Antidepressants Blog

One cause of depression is a sense of being stuck in a frustrating, disheartening situation. Such situations are everywhere in life. Most people at one time or another must face something which they cannot fix, to which they can only adjust. HIV infection is certainly reason for depression: “One of the worst things about this virus,” said June, “is that you never know what’s coming next. I’m beginning to feel over my head. That’s pretty depressing.” For people facing HIV infection, depression, like anger, is a reasonable response.
Another cause of depression is predisposition: people who have been depressed before their diagnosis might be more likely to be depressed afterward. Another cause is medications. Many of the medications used to treat opportunistic infections and HIV itself can sometimes cause depression.
Alcohol, which is a depressant, is a particularly treacherous cause of depression because it can start a cycle. To feel better about their depressions, people drink, which makes them feel depressed and out of control. So to feel better, they drink some more, get more depressed, and so on and on.
Occasionally, depression may be caused by the virus itself. That is, depression can be a symptom of dementia, a condition that results when the virus enters the brain.
Frequently, depression is caused by unexpressed anger. Anger is hard to express, especially if it is directed at” something as vague as fate, or something as personal as your own body or your behavior. People who do not express such anger either consciously restrain it or unconsciously ignore it. In either case, they unknowingly turn their anger inward on themselves and become depressed.

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Lacking a feedback loop is not sufficient criterion for an extreme or psychotic state. To understand the difference between Herr E.’s process and the ones we normally meet, we need one more concept: metacommunication.
This fancy term means communicating about some aspect of communication. Metacommunication is the ability to comment on a message, its sender or its effect. For example, if I am able to metacommunicate. I can communicate about my communication signals, what I say, how I say it, whether or not I feel the receiver has understood, the reason I have spoken, etc. Herr E. cannot metacommunicate; he cannot talk about the way he is communicating, or what it is he is saying. Thus he cannot comment on his communicative mode to say that he is projecting or dreaming.
METACOMMUNICATION AND THE GROWER’S CLUB
One of the basic paradigms of classical analysis is that there is always someone present in the patient to metacommunicate. This means that the therapist assumes that the client is interested in or will eventually be interested in dreams, relationships, body experiences and therapeutic strategies.
Most of the time, patients coming to psychotherapy are capable of and interested in metacommunicating. These people and their therapists belong to what I call the ‘grower’s club:’ those interested in growth, development and insight. Like most club members everywhere members of the grower’s club are prejudiced against non-members. Great numbers of our population, however, do not belong to the grower’s club, and furthermore, they need not belong. They have other processes. Some of those people called schizophrenics and many other psychotic individuals do not belong to this club. They do not like to, are not able tp, or think it is ridiculous to talk about their communication and their states. Moreover most of you reading this paragraph right now are capable of  metacommunicating only some of the time. I myself, for example, hate to metacommunicate about anger while I am in the midst of it. I try, but do not always succeed.
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Doxycycline
Doxycycline (Vibramycin, Pfizer), a tetracycline, continues to be the preferred agent for persons unable to tolerate mefloquine or for those traveling to areas where mefloquine resistance is present. The drug is taken in a dose of 100 mg daily during exposure and continued for 4 weeks after the traveler returns home. No loading dose is required. Doxycycline has been shown to have comparable prophylactic efficacy to mefloquine, but the need for daily dosing may reduce adherence and, therefore, the drug’s effectiveness. Side effects of doxycycline include gastrointestinal upset, esophagitis, and vaginal candidiasis. Furthermore, since the drug can be photosensitizing, its use requires adequate sunscreen protection. Doxycycline is contraindicated in pregnant or lactating women and in children younger than 8 years of age. Long-term administration of tetracyclines has generally been well tolerated.

Atovaquone/Proguanil
The U.S. Food and Drug Administration recently approved a fixed combination tablet of atovaquone and proguanil (Malarone, Glaxo Wellcome) for the chemoprophylaxis of malaria. Travelers need only take the medication during periods of exposure and for 1 week after departure. This is an advantage over mefloquine and doxycycline, which need to be taken for 4 weeks following exposure. Atovaquone/proguanil has been found to be useful against strains of malaria that are resistant to other agents. The adult dosing regimen for prophylaxis consists of one tablet (250 mg atovaquone/100 g proguanil) daily starting 2 days before travel, one tablet per day during travel, and one tablet daily for 7 days after leaving an endemic area. The most common adverse effects are abdominal pain, nausea, and headaches. Since insufficient data exist on its safety in pregnancy, it should not be taken by pregnant or lactating women. Atovaquone/proguanil is also contraindicated in those with severe renal impairment. Overall, this combination is well tolerated and efficacious in the prevention of P. falciparum. More data are needed to confirm its efficacy against the other malaria species.

