Army suicides to top 2008

By PAULINE JELINEK, Associated Press Writer

WASHINGTON – Soldier suicides this year are almost sure to top last year's grim totals, but a recent decline in the pace of such incidents could mean the Army is starting to make progress in stemming them, officials said Tuesday.

Army Vice Chief of Staff General Peter Chiarelli said that as of Monday, 140 active duty soldiers were believed to have died of self-inflicted wounds so far in 2009. That's the same as were confirmed for all of 2008.

"We are almost certainly going to end the year higher than last year ... this is horrible, and I do not want to downplay the significance of these numbers in any way," he said.

But Chiarelli said there has been a tapering off in recent months from large surges in suspected suicides in January and February.

"Our goal since the beginning has been to reduce the overall incidence of suicide and I do believe we are finally beginning to see progress being made," Chiarelli told a Pentagon press conference.

He attributed those hints of a turning to some unprecedented efforts the Army has made since February to educate soldiers and leaders about the issue.

Officials are still stumped about what is driving the historically high rates across the military force. When asked whether the rates reflect unprecedented high stress from long and repeated deployments to provide manpower for the wars in Iraq and Afghanistan, Chiarelli said he didn't know.

"The reality is there is no simple answer," he said. "Each suicide is as unique as the individuals themselves."

Chiarelli said that on top of the 140 suicides reported from the active duty force, there were another 71 suicides by troops in the National Guard and Reserve.

All of the numbers are preliminary in that investigations into some of the deaths are still ongoing. Of the 140 so far this year among active duty troops, 90 have been confirmed as suicides and 50 are suspected but the probes are not yet finished.

Each year, nearly all suspected suicides are eventually confirmed. For instance in 2008, there were 143 suspected and 140 were eventually confirmed.

Chiarelli said officials will continue to focus on things that are symptoms of high-risk individuals such as undiagnosed brain injuries like concussions; on Post-Traumatic Stress, and on risky behavior such as poor diet and sleep habits as well as more serious behaviors such as drug and alcohol abuse.

The Army widened its suicide prevention in March in an attempt to make rapid improvements. In October, the service introduced its Comprehensive Soldier Fitness program, which Chiarelli called "the biggest step ... taken to enhance wellness in the entire force through prevention rather than treatment."

The program aims to put the same emphasis on mental and emotion strength as the military traditionally has on physical strength. Basic training now includes anti-stress programs as part of a broader effort to help soldiers deal with the aftereffects of combat and prevent suicides.

Also last month, the Army started using a new screening questionnaire to try to determine preexisting or current mental health issues among troops as part of the enlistment process.

Despite those campaigns, another jump in suicide figures for 2009 would make it the fifth straight year that such deaths have set a record within the military. Last year's 140 record erased a high 115 in 2007 and 102 in 2006.

Chiarelli said officials are concerned with increases this year at Fort Campbell, Fort Stewart and Schofield Barracks and are trying to learn why suicides rates are down at Fort Hood, Fort Bragg and Fort Drum.

At Fort Campbell in Kentucky there were 18, while at Fort Bragg, N.C., which has almost double the population, there have been six all year.

Using some bases as examples of the trend downward, Chiarelli said that of the 18 suicides reported this year at Fort Campbell, 11 of those were in the first four months of the year. At Schofield Barracks in Hawaii, there were seven all year so far — five in the first five months of the year and only two since.

The numbers kept by the service branches don't show the whole picture of war-related suicides because they don't include deaths after people have left the military. The Department of Veterans Affairs tracks those numbers and says there were 144 suicides among the nearly 500,000 service members who left the military from 2002-2005 after fighting in at least one of the wars.

The true incidence of suicide among military veterans is not known, according to a report last year by the Congressional Research Service. Based on numbers from the Centers for Disease Control and Prevention, the VA estimates that 18 veterans a day — or 6,500 a year — take their lives, but that number includes vets from all previous wars.

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On the Net: http://www.army.mil

How To Determine What You Want In Life

How To Determine What You Want In Life





What do you really want in life?



Most people don’t discover what they want in life until it’s time to die – and that’s a shame.



