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Have you noticed you began shopping or spending more frequently over time? Have you ever considered self-destruction or suicide as a result of your shopping/spending? Upon stopping over-shopping or overspending did you continue to be tempted/preoccupied by it? Have you kept your shopping/spending a secret from most of those you are close to? Have you told yourself +??this is my last time+?? and still over-shopped or overspent? Have you continued to shop or spend despite having been had legal issues such as bankruptcy or divorce? Do you often feel a need for control or tend toward perfectionism? Do you have issues with clutter or hoarding the items you+??ve purchased? Have you purchased items that you+??ve never if rarely even used? Do you have trouble speaking up for yourself cheap viagra gold 800mg online, asking for help discount viagra gold 800mg amex, or saying +??no+??? Most compulsive shoppers or spenders will answer yes to at least seven (7) of these shopping addiction quiz questions order cheap viagra gold line. You can print out this shopping addiction quiz and share the results with your doctor or other mental health professional. Getting a psychological evaluation is a good first step. For treatment of a shopping addiction, therapists use cognitive-behavioral therapy to help the person recognize and change their behaviors. Some compulsive shoppers may learn to limit their shopping and for the most severe patients, the therapist may recommend that someone else control their finances altogether. Antidepressant medication may be considered as a treatment. There are also 12-step programs for support, like Debtors Anonymous and Shopaholics Anonymous. And many compulsive spenders run up of tens of thousands of dollars in bills, so credit counseling is also helpful. In discussing shopping addiction treatment, psychiatrist, Dr. Develop other ways to handle emotionsLearn to ride through urges and preoccupationsDevelop habits in storesAnd keep in mind that while behavior change is clearly crucial to treatment and recovery from a shopping addiction, so is reaching out for help. Robinson, a leading researcher on workaholism, describes some of the differences between simply "working too much" or being a hard worker and workaholic in his book:Hard workers experience their work as a necessary and, at times, fulfilling obligation. Workaholics see their work as a place of safety from the unpredictableness of life and distance from unwanted feelings and/or commitments. Hard workers know when to set limits on their work in order to be fully available and present for their family, friends, and to be able to participate in play. Workaholics allow their work to take top billing over all other areas of their life. Commitments to family, friends, and their children are often made and then broken to meet work demands. Workaholics get an adrenalin rush from meeting impossible demands. The mind of the workaholic continues to grind away about work issues/problems to be fixed. Research shows that the seeds of workaholism are often planted in childhood, resulting in low self-esteem that carries into adulthood. According to Robinson, many workaholics are the children of alcoholics or come from some other type of dysfunctional family, and work addiction is an attempt to control a situation that is not controllable. These children grow up thinking that nothing is ever good enough. Saul, PhD, a psychotherapist in Columbus, Ohio, who frequently counsels workaholics. Chained to the Desk by Bryan Robinson, Family Therapy Networker, July/Aug. Written by Martha Keys Barker, LCSW-CSigns that work holds too much importance for you. When individuals describe themselves as " workaholics," they usually mean that they work hard. Frequently the description is given as a matter of pride. Since our society encourages and rewards workaholic behavior, identifying work addiction is difficult. However, several factors or symptoms help us to distinguish between the hard worker and the workaholic:The workaholic not only works hard but also sets impossibly high standards and is beset by a sense of never being good enough. He/She has a strong need to control other people and situations, and he/she finds it difficult to delegate responsibilities. The workaholic life is characterized by a striking lack of balance. The workaholic gives himself little time to develop and enjoy personal relationships. Caring for herself is low on her priority list, and health problems are often ignored until they become debilitating. Moving from task to task, deadline to deadline, the workaholic feels most alive when totally immersed in a project or dashing between several projects. The workaholic may become addicted to the adrenaline rush generated by dealing with a crisis. The workaholic uses work to escape from difficult feelings and in this process loses awareness of her desires and needs. The family members and friends of the workaholic experience themselves as a lower priority than his/her work, and this experience frequently erodes relationships. If you answer yes to 3 or more questions, you may have a problem worth discussing with a mental health counselor or your doctor. Do you get more excited about your work than about family or anything else? Is work the activity you like to do best and talk about most? Do you turn your hobbies into money-making ventures? Do you take complete responsibility for the outcome of your work efforts? Have your family or friends given up expecting you on time? Do you underestimate how long a project will take and then rush to complete it?