Primaquine
Primaquine (base, Sanofi-Synthelabo) has activity against both the blood and liver stages of malaria parasites. In patients who have been infected with P. vivax or P. ovale, relapses can occur far after chemoprophylaxis is discontinued because the standard drugs fail to eliminate the liver hypnozoites. To prevent relapses, a course of primaquine may be given as terminal prophylaxis (to eliminate latent intrahepatic stages) at the conclusion of the standard post-travel chemoprophylaxis regimen. One 26.3 mg tablet is administered daily for 14 days after the trip. Terminal prophylaxis is generally indicated only for people who have a prolonged exposure in malaria endemic areas or who have visited areas of intense P. vivax transmission. Primaquine causes acute intravascular hemolysis in those with an inborn deficiency of glucose-6-phosphate-dehydrogenase (G6PD). The drug should not be prescribed without confirming a normal G6PD level. Primaquine should not be used in pregnant patients.

Future Options
Since primaquine is effective against the hypnozoites developing in the liver, it has recently been reconsidered for causal prophylaxis (to interfere with the early intrahepatic development) of malaria, particularly if the exposure is short. Travelers would need to take primaquine only during exposure and for 1 week after. Randomized controlled trials of the use of primaquine as a chemoprophylactic agent (30 mg base/day) have demonstrated protective efficacy against both P. falciparum and P. vivax infections, but at this time primaquine is not licensed for this indication. Tafenoquine is a long-acting primaquine analogue with the same mechanism of action, but this drug is not yet licensed in the United States. Like primaquine, it can be used for causal prophylaxis. It has a long elimination half-life (14-28 days for tafenoquine versus 4-6 hours for primaquine) that allows for infrequent dosing regimens. Preliminary reports indicate that a once-weekly dose is effective against P. falciparum, and a 3-day loading dose alone provides protection for several weeks. Tafenoquine remains only a future option for the prevention of malaria, but it may improve medication compliance with malaria chemoprophylaxis.
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Insects. Insect bites   normally cause pain and swelling because of the effect of the venom. The degree of reaction produced depends upon the type and quantity of venom introduced. But in some children, the venom acts as an antigen and with the antibodies already present, induces an allergic reaction. Insects can be divided into two groups: biting and stinging Yellow Jacket   according   to   the   allergic  reaction     produced.
Biting-insect Allergy. Allergic reaction to biting insects such as mosquitoes, is not immediate; it is delayed. It is only after several hours of the bite that the site becomes red and swollen. There may be some rise in the body temperature. However, the reaction is never serious or fatal.
It does not require any treatment, except an occasional tablet of antihistamine to check itching. The body reacts less to them after many such bites. This is also the reason why these reactions are more severe in children than in adults or older people.
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Growing old is an inevitable part of life, but many of the signs attributed to ageing are due rather to vitamin and mineral deficiencies accumulated over the years than to the ageing process itself.

Vitamin C can play a big part in halting many of the ageing processes and if taken in adequate doses throughout life, can prolong the period of vigorous and healthy matur­ity, not merely prolong life itself.

It has been shown by many researches that although the need for Vitamin C increases with age, the actual vita­min content of human tissues decreases as the years ad­vance. In fact, a Vitamin C deficiency is very common in elderly people.

This is evident in the spots of bruising so often seen under the skin on older people’s forearms — the smallest injury will cause a bruise. Also in the teeth loosened in their sockets where the colloid substance which holds the teeth firmly in the gums has deteriorated; in the bent backs and brittle bones due to thinning of the matrix in which the calcium of the bones is deposited; in the loss of height through subsidence of the firm fibro-elastic tissue of the intervertabral discs and in the stiffness of joints whose smooth cartilage is eroded by deterioration of the Vitamin C dependent colloid substance of which it is made.

Literally, Vitamin C is responsible for holding all the connecting tissues of the body together, and, when it is deficient as it becomes in old age, the body is inclined to literally ‘come apart at the seams’. Not only this but the poor resistance of old people to infections, specially chest infec­tions, is due to a relative Vitamin C deficiency.

There are so many references in<,the medical literature showing that ascorbic acid requirements are increased in old age and that the elderly suffer from serious depletion, that it is difficult to understand why the 500 mg ascorbic acid tablets allowed as a pharmaceutical benefit (for pen­sioners) should have recently been cut down to 50 mg maximum tablet.