Most people spend the best years of their lives watching television or doing things they dislike. An author described humanity by saying, “Most people die at twenty and are buried at eighty.” Are you one of the living zombies?



What do you really want in life?



Some people struggle in answering such question. When asked what they want or what their goals in life are, many are unsure. They dillydally in their decision, hardly giving any thought about what they want in life. People without definite goals are letting time pass them by. Are you one of these people?



If you are undecided about what you want out of life, do not worry. There are many ways of discovering your purpose in life.



To discover what you want in life, try looking deep into your heart. Oftentimes, people are ruled by logic. People live by what they think they should be or by what others like them to be. The discovery process is the perfect time to listen to your heart. What your heart desires comes from the whispers of your authentic self. Your authentic self is the real you.



Listen to your heart to be able to listen to your authentic self. What your heart says usually feels right. What your heart desires is what you usually love to do and this represents your passion. Anything done with passion is like play where the task is accomplished without hesitation. You pour out your very best and feel no pressure or resistance.



You will totally enjoy doing things that are your passion. Setbacks, difficulties, and obstacles will make it more challenging, but should not deter you from pursuing your goals. Naturally, there may be barriers that may prevent you from reaching your goal, but your heart’s desire will find ways to overcome these barriers so that you may ultimately get what you want in life. Remember this: the universe supports people who are pursuing their passion and those who are pursuing their destiny.



However, this does not mean that you don’t use your head. People are born with both the mind and heart. Your duty is to live your best life and be in harmony with your mind and heart. The poet Rumi wisely said, “Live completely in the head and you cannot feel the breath and rhythm of life. Live completely in the heart and you may find yourself acting like a love-struck fool with poor judgment and discipline. It’s all a fine balance - the head and heart must forge a lifetime partnership if one wants to live a beautiful life.”



Listen to your instinct. Part of human nature is the mysterious and spontaneous reaction on things. Often times, these are called instincts. Your authentic self communicates with you and guides you via instincts. Instincts are those gentle nudges that urge you to act and follow a certain path. Your role then is to listen attentively.



Often times, we listen to what others say and allow them to run our lives. Parents often do this to their children. “We come from a family of doctors, so my son must also be a doctor.” How often do we hear this from parents who have good intentions for their children? Parents unconsciously block the true expression of their child’s real self and calling. Friends and critics will discourage you and point out the impossibility of your dream. Before heeding their advice, evaluate the accomplishments of the critics. Did they achieve theirs dreams? Do they dream big at all?



Remember, it is your destiny that is in line, not theirs. It doesn’t mean, though, that you will not listen to what other people say. Hear them out just the same. But the final decision should be yours.



There is only thing to remember: Every person, to live truly and greatly, must define how he wants to live and what his brightest life will look like. Listen to your instincts and follow your heart’s desire. You will never go wrong.

Making Your Bad Marriage Good

I was talking to the team at Save My Marriage Today recently, and we were talking about marriages gone bad. It seemed at one time that the only place that marriages went bust was in Hollywood, but anyone you talk to now either knows someone divorced or someone with marital problems. Hey, it may even be you.

The single biggest reason couples break up is due to "falling out of love" or poor communication. It seems as though many couples reach the 5 or 10 year anniversary and it becomes a time of regret and reflection on opportunities lost. Too many people end their marriages because the love is not the same as it used to be, and they don't know how to love their partners anymore. It's so frustrating!

If "falling out of love" sounds familiar to you, help is at hand:

http://www.savemymarriagetoday.com

Online author Andrew Rusbatch showed me the latest course he has created to help troubled couples, and to be honest, I was very impressed! Andrew is the host of Save My Marriage Today Home Study Course. It's a fantastic course that covers all the essential aspects to a healthy marriage.

Are you or your partner falling out of love?
Marriage falling apart and feeling powerless?
Anger and conflict tearing you two apart?
Is your marriage affected by addiction issues?
Partner cheated on you?
Marriage affected by money problems?
Are you in a marriage that is suffering because your partner has depression?
Is the honeymoon over?



Many couples break up over issues that could have been resolved if they had only taken the time for self-examination. Let's face it, you can't always control what your partner does, and the Save My Marriage Today Premium Home Study Course recognizes this and focuses on your actions and beliefs, and how they are shaping your approach to save your marriage.

