“There are traffic lights longerthan my social life,” Jake said wearily when he met with me. “This problem is ruining my life. It’s like fighting demons.”‘
Jake was preoccupied with his arms and legs, which he thought were too skinny, and his “pale” skin. “I have no sex life or love life. I’m almost completely socially avoidant. I hardly ever go out. If I do go to a night club, I feel suicidal. … I’m still in shock that I look so horrible after all these years. It amazes me that no one faints when I get on the subway!”
Jake had been married to someone he hated and later divorced. “I married someone I felt no desire for. She was an awful person, but she was the only one who would accept me. She was probably the worst woman in the whole world, but I didn’t think anyone else would accept me because of how I look. I felt lucky to have anyone.”
Samantha avoided swimming or any activities requiring shorts. She, too, was concerned with pale skin and with freckles on her arms, legs, chest, and back. “The color of my skin is dead looking,” she said. “It causes problems in my social life. I miss parties sometimes, and if I go I can’t focus on conversations because I’m thinking about my freckles and pale skin. I’m constantly scrutinizing other people’s skin. I’m noticing what a nice color it is, or that they don’t have any freckles. The only time I really tune into the conversation is when I hear anything about freckles or skin. Then my ears perk up. “This problem also interferes with my sex life. My husband told me to make sure I told you. I feel very self-conscious, and I don’t want him to see my body. I can’t relax and enjoy anything. My husband can’t understand me. He tries but he can’t, and he gets angry about it.”
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Archive for Anti Depressants-Sleeping Aid
At certain times in the hormonal cycle of a woman, especially an adolescent, she may feel particularly drowsy or lethargic. In rare and extreme cases the cycle can produce bizarre behavior, including voracious appetite or unusual sexual activity, similar to that seen in men with Kleine-Levin syndrome. After menopause, another period of hormonal turbulence, deep sleep declines dramatically, which may lead to feelings of daytime somnolence.
Also, excessive sleepiness may be an early sign of pregnancy. Expectant mothers almost always extend their total daily sleep, usually by as much as two hours, throughout their pregnancies. As most mothers know, the effects of hormonal disruption can last for months after the baby is born. The desire to sleep persists, but the opportunity—what with nighttime feedings, diaper changes, and other changes in lifestyle—is no longer there. One of my patients jokingly told me she had designed the perfect cure for parental hypersomnia: send the kid to college. This therapeutic approach has drawbacks, she admitted: it’s expensive, and it usually takes eighteen years before you can actually begin the treatment.
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A similar situation occurs when a day shift worker has to do a night shift He is sleeping at the wrong time according to his biological clock. It has been shown that, after working night shift for a while, the biological clock is reversed and the body temperature is maximum in the middle of the night, which is opposite to the normal day shift body temperature pattern. It will take a few days before the biological clock can be reset to the new shift. Sleeping pills are recommended if one cannot sleep after a change of shift duty. The longer acting sleeping pills are preferred, as most shift workers find they can fall asleep after the shift but are unable to maintain sleep. The pills can speed up the resetting of their biological clock to the clock of the new shift, provided they wake up at the same time each day. Sleeping pills should not be used after one week as the biological clock should have been reset by then, and there is always the possibility of addiction. Perhaps those people who still have sleeping problems after a week should look for work that does not require shift duty.
It is much easier to delay the time of going to sleep than to advance the sleep time to an earlier hour and try to sleep when you are not sleepy at all. Dr Charles Czeisler of the Harvard Medical School recommends that shift workers should rotate into a later shift rather than into an earlier shift. Hence a worker should rotate from a morning shift to an evening shift and then to a night shift and back to the morning shift, and so on. He also recommends that shift workers should stay at the same shift for at least three weeks at a time before rotating to another shift.
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For a number of reasons the eyelids are of particular importance. We have noted how
over-alertness is one of the main signs of anxiety. A feature of being over-alert is keeping one’s eyes open, so as to be on guard for any possible source of danger. The anxious patient
characteristically has his eyes widely open, so that the edge of the upper lid does not cover the top of the coloured part of the eye as it normally does. I have seen some patients with severe anxiety who have been so over-alert that they have virtually found it impossible to allow their eyes to close even for a moment.
It would seem that there is some such sequence of events as this. The brain is disturbed by receiving more nervous impulses than it can properly handle. As a result of this, a state of anxiety develops. The brain signals the eyes, “Keep on the lookout. Keep wide open.” From time to time the nerves of the eyes report back, “Eyelids wide open.” It would seem then that the ideas of anxiety and wide open eyelids become associated together in the brain. Now, if we learn to allow our eyelids to remain comfortably in a less fully open position, this will be reported to the brain, and this state of affairs is associated with an absence of anxiety. So instead of being
over-alert, the mind becomes calmer. This calmness of mind allows the better integration of the nervous impulses, and anxiety is reduced. This, of course, is only a more specialized example of the general principle that relaxation of the body brings with it the sensation of relaxation of the mind.
While investigating these matters in the East a few years ago I observed a number of very serene yogis whose eyelids remained in a nearly half-closed position, and whose eyelids moved quite slowly, so that when they blinked their eyelids moved slowly and leisurely. This extreme degree of relaxation is, of course, dangerous in itself, as the protective value of the blink reflex is lost. Nevertheless, without much effort we can encourage our eyelids to take up a more relaxed position. If we practise this a little, we find that the eyelids respond by developing this relaxed state quite naturally and easily much sooner than we might expect.
When about to commence practising our exercises we allow our eyelids to close. This is a natural, easy closure. There is nothing forced about it. The edges of the lids are just lightly touching each other. As we relax more completely, we notice that the eyelids part just a little so that they are no longer touching each other, and we become aware of a chink of light. This is the fully relaxed position of the eyelids, and we should aim for this as we become more expert in our exercises.
Some people do not close their eyes before they commence to relax. They are just left open. As relaxation becomes more complete the lids close very slowly over a period of a few minutes. With this method, relaxation of the mind and a good degree of regression is obtained before the lids actually close.
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