounds may view depressive symptoms in different ways. Such factors should be considered when working with women from special populations.

Victimization

Studies show that women molested as children are more likely to have clinical depression at some time in their lives than those with no such history. In addition, several studies show a higher incidence of depression among women who have been raped as adolescents or adults. Since far more women than men were sexually abused as children, these findings are relevant. Women who experience other commonly occurring forms of abuse, such as physical abuse and sexual harassment on the job, also may experience higher rates of depression. Abuse may lead to depression by fostering low self-esteem, a sense of helplessness, self-blame, and social isolation. There may be biological and environmental risk factors for depression resulting from growing up in a dysfunctional family. At present, more research is needed to understand whether victimization is connected specifically to depression.

Poverty

Women and children represent seventy-five percent of the U.S. population considered poor. Low economic status brings with it many stresses, including isolation, uncertainty, frequent negative events, and poor access to helpful resources. Sadness and low morale are more common among persons with low incomes and those lacking social supports. But research has not yet established whether depressive illnesses are more prevalent among those facing environmental stressors such as these.

Depression in Later Adulthood

At one time, it was commonly thought that women were particularly vulnerable to depression when their children left home and they were confronted with "empty nest syndrome" and experienced a profound loss of purpose and identity. However, studies show no increase in depressive illness among women at this stage of life.
As with younger age groups, more elderly women than men suffer from depressive illness. Similarly, for all age groups, being unmarried (which includes widowhood) is also a risk factor for depression. Most important, depression should not be dismissed as a normal consequence of the physical, social, and economic problems of later life. In fact, studies show that most older people feel satisfied with their lives.
About 800,000 persons are widowed each year. Most of them are older, female, and experience varying degrees of depressive symptomatology. Most do not need formal treatment, but those who are moderately or severely sad appear to benefit from self-help groups or various psychosocial treatments. However, a third of widows/widowers do meet criteria for major depressive episode in the first month after the death, and half of these remain clinically depressed 1 year later. These depressions respond to standard antidepressant treatments, although research on when to start treatment or how medications should be combined with psychosocial treatments is still in its early stages.













Even severe depression can be highly responsive to treatment. Indeed, believing one's condition is "incurable" is often part of the hopelessness that accompanies serious depression. Such individuals should be provided with the information about the effectiveness of modern treatments for depression in a way that acknowledges their likely skepticism about whether treatment will work for them. As with many illnesses, the earlier treatment begins, the more effective and the greater the likelihood of preventing serious recurrences. Of course, treatment will not eliminate life's inevitable stresses and ups and downs. But it can greatly enhance the ability to manage such challenges and lead to greater enjoyment of life.
The first step in treatment for depression should be a thorough examination to rule out any physical illnesses that may cause depressive symptoms. Since certain medications can cause the same symptoms as depression, the examining physician should be made aware of any medications being used. If a physical cause for the depression is not found, a psychological evaluation should be conducted by the physician or a referral made to a mental health professional.

Types of Treatment for Depression

The most commonly used treatments for depression are antidepressant medication, psychotherapy, or a combination of the two. Which of these is the right treatment for any one individual depends on the nature and severity of the depression and, to some extent, on individual preference. In mild or moderate depression, one or both of these treatments may be useful, while in severe or incapacitating depression, medication is generally recommended as a first step in the treatment.³ In combined treatment, medication can relieve physical symptoms quickly, while psychotherapy allows the opportunity to learn more effective ways of handling problems.