Andrew's Save My Marriage Today Premium Home Study Course helps all couples, both young and old, consider their relationship problems and how their misconceptions and attitudes can help shape a recovery or add to their ordeal.

Its quite normal for a marriage to go through cycles, and arguments will happen from time to time. In fact, one thing they talk about in the course is how disagreements are normal. It's nothing to be ashamed about! Its how you deal with those arguments and disagreements that determines the health of your relationship.

The Save My Marriage Today Premium Home Study Course is an instant-download 12-part video and written course, AND includes FOUR additional topic-specific courses where Andrew, Richard and Amy delve into relationship issues for couples dealing with depression, addiction, infidelity, and money problems. That's 8 hours of video and 5 study guides to work your way through!

Plus there are bonus interviews with guest relationship coaches Scot and Emily McKay discussing ways to cope with a partner with mental illness, and Mimi Tanner discussing how to keep your spouse interested in you forever.

In addition to this is a free email consultation so that customers can discuss any additional marriage issues with a member of the team. This really can help ANY couple with almost ANY marriage problem!

I really do believe Andrew and the Save My Marriage Today team are onto a good thing here, and they really want to help. The techniques are fresh, thought provoking, come from a range of perspectives, and have been proven over and over to help save marriages. I was very impressed with this course and have recommended it to everyone I know.

I would encourage you to look for yourself and do something today to kick-start your marriage-saving solution. There is never a better time to save your marriage!

Visit: http://www.savemymarriagetoday.com/premium

And take control of your future. I’m sure you will be as impressed as I was.

Stress and The Body

Hot Reactors
Chronic stress can lead to poor health. Some people tend to react to stressors with an all out physiological effort that takes a toll on their health. We call these people hot reactors. If you notice that you get angry easily (you are often anxious or depressed, you urinate frequently, you experience constipation or diarrhea more than usual, or you experience nausea or vomiting), you may be a hot reactor. In that case, you may want to seek regular medical examinations to identify illnesses when they can be easily cured or contained and learn to use stress management techniques and strategies.

Psychosomatic Disease
People have died or have become ill from severe stress, when there seems nothing physically wrong with them. Some illnesses are easily seen as being physical, while others are assuredly recognized as being mental, yet it is impossible to deny the interaction between the mind and the body and the effects of one upon the other. The mind makes the body susceptible. These conditions are called psychosomatic. Psychosomatic disease is not “all in the mind”, contrary to popular belief, but involves both mind and body. Psychosomatic disease is real, can be diagnosed, and is manifested physically. However, it also has a component in the mind, although it is not easily measured. That common cold may be a function of psychological stress, which decreases the effectiveness of the immunological system and results in the body being more vulnerable to cold viruses. That cold may also be caused by psychological stress using up particular vitamins in the body and leading to decreased effectiveness in combating viruses. Psychogenic refers to a physical disease caused by emotional stress. Asthma is an example of this. Somatogenic psychosomatic disease occurs when the mind increases the body's susceptibility to some disease causing microbes or some natural degenerative process. Examples are rheumatoid arthritis and cancer.

Stress-related Conditions and Illnesses
Hypertension
This is the excessive and damaging pressure of the blood against the walls of the arterial blood vessels. There are several causes of hypertension. Excessive sodium (salt) intake may cause hypertension in those genetically susceptible. It can also be caused by a kidney disease, a narrow opening in the aorta (main blood vessel), and the use of contraceptives. However, these conditions cause only an estimated ten percent of all hypertension. Approximately 90 percent of hypertension is termed essential hypertension and has no known cause.

Forty-one percent of the United States population aged twenty to seventy-four are hypertensive, although many of these people do not even know it, since hypertension occurs without signs and symptoms. Since blood pressure increases during stress, the relationship between stress and hypertension has long been suspected. Recognizing this relationship, educational programs for hypertensives have included stress management. Although hypertension can be controlled with medication, the possibility of disturbing side effects from these drugs has led to attempts to control hypertension in other ways. Since obesity, cigarette smoking, and lack of exercise correlates to hypertension, programs involving weight control, smoking withdrawal, and exercise, as well as decreased ingestion of salt, have all been used to respond to high blood pressure.

