Welcome toThe Basics About Panic Attacks - Introduction

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• Don't Panic,
  Chapter 3. Panic within Psychological Disorders

Although the first panic attack may seem to appear "out of the blue," it typically comes during an extended period of stress. This stress is not caused by a few days of tension, but extends over several months. Life transitions, such as moving, job change, marriage, or the birth of a child, often account for much of the psychological pressure.

For some individuals, learning to manage this stressful period or to reduce the pressures will eliminate the panic episodes. For others, it is as though the stress of the life transition or problem situation uncovered a psychological vulnerability. If the panic-prone individual accepts increased responsibilities -- for instance, through a job promotion or through the birth of a first child -- he may begin to doubt his ability to meet the new demands, the expectation of others, and the increased energy required for these responsibilities. Instead of focusing on mastering the task, he becomes more concerned with the possibility of failure. This attention to the threat of failure continually undermines his confidence. Either gradually or quickly, he translates these fears into panic.

Certain people experience symptoms in the middle of sleep. These are either caused by panic disorder or are identified as "night terrors". Most nighttime (or nocturnal) panics take place during non-REM sleep, which means they do not tend to come in response to dreams or nightmares. They occur between a half-hour to three and a half hours after falling asleep and are usually not as severe as daytime panics. These are distinct from night terrors, known as pavor-nocturnus in children and incubus in adults. The similarities are that they produce sudden awakening and autonomic arousal and tend to not be associated with nightmares. However, a person who experiences a night terror tends to have amnesia for it and returns to sleep without trouble. He also can become physically active during the terror -- tossing, turning, kicking, sometimes screaming loudly or running out of the bedroom in the midst of an episode. Nocturnal panic attacks, however, tend to cause insomnia. The person has a vivid memory of the panic. He does not become physically aggressive during the panic attack, but remains physically aroused after the occurrence.

WHAT IS AGORAPHOBIA?

Each person diagnosed with agoraphobia (meaning "fear of the marketplace") has a unique combination of symptoms. But common to all agoraphobics is a marked fear or avoidance either of being alone or of being in certain public places. It is a response strong enough to significantly limit the individual's normal activities.

For the person who experiences panic attacks, the distinction between agoraphobia and panic disorder is based on how many activities he avoids. In panic disorder, the person remains relatively active, although he may avoid a few uncomfortable situations. If the panic-prone person begins to significantly restrict his normal activities because of his fearful thoughts, agoraphobia is the more appropriate diagnosis.

For some, agoraphobia develops from panic disorder. Repeated panic attacks produce "anticipatory anxiety," a state of physical and emotional tension in anticipation of the next attack. The person then begins to avoid any circumstances that seem associated with past panic attacks, becoming more and more limited in his range of activities.

The fearful thoughts that plague the agoraphobic often revolve around loss of control. The person may fear the development of uncomfortable physical symptoms familiar from past experiences (such as dizziness or rapid heartbeat). He may then worry that these symptoms could become even worse than they were in the past (fainting or heart attack), and/or that he will become trapped or confined in some physical location or social situation (such as a restaurant or party). In the first two situations, the person senses that his body is out of control. In the third, he feels unable to readily control his surroundings.

The following list shows the types of surroundings that can provoke these fears.

FEAR OF THE SURROUNDINGS

• Public Places or Enclosed Spaces
• Confinement or Restriction of Movement
  • Streets
  • Barber's, hairdresser's, or dentist's chair
  • Stores
  • Lines in a store
  • Restaurants
  • Waiting for appointments
  • Theaters
  • Prolonged conversations in person or on the churches, phone
  • Crowds
• Travel
  • On trains, buses, planes, subways, cars
  • Over bridges, through tunnels
  • Being far away from home
• Remaining at Home Alone
• Open Spaces
  • Traffic
  • Parks
  • Fields
  • Wide streets
• Conflictual Situations
  • Arguments, interpersonal conflicts, expression of anger

The agoraphobic may avoid one or many of these situations as a way to feel safe. The need to avoid is so strong that some agoraphobics will quit their jobs, stop driving or taking public transportation, stop shopping or eating in restaurants, or, in the worst cases, never venture outside their home for years.

Listed below are the types of fearful thoughts associated with the dreaded situations. These are irrational, unproductive, and anxiety-producing thoughts which last anywhere from a few seconds to more than an hour. At the same time, they are the primary cause of agoraphobic behavior. These thoughts serve to perpetuate the agoraphobic's belief: "If I avoid these situations, I'll be safe."

FEARFUL THOUGHTS

• Fainting or collapsing in public
• Developing severe physical symptoms
• Losing control
• Becoming confused
• Being unable to cope
• Dying
• Causing a scene
• Having a heart attack or other physical illness
• Being unable to get home or to another "safe" place
• Being trapped or confined
• Becoming mentally ill
• Being unable to breathe

Some agoraphobics experience no symptoms of panic. Fearful thoughts continue to control these individuals, but they have restricted their lifestyle, through avoidance, to such a degree that they no longer become uncomfortable.

When agoraphobics retreat to protect themselves, they often have to sacrifice friendships, family responsibilities, and/or career. Their loss of relationships, affections, and accomplishments compounds the problem. It leads to low self-esteem, isolation, loneliness, and depression. In addition, the agoraphobic may become dependent on alcohol or drugs in an unsuccessful attempt to cope.