The elderly, of whom most are pensioners, need far more than the meagre 50 mg tablets allowed. Even 3 to 6 fifty milligram tablets a day would only provide 150 mg to 300 mg a day. But it has been found that elderly people are greatly improved on at least 1000 mg or 1 gram a day and that many of their disabilities disappear when 2-3 grams, even 4 grams, of Vitamin C are taken daily.

The great advantage of Vitamin C is that it is non-toxic and that large doses can be taken daily for long periods with only benefit and no serious side effects.
*17/21/7*
Pharmacy information, side effects, interations

Vitamin C assists Vitamin A, the B Complex and Zinc in controlling the acne that is so often the despair of teenagers, but may continue into adult life. It is especially valuable in combating the staphylococcus germs which infect the hair follicles and pores of the skin, and are the basis of both the white headed and the deep-seated pimples.

At least one to three grams a day, taken in divided doses, will often prevent the black heads from turning into unsightly pustles.

The type of acne termed rosacae is more prevalent in middle age. It is caused by networks of enlarged capillary vessels and open pores on the nose and across the cheeks. Vitamin C, coupled with the B vitamin, B2 (riboflavine) and bioflavinoid prevents and improves the redness due to di­lated surface capillaries. At least 3 doses of 500 mg daily, coupled with a Vitamin B2 tablet and 2 bioflavinoid tablets three times a day over long periods are needed to cure the unsightly pink flush across the nose and cheeks.

The redness and itching of prickly heat is claimed by Singapore doctors to be alleviated in both children and adults by taking Vitamin C in quite moderate doses say, 250 mg to 500 mg three times a day during the tropical heat and humidity. This treatment should be very helpful in the northern parts of Australia during summer months.

Experimenting with the effect of megadoses of Vita­min C in acute skin affections complaining of inflammation and intolerable itching, Dr A. Glew of Brisbane reports dramatic relief of a case of eczema and a case of psoriasis immediately following intravenous sodium ascorbate, 15 to 30 grams.
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Mosquitoes are especially prevalent in summer. They are more active at night, and also take advantage of not having a moving target while your child sleeps. Children who are sensitive to mosquito bites develop very itchy red lumps at the bite sites. If your child is bitten on the face, this can lead to marked swelling. You can apply help to reduce swelling. Try to discourage your child from scratching at the bite, in order to prevent infection. If your child has severe swelling and itching at the site of the bite, and this interferes with his sleep, the short-term use of an antihistamine may help him to sleep, as well as decreasing the itching.

Prevention

For a young baby a net over the cot is the safest form of protection against mosquitos. When taking your baby outdoors, make sure you dress him in light clothing which has long sleeves and trousers. Insect repellent can be used on older children but apply it sparingly, and make sure that they do not get it in their mouths or eyes. Roll-on repellents are preferable to aerosols when used for children.

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Sit down as a family and play the ‘ ‘Sex Contingencies” game. This exercise will allow you to review the material from all twelve chapters of this book and to share your feelings now that you have read and thought about super marital sex. Each person should take a turn responding to each of the following ten items.

1. WHAT do you consider to be a sexual act? Do you view sex in a different, more inclusive manner after reading this book?

2. WHO would be the best sexual partner for you? What would be the characteristics of someone you could love for life?

3. WHY would you have sex? Has your personal “model” of sexuality changed in the direction of the fourth perspective?

4. WHEN would you prefer to have sex? Do you relate your personal intimate relationship to the systems view that incorporates all phases of daily living, a sex beyond the limits of “nighttime”?

5. WHERE would you prefer to have sex? Have you thought about your own private, intimate place and about providing an intimate place for everyone in the family?

6. HOW do you prefer to have sex? Have you learned that the posture of the future is really a positioning for a new intimacy, a finding of a new perspective for sex in lasting relationships?

7. WHERE DOES SEX FIT IN YOUR LIFE? What priority do you assign to sexuality, and are you making the commitment necessary to match your own priority for sex?

8. HOW SECRET should sex be? Have you learned about making sexuality an open discussion of family life, to be discussed and examined together even as it is protected as the most personal and private of all life experiences?

9. HOW MUCH VARIETY do you feel you require in your sexuality? Have you learned that the comfort of sameness can exceed the challenge and pressures of newness, that super sex is not different sex?

10.    so WHAT? What does sex mean to you, to your family, to your marriage

now that you have read about another perspective on sexuality?

I hope that you find in these sample questions and in the material I have shared with you in this book a new challenge for a new sex for a new time. I hope you have made progress toward a super marital sex, a committed, enduring, comfortable intimacy that is “super” because it goes beyond the limits of the body to the potential of the merging of spirits.

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