Stroke
Apoplexy (also called stroke) is a lack of oxygen in the brain resulting from a blockage or rupture of one of the arteries that supply it. Stroke is related to hypertension, which may also result in a cerebral hemorrhage. Stroke has been linked with high blood pressure, diet and stress.

Coronary Heart Disease
Heart attack kills more Americans than any other single cause of death. That stress is related to coronary heart disease is not surprising when we consider the physiological mechanisms that stress brings into play: accelerated heart rate, increased blood pressure, increased serum cholesterol, and fluid retention resulting in increased blood volume. Further, the stereotypical heart attack victim has been the highly stressed, overworked, overweight businessperson with a cigarette dangling from his lips and a martini in his hand.

Ulcers
Ulcers are fissures or cuts in the wall of the stomach and other parts of the intestines. For many years, it was thought that stress led to the excessive amounts of hydrochloric acid being produced in the stomach and the intestines. One theory explaining the effects of stress on the development of ulcers pertains to the mucous coating that lines the stomach. The theory states that, during chronic stress, secretions cause the stomach lining to constrict. This, in turn, results in a shutting down of mucosal production. Without the protective barrier, hydrochloric acid breaks down the tissue and can even reach blood vessels, resulting in bleeding ulcer.
Many cases of ulcers are caused by a bacterium called H. pylori. It is believed that H. pylori inflames the gastrointestinal lining, stimulates acid production, or both. Another major cause of ulcers is the ingestion of aspirin and other non-steroidal anti-inflammatory drugs, like ibuprofen and naproxenan piroxicam. These drugs promote bleeding in the stomach and can wear away its protective lining. Still, stress can exacerbate the conditions in the digestive tract to make ulcers more likely to occur. Stress results in an increase in hydrochloric acid in the intestines and stomach, and a decreased effectiveness of the immune system that is marshaled to combat the invasion by H. pylori.

Migraines
Migraine headaches are the result of a constriction and dilation of the carotid arteries of one side of the head. The constriction phase, called the pre13 attack or prodome, is often associated with light or noise sensitivity, irritability, and a flushing or pallor of the skin. When the dilation of the arteries occurs, certain chemicals stimulate adjacent nerve endings, causing pain. The migraine is not just a severe headache. It is a unique type of headache with special characteristics, and it usually involves just one side of head. The prodome consists of warning signs, such as flashing lights, differing
patterns, or some dark spaces. Migraines are a sign and symptom of a lifestyle gone awry. Signs and symptoms should be treated with either medication or meditation without eliminating the underlying cause. Rather than care for the migraine after it strikes, why not prevent it in the first place by changing your lifestyle?

Cancer
Although many people do not realize it, both the prevention and the treatment of cancer are suspected of being related to stress. Some researchers believe that chronic stress results in a chronic inability of the immune response to prevent the multiplication of mutant cells, which some believe are present but normally controlled in most people. The role of stress in the development of cancer is still being debated. Since cancer is the second leading cause of death in the US, research in this area has been and is presently being conducted. Further, some support has been provided for the cancer-prone personality type. The cancer-prone person has been described as holding resentment, with the inability to forgive, using self-pity, lacking the ability to develop and maintain meaningful interpersonal relationships, and having poor self-image.

Tension Headaches
Headaches may be caused by muscle tension accompanying stress. This muscle tension may include the forehead, jaw, or neck. Once the headache occurs, it tends to fuel itself. It is difficult to relax when you're in pain. Treatment for tension headaches may include medication, heat on tense muscles, or massage. Others have also reported on the effectiveness of relaxation training for control and prevention of tension headache.

Allergies And Asthma
Some medical scientists, unable to identify any antigen in many asthmatics, have argued that allergies are emotional diseases. This was shown in an experiment in which a woman who was allergic to horses began to wheeze when shown only a picture of a horse, another woman who was allergic to fish had an allergic reaction to a toy fish and empty fishbowl' and others reacted to uncontaminated air when suspecting it contained pollen. Crying-induced asthma, brought on during stressful events is another example. Some have concluded, therefore, that the effects of stress on the immune system either decrease our ability to withstand an antigen or, even in the absence of an antigen, can lead to allergic-like response. Some allergy sufferers
-- in particular, asthmatics -- are being taught relaxation techniques and breathing control exercises to enable them to control their physiology during allergic reactions.