Antidepressant Medications

There are several types of antidepressant medications used to treat depressive disorders. These include newer medications-chiefly the selective serotonin reuptake inhibitors (SSRIs)-and the tricyclics and monoamine oxidase inhibitors (MAOIs). The SSRIs-and other newer medications that affect neurotransmitters such as dopamine or norepinephrine-generally have fewer side effects than tricyclics. Each acts on different chemical pathways of the human brain related to moods. Antidepressant medications are not habit-forming. Although some individuals notice improvement in the first couple of weeks, usually antidepressant medications must be taken regularly for at least 4 weeks and, in some cases, as many as 8 weeks, before the full therapeutic effect occurs. To be effective and to prevent a relapse of the depression, medications must be taken for about 6 to 12 months, carefully following the doctor's instructions. Medications must be monitored to ensure the most effective dosage and to minimize side effects. For those who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing recurring episodes.
The prescribing doctor will provide information about possible side effects and, in the case of MAOIs, dietary and medication restrictions. In addition, other prescribed and over-the-counter medications or dietary supplements being used should be reviewed because some can interact negatively with antidepressant medication. There may be restrictions during pregnancy.
For bipolar disorder, the treatment of choice for many years has been Lithium, as it can be effective in smoothing out the mood swings common to this disorder. Its use must be carefully monitored, as the range between an effective dose and a toxic one can be relatively small. However, lithium may not be recommended if a person has pre-existing thyroid, kidney, or heart disorders or epilepsy. Fortunately, other medications have been found helpful in controlling mood swings. Among these are two mood-stabilizing anticonvulsants, carbamazepine (Tegretol^®) and valproate (Depakene^®). Both of these medications have gained wide acceptance in clinical practice, and valproate has been approved by the Food and Drug Administration for first-line treatment of acute mania. Studies conducted in Finland in patients with epilepsy indicate that valproate may increase testosterone levels in teenage girls and produce polycystic ovary syndrome in women who began taking the medication before age 20. ¹¹ Therefore, young female patients should be monitored carefully by a physician. Other anticonvulsants that are being used now include lamotrigine (Lamictal^®) and gabapentin (Neurontin^®); their role in the treatment hierarchy of bipolar disorder remains under study.
Most people who have bipolar disorder take more than one medication. Along with lithium and/or an anticonvulsant, they often take a medication for accompanying agitation, anxiety, insomnia, or depression. Some research indicates that an antidepressant, when taken without a mood stabilizing medication, can increase the risk of switching into mania or hypomania, or of developing rapid cycling, in people with bipolar disorder. Finding the best possible combination of these medications is of utmost importance to the patient and requires close monitoring by the physician.

Herbal Therapy

In the past few years, much interest has risen in the use of herbs in the treatment of both depression and anxiety. St. John's wort (Hypericum perforatum), an herb used extensively in the treatment of mild to moderate depression in Europe, has recently aroused interest in the United States. St. John's wort, an attractive bushy, low-growing plant covered with yellow flowers in summer, has been used for centuries in many folk and herbal remedies. Today in Germany, Hypericum is used in the treatment of depression more than any other antidepressant. However, the scientific studies that have been conducted on its use have been short-term and have used several different doses.
To address increasing American interests in St. John's wort, the National Institutes of Health conducted a clinical trial to determine the effectiveness of the herb in treating adults who have major depression. Involving 340 patients diagnosed with major depression, the eight-week trial randomly assigned one-third of them to a uniform dose of St. John's wort, one-third to a commonly prescribed SSRI, and one-third to a placebo. The trial found that St. John's wort was no more effective than the placebo in treating major depression.¹³ Another study is looking at the effectiveness of St. John's wort for treating mild or minor depression.
Other research has shown that St. John's wort can interact unfavorably with other medications, including those used to control HIV infection. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb appears to interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Because of these potential interactions, patients should always consult with their doctors before taking any herbal supplement.

Psychotherapy for Depression

Several types of psychotherapy-or "talk therapy"-can help people with depression.
In mild to moderate cases of depression, psychotherapy is also a treatment option. Some short-term (10 to 20 week) therapies have been very effective in several types of depression. "Talking" therapies help patients gain insight into and resolve their problems through verbal give-and-take with the therapist. "Behavioral" therapies help patients learn new behaviors that lead to more satisfaction in life and "unlearn" counter-productive behaviors. Research has shown that two short-term psychotherapies, interpersonal and cognitive-behavioral, are helpful for some forms of depression. Interpersonal therapy works to change interpersonal relationships that cause or exacerbate depression. Cognitive-behavioral therapy helps change negative styles of thinking and behaving that may contribute to the depression.

Electroconvulsive Therapy

For individuals whose depression is severe or life threatening or for those who cannot take antidepressant medication, electroconvulsive therapy (ECT) is useful.³ This is particularly true for those with extreme suicide risk, severe agitation, psychotic thinking, severe weight loss or physical debilitation as a result of physical illness. Over the years, ECT has been much improved. A muscle relaxant is given before treatment, which is done under brief anesthesia. Electrodes are placed at precise locations on the head to deliver electrical impulses. The stimulation causes a brief (about 30 seconds) seizure within the brain. The person receiving ECT does not consciously experience the electrical stimulus. At least several sessions of ECT, usually given at the rate of three per week, are required for full therapeutic benefit.

Treating Recurrent Depression

Even when treatment is successful, depression may recur. Studies indicate that certain treatment strategies are very useful in this instance. Continuation of antidepressant medication at the same dose that successfully treated the acute episode can often prevent recurrence. Monthly interpersonal psychotherapy can lengthen the time between episodes in patients not taking medication.

