Saturday, June 23, 2007

PSYCHOSOMATIC PROBLEMS

Psychosomatic illness
Psychosomatic disorder, now more commonly referred to as psychophysiologic illness, is an illness whose symptoms are caused by mental processes of the sufferer rather than immediate physiological causes. If a medical examination can find no physical or organic cause, or if an illness appears to result from emotional conditions such as anger, anxiety, depression or guilt, then it might be classified as psychosomatic.
However, the term "psychosomatic" has developed a negative connotation in recent years, as many people mistakenly believe it to mean that the patient is "making up" his or her symptoms such as pain, has "mental problems," or is otherwise malingering. This is not its true meaning, as psychosomatic pain, for example, is very real pain, and is caused by unconscious rather than conscious sources, and is perfectly normal and not under conscious control.
Psychosomatic symptoms show that a human body can create physical symptoms that compensate for relationship deficiencies. (For example, hypnosis-induced allergic reactions indicate that a person's immune response can dramatically change during an intense mind-body relationship).
Very often, psychosomatic illness is influenced by external factors or players. Severe stress caused by factors in work, relationship, and family are known to cause bowel illness and accompanying dehydration, stomach or headaches, nausea, incontinence, or loss of hair.
Somatopsychic illness is an illness where the mental and psychological processes of the sufferer are affected by physiological causes. Emotional conditions similar to psychosomatic illness are experienced as well as decreased mental functioning. Physiological factors involved include, but are not limited to, cases of persons diagnosed with chronic pain and/or a physical disorder, cases where the person experiences frequent episodes of pain over a long period of time, and cases where a person has exacerbated levels of physical pain over a prolonged period of time..

Solutions
Although psychosomatic disease might improve or disappear following suggestion by a recognized authority, both the psycho and somatic aspects of psychosomatic symptoms may vanish if people improve the relationship of mind to body. Anorexia nervosa and bulimia nervosa, for example, are usually considered to be psychosomatic illnesses. Like many eating disorders, they respond well to relationship coaching and various forms of psychotherapy.
It is often very difficult to distinguish if a disease has a psychological root, however, it is suggested that 70% of all diseases are the result of anxiety and stress and hence, have a "psychological" root in this sense, even though stress and anxiety themselves involve many biochemical, hormonal and genetic aspects.
Emotional conditions such as anger, anxiety, depression and guilt can be treated using Hypnotherapy and Eye Movement Desensitization and Reprocessing, among other therapies, although these two particular treatments are considered controversial by many.
Cognitive behavior therapy is a widely-used treatment for anxiety, depression and related disorders.

History
Many identifiable illnesses have previously been labelled as 'hysterical' or 'psychosomatic', for example asthma, allergies, and migraines. Some illnesses are under debate, including multiple chemical sensitivity, Gulf War Syndrome, and Chronic Fatigue Syndrome. Some people suggest that stigmatics suffer a psychosomatic illness based on identifying with the biblical crucified Jesus.

Illness as Metaphor
Hypochondria
Munchausen syndrome
Tension myositis syndrome
Theory of Deadly Initials
Nocebo
Placebo
Placebo (origins of technical term)
Fibromyalgia

Saturday, June 16, 2007

QUIT SMOKING...YOU CAN DO IT

MOST IMPORTANT, know this —YOU CAN DO IT..
MOST IMPORTANT, know this —YOU CAN DO IT..
MOST IMPORTANT, know this —YOU CAN DO IT..
MOST IMPORTANT, know this —YOU CAN DO IT..
MOST IMPORTANT, know this —YOU CAN DO IT..

MOST IMPORTANT, know this —YOU CAN DO IT..