Post Traumatic Stress Disorder
PTSD is a condition that develops in people who have experienced an extreme psychological and/or physical event that is interpreted as particularly distressing. PTSD is defined as:
· A threat to one's life or serious injury or being subject to horror with intense fear and helplessness
· Recurrent flashbacks, repeated memories and emotions, dreams, nightmares, illusions or hallucinations related to traumatic events from which one is often amnesic
· Trying to avoid feelings, thoughts, or places that may trigger associations
with trauma
· Poor sleep, poor appetite
· Self-recrimination
· Feeling jumpy, irritable, or emotionally explosive or "spaced out"
· Having difficulty concentrating, socializing, or working
Among the characteristics of those who have successfully managed PTSD are that they had supportive relationships with family and friends, they did not dwell on the trauma, they had personal faith/religion/hope, and they had a sense of humor.

Other Conditions
Stress has been shown to affect other health conditions, as well. Stress can lead pregnant women to miscarry. In a study, 70 percent of women who had miscarriage had at least one stressful experience four to five months before the miscarriage, as compared with 52 percent who did not have one. Even sports injuries occur more frequently in athletes who have experienced stressors and who do not have the resources and skills to cope well with stress. With high stress and poor coping resources, the result is increased muscle tension and attention redirected toward the stress and away from the event.

Taking Medication: 16 Ways to Become a Smart Self-Advocate By Margarita Tartakovsky, M.S.

When we walk into the doctor’s office, for many of us, the scenario looks like this: We list off our symptoms, the doctor asks a few questions, writes out a prescription and we go on our way.

From her work in primary care settings, Risa Weisberg, Ph.D, assistant professor (research) and co-director of the Brown University Program for Anxiety Research at Alpert Medical School, has seen “firsthand how a great many patients accept a prescription from their provider without asking many questions about it, or often, without even knowing for what symptoms/disorder it is being prescribed.”

Such a scenario can stall or sabotage your treatment. Confused, you’re likely left with tons of questions, unaware of what you’re taking and how it’s supposed to help. You may be feeling helpless — a spectator in your own recovery — and hopeless, if the medication doesn’t seem to work or has bad side effects. Your doctor likely is clueless about your real concerns, not having all the information to guide his or her decision-making process.

But you don’t have to feel like a powerless bystander, on the outskirts of your own treatment. In order to become a sharp self-advocate, you just need some information. Here’s some hints for for taking medication safely and effectively. At the end, you’ll also find a basic glossary of common medication-related terms.

1. Haven’t picked a physician yet? Do your homework and conduct an interview. Before you decide on a doctor, whether it’s a primary care physician or a psychiatrist, ask some questions about qualifications and see if he or she is a good fit for you. Questions to get you started: Where did you go to school and do your training? Do you specialize in a specific mental illness? Do you have hospital privileges? Here’s a list of excellent questions to ask a psychiatrist during and after your first appointment. They focus on bipolar disorder, but you can easily adapt them to any disorder.

2. Ask the doctor about your diagnosis. You have the right to know precisely what you’re diagnosed with and how the doctor came to that conclusion. Making a diagnosis doesn’t happen in a 5-minute interview. You want to make sure that the doctor conducted a thorough evaluation. Did the doctor get your medical and mental health history? Did you complete a standardized test? Did the doctor ask about your symptoms and recent experiences?

3. Seek out psychotherapy. Medication isn’t your only option. Depending on the disorder, you may only need psychotherapy or you may take medication and see a therapist. Psychotherapy provides lasting benefits, whereas a medication’s effects stop as soon as you stop taking it. Cognitive-behavioral therapy effectively treats depression, anxiety disorders and bipolar disorder. To find a therapist, you can ask your doctor for a recommendation, browse the Web or check with universities and medical schools. Be sure the therapist specializes in your mental illness. For advice on finding a good therapist, check out this eBook.

