Short essay on the meaning of "hometown" - where we grew up as children is the home of our soul and childhood memories.

Life Letters

By the time you read this, I'll be back in Maine, the state where I was born and called home for much of my life. I'm not permanently moving out of South Carolina, although I can certainly understand the secret and sometimes not so secret wish of those southerners who would like to see we northerners pack up and head back from whence we came. I honestly don't blame them. Had I been born and raised in the south, I would probably feel the same way. And yet, to those southerners who wish us good riddance, sorry, I'm not leaving. I know a good thing when I've found it, and while my love for this state may not ever equal that of the natives, I cherish it still. I've been captivated by its scenic vistas, its magical and magnificent awakening at spring time, its diversity of both its landscapes and its people, and by its rich cultural heritage. I have never for a moment taken any of its gifts for granted, and I never will.

And yet, there is this call homeward, this yearning for utterly familiar places and faces, for the sense of absolute belonging and security that I have yet to feel anywhere else. It was Thomas Wolfe, the renowned southern author who perhaps captured this longing best for me when he wrote, "In every man there are two hemispheres of light and dark, two worlds discrete, two countries of his soul's adventure. And one of these is the dark land, the other half of his heart's home, the unvisited domain of his father's earth." While South Carolina is my warm and sunny land of light and of adventure, it is my father's earth that has been calling to me; the land where he was born and raised his children, the land that he loved, and that I dreamed of leaving, my dark land, and his soul's home.

It was also Thomas Wolfe who observed that we can't go home again. His words ring true in my case, I can't. The house that I grew up in will be sold this summer and its doors once and for all will be closed to me. My parents and sister followed me southward, my grandparents are deceased, and a number of my closest friends from childhood have moved away. Many of the buildings I remember, although smaller than I recall, are still standing, but they no longer house the shops we used to frequent, and few of the faces I encountered on the streets were familiar ones the last time I visited.

I left Maine when I was seventeen in search of what Wolfe described as "a land more kind than home." I believe that I have finally found this land here in the south, a place that feels gentler, if not kinder, one that I have settled into and appreciate; the place my father's grandchildren now call home.

I'll be spending the summer and early autumn in a small town in central Maine, not the place that I grew up in, but one that resembles it closely enough to introduce my daughter to a world that bares some resemblance to the one where I was raised. I want to share with her some of those blessings I left behind, to spend some time with people who share many of my childhood memories, and I want to answer an age old and inexplicable call from home.

I'll write once I'm settled in.

next: Life Letters: The Love Tree

A look at effectiveness of self-help measures and alternate therapies for treating depression.

There are a wide range of self-help measures and alternate therapies which can be useful for some types of depression, either alone or in conjunction with physical treatments (such as antidepressants)or psychological treatments.

However, the more biological types of depression (melancholic and psychotic depression) are very unlikely to respond to self-help and alternative therapies alone although these can be valuable adjuncts to physical treatments.

What follows is not intended to be an exhaustive list, but includes those which are more commonly found helpful. We provide brief information and links to other sources of information. We also have information on other self-help measures for depression such as meditation, diet, exercise and relaxation.

• Bibliotherapy
• Omega-3
• St John's Wort
• Light therapy
• Yoga
• Aromatherapy
• Massage therapy
• Acupuncture

Bibliotherapy

Bibliotherapy involves, essentially, reading books or other materials (such as those available via the Internet) on how to overcome depression and applying the practices oneself. (Recommended Australian books are 'Beating the Blues: A Self-help Approach to Overcoming Depression', by S Tanner and J Ball and 'Dealing with Depression: A common sense guide to mood disorders', by Gordon Parker.) The person works independently (or with some supervision) through the material, applying the techniques outlined in it. Bibliotherapy usually uses the cognitive behavior therapy approach.

Omega-3 for Treatment of Depression

There is some evidence that Omega-3 oils, commonly found in fish such as salmon, tuna, mackerel and swordfish, play a role in mental well-being, particularly in cases of bipolar disorder, but some studies also demonstrate antidepressant properties.

St John's Wort for Treatment of Depression

St John's Wort is a popular herbal remedy for depression. It is a flower with many chemical compounds, some of which are believed to help depression by preventing nerve cells in the brain from reabsorbing the chemical messenger serotonin, or by reducing levels of a protein involved in the body's immune system functioning.

Studies have shown that St John's Wort is an effective antidepressant in cases of people with mild non-melancholic depression but ineffective for people with melancholic (biological) depression.