The Path to Healing

Reaping the benefits of treatment begins by recognizing the signs of depression. The next step is to be evaluated by a qualified professional. Although depression can be diagnosed and treated by primary care physicians, often the physician will refer the patient to a psychiatrist, psychologist, clinical social worker, or other mental health professional. Treatment is a partnership between the patient and the health care provider. An informed consumer knows her treatment options and discusses concerns with her provider as they arise.
If there are no positive results after 2 to 3 months of treatment, or if symptoms worsen, discuss another treatment approach with the provider. Getting a second opinion from another health or mental health professional may also be in order.
Here, again, are the steps to healing:

• Check your symptoms against this list.
• Talk to a health or mental health professional.
• Choose a treatment professional and a treatment approach with which you feel comfortable.
• Consider yourself a partner in treatment and be an informed consumer.
• If you are not comfortable or satisfied after 2 to 3 months, discuss this with your provider. Different or additional treatment may be recommended.
• If you experience a recurrence, remember what you know about coping with depression and don't shy away from seeking help again. In fact, the sooner a recurrence is treated, the shorter its duration will be.

Depressive illnesses make you feel exhausted, worthless, helpless, and hopeless. Such feelings make some people want to give up. It is important to realize that these negative feelings are part of the depression and will fade as treatment begins to take effect.

Self-Help for Treatment of Depression

Along with professional treatment, there are other things you can do to help yourself get better. If you have depression, it may be extremely difficult to take any action to help yourself. But it is important to realize that feelings of helplessness and hopelessness are part of the depression and do not accurately reflect actual circumstances. As you begin to recognize your depression and begin treatment, negative thinking will fade.
To help yourself:

• Engage in mild activity or exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can as you can.
• Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
• Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
• Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
• Remember that positive thinking will replace negative thoughts as your depression responds to treatment.

 

What is “Palliative Care”?

The World Health Organization defines palliative care (PC) as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through prevention of and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual.” To meet these multidimensional needs, PC is usually provided by a team including physicians, nurses, social workers, and chaplains. Patients can receive PC at any time along the trajectory of a serious or life-threatening illness. (This is distinguished from hospice care, a subset of PC that is reserved for end of life treatment.) PC can also be provided in conjunction with treatments aimed at life prolongation. For example, a patient with metastatic breast cancer may be treated by an oncologist who focuses on cancer treatment while a PC team focuses on management of symptoms (pain, nausea, shortness of breath, depression, anorexia, fatigue, spiritual distress, etc) and assists with advance care planning.

In the United States, PC is generally provided as an inpatient or outpatient consultation. Providers may request a PC consultation to assist with clarification of the patient’s goals of medical care, symptom management, communication between the medical team(s) and the patient and family, prognostication in advanced illness, advance care planning, and end of life (EOL) care. For instance, a common consultation is to help a patient with advanced liver disease to understand the severity of the illness and treatment options, and to manage pain, shortness of breath, and nausea.

The ultimate goals of consultation are to treat symptoms of advanced illness and to assist patients and families in understanding their prognosis, in expressing the goals (or most important factors) in their medical care, and in receiving medical care that is aimed at achieving their goals of care. For example, is the patient with liver disease more interested in staying in the hospital to receive intravenous therapies of marginal benefit or in returning home to spend time with family and friends?

Hospice Care
Hospice care, by contrast, is a specific type of palliative care for patients nearing the end of life. In the United States, hospice refers to a healthcare benefit provided through Medicare Part A or private insurance. A patient is eligible to receive hospice care if two physicians certify that he or she has a life expectancy of six months or less if the “disease runs its usual course.” In addition, the patient must choose to trade standard Medicare Part A (inpatient) coverage for the hospice benefit, which covers medical care that is usually provided in the home and is focused on comfort and relief of suffering rather than life prolongation. Patients with any end-stage disease (heart failure, dementia, COPD, HIV, cancer) are appropriate for hospice referral. Hospice care is the form of PC that most physicians are familiar with; however PC is a much broader discipline.

Discussing End of Life Care with Patients
In addition to focusing on the relief of suffering, palliative providers are often involved in discussions about advance care planning and EOL care. For example, we may discuss prognosis, current treatment options, and options for future care with a patient with end-stage COPD. Specifically we would talk about what is most important to the patient in the time they have left to live and how their medical care can help them to achieve these goals. We would review if the patient is interested in intubation/ICU care or care that is entirely focused on their comfort in the event of a future COPD exacerbation.

There is a robust body of literature demonstrating that the majority of patients want to have these discussions with their providers, yet fewer than 50% of patients actually do (Reilly et al, Arch Intern Med 1994:154(20):2299–2308). Providers often cite barriers to having these conversations, such as a lack of training, lack of time, and concern that such discussions may harm patients or “take away their hope.”

