Chapter 90 of the book Self-Help Stuff That Works

by Adam Khan:

OUR MOODS HAVE A significant impact on our health and our ability to make sound decisions. When something consistently alters your mood for the worse, it's bad for you. And whatever puts you in a bad mood is bad for your spouse and kids too, because your moods are contagious.

The bad moods of many people are often caused by one of their relatives - Mom, Dad, a brother or sister, an in-law. The trouble is, we tend to put up with lousy behavior from a relative - behavior we would never tolerate in our spouse or children or in our friends. We don't speak up. We feel that we have to put up with it because they are "family." But we don't.

There is no law that says you have to stay on good terms with a person just because he's a relative. You don't. And trying to stay on good terms might bring you down and, by contagion, put your spouse and children in a bad mood often enough to affect their health and their ability to get along with others.

It's only a matter of luck whether your relatives can also be your friends. If you didn't get lucky, don't worry about it. You have your spouse and kids to take care of. And there are plenty of people other than your relatives you can have for friends - people who will treat you well.

Should you write off a relative who brings you down? No. There's a better way. Simply follow these two rules:

1. Be honest
2. Don't judge

These two will help you clean up a relationship. Those who bring you down will tend to gradually remove themselves voluntarily from your life.

The truth is, when someone is bringing us down regularly, we are collaborating in the process by withholding honest statements. For example: "Would you please call me later? I'm busy right now." We don't say stuff like that because we're trying to be polite. We don't want to be rude. But whatever the reason we have for withholding honest communication, hiding the truth only digs us deeper and deeper into the mess.

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The way out is with straightforward information, such as the following: "I don't really feel we should talk about him behind his back." "That question kind of makes me uncomfortable." "I don't want you to visit." "I think you drink too much and I don't want my kids to be around it." Simple, honest communication is all you need.

Some honest statements may seem unnecessarily harsh. But those are the kind of things you need to say sometimes if you want to protect your psychological and physical health and that of your spouse and kids. The problem is we sometimes don't have enough courage to say those things until we are really mad. They seem so harsh, you'd think you'd have to be angry to say them. But you don't. You don't even have to think the person is wrong. In fact, that's the other half it: Restrain yourself from judging the person. If you judge your relative and make him wrong, you hurt him and yourself, and that's unnecessary. You can speak honestly without judgment. It may take some practice, but you can do it. Concentrate on it. Memorize those two rules. Chant them to yourself when you're visiting with the person or talking to them over the phone. Be honest gently, without judgment.

So the way to deal with a relative who puts you in a bad mood is to let him be the way he is while also taking care of yourself by being honest. Remind yourself that if you had similar upbringing and genetics, you might very well be like him, so there's no justification for writing him off as a bad person. You don't know how he came to be that way and you don't know his motives. All you really know is he brings you down.

Concern yourself with being honest - without judgment - and the honesty will take care of your situation for you. Your relative will either respond to your honesty well and your relationship will improve, or he won't like your honesty - he won't want to be around you - and he will voluntarily phase you out of his life. Either way, you're better off. It may be a little rough for awhile, but you and your spouse and your children will come out on the other side healthier and happier.

Learn more about the fine art of preventing yourself from passing judgment on people:

Here Comes the Judge

If you have someone in your life who brings you down
or makes trouble for you regularly, and you've already
tried being honest with them and it didn't work, read this:
The Bad Apples

next: Very Impressive

Self-Therapy For People Who ENJOY Learning About Themselves

In old movies, if you wanted to show that someone was really "crazy" you'd show them talking to themselves. Even if they were only doing it mentally, in their own heads, it was supposed to be a sure sign of mental illness. What's really bizarre about this is that the act of talking to ourselves is actually a sign that we are self-aware and that we seek insight into our own actions. It's really a hallmark of being human and proof that we are a higher species.

WE ALL DO IT

We all have mental conversations with ourselves. Self-talk is so constant that meditation groups, relaxation tapes, and self-help books focus on just trying to get us to be able to stop all the self-talk for a few seconds of deep relaxation.

But in a sense, we CAN measure our degree of psychological pain by checking out our self-talk. It's not whether we do it, it's WHAT we say to ourselves that matters!

WHAT DO WE SAY TO OURSELVES?

It would be wonderful if we only said well-thought-out, self-protective, self-loving things to ourselves. It would be wonderful, but it's just not true for most of us most of the time a lot of self-talk is critical.

It's as if our private mental world is occupied by a watchdog who is always anxious to point out our flaws. To a degree, this is self-protective. It "resets our automatic pilot" when it is veering too far off course. But one of the quickest and best ways to improve our lives is through changing negative self-talk.

How do we go about it?

HOW TO CHANGE YOUR SELF-TALK

1. Become Aware Of It.
2. Label Its Source.
3. Change It.
4. Notice How Different You Feel.
5. Decide Whether To Change It Further.
6. Don't Think You Are Finished.

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BECOMING AWARE OF YOUR SELF-TALK

Journaling seems to be the most popular technique for becoming aware of your self-talk at the moment.

But whether you use a real journal or just try to notice what you say to yourself without a journal,

LOOK FOR DISAGREEMENTS WITHIN YOURSELF!

Sometimes these disagreements will be almost "auditory." One side will say something and the other side will say "That's not true," etc. But ANY self-talk that makes you feel bad contains a "disagreement." (The disagreement is between the self-talk and the part of us that doesn't want to feel bad!).

LABELING ITS SOURCE

All self-talk that makes you feel bad originally came from someone else! Learn to identify WHO SAID THIS ABOUT YOU in your past. And mentally "label" the negative self-talk with the name of the person you got it from.

IMPORTANT HINT:

Since parents have so much influence in our lives, much self-talk (both positive and negative) comes from them. It will help you a lot to use your parent's first name - "Herman" or "Brenda" or whatever - instead of using "Dad" or "Mom" when you label these internal messages. (This will remind you that they were only "people" who were capable of making mistakes, not "gods" who could never be wrong.)

CHANGING IT

Simply change the thing you say to yourself into something that you'd like to believe that makes you feel better.

NOTICING HOW DIFFERENT YOU FEEL

Try the new self-talk for a short time (anything from a few hours to a couple days or so). See how it feels, and learn how much of the new, kinder statement you actually believe.

DECIDING WHETHER TO CHANGE IT FURTHER

Make a NEW DECISION about what you will say to yourself about this in the future.

Make it self-caring, self-protective, and something you honestly believe to be true.

KNOWING YOU ARE NOT FINISHED!

You will be growing and changing all of your life. Updating your self-talk will always be necessary.

Even when you finally finish making new decisions about the really negative stuff there will still be the need to update self-talk based on the changes that life brings your way.

BECOME YOUR OWN THERAPIST

Good therapy also aims at well-thought-out, self-loving, and self-protective new decisions. When you follow the steps in this topic you are essentially becoming your own therapist. Do as much as you can on your own, but give your therapist a call if you run into painful things you can't change on your own.

next: Self-Therapy

A short essay on how teachers inform students of Einstein's genius, but very few are offer glimpses into the soul of this scientist.

When Heart and Mind Unite

Life Letters

Recently my daughter and I were discussing the life of Albert Einstein. When I asked her what she had learned about him in school over the years, she responded in her usual fashion when queried about academic subjects, "not much," she said, bored already. I pressed her for details, and eventually discovered that the extent of her knowledge was that he'd been a famous scientist. As we proceeded to review some basic facts about this world-renowned physicist, that he'd developed the theory of relativity, made significant contributions to the field of quantum physics, and had been instrumental in the development of the atom bomb, it occurred to me that although teachers inform students of Einstein's genius, very few are offer glimpses into the soul of this scientist.

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Einstein spent a significant portion of his adult life advocating for the cessation of social injustice and war. His role during World War I in establishing a nonpartisan coalition that worked to promote peace and which advocated for a supranational organization to prevent future wars was only one of his many roles as a political activist.

He spoke and wrote to audiences around the world calling for peace, nuclear disarmament, and social justice, insisting that the citizens of the world address difficult but vital issues and questions including, "Here, then, is the problem we present to you, stark and dreadful and inescapable: Should we put an end to the human race, or shall mankind renounce war?"

