Reviewed by Kimball Johnson, MD
Adapting to life after divorce is hard for guys under the best of circumstances. But you can make it easier on yourself, your ex, and your children if you avoid some of the most common mistakes.
Too many men seek out a new relationship before the dust has settled on their divorce, says psychologist Sam J. Buser, PhD, coauthor of The Guys-Only Guide to Getting Over Divorce. They rush into new relationships — and often into new marriages — within the first year.
“That’s no doubt the biggest mistake,” says Buser, who is based in Houston.
Buser says that men often jump into dating because they’re lonely, vulnerable, and sad, and they’re looking for someone to help them feel better.
“The relationships they start do not often work out in the long run,” he says. “I advise my patients to wait at least two years. I’ve never had a man take me up on that advice, but I do try to slow them down.”
He also advises men to date casually at first.
“Tell the woman you’ve just been through a tough divorce and that you’re not ready for a committed relationship,” he suggests. “Acknowledge that it is not the right time for that.”
After a divorce, it’s easy for guys to let themselves become isolated, especially if the ex gets custody of the kids. That’s another big mistake. It can worsen feelings of depression, guilt, and loneliness, a potentially dangerous mix. Divorced men are twice as likely to commit suicide as married men.Â
Divorced men are also more prone to alcohol problems, so be careful of starting down that road.Â
“You don’t have to drink every day to have a problem,” Buser says. “Drinking a six pack is a binge.”
Buser’s advice: Connect with other guys. Call up old friends, join a softball team, a club, or a professional association.
“Expand your social and professional network to avoid isolation.”
He also says that the aftermath of a divorce is great time to go back to school. It keeps you active, stimulates your mind, potentially advances your career, and gets you out of the house.
You’ve met someone new. You’re excited and happy. Good for you. Just don’t make the mistake of expecting your kids to be upbeat about it.
“The last thing the kids want to see is parents getting involved with someone else,” says Gordon E. Finley, PhD, a psychologist who specializes in issues facing divorced men and an emeritus professor of psychology at Florida International University in Miami. “They are going to be unhappy. Date when you feel ready, but leave the kids out of it.”
Buser agrees. “Focus on the other adult when starting a relationship,” he says. “She can meet the kids when you know you are serious.”Read More
People with autism are less likely to commit crimes. Identifying individuals at risk for psychotic breaks, though, may be the one appropriate focus of the mental health discussion raised around Adam Lanza. Â
Given the unspeakable events last week in Newtown, everyone is searching for answers about what might have driven Adam Lanza to kill. Attention has focused on his possible autism spectrum diagnosis, but as researchers and advocates have pointed out, autistic people are actually less likely to commit crimes compared to those without the condition.
There is, however, another disorder that can both be linked with planned violence and mistaken for autism, which may account for part of what went wrong, in this instance or others. That’s psychosis, which can occur as part of schizophrenia or in some cases of severe depression or drug misuse. While it’s important to understand the differences between autism and psychosis, it’s also critical to know that stigmatizing, bullying, rejecting, and isolating people who are different exacerbates every mental illness and developmental disability ever studied.
One of my colleagues, Dr. Bruce Perry, is senior fellow at the Child Trauma Academy and a child psychiatrist who has worked with or consulted on cases involving both children exposed to extreme violence and young perpetrators. He consulted with authorities guiding the response to Columbine.
To be clear, no one can diagnose a patient from afar, and there are too many unknowns in this case to diagnose Lanza. Still, for academic purposes and to the point of accurate mental health discussion and addressing ideas about identifying at-risk individuals, Perry says of the shooter: “My first thought was that he might have had a psychotic break — and that his odd, disengaged behaviors earlier in life — reasonably labeled as something like an ASD by some — might actually have been prodromal psychotic disorder.”
Schizophrenia is often not diagnosed until a first psychotic episode occurs, typically in the late teens or early 20s. These episodes are marked by delusions, hallucinations (mainly auditory), and often extreme paranoia. But long before these occur, some children who ultimately develop the disorder seem “off” and retreat from social contact. This is part of a set of symptoms known as a “prodrome” because it precedes those that characterize the later illness.
Like autism, schizophrenia is now believed to be a condition involving differences in early brain development, which probably begin in the womb, even though symptoms may not appear until years or even decades later. Lanza was 20, which is right in the typical range for a first psychotic episode to occur. But that is the most we can say.
