Insomnia : Causes

Transient insomnia is often caused by a temporary situation in a person's life, such as an argument with a loved one, a brief medical illness, or jet lag . When the situation is resolved or the precipitating factor disappears, the condition goes a...

The symptoms of insomnia can vary greatly from person to person. Some people find that they have trouble falling asleep at night and can lie in bed for hours without being able to drift off. Others find that they fall asleep easily but wake many t...

Insomnia, unlike some medical conditions, is easily recognizable. People know when they aren't getting enough sleep. The key to treating insomnia is determining its causes. Some people can identify sleep-inhibiting factors such as a death in the f...

Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. More recently, however, the word stressor has been used for the stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. Is it primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions, or is it an internal interpretation of, or reaction to, a stressor; or is it both?

In this report you'll learn about a multitude of techniques that can help reduce stress, including breath focus, progressive muscle relaxation, meditation, yoga, massage, and more.

Everyone feels stress from time to time. It's a fact of daily life. Stress has its upside, but too much of it can leave you feeling out of control. And chronic stress can have negative consequences on your health.

Disturbance in the physiology of the individual. Among psychologists and psychiatrists, stress refers to a psychological reaction within the person to events that generate strong emotion that cannot be easily regulated; for other social scientists, the term stress is used to describe a disturbance in the individual's physiology. These two definitions of stress are not identical. For example, a fall from a tree that leads to a broken arm creates physiological changes in a child that would be regarded as stressful, for there is a cascade of biological events that occurs in such an act of harm to the child. However, many children who have had such falls are not necessarily psychologically upset, anxious, or fearful, even though there was a physiological stress reaction. On the other hand, a child who believes his parent does not like him, experiences rejection from a friend, or is feeling guilt over violating a moral standard will experience unpleasant psychological feelings that disrupt ordinary functioning. That disruption is a result of a psychological stress. This definition of stress need not involve any strong cascade of physiological changes, as occurred in the fall that leads to a broken arm. Nonetheless, psychiatrists and psychologists would say in the second instance that the child was experiencing stress. A problem with understanding the effects of either physiological or psychological stress more completely is that there are no sensitive techniques to ascertain the private reactions that are occurring in the child's body or mind. Many scientists make the assumption that certain events will produce stress in the child, recognizing that in some cases the event will not be stressful. For example, most sociologists, psychologists, and psychiatrists assume that death of a parent, marital strife, separation and divorce, abuse, rejection by a close friend, and chronic failure in school will create stress in the child. Although this assumption is reasonable there is no one-to-one relationship between the occurrence of those and similar external events and a physiological or psychological reaction of stress within the child. Hans Selye is credited with introducing the importance of the concept of stress. Selye discovered that if an individual is under chronic physiological stress there are permanent changes that occur in the body leading to a compromised immunity and a reduced resistance to many forms of disease. Thus college students who are stressed during final examination periods will show a lowered resistance to getting colds and other minor infectious diseases.

Knowing the causes of your stress will help you find ways to manage it.

Sometimes no matter how hard and fast you work, you miss your deadline, adding to your physical and emotional stress.

Stress is defined as an organism's total response to environmental demands or pressures. When stress was first studied in the 1950s, the term was used to denote both the causes and the experienced effects of these pressures. Since the 1990s, however, the word stressor has been used for a stimulus that provokes a stress response. One recurrent disagreement among researchers concerns the definition of stress in humans. The issue is whether it is primarily an external response that can be measured by changes in glandular secretions, skin reactions, and other physical functions—or if it is an internal interpretation of, or reaction to, a stressor, or both.

When you're faced with a highly stressful event in your life, the strategies outlined here will help you cope.

Ways to manage stress: Get enough sleep, follow a healthy diet and make time for yourself.

Many people believe stress is all in the mind. But dealing with stressful situations can have physiological consequences.

By consciously learning to be present and mindful, you can transform your inattention to attention and your stress into solutions.

Some stress is inevitable, but as you grow older, the key is to minimize stress while maximizing happiness and enjoyment.

Detailed information on women and managing stress

If you take a healthy attitude toward stress in your travel plans, the payoffs include improved physical well-being, mental alertness and better job performance.

Lower your risk: Control stress. When you’re stressed, your heartbeat speeds up and your blood pressure skyrockets. The next time you feel tension taking over, sit back and look at what’s bothering you.

Yoga is one of the few stress-relief tools that has a positive effect on all the body systems involved.

Recent studies are changing our notion about why men develop impotence. While it was once believed that psychological problems were the main cause, we now understand that medical factors -- such as poor blood flow, nerve damage, and medication side effects -- play an important role in most cases of impotence.

As a working parent, do you need some relief from the stress of managing a career and a family?

Your wedding day can be one of the best days of your life, it can also be one of the most stressful.

By understanding what is causing you stress, you may be able to make changes to help you feel more in control.