Professional Help

Panic disorder is the only psychological problem whose predominant feature is recurring panic (or anxiety) attacks. The following is a brief summary of professional treatment of this problem.

One of the most difficult problems for individuals with panic disorder is getting the right diagnosis. Panic disorder is regarded as one of the great impostors of medicine because its symptoms are similar to those found in a number of physical ailments, including heart attacks, some respiratory illnesses and thyroid diseases. Once diagnosed and proper treatment begun, recovery may occur in a matter of months, but can take longer depending on individual circumstances.

The most successful treatment regimens include a combination of behavior therapy and cognitive therapy, sometimes with medication. Support groups may also be extremely useful, because many individuals need the reassurance that they are not alone. A successful treatment program must address all the individual's problems, including depression or substance abuse, that might accompany the underlying emotional disorder.

Cognitive-behavior therapy attempts to alter the way a person thinks and acts in certain circumstances. Specifically, the therapist helps the patient develop anxiety reduction skills and new ways to express emotions. Relaxation techniques, such as controlled breathing, are a typical feature. The patient also may be taught to re-examine the thoughts and feelings that trigger his fears and maintain his anxiety. The patient often is gradually exposed to the feared situation, and taught that he can cope.

There are a number of anti-anxiety and antidepressant medications that can be effective in controlling panic disorder. The medication regimen may last just a few weeks, but in many cases this therapy may be required for a year or longer. Medication should be accompanied by other therapy, however, because the majority of patients treated only with drugs relapse once the medication is discontinued.

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(vardenafil HCI) Tablets

Read the Patient Information about LEVITRA before you start taking it and again each time you get a refill. There may be new information. You may also find it helpful to share this information with your partner. This leaflet does not take the place of talking with your doctor. You and your doctor should talk about LEVITRA when you start taking it and at regular checkups. If you do not understand the information, or have questions, talk with your doctor or pharmacist.

What important information should you know about LEVITRA?

LEVITRA can cause your blood pressure to drop suddenly to an unsafe level if it is taken with certain other medicines. With a sudden drop in blood pressure, you could get dizzy, faint, or have a heart attack or stroke.

Do not take LEVITRA if you:

• take any medicines called "nitrates."
• use recreational drugs called "poppers" like amyl nitrate and butyl nitrate. take medicines called alpha-blockers. (See "Who Should Not Take LEVITRA (vardenafil HCI)")

Tell all your healthcare providers that you take LEVITRA. If you need emergency medical care for a heart problem, it will be important for your health care provider to know when you last took LEVITRA.

What is LEVITRA?

LEVITRA is a prescription medicine taken by mouth for the treatment of erectile dysfunction (ED) in men.

ED is a condition where the penis does not harden and expand when a man is sexually excited, or when he cannot keep an erection. A man who has trouble getting or keeping an erection should see his doctor for help if the condition bothers him. LEVITRA may help a man with ED get and keep an erection when he is sexually excited.

LEVITRA does not:

• cure ED
• increase a man's sexual desire
• protect a man or his partner from sexually transmitted diseases, including HIV. Speak to your doctor about ways to guard against sexually transmitted diseases.
• serve as a male form of birth control

LEVITRA is only for men with ED. LEVITRA is not for women or children. LEVITRA must be used only under a doctor's care.

How does LEVITRA work?

When a man is sexually stimulated, his body's normal physical response is to increase blood flow to his penis. This results in an erection. LEVITRA helps increase blood flow to the penis and may help men with ED get and keep an erection satisfactory for sexual activity. Once a man has completed sexual activity, blood flow to his penis decreases, and his erection goes away.

Who can take LEVITRA?

Talk to your doctor to decide if LEVITRA is right for you.

LEVITRA has been shown to be effective in men over the age of 18 years who have erectile dysfunction, including men with diabetes or who have undergone prostatectomy.

Who should not take LEVITRA?

Do not take LEVITRA if you:

• take any medicines called "nitrates" (See "What important information should you know about LEVITRA (vardenafil HCI)?"). Nitrates are commonly used to treat angina. Angina is a symptom of heart disease and can cause pain in your chest, jaw, or down your arm.
  Medicines called nitrates include nitroglycerin that is found in tablets, sprays, ointments, pastes, or patches. Nitrates can also be found in other medicines such as isosorbide dinitrate or isosorbide mononitrate. Some recreational drugs called "poppers" also contain nitrates, such as amyl nitrate and butyl nitrate. Do not use LEVITRA if you are using these drugs. Ask your doctor or pharmacist if you are not sure if any of your medicines are nitrates.
• take medicines called "alpha-blockers." Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. If LEVITRA is taken with alpha-blockers, your blood pressure could suddenly drop to an unsafe level. You could get dizzy and faint.
• you have been told by your healthcare provider to not have sexual activity because of health problems. Sexual activity can put an extra strain on your heart, especially if your heart is already weak from a heart attack or heart disease.
• are allergic to LEVITRA or any of its ingredients.

WHAT SHOULD YOU DISCUSS WITH YOUR DOCTOR BEFORE TAKING LEVITRA?

Before taking LEVITRA, tell your doctor about all your medical problems, including if you:

• have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your doctor if it is safe for you to have sexual activity.
• have low blood pressure or have high blood pressure that is not controlled
• have had a stroke
• or any family members have a rare heart condition known as prolongation of the QT interval (long QT syndrome)
• have liver problems
• have kidney problems and require dialysis
• have retinitis pigmentosa, a rare genetic (runs in families)
• have ever had severe vision loss, or if you have an eye condition called non-arteritic anterior ischemic optic neuropathy (NAION)
• have stomach ulcers
• have a bleeding problem
• have a deformed penis shape or Peyronie's disease
• have had an erection that lasted more than 4 hours
• have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia

Can other medications affect LEVITRA?