Some Web sources for finding a therapist:

• Psych Central’s therapist finder
• The Association for Behavioral and Cognitive Therapy for CBT-trained therapists
• Children and Adults with Attention Deficit/Hyperactivity Disorder
• Anxiety Disorders Association of America
• National Eating Disorder Association

4. Before taking the medication, ask specifics. Peter Roy-Byrne, M.D., professor and chief of psychiatry at the University of Washington at Harborview Medical Center, and Michael R. Liebowitz, M.D., professor of clinical psychiatry at Columbia University and managing director of The Medical Research Network, suggest asking:

• How will I know if this medication is working?
• What are the side effects, and what do I do if I experience them?
• When will the medication start to work?
• How long will I have to take it?
• If I take it for X amount of time, what’s the likelihood of reducing symptoms?
• What are the dose requirements?
• Will you be monitoring me throughout the course of this medication?
• When will you talk to me next?

The Agency for Healthcare Research and Quality has a basic handout with more questions. Here’s a thorough list if your child is taking medication, which you can easily revise for your situation.

5. Unsure about medication? Explore why. Are you on the fence because of potential side effects, the stigma of having a disorder or taking medication, a bad past experience, fears of addiction or uncertainty about the validity of your diagnosis? Talk to the doctor about your concerns before making the decision to take or refuse the medication.

6. Research your medication. Before having your prescription filled, look for information about your medication and its side effects.

7. Pose questions to your pharmacist. Along with your physician, the pharmacist is a great resource for information, so ask away!

8. Remember that you and your doctor are a “health care team,” Weisberg said. Together, you collaborate on your treatment. And as such, you should feel comfortable asking questions and raising concerns, all the while respecting your physician’s expertise. If you feel like your doctor isn’t listening or brushes you off, find a professional who will be part of your team. It’s what doctors are there for.

9. Keep a list of your medication. Include the name of your medication and the dose and always bring your list to appointments, said Holly Swartz, M.D., associate professor of psychiatry at the University of Pittsburgh School of Medicine and Western Psychiatric Institute and Clinic in Pittsburgh. Your list is especially essential if you’re seeing both an internist and a psychiatrist, she added.

10. Keep another list of medication you stopped taking. Include the reasons you stopped taking the medication, Dr. Swartz said. This gives your doctor the whole picture and helps guide decisions about what medications will be safe and effective for you.

11. Purchase a pill box. A pill box can be helpful if you’re taking many medications or multiple doses, said Dr. Swartz, who suggests counting out your pills in the beginning of each week.

12. Take your medication as prescribed. This may seem like a no-brainer, but many individuals skip a dose or stop taking medication altogether, because they left their medication at home, forgot to get a refill, couldn’t stand the side effects or felt better. Not taking your medication can make symptoms return.

“If you stop an anxiety drug, the anxiety may come back, and with the passage of time, it could be worse than before,” Dr. Roy-Byrne said. Or you may experience “discontinuation syndrome,” what many people think of as withdrawal. Symptoms vary for each individual, but may include insomnia, dizziness, anxiety, blurred vision and hallucinations.

Relapse is another concern. Individuals with bipolar disorder are at higher risk for relapse if they stop taking medication, Dr. Swartz said.

13. Monitor your progress. Some doctors will give you tools, such as a standardized scale to measure your progress. If they don’t, start documenting it on your own and bring the materials to every appointment. For instance, for bipolar disorder, Melvin McInnis, M.D., psychiatrist and professor of mood disorders with the department of psychiatry and the Depression Center at the University of Michigan, suggests keeping a journal with your mood, quality of sleep and energy levels and finding a self-report scale to track your symptoms. If you can’t find a good scale, create a daily log of symptoms your medication is supposed to reduce and evaluate them from 1-10. And keep a record of side effects. Dr. Roy-Byrne also has his patients closely monitor their symptoms before they start taking medication. This way, it’s easier to pinpoint the changes the medication has caused, not your natural symptoms.