New research shows that prolonged stress can accelerate the aging of body cells.

A British study suggests a link between increased stress and a rise in cholesterol level, and a follow-up several years later showed the trend continued over time.

Practicing deep, focused breathing is a relaxation technique that can help alleviate stress, which in turn will likely have positive effects on general health and well-being.

Stress is an individual's physical and mental reaction to environmental demands or pressures.

Stress is a term that refers to the sum of the physical, mental, and emotional strains or tensions on a person. Feelings of stress in humans result from interactions between persons and their environment that are perceived as straining or exceeding their adaptive capacities and threatening their well-being. The element of perception indicates that human stress responses reflect differences in personality as well as differences in physical strength or health. A stressor is defined as a stimulus or event that provokes a stress response in an organism. Stressors can be categorized as acute or chronic, and as external or internal to the organism. The Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV-TR ) defines a psychosocial stressor as "any life event or life change that may be associated temporally (and perhaps causally) with the onset, occurrence, or exacerbation [worsening] of a mental disorder." Stress affects the lives of most adults in developed countries in many ways. It is a major factor in rising health care costs; one public health expert maintains that 90% of all diseases and disorders in the United States are stress-related. Stress plays a part in many social problems such as child and elder abuse , workplace violence, juvenile crime, suicide , substance addiction , "road rage," and the general decline of courtesy and good manners. Stress also affects the productivity of businesses and industries. One nationwide survey found that 53% of American workers name their job as the single greatest source of stress in their lives. Furthermore, the overall cost of medical care, time lost from work, and workplace accidents in the United States comes to over $150 million per year.

Over the course of evolution, the human mind and body have developed means of handling stressful situations. Over the short term, such stress response pathways are highly adaptive, allowing a person to manage his or her resources in order to navigate the crisis; in some cases, however, these processes go awry and result in pathology. Chronic stress is becoming increasingly problematic in the United States as workers work longer and harder hours. Approximately one-third of all workers report that they are in high-stress jobs, and that not only is stress implicated in 15 percent of all disability claims, the number of stress-related absences is increasing. Such prolonged exposure to stress can also result in consequences in the form of physical illness. Alternatively, a severe acute stressor may result in a stress-response syndrome such as an acute stress disorder or a post-traumatic stress disorder. In acute stress, the mind and body respond with a fight or flight response that involves activation of the sympathetic nervous system and release of stress hormones such as cortisol. Psychologically, this increases the organism's alertness and response time. Physiologically, these changes provide the organism with the energy needed to meet the emergency. Such intense activation helps the organism in the short term, but prolonged activation of this system creates problems in that it may increase the risk of certain disease states, and, once set into motion, chronic stress responses may be difficult to extinguish. This has led some researchers to investigate potential mediating factors such as personality. For example, a correlation has been established between a personality characterized by hostile competitiveness (type A) and increased risk of myocardial infarction (heart attack). An acute stressor or psychological trauma, such as a life-threatening circumstance, presents a person with new information that may be difficult to assimilate. In an attempt to adapt, the person will typically alternate between contemplation of the stressor and avoidance of reminders of the event. Such a cycle allows for dose-by-dose psychological processing of the event. Difficulties in adaptation may present as an acute stress disorder that manifests itself as an extreme version of this cycle. People with such a disorder may have intrusive remembrances, nightmares, or even flashbacks of the stress event. These can alternate with emotional numbing, interpersonal alienation, and extreme avoidance of traumatic reminders. A diagnosis of postraumatic stress disorder (PTSD) is made if these symptoms persist longer than one month. Studies suggest that approximately 0.5 percent of men and 1.3 percent of women meet criteria for PTSD over their lifetime. A larger percentage (approximately 15%) of subjects were found to have some symptoms but did not meet criteria for the full disorder. At present, psychotherapy is the mainstay of treatment for stress response syndromes. A variety of approaches exist, but they share a common goal of assisting the patient with conscious contemplation of the event in such a way that it may be assimilated and anxiety responses extinguished. Care must be taken to create an environment of safety and to avoid retraumatization, which may occur with overly rapid exposure to traumatic memories. Patients experience decreased feelings of guilt and shame as they learn that they responded to the trauma as adequately as possible. Contemplation of the event in therapy may lead to further benefits, including an enhanced understanding of the meaning of the event in the larger context of the individual's life. Psychopharmacologic treatment may be a useful adjunct for specific symptom clusters such as associated anxiety, depression, and insomnia. The prognosis for treatment is good and is improved if the patient was without preexisting psychiatric comorbidity and if the treatment occurs in close proximity to the event. Brief treatment is frequently h

My fingertips have recently started peeling. I have been under a considerable amount of stress lately. Could there be any correlation?

Women experience symptoms of stress 30 percent more often than men, research has shown.

No one can avoid all stress -- and a certain amount actually is good for you. But it's always best to keep unhealthy levels in check when possible.