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. LEVITRA and other medicines may affect each other. Always check with your doctor before starting or stopping any medicines. Especially tell your doctor if you take any of the following:

• medicines called nitrates (See "What important information should you know about LEVITRA (vardenafil HCI)?")
• medicines called alpha-blockers. These include Hytrin® (terazosin HCl), Flomax® (tamsulosin HCl), Cardura® (doxazosin mesylate), Minipress® (prazosin HCl) or Uroxatral® (alfuzosin HCl). Alphablockers are sometimes prescribed for prostate problems or high blood pressure. In some patients the use of PDE5 inhibitor drugs, including LEVITRA, with alpha-blockers can lower blood pressure significantly leading to fainting. You should contact the prescribing physician if alpha-blockers or other drugs that lower blood pressure are prescribed by another healthcare provider.
• medicines that treat abnormal heartbeat. These include quinidine, procainamide, amiodarone and sotalol.
• ritonavir (Norvir®) or indinavir sulfate (Crixivan®)
• ketoconazole or itraconazole (such as Nizoral® or Sporanox®)
• erythromycin
• other medicines or treatments for ED

How should you take LEVITRA?

Take LEVITRA exactly as your doctor prescribes. LEVITRA comes in different doses (2.5 mg, 5 mg, 10 mg, and 20 mg). For most men, the recommended starting dose is 10 mg. Take LEVITRA no more than once a day. Doses should be taken at least 24 hours apart. Some men can only take a low dose of LEVITRA because of medical conditions or medicines they take. Your doctor will prescribe the dose that is right for you.

• If you are older than 65 or have liver problems, your doctor may start you on a lower dose of LEVITRA.
• If you have prostate problems or high blood pressure, for which you take medicines called alpha-blockers, your doctor may start you on a lower dose of LEVITRA.
• If you are taking certain other medicines your doctor may prescribe a lower starting dose and limit you to one dose of LEVITRA in a 72-hour (3 days) period.
• If you are taking certain other medicines your doctor may prescribe a lower starting dose and limit you to one dose of LEVITRA in a 72-hour (3 days) period.

Take 1 LEVITRA tablet about 1 hour (60 minutes) before sexual activity. Some form of sexual stimulation is needed for an erection to happen with LEVITRA. LEVITRA may be taken with or without meals.

Do not change your dose of LEVITRA without talking to your doctor. Your doctor may lower your dose or raise your dose, depending on how your body reacts to LEVITRA.

If you take too much LEVITRA, call your doctor or emergency room right away.

What are the possible side effects of LEVITRA?

The most common side effects with LEVITRA are headache, flushing, stuffy or runny nose, indigestion, upset stomach, or dizziness. These side effects usually go away after a few hours. Call your doctor if you get a side effect that bothers you or one that will not go away.

LEVITRA may uncommonly cause:

• an erection that won't go away (priapism). If you get an erection that lasts more than 4 hours, get medical help right away. Priapism must be treated as soon as possible or lasting damage can happen to your penis including the inability to have erections.
• color vision changes, such as seeing a blue tinge to objects or having difficulty telling the difference between the colors blue and green.

In rare instances, men taking PDE5 inhibitors (oral erectile dysfunction medicines, including LEVITRA) reported a sudden decrease or loss of vision in one or both eyes. It is not possible to determine whether these events are related directly to these medicines, to other factors such as high blood pressure or diabetes, or to a combination of these. If you experience sudden decrease or loss of vision, stop taking PDE5 inhibitors, including LEVITRA, and call a doctor right away.

These are not all the side effects of LEVITRA. For more information, ask your doctor or pharmacist.

How should LEVITRA be stored?

• Store LEVITRA at room temperature between 59° and 86° F (15° to 30° C).
• Keep LEVITRA and all medicines out of the reach of children.

General Information about LEVITRA.

Medicines are sometimes prescribed for conditions other than those described in patient information leaflets. Do not use LEVITRA for a condition for which it was not prescribed. Do not give LEVITRA to other people, even if they have the same symptoms that you have. It may harm them.

This leaflet summarizes the most important information about LEVITRA. If you would like more information, talk with your healthcare provider. You can ask your doctor or pharmacist for information about LEVITRA that is written for health professionals.

For more information you can also visit , or call 1-866-LEVITRA.

What are the ingredients of LEVITRA?

Active Ingredient: vardenafil hydrochloride

Inactive Ingredients: microcrystalline cellulose, crospovidone, colloidal silicon dioxide, magnesium stearate, hypromellose, polyethylene glycol, titanium dioxide, yellow ferric oxide, and red ferric oxide.

Norvir (ritonavir) is a trademark of Abbott Laboratories Crixivan (indinavir sulfate) is a trademark of Merck & Co., Inc. Nizoral (ketoconazole) is a trademark of Johnson & Johnson Sporanox (itraconazole) is a trademark of Johnson & Johnson Hytrin (terazosin HCl) is a trademark of Abbott Laboratories Flomax (tamsulosin HCl) is a trademark of Yamanouchi Pharmaceutical Co., Ltd. Cardura (doxazosin) is a trademark of Pfizer Inc. Minipress (prazosin HCl) is a trademark of Pfizer Inc. Uroxatral (alfuzosin HCl) is a trademark of Sanofi-Synthelabo

LEVITRA is a registered trademark of Bayer Aktiengesellschaft and is used under license by GlaxoSmithKline and Schering Corporation.