Multiple studies have evaluated the effects of these conversations on patients’ treatment choices, quality of life, and mental health in addition to the effects on caregivers’ quality of life, mental health, and perception of the patient’s death. The Coping With Cancer study was a multisite prospective cohort study of 332 patients with metastatic cancer who progressed through first-line chemotherapy, and their caregivers (Wright et al, JAMA 2008:300(14):1665–1673). The 37% of patient/caregiver dyads who reported having a discussion about end of life care with their providers were compared to the dyads who reported not having these conversations. The patients who had the discussions were more likely to prefer medical care focused on relief of pain and suffering over life-extending treatments. These patients also were more likely to complete a DNR order and less likely to be admitted to the ICU, receive mechanical ventilation, or undergo a resuscitation attempt. Interestingly, patients who received less aggressive care experienced a better quality of life without a decrement in survival time. EOL discussions were not associated with patients feeling depressed, sad, terrified, or worried or meeting DSM criteria for a psychiatric disorder.

Their caregivers benefitted, too. Caregivers of patients who received aggressive care in the last week of life were more likely to develop major depressive disorder, experience regret, feel unprepared for the patient’s death, and report poorer quality of life and health after the patient’s death. This study supports the concept that EOL discussions and less aggressive EOL medical care are associated with better quality of life among patients and their caregivers.

Patients report that the manner in which EOL discussions are held is as important as the content of the discussions. According to current research, cancer patients in Western countries want realistic, truthful information that is delivered with a focus on what can be done (symptom management, emotional support, practical support, and maintenance of dignity). They value discussions in which the provider explores realistic goals as a means of fostering hope. Such goals might include control of pain and shortness of breath so patients can spend more time talking with their families. Patients feel that a discussion of what the future may hold should be well-timed. They want the information to be given when loved ones can be present and when the provider can spend an adequate amount of time with them. Lastly, patients value respect for their emotional state and an acknowledgement of the emotional, spiritual, and existential impact of having a life-threatening illness.

TCPR’S VERDICT: Given the heavy emotional burden associated with advanced illness, there has always been a significant role for psychiatry in PC. An important demonstration of this role is the inclusion of psychiatry as a specialty supporting the subspecialty of Hospice and Palliative Medicine. The challenge ahead is to further develop strategies for advancing the collaboration between providers of palliative and psychiatric care.

Bereavement Support

1. Smile. Put a smile on your face and in your eyes, voice and heart as often as possible.
2. Make eye contact. Look people openly, warmly and squarely in the eye.
3. Open your body language. While facing the person with whom you are talking, open your chest, your heart and your arms.
4. Address people by name. Honor people by calling them by name as you greet them, give them thanks, ask a question or bid them farewell.
5. Speak with a friendly tone. Warm your tone of voice with love and kindness.
6. Be present. Give your complete and undivided attention to others when they are speaking to you.
7. Express gratitude. Focus your attention on the goodness in others, verbalize all that you appreciate and give thanks.
8. Slow down. Breathe and gift yourself and others with time to address situations and transition from them.
9. Reflect empathy and compassion. Honor people’s emotional experiences. Normalize and validate their feelings so they feel heard, known and understood.
10. Have integrity. Keep your word. Do what you say you are going to do.  Live according to your values.
11. Have good manners. Be polite, conscientious and gracious.
12. Demonstrate thoughtfulness. Get out of your own head and be of service to others. Consider their feelings and experiences.
13. Give genuine compliments. Tell others their strengths, give positive feedback and express what you admire about them.
14. Give salutations. Make the effort to open and close verbal and email interactions with a nice greeting or closure, rather than abruptly asking for something with neither a hello nor goodbye.
15. Be generous. Give and share whatever you can, whenever you can.
16. Be kind. Be the bigger person. Kindness is a choice. 
17. Show compassion. Demonstrate self-compassion by cutting yourself some slack extend this same compassion to others.
18. Be patient. Breathe and breathe out. Patience is a virtue.
19. Demonstrate self-awareness. Notice the impact you have on others by paying attention to their facial expressions, tone and body language. Consider how what you are saying will feel to them and how it will impact them. Make adjustments accordingly.
20. Be truthful. The truth has different layers and sometimes the deepest layer is hurtful or inappropriate. Speak the truth from the deepest layer that is appropriate. Speak from a place of kindness.
21. Be reliable. Follow through with responsibilities and commitments with competency and effective communication.
22. Be forgiving. Each time somebody else makes a mistake it is an opportunity for you to extend kindness and compassion and to let go of resentments that keep you tethered to the past.
23. Apologize. We are human and nobody is perfect. When you make a mistake, make an amend or extend a sincere and timely apology.
24. Take responsibility. Drop the defensiveness and the excuses and accept responsibility for yourself, your actions and your behaviors.
25. Express love. Be open-minded and non-judgemental. Extend love to yourself and to others. Choose to be loving whenever possible—it is always possible.