Mental stress does more than diminish your sense of well-being. It also can increase your risk for heart disease.

During stressful times, your body produces various chemicals, including cortisol, an immune-suppressing hormone. The more cortisol produced, the weaker your immune cells become and the more susceptible you are to illness.

You're familiar with the symptoms of stress -- a pounding heart, increased perspiration, tight neck and shoulder muscles, anxiety and fear. But you may not know how to prevent or relieve these symptoms.

The formula for success at work is not only hard work, but also frequent breaks for mental and physical rest.

Here are suggestions on how to avoid and deal with the stresses in your life.

Whether your credit card balances are soaring, or you and your partner are arguing constantly over nickels and dimes, there are things you can do to relieve financial stress.

The more you learn about the pressure times and triggers at your workplace, the better you'll be able to plan for them.

No matter the source of your stress, it can produce physical, mental, and emotional symptoms that can affect any part of the body.

Stress is a powerful force for good and for ill. It can help us cope with life's challenges, but it can also affect our health by making pre-existing conditions worse or even bringing on new ones.

To manage your stress, you must first learn to recognize when you are under stress. Every one reacts to stress differently; find out how you respond to stressful situations.

Anything that brings on feelings of stress is called a stressor. Today, we often face many stressors.

Stress tests are not recommended unless you experience chest pain or tightness during exercise or other activities that stress the heart.

Guidelines from the American Heart Association and the American College of Cardiology offer advice on protecting the heart during noncardiac surgery.

Resilience is the ability to handle stressful events and remain mentally strong and healthy. The presence of a certain form of neurochemical may be one explanation for why some people are more resilient than others.

In experiments on mice, suppressing a chemical linked to stress and appetite prevented the formation of abdominal fat cells, which could lead to new possibilities for weight loss drugs.

What is the relationship between stress and infertility? Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Stress can come from any situation or thought that makes you feel frustrated, angry, or anxious. What is stressful to one person is not necessarily stressful to another. Anxiety is a feeling of apprehension or fear. The source of this uneasiness is not always known or recognized, which can add to the distress you feel.

Anxiety is a bodily response to a perceived threat or danger. It is triggered by a combination of biochemical changes in the body, the patient's personal history and memory, and the social situation. It is important to distinguish between anxiety as a feeling or experience and an anxiety disorder as a psychiatric diagnosis. A person may feel anxious without having an anxiety disorder. Also, a person facing a clear and present danger or a realistic fear is not usually considered to be in a state of anxiety. In addition, anxiety frequently occurs as a symptom in other categories of psychiatric disturbance.

Systematic desensitization is a technique used to treat phobias and other extreme or erroneous fears based on principles of behavior modification .

Anxiety is familiar to everyone due to the many stresses and complexities of modern life.

This report features up-to-date information on the signs, causes, and treatments of many common phobias and anxiety disorders.

History Generalised anxiety disorder is a relatively recent diagnosis. Before 1980 it was subsumed under the label of anxiety neurosis, a disorder first delineated by Freud in 1894 1 and characterised by persistent feelings of unattached fearfulness described as free-floating anxiety. 1 However, the disorder described by Freud also included the symptom of panic, and when panic disorder was subsequently identified as a separate illness by Klein, 2 the part of anxiety neurosis that did not include panic became known as generalised anxiety disorder.

Anxiety is a multisystem response to a perceived threat or danger. It reflects a combination of biochemical changes in the body, the patient's personal history and memory, and the social situation. As far as we know, anxiety is a uniquely human experience. Other animals clearly know fear, but human anxiety involves an ability, to use memory and imagination to move backward and forward in time, that animals do not appear to have. The anxiety that occurs in post-traumatic syndromes indicates that human memory is a much more complicated mental function than animal memory. Moreover, a large portion of human anxiety is produced by anticipation of future events. Without a sense of personal continuity over time, people would not have the "raw materials" of anxiety. It is important to distinguish between anxiety as a feeling or experience, and an anxiety disorder as a psychiatric diagnosis. A person may feel anxious without having an anxiety disorder. Also a person facing a clear and present danger or a realistic fear is not usually considered to be in a state of anxiety. In addition, anxiety frequently occurs as a symptom in other categories of psychiatric disturbance.

Fears, Phobias, and AnxietyEverybody experiences fear at some time or another. Fear is a powerful emotion that arises in situations that are interpreted as dangerous.

Unlike the relatively mild, brief anxiety caused by a stressful event such as a business presentation or a first date, anxiety disorders are chronic, relentless, and can grow progressively worse if not treated.

Anxiety is normally a helpful emotion that rouses the individual to action and alerts the individual to danger. Everyone has anxiety; it is common to feel anxiety before a ?first date,? when beginning a new job, or before an examination.