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David: Is there any medication out there that can help block the "feeling of wanting to eat" or is it all on the emotional level? Dr Gross: Numerous medications have been studied for this purpose order viagra gold us. I have a chapter in my upcoming book about this and I call it "Priced by the Pound" purchase 800mg viagra gold with amex. David: And I think Kate brings up a great point here purchase viagra gold 800 mg with mastercard, doctor. Right now, society frowns on people being overweight. How, as a compulsive overeater, can you deal with that emotionally, and not let your self-esteem hit rock bottom? And you can email the doctor at This e-mail address is being protected from spambots. I want to address one thing about Meridia, there are some questions as to its safety. Medically and psychologically, no medications should be used without careful discussion with your doctor of the risks and side-effects, versus the potential benefits. David: One other question I wanted to ask, since you compared compulsive overeating with an addiction. With an addiction, the doctors say you are never really "cured," you just manage it better. The difference between alcoholism and compulsive overeating is that while the alcoholic can stay out of bars, the compulsive overeater can never get away from food. I think that accounts for a lot of the relapse problems. Dr Gross: I consider all highly structured diet programs to be similar to a detox. The research shows that sometimes it is helpful for people to take a break from making decisions about food, that is why many commercial diet programs have highly structured eating plans at the beginning, and allow more choices as time goes on. How can I be expected to even be willing to try another drug? When I do take a medication, I then need something else to help me sleep. I assume you are trying these medications for depression. The research shows that a combo of medications and psychotherapy is best for complicated situations. Maybe you could share some of the emotional issues you are dealing with as a result of compulsive overeating. A lot of times, people feel they are the only ones who feel this way and by sharing this you might be helping someone else here tonight. Gross, you have a program to help compulsive overeaters. Can you describe it and tell us a little more about it? Dr Gross: My program is called "The food and feelings system for weight loss wellness". It can be an additive to any program for the diet math "the calories and exercise part". It starts with having your food and feelings profile done. Then you get a teaching module for each one of these. David: Here are some audience responses regarding emotional issues:jat: I am dealing with overeating and Obsessive Compulsive Disorder. I was doing so well with food, then I had a hysterectomy about 2 years ago and have gained so much weight. Now body image is a major issue as well as depression. My liver stuck out of my stomach even when I was at my heaviest. Dr Gross: I define motivation as "you, plus all available help". Think hard about what has worked for you in the past and what has not. Having a trainer or a doctor or a nutritionist to give you professional help is a big advantage. Write down your goals, and why you want to lose weight, and read it everyday. Dr Gross: There is a reflex between your stomach and your brain. Momma nature wanted us to survive, so she made us with a very strong connection to food. Do you know of anything available that would help me know what my issues are concerning how my feelings control my diet? Dr Gross: The food and feelings profile I mentioned, was designed to do that, to help you figure out what your triggers are for overeating. If you This e-mail address is being protected from spambots. You need JavaScript enabled to view it me, I can give you more info about that. But in the mean time, ask yourself this question: what sends me to the fridge? Five months and 35 pounds later, and no sense of guilt - only what!!?? Create a tool box of other things you can do besides overeating, surround yourself with little things you love, reward yourself with non-food items, figure out what builds you up and nourishes you emotionally. David: If food is your "comforter" and helps you through the emotional issues, what do you replace it with? Dr Gross: That depends on what the emotional issues are. If you have self-esteem problems you must learn to think more positively about yourself. Most of us are much better at doing this for other people, than we are for ourselves.

