Definition

Acute stress disorder develops within one month after an individual experience or sees an event involving a threat or actual death, serious injury, or physical violation to the individual or others, and responded to this event with strong feelings of fear, helplessness or horror. The diagnosis was established to identify those individuals who would eventually develop post-traumatic stress disorder. As far back as World War I this condition was referred to as "shell shock," in which there are similarities between reactions of soldiers who suffered concussions caused by exploding bombs or shells and those who suffered blows to their central nervous systems. Civilians may also suffer from it. More recently, ASD was brought to light as it became clear that for a short period, people might exhibit PTSD-like symptoms immediately after a trauma.

Trauma has both a medical and a psychiatric definition. Medically, trauma refers to a serious or critical bodily injury, wound or shock. This definition is often associated with trauma medicine practiced in emergency rooms and represents a popular view of the term. Psychiatrically, trauma has assumed a different meaning and refers to an experience that is emotionally painful, distressful or shocking, which often results in lasting mental and physical effects.

Psychiatric trauma, or emotional harm, is essentially a normal response to an extreme event. It involves the creation of emotional memories about the distressful event that are stored deep within the brain. In general, it is believed that the more direct the exposure to the traumatic event, the higher the risk for emotional harm. Thus in a school shooting, for example, the student who is injured probably will be most severely affected emotionally; and the student who sees a classmate shot or killed is likely to be more emotionally affected than the student who was in another part of the school when the violence occurred. But even secondhand exposure to violence can be traumatic. For this reason, all children and adolescents exposed to violence or a disaster, even if only through graphic media reports, should be watched for signs of emotional distress.

Symptoms

For a diagnosis of acute stress disorder, symptoms must persist for a minimum of two days to up to four weeks within a month of the trauma.

A person may be described as having acute stress disorder if other mental disorders or medical conditions do not provide a better explanation for the person's symptoms. If symptoms persist after a month, the diagnosis becomes post-traumatic stress disorder.

Symptoms include:

· Lack of emotional responsiveness, a sense of numbing or detachment

· A reduced sense of surroundings

· A sense of not being real

· Depersonalization or a sense of being dissociated from self

· An inability to remember parts of the trauma, "dissociate amnesia"

· Increased state of anxiety and arousal such as a difficulty staying awake or falling asleep

· Trouble experiencing pleasure

· Repeatedly re-experiencing the event through recurring images and/or thoughts, dreams, illusions, flashbacks

· Purposeful avoidance of exposure to thoughts, emotions, conversations, places or people that remind them of the trauma

· Feelings of stress interfering with functioning; social and occupational skills are impaired affecting the patient's ability to function, pursue required tasks and seek treatment

Causes

When a fearful or threatening event is perceived, humans react innately to survive: They either are ready for battle or run away (hence the term "fight-or-flight response"). The nature of the acute stress response is all too familiar. Its hallmarks are an almost instantaneous surge in heart rate, blood pressure, sweating, breathing and metabolism, and a tensing of muscles. Enhanced cardiac output and accelerated metabolisms are essential to mobilizing for fast action. This explanation is thought to be in part a cause for anxiety disorders. Yet over the past decade, the limitations of the acute stress response as a model for understanding anxiety have become more apparent. The first and most obvious limitation is that the acute stress response relates to arousal rather than anxiety. Anxiety differs from arousal in several ways: First, with anxiety, the concern about the stressor is out of proportion to the realistic threat. Second, anxiety is often associated with elaborate mental and behavioral activities designed to avoid the unpleasant symptoms of a full-blown anxiety or panic attack. Third, anxiety is usually longer lived than arousal. Fourth, anxiety can occur without exposure to an external stressor. Cognitive factors, especially the way people interpret or think about stressful events, play a critical role in the etiology of anxiety. A decisive factor is the individual's perception, which can intensify or dampen the response. One of the most salient negative cognitions in anxiety is the sense of uncontrollability. It is typified by a state of helplessness due to a perceived inability to predict, control or obtain desired results. These are among the factors considered as causes of anxiety disorders such as acute stress disorder.

Treatment

Cognitive behavioral therapy is the treatment that has met with the most success in combating ASD. It has two main components: First, it aims to change cognitions, patterns of thought surrounding the traumatic incident. Second, it tries to alter behaviors in anxiety-provoking situations.Cognitive behavioral therapy not only ameliorates the symptoms of ASD, but also it seems to prevent people from developing post-traumatic stress disorder. The chance that a person diagnosed with acute stress disorder will develop PSTD is about 80 percent; the chance that they will develop PTSD after cognitive-behavioral therapy is only about 20 percent.

Psychological debriefing and anxiety management groups are two other types of therapy that have been examined for the treatment of ASD. Psychological debriefing involves an intense therapeutic invention immediately after the trauma, so that traumatized individuals can "talk it all out." In anxiety management groups, people share coping strategies and learn to combat stress together. However, both types of therapy have proven to be largely ineffectual for the treatment of ASD.