If you have tried to quit smoking and failed before, take comfort in the fact that most smokers fail several times before quitting successfully. Your past failures are not a lesson that you are unable to quit. Instead, view them as part of the normal journey toward becoming a nonsmoker.
The information below will ease your way and help insure that this is the last time you ever need to go through the quitting process. You can do it!
Please wait a few moments while this page loads. You may wish to print it out.
QUITTING TIPS
The most important step to take is the first step --admitting you have an addiction.
When asked why you smoke, you might have said, "I just like to smoke!" or "It's my choice to smoke."
The tobacco companies have promoted the idea that smoking is a matter of personal choice. As I see it, there really isn't as much choice as they have suggested to their customers.
Ask yourself, and be totally honest: Am I addicted to tobacco? Am I truly making a freely made choice when I smoke?
You might consider that you need to have a cigarette. Studies have shown that nicotine addiction is as hard to break as heroin or cocaine addiction.
In Nicotine Anonymous' 12 Step program, which sprang from the venerable Alcoholics Anonymous program, the first step is admitting to yourself, "I'm powerless over tobacco." Making this admission may seem trivial to you, but for many it is a very significant part of completing the journey to becoming a non-smoker.
By telling smokers that smoking is a personal choice, the tobacco industry has helped to keep its customers in denial about the true extent of their addiction. If smoking is a choice, then what's the rush to quit? The tobacco companies have used this spin to help keep millions of customers buying their deadly products.
Admitting that you're smoking more out of addiction than choice will help motivate you to go on to the next steps -- taking control of yourself and becoming a nonsmoker.
This admission will further serve you by helping you stay smoke free later. In the months and years after you quit, when temptations to smoke occasionally overpower you -- and they will -- remind yourself, "I have an addiction and I'm powerless over tobacco." Saying this to yourself in overwhelmed moments of desire will help give you the strength to say no to "just one" cigarette.
If you can make it for just five minutes without giving in, the urge to smoke be controllable or disappear. In this way, you'll be able to stay smokefree for life.
For me there were two very distinct and EQUALLY IMPORTANT phases to quitting:
Phase One — Quitting with helpPhase Two — Staying smokefree and not relapsing
Phase One:Quitting with help
When quitting, people who are the most successful at living life typically get help, and plenty of it.
For example, they might read up on how to prevent illness, and go to the doctor when sick. In business, a businessperson will get a lawyer to write the contracts, a marketing firm to do the marketing, an ad agency to create the ads, an accountant to do the accounting – and so on. The fact is that people who are successful in life get help. Real men ask directions!
Sadly, eighty percent of smokers who quit do so without being in any program – and studies show that 95% of these self-reliant quitters fail, and go right back to smoking. It's the same rate of recidivism as with heroin. With a 95% chance of failure without a program, you may wish to consider getting some help this time around.
For those who have repeatedly failed at quitting in the past, it's comforting to learn that most smokers in fact fail several times before stopping successfully. Your past failures are not a lesson that you are unable to quit. Instead, they are part of the normal journey toward becoming a nonsmoker.
I certainly failed -- 11 times. Every time I failed, I lost a little more faith that I could really quit. So each time I quit, it got harder and harder to motivate myself to set a date. I had begun to feel it was hopeless.
My mission here is to restore your faith in yourself. You CAN quit. Even if you've failed several times in the past, understand that this is normal. You're not alone.
You need to get your resolve up, and try again. YOU CAN DO IT!
Get help -- lots of it. Get into a good program, or better yet, a combination of more than one.
Call your local branch of the American Cancer Society, or the American Lung or Heart Associations. All have inexpensive and effective, mainstream programs.
Other top of the line, physician-endorsed methods: nicotine replacement and Zyban. The nicotine patch or gum are now available over-the-counter at any pharmacy. The anti-depressant Zyban and nicotine inhaler require a prescription.
The Schick-Shadel Treatment Centers offer aversion therapy -- self-administering a mild electric shock from an ordinary 9 volt battery as one smokes a cigarette. They claim a 95% initial success rate, and 50% after a year. I used this therapy successfully, and will come back to this later.
Buy a How to Quit Smoking Book, or a motivational cassette tape program in a bookstore, and listen to the tapes in your car. Every little bit helps!
In addition, visit our Quitlinks page, for to see the results of recent studies on which quit products work best.
Talk to a live human being free
Call 1-800-QUIT NOW for free support with a trained counselor, who will talk to you whether you are ready to quit or just thinking about it. This number will forward to your State's tobacco cessation program, which offers live phone support in your area. When you call, a friendly staff person will offer a choice of free services, including self-help materials, a referral list of other programs in your community, and one-one-counseling over the phone.
There is also the National Cancer Institute's Smoking Quitline, 1-877-44U-Quit, offering proactive counseling by trained personnel.
Try a free meeting
If joining a small group of other quitters appeals to you, then try a Nicotine Anonymous meeting. It's likely there's one near you where you live. It's a 12-step program based on AA; they're nonprofit and free. Ask directory assistance to get the number for a local Nicotine Anonymous chapter, or call the national line at (800) 642-0666. You can also check their website. (A for-profit company trademarked "Smokers' Anonymous" -- so you want the FREE program -- Nicotine Anonymous).
Don't count on any of these programs to make it a breeze. None of them will do that -- but they WILL reduce your distress by 15% to 50%, depending on how addicted you are psychologically, vs. physically.
I'm not promising it will be easy -- it won't. So get your resolve and willpower up, because you'll need it! And you CAN do it.
Don't ask, "Does this program work?" Rather, ask yourself, "Am I willing to DO the work?" You know how to work, don't you? I'm betting that you do.
I come from a wealthy background, and at one point it occurred to me that wealthy folks may have a much harder time quitting smoking, alcohol, or even dieting -- because they're used to getting whatever they want, whenever they want it. If you count yourself among this group, you might wish to consider an inpatient treatment center. You'd reside in a hospital for up to a week with a group of other people who are also quitting.
A Note About Tobacco Ads
Many teens, if asked, would say that tobacco ads have no influence over them. However, new studies tell us that advertising plays a greater role than even peer pressure in getting teens to smoke.
And one recent study shows that the three most heavily advertised brands are the same three brands most often smoked by teens -- Camels, Marlboros and Newport. It's no accident. Cigarette ads clearly influence our teens. Tobacco ads may not influence your conscious mind -- but they do influence the unconscious mind.
Your Unconscious Mind
What is the unconscious mind? In a famous study, the Russian scientist Pavlov rang a bell every time he fed his dog -- and eventually the dog would salivate just on hearing the bell -- even though there was no food there. The dog had made an unconscious association between the ringing and dinner, and began to drool!
Cigarette ads reach our unconscious minds. These ads create an unconscious association between the addiction of cigarettes and strong, positive images of attractive, healthy people, sports like tennis or mountain climbing, beautiful country scenes, cowboys gathered around a campfire or on horseback, masculinity and manhood, being feminine and womanhood, being a 'real person,' and so on. As of 2000, the tobacco industry has been spending over $5 billion annually to advertise its deadly products. That's a lot of bell ringing! And it's not lost on our kids.
The smoker's unconscious mind also makes repeated pleasant associations with the act of smoking -- watching the smoke slowly curling, putting a cigarette to the lips, languidly inhaling and exhaling, absently handling a cigarette -- all these are very much a part of the psychological addiction to tobacco. Quitters often feel as though they are losing a best friend.
Aversion therapy sends negative associations to the unconscious mind as the quitter smokes cigarettes. This clinically proven method helps to undo the years of daily positive associations with smoking. It helps to reduce future psychological cravings for cigarettes. In this way, the Schick-Shadel Treatment Centers aversion therapy program makes the quitting process a good deal easier.
For most addicted smokers, the addition is about half mental, half physical. Studies show that the ratio varies with each individual. The physical portion of the addiction is to nicotine. As to the mental or psychological aspect, a smoker's conscious mind says, 'I will stop smoking -- no problem.' But the unconscious mind has been conditioned for years that cigarettes give pleasure, and that's all it can focus on. The unconscious mind says, 'Gimmie a cigarette -- now!' It only recognizes what feels good. It demands a cigarette, without regard to right or wrong, and ignores the conscious mind's intentions. Aversion therapy is one way to help counteract this.
During the process of quitting, the new habit of being a nonsmoker forms. The ex-smoker's unconscious mind gradually gets used to being a nonsmoker, as the urges to smoke slowly fade away.
The Boilerplate Points
Do your best to follow as many of these as you can. The points below are advocated by most of today's credible quit-smoking products and programs. They are widely accepted as an essential and necessary part of quitting successfully. Just using the patch or Zyban without following the points below will hinder your chances to quit for good this time.
DEEP BREATHING PERHAPS THE SINGLE MOST POWERFUL AND IMPORTANT TECHNIQUE Every time you want a cigarette, do the following. Do it three times. Inhale the deepest lung-full of air you can, and then, very slowly, exhale. Purse your lips so that the air must come out slowly.As you exhale, close your eyes, and let your chin gradually sink over onto your chest. Visualize all the tension leaving your body, slowly draining out of your fingers and toes, just flowing on out. This is a variation of an ancient yoga technique from India, and is VERY centering and relaxing. If you practice this, you'll be able to use it for any future stressful situation you find yourself in. And it will be your greatest weapon during the strong cravings sure to assault you over the first few days. This deep breathing technique will be a vital help to you. Reread this point now, and as you do, try it for the first time. Inhale and exhale three times. See for yourself!
The first few days, drink LOTS of water and fluids to help flush out the nicotine and other poisons from your body.
Remember that the urge to smoke only lasts a few minutes, and will then pass. The urges gradually become farther and farther apart as the days go by.
Do your very best to stay away from alcohol, sugar and coffee the first week or longer, as these tend to stimulate the desire for a cigarette. Avoid fatty foods, as your metabolism will slow down a bit without the nicotine, and you may gain weight even if you eat the same amount as before quitting. So discipline about diet is extra important now. No one ever said acquiring new habits would be easy!
Nibble on low calorie foods like celery, apples and carrots. Chew gum or suck on cinnamon sticks.
Stretch out your meals; eat slowly and wait a bit between bites.
After dinner, instead of a cigarette, treat yourself to a cup of mint tea or a peppermint candy.
In one study, about 25% of quitters found that an oral substitute was invaluable. Another 25% didn't like the idea at all -- they wanted a clean break with cigarettes. The rest weren't certain. Personally, I found a cigarette substitute to be a tremendous help. The nicotine inhaler (by prescription) is one way to go: it's a shortened plastic cigarette, with a replaceable nicotine capsule inside.
A simpler way to go is bottled cinnamon sticks, available at any supermarket. I used these every time I quit, and they really helped me. I would chew on them, inhale air through them, and handle them like cigarettes. After a while, they would get pretty chewed up on one end -- but I'd laugh, reverse them and chew on the other end. Others may prefer to start a fresh stick. Once someone asked me, "Excuse me, but is that an exploded firecracker in your mouth?" I replied that I was quitting smoking – and they smiled and became supportive. Luckily, I never needed the cinnamon sticks after the first three days of being a nonsmoker.
Go to a gym, sit in the steam, exercise. Change your normal routine – take time to walk or even jog around the block or in a local park.
Look in the yellow pages under Yoga, and take a class – they're GREAT! Get a one hour massage, take a long bath -- pamper yourself.
Ask for support from coworkers, friends and family members. Ask for their tolerance. Let them know you're quitting, and that you might be edgy or grumpy for a few days. If you don't ask for support, you certainly won't get any. If you do, you'll be surprised how much it can help. Take a chance -- try it and see!
Ask friends and family members not to smoke in your presence. Don't be afraid to ask. This is more important than you may realize.
On your quit day, hide all ashtrays and destroy all your cigarettes, preferably with water, so no part of them is smokeable.
To talk to a live human being, call the National Cancer Institute's free Smoking Quitline, 1-877-44U-Quit. Proactive counseling services by trained personnel will be provided in sessions both before and after quitting smoking.
Check out http://www.quitnet.org/ and go to their chat room, where those quitting are doing it together, not alone. It can be a great source of support -- like a Nicotine Anonymous meeting, but on line. This site was put together by the Massachusetts Department of Public Health's Tobacco Control Program, which has a budget in the millions, thanks to Massachusetts's State cigarette tax increase of the early 90's.
At Nicotine Anonymous meetings, you'll find warm bodies, which can be more comforting than a computer screen. If this appeals to you more, pick up your telephone and ask directory assistance for the phone number of your local chapter. These are based on the classic 12-steps, borrowed from AA. The meetings are free and run entirely by volunteers. If there are no meetings in your city, try calling (800) 642-0666, or check the website. There you can also find out how to start your own meeting. That's how it spread all over the U.S. Support groups like Nicotine Anonymous might initially seem unnecessary -- but they provide a GREAT outlet to vent verbally. This could help spare your family and friends much grumpiness. It's truly therapeutic to see how other quitters are doing in their own struggles to stop.
Write down ten good things about being a nonsmoker -- and then write out ten bad things about smoking. Do it. It really helps.
Don't pretend smoking wasn't enjoyable – it was. This is like losing a good friend – and it's okay to grieve the loss. Feel that grief, don't worry, it's okay. Feel, and you heal. Stay with it -- you can do it!
Several times a day, quietly repeat to yourself the affirmation, "I am a nonsmoker." Many quitters see themselves as smokers who are just not smoking for the moment. They have a self-image as smokers who still want a cigarette. Silently repeating the affirmation "I am a nonsmoker" will help you change your view of yourself, and, even if it may seem silly to you, this is actually useful. Use it!
Here is perhaps the most valuable information among these points. In Phase 2, the period which begins a few weeks after quitting, the urges to smoke will subside considerably. However, it's vital to understand that from time to time, you will still be suddenly overwhelmed with a desire for "just one cigarette." This will happen unexpectedly, during moments of stress, whether negative stress or positive (at a party, or on vacation). If you are unprepared to resist, succumbing to that "one cigarette" will lead you directly back to smoking. Remember the following secret: in these surprise attacks during Phase 2 -- and they will definitely come -- do your deep breathing, and hold on for five minutes, and the urge will pass.
In conclusion, get the info and support you need to make the stopping process a little easier. DO NOT try to go it alone. Get help, and plenty of it.

