Main Services & Prices

would like to be your partner in health care. Feel free to ask your questions and
share your concerns with me. I will work with you to develop a wellness program for
the care and treatment you need.

I welcome you to my practice and look forward to caring for you.

provides a full range of medical services including the following:

Alcoholism
Alcoholism is a chronic addiction disorder in which a person becomes dependent on
alcohol. Individuals with this condition are unable to control how much they drink and often
experience serious consequences as a result of their alcohol consumption. Some people
may not be characterized as alcoholics, but can suffer from alcohol abuse, meaning that
they drink excessively but are not fully dependent on alcohol. Both conditions are
considered serious and require long-term treatment in order to resume a normal, fully
functioning lifestyle. ...
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Alcoholism is a chronic addiction disorder in which a person becomes dependent on
alcohol. Individuals with this condition are unable to control how much they drink and
often experience serious consequences as a result of their alcohol consumption. Some
people may not be characterized as alcoholics, but can suffer from alcohol abuse,
meaning that they drink excessively but are not fully dependent on alcohol. Both
conditions are considered serious and require long-term treatment in order to resume a
normal, fully functioning lifestyle.

Causes of Alcoholism
Both alcoholism and alcohol abuse can develop over time as a result of several different
factors. Some patients may be genetically predisposed to developing these conditions,
including those with a family history of alcohol problems. Many people may develop
alcoholism as a result of high stress and anxiety levels, low self-esteem, or depression.
Additional risk factors for developing alcoholism may include:

Steady and increased drinking over time

People who begin drinking at an early age
Social and cultural factors
Certain mental health disorders such as bipolar disorder
Mixing alcohol and medication

Symptoms of Alcoholism
Many people with alcoholism deny that they have a drinking problem. Friends and family
may be aware of certain signs of this condition, however not everyone with a drinking
problem is necessarily an alcoholic. Signs of alcoholism or alcohol abuse may include:

Drinking alone
Uncontrollable drinking
Frequently blacking out
Feeling a need to drink
Loss of interest in other activities or hobbies
Experiencing withdrawal symptoms when not drinking
Hiding drinking or drinking secretly
Keeping alcohol at work or in the car
Becoming intoxicated to feel good

Alcoholism can cause problems in personal relationships, with employment or finances

and can affect every aspect of a person's life.

Complications of Alcoholism
In addition to the personal and social ramifications of alcoholism, alcohol can affect a
person's judgment causing poor choices to be made. People suffering from alcoholism
may be involved in motor vehicle accidents, domestic disputes, and have an increased
likelihood of committing violent crimes. Alcoholism may also cause a variety of healthrelated problems including:

Liver disease
Heart problems
Digestive problems
Sexual dysfunction
Weakened immune system
Diabetes complications
Increased cancer risk
Neurological problems
Birth defects if alcohol is used during pregnancy

Treatment of Alcoholism
Treatment for alcoholism varies, but the common goals are to help the individual stop
abusing alcohol, maintain an alcohol-free lifestyle, and sustain a productive family and
professional life. The first step in successful treatment of alcoholism often begins when
the individual admits that they have a problem and need help. Treatments may differ

based on the individual, and on different factors such as dependence on alcohol, physical
health and medical history, age and lifestyle. Common treatment options for alcoholism
may include:

Counseling
Aversion therapy
Detoxification
Intervention
Medication
Spiritual practice

These treatments may be administered at an inpatient or outpatient facility, and may be

short or long-term. In addition, alcoholism commonly occurs along with other mental
health disorders, so treatment for these underlying conditions may be a part of the
treatment process. It is important for patients with alcoholism to have a strong support
system through friends and family or self-help groups like Alcoholics Anonymous.
Recovering from alcoholism is a life-long commitment that requires strength and
determination.

Depression
Depression is a medical condition that causes extreme feelings of sadness and emptiness.
People who suffer from depression may lose interest in activities they once enjoyed, and
experience a constant feeling of hopelessness on a daily basis. Depression, also known as
clinical or major depression, may be triggered by certain events or occur along with other
illnesses. Severe depression can interfere with a person's ability to work, sleep, eat, interact
with others or enjoy life. With treatment, however, depression can become a manageable
condition. ...
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Depression is a medical condition that causes extreme feelings of sadness and
emptiness. People who suffer from depression may lose interest in activities they once
enjoyed, and experience a constant feeling of hopelessness on a daily basis. Depression,
also known as clinical or major depression, may be triggered by certain events or occur
along with other illnesses. Severe depression can interfere with a person's ability to work,
sleep, eat, interact with others or enjoy life. With treatment, however, depression can
become a manageable condition.