Anxiety is a multisystem response to a perceived threat or danger. It reflects a combination of biochemical changes in the body, the patient's personal history and memory , and the social situation at hand. Human anxiety involves an ability to use memory and imagination and to move backward and forward in time; a large portion of human anxiety is produced by anticipation of future events. Without a sense of personal continuity over time, people would not have the "raw materials" of anxiety. It is important to distinguish between anxiety as a feeling or experience, and an anxiety disorder as a psychiatric diagnosis. A person may feel anxious without having an anxiety disorder. Short-term anxiety can be considered within the range of normal human experience. It is only when anxiety presents with great intensity or long duration that it is classified as a pathological state. Particular manifestations of anxiety, such as a flashback experience, the development of a phobia, or the sudden onset of a panic attack, are suggestive of a serious anxiety problem.

Anxiety disorders are a group of disorders that can affect adults, adolescents and children. They overwhelm people with chronic feelings of anxiety and fear.

This guide is designed to help you learn about anxiety disorders. Knowing more, you may feel more comfortable talking with a health professional about your experience and your symptoms.

Anxiety is a condition of persistent and uncontrollable nervousness, stress, and worry that is triggered by anticipation of future events, memories of past events, or ruminations over day-to-day events, both trivial and major, with disproportionate fears of catastrophic consequences.

A condition of persistent nervousness, stress, and worry that is triggered by anticipation of future events, memories of past events, or ruminations about the self Stimulated by real or imagined dangers, anxiety affects people of all ages and social backgrounds. When it occurs in unrealistic situations or with unusual intensity, it can disrupt everyday life. Some researchers believe anxiety is synonymous with fear, occurring in varying degrees and in situations in which people feel threatened by some danger. Others describe anxiety as an unpleasant emotion caused by unidentifiable dangers or dangers that, in reality, pose no threat. Unlike fear, which is caused by realistic, known dangers, anxiety can be more difficult to identify and alleviate. A small amount of anxiety is normal in the developing child, especially in adolescents and teens. Anxiety is often a realistic response to new roles and responsibilities, as well as to sexual and identity development. When symptoms become extreme, disabling, and/or when a child or adolescent experiences several symptoms over a period of a month or more, they may be a sign of an anxiety disorder and professional intervention may be necessary. The two forms of childhood anxiety are overanxious disorder and separation anxiety, although many physicians and psychologists also include panic disorder and obsessive-compulsive disorder, which tend to occur more frequently in adults. Anxiety that is the result of experiencing a violent event, disaster, or physical abuse is identified as post-traumatic stress disorder (PTSD). Most adult anxiety disorders begin in adolescence or young adulthood, and are more common among women than men.

Treating AnxietyAnxiety—feeling frightened, tense, uneasy—is a normal response to a threat. Anxiety can disrupt your life, but it’s nothing to be ashamed of.

You may suffer from generalized anxiety disorder if you go through the day worried, tense or anxious about your family, health or work, even when you know there are no signs of trouble.

Discussion of the effect of anxiety disorders on children and how they can be treated.

Despite their age, benzodiazepines still provide unique benefits and are unlikely to be entirely superseded by newer medications. Includes a comparison chart of newer and older drugs for insomnia, anxiety, and depression.

Understanding Social Phobia (Social Anxiety Disorder)You have to give a presentation next week. Just thinking about it makes your heart race.

Separation anxiety is common in children, but most grow out of it. However, in a small percentage of children (and more rarely, in adults) it becomes a disorder. Typical treatment methods include cognitive and behavioral therapy.

Research suggests that for patients who are starting treatment for depression, their type of attachment anxiety should be taken into consideration as a factor in determining the best course of treatment.

There is evidence that certain herbs and supplements may be effective in treating certain types of anxiety disorders.

When I get nervous, I get a tic that affects the left side of my face, including my eye. What can I do about this? Is there anything I can take for it?

Anxiety:  Progressive Muscle Relaxation and Guided ImagerySymptom and DescriptionIt is common to feel stress or anxiety when you have cancer. Anxiety can be a vague or uneasy feeling of distress.

A common disorder infrequently diagnosed Generalized anxiety disorder (GAD) is a common and often chronic disorder, with an estimated lifetime prevalence rate of 5.7% in the general population, but it is often overlooked and undertreated. 1 Why should this be so? Comorbid disorders motivate help-seeking The core symptoms of GAD are chronic worry and tension.

Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. True clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for an extended period of time. See also: Adolescent depression; Depression in the elderly.

Depression, also known as depressive disorders or unipolar depression, is a mental illness characterized by a profound and persistent feeling of sadness or despair and/or a loss of interest in things that once were pleasurable. Disturbance in sleep, appetite, and mental processes are a common accompaniment.

This report offers in-depth information on the causes of depression and the treatments and medications that can lift your mood.

Detailed information on depression and depression in women, including types, symptoms, diagnosis, and treatment

People who are depressed have a cluster of symptoms characterized by sadness and a profound lack of energy and well-being.