He appealed to the social and moral conscience of scientists cautioning, "the concern for man himself must always constitute the chief objective of all technological effort...in such a manner as to assure that the results of our scientific thinking may be a blessing to mankind, and not a curse."

He pointed out our interconnectedness and interdependence observing, "How strange is the lot of us mortals! Each of us is here for a brief sojourn; for what purpose he knows not, though he sometimes thinks he senses it. But without deeper reflection one knows from daily life that one exists for other people -- first of all for those upon whose smiles and well-being our own happiness is wholly dependent, and then for the many, unknown to us, to whose destinies we are bound by the ties of sympathy. A hundred times every day I remind myself that my inner and outer life are based on the labors of other men, living and dead, and that I must exert myself in order to give in the same measure as I have received and am still receiving... "

He also reminded those of us who long for a better world that it is absolutely essential that we too play a role in its creation. "Whatever there is of God and goodness in the universe, it must work itself out and express itself through us. We cannot stand aside and let God do it."

While I'm hoping that some day my daughter achieves an elementary understanding of the scientific contributions Einstein made to our world, today, on the first year anniversary of the world trade center attack, what is of far greater importance to me is that one day she'll comprehend how and why he fought so hard to save it.

Note: The Einstein quotes in this article were collected from the following website: http://www.aip.org/history/einstein/

next:Life Letters: Our Mother's Stories

Chapter 71 of the book Self-Help Stuff That Works

by Adam Khan:

...AND MEDITATION IS A metaphor for life. Meditation consists of keeping your mind on one thing. Of course, what happens is your mind drifts onto other things. You notice your mind has drifted, you're tempted to keep thinking about it, but then you let it go and bring yourself back to your meditation.

Although life is a little more complicated, it is much the same: You notice you've gone off the track and you get back on.

You can't have it all, do it all or be it all. To live hap-pily, you have to narrow your purposes down to a few: certain relationships, certain important values, and a general purpose for your life. Then the world and your own mind/body will continually take you off onto side-trips and distractions. Salespeople, in-laws, your desire for diversions and pleasures and entertainments, advertisers, people who want something from you (like your attention), and many more sources of distraction are constantly coming your way.

So you get off purpose. And then you notice you've gone off on a purpose that has nothing to do with what's important to you, and you let it go and get back to your own purposes.

For example, I was doing some work in my living room one hot summer night and I wasn't wearing a shirt. Two teenage boys skateboarding by across the street looked in my window and one of them said,"Hey, put on a shirt! I was being invaded in my own living room. He said it again. It was clearly wrong, and I wanted to go over there and wring their scrawny little necks, or at least call the police, or do something that would show those two punks they can't get away with that with me! But all of that has nothing to do with my chosen purposes. No real harm was done. It was simply another opportunity to either get off track or let it go and get back to my work.

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Make your entire life a meditation. Less of your time will be wasted on things that aren't important to you and more of your goals will be achieved.

Notice when you're drifting away from your own purposes, and then get back on track.

A good principle of human relations is don't brag, but if you internalize this too thoroughly, it can make you feel that your efforts are futile.
Taking Credit

Aggressiveness is the cause of a lot of trouble in the world, but it is also the source of much good.
Make it Happen

Comfort and luxury are not the chief requirements of life.
Here's what you need to really feel great.
A Lasting State of Feeling Great

What is more fun: Things that require the expenditure of resources like material and electricity and gas? Or self-powered activities?
Burn Your Own BTUs

next: Vocabulary Raises

Medications used in treating an acute manic episode and acute depression associated with bipolar disorder.

Selecting a mood stabilizer for an acute manic episode

The first-line drugs for treating a manic episode during the acute phase are lithium and valproate. In choosing between these 2 medications, your doctor will consider your treatment history (whether either of these medicines has worked well for you in the past), the subtype of bipolar disorder you have (e.g., whether you have rapidcycling bipolar disorder), your current mood state (euphoric or mixed mania), and the particular side effects that you are most concerned about.

Lithium and divalproex are each good choices for "pure" mania (euphoric mood without symptoms of depression), while divalproex is preferred for mixed episodes or for patients who have rapid-cycling bipolar disorder. It is not unusual to combine lithium and divalproex to obtain the best possible response. If this combination is still not fully effective, a third mood stabilizer is sometimes added.

Carbamazepine is a good alternative medication after lithium and divalproex. Like divalproex, carbamazepine may be particularly effective in mixed episodes and in the rapid-cycling subtype. It can be easily combined with lithium, although it is more complicated to combine it with divalproex.

The newer anticonvulsants (lamotrigine, gabapentin, and topiramate) are often best reserved as back-up medications to add to firstline medications for mania, or to use instead of the first-line group if there have been difficult side effects.

How quickly do mood stabilizers work?

It can take a few weeks for a good response to occur with mood stabilizers. However, it is often helpful to combine mood stabilizers with other medications that provide immediate, short-term relief from the insomnia, anxiety, and agitation that often occur during a manic episode. The choices for so-called "adjunctive"medication include:

• antipsychotic medicines, especially if the person is also having psychotic symptoms (see above).
• a sedative called a benzodiazepine. Benzodiazpeines include lorazepam (Ativan), clonazepam (Klonopin), and others. They should be carefully supervised, or avoided, in patients who have a history of drug addiction or alcoholism.

Although both benzodiazepine sedatives and antipsychotic medicines can cause drowsiness, the dosages of these medications can generally be lowered as the person recovers from the acute episode. However, some individuals need to continue taking a sedative for a longer period to control certain symptoms such as insomnia or anxiety. Longer-term treatment with an antipsychotic is sometimes needed to prevent relapse.

Selecting an antidepressant for an acute depression

Although a mood stabilizer alone may treat milder depression, an antidepressant is usually needed for more severe depression. It is dangerous to give antidepressants alone in bipolar disorder, because they can trigger an increase in cycling or cause the person's mood to "overshoot" and switch from depression to hypomania or mania. For this reason, antidepressants are always given in combination with a mood stabilizer in bipolar disorder.

Antidepressants usually take several weeks to show effects. Although the first antidepressant tried will work for the majority of patients, it is common for patients to go through 2 or 3 trials of antidepressants before finding one that is fully effective and doesn't cause troublesome side effects. While waiting for the antidepressant to work, it may be helpful to take a sedating medication to help relieve insomnia, anxiety, or agitation.

If depression persists despite use of an antidepressant with a mood stabilizer, adding lithium (if not already in use) or changing the mood stabilizer might help. Lamotrigine, in particular, may be helpful in depression.

Strategies to limit side effects

All of the medications that are used to treat bipolar disorder can produce bothersome side effects; there are also some serious but rare medical reactions. Just as different people have varying responses to different medications, the type of side effects different people develop can vary widely, and some people may not have any side effects at all. Also, if someone has problems with side effects on one medication, this does not mean that that person will develop troublesome side effects on another medication.

Certain strategies can help prevent or minimize side effects. For example, the doctor may want to start at a low dose and adjust the medication to higher doses very slowly. Although this may mean that you need to wait longer to see if the medication will help the symptoms, it does reduce the chances of side effects developing. In the case of lithium or divalproex, blood level monitoring is very important to insure that a patient is receiving enough medication to help, but not more than is necessary. If side effects do occur, the dosage can frequently be adjusted to eliminate the side effects or another medication can be added to help. It is important to discuss your concerns about side effects and any problems you may be experiencing with your doctor, so that he or she can take these into account in planning your treatment.