Early symptoms of schizophrenia can sometimes be indistinguishable from those of autism: they include social withdrawal; communication problems and restricted speech; odd, repetitive behavior; an apparent lack of emotion or emotional expression and often, lack of conformity in terms of hygiene and dress. In both cases, the symptoms can start in early childhood, though with schizophrenia, there is often a noticeable exacerbation of prodromal symptoms in the year or two before the first psychotic episode.
Both conditions are also sometimes linked with extremely high intelligence, which makes our failure to provide effective help even more wasteful. Lanza was an honors student, whom some of his classmates labeled a “genius.” He was known to dress formally and carry a briefcase, not the backpacks favored by most schoolchildren. In some instances then, because we don’t have biological markers to provide a definitive diagnosis, it may be impossible to tell if someone has an ASD or is going to develop schizophrenia until psychosis itself occurs.
Indeed, some of the same genes that have been linked to autism risk are also linked to schizophrenia risk — and some of the same environmental triggers also raise risk for both. For example, having an older father or being in the womb while your mother suffers from certain infections elevate both the risk of autism and schizophrenia. It is not known why the predisposition becomes one disorder rather than the other.
Says Perry, “Certainly from what little we know about these kinds of spree events involving children, there are often intrusive, recurring psychotic ideations [in the perpetrators], such as seen in psychotic breaks such as the Aurora shooter or in a severe depression with psychotic features such as with Andrea Yates. [These] help drive the behavior.”
Acute psychosis is linked with an increased risk of violence, which is at least doubled in schizophrenia compared to that seen in normal people and arises in other disorders involving paranoid fears and delusions. This risk is even higher for people with schizophrenia who have alcoholism or addiction: their risk of violence is nine times higher. A 2011 review of the research found that 35 percent of people with a first episode of psychosis have committed some type violence, but only 1 percent of this group engaged in violence serious enough to result in hospitalization or death.
That said, people with schizophrenia in treatment taking appropriate medication are no more likely to be violent than anyone else and only 5 to 10 percent of all murders are committed by people with any type of mental illness.
It’s important here, too, to distinguish between psychosis — which involves delusions, hallucinations, and loss of contact with reality — and psychopathy, which involves predatory, self-centered and violent behavior and complete lack of concern for the feelings of others. Psychopathy is the extreme form of antisocial personality disorder and is, not surprisingly, the diagnosis linked to the most extreme crimes, like serial killing. Neither autism nor schizophrenia is linked with psychopathy.Â
And as for autism — if it ultimately turns out to be what Lanza had — that diagnosis is actually linked with reduced crime risk. People with autism tend to be extremely conscientious, often strictly following moral rules in ways that cause social problems; for example, by avoiding white lies. “From what we do know about ASD, [the shootings] would be pretty atypical,” says Perry. “There’s no risk in the diagnosis itself,” agrees Dr. Harold Bursztajn, co-founder of the Program in Psychiatry and the Law at Harvard Medical School, who has reviewed the research.
In some cases, however, Bursztajn notes, “There is a risk that people who are impaired in social functioning — who have a difficult time communicating, who become isolated– can at times respond impulsively and at other times hold grudges forever and be hypersensitive and never able to get over a slight. They can become depressed, psychotic and delusional. So what we’re looking at is not a risk associated with a diagnosis, but a risk associated with an impairment.” That impairment is not inherent to autism, but can come from the isolation that stigma and lack of appropriate services creates.
Both the major autism charity, Autism Speaks and the Autistic Self Advocacy Network (ASAN) have issued press releases trying to prevent the Connecticut attacks from leading to increased stigmatization and fear of autistic people, noting the data showing no connection between the diagnosis itself and violence. Fears related to autism, however, remain. “Some popular perceptions are based in our own social anxieties in the face of such tragedy,” says Bursztajn, “The quick fix becomes diagnosis instead of analysis.”