St John's Wort can have side-effects however. There are several reports suggesting that it may have some toxic effects on reproductive functioning. There are other possible problems with St John's Wort, including possible interactions with certain medications.

Light therapy for Treatment of Seasonal Affective Disorder

Light therapy involves exposing someone to bright light for around a half an hour each day. The bright light can be either in the form of conventional fluorescent lamps or bright sunlight.

Light therapy has been shown to have particular benefit for people who suffer from a form of depression known as Seasonal Affective Disorder (SAD), where depression occurs on a regular basis in particular seasons (especially autumn and winter) and then goes away in the alternate seasons (spring and summer). This condition is more common in the northern hemisphere, but it does exist in Australia.

Yoga for Treating Depression

Yoga is an ancient Indian exercise philosophy that provides a gentle form of exercise and stress management. It consists of postures or 'asanas' that are held for a short period of time and are often synchronized with the breathing. It is very helpful for reducing stress and anxiety which are often precursors to depression. A number of studies have shown that yoga breathing exercises are beneficial for depression.

Aromatherapy for Treating Depression

Aromatherapy is the use of essential oils to produce different emotional and physiological reactions. There is some evidence that aromatherapy can be helpful in alleviating mental disorders including depression.

A Study at Yale University found that some essential oils affect the nervous system, can help relieve tensions and anxieties, and even reduce blood pressure. A number of essential oils are believed to be especially beneficial in the treatment of depression as they help to balance and relax the nervous system.

Massage therapy for Treatment of Depression

Massage therapy is believed to be helpful for people with depression, although further studies are needed to conclusively prove this. Massage produces chemical changes in the brain that result in a feeling of relaxation, calm and well-being. It also reduces levels of stress hormones - such as adrenalin, cortisol and norepinephrine - which in some people can trigger depression.

Acupuncture for Treating Depression

Acupuncture is an ancient form of healing developed within the traditional medicine China , Japan and other eastern countries. Acupuncture is based on the principle that stimulation of specific areas on the skin affects the functioning of certain organs of the body. Fine needles are inserted into specific points (called acupuncture points) just below the surface of the skin. It is believed that acupuncture can help to relieve depression, along with anxiety, nervous tension and stress.

A small number of studies support the view that acupuncture plays a valuable role in alleviating depression.

Other self-help measures include: meditation, relaxation, a healty diet, alcohol and drug avoidance, and exercise.

Sources: Office of Dietary Supplements - NIH, National Center for Complementary and Alternative Medicine

next: Complimentary Therapies for Depression

Nutrition therapy, could it be the key to treating alcoholism? Learn about nutrition treatment for alcoholics and how it differs from traditional alcoholism treatment.

AA Meetings Weren't Enough

By the time Kathi Tuff finally discovered the treatment method that ended her dependence on alcohol, she'd been binge drinking for 23 of her 37 years and in and out of Alcoholics Anonymous (AA) for 13. "I remember being 15 and having guzzling contests with a group of guys at the local pizza joint and winning," says Tuff, who started drinking in the ninth grade. "I could drink anyone under the table."

Tuff first went into rehab in 1989 at the age of 24, but found recovery a series of false starts. "I'd binge for three weeks, then white-knuckle it. I always wanted to drink," she says. She fought depression, cravings, and constant emotional pain. AA meetings helped, but not enough.

"I was sober for ten years until 1999, when I really messed up," she says. The pain of a tough divorce weakened her resolve, and just after starting to date the man who is now her husband, Tuff went on a three-day bender. "Denny went out of town for the weekend and I just lost it. When he came back, he had to pick up the pieces."

Tuff's experience of relapsing after ten years of sobriety is more common than people might think. The shameful secret about modern alcoholism treatment is its abysmal long-term success rate. A commonly cited statistic for alcohol treatment programs nationwide is less than 20 percent recovery after one year. Think about it: That means that of every five people who enter an addiction program, only one will actually stay sober.

Luckily for Tuff, her husband-to-be was uniquely suited to help her. A recovering alcoholic himself, Denny Tuff is an alcoholism counselor and residential manager at Bridging the Gaps, a treatment program in Winchester, Virginia. Thanks to his 30 years of experience with recovering alcoholics, he knew there was a different approach that might work for Kathi. He insisted that she consult Charles Gant, a Washington, D.C.-based physician (now retired from practice) and author of End Your Addiction Now.

Gant is among a handful of mavericks who are convinced that the standard approach to alcoholism is missing an essential component: a biochemical way to loosen alcohol's grip. Their methods, which are slowly gaining acceptance, put a twist on the mind/body dynamic underlying traditional treatment programs.