Go cold turkey, or gradually cut down?
This is a personal choice. Do whichever you think will work best for you. Smokenders is a gradual quit program. But I wasn't one of those who could quit by slowly cutting down – although that works best for some. I always went cold turkey.
I'd always quit on a Monday -- a regular workday, when work would occupy my thoughts. My usual routine tasks were familiar and helped get me through the first few difficult days, which were always the most difficult part for me.
Once I tried quitting during a vacation. I found there was little to do, except to obsess all day long over having a smoke. I failed that time. The positive stress of being on vacation actually added to my stress in quitting. More about positive stress in the crucially important section which now follows. Do read on!
Phase TwoStaying smokefree and not relapsing
Here is the most valuable secret I can share with you, and probably the most important information on this page.
After the urges to smoke have become more and more infrequent, overwhelming surprise attacks are sure to come, a few weeks and months into your new smokefree life.
When these nearly out-of-control urges came (and they always engulfed me in unexpected moments), I learned that if I did my deep breathing (see above), and if I could just HOLD ON for 5 minutes -- the overpowering urge to smoke would completely pass.
That is by far the single most important thing I learned -- the hard way -- about how to quit successfully.
Because I didn't know this, I failed 11 times. I finally stopped for good on my 12th try, in Spring 1985. It's the key to what has empowered me to stay smokefree for the past dozen years or so.
So know that out-of-control, very nearly irresistible urges to have "just one" are going to take you by surprise, like a sudden gale that seems to come from nowhere. This will happen one or more times in the coming months.
Every time it does, do your deep breathing (see above), hold on for 5 minutes -- you can do it -- and the urge will completely pass.
I'm convinced that this is the single most important secret to quitting for life.

A NOTE TO NONSMOKERS If you live with a smoker, or are close friends with one: don't be a NAG about their smoking habit! (You can make noise about their smoking in the house or near you, because their second hand smoke hurts you – but don't nag them to quit. There's a BIG difference!)
Just three times a year you can ask your loved one – briefly – VERY briefly – to please quit smoking -- in VERY loving and warm tones. (Try surrounding your request with HONEST complements, keep it BRIEF, and they might be more open to hearing you.
But if you speak up more than three times per YEAR, then you're a yukky, obnoxious NAG. Ick! And your beloved smoker will be so ANGRY with you that they'll keep smoking just to spite you. You'll be defeating your very purpose.
I ask nonsmokers to honor their smoking loved ones, and treat them like adults.
And if your loved ones are nagging you, don't fall into the old trap of hurting yourself by continuing to smoke out of your anger toward them. Instead, let them know how you feel.
.
Sometimes, life is painful. It's supposed to be that way. All of us are faced with grief, loss and struggle. And it's by our struggles that we define and strengthen our character.
In my live talks and video for youth, I revive the ancient practice of initiation. As I initiate them into life, I let teens know that sometimes life will be painful.
"And when those moments come, you need to take the ADULT path," I tell the students, "and stay with the difficulty -- and not go lighting a cigarette, raiding the icebox, taking drugs, blasting music or switching on the TV -- or, going to work for too many long hours. All these are just ways of avoiding painful feelings and numbing them out."
If you stay with your pain, you'll begin to see what's causing it. And when you're ready, you can take a step to solve the problem.

FEEL -- AND YOU HEAL
One example: grieving your sadness to completion is the most effective way to heal it --rather than burying it, or carrying it with you deep inside for years. This is a core part of psychotherapy, and it works.
The same is true of anger – let your anger out in reasonable, mild little bits here and there, as you go along, right as things come up. This is better than letting it build up, and later exploding in rage.
It's helpful -- and healing -- to let your feelings out verbally, as you quit smoking. Better words should come out of your mouth, in loud complaining tones, than extra unneeded calories going in!
Don't worry, if you ask for support and tolerance, you'll get it. A great outlet for this is Nicotine Anonymous meetings. There you'll get plenty of support -- and hugs too, if you ask for them. Don't isolate, and do lean on others.
Especially for men, this is a sign of STRENGTH. Not going to a support meeting could be construed an act of fear, and therefore cowardice. So be brave, and seek support from others. It's a sign of a strong man in my book. Real men do ask directions!
It's true that smoking is mostly very enjoyable, even comforting, for you. Let's not lie about it. Quitting will be like losing a great, dear friend -- and you may find yourself grieving a bit. That's only natural, and it's okay.
But if you don't quit and "grieve" now, this great "friend" of yours will probably turn on you and kill you one day. It's statistically equivalent to playing Russian Roulette with not one, but two, bullets in the gun: if you smoke, you have a 40% chance of dying due to the habit. Not to mention continuing to put up with having to go outside most times you smoke.
In coming decades, we'll look back on smoking as a thing of the last century. We know that statistically, only children and teens begin the habit. As our government passes laws making it increasingly difficult for youth to obtain cigarettes, and as Uncle Sam limits the advertising of tobacco more in the future, teens will not start smoking in such huge numbers. Finally, one day smoking will be no more. No more deaths, no more disease, no more grieving families around the world.
Welcome to the wonderful world of nonsmokers. You can do it!

One definition of insanity is...
Repeating the same behavior over and over again, expecting different results.
To Review
Phase One was realizing that with the help of one or more programs, I could stay off cigarettes for one to three months.
But I did that 11 times.
Phase Two -- the period starting a few weeks after going cold turkey -- the urges to smoke would greatly diminish, even disappear. But it was vital that I came to realize that any time from a week to a year after quitting, I was sure to get an occasional surprise ATTACK – during which I was suddenly OVERWHELMED with the desire to smoke.
Usually these attacks would sneak up on me during moments of stress – positive stress (out with friends, partying, or on a vacation) or negative stress (while immersed in an angry, sad or lonely moment – you know about those.)
During these surprise attacks I would always rationalize, "I could have just one. Just one…I haven't had one for three months – so what's the harm of having just one now? I want it SO BADLY!" And I would take ONE, and ZAP! The next day I'd have "just one more," and before I knew it I was once again a full-fledged smoker, 100% addicted again, back up to a pack a day within just two or three weeks.
THE SECRET IS SIMPLEHang on for five minutes.
I finally stayed smokefree in this way:
When the surprise attacks came a few weeks or months after quitting, I told myself, "Hang on for five minutes – and this out-of-control urge to smoke will pass."
After 11 failed attempts, I looked back and I realized that several times in the past, surprise attacks were ALWAYS the critical moment in which I would inevitably become re-addicted, as "innocent" as "just one cigarette" might seem.
As I wrestled with myself thinking about this during an attack, I thought, "Okay. Relief is about four minutes away..."
Still I was dying for a smoke – okay, so now it was just THREE more minutes to hold on for... Now TWO...
And sure enough, at the end of five minutes – the urge would be all gone, and I would be quite proud of myself for holding on (plus I got to deny my smoking friend his pleasure in seeing me light up like him).
It's harsh, but --
Only a baby gets to relieve itself whenever it feels like it. Adults know how to delay gratification! It's time to remember you're an adult. So grow up and join the rest of the adults!


Addditional stop smoking info and resources

































MOST IMPORTANT, know this —YOU CAN DO IT..