Another reason many believe that autistic people are at higher risk of committing violent crimes may be a misunderstanding of what is meant by deficits in empathy, which are associated with autism in the public mind. Says Ari Ne’eman, who is autistic and is president of ASAN, “One of the most damaging stereotypes surrounding autistic people is the myth that we lack empathy. In fact, the research literature has confirmed what we’ve been saying for the longest time: we experience empathy at the same levels as the neurotypical population, even if the outside world doesn’t always understand our ways of communicating it,”
While autistic people sometimes have difficulty understanding the thoughts and intentions of others — an ability sometimes known as cognitive empathy or theory of mind– research finds that they are not impaired in “emotional empathy” or the ability to share the pain and pleasure of others. In fact, some autistic people have such high levels of emotional empathy that their distress about other people’s pain prevents them from actually being able to reach out and help.
Problems with cognitive empathy, however, can lead autistic people to behave insensitively at times. They may not automatically understand, for example, that telling someone “you look fat in that,” is not the socially appropriate response to the question, but this does not mean that they don’t care if they hurt people. Unlike in the case of psychopaths — who are high on cognitive empathy but lack emotional empathy — when autistic people hurt others, it’s usually unintentional.
Autism is also accompanied by sensory problems, typically various oversensitivities to bright lights, loud noises, scratchy clothing and certain tastes. Being overwhelmed by these experiences may sometimes lead them to melt down and lash out — but this is impulsive, not planned, and is more likely to harm the person themselves than anyone else.
Reduced sensitivity to some sensations, particularly pain, is also reported in some autism cases. Some who knew Lanza have said that he had an unusually high tolerance for physical pain and was seemingly unaffected by it. It is possible that this symptom might reduce empathy for the pain of others: if you don’t know what pain is like yourself or feel it less intensely, you may wrongly believe others are similarly numb. However, there are people who are entirely without the sensation of pain who are not impaired in empathy. It’s complicated.
Schizophrenia is linked with a different sort of impairment in cognitive empathy or “theory of mind,” compared to autism. In autism, there can be difficulty recognizing other people’s thoughts or intentions, while in schizophrenia, there’s a tendency to see intentional action where it doesn’t exist. For example, an autistic person might ignore someone who is crying because he doesn’t realize that means that the person is upset– while a person with schizophrenia might see those tears and that emotional experience as part of an elaborate plot.
You might say autistic people have too little theory of mind — while schizophrenic people have too much, seeing conspiracies, connected behavior and intent in what are actually random coincidences. When this paranoia attaches to a particular person or institution, a real risk of violence can ensue.
As advocates point out, however, the vast majority of people with mental illness are no threat to anyone, except sometimes themselves. The mentally ill and developmentally disabled are more likely to be victims of violent crimes than perpetrators of it.
So what about the psychiatric medications Lanza was said to have been taking: could they have spurred the killing spree? If he was on antidepressants in the same class as Prozac, known as SSRI’s, they could have been part of the problem, particularly if he had just started medication. “We do know that there have been reports of idiosyncratic responses to SSRI’s in adolescents and young adults suggesting increased suicidal and homicidal ideations,” Perry says.
David Healy, a British psychiatrist who has studied the connections between medications and violence and testified in court cases related to the links, says, “There is a general discounting of the possibility that psychotropic drugs could cause the kind of violence seen in Connecticuit or Aurora.”
He adds, “Doctors and others stress that it is the illness not the drugs that causes violence and that we are grossly undertreating patients. But if we are undertreating patients at least half of these school shootings should be perpetrated by individuals not on treatment when in fact comfortably over 90% involve individuals on drugs.”
Concludes Perry, “The bottom line is that we need to do a psychological autopsy on the shooter — and other similar cases — to see if there are reasonable places where we can be better at identification of at risk individuals. And finally, the lethality of this kind of (almost incomprehensible) spree behavior is magnified by the weapons used. 22 slashed Chinese school children is terrible — but not as bad as 26 dead in Connecticut.”
Moreover, a tragic irony of these cases is that the stigma they associate with mental illness actually contributes to the disorders themselves by deterring the sick from seeking treatment and creating fear in others that adds to their isolation and depression. Says Bursztajn, “Stigmatizing people who are already isolated makes it much more difficult for them to use their best social judgment and be able to distinguish between fantasy and delusion. The highest risk factor for violence is social stigmatization.” That’s something we all need to keep in mind in coping with this complex, tangled tragedy in light of our own emotions and the debate that will appropriately follow.
This article available online at:
By Hilly Janes
Shower or bath?