Sources:

• Post RM, Calabrese JR., Bipolar depression: the role of atypical antipsychotics, Expert Rev Neurother. 2004 Nov;4(6 Suppl 2):S27-33.
• Sachs, G. et al. (2007). "Effectiveness of Adjunctive Antidepressant Treatment for Bipolar Depression". New England Journal of Medicine 356 (17): 1711-1722.
• Muller-Oerlinghausen B, Retzow A, Henn FA, Giedke H, Walden J. Valproate as an adjunct to neuroleptic medication for the treatment of acute episodes of mania a prospective, randomized, double-blind, placebo-controlled, multicenter study. European Valproate Mania Study Group. J Clin Psychopharmacol 2000;20:195-203.
• Freeman TW, Clothier JL, Pazzaglia P, Lesem MD, Swann AC. A double-blind comparison of valproate and lithium in the treatment of acute mania. Am J Psychiatry 1992;149:108-11.
• Vasudev K, Goswami U, Kohli K. Carbamazepine and valproate monotherapy: feasibility, relative safety and efficacy, and therapeutic drug monitoring in mania disorder. Psychopharmacology (Berl) 2000;150:15-23.

next: Disastrous Medication Changes
~ bipolar disorder library
~ all bipolar disorder articles

Comprehensive information about GLA (Gamma-linolenic acid) for the treatment of ADHD, alcoholism and weight loss. Learn about the usage, dosage, side-effects of GLA.

• Overview
• Uses
• Dietary Sources
• Available Forms
• How to Take It
• Precautions
• Possible Interactions
• Supporting Research

Overview

Gamma-linolenic acid (GLA) is an essential fatty acid (EFA) in the omega-6 family that is found primarily in plant-based oils. EFAs are essential to human health but cannot be made in the body. For this reason, they must be obtained from food. EFAs are needed for normal brain function, growth and development, bone health, stimulation of skin and hair growth, regulation of metabolism, and maintenance of reproductive processes.

Linoleic acid (LA), another omega-6 fatty acid, is found in cooking oils and processed foods and converted to GLA in the body. GLA is then broken down to arachidonic acid (AA) and/or another substance called dihomogamma-liolenic acid (DGLA). AA can also be consumed directly from meat, and GLA is available directly from evening primrose oil (EPO), black currant seed oil, and borage oil. Most of these oils also contain some linoleic acid.

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The average North American diet provides more than 10 times the necessary amount of linoleic acid and tends to have too much omega-6 fatty acids compared to omega-3 fatty acids, another important class of EFAs. In fact, for optimum health, the ratio of omega-6 to omega-3 fatty acids should be between 1:1 and 4:1. The typical North American and Israeli diets are usually in the range of 11:1 to 30:1. This imbalance contributes to the development of long-term diseases such as heart disease, cancer, asthma, arthritis, and depression as well as, possibly, increased risk of infection.

Interestingly, not all omega-6 fatty acids behave the same. Linoleic acid (not to be confused with alpha-linolenic acid, which is in the omega-3 family) and arachidonic acid (AA) tend to be unhealthy because they promote inflammation, thereby increasing the risk of the diseases mentioned when consumed in excess. In contrast, GLA may actually reduce inflammation.

Much of the GLA taken from the oils mentioned or as a supplement is not converted to AA, but rather to DGLA. DGLA competes with AA and prevents the negative inflammatory effects that AA would otherwise cause in the body. Having adequate amounts of certain nutrients in the body (including magnesium, zinc, and vitamins C, B3, and B6) helps to promote the conversion of GLA to DGLA rather than AA.

It is important to know that many experts feel that the science supporting the use of omega-3 fatty acids to reduce inflammation and prevent diseases is much stronger than the information regarding use of GLA for these purposes. Two important, and most studied, omega-3 fatty acids include eicosopentaenoic acid (EPA) and docosahexaenoic acid (DHA), both found in fish and fish oils.

 

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Uses

Some clinicians and preliminary research suggest that GLA may be useful for the following purposes:

Diabetes
Omega-6 fatty acid supplementation, in the form of GLA from EPO or other sources may assist nerve function and help prevent nerve disease experienced by those with diabetes (called peripheral neuropathy and felt as numbness, tingling, pain, burning, or lack of sensation in the feet and/or legs).

Eye Disease
GLA may be beneficial in dry-eye conditions such as Sjögren's syndrome (a condition with symptoms of dry eyes, dry mouth, and, often, arthritis).

Osteoporosis
A deficiency in essential fatty acids (including GLA and EPA, an omega-3 fatty acid) can lead to severe bone loss and osteoporosis. Studies have shown that supplements of GLA and EPA together help maintain or increase bone mass. Essential fatty acids may also enhance calcium absorption, increase calcium deposits in bones, diminish calcium loss in urine, improve bone strength, and enhance bone growth, all of which may contribute to improved bone mass and, therefore, strength.

Menopausal Symptoms
Although EPO has gained some popularity for treating hot flashes, the research to date has not demonstrated a benefit of GLA or EPO over taking a placebo. With that said, there are individual women who report improvement; therefore, it may be worthwhile to talk to your doctor about whether it is safe for you to try EPO or another form of GLA supplements to alleviate hot flashes.

Premenstrual Syndrome (PMS)
Although results of studies have been mixed, some women find relief of their PMS symptoms when using GLA supplements from EPO or another source. The symptoms that seem to be helped the most are breast tenderness and feelings of depression as well as irritability and swelling and bloating from fluid retention. Breast tenderness from causes other than PMS may also improve with use of GLA.

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Eczema
Several early studies suggested that EPO (rich in GLA) is more beneficial than placebo at relieving symptoms associated with this skin condition such as itching, redness, and scaling. However, more recent studies have not had the same positive results testing GLA supplements derived from EPO. The bottom line is that whether EPO and GLA supplements work for someone with eczema may be very individual. Talk to your doctor about the possibility and safety of trying GLA for this condition.

Allergies
People who are prone to allergies may require more EFAs and often have difficulty converting LA to GLA. In fact, women and infants who are prone to allergies appear to have lower levels of GLA in breast milk and blood.

To date, the use of EFAs to prevent allergic reactions or reduce their magnitude has had mixed results. There have been some reports of individuals lessening their allergic reaction by taking GLA from EPO. For example, one young boy who broke out in hives when around dogs, no longer had this response after taking EPO for one month. Well-conducted research studies are needed to determine whether EPO can be helpful for large numbers of people with allergies.

On the other hand, a study evaluating dietary intake of omega-6 fatty acids relative to the risk of having hay fever (called allergic rhinitis) found different results for this other type of allergic reaction. Nurses in Japan with higher amounts of omega-6 in their diet were more likely to have hay fever.

Omega-6 fatty acids from the diet or supplements, such as GLO from EPO or other sources, have a longstanding history of folk use for allergies. Whether this supplement improves your symptoms, therefore, may be very individual. Work with your healthcare provider to first determine if it is safe for you to try GLA and then follow your allergy symptoms closely for any signs of improvement or lack there of.

Rheumatoid Arthritis
Some preliminary information indicates that GLA, from EPO, borage oil, or black currant seed oil, may diminish joint pain, swelling, and morning stiffness. GLA may also allow for reduction in the amount of pain medication used by those with rheumatoid arthritis. The studies to date, however, have been small in size. Additional research would be helpful, including testing a proposed theory that using GLA and EPA (an omega-3 fatty acid from fish and fish oil) together would be helpful for rheumatoid arthritis.

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In the meantime, talk to your doctor about whether using GLA is safe for you and then pay attention, over 1 to 3 months of use, to whether your symptoms get better or not. In terms of borage oil, some researchers theorize that it may not be safe to use with non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, which are commonly used for arthritis). This theory needs to be tested. See Possible Interactions.

GLA for attention deficit/hyperactivity disorder (ADHD)
Research to date has suggested an improvement in symptoms and behaviors related to attention deficit/hyperactivity disorder (ADHD) from omega-3 fatty acids. Results of studies supplying omega-6 fatty acids in the form of GLA from EPO or other sources to children with attention deficit/hyperactivity disorder (ADHD), however, have been mixed and, therefore, not conclusive. More research on GLA for attention deficit/hyperactivity disorder (ADHD) is needed before conclusions can be drawn. In the meantime, ensuring a healthier balance of omega-3 to omega-6 fatty acids in the diet seems worthwhile for those with this behavioral condition.

GLA for Alcoholism
EPO may help lessen cravings for alcohol and prevent liver damage. Some of this information comes from animal studies; more research in people is needed.