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teenage sex

Here are some precautions you can take to protect yourself against acquaintance rape - date rape.

How to protect yourself from rape date drugs.

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Helping your child make healthy food choices is a delicate balancing act - you have to consider calories, nutrients, serving sizes, and many other issues, all at the same time. Three important nutrients you need to make sure your child gets in adequate amounts are calcium, iron, and fiber. Keep reading to learn more about the importance of these nutrients to your child's health.

Calcium Counts

It's important that school-age children get adequate amounts of dietary calcium to ensure strong, healthy bones. Children ages 4 to 8 require 800 milligrams of calcium daily, whereas children ages 9 to 18 require 1,300 milligrams daily. You can meet these requirements by offering your children calcium-rich foods.

The preteen and teen years are the time to prevent the bone disease osteoporosis, which involves a reduction in the amount of bone mass. This is true because peak bone mass and calcium content of the skeleton is reached during the teen years.

Calcium is the major mineral that strengthens bones. Bone calcium begins to decrease in young adulthood and progressive loss of bone calcium occurs as we age, particularly in women. Teens, especially girls, whose diets don't provide the nutrients to build bones to maximum potential are at greater risk for developing weakened bones and having disabling injuries later in life.

Children older than 10 years should get 1,300 milligrams of calcium each day. In order to meet that requirement, try the following tips.

• Provide low-fat and nonfat versions of dairy favorites, such as cheeses, yogurt, and milk.
• Encourage your teen to eat dairy foods, because teens tend to drink less milk than younger children do. Explain that these foods provide the highest-quality calcium in a form the body can absorb quickly.
• Encourage your teen to choose low-fat or nonfat milk instead of sodas and sugary fruit drinks that contain very little or no nutrition.
• Talk to your daughter about osteoporosis and the importance of dairy products in a healthy diet. Girls often begin to diet at this age and forgo dairy foods they think will make them fat. Offer low-fat and nonfat dairy products as a healthy alternative.
• Act as a role model and consume dairy products - you could probably use the calcium too!

Some people lack the intestinal enzyme (lactase) that helps digest the sugar (lactose) in dairy products. People with this problem, called lactose intolerance, may have cramps or diarrhea after drinking milk or eating dairy products. Fortunately, there are low-lactose and lactose-free dairy products, as well as lactase drops that can be added to dairy products and tablets that can be taken so that those with lactose intolerance can enjoy dairy products and benefit from the calcium.

Can a dairy-free diet supply enough calcium? There are other sources of calcium, but to get enough calcium in the diet from vegetables only is extremely difficult. Alternative sources of calcium include antacid tablets with calcium or calcium supplements. Discuss the advisability of calcium supplements with your child's doctor if your teen isn't getting enough calcium in her diet.

There are other foods that are sources of calcium, such as calcium-fortified juices, leafy green vegetables, and canned fish with bones (sardines and salmon), that can be added to your teen's diet. Also, don't forget to motivate your child to be involved in physical activities and exercise. If your child is an athlete, weight-bearing exercises such as jogging and walking can also help develop and maintain strong bones.

The Importance of Iron

Iron is another essential nutrient that you should make sure is in your child's diet. Infants need 6 to 10 milligrams of iron, and children need 10 to 15 milligrams each day. After age 10, your child should be getting 15 milligrams of iron each day.

Teen boys need extra iron to support their rapid growth, and teen girls need enough iron to replace what they lose once they begin menstruating. The bleeding during a menstrual period involves loss of red blood cells that contain iron. Iron deficiency can be a problem, particularly for girls who experience very heavy periods. In fact, many teenage girls are at risk for iron deficiency, even if they have normal periods, because their diets may not contain enough iron to offset the blood loss. Also, teens can lose significant amounts of iron through sweating during intense exercise.

Iron deficiency can lead to fatigue, irritability, headaches, lack of energy, and tingling in the hands and feet. Significant iron deficiency can lead to iron-deficiency anemia. If your child has any of these symptoms, talk to your child's doctor; he or she may prescribe iron supplements. Never give your child iron supplements without consulting your child's doctor, because an iron overdose can cause serious problems.

Avoid iron deficiency by encouraging your child or teen to eat an iron-rich diet that includes beef, chicken, tuna, and shrimp. Iron in these foods is more easily absorbed by the body than the iron found in plant foods. However, dried beans, nuts, and dried fruits can be used to support an otherwise iron-rich menu. Look to iron-fortified breakfast cereals as another iron boost for your teen; just make sure to purchase whole-grain, low-sugar varieties. The followimg foods are a few examples of iron-rich foods:

• fish and shellfish
• red meats
• organ meats (such as liver)
• fortified cereals
• whole-grains
• dried beans and peas dried fruits
• leafy green vegetables
• blackstrap molasses

Fiber Facts

Fiber is an important nutritional component for your child's health. Dietary fiber may play a role in reducing the chances of heart disease and cancer later in life, and fiber helps promote bowel regularity. If you follow the suggestions for fruit and vegetable servings each day and encourage your child to eat whole-grain breads and cereals, you'll be well on the way toward ensuring that your child gets enough fiber.