If you have tried to quit smoking and failed before, take comfort in the fact that most smokers fail several times before quitting successfully. Your past failures are not a lesson that you are unable to quit. Instead, view them as part of the normal journey toward becoming a nonsmoker.
The information below will ease your way and help insure that this is the last time you ever need to go through the quitting process. You can do it!
Please wait a few moments while this page loads. You may wish to print it out.
QUITTING TIPS
The most important step to take is the first step --admitting you have an addiction.
When asked why you smoke, you might have said, "I just like to smoke!" or "It's my choice to smoke."
The tobacco companies have promoted the idea that smoking is a matter of personal choice. As I see it, there really isn't as much choice as they have suggested to their customers.
Ask yourself, and be totally honest: Am I addicted to tobacco? Am I truly making a freely made choice when I smoke?
You might consider that you need to have a cigarette. Studies have shown that nicotine addiction is as hard to break as heroin or cocaine addiction.
In Nicotine Anonymous' 12 Step program, which sprang from the venerable Alcoholics Anonymous program, the first step is admitting to yourself, "I'm powerless over tobacco." Making this admission may seem trivial to you, but for many it is a very significant part of completing the journey to becoming a non-smoker.
By telling smokers that smoking is a personal choice, the tobacco industry has helped to keep its customers in denial about the true extent of their addiction. If smoking is a choice, then what's the rush to quit? The tobacco companies have used this spin to help keep millions of customers buying their deadly products.
Admitting that you're smoking more out of addiction than choice will help motivate you to go on to the next steps -- taking control of yourself and becoming a nonsmoker.
This admission will further serve you by helping you stay smoke free later. In the months and years after you quit, when temptations to smoke occasionally overpower you -- and they will -- remind yourself, "I have an addiction and I'm powerless over tobacco." Saying this to yourself in overwhelmed moments of desire will help give you the strength to say no to "just one" cigarette.
If you can make it for just five minutes without giving in, the urge to smoke be controllable or disappear. In this way, you'll be able to stay smokefree for life.
For me there were two very distinct and EQUALLY IMPORTANT phases to quitting:
Phase One — Quitting with helpPhase Two — Staying smokefree and not relapsing
Phase One:Quitting with help
When quitting, people who are the most successful at living life typically get help, and plenty of it.
For example, they might read up on how to prevent illness, and go to the doctor when sick. In business, a businessperson will get a lawyer to write the contracts, a marketing firm to do the marketing, an ad agency to create the ads, an accountant to do the accounting – and so on. The fact is that people who are successful in life get help. Real men ask directions!
Sadly, eighty percent of smokers who quit do so without being in any program – and studies show that 95% of these self-reliant quitters fail, and go right back to smoking. It's the same rate of recidivism as with heroin. With a 95% chance of failure without a program, you may wish to consider getting some help this time around.
For those who have repeatedly failed at quitting in the past, it's comforting to learn that most smokers in fact fail several times before stopping successfully. Your past failures are not a lesson that you are unable to quit. Instead, they are part of the normal journey toward becoming a nonsmoker.
I certainly failed -- 11 times. Every time I failed, I lost a little more faith that I could really quit. So each time I quit, it got harder and harder to motivate myself to set a date. I had begun to feel it was hopeless.
My mission here is to restore your faith in yourself. You CAN quit. Even if you've failed several times in the past, understand that this is normal. You're not alone.
You need to get your resolve up, and try again. YOU CAN DO IT!
Get help -- lots of it. Get into a good program, or better yet, a combination of more than one.
Call your local branch of the American Cancer Society, or the American Lung or Heart Associations. All have inexpensive and effective, mainstream programs.
Other top of the line, physician-endorsed methods: nicotine replacement and Zyban. The nicotine patch or gum are now available over-the-counter at any pharmacy. The anti-depressant Zyban and nicotine inhaler require a prescription.
The Schick-Shadel Treatment Centers offer aversion therapy -- self-administering a mild electric shock from an ordinary 9 volt battery as one smokes a cigarette. They claim a 95% initial success rate, and 50% after a year. I used this therapy successfully, and will come back to this later.
Buy a How to Quit Smoking Book, or a motivational cassette tape program in a bookstore, and listen to the tapes in your car. Every little bit helps!
In addition, visit our Quitlinks page, for to see the results of recent studies on which quit products work best.
Talk to a live human being free
Call 1-800-QUIT NOW for free support with a trained counselor, who will talk to you whether you are ready to quit or just thinking about it. This number will forward to your State's tobacco cessation program, which offers live phone support in your area. When you call, a friendly staff person will offer a choice of free services, including self-help materials, a referral list of other programs in your community, and one-one-counseling over the phone.
There is also the National Cancer Institute's Smoking Quitline, 1-877-44U-Quit, offering proactive counseling by trained personnel.
Try a free meeting
If joining a small group of other quitters appeals to you, then try a Nicotine Anonymous meeting. It's likely there's one near you where you live. It's a 12-step program based on AA; they're nonprofit and free. Ask directory assistance to get the number for a local Nicotine Anonymous chapter, or call the national line at (800) 642-0666. You can also check their website. (A for-profit company trademarked "Smokers' Anonymous" -- so you want the FREE program -- Nicotine Anonymous).
Don't count on any of these programs to make it a breeze. None of them will do that -- but they WILL reduce your distress by 15% to 50%, depending on how addicted you are psychologically, vs. physically.
I'm not promising it will be easy -- it won't. So get your resolve and willpower up, because you'll need it! And you CAN do it.
Don't ask, "Does this program work?" Rather, ask yourself, "Am I willing to DO the work?" You know how to work, don't you? I'm betting that you do.
I come from a wealthy background, and at one point it occurred to me that wealthy folks may have a much harder time quitting smoking, alcohol, or even dieting -- because they're used to getting whatever they want, whenever they want it. If you count yourself among this group, you might wish to consider an inpatient treatment center. You'd reside in a hospital for up to a week with a group of other people who are also quitting.
Presently, two excellent inpatient programs are offered, at The Mayo Clinic in Rochester, MN (they have a second location as well), and St. Helena Hospital in Northern California. At the St. Helena site's menu bar, click on Wellness, and then click on the Nicotine Addiction Program.
How are your self denial muscles? Pretty good, no doubt! Let's see. Are you able to easily put off getting a brand new car, or going to a $60 per head restaurant? How about postponing that vacation in Monte Carlo, Aspen, or Florida? Good! If you can do those things, chances are good you won't need an inpatient program, and you'll have all the self-denial muscles you'll need to quit smoking. But you'll need to flex them. And yes, it might hurt a bit.