Definition

The term "fetishism" was coined in the late 1800s. It originates from the Portuguese word feitico, which means "obsessive fascination". There is a degree of fetishistic arousal in most normal individuals who find particular bodily features attractive. However, fetishistic arousal is generally considered a problem when it interferes with normal sexual or social functioning and where sexual arousal is impossible without the fetish object.

Fetishism is characterized as a disorder when there is a pathological assignment of sexual fixation, fantasies or behaviors toward an inanimate object -- frequently an item of clothing -- such as underclothing or a high-heeled shoe -- or to nongenital body parts -- such as the foot. Only through use of this object can the individual obtain sexual gratification. The fetishist usually holds, rubs or smells the fetish object for sexual gratification or asks their partner to wear the object during sexual encounters. Fetishism is a more common occurrence in males, and the causes are not clearly known. Fetishism falls under the general category of paraphilias, abnormal or unnatural sexual attractions.

Inanimate object fetishes can be categorized into two types: form fetishes and media fetishes. In a form fetish, the object and its shape are important, such as high-heeled shoes. In a media fetish, the material of the object is important, such as silk or leather. Inanimate object fetishists often collect the object of their favor. In some cases, the fetishism is severe enough to inspire the fetishist to acquire objects of his desire through theft or assault. Fetishists smell, rub or handle these objects while masturbating or ask their sex partners to wear the objects; male fetishists may be unable to get erections without the presence of the objects. Nearly all fetishists are male, though some women also exhibit fetishism.

Aside from those listed above, other common objects used by fetishists are panties, bras, slips, stockings, other intimate apparel, footwear and gloves. Common materials other than those listed above also include rubber and fur. For some, merely a picture of the fetish object may arise the fetishists, though most prefer or require the actual object. It is not about the person who has worn the object; rather it is about the object itself. Examples of animate fetish objects include hair, legs and buttocks.

Fetishism excludes cross-dressing and objects specially designed for sexual use such as vibrators and dildos.

Symptoms

The sexual acts of fetishists are characteristically depersonalized and objectified, with the focus being exclusively on the fetish. Non-fetishists may at various times become aroused by a particular body part or an object and make it a part of their sexual interaction with another person, but they do not fixate on it. In general, the fetishist can only become sexually aroused and orgasmic when the fetish is being used. In other instances, a response may occur without the fetish, but at a diminished level. When the fetish object is not present, the fetishist fantasizes about it.

The diagnostic criteria for fetishism includes:

· Repeatedly for a period of at least six months, the patient has recurrent, intense sexually arousing fantasies, urges or behaviors involving nonliving objects (such as female undergarments and shoes).

· The fantasies, sexual urges or behaviors cause significant distress or impair social, occupational or personal functioning.

· The fetish objects are not articles of clothing used in cross-dressing as in transvestite fetishism and are not designed for tactile genital stimulation such as a vibrator.

Other features of fetishism include:

· Employment or volunteer work to enable fetish behavior, for example, a job in a shoe shop in the case of a shoe fetish

Some disorders such as mental retardation and dementia have similar or even the same symptoms. The clinician, therefore, in her diagnostic attempt needs to rule out other potential disorders to establish a precise diagnosis.

Common types of fetishism

· Amputee fetishism

· Breast fetishism

· Corset fetishism (Tightlacing)

· Diaper fetishism

· Foot fetishism

· Food fetishism

· Furry fetishism/Toonophilia

· Glove fetishism

· Infantilism

· Leather fetishism

· Medical fetishism

· Pregnancy fetishism

· Rubber fetishism

· Boot fetish

· Spandex fetishism

· Stocking fetishism

· Swimcap fetishism

· Tickling fetishism

· Transvestic fetishism

· belly button fetish

Causes

The cause of fetishistic behavior as a pattern of sexual gratification cannot be explained easily.

Some theorists believe that fetishism develops from early childhood experiences, in which an object was associated with a particularly powerful form of sexual arousal or gratification. Other learning theorists focus on later childhood and adolescence and the conditioning associated with masturbation activity. Studies show that fetishists have poorly develop social skills, are isolated in their lives and have a diminished capacity for establishing intimacy.

Behavioral learning models suggest that a child who is the victim or observer of inappropriate sexual behaviors learns to imitate and is later reinforced for the behavior. Compensation models suggest that these individuals are deprived of normal social sexual contacts and thus seek gratification through less socially acceptable means. In the far more common cases, involving males, the patterns suggest that causes stem from doubts about ones own masculinity, potency, and a fear of rejection and humiliation. By his fetishistic practices and the mastery over an inanimate object, the individual apparently safeguards himself and also compensates for some of his feelings of inadequacy.