Causes of Depression
The exact cause of depression is unknown. Depression can sometimes be triggered by a
traumatic event such as the death of a loved one, divorce, emotional or financial stress,
or childhood trauma. Other factors that may contribute to depression include:

Hormonal changes
Heredity
Chemical imbalances or changes within the brain
The use of certain medications such as steroids, or alcohol or drug abuse may contribute
to the onset of depression. Patients suffering from serious illnesses such as cancer or
other long-term conditions may also develop depression.

Symptoms of Depression
While most people may feel sad every once in a while, clinical depression affects the lives
of those afflicted on a daily basis. Symptoms of clinical depression include:

Feeling sad or hopeless

Loss of interest in normal activities
Crying spells
Trouble sleeping
Trouble concentrating
Irritability
Change in appetite
Fatigue
Unexplained aches and pains
Suicidal thoughts
Depression is a serious condition that can severely affect individuals and their families.
Left untreated, depression may lead to anxiety, isolation, difficulties at work or school,
alcohol or substance abuse, and in extreme cases, suicide.

Diagnosing Depression
To diagnose depression, the doctor will conduct a full physical examination and a review
of all symptoms. Blood and urine tests may also be performed to rule out any underlying
medical conditions that may contribute to the depression. A full psychological evaluation
is also performed to make a proper diagnosis and create a treatment plan.

Treatment of Depression
Depression is typically treated with a combination of psychotherapy and antidepressant
medication. Antidepressants help to alter brain chemistry to improve mood.
Psychotherapy, in the form of therapy or counseling, aims to treat depression by teaching
the individual new ways of thinking and behaving, and changing habits that may be
contributing to the depression.
Individuals with severe depression that does not respond to medication or therapy, may

benefit from electroconvulsive therapy (ECT). With this therapy, electrical currents are
passed through the brain, affecting the levels of neurotransmitters, which often results in
immediate relief of severe depression.
In extreme cases, hospitalization may be temporarily necessary if the patient cannot
properly care for themselves or if they are in danger of harming themselves or others.

Binge Eating Disorders

A binge eating disorder is an eating disorder where people consume unusually large
amounts of food in one sitting. Many people who are binge eaters feel a lack of control over
their eating and may feel extremely depressed and guilty after a binge eating episode.
Binge eaters may be overweight or obese, but can also be of normal weight. Binge eaters
are twice as likely to be women than men. There is no specific cause for binge eating but it
may be a result of family history, biological factors, long-term dieting and psychological
issues. Binge eating may be caused by depression or anxiety or may be the result of painful
childhood experiences or family problems. ...
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A binge eating disorder is an eating disorder where people consume unusually large
amounts of food in one sitting. Many people who are binge eaters feel a lack of control
over their eating and may feel extremely depressed and guilty after a binge eating
episode. Binge eaters may be overweight or obese, but can also be of normal weight.
Binge eaters are twice as likely to be women than men. There is no specific cause for
binge eating but it may be a result of family history, biological factors, long-term dieting
and psychological issues. Binge eating may be caused by depression or anxiety or may
be the result of painful childhood experiences or family problems.

Symptoms of Binge Eating Disorders

Symptoms of binge eating disorders can be behavioral and emotional and may include:

Eating when depressed, sad or bored

Eating large amounts of food when not hungry
Eating alone during binge episodes
Feeling disgusted, guilty, or depressed after binge episode
Eating until physically uncomfortable
Cannot not exercise control over consumption of food
Typical binge episodes may include:

Large amounts of food eaten quickly

Low nutritional value of food
Relatively high taste value of food

Eating alone and in an isolated environment

Treatment of Binge Eating Disorders

Treatment for a binge eating disorders may include cognitive behavioral therapy, support
groups, and psychological counseling. The goal of treatment is to reduce eating binges,
improve emotional well-being, and when necessary, help patients to lose weight. All these
methods of treatment focus on improving the patient's ability to cope with difficult
situations, and to encourage them to keep track of their eating habits. Self-help strategies
such as books, videos and internet programs may also be effective in treating binge
eating disorders.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a condition that is characterized by extreme fatigue that does
not improve with rest. Fatigue caused by this condition is ongoing and may worsen after
physical activity or mental exertion. Anyone can suffer from chronic fatigue syndrome,
although it is most common in middle aged women. The exact cause of chronic fatigue
syndrome is unknown which makes this condition difficult to treat. ...
Read More...
hronic fatigue syndrome is a condition that is characterized by extreme fatigue that does
not improve with rest. Fatigue caused by this condition is ongoing and may worsen after
physical activity or mental exertion. Anyone can suffer from chronic fatigue syndrome,
although it is most common in middle aged women. The exact cause of chronic fatigue
syndrome is unknown which makes this condition difficult to treat.