When to Refer for Medical Treatment

When Grief develops into clinical depression one (1) and family does not know to pinpoint
the Symptoms accurately. For this reason the symptoms and the psychological aspects have been out lined for your education and understanding for this diagnose.

Signs and Symptoms:

Early morning awaking

Serious Weight Loss

Anhedonia:

"The loss of joy," is defined as a lack of the feelings of enjoyment or accomplishment that typically accompany pleasurable events such as socializing with friends, eating a good meal and sex. An individual who is experiencing Anhedonia may no longer feel a desire to go to work, attend classes, manage their health, interact with other people, or engage in hobbies or entertainment. Anhedonia is a common symptom of mood disorders such as major depressive disorder or dysthymic disorder, but it can also be experienced independent from a diagnosed mental health condition. -

Agitation: The Causes

Agitation can come on suddenly or over time. It can last for just a few minutes, or for weeks or even months. Pain, stress, and fever can all increase agitation.
Agitation by itself may not be a sign of a health problem. However, if other symptoms occur, it can be a sign of disease.  Agitation  with a change in alertness (altered consciousness) can be a sign of delirium. Delirium has a medical cause and should be checked by a health care provider right away.
 
Causes

There are many causes of agitation, some of which include:

• Alcohol intoxication or withdrawal
• Allergic reaction
• Caffeine intoxication
• Certain forms of heart, lung, liver, or kidney disease
• Intoxication or withdrawal from drugs of abuse (such as cocaine, marijuana, hallucinogens, PCP, or opiates)
• Hospitalization (older adults often have delirium while in the hospital)
• Hyperthyroidism (overactive thyroid gland)
• Infection (especially in elderly people)
• Nicotine withdrawal
• Poisoning (for example, carbon monoxide poisoning)
• Theophylline, amphetamines, steroids, and certain other medicines
• Trauma
• Vitamin B6 deficiency

Agitation can occur with brain and mental health disorders, such as:

• Anxiety
• Dementia (such as Alzheimer's disease)
• Depression
• Mania
• Schizophrenia

5 Easy Ways to Combat Overthinking

Do you ever become trapped in an overanalyzing rut?
I tend to think a lot in general, but sometimes, I find myself looking at a subject way too closely and way too much, and the ruminating takes on a life of its own. (It might even revolve around an abstract concept as opposed to an actual event that’s occurring.)
When introspection becomes stressful, there are antidotes. Here are some of my personal suggestions…

1. Adopt a hobby.

Maybe if your spare time is filled with an activity that you love, overthinking spells will be pushed to the curb. I’ve started to re-immerse myself in the French language since I’m a total Francophile. Weekend hours are set aside for verb conjugations and charming vocabulary. Oui, oui, oui.

2. Write it down.

I have journaled to lighten my mental load, where I can flesh out thoughts and feelings. (I find that the physical act of writing into a notebook is a more effective cathartic release than an online diary, but to each his or her own.) For someone who isn’t interested in writing, journaling may be viewed as a burden, so it certainly comes down to individual preference.

3. Keep your hands occupied.

According to this article, the psychological theory proposes that when we’re stressed, we absorb information through two channels. “One is the basic, primal sensory channel: the sights, sounds, sensations, and smells of the situation. The other is an intellectual channel: our brains are trying to make sense of what’s going on, and put it into words and a context that we can talk about.”
Researchers explain that if the sensory channel is occupied, the intellectual channel is muted; therefore, stress relief techniques that incorporate the hands “will use up more ‘brain cycles’ and pull processing power away from intellectual activities.” A stress ball may do the trick, along with drawing or knitting. (I’ve experimented with colorful rugs via latch hook!)
The article also presents another theory, which states that large muscle groups contract in preparation for flight when we’re consumed with stress. Muscle fibers in your arms relax and reduce tension when squeezing stress balls or keeping your hands busy with objects of a similar nature.

4. Move around.

I revel in long walks around the neighborhood – preferably in beautiful weather – and have found that walking unleashes mental chatter and induces clarity. Exercise, rolling blade, or any other movement can help as well.

5. Talk to someone.

Sometimes, being honest and vulnerable with someone you’re comfortable with will clear your mind. After exposing your overanalysis to others, it suddenly doesn’t appear as daunting. And who knows, maybe they can relay insight about the topic at hand, which could provide further guidance. With this further guidance contact Dr. Losito 24/7 to receive the reassurance of what is on your mind.