A five to ten-minute bath or shower will add moisture to the skin, but soaking for any longer than that could start drying it out, meaning you need to apply a moisturiser afterwards.
Showers use less water than baths and allow you to give yourself a final cold rinse for a much-needed seasonal circulation boost – a brilliant way to help clear a hangover or impart a rosy glow before a big night out.
Aerosol, roll-on or stick deodorant?
Sprays are difficult to apply accurately – so tend to leave an overpowering fog in the bathroom. They’re also annoyingly bulky if you want to take one to the gym or on holiday.
Roll-ons (said by the NHS to be more effective than sprays) tend to be a little messy and may take longer to dry, so the risk of residual marks on your clothes is high.
Stick (or solid) varieties don’t have any of the drawbacks of sprays andÂ roll-ons – and, in my experience, have no disadvantages at all.
Sex or sleep? A new book uses science to give surprising solutions
Heels or flats?
Flat shoes may seem more sensible, but that isn’t necessarily the case. Ballet-style pumps don’t support the foot and, as they don’t have a strap, force the toes to ‘claw’ to stop the shoes slipping off. If you’re going to wear flats, the UK Society Of Chiropodists And Podiatrists recommends Mary-Jane styles with a strap.
High heels, because you are almost on tip toe, tend to shorten the calf muscles, making switching to trainers or bare feet difficult and painful. The higher the heel, the greater the pressure on the ball of the foot – which can lead from blisters, corns and calluses to serious foot, knee and back pain.
The best heels are strappy, gladiator styles with a fat heel, as they give the foot some support and are easier to balance in. Experts say we should change shoe type and heel height every day, or go with 3-5cm – best for feet and legs.
ANSWER: 3-5cm heels.
Sandwich or dairy before a night out?
Before a big night out, it’s important to prepare yourself just in case you have one too many drinks: no one wants to feel like hell the following morning.
Health professionals recommend that you grab something to eat to line your stomach before you drink alcohol, so a sandwich is fine (it’s best to make it something simple and nutritious like ham and tomato on wholegrain bread).
However, best of all is milk or yoghurt. The fats in dairy are digested quite slowly, so will protect your stomach lining for longer than a sandwich. Yoghurt with probiotic live bacteria may even help your digestion.
Wine or gin-and-tonic? 25ml of gin with a calorie-free tonic contains just 56 calories and one unit of alcohol
Wine or gin-and-tonic?
A measure of gin (25ml) with a calorie-free tonic containsÂ just 56 calories and one unitÂ of alcohol.
A glass of red wine (175ml) is around 110 calories and two units of alcohol. Gin alsoÂ contains fewer congeners – the substances produced in fermentation that are thought to contribute to hangovers.
So, if you have the willpower to stick to a glass or two of gin-and-tonic, it’s one of the best alcoholic drinks you can pick.
Nuts or crisps?
When choosing between party nibbles, remember peanuts will keep you going for longer because they contain more protein and fat than crisps, but that comes at a high calorific price.
There are about 300 calories and 25g of fat in a small bag of peanuts, but only 184 calories and 11g of fat in the average 35g bag of crisps.
If you can go for a baked variety of crisps, you’ll cut down significantly on the fat. Of course, nuts and crisps are salty – but a bag of crisps still has a small advantage with 0.4g salt compared to 0.6g in peanuts.
Black orÂ green olives?
Green olives are less ripe than black ones, and lower in calories and fat.
Ten green ones would be about 30 calories, while ten black ones would clock up about 70. If they come in olive oil, the calorie intake increases, while if they’re packed in brine, they’ll make you thirsty – so ask for a glass of water to go with them if you don’t want to end up knocking back copious quantities of alcohol.
Fizzy water or still?
If you’re worried that the carbon dioxide added to water to make it sparkling will contribute to global warming or that fizzy drinks destroy tooth enamel, don’t be. The amount of carbon dioxide is negligible and therefore unlikely to do any harm. And it’s sugar and acid in drinks that cause dental problems, not the bubbles. So there’s little toÂ worry about here – apart from one thing.
When you drink fizzy water, the gas has to go somewhere – which may leave you bloated, and could contribute to some embarrassing social problems later in the day.
Pass on gossip – or keep quiet?
Pass on gossip -Â or keep quiet?