Most such programs, with their emphasis on daily counseling sessions and attendance at AA meetings, focus on the mind. The 12 steps of AA couldn't be a more dramatic example of the belief that to control the body, you must first control the mind: "Admit that you are powerless over alcohol and that your life has become unmanageable," reads the first of the 12 steps. Another counsels taking "a searching and fearless moral inventory."

Alcoholism - A Biochemical Imbalance

Gant and his colleagues believe that the body's needs must be attended to first. In their view, alcoholism is primarily a brain chemistry imbalance fueled by a deficiency in certain nutrients. A critical part of treating it, then, is to replenish those missing nutrients. Eating a diet high in protein, brain-healthy fats, and high-fiber carbohydrates, and taking supplements that include vitamins, minerals, and amino acids, they say, can actually rewire the brain to reduce cravings.

"We've accepted that alcoholism is a disease," Gant says. "Now we have to start treating it like one." The notion that alcoholism biochemical basis isn't brand new, of course. The first glimmerings came in the 1960s, and it was in 1990 that genetics researcher Kenneth Blum identified a gene that causes some people's brains to react differently to alcohol, setting the stage for addiction. Since then a vast body of research, much of it involving rats and mice, has documented alcohol's biochemical effects on the brain. We now know much more than we used to about why it's so terribly difficult for some alcoholics to get sober and stay that way.

"For the alcoholic, metabolism is far stronger than free will," says Amityville, New York, physician Joseph Beasley, an early proponent of research into the brain chemistry underlying addiction and the author of How to Defeat Alcoholism: Nutritional Guidelines for Getting Sober. "Diet and nutrition therapy should be part of any alcohol treatment program."

Yet most psychiatrists, counselors, and doctors in the field are woefully ignorant of the concept. "Alcoholism is a physical disease," says Joan Mathews Larson, a nutritionist who's the author of Seven Weeks to Sobriety and director of the influential Health Recovery Center, an outpatient treatment program headquartered in Minneapolis. "So treatment should offer more than just talk. It's like saying a person's diabetes can be turned around by 'taking a searching and fearless moral inventory'. Meanwhile, every organ in their body is collapsing." Larson, whose crusade to treat alcoholism with nutrition therapy was launched when her son committed suicide after completing a residential program, published a study showing that 74 percent of alcoholics who finished her program were still sober more than three years later.

It's not that those who advocate a nutritional approach think AA-based programs are entirely off-base. In fact, all the treatment programs that feature nutritional therapy also include either 12-step sessions or some other type of counseling. The point is that beating alcoholism requires shoring up the body as well as the mind.

How Nutritional Therapy for Alcoholism Works

The cornerstone of the Nutritional approach is to reduce the body's dependence on the simple carbohydrates that, like alcohol, convert quickly to sugar in the bloodstream: white bread, pasta, rice, and many baked goods. Relying on such refined carbs, nutritional advocates say, promotes the same blood sugar highs and lows that alcohol does, which can stoke the desire to drink.

What's more, alcoholics often respond to the steady infusion of sugar into their bodies by overproducing insulin, which then removes dangerously high amounts of sugar from the blood. Plummeting blood sugar, known as hypoglycemia, can lead to anxiety, irritability, and cravings—anything to get sugar, or, in this case, alcohol, back in the bloodstream.

The anti-alcohol diet emphasizes high-protein foods rich in amino acids. Substituting protein for simple carbohydrates helps break the vicious cycle of blood sugar cravings, and the amino acids are key to brain function. "We're giving the brain certain foods so it can make the natural chemicals we need to feel happy," says Julia Ross, who's the author of The Mood Cure and director of Recovery Systems in Mill Valley, California.

Alcohol, it seems, tamps down the body's ability to make neurotransmitters that affect mood. Chemicals produced when alcohol is metabolized are similar to the mood-lifters dopamine and serotonin; hence that giddy feeling we get with the first drink. This, along with the big boost of blood sugar, brings a temporary high.

But in the long term, an alcoholic's brain, fooled by the continual presence of feel-good chemicals from alcohol, shuts down production of its own. The result: depression, anxiety, mood swings, and the constant urge to drink to feel better.

Nutritional treatment aims to restore the body's natural supply of these chemicals. But everyone's metabolism is different, so the approach must be highly customized. Gant, for instance, uses blood tests to determine if a patient is primarily deficient in serotonin, dopamine, GABA, or endorphins.