Symptoms of Chronic Fatigue Syndrome

Many people with chronic fatigue syndrome may experience symptoms similar to those of
the flu or other viral infections. These symptoms may include:

Persistent fatigue
Loss of memory or concentration
Sore throat
Swollen lymph nodes
Muscle soreness
Headache
Trouble sleeping
Extreme exhaustion after exercise
The main symptom that individuals experience is fatigue, which seems to occur
continuously, however, other symptoms may come and go over time with no recognizable

pattern.

Causes of Chronic Fatigue Syndrome

The exact cause of chronic fatigue syndrome is unknown, although it sometimes occurs
after a viral infection such as a cold or other viral illness. Other causes may include
immune system problems, genetics, or hormonal imbalances. In addition, some people
may be more likely than others to develop chronic fatigue syndrome including those who
are:

In their 40's and 50's

Women
Overweight
Living stressful lives
Low blood pressure and nutritional deficiencies may also contribute to chronic fatigue
syndrome. Left untreated, chronic fatigue syndrome may lead to frequent absences from
work or school, depression, and social isolation.

Diagnosis of Chronic Fatigue Syndrome

Chronic fatigue syndrome may be difficult to diagnose because the symptoms can mimic
those of other health conditions. While there is no specific diagnostic test for chronic
fatigue syndrome, a doctor will review all symptoms, perform a physical examination and
additional tests such as blood tests and urinalysis, to rule out any underlying medical
conditions. If chronic fatigue syndrome is suspected, a customized treatment plan will be
created.

Treatment of Chronic Fatigue Syndrome

There is no specific treatment for chronic fatigue syndrome. Treatments may vary, but the
common goal is to relieve symptoms through a combination of methods. An individualized
treatment approach is most effective in treating this complex condition. For many
patients, multiple techniques may be recommended before finding a unique approach that
works. Depending on the symptoms, a doctor may recommend:

Avoiding stress
Gradual exercise training
Cognitive behavior therapy
Pain relievers such as ibuprofen or acetaminophen
Allergy treatment such as antihistamines and decongestants
Acupuncture or massage for pain

Medication may also be prescribed to treat depression in individuals that suffer from
chronic fatigue syndrome. Antidepressants may also help to improve sleep and relieve
pain.
In addition to following a treatment plan prescribed by a doctor, individuals suffering from
chronic fatigue syndrome may find relief by maintaining a healthy, stress-free lifestyle,
getting enough sleep, eating a healthy, well-balanced diet and attending support groups.

Other Mental Health Care Professionals

In addition to psychiatrists, social workers, professional counselors and psychiatric nurse
practitioners, there are several other types of mental health care workers providing valuable
services in various aspects of mental health care. Although specific training is required for
each specialty, there are common elements involving patient care, confidentiality and
compassion. ...
Read More...
In addition to psychiatrists, social workers, professional counselors and psychiatric nurse
practitioners, there are several other types of mental health care workers providing
valuable services in various aspects of mental health care. Although specific training is
required for each specialty, there are common elements involving patient care,
confidentiality and compassion.

Psychiatric Nurses
Psychiatric nurses treat patients with all types of psychiatric disorders. Their training in
behavioral therapy enables them to assist those who deal with patients, as well as
patients themselves. They are well-equipped to interact with patients' loved ones,
teachers and law enforcement personnel. Psychiatric nurses are trained to work with
patients of all ages, to deal with challenging behavior, and to administer psychiatric
medication. Psychiatric nurses are involved in two major aspects of psychiatric care:
assessment and intervention. Assessment includes taking patient histories and evaluating
patient behavior. Intervention may be physical, pertaining to a patient's safety, for
example; biological, concerning the administration of medication; or psychosocial,
involving psychotherapy. Because psychiatric nurses have medical training, they are able
to intervene and assist in medical, as well as psychiatric, crises.

Psychologists
Psychologists evaluate, diagnose and treat psychiatric illness. They are also involved in
studying mental processes and human behavior. They have doctoral degrees, usually in
psychology. There are three primary categories of psychologists:

Clinical and school psychologists

Academic and research psychologists
Organizational psychologists
Psychologists who work in hospitals with psychiatric patients are usually clinical
psychologists, who focus on testing and evaluating patients, and on psychotherapy.
Psychologists are not licensed to prescribe medication.