A Note About Tobacco Ads
Many teens, if asked, would say that tobacco ads have no influence over them. However, new studies tell us that advertising plays a greater role than even peer pressure in getting teens to smoke.
And one recent study shows that the three most heavily advertised brands are the same three brands most often smoked by teens -- Camels, Marlboros and Newport. It's no accident. Cigarette ads clearly influence our teens. Tobacco ads may not influence your conscious mind -- but they do influence the unconscious mind.
Your Unconscious Mind
What is the unconscious mind? In a famous study, the Russian scientist Pavlov rang a bell every time he fed his dog -- and eventually the dog would salivate just on hearing the bell -- even though there was no food there. The dog had made an unconscious association between the ringing and dinner, and began to drool!
Cigarette ads reach our unconscious minds. These ads create an unconscious association between the addiction of cigarettes and strong, positive images of attractive, healthy people, sports like tennis or mountain climbing, beautiful country scenes, cowboys gathered around a campfire or on horseback, masculinity and manhood, being feminine and womanhood, being a 'real person,' and so on. As of 2000, the tobacco industry has been spending over $5 billion annually to advertise its deadly products. That's a lot of bell ringing! And it's not lost on our kids.
The smoker's unconscious mind also makes repeated pleasant associations with the act of smoking -- watching the smoke slowly curling, putting a cigarette to the lips, languidly inhaling and exhaling, absently handling a cigarette -- all these are very much a part of the psychological addiction to tobacco. Quitters often feel as though they are losing a best friend.
Aversion therapy sends negative associations to the unconscious mind as the quitter smokes cigarettes. This clinically proven method helps to undo the years of daily positive associations with smoking. It helps to reduce future psychological cravings for cigarettes. In this way, the Schick-Shadel Treatment Centers aversion therapy program makes the quitting process a good deal easier.
For most addicted smokers, the addition is about half mental, half physical. Studies show that the ratio varies with each individual. The physical portion of the addiction is to nicotine. As to the mental or psychological aspect, a smoker's conscious mind says, 'I will stop smoking -- no problem.' But the unconscious mind has been conditioned for years that cigarettes give pleasure, and that's all it can focus on. The unconscious mind says, 'Gimmie a cigarette -- now!' It only recognizes what feels good. It demands a cigarette, without regard to right or wrong, and ignores the conscious mind's intentions. Aversion therapy is one way to help counteract this.
During the process of quitting, the new habit of being a nonsmoker forms. The ex-smoker's unconscious mind gradually gets used to being a nonsmoker, as the urges to smoke slowly fade away.
The Boilerplate Points
Do your best to follow as many of these as you can. The points below are advocated by most of today's credible quit-smoking products and programs. They are widely accepted as an essential and necessary part of quitting successfully. Just using the patch or Zyban without following the points below will hinder your chances to quit for good this time.
DEEP BREATHING PERHAPS THE SINGLE MOST POWERFUL AND IMPORTANT TECHNIQUE Every time you want a cigarette, do the following. Do it three times. Inhale the deepest lung-full of air you can, and then, very slowly, exhale. Purse your lips so that the air must come out slowly.As you exhale, close your eyes, and let your chin gradually sink over onto your chest. Visualize all the tension leaving your body, slowly draining out of your fingers and toes, just flowing on out. This is a variation of an ancient yoga technique from India, and is VERY centering and relaxing. If you practice this, you'll be able to use it for any future stressful situation you find yourself in. And it will be your greatest weapon during the strong cravings sure to assault you over the first few days. This deep breathing technique will be a vital help to you. Reread this point now, and as you do, try it for the first time. Inhale and exhale three times. See for yourself!
The first few days, drink LOTS of water and fluids to help flush out the nicotine and other poisons from your body.
Remember that the urge to smoke only lasts a few minutes, and will then pass. The urges gradually become farther and farther apart as the days go by.
Do your very best to stay away from alcohol, sugar and coffee the first week or longer, as these tend to stimulate the desire for a cigarette. Avoid fatty foods, as your metabolism will slow down a bit without the nicotine, and you may gain weight even if you eat the same amount as before quitting. So discipline about diet is extra important now. No one ever said acquiring new habits would be easy!
Nibble on low calorie foods like celery, apples and carrots. Chew gum or suck on cinnamon sticks.
Stretch out your meals; eat slowly and wait a bit between bites.
After dinner, instead of a cigarette, treat yourself to a cup of mint tea or a peppermint candy.
In one study, about 25% of quitters found that an oral substitute was invaluable. Another 25% didn't like the idea at all -- they wanted a clean break with cigarettes. The rest weren't certain. Personally, I found a cigarette substitute to be a tremendous help. The nicotine inhaler (by prescription) is one way to go: it's a shortened plastic cigarette, with a replaceable nicotine capsule inside.
A simpler way to go is bottled cinnamon sticks, available at any supermarket. I used these every time I quit, and they really helped me. I would chew on them, inhale air through them, and handle them like cigarettes. After a while, they would get pretty chewed up on one end -- but I'd laugh, reverse them and chew on the other end. Others may prefer to start a fresh stick. Once someone asked me, "Excuse me, but is that an exploded firecracker in your mouth?" I replied that I was quitting smoking – and they smiled and became supportive. Luckily, I never needed the cinnamon sticks after the first three days of being a nonsmoker.
Go to a gym, sit in the steam, exercise. Change your normal routine – take time to walk or even jog around the block or in a local park.
Look in the yellow pages under Yoga, and take a class – they're GREAT! Get a one hour massage, take a long bath -- pamper yourself.
Ask for support from coworkers, friends and family members. Ask for their tolerance. Let them know you're quitting, and that you might be edgy or grumpy for a few days. If you don't ask for support, you certainly won't get any. If you do, you'll be surprised how much it can help. Take a chance -- try it and see!
Ask friends and family members not to smoke in your presence. Don't be afraid to ask. This is more important than you may realize.
On your quit day, hide all ashtrays and destroy all your cigarettes, preferably with water, so no part of them is smokeable.
To talk to a live human being, call the National Cancer Institute's free Smoking Quitline, 1-877-44U-Quit. Proactive counseling services by trained personnel will be provided in sessions both before and after quitting smoking.
Check out http://www.quitnet.org/ and go to their chat room, where those quitting are doing it together, not alone. It can be a great source of support -- like a Nicotine Anonymous meeting, but on line. This site was put together by the Massachusetts Department of Public Health's Tobacco Control Program, which has a budget in the millions, thanks to Massachusetts's State cigarette tax increase of the early 90's.
At Nicotine Anonymous meetings, you'll find warm bodies, which can be more comforting than a computer screen. If this appeals to you more, pick up your telephone and ask directory assistance for the phone number of your local chapter. These are based on the classic 12-steps, borrowed from AA. The meetings are free and run entirely by volunteers. If there are no meetings in your city, try calling (800) 642-0666, or check the website. There you can also find out how to start your own meeting. That's how it spread all over the U.S. Support groups like Nicotine Anonymous might initially seem unnecessary -- but they provide a GREAT outlet to vent verbally. This could help spare your family and friends much grumpiness. It's truly therapeutic to see how other quitters are doing in their own struggles to stop.
Write down ten good things about being a nonsmoker -- and then write out ten bad things about smoking. Do it. It really helps.
Don't pretend smoking wasn't enjoyable – it was. This is like losing a good friend – and it's okay to grieve the loss. Feel that grief, don't worry, it's okay. Feel, and you heal. Stay with it -- you can do it!
Several times a day, quietly repeat to yourself the affirmation, "I am a nonsmoker." Many quitters see themselves as smokers who are just not smoking for the moment. They have a self-image as smokers who still want a cigarette. Silently repeating the affirmation "I am a nonsmoker" will help you change your view of yourself, and, even if it may seem silly to you, this is actually useful. Use it!
Here is perhaps the most valuable information among these points. In Phase 2, the period which begins a few weeks after quitting, the urges to smoke will subside considerably. However, it's vital to understand that from time to time, you will still be suddenly overwhelmed with a desire for "just one cigarette." This will happen unexpectedly, during moments of stress, whether negative stress or positive (at a party, or on vacation). If you are unprepared to resist, succumbing to that "one cigarette" will lead you directly back to smoking. Remember the following secret: in these surprise attacks during Phase 2 -- and they will definitely come -- do your deep breathing, and hold on for five minutes, and the urge will pass.
In conclusion, get the info and support you need to make the stopping process a little easier. DO NOT try to go it alone. Get help, and plenty of it.

Go cold turkey, or gradually cut down?
This is a personal choice. Do whichever you think will work best for you. Smokenders is a gradual quit program. But I wasn't one of those who could quit by slowly cutting down – although that works best for some. I always went cold turkey.
I'd always quit on a Monday -- a regular workday, when work would occupy my thoughts. My usual routine tasks were familiar and helped get me through the first few difficult days, which were always the most difficult part for me.
Once I tried quitting during a vacation. I found there was little to do, except to obsess all day long over having a smoke. I failed that time. The positive stress of being on vacation actually added to my stress in quitting. More about positive stress in the crucially important section which now follows. Do read on!
Phase TwoStaying smokefree and not relapsing
Here is the most valuable secret I can share with you, and probably the most important information on this page.
After the urges to smoke have become more and more infrequent, overwhelming surprise attacks are sure to come, a few weeks and months into your new smokefree life.
When these nearly out-of-control urges came (and they always engulfed me in unexpected moments), I learned that if I did my deep breathing (see above), and if I could just HOLD ON for 5 minutes -- the overpowering urge to smoke would completely pass.
That is by far the single most important thing I learned -- the hard way -- about how to quit successfully.
Because I didn't know this, I failed 11 times. I finally stopped for good on my 12th try, in Spring 1985. It's the key to what has empowered me to stay smokefree for the past dozen years or so.
So know that out-of-control, very nearly irresistible urges to have "just one" are going to take you by surprise, like a sudden gale that seems to come from nowhere. This will happen one or more times in the coming months.
Every time it does, do your deep breathing (see above), hold on for 5 minutes -- you can do it -- and the urge will completely pass.
I'm convinced that this is the single most important secret to quitting for life.