Another key element of the recovery diet is fat, which many experts contend has been given an undeserved bad name. Beasley is a fan of olive oil, while Ross even touts butter and other foods containing saturated fat. Omega-3 fatty acids, found in fish like salmon and sardines are also favored. Fats are burned steadily over long periods of time, so they help keep blood sugar levels stable. And omega-3s are thought to boost levels of dopamine in the brain.

Certain supplements, too, are essential to the nutritional approach, though these must be tailored to a person's individual body chemistry. The amino acid glutamine is thought to be crucial for quelling cravings during alcohol withdrawal. Key neurotransmitter boosters include DLPA, which jump-starts endorphin production, and tyrosine, a mood-lifter. And most programs feature 5-HTP or prescription tryptophan, which help the body make serotonin. (See "The Recovery Diet," page 80, for more details.)

What does all this nutritional advice look like on a plate? A typical day would almost certainly start with eggs, perhaps in the form of a vegetable-rich omelet. Lunch and dinner are usually built around fish or chicken paired with vegetables, with some nuts and beans thrown in for good measure. Ross, Larson, Beasley, and Gant all have favorite foods—Ross calls them "good mood foods"—that they advocate eating as often as possible. Eggs, because they're high in protein and amino acids, are at the top of everyone's list, along with avocados, olive oil, almonds, and greens. And every person would also take his or her own mix of supplements.

A Major Difference Between Nutrition and Traditional Alcoholism Treatment

One last thing: These programs also require recovering alcoholics to give up all addictive substances, including caffeine and nicotine. Sugar is a no-no, too. This flies in the face of standard alcohol treatment, which holds that it's punishment enough for an alcoholic to give up booze, so if he or she needs other "crutches" to get by, so be it. (In fact, at many meetings in AA and 12-step based programs, there's a ready supply of candy and cookies.) Nope, say the nutrition experts, it all has to go.

"Sugar, caffeine, and nicotine are dangerous traps for the alcoholic," says Beasley bluntly. "You feel better for a little while, but then your energy level crashes and you feel worse. We have to get people off the roller coaster."

Jeff Underhill*, who lives in the San Francisco Bay Area, was on that roller coaster for years until he changed his diet six months ago. Following the plan in Julia Ross's The Mood Cure, he's eliminated sugar and white flour, substituting protein, vegetables, fish oils, and amino acid supplements. The new way of eating has definitely paid off: "I've lost the craving for alcohol," he says. "My wife still has a glass of wine at night and it actually smells repugnant to me—I don't have any desire for it." Even without the alcohol, he's finding it easier to cope with the stresses of his high-pressure job in technology.

If the nutritional approach to alcohol treatment is so promising, why isn't it more widespread? It's not like there isn't any research to back it up. Numerous studies comparing it to more traditional treatment have been undeniably impressive.

One, at a veterans' hospital in Waco, Texas, studied people who'd been hard-core alcoholics for up to 20 years. At the end of six months of nutritional treatment, 81 percent were still sober, compared with 38 percent of the control group. (Remember, the average recovery rate among standard treatment programs is only 20 percent.) In San Mateo, California, a pilot program treating alcoholics with amino acid supplements was also highly successful, with 73 percent of participants sober at the end of treatment.

"It works, and we've just got to get those in mainstream alcohol treatment to realize that it does," says Beasley.

The reasons it hasn't taken hold are many, says Julia Ross. Most addiction counselors come from a psychological rather than a physiological background, she says, and most doctors don't get much training in nutrition. A final deterrent is AA's abhorrence of anything that resembles "pill popping," which makes it difficult to sell a daily regimen of supplements.

There's also some skepticism on the part of mainstream experts about amino acid supplements in particular. Some endocrinologists argue that, when taken orally, they never make it past the blood-brain barrier and so have no effect. "It's called the placebo effect," says one endocrinologist drily. Other experts are on the fence, waiting for further research. Endocrinologist Anthony Karpas of Atlanta argues that the actions of certain amino acids, such as tryptophan, are well-known and that these remedies have real potential.

When it comes to viewing alcoholism as a brain chemistry problem, though, the tide of mainstream medical opinion is clearly turning. Last year the National Institutes of Health (NIH)'s Institute on Alcohol Abuse and Alcoholism announced a five-year initiative to study the brain chemistry that underlies alcoholism. The NIH has also held several workshops that included presentations on using fatty acids to treat alcoholism. Another encouraging development is the recent appointment of Nora Volkow as director of the National Institute on Drug Abuse; her research has helped establish the importance of dopamine in addiction. Taken together, these changes suggest that brain chemistry may finally be achieving its rightful place at the center of addiction research.