Physician Assistants

Physician assistants (PAs) are trained to do many of the tasks

physicians perform. They are capable of interviewing patients, taking family histories and
making diagnoses. Like physicians, they have medical training and so are able to
evaluate whether there may be physical causes for psychiatric symptoms and vice-versa.
They are also certified to prescribe medication. After obtaining an undergraduate degree,
a PA must complete a two-to-three-year program of study, log many hours of clinical
experience, and pass a certifying examination. In addition, to specialize in a particular
area, a PA must complete a residency in her or his field.

Nursing Aides and Orderlies

Nursing aides, sometimes called nursing attendants, provide direct assistance to patients.
When patients are physically, as well as psychiatrically afflicted, or when psychiatric
illness prevents patients from caring for themselves physically, nursing aides are the
primary caregivers. Typically, they assist patients with everyday tasks, such as eating and
dressing. If patients are severely disabled, nursing aides may be required to lift or
reposition them or to push their wheelchairs. Nursing aides receive many hours of training
to learn how to handle patients physically and emotionally, and are required to pass an
examination. An aide who goes on to complete a certification exam earns the title of
certified nurse aide (CNA), and is then qualified to work in a supervisory capacity.
Orderlies provide some of the same care as nursing aides, although they do not usually
interact as much with patients. Typically, they are concerned with patient transport, or the

cleaning of facilities and equipment.

Occupational Therapists and Art Therapists

Several other types of therapists are involved in mental health care. Each has different
training, and each approaches patient care from a slightly different perspective. Each of
these specialists is likely to be found in any well-staffed psychiatric environment, such as
a hospital, nursing home or special education classroom.

Occupational Therapists
Occupational therapists (OTs) help psychiatric patients handle everyday life. Patients with
psychiatric disorders may find normal activities, such as shopping, riding the train or
eating in a restaurant, daunting because of their fears or compulsions. OTs assist patients
in evaluating their problems, and in setting goals and providing focused therapy to help
achieve them.

Art Therapists
Trained in both art and psychology, art therapists use the creative process to help
psychiatric patients examine their inner turmoil and tame their emotional demons. These
therapists may use graphic art, poetry, music or drama to help patients uncover
subconscious thoughts, explore buried feelings, and feel more aware of and in control of
their lives.

Bipolar Disorder
Bipolar disorder, previously known as manic-depressive illness, is a complex psychiatric
disorder that involves sudden and dramatic mood swings between mania and depression.
An episode may last for hours, days, weeks or months and symptoms may be severe,
sometimes resulting in dangerously impulsive or self-destructive behavior and sometimes
leading to depression so deep it results in suicide. ...
Read More...
Bipolar disorder, previously known as manic-depressive illness, is a complex psychiatric
disorder that involves sudden and dramatic mood swings between mania and depression.
An episode may last for hours, days, weeks or months and symptoms may be severe,
sometimes resulting in dangerously impulsive or self-destructive behavior and sometimes
leading to depression so deep it results in suicide.

Causes of Bipolar Disorder

It is known that individuals with bipolar disorder have physiological changes in their

brains. Although precipitating factors have been researched, precise causes for the
changes have not been pinpointed. The following genetic and environmental factors
appear to play important roles in the development of bipolar disease:

Imbalances in brain chemicals called neurotransmitters

Hormonal imbalances
Heredity, having a blood relative with a psychiatric disorder
Environmental stress
Childhood abuse
Trauma

Types of Bipolar Disorder

There are three different types of bipolar disorder, characterized by the severity of the
disease:

Bipolar I
Bipolar II
Cyclothymic disorder or cyclothymia
Patients with bipolar I typically suffer manic or depressive episodes lasting for a week or
more. The episodes, though they may be alleviated with medication, are frequently
severe enough to require hospitalization. Bipolar II is a less severe variety of the disorder.
Patients with bipolar II may have noticeably elevated or depressed moods, though these
are less severe, and last for shorter periods, than those of patients with bipolar I.
Cyclothymic disorder is a milder form of bipolar disorder characterized by mood swings
more extreme than those of the average person, but not disabling.
There are other variations in bipolar disorder in which symptoms may differ in specific
ways, such as:

Seasonal changes in mood

Rapid-cycling bipolar disorder
Bipolar disorder with psychotic symptoms
Bipolar disorder in children
Mixed state bipolar disorder
Hypomania

Symptoms of Bipolar Disorder

The symptoms of bipolar disorder are extreme versions of the emotional states all
individuals experience. In patients with this disorder, however, the emotional states are
not only exaggerated, but often seem to have no relation to experienced events. Beyond
that, the symptoms start and stop abruptly, and are extreme enough to interfere with

normal functioning.