To determine how many grams of fiber your child should be consuming each day, it is recommended that you add 5 to your child's age in years. You can boost fiber intake by serving fresh salad with meals, adding oat or wheat bran to any baked goods you make, and offering legumes such as chickpeas, lentils, and kidney beans at least once a week.

If you are increasing fiber intake, you should do so gradually because excessive fiber can cause bloating and gas. Don't forget to have your child drink plenty of water each day, since liquid intake can help reduce the chance of fiber-related intestinal distress. Be aware that excessive fiber intake can interfere with the body's absorption of crucial vitamins and minerals.

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Responses to frequently asked questions about adhd coaching covering who needs an ADHD coach, the benenfits of AD/HD coaching and how to become an ADHD coach.

Q. What's a Coach?

A. Well it's not an entirely new concept. The practice of coaching, mentoring, training individuals has been around for a very long time. More and more, the idea of coaching seems to be broadening into areas of personal achievement such as academic studies, business and workplaces, as well as life at home. Almost everyone has had an experience of giving coaching or being coached at one time or another, perhaps because it happens rather naturally.

The Oxford dictionary defines a COACH as: a teacher, mentor, instructor, advisor, personal trainer, someone who specialises in offering private tuition to individuals and groups.

Q. What is an AD/HD Coach?

A. An AD/HD Coach offers specialised coaching services that are specially designed for people with AD/HD Specific Learning Difficulties, Dyslexia, Dyspraxia, Aspergers, and related problems.

Q. How do you train to become an AD/HD Coach?

A. At The Coaching Centre, our training courses offer an in-depth study programme into understanding the current facts and research findings available on neurological, learning and behavioural disorders, along with the best known methods, techniques and practical strategies, effective in designing and planning behavioural modifications and treatments within this population.

1. We teach Coaches from a systematic and behavioural perspective and approach.
2. Coaches learn how to recognise, identify, and strategize around a wide range of related problems.
3. Coaches learn to conduct clinical interviews, draw up assessment plans, determine appropriateness of clients for coaching, make referrals, develop action plans with specific steps, prioritising goals, collaboration as a team member with doctors, teachers, parents, special needs departments, and community resources.

An AD/HD Coach becomes a private practitioner who offers a highly specialised service and sets the terms of that service delivery through a written agreement.

Q. Who needs an AD/HD Coach?

Anyone any age will benefit from having the skilled services of a coach. AD/HD coaching should be considered as one possible treatment option, when designing a multi-model treatment programme. Coaching should never be considered a replacement for medical or therapy treatments. It's greatest benefits are derived when combined with other treatments, addressing changes in routine and behaviour or when new skills need to be learned.

We are amazed by the results we get in AD/HD coaching. It seems to fill a gap that exists in available services for AD/HD client groups. The need for coaching is a very serious concern when you consider how often people describe feeling dropped and unsupported after receiving a diagnosis. Our AD/HD D sufferers have a need for quick results, perhaps that is why coaching is such an effective tool and such a popular choice in professional circles.

Clients, teachers, doctors, parents, all notice improvements in behaviour and performance in a very short period of time when there is a good relationship between coach and client. Parents say they especially appreciate having a coach because they are not nagging the child all the time.

AD/HD coaches also help people with other disorders to improve their performance and learn new skills. Anyone who has suffered with a life-long learning disability knows the devastating effects a lack of proper services can cause. Coaching skills should be taught to workers in special needs.

AD/HD underachievers are struggling with chronic disorganisation, procrastination, and general chaos. They will benefit immediately from having a coach to help them finish what they start and stay on track.

Q. What are some of the benefits of AD/HD Coaching?

• Getting another chance. Having listened to thousands of stories from AD/HD sufferers, I am sure it won't surprise you to hear that some of the most critical learning experiences ended in total disappointment, negative feedback, feelings of failure, anger and frustration.
• The long and boring controversy about whether or not AD/HD is real, hasn't helped to promote good services or dismiss the idea that this condition could be an excuse for laziness or craziness, leaving most to struggle silently.
• Is it any wonder why AD/HD sufferers develop such an avoidance and dislike on the whole subject of getting help. They constantly fear asking for help on the basis of what people may think or say. Many report back that nothing offered to them has ever worked well, nor did anyone seem to care, so why bother. That can be a very difficult mind-set to shift.
• For long time professionals in the AD/HD field realised that traditional therapy methods don't seem to really work. They went so far as to prove this in research. However, some behavioural therapies have been found to be helpful in AD/HD and the literature is now supporting methods like coaching.
• What real choices do we have? I think if all we have to offer is more tablets, more hard work, and years of more therapy sessions, then I am afraid we had better get with the modern times and start to research and study the benefits of coaching.

Coach-Client Relationship

The results of Coaching can be amazing and immediate.

What is the role of a client?

Coaching is a process that happens over time Since it is a client driven service, you must possess a strong desire for personal growth and improvement. Coaching focuses on your being in action towards selfidentification, self -improvement, creating life balance, and reaching goals.

How does coaching work?

Regular meetings and check-ins are an essential part of the coaching process. The sessions can be done in person, by telephone, by fax or by email, which ever is preferable to you. However before coaching begins, you and the coach will need an in-depth, one to two hour initial meeting to develop the step by step plans needed to achieve goals.

HOW DOES COACHING HELP AN INDIVIDUAL WITH AD(H)D?

AD(H)D Coaching is different for each coach and each client. Each coach has a preferred way of working and each client has different needs. Following the initial free consultation that will determine if coaching is right for you.