Beware if youÂ are the officeÂ gossip girl – experiments show that the listener unconsciously associates some of the negative things they are hearing about someone else with theÂ person who is telling them the information.
So, as my mother used to say: ‘If youcan’t sayÂ anything nice, don’t say anything at all.’
ANSWER: Keep quiet.
Have sex or go to sleep?
A lack of lovemaking, especially in long-term relationships, is associated with depression and psychological problems. It also leads to couples having more arguments, and feeling stressed and worthless. Inevitably, a lack of sexual relations is associated with increased risk of relationship break-up.
Rosemary Besson, an expert in female sexual desire, says that, for women, desire is not the cause of lovemaking, but its result – women may not feel like it at first, but become aroused as things get going.
ANSWER: Have sex.
Lie-in or get up?
Lying-in will disrupt your regular sleep pattern and make it much harder to get up early when thing get back to normal.
You’re much more likely to feel refreshed and relaxed by spending time doing something you really enjoy during your days off – or getting some exercise.
ANSWER: Get up.
Latte or cappuccino?
The amount that coffee-shop drinks have contributed to our weight gain in the past decade or so cannot be underestimated.Choosing a tall cappuccino with semi-skimmed milk (96Â calories) instead of a tall latte with whole milk (171 calories) will save you 75 calories. If you do it every day for a year, that’s a potential weight loss of 8lb.
Most mainstream coffee shops have all their nutrition information available online – so make sure you check how your favourite drink compares to others before you place your order.
Extracted from LATTE OR CAPPUCCINO? by Hilly Janes (Michael O’Mara Books, Â£9.99). Â© 2012 Michael O’Mara Books Ltd. To order a copy for Â£8.49 (inc. p&p), call 0844 472 4157.
Published: Dec. 19, 2012 at 9:12 PM
DURHAM, N.C., Dec. 19 (UPI) – Seth Curry helped No. 1 Duke overcome a slow start Wednesday and the Blue Devils eventually ran away from Cornell 88-47.
It was the first game for Duke since it assumed the top spot in the national rankings and the Blue Devils (10-0) remained one of eight unbeaten teams in major college basketball.
Duke led by only four points inside the 4-minute mark of the first half, but the Blue Devils held Cornell scoreless for the final 1:43 of the opening period and for the first 6:26 of the second.
Duke scored 23 points in that stretch and Curry finished with 20. He made three of the Blue Devils’ seven 3-pointers and his 7-of-10 from the field paced Duke to a 53 percent shooting night.
Mason Plumlee added 18 points for Duke and Rasheed Sulaimon had 16.
Shonn Miller tallied 12 points for Cornell (4-7), which turned the ball over 25 times and made only 1-of-10 from beyond the arc.
Dec. 18, 2012 — Taking aspirin regularlyÂ appears to slightly raise the risk of the eye condition known as age-related macular degeneration or AMD, new research suggests.
The increased risk only occurred with people who had taken aspirin regularly 10 years before they were diagnosed with the potentially blinding eye disease. They had taken aspirin at least twice a week for more than three months, says researcher Barbara E.K. Klein, MD, MPH.
The risk was for the type of macular degeneration known as wet or neovascular AMD, says Klein, professor of ophthalmology and visual sciences at the University of Wisconsin School of Medicine, Madison.
Wet macular degeneration is generally more severe than another version, known as dry macular degeneration.
Although people taking aspirin regularly were two times more likely to get the condition, Klein says the absolute risk is still low because the condition is not common. About 1% of people aged mid-40s and older get wet macular degeneration, she says.
Klein studied nearly 5,000 men and women, ages 43 and older. She followed them for 20 years, although not all of them stayed in the study that long.
The research is published in the Journal of the American Medical Association.
Previous research findings about aspirin use and macular degeneration risk have been mixed.
As aspirin use and macular degeneration are increasing, Klein decided to follow men and women over many years to see if she could find a link.
Nearly 20% of adults, or 1 in 5, take aspirin regularly. Some use it for temporary relief of pain or fever. Others take it daily to preventÂ heart attacks.
The macula is a small area of the retina, the tissue lining the back of the eye, that is responsible for central vision.
Klein looked at wet (late) and dry (early) macular degeneration for the study. Both areÂ potentially blinding conditions.