It's important not to underestimate the dangers associated with depression, especially if you've had multiple episodes or lingering symptoms. For example, people who don't get treated for their depression have a higher risk for suicide.

Depression is a complicated and common mental health condition that affects about 10 to 15 percent of Americans. The following questions and answers can help you recognize and get effective treatment for depression.

Men suffer from depression in smaller numbers than women do, but their treatment needs differ due to responses to medication, especially in older men. Additional medication may be necessary to treat the sexual side effects.

The analysis of more than 15,000 young people in the United States found about a third of the cases of depression and obesity among those teens could be attributed to being from families with low incomes.

In general, only about three percent of the elderly living independently in the community will experience depression. That figure increases to around 20 to 30 percent of persons in nursing homes or with chronic illnesses like emphysema, heart disease or diabetes.

In elderly patients, symptoms of depression can be mistaken for symptoms of another medical problem, so it is important for clinicians to consider all physical problems and medications of elderly patients before making a diagnosis.

Many people with depression do not receive adequate medical treatment, and even if they are treated, doctors may not be paying enough attention to their patients' needs.

Learning more about this illness will allow you to understand what your symptoms may mean and make it easier for you to seek help.

Too often, parents miss the signs of depression. Or, they believe their teen will “snap out of it” eventually.

A woman’s unique biological, social, and cultural factors may increase her risk for depression.

Everyone feels down at times, but diabetics are especially prone to depression. An unhappy period that’s intense or lasts for more than a couple of weeks can be a sign of depression. Depression is a serious illness.

Depression is not "all in your head." It is a real illness that saps your energy. It can leave you feeling sad, hopeless, lonely and guilty. It is related to a chemical imbalance in the brain and to certain traits such as low self-esteem and pessimism. Some kinds of depression may be inherited.

The mind and the body are intimately connected, and our overall health depends on both working well. This is most evident in depression: Research shows that people who suffer from clinical depression face a higher risk of contracting one of the stress-linked illnesses than the rest of the population.

Depression can often develop as a result of a heart attack or cardiac surgery, and has more serious effects on heart health and overall health than depression that was present before a heart attack.

Seasonal affective disorder is thought to be caused by decreased exposure to sunlight during the winter months. Light therapy helps some people, and the FDA has approved the antidepressant bupropion for treatment as well.

Studies suggest mental health care following a heart attack can improve patient health and mortality.

Studies of a link between depression and osteoporosis suggest the bone deterioration could be a result of the depression, or may be caused by taking antidepressant medications for a long period of time.

Depressed patients are more likely to respond to medical treatment if their doctors practice empathy and effective communication skills.

Discussing the definition and treatment of a contested psychological diagnosis???atypical depression.

Two studies examine the correlation between depression in adults and its prevalence in their children, and the effect of adults' treatment on the children's mental health.

Exposure to the right kind of light may go a long way toward reducing seasonal affective disorder symptoms.

A roundup of studies exploring the beneficial effects of exercise on depression, anxiety, and insomnia. Is it a case of the chicken and the egg?

Teen depression is a serious illness. The benefits of getting help, including taking medications if needed, far outweigh the potential risks.

A study claims that obese people are more likely to suffer from anxiety and depression, but the findings do not prove that the conditions are causally related to each other.

Behavioral activation therapy is a variation of cognitive therapy that encourages patients to fight depression by examining their feelings and experiences and focusing on their positive accomplishments.

Folate, a B vitamin, breaks down homocysteine, which may be associated with depression. Because of this it has been tested as a possible treatment, but the results have been mixed and more research is needed.

Researchers in China found that Chinese citizens were more likely to express symptoms of depression as having a physical component as well as an emotional one, due to the way their culture interprets such feelings.

Concern about antidepressants increasing the risk of suicide in children could have the unintended effect that children suffering from depression may not receive needed treatment.

Hypotheses explaining how depression manifests itself. The American Psychiatric Association requires any five of nine symptoms for a diagnosis of major depression. As the definition implies, these symptoms do not all appear in everyone who is depressed. Two studies explore the consequences for the understanding of depression and come to contrasting conclusions. One study suggests that an individual patient's symptoms are not consistent, but change more or less unpredictably from one episode of depression to the next. The other study suggests that there are several sets of depressive symptoms that are distinguishable genetically and therefore likely to persist in a given individual.

An explanation of the two-way relationship between depression and stroke. Depressed people are at higher risk for a stroke, but depression often precedes as well as follows a stroke.

A Harvard Medical School physician answers your question about whether Accutane, a powerful acne medication, has been linked to depression or suicide.

People who suffer from depression are more likely to have a sleep-related breathing problem such as apnea. Treating the sleep problem may help alleviate the depression in some people.

Discusses options for treatment of seasonal affective disorder.The treatment of seasonal affective disorder throws light on dark moods.

Are children with ADD more likely to be depressed? Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".