Symptoms of Mania
Symptoms of a manic episode have a wide range. While some symptoms are similar to
those experienced during a period of joy, many topple over into a kind of chaos.
Symptoms of mania include:

Eupohoria
Inflated self-esteem
Rapid speech and racing thoughts
Increased physical activity
Agitation, irritation or aggression
Heightened sexual desire
Impulsive or risky behavior
Distractibility
Decreased appetite or need for sleep
Substance abuse

Symptoms of Depression
Depressive episodes of bipolar disorder differ from simple sadness since they frequently
are not reactions to a sad event and since they reach a depth of despair not experienced
by healthy individuals. Symptoms of a depressive episode may include:

Anxiety
Hopelessness
Dissociation
Feelings of guilt
Sleep disturbances
Decreased or increased appetite
Extreme fatigue or lack of energy
Inactivity
Loss of interest in sex and other pleasurable activities
Inexplicable chronic pain
Suicidal thoughts

Symptoms of bipolar disorder can be exacerbated by many things, including hormonal

changes, physical illnesses, traumatic events, and ongoing abusive treatment.

Diagnosis of Bipolar Disorder

Bipolar disorder is a complex psychiatric illness, diagnosed by a careful evaluation of

symptoms by a qualified psychiatrist. Everyone experiences mood swings to a greater or

lesser degree, but the mood swings of patients with bipolar disorder are more
exaggerated and intense than those of the average person, interfering with their normal
activities. Psychiatrists diagnose bipolar disorder by taking a thorough history of
symptoms and through personal observation of behavior patterns.
Patients' symptoms are assessed using criteria formulated in the Diagnostic and
Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric
Association. Observable or reported symptoms of mania alternating with depression over
an extended period of time are clues to the existence of the disorder. Since there is a
genetic component to the disorder, a thorough family history will also be taken to assist in
diagnosis.

Treatment of Bipolar Disorder

Bipolar disorder is treated with several different types of medications, as well as with
psychotherapy designed to help the patient cope with the underlying disease.
Medications administered to treat bipolar disorder include mood stabilizers,
antidepressants, anti-seizure medications, anti-psychotics and anti-anxiety medications.
Balancing medications is difficult even for highly experienced psychiatrists since small
changes in dosage can make substantive changes in mood and behavior, and since
medications may have to be altered as moods shift. Hospitalization is often necessary for
patients with severe bipolar disorder, particularly when they are in the throws of a severe
episode. Usually such hospitalizations are brief, necessary only until the patient is
stabilized on medication.

Risks of Bipolar Disorder

If left untreated, bipolar disorder is life-threatening and eventually can lead to suicide. The
condition is not curable at the present time, but ongoing treatment can keep the patient
stabilized. Once a patient with bipolar disorder has achieved an emotional balance with
treatment, normal functioning is possible. Long-term treatment, during which the patient
learns to recognize and report symptoms of mania and depression as soon as they
appear, can help make this potentially life-threatening disease manageable.

Palpitations
Patients who experience heart palpitations feel that their hearts are beating rapidly
(tachycardia), fluttering, beating irregularly, or pounding. Normally, heart palpitations are not
serious and are often triggered by stress, anxiety, exercise or certain medications. Heart
palpitations may occur while the patient is sitting, standing, or lying down, during or
immediately after strenuous activity, or during periods of rest. They are occasionally felt in
the throat or neck, as well as in the chest. ...

Read More...
Patients who experience heart palpitations feel that their hearts are beating rapidly
(tachycardia), fluttering, beating irregularly, or pounding. Normally, heart palpitations are
not serious and are often triggered by stress, anxiety, exercise or certain medications.
Heart palpitations may occur while the patient is sitting, standing, or lying down, during or
immediately after strenuous activity, or during periods of rest. They are occasionally felt in
the throat or neck, as well as in the chest.

Risk Factors for Palpitations

Individuals are at greater risk for palpitations if they fit into any of the following categories:

Are highly stressed or prone to anxiety

Are pregnant
Take medications containing stimulants
Have hyperthyroidism
Have heart problems
Consume excessive caffeine
Smoke or drink alcohol to excess
Use recreational drugs
Patients with fever, nausea or vomiting, anemia, hypoglycemia (low blood sugar),
hyperthyroidism or lung disease are also susceptible to palpitations.