But these changes won't amount to much if nutrition doesn't make it into the mainstream alcohol treatment programs where the majority of alcoholics seek help. "We need to engineer this at the establishment level," Beasley says. "This is very good science that simply isn't being practiced."

Kathi Tuff is proof positive that nutritional treatment has the power to turn a life around. "I feel so much better than I've ever felt," she says. "I just wanted the alcohol out of my system— and to stop wanting it. Finally, it feels like that's happened."

Finding Help

If you or a loved one are seeking recovery and want to incorporate nutritional therapy into the plan, your best bet is to work with a specialist or enter one of the nutrition-based recovery programs around the country. That's because this approach is most effective when it's customized to your individual body chemistry; it's not recommended as a go-it-alone solution.

Some of these programs are residential; others are outpatient but provide housing for out-of-state clients. Still others offer long-distance counseling. Insurance coverage varies; check with your insurer to find out whether you're covered. Here's a list of the programs.

Nutritional Consulting Services

Connected Pathways
Karyn Hurley
888.847.4233
315.472.1476
www.connectedpathways.com

Recovery Systems
Julia Ross
415.383.3611, ext. 1

Residential Programs

Bridging the Gaps Treatment Program
423 W. Cork St.
Winchester, Virginia 22601
866.711.1234
540.535.1111
www.bridgingthegaps.com

Desert Canyon Treatment Center
Sedona, Arizona
888.811.8371
www.desert-canyon.com

Health Recovery Center
(two locations)
3255 Hennepin Ave. S.
Minneapolis, Minnesota 55408 612.827.7800

Health Recovery Center
50 S. Steele St., Suite 330
Denver, Colorado 80209
720.941.0442
866.244.8866
www.healthrecoverycenter.com

Lake Grove Treatment Centers of New York, Inc.
3390 Rte. 112
Medford, New York 11763
631.205.1950, ext. 222

Source: Alternative Medicine

back to: Complimentary and Alternative Medicine

• About Change
• About Joy
• About Love
• Analyzing Your Dreams
• Angels, Infants, and Hope
• Clear Communication: #1
• Clear Communication: #2
• Couples: Passive & Controlling Partners
• Depression In The Culture
  
• Employment
• Growing Up Emotionally
• How Happy Couples Stay That Way
• How Much Change Is Possible?
• How To Have A Lousy Sex Life
• How To Talk About Feelings
• How Are You Spending Your Life?
• Life's Craziest Beliefs
• Knowing #1: How Do You Know?
• Knowing #2: How Smart Are You?
• Knowing:#3 Your Core Beliefs
• Knowing #4: Educated Guesses
• Mistakes Every Good Parent Makes
• Motivation
• My Wishes For Real People
• Natural Anger
• Peace On Earth
• Perfectionism
• Personal Freedom
• Powerful Ideas: #1
• Problems With Anger
• Relationship Analysis (online evaluation)
• Relationships
• Self-help Quiz #1
• Self-help Quiz #2
• Should We Blame Our Parents?
• Stop Making Comparisons!
• Subconscious Life Scripts
• Success

• Were You Loved As A Child?
• What Helps?
• What Terror Does To Us
• What To Tell A Therapist
• Who Can You Trust?
• Who Is The Real You?
• Who Needs Help?
• Who's Healthy?
• Why Are You Treated The Way You Are?
• Why Do We Work So Hard?

next: I Am Often Afraid or Anxious.

• About Change
• About Love
• About Shame
• Boundaries
• Can You Make Someone Change?
• Clear Communication: #1
• Clear Communication: #2
• Couples: Passive & Controlling Partners
  
• Feeling Safe
• Getting Enough Attention
• Growing Up Emotionally
• Getting Practical #2: Relationships, Couples, Families, and Careers
• Handling Criticism
• Healing From Sexual Abuse: A Strategy
• How Happy Couples Stay That Way
• How To Have A Lousy Sex Life
• How To Play
• How To Talk About Feelings
• Living With Alcoholics
• Love Relationships
• Personal Freedom
• Quitting Addictions
• Relationship Analysis (online evaluation)
• Relationships
• The Three Stages of Relationships
• What Helps?
• What Terror Does To Us
• Who Can You Trust?
• Why Are You Treated The Way You Are?

next: I Want Help With Children

Many herbal and dietary supplements can cause serious health problems for users. Learn about the dangers of herbal treatments and dietary supplements.

Herbal supplements are a type of dietary supplement that contains herbs, either singly or in mixtures. An herb (also called a botanical) is a plant or plant part used for its scent, flavor, and/or therapeutic properties.