My mother has advanced lung cancer and is receiving chemo. I live with her and am also her caregiver. We have been very close all of our lives, and I am having a hard time adjusting well. Sometimes I even get angry with her and then I feel guilty. The next step is I get depressed and have thought about a way out, but have not attempted anything. Can you suggest anything to help me cope?

During the dark days of winter, many people develop signs of depression that are tied to the changing amount of daylight.

Depression is sometimes referred to as the common cold of mental illness. It is a debilitating disease with significant societal costs. It is, however, one of the most clearly defined and treatable of mental illnesses. Technically, the term "depression" is used to cover a variety of symptomatic conditions, all characterized by negative mood and a loss of pleasure. Together these conditions comprise a spectrum ranging from major depression to dysthymia to adjustment reactions to normal grief and sadness. At one extreme of this continuum lies major depressive disorder, a syndrome characterized by severe episodes of depressed mood accompanied by loss of sleep, appetite, concentration, energy, and hope. The depressed mood must persist for greater than two weeks in order to warrant this diagnosis. At the other end of the continuum lies the diagnosis of dysthymia, which is characterized by a lower level of mood disturbance that persists chronically; that is, involving more days than not for a period of two years or greater. Many patients complain of depressed mood but do not fit neatly into either of these two categories. These patients' symptoms are frequently best accounted for as a reaction to an acute life stressor. These reactions are typically nonpathological and resolve with time, but they may constitute an adjustment reaction if normal functioning is sufficiently disturbed. Depression is both common and costly. It has a lifetime prevalence of 5 to 10 percent of women and 2 to 5 percent of men. It is an expensive disorder in both direct and indirect terms, as depression causes a higher degree of functional disability than many medical illnesses including diabetes, chronic lung disease, and arthritis. Additional costs to society result from the effect of untreated depression on the treatment of medical illnesses, where it contributes to longer hospital stays and morbidity. This has been particularly well demonstrated in the treatment of myocardial infarction (heart attack), where the presence of major depression has consistently been found to increase mortality. Depressive illness is thought to result from a combination of biological and psychological factors. The biological component is strongly suggested by the high genetic concordance of depressive disorders. In the twenty-first century, there are various competing theories about the nature of this genetic/biological contribution, but the available data do not yet indicate the specific nature of the illness. The psychological component is similarly suggested by the correlation of onset of major depression with negative life events and with the increased risk of depression in individuals who experienced abuse in childhood. A variety of psychological theories exist and are linked to models of psychotherapeutic treatment. Interpersonal psychotherapists, for example, emphasize the role of grieving due to the loss of an important relationship or a transition in social roles (e.g., transition from working to retirement, marriage to divorce). Cognitive therapists emphasize a mind-set of construing life events in a way that leads to depression. Alternately, psychodynamic therapists search for the ways that unconscious coping processes and repetitive relational patterns result in negative effects. A commonly postulated mechanism would include the turning of anger in on the self. For example, a depressed woman may feel critical of herself rather than direct her anger toward an abusive spouse. Treatment of depression parallels theories of etiology in that both biological and psychological treatments exist and have been efficacious. A number of different antidepressant medications have been developed, including monoamine oxidase (MAO) inhibitors, tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRI). These medicines have demonstrated efficacy in both the treatment of acute depressive episodes and in the prevention of relapses. A variety of psychological therapie

A combination of factors causes depression. Some cases are triggered by a stressful experience, such as the death of a spouse or loss of a job. Some illnesses, such as cancer, also can cause depression, as can alcohol and drug abuse.

Chances are you know the difference between occasional sadness and depression. But here's a fact you may not know: Hypothyroidism, a common thyroid disorder, can cause depression.

When recommending treatment for clinical depression, physicians typically prescribe a tried-and-true regimen: anti-depressant medication and "talk" therapy. In the future, however, health professionals may be advocating a healthy dose of exercise.

Take action if you suspect a friend and/or family member suffers from depression. It's a condition that can cloud thinking and make people believe they aren't worth helping, so they often can't help themselves.

The unrealistic expectations of the season, time and financial pressures, missing loved ones and reflecting on past events as the year comes to an end all contribute to the blues.

The medical community once thought depression affected only adults. The risk for the condition begins in the early teens, however, and increases steadily through the mid-20s.

Although anyone can suffer from depression, it is particularly common among older adults. Depression affects 15 out of every 100 adults older than 65.

Because depression isn't a normal part of growing older, it's important to learn the signs of this condition and seek help if you or a loved one could be suffering from it.

Everyone gets down in the dumps from time to time. But you may have clinical depression if a feeling of sadness or loss of interest in life and friends lingers for two weeks or more.

Instead of asking for help, men who are depressed are likely to drink alcohol to excess, take drugs, or become frustrated, discouraged, and irritable.

Although sadness touches all our lives, true depression is different in its intensity and persistence.

What's the difference between a bad case of the blues and the painful mental disorder known as depression? According to the experts, impaired functioning is usually a clear-cut indication of clinical depression.