Overthinking can be unpleasant, draining and debilitating, but hopefully, the tips noted above can disrupt these incessant cycles.

Do Not Grieve Alone

The single most important factor in healing from loss is having the support of other people. Even if you aren’t comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving. Sharing your loss makes the burden of grief easier to carry. Wherever the support comes from, accept it and do not grieve alone. Contact Dr. Losito an excellent and experienced grief and loss therapist.

Finding support after a loss

• Turn to friends and family members – Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Draw loved ones close, rather than avoiding them, and accept the assistance that’s offered. Oftentimes, people want to help but don’t know how, so tell them what you need—whether it’s a shoulder to cry on or help with funeral arrangements.
• Draw comfort from your faith – If you follow a religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you—such as praying, meditating, or going to church—can offer solace. If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.
• Join a support group – Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers.
• Talk to Dr. Losito – If your grief feels like too much to bear, call a Dr. Losito a mental health professional with experience in grief counseling.  He is an experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.

Common Symptoms of Grief

 

While loss affects people in different ways, many experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal—including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.

• Shock and disbelief – Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting him or her to show up, even though you know he or she is gone.
• Sadness – Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.
• Guilt – You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
• Anger – Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.
• Fear – A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
• Physical symptoms – We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Post Bereavement Thoughts

 

 

Yes I can recognizes Life that is not near than near. On 14 Feb 1996, Death came to my doorstep unannounced. This was a day Really Really Changed my siblings, nieces, and nephew's lives.  

While the One I loved ran away when I needed that person's support and understanding.

 

I miss you Pop on this day of your anniversary of your death.

 

 

 

Working the Positive Path

Being with the Most Positive Thoughts have been being in front of Christ our God in the Most Holy Blessed Sacrament of the Altar. 

Being with Christ our God Is the Most Beneficial means to remain positive during the days of Celebration of His Holy Birth and beyond into the New Year.  

He is our Enteral Physician ! 

Consequently, you can add these items as well into your path of Happiness.

I want to share my path to positive thinking. Maybe the steps I took can help you reach your goal of bringing more positivity into your life.

• I surrounded myself with like-minded positive people and had to actively shift some of my relationships. I brought those with positive energy closer and devoted less time to those who were bringing me down.
• Instead of looking at tasks as a burden, I started to make things fun. The have-to’s can be exciting. Instead of dreading the gym, I rented a bike and explored New York City. Rather than avoiding chores, I make them a game and wound up smiling the whole time.
• I became grateful. Instead of looking at the past with regret, I have tried to reprogram my thoughts. I am now grateful for many of the experiences because they have taught me so much. I remind myself about what I learned from the friendship/relationship that ended. I look for the things that I am thankful for and appreciative of and remind myself of these things when I am feeling a wave of negativity. It shifts my mindset.
• I found purpose. I began finding and attracting others who shared my mindset, not in a therapeutic sense, but who desired to make the world a more positive place. I have friends who are not in the helping profession, yet make it their intention everyday to do something that can change the world in some way, and maintain positive thinking. A friend of mine is an illustrator. She helps authors make their stories come to life. Another is a consultant. He helps small businesses become profitable. Their intentions are to find positivity in their work. This energy is exuded to those around them.

Some tools may work for you, others may not, but be gentle with yourself. Try shifting your negative mindset subtly. Remember, the goal is to find your path to positive thinking that lasts a lifetime.

Identifying Negative Thought Patterns

As we are in the second week advent. Let us all work on becoming better with our thoughts for the Birth of Christ fast approaching the us in 15 days.  When in doubt please contact your local mental health provider and or call Dr. Nicholas at 877 867 8556 during the Emergency Room moment.  

Most of all let us rely on Christ our God for the most informable healing and guidance during the of His Birth. 

Notice if you have any of the following negative thoughts about yourself or others. Then identify when these negative thoughts come up most often; particular places, people, or events may be associated with them.

Do you…

1. Reject yourself or others’ ideas or experiences? Say “no” more than “yes”?
2. Criticize yourself or others about thoughts and choices made?
3. Blame yourself or others for your current situation? Do you take responsibility for your current mindset and where you are in your life?
4. Cling to your point of view? Find it hard to see the other side of the story?
5. Cause Conflicts and find that in a disagreement you continue to raise the conflict or bring up more issues that leave things messier than when you started? Are you unable to “let it go”?
6. Resent by being unwilling to forgive yourself or another; get stuck in how it “should be” rather than what it is?
7. Jump the gun and future trip about what negative events will occur or predict that you or someone else will fail?
8. Judge by casting judgement or blame on others, discounting your role in things and/or making unrealistic expectations for yourself or another?