Many herbs have a long history of use and of claimed health benefits. However, some herbs have caused health problems for users. This fact sheet contains points you should consider for your safety if you use, or are thinking about using, herbs for health purposes. It does not discuss whether herbs work for specific diseases and conditions.

1. It's important to know that just because an herbal supplement is labeled "natural" does not mean it is safe or without any harmful effects. For example, the herbs kava and comfrey have been linked to serious liver damage.

2. Herbal supplements can act in the same way as drugs. Therefore, they can cause medical problems if not used correctly or if taken in large amounts. In some cases, people have experienced negative effects even though they followed the instructions on a supplement label.

3. Women who are pregnant or nursing should be especially cautious about using herbal supplements, since these products can act like drugs. This caution also applies to treating children with herbal supplements.

4. It is important to consult your health care provider before using an herbal supplement, especially if you are taking any medications (whether prescription or over-the-counter). Some herbal supplements are known to interact with medications in ways that cause health problems. Even if your provider does not know about a particular supplement, he can access the latest medical guidance on its uses, risks, and interactions.

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   If you use herbal supplements, it is best to do so under the guidance of a medical professional who has been properly trained in herbal medicine. This is especially important for herbs that are part of a whole medical system, such as traditional Chinese medicine or Ayurvedic medicine.

6. In the United States, herbal and other dietary supplements are regulated by the U.S. Food and Drug Administration (FDA) as foods. This means that they do not have to meet the same standards as drugs and over-the-counter medications for proof of safety, effectiveness, and what the FDA calls Good Manufacturing Practices.

About Dietary Supplements

Dietary supplements were defined in a law passed by Congress in 1994. A dietary supplement must meet all of the following conditions:

• It is a product (other than tobacco) intended to supplement the diet, which contains one or more of the following: vitamins; minerals; herbs or other botanicals; amino acids; or any combination of the above ingredients.

• It is intended to be taken in tablet, capsule, powder, softgel, gelcap, or liquid form.

• It is not represented for use as a conventional food or as a sole item of a meal or the diet.

• It is labeled as being a dietary supplement.

1. The active ingredient(s) in many herbs and herbal supplements are not known. There may be dozens, even hundreds, of such compounds in an herbal supplement. Scientists are currently working to identify these ingredients and analyze products, using sophisticated technology. Identifying the active ingredients in herbs and understanding how herbs affect the body are important research areas for the National Center for Complementary and Alternative Medicine (NCCAM).

2. Published analyses of herbal supplements have found differences between what's listed on the label and what's in the bottle. This means that you may be taking less--or more--of the supplement than what the label indicates. Also, the word "standardized" on a product label is no guarantee of higher product quality, since in the United States there is no legal definition of "standardized" (or "certified" or "verified") for supplements.

3. Some herbal supplements have been found to be contaminated with metals, unlabeled prescription drugs, microorganisms, or other substances.

4. There has been an increase in the number of Web sites that sell and promote herbal supplements on the Internet. The Federal Government has taken legal action against a number of company sites because they have been shown to contain incorrect statements and to be deceptive to consumers. It is important to know how to evaluate the claims that are made for supplements. Some sources are listed below.

Office of Dietary Supplements (ODS), NIH

ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications and the International Bibliographic Information on Dietary Supplements (IBIDS) database.

Web site: ods.od.nih.gov

Source: National Center for Complementary and Alternative Medicine (NIH)

next: Supplement-Vitamins Homepage

Chapter 119 of Adam Khan's book Self-Help Stuff That Works

WHEN DALE CARNEGIE WROTE his classic book on human relations, How to Win Friends and Influence People, he left out a chapter; it wasn't finished on time, so the book was published without it. The chapter was supposed to cover the subject of dealing with people you cannot win with.

For most people, when you treat them fairly, they treat you fairly in return. But as you know, there exists in this world a small percentage of people who will simply take advantage of you when you try to treat them fairly. There are people who will play games with you, deceive you, and some who will actively prevent you from making your relationship work. Carnegie's unwritten chapter was for the times when "somebody has to go to jail, be spanked, divorced, knocked down, sued in court."

Even beyond those extreme cases, every once in awhile you'll get stuck working with or having to interact with someone who continually brings you down or in some way makes your life difficult. They may seem to be very nice people. They might smile and come across with a lot of charm. But the end result of your interactions are: You're worse off. You try to make things work, you try to be fair, and you get the short end of the stick every time. You've tried to talk with them, perhaps, and it doesn't make things better, and they probably make you feel bad for saying anything.