Cancer
Results of studies looking at the relationship of omega-6 fatty acids to cancer have been mixed. While LA and AA are cancer promoting in studies of colon, breast, and other cancers, GLA has shown some benefit for breast cancer in certain studies. The information is not conclusive and is somewhat controversial. The safest bet is to eat a diet with the proper balance of omega-3 to omega-6 fatty acids (see How to Take It), starting from a young age, to try to prevent the development of cancer.

GLA for Weight Loss
Results of studies regarding use of EPO for weight loss have been mixed and, therefore, use of this type of supplement won't work for everyone. One study suggests that if the supplement is going to work, it does so mainly for overweight individuals for whom obesity runs in the family. In addition, a few other small studies suggest that the more overweight you are, the more likely that EPO will help. In fact, if your body weight is only 10% above normal (for example, 10 to 20 pounds above average), EPO is unlikely to help you lose weight.

High Blood Pressure and Heart Disease
Animal studies suggest that GLA, either alone or in combination with two important omega-3 fatty acids, EPA and DHA both found in fish and fish oil, may lower the blood pressure of hypertensive rats. Together with EPA and DHA, the GLA helped to prevent the development of heart disease in these animals as well. It is unclear whether these benefits would occur in people.

In one study evaluating people with peripheral artery disease (blockage in the blood vessels in the legs from atherosclerosis [plaque] causing cramping pain when walking), men and women with this condition did experience improvement in their blood pressure from the combination of EPA and GLA. Much more research is needed in people before conclusions can be drawn. Plus, it may not be the GLA conferring the benefit at all - Å“ the omega-3 fatty acids, which are better known for improving blood pressure and the risks for heart disease, may be solely responsible.

Ulcers

Very preliminary evidence from test tube and animal studies suggest that GLA from EPO may have anti-ulcer properties. It is premature to know how this might apply to people with stomach or intestinal ulcers or gastritis (inflammation of the stomach).

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Dietary Sources of GLA

GLA is found in the plant seed oils of evening primrose, black currant, borage, and fungal oils. Spirulina (often called blue-green algae) also contains GLA.

 

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Available Forms

GLA supplements are derived from evening primrose oil (EPO) as well as black currant seed and borage seed oils. The GLA supplements are often packaged in oil containing capsules. EPO has been the most researched source of GLA.

Generally, high-quality oil will be certified as organic by a reputable third party, packaged in light-resistant containers, refrigerated, and marked with a freshness date.

 

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How to take GLA

For general health, there should be a balance between omega-6 and omega-3 fatty acids; the ratio should be in the range of 1:1 to 4:1; the typical North American diet, however, normally provides ratios from 11:1 to 30:1.

Pediatric

• For nursing infants, adequate amounts of essential fatty acids are generally supplied in breast milk if the mother is adequately nourished.
• For older children, essential fatty acids should be obtained through the diet. Because it is important to maintain a balance of fatty acids within the body, it may be appropriate to check fatty acid levels before considering GLA supplements for children.

It is important to note that although dietary guidelines as described have been suggested, there are no established therapeutic doses for GLA supplements in children. Some clinicians suggest that EPO 2,000 to 4,000 mg per day may be used safely for children with eczema; research is needed to confirm.

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Adult

• The recommended dosage for rheumatoid arthritis is 1,400 mg per day of GLA or 3,000 mg of EPO.
• For diabetes it is 480 mg per day of GLA.
• For breast tenderness or other symptoms of PMS, 3,000 to 4,000 mg of EPO per day is the dose suggested.
• For other conditions discussed in Uses, a specific safe and appropriate dose of GLA supplements has not yet been established.
• Studies have suggested that up to 2,800 mg of GLA per day is well tolerated.

 

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Precautions

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable healthcare provider.

Omega-6 supplements, including GLA and EPO, should not be used if you have a seizure disorder because there have been reports of these supplements inducing seizures.

Borage seed oil, and possibly other sources of GLA, should not be used during pregnancy because they may be harmful to the fetus and induce early labor.

Doses of GLA greater than 3,000 mg per day should be avoided because, at that point, production of AA (rather than DGLA) may increase.

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Possible Interactions

If you are currently being treated with any of the following medications, you should not use GLA without first talking to your healthcare provider.

Ceftazidime
GLA may increase the effectiveness of ceftazidime, an antibiotic in a class known as cephalosporins, against a variety of bacterial infections.

Chemotherapy for cancer
GLA may increase the effects of anti-cancer treatments, such as doxorubicin, cisplatin, carboplatin, idarubicin, mitoxantrone, tamoxifen, vincristine, and vinblastine.

Cyclosporine
Taking omega-6 fatty acids, such as GLA, during therapy with cyclosporine, a medication used to suppress the immune system after an organ transplant, for example, may increase the immunosuppressive effects of this medication and may protect against kidney damage (a possible side effect from this medication).

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Theoretically, use of NSAIDs, such as ibuprofen, together with borage oil or other GLA containing supplements may counteract the effects of the supplement. Research in this area is needed to know if this theory is accurate.

Phenothiazines for schizophrenia
Individuals taking a class of medications called phenothiazines (such as chlorpromazine, fluphenazine, perphenazine, promazine, and thioridazine) to treat schizophrenia should not take EPO because it may interact with these medications and increase the risk of seizures. The same may be true for other GLA containing supplements.

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back to: Supplement-Vitamins Homepage

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Supporting Research

al-Sabanah OA. Effect of evening primrose oil on gastric ulceration and secretion induced by various ulcerogenic and necrotizing agents in rats. Food Chem Toxicol. 1997;35(8):769-775.

Arnold LE, Kleykamp D, Votolato N, Gibson RA, Horrocks L. Potential link between dietary intake of fatty acid and behavior: pilot exploration of serum lipids in attention-deficit hyperactivity disorder. J Child Adolesc Psychopharmacol. 1994;4(3):171-182.

Barham JB, Edens MB, Fonteh AN, Johnson MM, Easter L, Chilton FH. Addition of eicosapentaenoic acid to gamma-linolenic acid-supplemented diets prevents serum arachidonic acid accumulation in humans. J Nutr. 2000;130(8):1925-1931.

Barre DE. Potential of evening primrose, borage, black currant, and fungal oils in human health. Ann Nutr Metab. 2001;45(2):47-57.

Baumgaertel A. Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatr Clin of North Am. 1999;46(5):977-992.

Belch JJ, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr. 2000;71(1 Suppl):352S-356S.

Bendich A. The potential for dietary supplements to reduce premenstrual syndrome (PMS) symptoms. J Am Coll Nutr. 2000;19(1):3-12.

Brown NA, Brown AJ, Harding JJ, Dewar HM. Nutrition supplements and the eye. Eye. 1998; 12(pt. 1):127-133.

Bruinsma KA, Taren DL. Dieting, essential fatty acid intake, and depression. Nutrition Rev. 2000;58(4):98-108.

Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder. Am J Clin Nutr. 2000; 71(suppl):327S-330S.

Calder PC, Miles EA. Fatty acids and atopic disease. Pediatr Allergy Immunol. 2000;11 Suppl 13:29-36.

Calder PC, Zurier RB. Polyunsaturated fatty acids and rheumatoid arthritis. Curr Opin Clin Nutr Metab Care. 2001;4(2):115-121.

Chenoy R, Hussain S, Tayob Y, O'Brien PM, Moss MY, Morse PF. Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. BMJ. 1994;19(308):501-503.

Corbett R, Menez JF, Flock HH, Leonard BE. The effects of chronic ethanol administration on rat liver and erythrocyte lipid composition: modulatory role of evening primrose oil. Alcohol Alcohol. 1991;26(4);459-464.

Darlington LG, Stone TW. Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders. Br J Nutr. 2001;85(3):251-269.

Davies CL, Loizidou M, Cooper AJ, et al. Effect of gamma-linolenic acid on cellular uptake of structurally related anthracyclines in human drug sensitive and multidrug resistant bladder and breast cancer cell lines. Eur J Cancer. 1999;35:1534-1540.

Engler MM, Schambelan M, Engler MB, Ball DL, Goodfriend TL. Effects of dietary gamma-linolenic acid on blood pressure and adrenal angiotensin receptors in hypertensive rats. Proc Soc Exp Biol Med. 1998;218(3):234-237.

Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr. 1998; 128(9): 1411-1414.

Frenoux JMR, Prost ED, Belleville JL, Prost JL. A polyunsaturated fatty acid diet lowers blood pressure and improves antioxidant status in spontaneously hypertensive rats. J Nutr. 2001;131(1):39-45.

Furse RK, Rossetti RG, Zurier RB. Gammalinolenic acid, an unsaturated fatty acid with anti-inflammatory properties, blocks amplification of IL-1 beta production by human monocytes. J Immunol. 2001;1;167(1):490-496.

Garcia CM, et al. Gamma linolenic acid causes weight loss and lower blood pressure in overweight patients with family history of obesity. Swed J Biol Med. 1986;4:8-11.

Giamarellos-Bourboulis EJ, Grecka P, Dionyssiou-Asteriou A, et al. In vitro interactions of gamma-linolenic acid and arachidonic acid with ceftazidime on multiresistant Pseudomonas aeruginosa. Lipids. 1999;34:S151-152.

Griffini P, Fehres O, Klieverik L, et al. Dietary W-3 polyunsaturated fatty acids promote colon carcinoma metastasis in rat liver. Cancer Res. 1998;58:3312-3319.

Graham-Brown R. Atopic dermatitis: unapproved treatments or indications. Clin Dermatol. 2000;18(2):153-158.

Head RJ, McLennan PL, Raederstorff D, Muggli R, Burnard SL, McMurchie EJ. Prevention of nerve conduction deficit in diabetic rats by polyunsaturated fatty acids. Am J Clin Nutr. 2000;71:386S-392S.

Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma. Arch Dis Child. 1996;75(6):494-497

Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med. 1983;28(7):465-468.

Ikushima S, Fujiwara F, Todo S, Imashuku S. Gamma linolenic acid alters the cytotoxic activity of anticancer drugs on cultured human neuroblastoma cells. Anticancer Res. 1990;10:1055-1059.

Kankaanpaa P, Nurmela K, Erkkila A, et al. Polyunsaturated fatty acids in maternal diet, breast milk, and serum lipid fattty acids of infants in relation to atopy. Allergy. 2001;56(7):633-638.

Kast RE. Borage oil reduction of rheumatoid arthritis activity may be mediated by increased cAMP that suppresses tumor necrosis factor-alpha. Int Immunopharmacol. 2001;1(12):2197-2199.

Keen H, Payan J, AllawiJ, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The Gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care. 1993;16(1):8-15.

Kenny FS, Pinder SE, Ellis IO et al. Gamma linolenic acid with tamoxifen as primary therapy tn breast cancer. Int J Cancer. 2000;85:643-648.

Kris-Etherton PM, Taylor DS, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr. 2000;71(1 Suppl):179S-188S.

Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging Clin Exp Res. 1998;10:385-394.

Kruger MC, Horrobin DF. Calcium metabolism, osteoporosis and essential fatty acids: a review. Prog Lipid Res. 1997;36:131-151.

Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with black currant seed oil. Br J Rheumatol. 1994;33(9):847-852.

Leng GC, Lee AJ, Fowkes FG, et al. Randomized controlled trial of gamma-linolenic acid and eicosapentaenoic acid in peripheral arterial disease. Clin Nutr. 1998;17(6):265 - 271,

Little C, Parsons T. Herbal therapy for treating rheumatoic arthritis. Cochrane Database Syst Rev. 2001;(1):CD002948.

Madhavi N, Das UN. Effect of n-6 and n-3 fatty acids on the survival of vincristine sensitive and resistant human cervical carcinoma cells in vitro. Cancer Lett. 1994;84:31-41.

Manjari V, Das UN. Effect of polyunsaturated fatty acids on dexamethasone-induced gastric mucosal damage. Prostaglandins Leukot Essent Fatty Acids. 2000;62(2):85-96.

McCarty MF. Nutritional modulation of mineralocorticoid and prostaglandin production: potential role in prevention and treatment of gastic pathology. Med Hypotheses. 1983;11(4):381-389,

Menendez JA, del Mar Barbacid M, Montero S, et al. Effects of gamma-linolenic acid and oleic acid on paclitaxel cytotoxicity in human breast cancer cells. Eur J Cancer. 2001;37:402-413.

Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200 - Å“2211.

Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr (Phila). 1987;26:406-411.

Morphake P, Bariety J, Darlametsos J, et al. Alteration of cyclosporine (CsA)-induced nephrotoxicity by gamma linolenic acid (GLA) and eicosapentaenoic acid (EPA) in Wistar rats. Prostaglandins Leukot Essent Fatty Acids. 1994;50:29-35.

Morse PF, Horrobin DF, Manku MS, et al. Meta-analysis of placebo-controlled studies of the efficacy of Epogram in the treatment of atopic eczema: relationship between plasma essential fatty changes and treatment response. Br J Dermatol. 1989;121(1):75-90.

Munoz SE, Lopez CB, Valentich MA, Eynard AR. Differential modulation by dietary n-6 or n-9 unsaturated fatty acids on the development of two murine mammary gland tumors having different metastatic capabilities. Cancer Lett. 1998;126:149-155.

Plumb JA, Luo W, Kerr DJ. Effect of polyunsaturated fatty acids on the drug sensitivity of human tumour cell lines resistant to either cisplatin or doxorubicin. Br J Cancer. 1993;67:728-733.

Richardson AJ, Puri BK. The potential role of fatty acids in attention-deficit/hyperactivity disorder. Prostaglandins Leukot Essent Fatty Acids. 2000;63(1/2):79-87.

Rothman D, DeLuca P, Zurier RB. Botanical lipids: effects on inflammation, immune responses, and rheumatoid arthritis. Semin Arthritis Rheum. 1995;25(2):87-96.

Shils ME, Olson JA, Shike M, Ross AC. Modern Nutrition in Health and Disease. 9th ed. Baltimore, Md: Williams & Wilkins; 1999:88-90, 1347-1348.

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(3 suppl):560S-569S.

Stevens LJ, Zentall SS, Abate ML, Kuczek T, Burgess JR. Omega-3 fatty acids in boys with behavior, learning and health problems. Physiol Behav. 1996;59(4/5):915-920.

Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr. 1995;62:761-768.

Stoll BA. Breast cancer and the Western diet: role of fatty acids and antioxidant vitamins. Eur J Cancer. 1998;34(12):1852-1856.

Thompson L, Cockayne A, Spiller RC. Inhibitory effect of polyunsaturated fatty acids on the growth of Helicobacter pylori: a possible explanation of the effect of diet on peptic ulceration. Gut. 1994;35(11):1557-1561.

Tsai W-S, Nagawa H, Kaizaki S, Tsuruo T, Muto T. Inhibitory effects of n-3 polyunsaturated fatty acids on sigmoid colon cancer transformants. J Gastroenterol. 1998;33:206-212.

Wainwright PE. Do essential fatty acids play a role in brain and behavioral development? Neurosci Biobehav Rev. 1992;16(2):193-205.

Wakai K, Okamoto K, Tamakoshi A, Lin Y, Nakayama T, Ohno Y. Seasonal allergic rhinoconjunctivitis and fatty acid intake: a cross-sectional study in Japan. Ann Epidemiol. 2001;11(1):59-64.

Werbach MR. Nutritional Influences on Illness. 3rd ed. Tarzana, Calif: Third Line Press; 1999:67-70, 89-103, 206-207, 358-362, 371, 445, 455, 471, 562-565, 622-623, 657-660, 666-670, 678-683.

Whitaker DK, Cilliers J, de Beer C. Evening primrose oil (Epogam) in the treatment of chronic hand dermatitis: disappointing therapeutic results. Dermatology. 1996;193(2):115-120.

Worm M, Henz BM. Novel unconventional therapeutic approaches to atopic eczema. Dermatology. 2000;201(3):191-195.

Wu D, Meydani M, Leka LS, et al. Effect of dietary supplementation with black currant seed oil in the immune response of healthy elderly subjects. Am J Clin Nutr. 1999;70:536-543.