A NOTE TO NONSMOKERS If you live with a smoker, or are close friends with one: don't be a NAG about their smoking habit! (You can make noise about their smoking in the house or near you, because their second hand smoke hurts you – but don't nag them to quit. There's a BIG difference!)
Just three times a year you can ask your loved one – briefly – VERY briefly – to please quit smoking -- in VERY loving and warm tones. (Try surrounding your request with HONEST complements, keep it BRIEF, and they might be more open to hearing you.
But if you speak up more than three times per YEAR, then you're a yukky, obnoxious NAG. Ick! And your beloved smoker will be so ANGRY with you that they'll keep smoking just to spite you. You'll be defeating your very purpose.
I ask nonsmokers to honor their smoking loved ones, and treat them like adults.
And if your loved ones are nagging you, don't fall into the old trap of hurting yourself by continuing to smoke out of your anger toward them. Instead, let them know how you feel.
.
Sometimes, life is painful. It's supposed to be that way. All of us are faced with grief, loss and struggle. And it's by our struggles that we define and strengthen our character.
In my live talks and video for youth, I revive the ancient practice of initiation. As I initiate them into life, I let teens know that sometimes life will be painful.
"And when those moments come, you need to take the ADULT path," I tell the students, "and stay with the difficulty -- and not go lighting a cigarette, raiding the icebox, taking drugs, blasting music or switching on the TV -- or, going to work for too many long hours. All these are just ways of avoiding painful feelings and numbing them out."
If you stay with your pain, you'll begin to see what's causing it. And when you're ready, you can take a step to solve the problem.

FEEL -- AND YOU HEAL
One example: grieving your sadness to completion is the most effective way to heal it --rather than burying it, or carrying it with you deep inside for years. This is a core part of psychotherapy, and it works.
The same is true of anger – let your anger out in reasonable, mild little bits here and there, as you go along, right as things come up. This is better than letting it build up, and later exploding in rage.
It's helpful -- and healing -- to let your feelings out verbally, as you quit smoking. Better words should come out of your mouth, in loud complaining tones, than extra unneeded calories going in!
Don't worry, if you ask for support and tolerance, you'll get it. A great outlet for this is Nicotine Anonymous meetings. There you'll get plenty of support -- and hugs too, if you ask for them. Don't isolate, and do lean on others.
Especially for men, this is a sign of STRENGTH. Not going to a support meeting could be construed an act of fear, and therefore cowardice. So be brave, and seek support from others. It's a sign of a strong man in my book. Real men do ask directions!
It's true that smoking is mostly very enjoyable, even comforting, for you. Let's not lie about it. Quitting will be like losing a great, dear friend -- and you may find yourself grieving a bit. That's only natural, and it's okay.
But if you don't quit and "grieve" now, this great "friend" of yours will probably turn on you and kill you one day. It's statistically equivalent to playing Russian Roulette with not one, but two, bullets in the gun: if you smoke, you have a 40% chance of dying due to the habit. Not to mention continuing to put up with having to go outside most times you smoke.
In coming decades, we'll look back on smoking as a thing of the last century. We know that statistically, only children and teens begin the habit. As our government passes laws making it increasingly difficult for youth to obtain cigarettes, and as Uncle Sam limits the advertising of tobacco more in the future, teens will not start smoking in such huge numbers. Finally, one day smoking will be no more. No more deaths, no more disease, no more grieving families around the world.
Welcome to the wonderful world of nonsmokers. You can do it!

One definition of insanity is...
Repeating the same behavior over and over again, expecting different results.
To Review
Phase One was realizing that with the help of one or more programs, I could stay off cigarettes for one to three months.
But I did that 11 times.
Phase Two -- the period starting a few weeks after going cold turkey -- the urges to smoke would greatly diminish, even disappear. But it was vital that I came to realize that any time from a week to a year after quitting, I was sure to get an occasional surprise ATTACK – during which I was suddenly OVERWHELMED with the desire to smoke.
Usually these attacks would sneak up on me during moments of stress – positive stress (out with friends, partying, or on a vacation) or negative stress (while immersed in an angry, sad or lonely moment – you know about those.)
During these surprise attacks I would always rationalize, "I could have just one. Just one…I haven't had one for three months – so what's the harm of having just one now? I want it SO BADLY!" And I would take ONE, and ZAP! The next day I'd have "just one more," and before I knew it I was once again a full-fledged smoker, 100% addicted again, back up to a pack a day within just two or three weeks.
THE SECRET IS SIMPLEHang on for five minutes.
I finally stayed smokefree in this way:
When the surprise attacks came a few weeks or months after quitting, I told myself, "Hang on for five minutes – and this out-of-control urge to smoke will pass."
After 11 failed attempts, I looked back and I realized that several times in the past, surprise attacks were ALWAYS the critical moment in which I would inevitably become re-addicted, as "innocent" as "just one cigarette" might seem.
As I wrestled with myself thinking about this during an attack, I thought, "Okay. Relief is about four minutes away..."
Still I was dying for a smoke – okay, so now it was just THREE more minutes to hold on for... Now TWO...
And sure enough, at the end of five minutes – the urge would be all gone, and I would be quite proud of myself for holding on (plus I got to deny my smoking friend his pleasure in seeing me light up like him).
It's harsh, but --
Only a baby gets to relieve itself whenever it feels like it. Adults know how to delay gratification! It's time to remember you're an adult. So grow up and join the rest of the adults!


Addditional stop smoking info and resources

Friday, June 15, 2007

News...Hans seized

Thrissur,
A huge haul of Hans and Pan Parag was seized from godowns in Kokkalai.This is a commendable jod done by our police.These substances are sold to small children at school gate by unscrupulous traders who have petty inhuman gain only in their mind.It is very risky as the children will grow up as hard drug addicts and criminals,and antisocials.
I have written so many letters to police authorities years back regarding the dangers of Pan Masala.Feels very happy now,as they have started acting positively about this grave social public health problem .

PROBLEM GAMBLING

Problem gambling is an urge to gamble despite harmful negative consequences or a desire to stop. The term is preferred to compulsive gambling among many professionals, as few people described by the term experience true compulsions in the clinical sense of the word. Problem gambling often is defined by whether harm is experienced by the gambler or others, rather than by the gambler's behavior. Severe problem gambling may be diagnosed as clinical pathological gambling if the gambler meets certain criteria.
Contents
1 Definition
2 Pathological gambling
2.1 Biological bases
2.2 Relation to other problems
3 Prevalence
4 Assessment
5 Treatment for Compulsive Gambling
6 Treatment for Problem Gambling
6.1 Counselling
6.2 Step-Based Programs
6.3 Peer-support
6.4 Self-Help
7 See also
8 References
9 External links
Definition
There has been much debate over how problem gambling should be defined.[1] Research by governments in Australia led to a universal definition for that country which appears to be the only research based definition not to use diagnostic criteria.
“Problem gambling is characterised by many difficulties in limiting money and/or time spent on gambling which leads to adverse consequences for the gambler, others, or for the community.”[2]
Most other definitions of problem gambling can usually be simplified to any gambling that cause harm to the gambler or someone else in any way, however these definitions are usually coupled with descriptions of the type of harm or the use of diagnostic criteria such as the South Oaks Gambling Screen [3] or Canadian Problem Gambling Index.[4]
Pathological gambling
Extreme cases of problem gambling may cross over into the realm of mental disorders. Pathological gambling was recognized as a psychiatric disorder in the DSM-III, but the criteria were significantly reworked based on large-scale studies and statistical methods for the DSM-IV. As defined by American Psychiatric Association, pathological gambling is an impulse control disorder that is a chronic and progressive mental illness.
Pathological gambling is now defined as persistent and recurrent maladaptive gambling behavior meeting at least five of the following criteria, as long as these behaviors are not better explained by a manic episode:
1. Preoccupation. The subject has frequent thoughts about gambling experiences, whether past, future, or fantasy.
2. Tolerance. As with drug tolerance, the subject requires larger or more frequent wagers to experience the same "rush".
3. Withdrawal. Restlessness or irritability associated with attempts to cease or reduce gambling.
4. Escape. The subject gambles to improve mood or escape problems.
5. Chasing. The subject tries to win back gambling losses with more gambling.
6. Lying. The subject tries to hide the extent of his or her gambling by lying to family, friends, or therapists.
7. Loss of control. The person has unsuccessfully attempted to reduce gambling.
8. Illegal acts. The person has broken the law in order to obtain gambling money or recover gambling losses. This may include acts of theft, embezzlement, fraud, forgery, or bad checks.
9. Risked significant relationship. The person gambles despite risking or losing a relationship, job, or other significant opportunity.
10. Bailout. The person turns to family, friends, or another third party for financial assistance as a result of gambling.
11. Biological Bases. The person has a lack of norepinephrine.
As with many disorders, the DSM-IV definition of pathological gambling is widely accepted and used as a basis for research and clinical practice internationally.