Complications of Palpitations
While occasional, fleeting palpitations do not normally require medical evaluation,
palpitations that occur frequently, worsen, or are associated with other troubling
symptoms, such as chest pain, severe shortness of breath, dizziness, or fainting, should
not be ignored.
In rare instances, palpitations may be associated with one of the following:

Sudden drop in blood pressure

Fainting
Life-threatening arrhythmia
Cardiac arrest
Heart failure
Stroke
In such cases, diagnostic testing, such as heart or blood-pressure monitoring, is

necessary.

Diagnosis of Palpitations
In order to diagnosis palpitations and their cause, one or more of the following tests may
be administered:

Electrocardiogram (EKG or ECG)

Stress test
Holter monitor
Echocardiogram
If a heart condition is found to be the underlying cause of a patient's palpitations, lifestyle
changes or medications may be prescribed or surgical intervention may be necessary. If
serious causes of palpitations are ruled out, patients are typically advised to avoid
triggers, such as excessive caffeine or alcohol, and medications with stimulating
properties. If underlying non-cardiovascular conditions, such as hyperthyroidism or
generalized anxiety disorder, are found to be causative, such issues must be medically
addressed.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a psychiatric condition triggered by a traumatic
event during which great physical harm occurs or is threatened. While almost everyone
experiences trauma at one time or another, for most people the feelings of terror and
helplessness subside over time. For patients with PTSD, symptoms may appear later, last
longer and be much more severe than for the average person. There are many reasons an
individual may develop PTSD, none of them under the individual's control. ...
Read More...
Post-traumatic stress disorder (PTSD) is a psychiatric condition triggered by a traumatic
event during which great physical harm occurs or is threatened. While almost everyone
experiences trauma at one time or another, for most people the feelings of terror and
helplessness subside over time. For patients with PTSD, symptoms may appear later, last
longer and be much more severe than for the average person. There are many reasons
an individual may develop PTSD, none of them under the individual's control.

Causes of PTSD
Some traumatic events are common parts of the human experience, such as natural
disasters, serious illnesses, accidents and exposure to war. PTSD was first known as
"shell shock" or "battle fatigue" because soldiers who had been in combat so frequently
suffered from it. There are, however, several other circumstances that may lead to the

disorder, such as personal battery or sexual assault. Traumas that may result in PTSD
may include the following:

Exposure to combat
Physical attack
Exposure to the abuse or attack of another
Rape or sexual molestation
Kidnapping
Childhood abuse or neglect
Being threatened with physical violence
Devastation of the home through natural disaster
Serious illness or injury
Traumatic death of a loved one

Risk Factors for PTSD

Some people are predisposed to develop PTSD. Individuals appear to be more likely to
develop PTSD if traumatized early in their lives when the brain is still developing. Risk
factors for PTSD may include:

Family history of mental health disorder

Previous trauma
Personal temperament
Idiosyncratic physiological responses to stress
Being female, since women are more likely victims of domestic or sexual abuse

Symptoms of PTSD
There are many disturbing symptoms of PTSD that often interfere with everyday life.
Such symptoms are grouped into three basic types:

Intrusive Memories
Intrusive memories may present as flashbacks during which the individual relives the
traumatic experience. In some cases, PTSD patients may experience hallucinations
during flashbacks. Patients with PTSD may have obsessive thoughts about the traumatic
experience. Memories may also intrude during sleep, precipitating extremely realistic,
disturbing nightmares about the traumatic event, or periods of insomnia.

Emotional Numbness
Individuals with PTSD may experience abnormal detachment, feeling emotionally unable
to connect with their surroundings. Such detachment, or dissociation, often causes
trouble in close relationships. Those suffering with this disorder may also experience

symptoms of depression which may include: hopelessness, inability to experience

pleasure, trouble concentrating or memory problems.

Severe Anxiety or Emotional Hyperarousal

Symptoms may include irritability, fear, anger, overwhelming guilt or shame and may lead
to self-destructive behavior, such as substance abuse. A common symptom of PTSD is
an unusually acute startle response.
Post-traumatic stress disorder symptoms are not constant. Symptoms may fade into the
background for a period of time but recur under stress, particularly when a reminder of
the traumatic event is experienced. A sensory trigger, a noise or an unexpected touch,
may precipitate serious symptoms.