A Poem: I Miss YOU.

In this moment in time as the Holy Days draws closer. I find that many are yearning for loved ones and dear friends to continue to be around in a physical way. Unfortunately, they can not be near in a physical way, but can be with them in a very soothing  way in the spiritual realms. 

The Important Factor is our loved ones are with each one of us in a way we all can remember, while they were still among the living and with us. 

Continue to keep each one of your loved one close near your heart, mind, and souls during the Holy Days that will bring us the gift of life and draw happiness with us that our loved ones are interceding for each one of during the days, which do not provide happiness and care. 

Here are a few of my dear loved ones that I continue to remember during the times life does not collaborate for me.

Pop, Little Pop & Nonna Fannie, Zia Rosa, Zio Felix, Zio Michelangelo, Mother Josephina, Cardinal John, Father Andrew,  Father Romalo, and Ed and Marge.

These were the Ancient Ones, who provided care, love, and direction in my life to become the man I am today.

I continue to ask for their Intercessions during the Holy Days of Christmas. I am sure you have loved ones that you continue to ask assistance through daily intercessions to provide each one of you a sense of comfort and joy in all of your daily ways of life. 

Of Course; all of you are encouraged to contact Dr. Nicholas, when there is a fine tuning required.

A New Start

Divorce is a life-altering process. It involves court dates, dividing assets, negotiating child custody, and a roller coaster of emotions. A divorce can leave you hurt, confused, and emotionally worn out. After a divorce, it may seem like your life is over, however; that is not the case. There is life after divorce. Here are some tips on how to get things back on track after dealing with a divorce: Give Yourself Time to Heal Allow yourself time to grieve the loss of your relationship. Accept that it’s over and take a step back and consider what you learned from the situation. A failed relationship, although difficult, can teach us a lot about what we want in future relationships. Let go of feelings of regret. Write in a journal to keep track of your emotions. Spend Time with Loved Ones Surround yourself with friends and family. Talk to a therapist if you’re feeling down. While you may not want to bring up painful memories from your past, sharing your thoughts with people who care about you is a great way to gain new perspective and to move past difficult periods in your life. Stay open and honest with your friends and family. Keep them in the loop. Update them on how you’re doing. Accept their support and advice. Break Out of Your Rut As hard as it may be, get yourself out of bed and make some plans for the day. Get to the gym. Being active for a half hour each day is clinically proven to help fight anxiety, depression, and stress. Sign up for classes or get involved in new hobbies that you’ve always wanted to. Accept social invitations and meet new friends. Hanging out with new groups of people will open new doors for you and will help to pull you out of your rut. Volunteer in Your Community One of the best ways to give yourself a mental break from your problems is to spend some time helping others. Volunteering is a great way to make a difference in someone else’s life, meet new friends, and feel good about yourself. Volunteering has been proven to increase your self confidence, combat depression, and make you feel like you are a part of your local community. When it’s Time to Get Back Out There After you feel that you have fully moved on, you can begin easing back into the dating world. Make sure that you feel ready yourself and that you are not accepting dates as a result of your friends pressuring you into getting back into the scene. At first, it may be hard to open up to strangers, but make a point of giving people a chance. According to marriage and family therapist, Lisa Paz, Ph.D, if dating feels good, it’s not too soon. If you feel like you’re forcing it, then you may need some more time to heal before trying again. When you’re ready to date, a great way to get back into the singles scene is to give Catholic Singles.com.  The service gives you access to over 700 million dating profiles and is a great way for busy people to meet eligible singles. Once you register on the site, you’ll be asked to take a quick quiz, which only consists of questions capability and of Faith.  You will then upload a photo and create a profile. Catholic Singles will then pair you with prospective matches and will show you a list of potential partners. You will see their photos, basic description, and the number of quiz questions that you both had in common. You will then be able to chat with these people to see if you are truly compatible. Moving on from a divorce is a process that takes time but is eventually something that you will move past. By applying the steps above, you’ll be one step closer to putting your life back together and feeling like your old self again! -

Comfort Yourself.