Biological bases
According to the Illinois Institute for Addiction Recovery Recent evidence indicates that pathological gambling is an addiction similar to chemical addiction. It has been seen that some pathological gamblers have lower levels of norepinephrine than normal gamblers.
According to a study conducted by Alec Roy, M.D. formerly at the National Institute on Alcohol Abuse and Alcoholism, norepinephrine is secreted under stress, arousal, or thrill, so pathological gamblers gamble to make up for their underdosage.
Further to this, according to a report from the Harvard Medical School Division on Addictions there was an experiment constructed where test subjects were presented with situations where they could win, lose or break even in a casino-like environment. Subjects' reactions were measured using a fMRI, a neuro-imaging device very similar to a MRI. And according to Hans Breiter, MD, co-director of the motivation and Emotion Neuroscience Centre at the Massachusetts General Hospital, "Monetary reward in a gambling-like experiment produces brain activation very similar to that observed in a cocaine addict receiving an infusion of cocaine."
Deficiencies in serotonin might also contribute to complusive behavior, including a gambling addiction.
Relation to other problems
As debts build up people turn to other sources of money such as theft, or the sale of drugs. A lot of this pressure comes from bookies or loan sharks that people rely on for capital to gamble with. Also, a teenager that does not receive treatment for pathological gambling when in their desperation phase is likely to contemplate suicide. 20% of teenagers that are pathological gamblers do consider suicide. This according to the article High Stakes: Teens Gambling With Their Futures by Laura Paul.
Abuse is also common in homes where pathological gambling is present. Growing up in such a situation leads to improper emotional development and increased risk of falling prey to problem gambling behavior.
Pathological gambling is similar to many other impulse control disorders such as kleptomania, pyromania, and trichotillomania. Other mental diseases that also exhibit impulse control disorder include such mental disorders as antisocial personality disorder, or schizophrenia.
Prevalence
According to a variety of sources, the prevalence (i.e., extent of existing cases) of problem gambling is 2-3% and pathological gambling is 1% in the United States, though this may vary by country. By contrast, about 86% of Americans have gambled during their lives and 60% gamble in a given year. Interestingly, despite the widespread growth in gambling availability and the increase in lifetime gambling during that past 25 years, past year problem gambling has remained steady. Currently, there is little evidence on the incidence of problem gambling (i.e., new cases).
Available research seems to indicate that problem gambling is an internal tendency, and that problem gamblers will tend to risk money on whatever game is available, rather than a particular game being available inducing problem gambling in otherwise "normal" individuals. However, research also indicates that problem gamblers tend to risk money on fast-paced games. Thus a problem gambler is much more likely to lose a lot of money on poker or slot machines, where rounds end quickly and there is a constant temptation to play again or increase bets, as opposed to a state lottery where the gambler must wait until the next drawing to see results.
Dopamine agonists, in particular pramipexole (Mirapex), have been implicated in the development of compulsive gambling and other excessive behavior patterns (e.g., PMID 16009751).
Assessment
The most common instrument used to screen for "probable pathological gambling" behavior is the South Oaks Gambling Screen (SOGS) developed by Lesieur and Blume (1987) at the South Oaks Hospital in New York. This screen is undoubtedly the most cited instrument in psychological research literature (printable PDF version).
Treatment for Compulsive Gambling
There is evidence that the SSRI paroxetine is efficient in the treatment of pathological gambling [5]. Additionally, for patients suffering from both pathological gambling and a comorbid bipolar spectrum condition, sustained release lithium has shown efficacy in a preliminary trial. [6]. The opiate antagonist drug nalmefene has also been trialled quite successfully for the treatment of compulsive gambling.
reatment for Problem Gambling
Most treatment for problem gambling involves counselling, step-based programs, self-help, peer-support, or a combination of these.
Counselling
Gambling counselling is usually delivered by professional counsellors who are often either qualified psychologists or social workers. In many jurisdictions services are free or subsidised by government agencies. Telephone counselling services are also available in many countries. Examples of services include Gamcare (UK) and Gambler's Help (Australia).
Step-Based Programs
The most common step-based program for gambling issues is Gamblers Anonymous. Gambler's Anonymous uses a 12 step program adapted from Alcoholics Anonymous and also places an emphasis on peer suppport. Other step-based programs (some commercially operated) that are both specific to gambling and generic to addiction have also be used to treat problem gamblers.
Peer-support
A growing method of treatment is peer support. With the advancement of online gambling, many gamblers experiencing issues use various online peer-support groups to aid their recovery. This protects their anonymity whilst allowing to attempt to self-recover often without having to disclose their issues to loved ones.
Self-Help
Research into self-help for problem gamblers is showing promising results. David Hodgins research into the use of workbooks followed up with telephone support has shown benefits.[7] Online self-help sites have been funded which aim to provide gamblers with support whilst protecting their anonymity. Sites include: First Step and WebGAM.
See also
· Compulsive hoarding

Gambling Addiction Questions and Answers

Is pathological gambling similar to chemical dependency?
Yes and no. Similarities between pathological gambling and chemical dependency include an inability to stop/control the addiction, denial, severe depression, and mood swings. Pathological gambling and chemical dependency are both progressive diseases with similar phases. These include "chasing" the first win/high, experiencing blackouts and using the object of addiction to escape pain. Both pathological gamblers and persons addicted to alcohol or drugs are preoccupied with their addiction, experience low self-esteem, use rituals, and seek immediate gratification.
Unlike chemical addiction, pathological gambling is a hidden disease ­ gamblers do not stumble, have needles in their arm, or smell of cards and dice. Pathological gamblers cannot overdose in the conventional sense, but they experience tremendous financial problems that require immediate attention. More resources are available to chemical dependency than gambling addiction, in part because most people do not perceive gambling as potentially addicting. It is very important that pathological gamblers receive crisis stabilization at the beginning of their treatment, because pathological gamblers have a much higher suicide rate than persons addicted to alcohol or drugs.

How are children affected by pathological gambling?
Children may be affected in several ways. They may be physically and/or emotionally abandoned by their parents, who are unable to provide their children with needed attention and nurturing because of the time spent gambling. "Casino kids" have been left by themselves at the outer rim of casinos while their parents gamble, according to some casino security officers. In some extreme cases, children are left in the family car in the casino parking lot for hours at a time while their parents gamble inside. Less obviously, children may also spend several hours each week with babysitters while their parents gamble in casinos, bingo halls or card rooms. All of these scenarios may lead a child to feel physically and emotionally abandoned.
In addition, the dysfunction that pathological gambling creates in a home often includes spouse and child abuse. Children are abused verbally, mentally and physically by the gambler, and often even more so by the co-dependent spouse. This devastating abuse frequently goes unnoticed or is denied by others as the child suffers in silence.
Another way children are affected by pathological gambling is when they become pathological gamblers themselves. Today, teens are approximately three times more likely than adults to become problem and pathological gamblers. It is imperative that we educate young people about the dangers of pathological gambling and the importance of seeking help if gambling becomes a problem.

Are gamblers addicted to money?
Pathological gamblers are addicted to action, not money. Many pathological gamblers will gamble to lose in the desperation phase of their addiction, because it is the action they seek, not the money. For a gambler, being in action is similar to being high on cocaine for the person addicted to cocaine. Both describe their "drug of choice" as seductive and ultimately destructive.

What is the physician's role in treating pathological gambling at the Illinois Institute for Addiction Recovery?
Pathological gambling has been recognized as a major addiction illness, similar in many ways to the chemical dependency of cocaine. It is characterized by the sudden euphoria of winning and the marked dysphoria, depression and frustration of repeated losing.
The physician is needed to assess these patients for the frequent incidence of cross addiction to drugs and alcohol, for potential drug withdrawal, and for potential suicidal tendencies associated with the depression that most patients experience. Underlying medical problems are often neglected while patients are in a gambling frenzy, leading to symptoms of illness and health deterioration. Laboratory tests and physical examinations can often uncover unexpected medical problems.
The most important medical contribution the physician makes is to assist patients who are experiencing withdrawal by supporting their need for group therapy, assessing for possible antidepressant medication, and making referrals for appropriate psychological help. The use of sedative medication is avoided, as these drugs may lead to a deepening of the depression and may actually exacerbate suicidal behavior.