Diagnosis of PTSD
PTSD is diagnosed by physical and psychological/psychiatric evaluation. Physical
examination is necessary to rule out physical causes for symptoms. The patient is then
interviewed by a trained professional and various psychological tests are administered.
Once it has been established that the patient's symptoms are interfering with normal
functioning and have persisted for more than a month, their severity is assessed and
appropriate treatment is begun.

Treatment of PTSD
There are two approaches to treating PTSD and they are frequently used in combination:
psychotherapy and medication.

Psychotherapy
Psychotherapy uses personal interactions with a trained professional, as well as with
family members or other individuals with PTSD to talk through the trauma and help the
patient develop coping skills. Types of psychotherapy used for PTSD patients, which are
sometimes used in combination, may include:

Cognitive therapy
Exposure therapy
Hypnotherapy
Psychodynamic therapy
Family therapy
Group therapy
Eye Movement Desensitization and Reprocessing or EMDR

Medication

Several psychotropic medications are commonly used to treat PTSD. These may include
one or more of the following categories of drugs:

Antidepressants
Tranquilizers
Mood stabilizers
Neuroleptics

Recovery from PTSD is a slow, often painful, process. Though the disorder is rarely
completely cured, treatment can vastly improve the patient's quality of life. Through the
use of psychotherapy and medications, symptoms may become much less frequent and
less severe and the patient may develop strong coping skills to deal with the feelings
related to the trauma.

Premature Ejaculation
A common sexual issue among men, premature ejaculation takes place when a man
reaches orgasm too quickly. The man does not have voluntary control of the timing of his
ejaculation and it may occur with very little stimulation. When this happens on a regular
basis, it often results in both the man and his partner feeling unfulfilled. The timing of the
premature ejaculation varies from person to person as well as by circumstances. Some men
experience an orgasm before intercourse even begins, while for others it may occur
immediately after vaginal penetration. ...
Read More...
A common sexual issue among men, premature ejaculation takes place when a man
reaches orgasm too quickly. The man does not have voluntary control of the timing of his
ejaculation and it may occur with very little stimulation. When this happens on a regular
basis, it often results in both the man and his partner feeling unfulfilled. The timing of the
premature ejaculation varies from person to person as well as by circumstances. Some
men experience an orgasm before intercourse even begins, while for others it may occur
immediately after vaginal penetration.
Premature ejaculation affects at least 20 percent of men between the ages of 18 and 59,
and is the most frequent sexual problem of men under the age of 40. It can reduce sexual
enjoyment, impact relationships and lower one's quality of life. Therefore, it is very
important to seek medical attention if the problem is occurring frequently enough to
interfere with your sexual pleasure.

Causes of Premature Ejaculation

Premature ejaculation is not typically caused by a physical disorder. In the vast majority of
cases, this problem arises due to psychological issues. It may be a matter of general

stress, anxiety about sexual performance, long-term feelings of guilt surrounding sexual
pleasure, unease because of intimacy with a new partner, erectile dysfunction or other
reasons.
For some patients, however, there are biological reasons for the premature ejaculation.
Some physical influences that may cause this condition are an infection within the
prostate or urethra, a thyroid disorder, problems with hormone levels or abnormalities of
the ejaculatory system. It is also possible, although less common, for premature
ejaculation to be a result of nerve damage after trauma or surgery in the genital region or
due to certain medications.

Diagnosis of Premature Ejaculation

Patients who have frequent premature ejaculation will typically require a physical
examination. Your doctor will also take a full medical and sexual history. In addition, a
blood test may be necessary to check hormone levels or for other suspected possible
causes. However, since there is not usually a physical cause, the results are most often
normal. Instead, your doctor will generally make this diagnosis based on a candid
discussion of your sexual complaints.

Treatment of Premature Ejaculation

There are a number of methods that can potentially help men experiencing premature
ejaculation. Sometimes, several techniques must be attempted before the patient finds
the right way to eliminate this issue in his particular case.

Relaxation Techniques
Any conscious effort made to lessen anxiety levels can produce the more relaxed state
necessary to avoid premature ejaculation. Some men are successful by turning their
focus to something other than their sexual stimulation, such as practiced deep breathing
or contemplating a thought that is completely nonsexual.

Physical Practice
By practicing measured sexual stimulation, a man may be able to overcome his
premature ejaculation issues. This typically involves providing small doses of stimulation,
then stopping as the man approaches orgasm. It can be repeated multiple times until the
man determines that he wants to ejaculate.