Over the course of the study, 512 people were diagnosed with early AMD and 117 with late AMD.
Although regular use of aspirin 10 years before the diagnosis was linked with late macular degeneration, aspirin use five years before the diagnosis was not linked with an increased risk of either form of AMD.
Klein can’t explain the link and says it requires more study. “The absolute risk of this is small,” she says. “There are so many folks who have been put on aspirin for [heart disease] prevention. … The [heart] protective effect is still primo.”
One co-author, Ronald Klein, MD, MPH, has served as a consultant for Pfizer, which makes AMD medicine. The study was funded by the National Institutes of Health and support from Research to Prevent Blindness.
“This study is suggestive that there may be a relationship but it is by no means definitive,” says George Williams, MD, professor and chair of the department of ophthalmology at Oakland University’s William Beaumont School of Medicine in Rochester, Mich.
Williams says a weakness in the study is that the men and women self-reported the aspirin use, so it may not have been totally accurate.
If a cardiologist has recommended aspirin for heart disease protection, Williams says, “I would not take anyone off it.”
People who take aspirin regularly should consider their risk of macular degeneration and the benefits of taking aspirin, says Michael Tolentino, MD, medical director of the Macular Degeneration Association and an ophthalmologist in Lakeland, Fla.
People at higher risk for the disease include those with a family history, those with light eyes, and smokers.
“Everything is a risk-benefit ratio,” he says.
He reports serving as consultant for Novartis, Genentech, Alarcon, and other companies involved in eye drugs.Read More
Having a child with ADHD means dedicating time to meeting their special needs, and to making sure that doesn’t come at the expense of your other children.
“Being a parent of a child with ADHD can be hard,” says Terry Dickson, MD, director of the Behavioral Medicine Clinic of NW Michigan, and an ADHD coach.
ADHD Multimodal Treatment
ADHD (attention deficit hyperactivity disorder) is characterized by inattention, hyperactivity, and the inability to control impulses. It affects an estimated 1.5 to 3.5 million school-age children in the U.S. Everyone, especially younger children, may have symptoms of ADHD from time to time. But with ADHD, the ability to function with daily activities is affected. A diagnosis of ADHD can be hard to make, and evaluation must be made by a specialist. There are several different approaches to…
Read the ADHD Multimodal Treatment article > >
“It’s so important for parents to show all of their children — both the child with ADHD and the kids without — that they are equally loved. But given the needs of a child with ADHD, it takes work to keep it balanced.”
When there’s a child with ADHD in the family, it’s common for their siblings to feel jealous and to act out if they sense their parents’ attention shifting away from them.
“It works like a squeaky wheel,” says Los Angeles psychotherapist Jenn Berman, PhD. “The child who is being the loudest gets the most attention from the parents.”
Usually, that’s the child with ADHD, so it’s normal for parents to spend most of their energy focusing on meeting that child’s special needs, whether it’s in therapy, extra time at home doing homework, or a special effort on managing disobedience or impulsivity.
The behavior of children with ADHD can also make them hard to get along with as a peer, which means their brothers or sisters simply might not like being around them.
“The child who doesn’t have ADHD might prefer to be at a friend’s house than at home, might not invite other kids over to hang out, or might be embarrassed socially,” says Dickson, who has a child with ADHD.
School is another outlet for kids who have a brother or sister with ADHD.
“It can be a reprieve where kids can get away from the stress they might be experiencing at home, or kids can use it as an opportunity to act out for attention,” says Mark Wolraich, MD, a pediatrics professor at the University of Oklahoma Health Sciences Center.
The bottom line is that parents need to share the love and the attention with all their children,whether or not they have ADHD.
Balance is the key. Here are tips from the experts on how to help your kids with an ADHD sibling learn, adjust, and grow:
1. Manage expectations. Parents expect immediate obedience from their kids who don’t have ADHD, Dickson says. It’s common for them to think that their child should know better because they don’t have the condition. But remember, they’re still kids, and helping them understand boundaries and rules is just as important for them as it is for the child with ADHD.
2. Be fair. Just like you shouldn’t be extra hard on your kids who don’t have ADHD, you shouldn’t be too lenient with the one that does, Dickson says. Be clear about the house rules and enforce them equally with all the kids.Read More