Yam D, Eliraz A, Berry EM. Diet and disease - Å“ the Israeli paradox: possible dangers of high omega-6 polyunsaturated fatty acid diet. Isr J Med Sci. 1996;32(11):1134-1143.

back to: Supplement-Vitamins Homepage

Self-Therapy For People Who ENJOY Learning About Themselves

These questions illustrate major points I've emphasized in various topics. Some of these major points were surprising when you first read them, so, if you've forgotten what the topics said,
you may get surprised again when check your answers!

Sometimes more than one answer is technically correct, but one answer is always best.

CHOOSE THE *BEST* ANSWER

From Life's Craziest Beliefs

1) Which of these is not one of life's craziest beliefs:

A) The world is a scary place.
B) I am alive to please people.
C) Hate and love are not opposites.
D) I can't change.

2) We often think that "everyone" believes the same "crazy beliefs" we do, mainly because:

A) We learn them through school.
B) We learn them through the media.
C) All our friends believe them.
D) They just seem so true.

From How Are You Spending Your Life?

3) Once we have plenty of physical energy, our next natural priority in life is to get enough:

A) Love and attention.
B) Money.
C) Information and learning.
D) Sex, drugs, and rock and roll.

4) When it comes to our relationships, "the more we risk the greater the reward"

A) Is true.
B) Is false.

5) People play tricky psychological "games" to get a lot of attention without the risk of being too intimate:

A) True.
B) False.

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6) Withdrawal is riskier than intimacy.

A) True
B) False.

7) We get more contact from others when we work with them than when we play psychological games with them.

A) True
B) False.

From Talking To Yourself

8) Mental self-talk that makes you feel bad always contains a "disagreement."

A) True.
B) False.

9) When you are finished updating your self-talk you will be:

A) Finished learning on your own.
B) Dead.
C) Finished learning from professionals.
D) Happy.

10) Mentally calling your parents by their first name (instead of "mom" or "dad" or "mother" or "father"):

A) Calling a Family Service Agency.
B) Calling your local Mental Health Association.
C) Either A & B.
D) Calling any good therapist.

A) Telephone interviews with a few therapists.
B) Get the opinions of friends.
C) Follow insurance company recommendations.
D) Use the Yellow Pages.

A) Something is wrong with the therapist.

B) You need their help.
C) They are probably trained in Jungian analysis.
D) They need your help.

From Getting Practical #1: The Basics

A) Is a bad idea because it's internally confusing.
B) Is very helpful.
C) Is a bad idea because it denies reality.
D) Is disrespectful.

From Are You Considering Therapy?

11) If you can't afford therapy the best way(s) to find out about inexpensive or free therapy is through:

12) Which of the following is the worst way to find a good therapist:

13) If your therapist is sure he or she knows you better than you know yourself, this shows:

14) We should take care of our physical needs (food, air, water, etc.):

A) As soon as we notice physical discomfort.
B) When we have scheduled it, not later.
C) As soon as we notice the first bit of pain.
D) When someone reminds us that we should.

15) Which of the following is the healthiest decision about alcohol:

A) "I'll never drink alcohol. It's just too risky."
B) "I'll only drink occasionally, when I feel the need."
C) "Since I'm not an alcoholic, I'll drink as often as I want to."
D) "I'll only drink when I'm happy."

16) Which of the following is true about guilt and shame:

A) Both of them are good for us.
B) Guilt can be good for us, but shame never is.
C) Neither of them is good for us.
D) Guilt is natural, but shame is not.

From Getting Practical #2: Relationships, Couples, Families and Careers

17) The main reason we have friends is:

A) To take care of each other.
B) To play together.
C) To learn from each other.

D) A, B & C Equally.

18) A parent's primary duty is:

A) To love, protect, teach and control.
B) To love, protect and teach.
C) To love and protect.
D) None of these.

19) Never apply for a new job if you think the job is "over your head."

A) True. It can be too discouraging.
B) False. It can teach you your limits.
C) True. It can waste your time.
D) False. You might actually get the job.

20) Expect to be rejected when you apply for a new job.

A) True. Rejection is a "gold star" on the road to success.
B) False. It makes you interview poorly.
C) True. You must get ready for the pain of it.
D) False. It creates low self-esteem.

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THE ANSWERS

1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20
C	C	A	A	A	B	B	A	B	B	C	C	A	A	D	C	B	C	D	A

EVALUATING YOUR ANSWERS

Go back to the original topics to learn more. Notice any question which shows you something good about how your life is going! Notice any question which shows you some way to improve your life!

Enjoy Your Changes!

Everything here is designed to help you do just that!

 

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next: I Am Curious About My Knowledge of Mental Health

Chapter 101 of the book Self-Help Stuff That Works
by Adam Khan:

SOME OF THE FIRST ZOOLOGISTS to study chimpanzees expected to find brutish apes and were surprised to see peaceful animals being tender toward each other. Later researchers, expecting to find peaceful animals, were often shocked to see them hunt monkeys and tear them limb from limb, or to see an angry male go on a rampage, sometimes injuring or even killing innocent chimp bystanders, or to see, for the first time ever in a nonhuman species, the chimpanzees engage in war.

The truth is, chimpanzees are capable of a wide range of feelings and behaviors. And that is also true of humans. Like you, for instance. Defending the life of someone close to you, you are capable of extreme brutality. When consoling a child, you're capable of the tenderest care. And everywhere in between.

You don't have a fixed personality. You change all the time. You are different now than you were even earlier today.

Any label you hold onto about yourself - a nice person, an angry person, a strong person - is foolish. It will limit you. The label is limiting, and when you force yourself to act in a way consistent with your label, you are taking something big and complex and trying to fit it into a small, simple container. You have to shave off a whole spectrum of behaviors and feelings you're capable of, some of which would be useful.

It's like being a carpenter but labelling yourself only as "the kind of person who hammers." What do you do when you need to saw something? You could grab a saw and get it done quickly. But if you've limited yourself to hammering, you'll pound away till the sun goes down and your work will look terrible when you're done.

Don't limit yourself. Don't label yourself. You're a human being and you're far more flexible than you think. Don't block yourself from your perception of other aspects of yourself. You're not dominate or submissive, inquisitive or close-minded, strong or sensitive - you're capable of all them. Like a carpenter using a wide range of tools, use your full spectrum of personality where it works best and you will accomplish more, get along better with others, and be happier.

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Don't limit yourself by giving yourself a narrow label.

Three simple techniques for improving your reading speed.
Speedy Reading

How to enjoy your work more, ultimately get paid more, and feel more secure on the job.
Thousand Watt Bulb

Here's a way to make your work more enjoyable.
Play the Game

One way to be promoted at work and succeed on the job may seem entirely unrelated to your actual tasks or purpose at work.
Vocabulary Raises

This is a simple technique to allow you to get more done
without relying on time-management or willpower.
Forbidden Fruits

next: Necessary Conflict

YOU CAN ORDER your own hardbound, lithowrapped, Smythe sewn, 384-page copy of Self-Help Stuff That Works online at any of the locations listed below. Click on the name, and it will take you to our book's page on their site.

Self-Help Stuff That Works is about as well-made as a book can be. The cover design is laminated right onto this hardbound book. The binding is sewn, so it lays open easily and won't crack or fall apart, even after years of hard use.
And this book was designed to be used. It is made to be referred to again and again when you need some counsel. When you're feeling blue or tired or at the end of your rope, or when you need a boost or just want to feel better, reach for this book. It is easy, enjoyable reading and the chapters are brief. Each of the chapters (there are over a hundred) ends with a simply-stated principle you can apply.
Since the things we learn are not etched in stone but stored in a gooey organ, an organ we use every day, it's important to not only learn good ideas, but to be reminded of them when we need them. Otherwise, the incoming information we are bombarded with every day tends to push the things we "know" into the back of our minds, and, while it is not forgotten, it is hard to remember when we need it.

• BarnesandNoble.com
• Amazon.com
• Books-A-Million.com
• A1Books.com
• Positively You (search)
• In Canada: !ndigo.ca
• In Australia: OzBooks.com

Most of the chapters are short enough to read in five minutes or less, and at the end of that five minutes, you'll come away with a technique you can use to improve either your situation or your attitude toward it.