Antidepressants
Certain selective serotonin reuptake inhibitors (SSRIs) have the effect of postponing
ejaculation. This can be especially helpful in cases in which depression has been
diagnosed as well. However, the benefits and risks of taking regular medications such as

these should be thoroughly discussed with your doctor before any prescriptions are
written.

Reduce Sensation
Some patients respond well to a decrease in the level of sensation felt in the penis, which
can lower their level of stimulation and allow a longer period of time before they reach
orgasm. This can be achieved by using condoms in some cases or by applying a topical
anesthetic to the penis prior to intercourse.
If there is no underlying condition responsible for the premature ejaculation and the
problem does not resolve with any of these treatment methods, psychological counseling
may be recommended. A mental health professional may be able to help you get to the
root of what is causing the premature ejaculation and design a plan to return your sexual
function.

Shortness of Breath
Shortness of breath (dyspnea) is a symptom with a great many possible causes. When
patients experience shortness of breath, they feel as if they cannot take in enough air. This
difficulty in breathing can be the result of myriad conditions, some relatively benign and
some life-threatening. While occasional, explicable bouts of shortness of breath are normal,
when they are intense, prolonged or recurrent, their root causes can only be determined
through comprehensive medical examination. ...
Read more
Shortness of breath (dyspnea) is a symptom with a great many possible causes. When
patients experience shortness of breath, they feel as if they cannot take in enough air.
This difficulty in breathing can be the result of myriad conditions, some relatively benign
and some life-threatening. While occasional, explicable bouts of shortness of breath are
normal, when they are intense, prolonged or recurrent, their root causes can only be
determined through comprehensive medical examination.
In general, shortness of breath accompanied by any of the following symptoms demands
immediate attention:

Chest pain
Coughing or wheezing
Choking
Fainting or loss of consciousness
Heart irregularities
Bleeding or injury

Shortness of breath associated with digestive problems such as difficulty swallowing,

heartburn, or pain in the upper back should also be promptly investigated.

Causes of Shortness of Breath

Shortness of breath can have its origins in many of the body's systems. The most serious
causes of shortness of breath are usually pulmonary or cardiovascular.

Pulmonary Causes
Because the lungs are involved in transporting oxygen to, and removing carbon dioxide
from, the tissues, problems with the lungs and other parts of the respiratory system can
interfere with breathing. Reasons for lung dysfunction include the following:

Asthma
Carbon-monoxide poisoning
Croup, pneumonia or tuberculosis
Pleurisy, emphysema or COPD
Lung cancer
Pneumothorax (collapsed lung)
Pulmonary edema
Pulmonary fibrosis
Sarcoidosis or tuberculosis
Interstitial lung disease

Shortness of breath can also be caused by inhaling certain substances, or swallowing an

object that then blocks an upper airway. Anything that interferes with the breathing
process requires urgent care.

Cardiovascular Causes
Serious underlying causes for shortness of breath may be cardiovascular, and include the
following:

Cardiomyopathy
Cardiac tamponade
Congestive heart failure
Heart arrhythmia
Heart attack
Hypotension or hypertension
Pericarditis

Once an underlying cardiovascular cause has been determined, medication or surgical

intervention may be necessary.

Digestive Causes
Patients with gastroesophageal reflux disease (GERD) or ascites (accumulation of
abdominal fluid) are also prone to shortness of breath. With GERD, stomach acid makes
its way into the esophagus, narrowing it and making breathing more difficult. With ascites,
the swollen abdomen can push against the diaphragm, affecting its ability to assist with
breathing.

Other Causes
Shortness of breath can also result from the following miscellaneous causes:

Overexertion
Obesity
Anemia
Blocked airway
Reaction to allergen or pollutant
Hormone or enzyme imbalance
Anxiety disorder
Panic attack
Broken ribs or other traumatic injury

Pregnancy, particularly in the third trimester, can produce shortness of breath, because
the expanding uterus puts pressure on the diaphragm. Patients with some systemic
illnesses, such as myasthenia gravis and Guillain-Barr syndrome, can also
experience shortness of breath.
If shortness of breath is due to the temporary congestion associated with an upperrespiratory infection, it usually resolves on its own in a matter of days. However, with
severe upper-respiratory infections that are bacterial in nature, antibiotics and, even,
oxygen may be necessary.

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33$Bipolar Disorder
22$Chronic Fatigue Syndrome

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520$ CBT 180 days
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33$Post-traumatic Stress Disorder
45$Premature Ejaculation
20$Shortness of Breath
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