We will:

Work in particular skill areas such as time management and organisation which are often the clients primary concerns.

Together we will assess your strengths and weaknesses and you will learn how to compensate for those weaknesses and develop personal styles to draw on your strengths.

However, for the individual with AD(H)D, symptoms can become more frequent and/or severe during times of stress and fatigue. Paying attention to lifestyle issues in coaching helps individuals learn to promote their own well being.

The highly acclaimed techniques of Coaching, commonly seen in the sports world, are currently believed to be the most effective way to help people who suffer with the life-long effects of AD/HD, Dyslexia, Dyspraxia, Aspergers and chronic low performance. The reason is simple: it is very effective. Coaching is not expensive and not a long-term complicated solution. Neither is Coaching a replacement for psychotherapy, it is a different skill.

The results of Coaching can be amazing and immediate. They are cost effective, and can dramatically improve one's ability to make important decisions, improve daily performance, improve learning skills, and excel in the attainment of life goals.

The client/coach relationship is built on understanding, honesty, and positive feedback. Realistic targets and expectations are discussed and contracted upon in a master action plan. The partnership begins with an assessment of one's real needs; an agreement is crafted around stated goals. The client is then guided, instructed, and encouraged throughout the specific steps towards the attainment of each goal, and changes and results desired. The coaching program is designed to end when the work is finished, and personal satisfaction has been achieved.

Who will benefit from Coaching?

Coaching will help most people, especially those who suffer from:

• AD/HD: Attention Deficit Disorders
• Dyslexia, Dyspraxia: Learning Difficulties
• Aspergers; Social and Communication Disorders

Coaching often focuses on and aims to improve:

• Poor time management
• Disorganisation Academic problems including homework and developing good study skills
• Career problems and employment planning
• Relationship difficulties
• Financial problems
• Building up new skills in almost every area of life

Who should be trained to be a coach?

1. People who already work with people in these populations,
2. Teacher, Teacher Assistants, School Personnel, Personal Consultants,
3. Special Needs Staff, and all other Care Workers,
4. Counsellors, Mental Health Practitioners, Tutors, Trainers, Mentors

About the author: Ms. Dianne Zaccheo, MSW, Director and Founder of The Coaching Centre 13 Upper Addison Garden, London W14 8AP. Dianne Zaccheo is a Medical Social Worker, Family Therapist, Trainer and Coach for some 22 years. She is internationally recognised as an expert in the field of AD/HD, Aspergers, Learning Disorders, Behavioural Problems. Dianne has worked extensively with children, families and schools, as well as within many institutions as a trainer, practitioner and group leader. She has a wealth of experience in the fields of family therapy, cognitive behavioural therapy, and coaching. She has developed a highly effective and unique model that encompasses therapeutic concepts with practical strategies and interventions leading towards empowerment and personal transformation.

Visit Diannes' site at http://www.zaccheotraining.com/training.php

Visit http://zaccheotraining.com/ for UK information and coaches. Anna of the Coaching Network in the UK advised us that they do have ".....coaches with professional experience of ADD /ADHD, although it doesn't show up as a specific criteria on our search engine at the moment (we're looking at some changes to the criteria so can consider adding this in). If anyone contacts us, we will refer them to the relevant coaches."

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Journal Articles and Book Chapters

• Peele, S. (1986), The implications and limitations of genetic models of alcoholism and other addictions.Journal of Studies on Alcohol, 47, 63-73.

Magazine Articles

• Peele, S. & DeGrandpre, R.J. (1995, July/August), My genes made me do it: Debunking current genetic myths.Psychology Today, pp. 50-53; 62-68.

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Children with Obsessive-Compulsive Disorder

In the UK it is estimated that 1 in 100 children have OCD. It is estimated by The National Mental Health Association, (NMHA) in America, that one million children and teenagers in that country have OCD.

There is little doubt that OCD often runs in families, although it appears genes are only partly the cause.

OCD can make a child's day-to-day life very difficult and stressful. The OCD symptoms often take up a great deal of the child's time and energy, making it difficult to complete tasks such as homework or household chores. In the morning, they often feel they must do their rituals exactly right, or the rest of the day will not go well. Meanwhile, they are probably feeling rushed to be on time for school. In the evenings, they may feel they have compulsive rituals to do before they can go to bed and at the same time they have to get their homework finished, as well as tidy their rooms!

All this stress and pressure means that children with OCD frequently don't feel well physically and are prone to stress-related ailments such as headaches or upset stomaches. Very often, they stay up into the night because of their OCD, and are then exhausted the next day.

Children will often say their obsessions feel like a lot of worries. They may worry about having a serious illness or worry that intruders might enter the house. They may worry about germs and toxic substances. Whatever fear it is, no matter how busy the child is or how much they try to think about other things, the worries just wont go away. Children may worry that they're "crazy" because they are aware that their thinking is different than that of their friends and family.

When the Obsessive-Compulsive Disorder is severe, the child may get teased or ridiculed and a child's self-esteem can be negatively affected because the OCD has led to embarrasment time-after-time. It can affect friendships because of the amount of time spent preoccupied with obsessions and compulsions, or because friends react negatively to unusual OCD-related behaviors.

Although we're not sure why, the obsessions will often change as the child gets older. For example, a child of six or seven may worry about germs but then at seventeen this might change to a fear of fires.