Retail price of the book:
USA $25.00
CANADA $34.00

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Another way of acquiring the book is to show the following information to any bookstore and they can order the book for you there.

Title: Self-Help Stuff That Works
Author: Adam Khan
ISBN: 0-9624656-7-4

If you have any difficulties, write us at youme@aol.com. Your e-mail address will not be put on our mailing list, and we will not give it to anyone else. We will respond promptly.

bite-size self-help stuff that works:

Find out why failing at losing weight may be a good thing. Click here.

How can you make people like you for five cents? Click here.

How can you have more time (and less stress)? Click here.

The ancient Hindus used the same technique as modern cognitive therapy to lessen human suffering. Curious? Click here.

Is there a quick and easy way to stop yourself from feeling angry or annoyed? Click here.

Count your blessings, appreciate what you have, and feel more satisfied with your life. Click here.

There is an enormous body of accumulated scientific evidence that optimism becomes a self-fulfilling prophesy. Click here.

How you can improve your health without spending money or breaking a sweat? Click here.

The secret of success is persistence. But how can you become more persistent? There's a hard way and an easy way. Click here.

Enhance the quality of your life using a technique developed in one of Hitler's concentration camps. Click here.

How is it possible that pessimistic thoughts in your head could shut down your immune system? The evidence is in. Click here.

next: LINKS to (mostly) Self-Help Resources

Learn about Autogenic Therapy, a deep relaxation technique for treatment of anxiety, stress and depression.

Before engaging in any complementary medical technique, you should be aware that many of these techniques have not been evaluated in scientific studies. Often, only limited information is available about their safety and effectiveness. Each state and each discipline has its own rules about whether practitioners are required to be professionally licensed. If you plan to visit a practitioner, it is recommended that you choose one who is licensed by a recognized national organization and who abides by the organization's standards. It is always best to speak with your primary health care provider before starting any new therapeutic technique.

• Background
• Theory
• Evidence
• Unproven Uses
• Potential Dangers
• Summary
• Resources

Background

Autogenic therapy uses visual imagery and body awareness to promote a state of deep relaxation. A detached but alert state of mind called "passive concentration" must be achieved for autogenic therapy exercises to be carried out. People participating in autogenic therapy are taught relaxation and body awareness techniques. It is believed that these approaches can then be used lifelong to promote a more healthy lifestyle, allowing people to call on their own capacity for self healing and stress reduction.

Autogenic therapy was developed in the 20th century by Dr. Johannes Schultz, a psychiatrist and neurologist. Dr. Shultz was influenced by the research of Professor Oscar Vogt, a psychiatrist and neurophysiologist who studied psychosomatic medicine. In the 1940s, Dr. Wolfgang Luthe added repetitive therapeutic suggestions to the autogenic technique.

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Theory

In autogenic therapy, achievement of a detached but alert state of mind called "passive concentration" is thought to bring about physical changes. Supporters of this technique assert that autogenic therapy enhances healing and the recuperative powers of the body. Autogenic therapy has been said to rebalance mental faculties and bring closer harmony between the hemispheres of the brain.

Autogenic therapy consists of six basic focusing techniques:

• Heaviness in the limbs
• Warmth in the limbs
• Cardiac regulation
• Centering on breathing
• Warmth in the upper abdomen
• Coolness in the forehead

These techniques are based on autosuggestion; in this way, autogenic therapy is similar to meditation or self-hypnosis. A person using autogenic therapy assumes a comfortable position, concentrates on a goal and uses visual imagination and verbal cues to relax the body. Autogenic therapy may involve imagining a peaceful place followed by focusing on different physical sensations, moving from the feet to the head.

The possible mechanism of action of autogenic therapy is not fully understood. It has been suggested that it works in ways similar to hypnosis or biofeedback.

Evidence

Scientists have studied autogenic therapy for the following health problems:

Gastrointestinal conditions
Preliminary research reports some improvements in gastrointestinal disorders (constipation, diarrhea, gastritis, stomach ulcers, stomach ache, chronic nausea and vomiting or spasm), although more studies are necessary before a recommendation can be made. Patients with ulcers should be evaluated by a health care provider.

Cardiovascular conditions
Initial studies suggest possible benefits of autogenic therapy in people with heart or blood vessel disorders (palpitations, irregular heartbeat, high blood pressure, cold hands or feet). However, this research is preliminary, and additional studies are necessary before a conclusion can be made. Patients with these potentially severe conditions should be evaluated by a health care provider.

Anxiety, stress, depression
Studies of autogenic therapy for anxiety report mixed results, and it is not clear if there is any benefit. For example, one randomized controlled trial suggests autogenic training may play a role in reducing anxiety in patients undergoing coronary angioplasty (catheterization). Another randomized controlled trial found cancer patients receiving autogenic training to have an improvement in stress levels. Early evidence suggests that autogenic therapy may not be an appropriate treatment for depression.

HIV/AIDS
Some researchers have reported improvements in HIV complications, including decreased pain, night sweats, weight loss and diarrhea. There are also controversial reports of longer survival, although these findings were noted before the current era of HAART (highly active antiretroviral therapy), which has significantly lengthened survival time in HIV. Research in these areas is not conclusive, and further studies would be helpful.

Hyperventilation
Early evidence reports some benefits of autogenic therapy in people who hyperventilate, although further research is necessary before a firm conclusion can be drawn.

Behavior problems
Preliminary research suggests autogenic relaxation may reduce stress and psychosomatic complaints in children and adolescents. Further research is needed before clear recommendations can be made.

Other
Autogenic therapy has been studied for a number of other conditions, including asthma, eczema, glaucoma, headache (migraine and tension), facial pain (myofascial paid disorders) and thyroid disease. This research is early and is not conclusive. More research would be helpful in these areas.

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Unproven Uses

Autogenic therapy has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially life-threatening. Consult with a health care provider before using autogenics for any use.

Angina Anorexia Asthma Behavioral problems Biliary disorders Bladder disorders Blepharospasm (involuntary winking) Blushing Brain injury Cancer Cerebral palsy Chronic fatigue syndrome Chronic pain Circulation disorders Decreased need for pain medication Degenerative joint disease Diabetes Dyspepsia Eating disorders Enhanced athletic performance Enhanced creativity Enhanced healing Epilepsy Exercise performance Facial spasm Food allergy Grief Headache High cholesterol Improved concentration Improved performance at work Improved stress hormone levels Increased survival time in illnesses Infertility Insomnia

Irritable bowel syndrome Ischemic heart disease Jet lag Joint pain Longevity Low back pain Muscle tension Nervous cough Neuralgia (nerve pain) Night sweats Obesity Pain Panic disorder Parkinson's disease Phantom limb pain Phobias Post-traumatic stress disorder Premenstrual syndrome Pregnancy Psychotherapy Quality of life Raynaud's disease Recovery from heart attack Recurrent infections Reduced heart attack risk Rheumatoid arthritis Sexual dysfunction Sleep disorders Stress-related disorders Tranquilizer addiction Tremor Ulcerative colitis Ventricular (heart) arrhythmias Weight loss Wound healing

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Potential Dangers

Autogenic therapy is thought to be safe for most people, although safety has not been thoroughly studied. Some people may experience a sharp increase or decrease in blood pressure when they do autogenic therapy exercises. If you have abnormal blood pressure or a heart condition, or if you are taking blood pressure drugs, speak with your health care provider before starting autogenic therapy.

Before beginning a program to learn autogenic therapy, have a physical exam and discuss possible physiological effects with your health care provider. If you have a potentially severe health condition such as diabetes, heart disease or high or low blood pressure, practice autogenic therapy only under the supervision of a qualified health care provider.

Autogenic therapy should not replace more proven treatments (for example, prescription drugs, diet or lifestyle changes) for severe illnesses. Autogenic therapy is not recommended for children younger than 5 or for people with severe mental or emotional disorders. If you become anxious or restless during or after autogenic therapy exercises, stop autogenic therapy or continue only under the supervision of a professional autogenic therapy instructor.