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Because NovoLog has a more rapid onset and a shorter duration of activity than human regular insulin purchase viagra gold no prescription, it should be injected immediately (within 5-10 minutes) before a meal purchase viagra gold with a visa. Injection sites should be rotated within the same region to reduce the risk of lipodystrophy cheap viagra gold uk. As with all insulins, the duration of action of NovoLog will vary according to the dose, injection site, blood flow, temperature, and level of physical activity. NovoLog may be diluted with Insulin Diluting Medium for NovoLog for subcutaneous injection. Diluting one part NovoLog to nine parts diluent will yield a concentration one-tenth that of NovoLog (equivalent to U-10). Diluting one part NovoLog to one part diluent will yield a concentration one-half that of NovoLog (equivalent to U-50). NovoLog can also be infused subcutaneously by an external insulin pump [see Warnings and Precautions, How Supplied/Storage and Handling ]. Diluted insulin should not be used in external insulin pumps. Because NovoLog has a more rapid onset and a shorter duration of activity than human regular insulin, pre-meal boluses of NovoLog should be infused immediately (within 5-10 minutes) before a meal. Infusion sites should be rotated within the same region to reduce the risk of lipodystrophy. The initial programming of the external insulin infusion pump should be based on the total daily insulin dose of the previous regimen. Although there is significant interpatient variability, approximately 50% of the total dose is usually given as meal-related boluses of NovoLog and the remainder is given as a basal infusion. Change the NovoLog in the reservoir, the infusion sets and the infusion set insertion site at least every 48 hours. NovoLog can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia [see Warnings and Precautions, How Supplied/Storage and Handling ]. For intravenous use, NovoLog should be used at concentrations from 0. NovoLog has been shown to be stable in infusion fluids such as 0. Inspect NovoLog for particulate matter and discoloration prior to parenteral administration. NovoLog is available in the following package sizes: each presentation contains 100 units of insulin aspart per mL (U-100). NovoLog has a more rapid onset of action and a shorter duration of activity than regular human insulin. An injection of NovoLog should immediately be followed by a meal within 5-10 minutes. Glucose monitoring is recommended for all patients with diabetes and is particularly important for patients using external pump infusion therapy. Any change of insulin dose should be made cautiously and only under medical supervision. Changing from one insulin product to another or changing the insulin strength may result in the need for a change in dosage. As with all insulin preparations, the time course of NovoLog action may vary in different individuals or at different times in the same individual and is dependent on many conditions, including the site of injection, local blood supply, temperature, and physical activity. Patients who change their level of physical activity or meal plan may require adjustment of insulin dosages. Insulin requirements may be altered during illness, emotional disturbances, or other stresses. Patients using continuous subcutaneous insulin infusion pump therapy must be trained to administer insulin by injection and have alternate insulin therapy available in case of pump failure. Hypoglycemia is the most common adverse effect of all insulin therapies, including NovoLog. Severe hypoglycemia may lead to unconsciousness and/or convulsions and may result in temporary or permanent impairment of brain function or death. Severe hypoglycemia requiring the assistance of another person and/or parenteral glucose infusion or glucagon administration has been observed in clinical trials with insulin, including trials with NovoLog. The timing of hypoglycemia usually reflects the time-action profile of the administered insulin formulations [see Clincal Pharmacology ]. As with all insulins, use caution in patients with hypoglycemia unawareness and in patients who may be predisposed to hypoglycemia (e. This may present a risk in situations where these abilities are especially important, such as driving or operating other machinery. Rapid changes in serum glucose levels may induce symptoms of hypoglycemia in persons with diabetes, regardless of the glucose value. Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions, such as longstanding diabetes, diabetic nerve disease, use of medications such as beta-blockers, or intensified diabetes control [see Drug Interactions ]. Intravenously administered insulin has a more rapid onset of action than subcutaneously administered insulin, requiring more close monitoring for hypoglycemia. All insulin products, including NovoLog, cause a shift in potassium from the extracellular to intracellular space, possibly leading to hypokalemia that, if left untreated, may cause respiratory paralysis, ventricular arrhythmia, and death. Use caution in patients who may be at risk for hypokalemia (e. As with other insulins, the dose requirements for NovoLog may be reduced in patients with renal impairment [see Clinical Pharmacology ]. As with other insulins, the dose requirements for NovoLog may be reduced in patients with hepatic impairment [see Clinical Pharmacology ]. Local Reactions - As with other insulin therapy, patients may experience redness, swelling, or itching at the site of NovoLog injection. These reactions usually resolve in a few days to a few weeks, but in some occasions, may require discontinuation of NovoLog. In some instances, these reactions may be related to factors other than insulin, such as irritants in a skin cleansing agent or poor injection technique. Localized reactions and generalized myalgias have been reported with injected metacresol, which is an excipient in NovoLog. Systemic Reactions - Severe, life-threatening, generalized allergy, including anaphylaxis, may occur with any insulin product, including NovoLog. Anaphylactic reactions with NovoLog have been reported post-approval. Generalized allergy to insulin may also cause whole body rash (including pruritus), dyspnea, wheezing, hypotension, tachycardia, or diaphoresis. In controlled clinical trials, allergic reactions were reported in 3 of 735 patients (0. In controlled and uncontrolled clinical trials, 3 of 2341 (0. Increases in anti-insulin antibody titers that react with both human insulin and insulin aspart have been observed in patients treated with NovoLog. Increases in anti-insulin antibodies are observed more frequently with NovoLog than with regular human insulin.