Treatment

Almost always the treatment must be long-term if it is to be effective. Treatment approaches have included traditional psychoanalysis, hypnosis, cognitive and behavior therapy as well as pharmacotherapy. Some prescription medicines help to decrease the compulsive thinking associated with the paraphilias. This allows concentration on counseling without as strong a distraction from the paraphiliac urges. Increasingly, the evidence suggests that combining drug therapy with cognitive behavior therapy can be effective, although research on the outcome of these therapies has been incomplete and often appear not to have been successful. More recently, a class of drugs called antiandrogens that drastically lower testosterone levels temporarily have been used in conjunction with these forms of treatment. The drug lowers the sex drive in males and reduces the frequency of sexually arousing mental imagery. This helps the individual concentrate on counseling. Increasingly, the evidence suggests that combining drug therapy with cognitive behavior therapy can be effective.

The level of sex drive is not consistently related to the behavior of paraphiliacs and that high levels of circulating testosterone do not predispose a male to paraphilias. That said, hormones such as medroxyprogesterone acetate (Depo-Provera) and cyproterone acetate help decrease the level of circulating testosterone thus reducing sex drive and aggression and resulting in reduction of frequency of erections, sexual fantasies and initiations of sexual behaviors including masturbation and intercourse. Hormones are typically used in tandem with behavioral and cognitive treatments. Antidepressants such as fluoxetine (Prozac) have also successfully decreased the sex drive but have not effectively targeted sexual fantasies.

Research suggests that cognitive-behavioral models are effective in treating paraphiliacs: Aversive conditioning involves using negative stimuli to reduce or eliminate a behavior. Covert sensitization entails the patient relaxing, visualizing scenes of deviant behavior followed by a negative event such as getting his penis stuck in the zipper of his pants. Assisted aversive conditioning is similar to covert sensitization except the negative event is made real most likely in the form of a foul odor pumped in the air by the therapist. The goal is for the patient to associate the deviant behavior with the foul odor and take measures to avoid the odor by avoiding said behavior. Thought stopping is another technique used to control fetishism. The therapist first determines the patient's other types of other attractions and fantasies. The therapist asks the patient to think about the fetish fantasy; once the fantasy is conjured, the therapist yells, "Stop!" At this point the patient immediately switches to the earlier agreed upon fantasies. This process is repeated several times in the presence of the therapist. Another technique used to control fetishism is fantasy reshaping, a modification of the thought-stopping process.

Reconditioning techniques center on immediate feedback to the patient so behavior will change right away. For example, a person might be connected to a biofeedback machine that is connected to a light and taught to keep the light within a specific range of color while the person is exposed to sexually stimulating material. Or masturbation training might focus on separating pleasure in masturbation and climax from the deviant behavior.

Nothing can ruin a relationship or marriage faster than jealously. Jealousy creates anxiety, anger, loneliness, hate, and fear. No one thinks clearly when jealous.

Having a relationship with a jealous person is tough. The jealous person acts untrusting or unworthy. Jealousy makes the person unattractive, even repulsive.

No one wants a jealous mate and no one likes being jealous. So what causes jealousy?

"Jealousy is the largest factor in breaking up marriages. Jealousy comes about because of the insecurity of the jealous person and the jealousy may or may not have foundation. This person is afraid of hidden communication lines and will do anything to try to uncover them.

When you are jealous, a line of communication is going on with your spouse or lover that is hidden from you. The mystery causes the pain. If you witnessed your spouse's communication line, so it was not hidden from you, you would not feel jealous.

Hidden communication lines or mysteries make you think of questions. "Will she find someone she likes better than me?" "Is he having an affair?" "Is she going to leave me?" "Does he think I'm unattractive?"

When you are jealous, the mystery makes you assume the worst. "Maybe he'll fall in love with his cute receptionist and leave me." "She's going to lunch with her old boyfriend because she's still attracted to him." "He'll come home and tell me he wants a divorce."

So how do you handle your feelings of jealousy? How do you deal with a spouse or boyfriend/girlfriend who is jealous?

Solutions

"Communication is the root of marital success from which a strong union can grow, and non-communication is the rock on which the ship will bash out her keel*." (*Keel : The main structural part of a ship that goes from bow to stern—front to back.)

If you are jealous, you need to communicate. You need to stop assuming the worst and ask questions. Communicate your feelings so you can work out solutions.

Bob says to his wife, "I don't want to feel this jealously. I want to get rid of it by asking you a question, okay? Good. So are you attracted to Vasu?"

His wife says, "Heavens no! Vasu just wanted some help with his son. I love YOU like crazy!"

Bang! The hidden communication is revealed. The mystery is resolved. Ramesh feels much better.

If Ramesh doesn't communicate, his wife's communication with Vasu makes Ramesh jealous, afraid and angry. Their marriage suffers.