At around the age of eight, children will begin to notice that their behaviours are abnormal and will try to hide them. They become embarrassed talking about their rituals and may deny that they have OCD. Younger children are not as aware and make no attempt to hide their behaviour.

Casual observers of parents of OCD children will often say they are too lax with them and shouldn't give in to their behaviours. But whilst to these observers the children may just appear to be naughty, to the children themselves, and their parents, their behaviour is the only way they can express their obsessions.

Diagnosis of OCD in children can often be very difficult. The children have a harder time articulating their OCD symptoms and this makes both diagnosis and treatment much harder.

OCD children very often do not get the emotional support that they need, not because their parents are uncaring, but because their parents are as confused and bewildered as they are. This confusion sometimes comes across as frustration and anger.

Children with OCD sometimes have episodes in which they are extremely angry with their parents. This is usually because they have been unwilling (or unable!) to comply with the child's OCD demands. It can be very difficult when a child obsessed with germs demands that they be allowed to shower for hours, or that their clothes be washed numerous times or in a certain way.

Medication doses are more difficult to initially regulate for children than for adults. Most children metabolize medications quite rapidly. So although they will probably be started on a very low dose, later it can be necessary to use higher, adult-sized doses.

There are several disorders that are thought to contribute to OCD. These are eating disorders, problems at birth that subtly change the brain's development, and Tourette's syndrome. Teenagers who show symptoms of other mental disorders, most often Depression and Substance Abuse, are at a higher risk of developing OCD by the age of eighteen than teenagers who don't.

Children with OCD appear more likely to have additional psychiatric disorders than those who do not have the disorder. Having two (or more) seperate psychiatric diagnoses at the same time is called Comorbidity or Dual Diagnosis. Below is a list of psychiatric conditions that frequently occur along with OCD.

• Additional Anxiety disorders (such as Panic Disorder or Social phobia)
• Depression, Dysthymia
• Disruptive behaviour disorders (such as Oppositional Defiant Disorder, ODD), or Attention-Deficit Hyperactivity Disorder, ADHD).
• Learning disorders
• Tic disorders/Tourette's syndrome
• Trichotillomania (hair pulling)
• Body Dysmorphic Disorder (imagined ugliness)
• Sometimes comorbid disorders can be treated with the same medication prescribed to treat the OCD. Depression, additional Anxiety disorders, and Trichotillomania may improve when a child takes Anti-OCD medication.

For teenagers, trying to hide an illness like OCD or feeling guilty or embarrassed by it, is the last thing a teenager needs. This, at a time when their bodies are changing and they are trying to get used to the new roles and responsibilities they have to face as independant adults.

This can make an already difficult time worse and place enourmous stress on the family. It is important to note that placing blame on the teenager is the wrong approach. Both teens and their parents need to understand that the thoughts and behaviors associated with OCD are in fact NOBODY'S fault.

Each teenager has their own way of describing the frustration and feeling caused by their compulsions, but it is clear that they make them feel awful. For example, such terms as "having parasites inside you" and " feelings of being trapped in a box, where the only way to get out is by performing a ritual" have been used.

Anti-OCD medications control symptoms, but do not "cure" the disorder, and the positive effects of OCD medications only work for as long as they are taken. When a child or teenager stops taking the medication, the OCD symptoms usually return. There is NO known cure for OCD; symptoms are only controlled.

If you think you might have Obsessive Compulsive Disorder (OCD), you should seek help and visit your doctor.

The Obsessive-Compulsive Foundation provides literature about the disorder as well as a list of doctors and support groups in America.

The organisation, Obsessive Action, provides a simular service in the UK.

next: Obsessive-Compulsive Disorder (OCD) Screening Test
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Self-Therapy For People Who ENJOY Learning About Themselves

We get angry about twenty times a day.

If we believe our anger is bad or that it's scary to be angry, we keep it inside.

The unexpressed anger builds up.

It takes so much energy to keep it bottled up that we get tired from all that effort. And, since we are not using our energy to get what we want, we miss out on many things. The tiredness and the losses add up to make us feel hopeless, lethargic, irritable, and sad. This is depression.

We get depressed from saved up anger.

GUILT VS. RESPONSIBILITY

Guilty feelings are the building blocks of depression.

Guilt is what we feel when we know we've made a mistake and think we need forgiveness from someone else.

Responsibility is what we feel when we make a mistake, learn from the mistake, repair any damage as well as we can,   and forgive ourselves.

We feel guilt in the hope that someone else will get us off the hook. In other words, we feel guilt to avoid responsibility for our own mistakes. And we end up depressed.

SUBCONSCIOUS TRICKERY

We don't feel guilty to change our behavior. We feel guilty to avoid changing our behavior!

Think of an alcoholic who comes home drunk at 3 in the morning, apologizes profusely the next morning,   and says she hates herself.

She is subconsciously trying to show that she "feels bad enough" so her partner will believe she is sorry and forgive her.

(The partner would be wise to tell her to stop all the apologies and the self-hate and just say: "I need help to stop drinking!")

SELF-PUNISHMENT AND DEPRESSION

For many people depression is self-inflicted punishment. They actually say to themselves: "I will make myself feel bad to pay for what I've done."

HOW WE LEARN DEPRESSION

Think of a child whose parent just yelled at them: "You are bad!"

If the parent's guilt-tripping works, the child might cry in a brokenhearted sort of a way and sit quietly for a long time feeling bad about themselves.