I have no fancy methods for dealing with these people. You can't really deal with them. If they're doing something illegal, you can certainly call the police, but most are too clever to do something illegal. My wife uses a good analogy in her speeches. She says trying to make things work with these people is like trying to wrestle with someone who is covered with mud: You're going to get muddy. No matter what you do or how well you do it or how noble your intentions, you'll get muddy.

So instead of trying to make things work out with these people, the goal is to avoid dealing with them at all. Go for minimal impact. Have as little to do with them as you can get away with (without causing yourself trouble). Ideally, you would eliminate them from your life completely. Stop calling, stop visiting, stop being nice. You don't have to be mean about it. Just fade them into the background and then all the way out of the picture.

I know this isn't a perfect world. Sometimes you'll have to keep interacting with someone who won't let you make things work. So go as far as you can to minimize their effect on your life. Talk to them as little as you can, look at them as little as you can. Focus your attention on your purpose and on the rest of the people around you.

When you come across someone and nothing works with him, cut your losses. Don't waste any more effort trying. This is a big world full of wonderful people and a few bad apples. Concentrate your attention on the good people and waste as little of your attention as you can on the ones who bring you down. You can do it a little at a time and it will improve your attitude. And if it improves your attitude, it's good for your relationships with your family and friends, and it's good for your health.

Try not to waste too much of your attention on people who bother you.

Here's a negative way to be positive. When you are feeling angry or bitter or jealous or annoyed, this way is often easier than trying to muster a positive attitude directly:
Argue With Yourself And Win!

Here's a conversation on how to change the way you interpret the events in your life so that you neither become a doormat nor get upset more than you need to:
Interpretations

The art of controlling the meanings you're making is an important skill to master. It will literally determine the quality of your life. Read more about it in:
Master the Art of Making Meaning

next: Refuse to Flinch

Chapter 108 of the bookSelf-Help Stuff That Works

by Adam Khan

CRITICISM HURTS. So any decent person tries to avoid criticizing others. But sometimes you can't avoid it forever, so finally, when you get mad enough, you speak. The problem is, when you criticize while you're mad, you aren't likely to do it well. You'll say what the person did wrong instead of saying what you want him or her to do differently in the future. And when you say something while you're angry, the listener gets defensive because anger is an attacking emotion.

One way of getting around this is to speak sooner. Criticize before you get angry. Criticize when it first occurs to you and you won't have to "try to control yourself." When you say it sooner, you'll naturally have more control over yourself. And people won't get very defensive because you're not attacking them. Oh, they might not like it. Nobody really likes being criticized. We would all prefer everyone loved us and showered us with gifts for just being ourselves. But that's not the way the world works. Criticism is a necessary part of relationships of any kind. Look at what happens to someone who never gets criticized. There have been people who have had so much power and money that everyone was afraid to criticize them: Hitler. Stalin. Sadaam Hussein. Howard Hughes. It made them lose touch with reality. You and I need criticism even though we don't like it.

And we need to criticize people. Not all the time, and it needs to be balanced with acknowledgments, but you can't go around only complimenting people - it isn't good for the people you work with or who live with you. You must criticize.

But say it early. Minimize the pain by not procrastinating. You'll say it better, the person will hear it better, you'll cause less pain and have more of an impact - the kind of impact you want to have on people: considerate and constructive.

And here is a tip on making a good criticism: Don't say what you didn't like; say what you would like in the future. Turn your complaint into a request. It is much easier to hear. For example, which would you rather hear: "You never pick up around here" or "Would you please pick up around here more often?" In other words, don't make them wrong for what they've done; just tell them what you want next time.

Speak up sooner and when you do, make requests. The end result is you'll get more of what you want from people, and they (and you) will be happier.

Criticize when it first occurs to you, and ask for what you want.

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How to be here now. This is mindfulness from the East applied to reality in the West.
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Expressing anger has a good reputation. Too bad. Anger is one of the most destructive emotions we experience, and its expression is dangerous to our relationships.
Danger

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If you think that you or someone you know has bipolar disorder, the next step is finding a doctor who can help you. Here's how.

A doctor makes the diagnosis of bipolar disorder based on information an individual provides, such as symptoms they have experienced. It is important to tell the doctor about all the moods you experience.

What kind of doctor can help treat bipolar disorder?

A doctor skilled in the diagnosis and treatment of bipolar and other mental health disorders may be a psychologist or a psychiatrist.