Primary care physicians should be asking their patients questions about five "warning flag" symptoms to determine whether they should be screened for depression or other mood disorders, researchers say.

Having a chronic condition such as COPD can lead to depression. You can get help. Talk with your doctor about your symptoms.

Living with diabetes may increase the likelihood of depression. The connection may be go both ways: information from a diabetes trial suggests the possibility of a link between antidepressant use and diabetes.

A recent study offers evidence that selective serotonin reuptake inhibitors may help those who develop depression after a heart attack.

Most people, most of the time, overestimate themselves. It is pervasive and powerful, but is not the same in all people or in all circumstances.

A discussion of the social impact of depression in the elderly and the benefits of treatment.

According to two studies, women going through menopause are much more likely to develop symptoms of depression, due in part to changes in hormone production. Hormone replacement may provide temporary relief from severe depression.

Reports of risky side effects may have dampened enthusiasm for selective serotonin reuptake inhibitors, which are among the world's most widely prescribed medications. A review of concerns and benefits associated with SSRIs.

Mental health among Americans may have declined during the 1990s. Revealing information on the mental health of Americans appears in data from three random telephone surveys of the adult population by the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System.

While there is a very small risk of suicide in adolescents who take antidepressants, they are also beneficial to many teenagers with depression. All factors should be weighed in treatment decisions, and patients should be monitored carefully.

Discussion of whether the new antidepressant Cymbalta (duloxetine) has any advantage over other antidepressants on the market.

DHEA may not be an anti-aging panacea, as some suggest, but a new study suggests that it may be able to temporarily lift mood.

Older people with macular degeneration are more likely to experience depression, but those who received problem-solving therapy to help them adapt to and cope with their condition were less likely to develop depression.

A study shows that interaction with animals can be a path to recovery from depression.

Age-related macular degeneration is the most common cause of severe vision loss in people over 55. A recent trial shows that education may help relieve disability and depression in those with the condition.

Is there a link between depression and migraines? Michael Craig Miller, M.D., is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

Caffeine is a substance that exists naturally in certain plants. It can also be produced synthetically and used as an additive in food products. It is a central nervous system stimulant and a diuretic.

A recent study alleviates concerns about coffee's role in heart disease and stroke and makes observations about coffee's physiological effects.

New studies suggest coffee may not be bad for you, as is generally supposed, and it may even have some benefits.

Caffeine is a naturally occurring stimulant found in the leaves, seeds, or fruit of over sixty plants around the world. Caffeine exists in the coffee bean in Arabia, the tea leaf in China, the kola nut in West Africa, and the cocoa bean in Mexico. Because of its use throughout all societies, caffeine is the most widely used psychoactive substance in the world. The most common caffeine sources in North America and Europe are coffee and tea. Since about 1980, extensive research has been conducted on how caffeine affects health. Most experts agree that moderate use of caffeine (300 milligrams, or about three cups of coffee, per day) is not likely to cause health problems.

Caffeine is a white, bitter crystalline alkaloid derived from coffee or tea. It belongs to a class of compounds called xanthines, its chemical formula being 1,3,7-trimethylxanthine. Caffeine is classified together with cocaine and amphetamines as an analeptic, or central nervous system stimulant. Coffee is the most abundant source of caffeine, although caffeine is also found in tea, cocoa, and cola beverages as well as in over-the-counter and prescription medications for pain relief. In the clinician's handbook for diagnosing mental disorders (the Diagnostic and Statistical Manual of Mental Disorders , known as the DSM-IV-TR ), caffeine-related disorders are classified under the rubric of substance-related disorders. DSM-IV-TR specifies four caffeine-related disorders: caffeine intoxication, caffeine-induced anxiety disorder, caffeine-induced sleep disorder, and caffeinerelated disorder not otherwise specified. A fifth, caffeine withdrawal, is listed under the heading of "Criteria Sets and Axes Provided for Further Study." Caffeine-related disorders are often unrecognized for a number of reasons: Caffeine has a "low profile" as a drug of abuse. Consumption of drinks containing caffeine is unregulated by law and is nearly universal in the United States; one well-known textbook of pharmacology refers to caffeine as "the most widely used psychoactive drug in the world." In many countries, coffee is a social lubricant as well as a stimulant; the "coffee break" is a common office ritual, and many people find it difficult to imagine eating a meal in a fine restaurant without having coffee at some point during the meal. It is estimated that 10–12 billion pounds of coffee are consumed worldwide each year. People often underestimate the amount of caffeine they consume on a daily basis because they think of caffeine only in connection with coffee as a beverage. Tea, cocoa, and some types of soft drink, including root beer and orange soda as well as cola beverages, also contain significant amounts of caffeine. In one British case study, a teenager who was hospitalized with muscle weakness, nausea, vomiting, diarrhea, and weight loss was found to suffer from caffeine intoxication caused by drinking 8 liters (about 2 gallons) of cola on a daily basis for the previous two years. She had been consuming over a gram of caffeine per day. Chocolate bars and coffee-flavored yogurt or ice cream are additional sources of measurable amounts of caffeine. Caffeine has some legitimate medical uses in athletic training and in the relief of tension-type headaches. It is available in over-the-counter (OTC) preparations containing aspirin or acetaminophen for pain relief as well as in such OTC stimulants as NoDoz and Vivarin. Caffeine is less likely to produce the same degree of physical or psychological dependence as other drugs of abuse. Few coffee or tea drinkers report loss of control over caffeine intake, or significant difficulty in reducing or stopping consumption of beverages and food items containing caffeine. The symptoms of caffeine intoxication are easy to confuse with those of an anxiety disorder. The DSM-TR-IV states that it is unclear as of 2000 whether the tolerance, withdrawal symptoms, and "some aspects of dependence on caffeine" seen in some people who drink large amounts of coffee "are associated with clinically significant impairment that meets the criteria for Substance Abuse or Substance Dependence." On the other hand, a research team at Johns Hopkins regards caffeine as a model drug for understanding substance abuse and dependence. The team maintains that 9%–30% of caffeine consumers in the United States may be caffeine-dependent according to DSM criteria for substance dependency.