The self-satisfied parent might say: "See, she feels so bad about herself that I know she won't do it again." But the child will do it again! Why?

Because the child hasn't learned a thing about her own behavior. When parents punish too severely (physically or psychologically), the child has no choice but to focus on the punishment and forget the behavior the parent said was the cause of the punishment.

When the parent eventually stops the shaming, the child will believe that feeling bad about herself is what saved her.

She has learned that in that family there are real advantages to being depressed.

Teaching a child the effects of their behavior is much more difficult than making them feel guilty. But it's the only way to get them to change.

[See Discipline and other articles in this series about parenting.]

The key to avoiding depression is to welcome and express your anger.

But what if so many things make you angry that you don't have enough time to express it all? What if your new anger constantly "overlaps" with your old anger?

Most people who have overlapping anger are living lives that are filled with mistreatment. They are simply so badly treated that anyone would be depressed. They will be depressed until they stop taking all that mistreatment.

Other people have overlapping anger because they talk themselves into being angry when they are really feeling something else (sadness, or scare, or even joy). They need to learn how to handle the feelings they are avoiding - and since they are so afraid of this, they will probably need a therapist to help them.

Depression: What To Do About It was written as a companion topic.

Since suppressed anger, guilt, and depression are such common problems, many articles in this series are related to these topics. Every article, regardless of the title, probably contains at least one idea you can use to overcome depression.

Enjoy Your Changes!

Everything here is designed to help you do just that!

next: Depression: What To Do About It

We CAN'T Just Snap Out of it!

FACT

FACT: It is not true to think of Obsessive Compulsive Disorder as the result of a "weak" or "unstable" mind. Far from it, in fact. In order to maintain the control it takes to cope with OCD, sufferers usually have to be very strong-minded people.

FACT: OCD affects 1 in 40 people, including 1 in 200 children, although most have very mild to moderate levels of the disorder. At it's most debilitating, OCD causes people to stay shut in their homes for months or years!

FACT: It seems to be that in every culture worldwide, about 2 to 3 per cent of the culture will have OCD at some time in their life.

FACT: On average, most OCDers will live with the disorder some 17 years before they get help.

FACT: The average age of diagnosis ranges from 19 to 25, and some OCD sufferers may reach their thirties and beyond before learning the reason for their repetitive thoughts and actions.

FACT: For a long time, OCD was referred to in the medical community as "the secret disorder" because patients didn't want to talk about it.

FACT: There is little doubt that OCD often runs in families. However, it appears that genes are only partially responsible for causing the disorder. If the development of OCD were completely determined by genetics, pairs of twins would always both have the disorder, or both not have it, but this isn't the case. If one identical twin does have it, there is a 13 percent chance that the other twin will NOT be affected.

FACT: Researchers still do not know how the drugs work in treating OCD! However, after decades of using them to treat patients, they DO know that they work, even if they are unsure why.

FACT: There are many health professionals out there who are not well informed about OCD. Obsessive Compulsive Disorder symptoms are often missed, so it's important for people to get information from various sources. The symptoms ARE relatively common, the disease IS very real, and there is NOTHING to be ashamed of.

FICTION

Public awareness of OCD has increased over the years, but there are still many misconceptions about the illness.

FICTION: It is NOT true that OCD and other anxiety disorders can be overcome if the patient tries hard enough. For people who suffer from OCD, trying really hard doesn't do a thing.

FICTION: It is wrong to think OCD can be cured. However, a combination of drugs and behaviour therapy can effectively decrease the Obsessive Compulsive Disorder symptoms and bring peace of mind (literally) to the sufferer.

FICTION: It is important to note the differences between a sex offender and a person with OCD having sexual fantasies: It is wrong to think the two are the same. The OCDer with this manifestation never actually commits an immoral or criminal act - often fearing doing the act, and will go out of their way to admit the deviant thoughts.

FICTION: You should not feel that just because you check several times to see if you've switched the cooker off or return to a door to make sure it is locked that you have OCD. You may have quirks that you think border on the compulsive. Perhaps you're over-neat, keep old shoes or clothes in case they come back into fashion, or maybe as a child you insisted on taking your own pillow when staying at a friend or relative's house. OCD goes well beyond the strange habits that most people have. It's all about the length of time and energy these behaviors take - someone may have a very neat desk, but someone else may have a home environment where the ordering of things takes hours and becomes ritualistic... that's OCD.

FICTION: Most people think that OCD sufferers are ONLY fixated on cleanliness - wrong. Some experts have speculated that there may be different types of OCD, and that some types are inherited while other types are not. Also, people with OCD might well fit into one behavioral category, but more likely they'll experience a variety of compulsions during a lifetime.

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Employees with Internet access on the job are abusing the privilege by spending hours sending and receiving personal email, perusing newsgroups, socializing in chat rooms, and playing interactive games. Managers either know or suspect what's happening, which leads to computer-related firings and a growing climate of misunderstanding and distrust. Clinical research shows that workplace issues resultant from Internet abuse range as follows:

The Internet is a tool that can easily be misused and cost managers money in terms of lost productivity. To learn more, Caught in the Net shares the attitudes, experiences, and perspectives of both sides of the office environment and presents a blueprint for managing this escalating issue with greater awareness and sensitivity.

Dr. Young offers extensive workshops on Internet abuse in the workplace. Please review our information on how to arrange Dr. Young's Corporate Seminars that will enlighten employees, human resource managers and even employee assistance providers. Click here to order Caught in the Net

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