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August 30, 2009

Redefining Strength

Filed under: Health Care — Nancy @ 5:19 pm -0700

All too often, we confuse strength with stoicism. We see an apparent absence of negative emotions and presume courage. We see an unadulterated expression of sadness and assume fragility.

I see this sometimes with new therapy clients. Like most of us, they’ve bought into the American dream (or American nightmare), where hard work, free will, and rugged individualism are viewed as keys to success and anything less is perceived as weakness or failure. When I ask how they feel about entering therapy, they report feeling weak for needing professional help, and even weaker if they are referred for psychiatric medication or a higher level of care. They feel ashamed when they cry in a therapy session, and they apologize to me. They berate themselves for not being strong enough to handle their mental illness, or the bad hand of cards they were dealt in life, on their own. They chide themselves for letting a breakup erode their confidence, for bursting into tears after being admonished by their boss, for letting life’s twists and turns and ups and downs affect them at all.

Taken to its logical extreme, this line of thought implies that it is a sign of weakness to experience and / or express negative emotions; strong people never experience negative emotions, or if they do, they suppress them; and strong people solve all of their problems on their own, without leaning on friends or family, and certainly without seeking professional help.

In reality, none of these statements are true. Vulnerability should not be confused with fragility. Experiencing and expressing a full range of emotions is not a sign of weakness. It is a manifestation of humanity.

My view of strength is quite different. In my mind, a strong person is someone who has a well-defined set of personal values and uses these values as a compass to guide her on her life path. She makes decisions and chooses actions that are consistent with her values. She maintains her principles with conviction, especially in the face of adversity. She is confident, tenacious, determined, responsible, and conscientious. She is not easily swayed by external pressure or public opinion, but she remains open to new ideas and various perspectives. She cares for herself so that she can maintain her fortitude. She mindfully accepts all of her emotions and experiences them fully, but she does not allow unpleasant emotions to prevent her from living a valued life. She seamlessly integrates logic, emotion, and intuition. She takes risks and makes mistakes. She has some successes and some failures. She emerges from her failures with grace, humility, and newfound wisdom which she applies to future endeavors. Her self-identity is well-defined. She lives unapologetically.

Having a mental illness has nothing to do with weakness, and seeking help for a mental illness is the antithesis of frailty. Consider what people with mental illnesses must endure. On the whole, they are more vulnerable to intense negative emotions, poor self-esteem, and self-destructive behavior. They face misunderstanding, stigmatization, and discrimination on a daily basis. They deal with family and friends who “just don’t get it,” an ignorant society, and a lack of awareness about their conditions. They struggle to navigate through a healthcare system that considers their disorders trivial and their treatment optional or, in many cases, fails to consider them at all.

Those who complete treatment successfully and manage their mental illnesses adaptively are amongst the strongest people I have ever had the privilege of knowing. They own their recovery and take responsibility for staying well. They make a point of living lifestyles that are conducive to health and happiness, even in cultures that teach otherwise. Armed with effective coping skills and hard-earned insight, they pursue life in a deeper, more meaningful way. They know when they need help and they know how to get it without delay. They make use of whatever tools they have, such as therapy, psychotropic medication, exercise, spiritual practice, or meditation. They surround themselves with a positive social network and they utilize family and friends for practical and emotional support. They are able to derive meaning from their suffering, and quite often they draw upon their own experiences to help others. They are wise beyond their years, and they don’t take their hard-earned sanity for granted.

from: http://www.blog.drsarahravin.com/psychotherapy/redefining-strength/

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August 27, 2009

Treatment of moderately severe acne and mild acne

Filed under: Plastic Surgery and Hair & Beauty — Tags: , — Nancy @ 12:34 am -0700

Treatment of moderately severe acne
Treatment for moderately severe acne usually includes topical agents. In addition, a doctor or dermatologist may prescribe an oral medication, usually for at least six months.

Suitable oral medications include:

Antibiotics such as tetracycline, minocycline, doxycycline or erythromycin
In females, oestrogens and antiandrogens such as Diane 35™/Estelle 35™ or spironolactone
Some patients are helped by nonsteroidal anti-inflammatory agents such as ibuprofen or naproxen
For resistant or persistent acne, oral isotretinoin may be more suitable
See your doctor or dermatologist for advice if your skin problem fails to improve within three months or you have severe acne.

Treatment of mild acne
Most patients with mild acne can be treated with topical treatment (gels, solutions and lotions) that can be obtained over-the-counter in New Zealand without prescription. Most people just use topical agents for facial skin as they can be difficult to apply to one’s back. Extra vitamins and minerals have not been proved to help.

Wash affected areas twice daily with a mild cleanser and water or an antiseptic wash.
Acne products should be applied to all areas affected by acne, rather than just put on individual spots.
A thin smear should only be applied to dry clean skin at nighttime.
Acne products may work better if applied in the morning as well.
They often cause dryness particularly in the first 2-4 weeks of use. This is partly how they work. The skin usually adjusts to this.
Apply an oil-free moisturizer only if the affected skin is obviously peeling.
Avoid applying oily cosmetics such as foundation or sunscreen.
It may take several weeks or even months to see convincing improvement.
Discontinue using product if severe irritation results. See your doctor for advice.
Suitable topical agents for mild acne that can be obtained without prescription include:

Antiseptic washes (Acnederm wash™, Benzac™ AC Wash, Dalacin™ T Prewash, Oxy™ Daily Skin Wash)
Mild salicylic acid preparations to exfoliate and unplug the follicles (Neutrogena® Oil-free Acne Wash and many others)
Benzoyl peroxide cream / lotion / gel (PanOxyl™ Acne Gel, Brevoxyl™ Cream, Oxy-10™, Clearasil™ Ultra Acne Cream, Benzac AC Gel)
Azelaic acid (Skinoren™ cream, Acnederm™ medicated lotion)
Hydrogen peroxide in stabilised cream (Crystacide®)
Tea tree oil products
Topical agents for mild acne which require prescription include:

Antibiotics, such as clindamycin solution (Topicil™) or erythromycin solution (Stiemycin™) and gel (Eryacne™) are best used with benzoyl peroxide or azelaic acid to reduce the chance of antibiotic resistance.
Retinoids i.e. tretinoin (Retin-A™), isotretinoin (Isotrex™), adapalene (Differin™).
Blue light acne treatment is a new procedure recently found to be safe and helpful for mild to moderate acne.

See your doctor or dermatologist for advice if your pimples fail to clear up within six weeks or you have severe acne.

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Effective Acne Treatment

Filed under: Health Care — Nancy @ 12:30 am -0700

Acne can be effectively treated, although response may sometimes be slow. Where possible, avoid excessively humid conditions such as a sauna, working in an unventilated kitchen or tropical vacations (but ultraviolet light helps).
Try not to apply irritant oils or cosmetics to the affected skin.
Abrasive skin treatments can aggravate both comedones and inflammatory lesions.
Try not to scratch or pick the spots
No relationship between particular foods and acne has been proven.

For acne remedy with physical treatments
Sunlight is anti-inflammatory and can help briefly. However, exposure to ultraviolet radiation results in ageing skin and can eventually lead to skin cancer.
Cryotherapy (freezing treatment) may be useful to control new nodules.
Intralesional steroid injections can be used to shrink older nodules.
Comedones can be expressed or removed by cautery or diathermy.
Microdermabrasion can help mild acne.
Lasers and other light systems appear helpful for acne. Treatment is often delivered twice weekly for four weeks. The effect may be enhanced by use of a photosensitising agent (photodynamic therapy).
Note: X-ray treatment is no longer recommended for acne as it may cause skin cancer.

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