Healthwise, it's been a good year for coffee. Coffee is earning a better reputation on the health front as a result of several studies. In summer 2005, University of Scranton chemists reported that coffee beat out fruits and vegetables as the number one source of antioxidants for Americans. It turns out that a cup of coffee delivers a decent jolt of potentially protective antioxidants along with caffeine and hundreds of other substances. And since we drink so much — the average American has three cups a day — the antioxidants add up.

Drinking coffee before exercising can decrease the level of blood flow just when the heart needs to pump more blood.

Data from a large study suggests that women who drink higher amounts of cola may have an increased risk of developing high blood pressure.

During the early stages of pregnancy, can you drink coffee? My partner works nights and drinks a lot of coffee. Are there other, safer alternatives to the caffeine from coffee?

Detailed information on chronic pain, including causes, types, symptoms, and treatment

After upper respiratory infections, pain is the next most common problem seen by primary care providers, one expert says.

Detailed information on chronic pain, including causes, types, symptoms, treatment, and pain management rehabilitation

Chronic pain, whether it comes and goes or is constant, makes it impossible to do your normal activities without discomfort.

Between regular appointments, what should you do if symptoms flare up, or new ones appear?

Understanding the Pain ResponseYour pain is important. It can slow healing and keep you from being active.

Alcohol use involves drinking alcohol, which is produced by fermenting the starch or sugar in fruits and grains. See also: Alcohol and diet; Alcoholism; Alcohol withdrawal state.

Alcohol (ethyl alcohol or ethanol) consumption has a social aspect to it, but it is often abused. The effect of alcohol consumption on the body depends on how often it is consumed, how much, and the alcohol content of the drinks. Frequent alcohol use may encourage alcohol dependence or alcoholism. Alcoholism is a chronic disease that progresses and is often fatal. It is a primary disorder and not only a symptom of other diseases or emotional disorders. Factors such as psychology, culture, genetics, and response to physical pain influence the severity of alcoholism.

This report includes information on recognizing the symptoms of problem drinking, treatment techniques, coping with a loved one's drinking, and overcoming denial.

Researchers at the Harvard Medical School have discovered that the herb kudzu can curb the urge to drink alcohol.

Alcohol is considered a drug because it depresses the central nervous system and can disrupt mental and motor skills, as well as damage internal organs when used excessively.

It helps to understand why and when you drink if you are going to successfully reduce the amount of alcohol you consume.

As a woman, your body is much more sensitive to the effects of alcohol and more easily damaged than a man’s body. Because women have less water in their body than men, alcohol doesn't dilute as much and more of it gets absorbed into the blood. That’s why women suffer greater physical damage and often become more intoxicated than men when they drink identical amounts of alcohol.

A Harvard Medical School physician answers your question about forsaking the potential health benefits of moderate alcohol consumption.

Excessive drinking can cause potentially fatal conditions, not only high blood pressure, but also damage to the brain, heart or liver; diabetes and stroke.

Is there any connection between rheumatoid arthritis and alcohol consumption? Does a prior history of waterborne hepatitis predispose a person to RA?

Tips for avoiding the worst consequence of holiday overindulgence.Drinking fluids may help with the morning-after misery from getting drunk.

If you drink, you most likely want to drink reasonably and responsibly. But what are the factors that can help you keep a check on your blood-alcohol content so you don't embarrass yourself or, worse, hurt yourself or others?

Alcohol-dependent employees incur twice the health care costs of the average employee, are more likely to steal from their employers, are more likely to be involved in workplace accidents and are five times more likely to file worker’s compensation claims.