14. Give your doctor feedback. Let your doctor know how you’re feeling, particularly if you’re experiencing bothersome side effects. Your doctor can help minimize side effects by adjusting the dose, changing how you take the medication or prescribing a different drug altogether. Have trouble sleeping? Your doctor may suggest taking medication in the morning. Not communicating with your doctor can compromise treatment. “If you have secretly stopped one medication, your doctor may start telling you to increase another medication without understanding that your new symptoms are actually unrecognized withdrawal symptoms from stopping the other medication,” Dr. Swartz said. When tapering off medication, if something doesn’t feel right, talk to your doctor, who can then make the proper adjustments.

15. Understand that it’s a process. Finding the right medication may “require a process of trial and error and refinement,” Dr. Swartz said. “Try not to feel discouraged if the medications do not work right away or cause side effects that require serial medication adjustments.” This is why giving feedback to your doctor and tracking your progress is key.

16. Disclose any supplements, vitamins or medication you’re taking. Any of these substances can interact with your medication — some with dangerous results.

Medication Lingo

Here’s a quick look at common terms you may run across:

Half-life: The time it takes for half of the medication to leave the body. For instance, Paxil has a short half-life, leaving the body in about a day, whereas Prozac, which has a longer half-life, takes a week.

Black-box warning: The most serious type of label applied to prescription drugs by the Food and Drug Administration (FDA). For instance, the FDA requires that all antidepressants carry a black-box warning about the potential increased risk of suicidal symptoms in 18- to 24-year-olds.

Side effects: Adverse effects caused by medication.

Discontinuation syndrome: One or more side effects that occurs when individuals stop taking medication abruptly, including dizziness, headache, insomnia and numbness. For more on discontinuation syndrome, see here and here.

Antidepressants: A group of medications used to treat mood disorders, including depression, by acting on neurotransmitters in the brain – namely dopamine, serotonin and norepinephrine. The following are types of antidepressants: selective serotonin reuptake inhibitors (SSRIs); serotonin and norepinephrine reuptake inhibitors (SNRIs); tricyclic antidepressants (TCAs); and monoamine oxidase inhibitors (MAOIs).

Antipsychotics (or neuroleptics): Developed in the mid-1950s, these medications are known as traditional or typical antipsychotics. They treat severe mental disorders such as schizophrenia by reducing symptoms such as hallucinations and delusions. Antipsychotics have a risk of extrapyramidal side effects, including tremors, slurred speech, akathisia (shakiness and fidgeting) and tardive dyskinesia (involuntary movements). Other medications, including Prozac, Zoloft and Lithium, also may cause tardive dyskinesia.

Atypical (or “second generation”) antipsychotics: Developed in the 1990s, this group of medications also treats psychotic symptoms. It’s the first line of treatment for schizophrenia and may be prescribed to treat the manic phase of bipolar disorder. Overall, tardive dyskinesia and extrapyramidal symptoms occur less often with atypical antipsychotics. However, recent studies suggest that Abilify may cause akathisia.

Atypical antipsychotics also may raise the risk of obesity, diabetes and high cholesterol. Clozapine is an effective atypical antipsychotic, but is usually prescribed when other medications don’t work, because of its ability to reduce white blood cells (which fight infection) in some people.

Monoamine oxidase inhibitors (MAOIs): Used in the 1950s, MAOIs were the first antidepressants on the market. They work by metabolizing dopamine, norepinephrine and serotonin to help boost mood. These medications typically are prescribed when other antidepressants haven’t worked, because they require stringent dietary restrictions.

Selective Serotonin Reuptake Inhibitors (SSRIs): This group of newer antidepressants acts on the neurotransmitter serotonin by blocking its reuptake (reabsorption). It’s believed that higher levels of serotonin in the brain will help mood. The most famous SSRI is Prozac, which was introduced in 1987. Common side effects include sexual problems, trouble sleeping, nausea, dizziness and weight gain. Mayo Clinic offers advice on reducing SSRI side effects.

Serotonin norepinephrine reuptake inhibitors (SNRIs): A class of medications that inhibits the reuptake of both serotonin and norepinephrine. Common side effects resemble those for SNRIs but typically cause fewer sexual problems. Effexor (venlafaxine) can cause high blood pressure at high doses, so it’s important to have your blood pressure checked regularly.

Tricyclic antidepressants (TCAs): An older group of medications, TCAs are prescribed when newer antidepressants are ineffective to treat depression. They’re also prescribed for bipolar disorder. TCAs either work on serotonin, norepinephrine or both (called “dual action”). They may not be safe for individuals with heart disease and may be fatal in overdose.