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Verbal abuse includes put-downs buy viagra gold cheap online, name-calling and unreasonable criticisms viagra gold 800 mg for sale. Elder abuse ??? this type of abuse happens between an elder and another person order viagra gold 800mg line, typically younger, such as the elder???s child. Elder abuse consists of other forms of abuse perpetrated against an elder. This form of abuse often consists of financial, emotional and even physical abuse. Spiritual abuse ??? spiritual abuse revolves around a person???s spirituality or religion. This type of abuse includes attacking another???s belief system, denying access to a house of worship or forced participation in a cult. All forms of abuse are illegal, although some are harder to prosecute than others. Many of these different types of abuse are also perpetrated against children and teens. For detailed information on child abuse and the types of child abuse, go here. Over three million reports of child abuse were filed with Child Protective Services around the country in the fiscal year 2010. In human terms, over 1500 children under the age of 18 died that year from child abuse and child neglect. Sadly, child abuse most often involves the biological parent of the child but is may also be at the hands of another caregiver or family member. Child abuse is defined both at the state and federal level. Normally, child abuse and neglect are defined together and often occur in the same situation. At the federal level, the definition of child abuse and neglect includes: Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitationAn act or failure to act which presents an imminent risk of serious harmEach state may then further define additional child abuse types and standards. Multiple types of child abuse often occur to the same child. Child abuse can occur:Prenatally, such as when a mother exposes an unborn child to drugsTo the child directly, such as in the case of physical abuseIn the environment, such as in the case of manufacturing methamphetamine in the presence of a childGenerally, child abuse is defined in relation to a parent or other caregiver and not in relation to acquaintances or strangers. Physical punishment, such as in the case of spanking or paddling, is not considered child abuse as long as the discipline does not in any way harm (including bruise) a child. Experts remind parents that punishment is just one form of discipline and that punishment should be used alongside positive methods of discipline, such as praise or rewards for good behavior, for the most effective results. Learn about the major types of child abuse and what constitutes physical abuse, sexual abuse, emotional abuse and neglect of a child. Types of child abuse are broken down in four distinct categories: Physical child abuse is an injury resulting from physical aggression. Even if the injury was not intended, the act is considered physical abuse. The injury from physical child abuse may be the result of:Beating, slapping, or hitting. Burning with cigarettes, scalding water, or other hot objects. Physical abuse is an injury resulting from physical aggression. Physical punishment is the use of physical force with the intent of inflicting bodily pain, but not injury, for the purpose of correction or control. As you can see, physical punishment can easily get out of control and become physical abuse. Some other specific types of physical child abuse are:Shaken Baby Syndrome - Shaking a baby or toddler can cause serious head injuries. Munchausen by Proxy Syndrome - Inducing medical illness in a child or wrongly convincing others that a child is sick is both dangerous and abusive. Drug use during pregnancy - Drug and alcohol use during pregnancy or lactation can be harmful to your child, leading to problems such as Fetal Alcohol SyndromeHundreds of thousands of children are physically abused each year by someone close to them, and thousands of children die from the injuries. For those who survive, the emotional scars are deeper than the physical scars. Burns, bite marks, cuts, bruises, or welts in the shape of an object. Sexual abuse of a child is any sexual act between an adult and a child, including penetration, intercourse, incest, rape, oral sex, and sodomy. Violations of bodily privacy - Forcing a child to undress, spying on a child in the bathroom or bedroom. Exposing children to adult sexuality - Performing sexual acts in front of a child, exposing genitals, telling "dirty" stories, showing pornography to a child. Commercial exploitation - Sexual exploitation through child prostitution or child pornography. Sexual child abusers can be:Fathers, mothers, siblings, or other relatives. Foster parents or host families of foreign-exchange students. Inappropriate interest in or knowledge of sexual acts. Avoidance of things related to sexuality, or rejection of own genitals or body. Your child spends large amounts of time online, especially at night. Your child turns the computer monitor off or quickly changes the screen on the monitor when you come into the room. Your child is using an online account belonging to someone else. It can range from a simple verbal insult to an extreme form of punishment. Emotional abuse is almost always present when another form of abuse is found. Surprisingly, emotional abuse can have more long-lasting negative psychiatric effects than either physical abuse or sexual abuse. Other names for emotional abuse are:Psychological maltreatment or psychological abuseEmotional child abuse can come from adults or from other children:Teachers or athletic coachesBullies at school or elsewhereMiddle- and high-school girls in social cliques Child neglect is a very common type of child abuse. According to Child Welfare Information Gateway, more children suffer from neglect than from physical and sexual abuse combined.

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