1. Stretch your body.
Anxiety tends to hijack the body. While everyone stores anxiety in different spots, common areas are the jaw, hips and shoulders, according to Anna Guest-Jelley, a body empowerment educator, yoga teacher and founder of Curvy Yoga. She suggested standing up and doing a full-body stretch. “Reach your arms overhead then slowly fold forward [and] slowly open and close your mouth as you do.”
2.Take a shower.
Taking a shower after a rough day always makes Darlene Mininni, Ph.D, MPH, author of The Emotional Toolkit, feel better. And she’s certainly not alone. Now research is illuminating why cleansing may wash away our woes.
Mininni cited this interesting review, which notes “a growing body of research suggests…after people cleanse themselves, they feel less guilty about their past moral transgressions, less conflicted about recent decisions, and are less influenced by recent streaks of good or bad luck.”
3. Visualize a peaceful image.
The image you pick can be anything from the sun to ocean waves to a furry friend, Guest-Jelley said. She suggested combining the visualization with breath, and repeating the sequence several times. As you inhale and reach your arms out in front of you, hold the image in your mind, she said. Then exhale and bring both hands to your heart, all the while thinking of the image, she said.
4. Speak compassionately to yourself.
Being self-compassionate boosts mental health, Mininni said. (Some research even suggests that it helps you reach your goals.) This means extending yourself some kindness as you would to a good friend, she said.
Unfortunately, being self-compassionate doesn’t come naturally to many of us. Fortunately, you can learn to treat yourself with consideration and care. Here are some ideas on being kinder to yourself and cultivating self-compassion.
5. Reach out.
Reach out to people you trust to support you. “We are wired to connect with others and to comfort each other through emotional and physical connection,” said Julie Hanks, LCSW, a therapist and blogger at Psych Central.
6. Ground yourself.
When stress strikes, some people feel lightheaded or like they’re floating outside their bodies, Guest-Jelley said. Making a point to feel your feet against the ground can help, she said. “Grounding your feet can bring you back into your body and help you navigate what you want to do next,” she said. “Visualize thick roots growing down from your feet into the center of the Earth, rooting you and giving you a firm foundation.”
7. Listen to soothing music.
“Create a playlist of soothing songs that help you to slow down or connect with memories or positive experiences,” Hanks said. We’ve mentioned before the benefits of listening to calming music. Pairing soothing tunes with deep breathing helps, too, according to one study, which found it lowered blood pressure.
8. Practice mindfulness.
To practice mindfulness, “You don’t need to sit like a pretzel,” Mininni said. Simply focus on what you’re doing right now, whether that’s washing the dishes, walking to your car or sitting at your desk, she said. Pay attention to the sights, scents and sounds surrounding you, she said.
For instance, if you’re washing the dishes, focus on the scent of the soap and the hot water cascading from the faucet and onto your hands, she said.
Mininni applies mindfulness to her feelings. In the moment, she asks herself what her emotion feels like. Doing this actually allows her to detach from her feelings and thoughts and simply observe them as if she were watching a movie. This helps you get out of your head and into your body, she said.
9. Move your body.
According to Hanks, “If you’re feeling tempted to engage in self-destructive behavior to calm down, engage in something positive and active, like exercise or playing a physical game.”
10. Picture the positive.
When we’re anticipating a potentially stressful situation, we start thinking of all the different ways it can go wrong. Again, you can use visualization to your advantage. “To pull yourself out of [an] internal dramalogue, try imagining the situation going well,” Guest-Jelley said. “Feel what you want to feel in the moment and see yourself disengaging from tricky conversations [and] situations,” she said.
11. Zoom out.
Look at the situation or stressor from a bigger perspective, Hanks said. “When you’re in the moment, current challenges seem enormous, but placing your situation into the ‘bigger picture’ of your life may help you realize that you may not need to give it so much emotional energy,” she said.
For instance, she suggested asking yourself: “Will this matter in one year? In fie years? When I reach the end of my life, how important will this situation be in retrospect?”
12. Practice alternate nostril breathing.
Breathing techniques are an instant way to soothe your body. Taking deep, slow breaths tells your brain that everything is OK, which then calms the rest of the body. Guest-Jelley suggested going through this series:

• Using your dominant hand, “make a U-shape with your thumb and pointer finger.
• If you’re using your right hand, press your right thumb into your right nostril, gently closing it. Inhale through your left nostril.
• Next, press your right index finger against your left nostril, closing it, as you release your thumb from the right nostril – allowing yourself to exhale through the right nostril.
• Repeat by inhaling through the right nostril, then closing it and exhaling through the left nostril.
• Continue like this for at least 10 full breaths.”

13. Let yourself feel bad.
Remember that you don’t have to fix your feelings right away. It’s important to have a toolbox of healthy strategies to turn to at any time. But don’t feel guilty for feeling bad or fault yourself if you aren’t seeing rainbows and unicorns.
Mininni stressed the importance of giving yourself permission to acknowledge and honor your feelings and stay with them. “Sometimes it’s OK to just say I’m having a really crappy day,” she said.