Mood stabilizers: These medications help to regulate mood and are prescribed for bipolar disorder and borderline personality disorder. Examples include lithium and anti-seizure medications, such as Depakote, Tegretol and Lamictal. Side effects include weight gain and nausea.

Benzodiazepines: A group of fast-acting medications, including Xanax, Ativan and Valium, that treats anxiety, panic disorder, insomnia and sometimes bipolar disorder. Benzodiazepines act on the gamma-aminobutyric (GABA) receptors, inducing relaxation. When used for a long time or in high doses, benzodiazepines may cause physical dependence. Stopping abruptly can trigger severe symptoms, including anxiety, irritability, difficulty sleeping, muscle cramps and confusion.

Stimulant medication: Medications used to treat attention deficit hyperactivity disorder (ADHD), including methylphenidates (Ritalin) and amphetamines (Adderall). Stimulant medications increase dopamine levels, affecting the core symptoms of ADHD: inattention, impulsivity and hyperactivity. Side effects include reduced appetite and sleeping problems, but these tend to go away after several weeks or after adjusting the dose.

Serotonin: Chemical in the brain that regulates mood, sleep, sex drive, appetite, memory and learning, body temperature and behavior.

Dopamine: Neurotransmitter that controls pleasure-seeking, emotion, attention and movement.

Norepinephrine: Neurotransmitter that regulates blood pressure, heart rate and respiration.

Additional Resources

Psych Central’s comprehensive medication guide
Guidelines for Anxiety Medication Use (can be applied to other illnesses)
Medication guide from the National Institute of Mental Health
Podcast from ADDA on medication for anxiety disorders with Dr. Roy-Byrne

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Virtual Therapy for PTSD

By Rick Nauert PhD Senior News Editor

Reviewed by John M. Grohol, Psy.D.

New research suggests post-traumatic stress disorder can affect 10 to 30 percent of combat zone soldiers, depending on the conflict in which they served. Given the instability of the global environment the ranks of active duty and retired soldiers will continue to grow.

As such, PTSD is on the rise and is a target for military health care personnel. A number of PTSD-focused studies presented at a military health research forum evaluated the effectiveness of both pharmacologic and alternative treatment options.

A novel intervention included use of virtual environments and new medicines to help military personnel diagnosed with PTSD or other comorbidities. If effective, the therapy technique could be used for the general public.

“PTSD is a condition that has affected decades of war veterans, and treatments continue to evolve,” stated Captain E. Melissa Kaime, M.D., Director of the CDMRP.

According to experts, about 20 percent of combat veterans returning from Iraq suffer from mild traumatic brain injury (mTBI) or PTSD.

Traditional treatment for these conditions consists of medication and psychotherapy, demanding frequent travel to a clinic, a potential hardship for many veterans.

Researchers led by Charles Levy, M.D., are attempting to leverage combat veterans’ comfort and familiarity with communications technology and immersive environments (through cell phones, the Internet, and video games) and build a prototype of a virtual world environment (VWE) in which to conduct therapy.

The VWE will simulate everyday life encounters that are challenging to those with mTBI/PTSD, and allow the veteran and therapist to confront and overcome barriers that block successful social reintegration.

The clinical team chose a supermarket as the virtual scenario where veterans could receive cognitive and emotional challenges, including following a shopping list, purchasing items, making change, colliding with other shopping carts, and engaging with clerks and other patrons at checkout.

Currently, a virtual supermarket is under construction that allows a therapist and patient, each at their own computer, to enter the virtual supermarket and experience these challenges together.

This research explores an innovative new concept. Previous use of virtual reality exposure among combat veterans has been limited to portraying battle as a part of exposure therapy.

“Oftentimes, the nuances of everyday life can unexpectedly trigger angry responses from warfighters hindered by mTBI and PTSD,” Levy said.

“This project shows great potential to expedite and expand care to veterans and wounded warriors in a short timeframe, in a way that minimizes travel for treatment, and in a cost-effective manner.”

Source: US Department of Defense Congressionally Directed Medical Research Programs