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Summary

Autogenic therapy has been recommended for many conditions. There is early evidence suggesting benefits in some cardiovascular and gastrointestinal disorders. However, there is no definitive scientific evidence that supports the use of autogenic therapy for any condition. Autogenic therapy is generally regarded as safe in most people, although it may not be advisable in young children and patients with emotional disturbances. Blood pressure changes may occur during autogenic therapy, and people with heart disease should speak with a health care provider before starting therapy.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Resources

1. Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
2. National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Selected Scientific Studies: Autogenic Therapy

Natural Standard reviewed more than 330 articles to prepare the professional monograph from which this version was created.

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Some of the more recent studies are listed below:

1. Ar'kov VV, Bobrovnitskii IP, Zvonikov VM. Complex correction of functional state in subjects with psychoautonomic syndrome [Article in Russian]. Vopr Kurortol Fizioter Lech Fiz Kult 2003;Mar-Apr, (2):16-19.
2. Blanchard EB, Kim M. The effect of the definition of menstrually-related headache on the response to biofeedback treatment. Appl Psychophysiol Biofeedback 2005;30(1):53-63.
3. Deter HC, Allert G. Group therapy for asthma patients: a concept for the psychosomatic treatment of patients in a medical clinic. A controlled study. Psychother Psychosom 1983;40(1-4):95-105.
4. Devineni T, Blanchard EB. A randomized controlled trial of an internet-based treatment for chronic headache. Behav Res Ther 2005;43(3):277-292.
5. Ehlers A, Stangier U, Gieler U. Treatment of atopic dermatitis: a comparison of psychological and dermatological approaches to relapse prevention. J Consult Clin Psychol 1995;63(4):624-635.
6. El Rakshy M, Weston C. An investigation into the possible additive effects of acupuncture and autogenic relaxation in the management of chronic pain. Acupunct Med 1997;15(2):74.
7. Ernst E, Kanji N. Autogenic training for stress and anxiety: a systematic review. Complement Ther Med 2000;8(2):106-110.
8. Ernst E, Pittler MH, Stevinson C. Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments. Am J Clin Dermatol 2002;3(5):341-348.
9. Farne M, Corallo A. Autogenic training and signs of distress: an experimental study. Boll Soc Ital Biol Sper 1992;68(6):413-417.
10. Galovski TE, Blanchard EB. Hypnotherapy and refractory irritable bowel syndrome: a single case study. Am J Clin Hypn 2002;Jul, 45(1):31-37.
11. Goldbeck L, Schmid K. Effectiveness of autogenic relaxation training on children and adolescents with behavioral and emotional problems. J Am Acad Child Adolesc Psychiatry 2003;42(9):1046-1054.
12. Gordon JS, Staples JK, Blyta A, et al. Treatment of posttraumatic stress disorder in postwar Kosovo high school students using mind-body skills groups: a pilot study. J Trauma Stress 2004;17(2):143-147.
13. Groslambert A, Candau R, Grappe F, et al. Effects of autogenic and imagery training on the shooting performance in biathlon. Res Q Exerc Sport 2003;74(3):337-341.
14. Gyorik SA, Brutsche MH. Complementary and alternative medicine for bronchial asthma: is there new evidence? Curr Opin Pulm Med 2004;10(1):37-43.
15. Henry M, de Rivera JL, Gonzalez-Martin IJ, et al. Improvement of respiratory function in chronic asthmatic patients with autogenic therapy. J Psychosom Res 1993;37(3):265-270.
16. Galovski TE, Blanchard EB. Hypnotherapy and refractory irritable bowel syndrome: a single case study. Am J Clin Hypn 2002 Jul;45(1):31-37.
17. Essential hypertension and stress. When do yoga, psychotherapy and autogenic training help? [Article in German]. MMW Fortschr Med 2002;May 9, 144(19):38-41.
18. Hidderley M, Holt M. A pilot randomized trial assessing the effects of autogenic training in early stage cancer patients in relation to psychological status and immune system responses. Eur J Oncol Nurs 2004;8(1):61-65.
19. Huntley A, White AR, Ernst E. Relaxation therapies for asthma: a systematic review. Thorax 2002;Feb, 57(2):127-131.
20. Ikezuki M, Miyauchi Y, Yamaguchi H, Koshikawa F. Development of Autogenic Training Clinical Effectiveness Scale (ATCES) [Article in Japanese]. Shinrigaku Kenkyu 2002;Feb, 72(6):475-481.
21. Kanji N, White AR, Ernst E. Autogenic training reduces anxiety after coronary angioplasty: a randomized clinical trial. Am Heart J 2004;147(3):E10.
22. Kanji N. Management of pain through autogenic training. Complement Ther Nurs Midwifery 2000;6(3):143-148.
23. Kanji N, White AR, Ernst E. Anti-hypertensive effects of autogenic training: a systematic review. Perfusion 1999;12:279-282.
24. Kermani KS. Stress, emotions, autogenic training and aids. Br J Holist Med 1987;2:203-215.
25. Kircher T, Teutsch E, Wormstall H, et al. Effects of autogenic training in elderly patients [Article in German]. Z Gerontol Geriatr 2002;Apr, 35(2):157-165.
26. Kornilova LN, Cowings P, Arlashchenko NI, et al. Individual characteristics of correction of the cosmonauts' vegetative status with a method of adaptive biofeedback [Article in Russian]. Aviakosm Ekolog Med 2003;37(1):67-72.
27. Labbe EE. Treatment of childhood migraine with autogenic training and skin temperature biofeedback: a component analysis. Headache 1995;35(1):10-13.
28. Legeron P. Stress psychology and the role of stress management [Article in French]. Ann Cardiol Angeiol (Paris) 2002;Apr, 51(2):95-102.
29. Linden W. Autogenic training: a narrative and quantitative review of clinical outcome. Biofeedback Self Regul 1994;19(3):227-264.
30. Matsuoka Y. Autogenic training [Article in Japanese]. Nippon Rinsho 2002;Jun, 60(Suppl 6):235-239.
31. O'Moore AM, O'Moore RR, Harrison RF, et al. Psychosomatic aspects in idiopathic infertility: effects of treatment with autogenic training. J Psychosom Res 1983;27(2):145-151.
32. Perlitz V, Cotuk B, Schiepek G, et al. [Synergetics of hypnoid relaxation]. Psychother Psychosom Med Psychol 2004;54(6):250-258.
33. Rashed H, Cutts T, Abell T, et al. Predictors of response to a behavioral treatment in patients with chronic gastric motility disorders. Dig Dis Sci 2002;May, 47(5):1020-1026.
34. Simeit R, Deck R, Conta-Marx B. Sleep management training for cancer patients with insomnia. Support Care Cancer 2004;12(3):176-183.
35. Stetter F. A review of controlled studies with autogenic training. Curr Opin Psych 1999;12(Suppl 1):162.
36. Stetter F, Kupper S. Autogenic training: a meta-analysis of clinical outcome studies. Appl Psychophysiol Biofeedback 2002;Mar, 27(1):45-98.
37. ter Kuile MM, Spinhoven P, Linssen AC, et al. Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups. Pain 1994;58(3):331-340.
38. Unterberger PG. High blood pressure and renal lesions: curable with hypnosis? [Article in German]. MMW Fortschr Med 2002;Feb 28, 144(9):12.
39. Watanabe Y, Cornelissen G, Watanabe M, et al. Effects of autogenic training and antihypertensive agents on circadian and circaseptan variation of blood pressure. Clin Exp Hypertens 2003;25(7):405-412.
40. Winocur E, Gavish A, Emodi-Perlman A, et al. Hypnorelaxation as treatment for myofascial pain disorder: a comparative study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;Apr, 93(4):429-434.
41. Wright S, Courtney U, Crowther D. A quantitative and qualitative pilot study of the perceived benefits of autogenic training for a group of people with cancer. Eur J Cancer Care (Engl) 2002;Jun, 11(2):122-130.
42. Zsombok T, Juhasz G, Budavari A, et al. Effect of autogenic training on drug consumption in patients with primary headache: an 8-month follow-up study. Headache 2003;Mar, 43(3):251-257.

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