If your mate is jealous, make sure you have no hidden lines of communication. Use communication to resolve the problem. For example, you notice Madhuri is acting upset and not talking. You ask yourself, "What communication line might be hidden from Madhuri?" You realize she's been acting annoyed ever since you started working for an attractive female boss.

"Madhuri, have I told you about my new boss?" Madhuri jumps up and now wants to talk. You communicate the facts and remove the mystery. Madhuri is cheerful and wants to go to a movie.

As well as using communication to resolve mysteries, communicate your feelings for your spouse or boyfriend/girlfriend. Tell him or her how you feel. Express your love. Show your affection.

Resolve the mysteries of the past. Discuss your feelings in the present. Make plans for the future. Because of communication, your relationship will be a big success. Live Happily And Let Others To Live Happily. Enjoy Life its PERCIOUS.

"Jealousy comes about because of the insecurity of the jealous person."

If any of my friends have time and want to know more about Jealousy. I can mail a case of 8 pages related to pure Romantic Jealousy. My E- mail Address rkpictures@rediffmail.com & fishbiz@rediffmail.com

Depression is a medical illness characterized by persistent sadness, discouragement, and loss of self-worth. These feelings are accompanied by reduced energy and concentration, sleep problems (insomnia), decreased appetite and weight loss. In the elderly, depression is also frequently characterized by excessive concerns about bodily aches and pains.

Causes, incidence, and risk factors

Detecting depression in the elderly may be complicated by several factors. Often the symptoms of depression such as fatigue, loss of appetite, and sleeping difficulties are associated with the aging process or a medical condition rather than with major depressive order.

Contributing factors include the loss of a spouse or close friends, chronic pain and illness, difficulty with mobility, frustration with memory loss, difficulty adapting to changing circumstances such as moving from a home to a retirement facility, or changes within the family.

Depression can also be a sign of a medical problem. It may be complicated by brain disorders associated with the aging process such as Alzheimer's disease.

Depression in the elderly is a widespread problem that is often not diagnosed and frequently under treated. Many older individuals will not admit to signs and symptoms of depression for fear of being seen as weak or crazy.

Symptoms

• depressed or irritable mood
• feelings of worthlessness or sadness
• loss of interest or pleasure in daily activities
• temper, agitation
• change in appetite, usually a loss of appetite
• change in weight
• unintentional weight loss (most frequent)
• weight gain
• difficulty sleeping
• daytime sleepiness
• difficulty falling asleep (initial insomnia)
• multiple awakenings through the night (middle insomnia)
• early morning awakening (terminal insomnia)
• fatigue (tiredness or weariness)
• difficulty concentrating
• memory loss
• abnormal thoughts, excessive or inappropriate guilt
• excessively irresponsible behavior pattern
• abnormal thoughts about death
• thoughts about suicide
• plans to commit suicide or actual suicide attempts

If these symptoms are present every day for more than 2 weeks, then depression is likely present.

Signs and tests

• a physical examination will help determine if there is a medical illness causing the depression
• psychological evaluation
• blood tests: CBC or blood differential, thyroid function tests, liver or kidney function tests
• a variety of other tests may be needed

Treatment

Sometimes depression can be alleviated by social interventions to help with isolation or loneliness such as group outings, volunteer work for the healthy elderly, or regular visits from concerned people.

Treatment of underlying medical conditions or the discontinuation of certain medications may alleviate symptoms.

Antidepressant drug therapy has been shown to increase quality of life in depressed elderly patients. These medications are carefully monitored for side effects, and doses are usually lower and increased more slowly than in younger adults.

Neuroleptic medications may help treat agitation in some individuals. Electroconvulsive therapy (ECT) may be indicated in the severely depressed if other measures are unsuccessful.

Expectations (prognosis)

If detected, depression may respond to medical treatment. Undetected, it may lead to complications. The outcome is usually worse for those who have limited access to social services, or to family or friends who can help promote an interest in activities.

Complications

Alzheimer's disease or other forms of may complicate dementia. It may also complicate other medical conditions in the elderly. Untreated depression in the elderly is associated with a high rate of suicide.

Prevention

Prevention is related to the contributing factors. Social supports that help deal with losses, mobility changes, and so on can be helpful. In many cases, there is no effective prevention.

For information purposes only.

None of the foregoing is a substitute for professional medical advice, examination, diagnosis, or treatment. Always seek the advice of a physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on. If you think you may have a medical emergency, call your doctor

Always be happy think positive and try your best to share your HAPPINESS. Some moments of our life may not be in our hands. Take Care Bye has a nice time.

Are you always worried about your increasing energy bills? Is the ever-increasing energy bill causing you sleepless nights? Is it costing you more and more to warm your home during winter and to cool it during summer?

Is paying your bill each month becoming a major problem for you?

Have you ever asked yourself the question what can I do to reduce this ever-increasi