What is the financial counselor's role in treating pathological gambling at the Illinois Institute for Addiction Recovery?
Pathological gamblers often find themselves in a devastating financial position by the time they reach treatment. Helping them become financially stable goes a long way in supporting their recovery and the well-being of their families.
It is the responsibility of the financial counselor first to determine the extent of the gambler's debt, and then to help guide them out of their financial problems through debt management, budgeting and restitution.
Gamblers in treatment at Proctor Hospital work extensively with the financial counselor, through every level of care, to achieve financial stability.
Is there one type of gambling that is more addictive than others?
Video poker and slot machines have been referred to as the "crack cocaine of gambling." Because of their immediate and effective reinforcement schedules, problem gamblers who regularly play these machines appear to progress into pathological gambling much faster than problem gamblers who only gamble at horse races, or other games that do not have such an immediate rate of gratification.
Just as crack cocaine ­ referred to as the "great precipitator" ­ shortened the length of time between first use of cocaine and chronic addiction, so too have video poker and slot machines apparently reduced the length of time between first wager and pathological gambling. In the past, a gambler would experience 15 to 25 years of "sick" gambling at the horse track before he or she reached the desperation phase. Today, it is not uncommon for a gambler addicted to slot or video-poker machines to progress into the desperation phase in two or three years.

Is there a biological basis for pathological gambling?
Biological findings from a recent study indicate that pathological gambling is an addiction similar to chemical addiction.
A study conducted by Alec Roy, M.D., a psychiatrist formerly at the National Institute on Alcohol Abuse and Alcoholism, showed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. This brain chemical is secreted under stress, arousal, thrill and excitement, so pathological gamblers may engage in activities such as gambling to increase their levels of norepinephrine.
This evidence supports the assertion made by Dr. Henry Lesieur, among others, that some pathological gamblers are "action seekers" who gamble, not for money, but for the excitement associated with being in action.
Many popular cine stars-"action seekers"- from India have lost astronomical amounts in American casinos!Remember day trading,option trading,speculations in share market are very well comes under this topic.

Thursday, June 14, 2007

SLEEP DISORDERS {INSOMNIAS}

Sleep disorders
A sleep disorder (somnipathy) is a disorder in the sleep patterns of a person or animal. Some sleep disorders can interfere with mental and emotional function. A test commonly ordered for some sleep disorders is the polysomnogram.
Contents
1 Common sleep disorders
2 Broad classifications of sleep disorders
3 Common causes of sleep disorders
4 General Principles of Treatment
5 See also
Common sleep disorders
The most common sleep disorders include:
Bruxism: The sufferer involuntarily grinds his or her teeth while sleeping.
Delayed sleep phase syndrome (DSPS): A sleep disorder of circadian rhythm, characterized by the inability to wake up and fall asleep at the desired times, but not by inability to stay asleep.
Hypopnea syndrome: Abnormally shallow breathing or slow respiratory rate while sleeping.
Narcolepsy: The condition of falling asleep spontaneously and unwillingly.
Night terror or Pavor nocturnus or sleep terror disorder: abrupt awakening from sleep with behavior consistent with terror.
Parasomnias: Include a variety of disruptive sleep-related events.
Periodic limb movement disorder (PLMD): Involuntary movement of arms and/or legs during sleep. See also Hypnic jerk, which is not a disorder.
Rapid eye movement behavior disorder (RBD): Acting out violent or dramatic dreams while in REM sleep.
Restless legs syndrome (RLS): An irresistible urge to move legs while sleeping. Often accompanies PLMD.
Shift work sleep disorder (SWSD).
Sleep apnea: The obstruction of the airway during sleep.
Sleepwalking or somnambulism: Engaging in activities that are normally associated with wakefulness (such as eating or dressing), which may include walking, without the conscious knowledge of the subject.
Snoring: Loud breathing patterns while sleeping, sometimes accompanying sleep apnea.
Broad classifications of sleep disorders
Dysomnias - A broad category of sleep disorders characterized by either hypersomnolence or insomnia. The three major subcategories include intrinsic (i.e., arising from within the body), extrinsic (secondary to environmental conditions or various pathologic conditions), and disturbances of circadian rhythm. MeSH
Insomnia
Narcolepsy
Obstructive sleep apnea
Restless leg syndrome
Periodic limb movement disorder
Hypersomnia
Recurrent hypersomnia - including Kleine-Levin syndrome
Posttraumatic hypersomnia
"Healthy" hypersomnia
Circadian rhythm sleep disorders
Delayed sleep phase syndrome
Advanced sleep phase syndrome
Non-24-hour sleep-wake syndrome
Parasomnias
REM sleep behaviour disorder
Sleep terror
Sleepwalking (or somnambulism)
Tooth-grinding
Bedwetting or sleep enuresis.
Sudden infant death syndrome (or SIDS)
Sleep talking (or somniloquy)
Sleep sex (or sexsomnia)
Exploding head syndrome - Waking up in the night hearing loud noises.

Medical or Psychiatric Conditions that may produce sleep disorders
Psychoses (such as Schizophrenia)
Mood disorders
Depression
Anxiety
Panic
Alcoholism
Sleeping sickness - can be carried by the Tsetse fly
Snoring - Not a disorder in and of itself, but it can be a symptom of deeper problems.
Common causes of sleep disorders
Changes in life style, such as shift work change (SWC), can contribute to sleep disorders.
Other problems that can affect sleep:
Back pain
Chronic pain
Sciatica
Neck problems
Environmental noise
Incontinence
Babies that wake frequently
Various drugs - Many drugs can affect the ratio of the various stages of sleep, thus affecting the overall quality of sleep. Poor sleep can lead to accumulation of Sleep debt.
A sleep diary can be used to help diagnose, and measure improvements in sleep disorders. The Epworth Sleepiness Scale is another useful diagnostic tool.
According to Dr. William Dement, of the Stanford Sleep Center, anyone who snores and has daytime drowsiness should be evaluated for sleep disorders.
Any time back pain or another form of chronic pain is present, both the pain and the sleep problems should be treated simultaneously, as pain can lead to sleep problems and vice versa.
General Principles of Treatment
Treatments for sleep disorders generally can be grouped into three categories: 1) behavioral/ psychotherapeutic treatments, 2) medications, and 3) other somatic treatments. None of these general approaches is sufficient for all patients with sleep disorders. Rather, the choice of a specific treatment depends on the patient's diagnosis, medical and psychiatric history, and preferences, as well as the expertise of the treating clinician. In general, medications and somatic treatments provide more rapid symptomatic relief from sleep disturbances. On the other hand, some emerging evidence suggests that treatment gains with behavioral treatment of insomnia may be more durable than those obtained with medications.
Some sleep disorders, such as narcolepsy, are best treated pharmacologically, whereas others, such as chronic and primary insomnia, are more amenable to behavioral interventions. The management of sleep disturbances that are secondary to mental, medical, or substance abuse disorders should focus on the underlying conditions.
For most sleep disorders, behavioral/psychotherapeutic and pharmacological approaches are not incompatible and can be effectively combined to maximize therapeutic benefits..
See also
Environmental noise health effects
Reversed vegetative symptoms
Sleep hygiene
White noise machine
American Academy of Sleep Medicine

Organic/symptomatic
Dementia - Multi-infarct dementia - Delirium
Psychoactive substance
Physical dependence - Korsakoff's syndrome
Schizophrenia, schizotypal and delusional
Schizophrenia - Disorganized schizophrenia - Schizotypal personality disorder - Delusional disorder - Folie à deux - Schizoaffective disorder
Mood (affective)
Mania - Bipolar disorder - Clinical depression - Cyclothymia - Dysthymia
Neurotic, stress-related and somatoform
Agoraphobia - Anxiety disorder - Panic disorder - Generalized anxiety disorder - OCD - Acute stress reaction - PTSD - Adjustment disorder - Conversion disorder - Somatoform disorder - Somatization disorder - Neurasthenia
Physiological/physical behavioural
Eating disorder (Anorexia nervosa, Bulimia nervosa) - Sleep disorder
Adult personality and behaviour
Personality disorder - Passive-aggressive behavior - Kleptomania - Trichotillomania - Voyeurism - Factitious disorder - Munchausen syndrome
Mental retardation
Mental retardation
Psychological development
Specific developmental disorder - Speech disorder - Expressive language disorder - Aphasia (Expressive, Receptive) - Landau-Kleffner syndrome - Lisp - Dyslexia - Dysgraphia - Gerstmann syndrome - Dyspraxia - Pervasive developmental disorder - Autism - Rett syndrome - Asperger syndrome
Behavioural and emotional, childhood and adolescence onset
ADHD - Conduct disorder - Oppositional defiant disorder - Separation anxiety disorder - Selective mutism - Reactive attachment disorder - Tic disorder - Tourette syndrome - Stuttering - Cluttering