Psychiatrist: A medical doctor who is a specialist in dealing with the diagnosis, treatment, and prevention of mental and emotional disorders. Like all medical doctors, he or she can prescribe medication. A psychiatrist may or may not provide non-medical therapies such as "talk therapy." In diseases such as bipolar disorder, it is often the case that the formal diagnosis and treatment plan will be made by a psychiatrist so that medication can be prescribed.

Psychoanalyst: One who practices psychoanalysis, a therapy which attempts to overcome repression and release energy for healthy, normal living. This therapy usually entails free association and dream analysis conducted over long periods of time in order to get to the sources of unconscious impulses.

Psychologist: A health care professional with an advanced academic degree called a PhD (doctor of philosophy--in this case "philosophy" means course of study), who deals with the diagnosis, treatment, and prevention of mental and emotional disorders. A psychologist uses non-medical therapies such as talk therapy, cognitive therapy, or coaching in the treatment of bipolar disorder. When further medical attention or prescription medication is required, a psychologist will refer a patient to a psychiatrist.

You will want to choose a specialist who is experienced and with whom you feel comfortable. You may consult with more than one doctor before deciding on the specialist who is right for you.

Your primary care or family doctor can often recommend a mental health specialist experienced in the diagnosis and treatment of bipolar disorder.

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Treating fibromyalgia symptoms can be very difficult. Some doctors and other practitioners are turning to alternative therapies to treat fibromyalgia.

What does it feel like to live with fibromyalgia?

"Imagine last night you drank more wine than you should have but had no water or food. You went to bed late and got up early, feeling stiff, achy, and tired," says Chanchal Cabrera, a British herbalist, fibromyalgia patient, and author of Fibromyalgia: A Journey Toward Healing (McGraw-Hill, 2002). People with fibromyalgia feel that way all the time, she says.

A truly mysterious ailment, fibromyalgia syndrome (FMS) involves chronic widespread muscle pain and fatigue. It affects about 2 percent of all Americans and accounts for 10 to 30 percent of all rheumatology consultations. FMS mainly afflicts people between the ages of 35 and 55 and occurs seven to 10 times more frequently in women.

And as if the pain and fatigue weren't enough, a constellation of other symptoms often accompanies the disorder—foggy thinking, sleep disturbances, painful menstrual cramps (dysmenorrhea), and irritable bowel symptoms—making a clear diagnosis difficult. Although the cause of FMS continues to elude researchers, certain stresses on the body, such as intense exercise, illness, or a traumatic event, appear to intensify symptoms or even bring on the condition itself.

"My fibromyalgia was triggered by a car accident in 1991, when I was a healthy and fit 28-year-old," says Cabrera, now 43 and living in Vancouver, British Columbia. "Within minutes of the impact, my neck and shoulders were in pain, and I had a dull headache. My slow descent into fibromyalgia had begun."

The body blows a fuse

Jacob Teitelbaum, MD, medical director of Maryland's Annapolis Center for Effective Chronic Fatigue Syndrome/Fibromyalgia Therapies, likens FMS to the body's "blowing a fuse" when its energy account becomes overdrawn. This short circuit results in hypothalamus suppression, Teitelbaum maintains. "The hypothalamus controls sleep, hormonal function, temperature, and autonomic functions such as blood pressure and blood flow," he says. "The hypothalamus uses more energy for its size than any other organ, so when there is an energy shortfall, it goes offline first."

"FMS has no single cause," Teitelbaum says. He surmises that the hypothalamus decreases its protective function in the face of what it perceives as overwhelming stress, which can stem from infection, injury, or a stressful, emotional incident. "FMS patients seem to have genetic differences in the way their hypothalamus, pituitary, and adrenal regulation handle stress," he says. "As a result, the muscles end up short of energy and in pain."

Is there hope?

Mary Shomon, now an author and patient advocate in Washington, DC, began to have symptoms of FMS at age 34, after two car accidents and numerous other health challenges. Through a holistic approach and alternative therapies, she finally found relief from her symptoms. However, 11 years later she still expresses dismay about the stigma and disbelief she encounters about fibromyalgia—particularly from the conventional medical community.

"Those of us who have suffered through it know firsthand that it is a very real condition," Shomon says. "We didn't dream it up or develop some psychosomatic syndrome, and we can't just think it away, buck up, and feel better, or just 'get over it' by sheer determination. Some doctors—and even some of our families and friends—think that fibromyalgia is psychosomatic, evidence of laziness, or is due to some inherent emotional or character weakness."

Conventional medicine has little to offer in the way of treatment, which frustrates patients and doctors alike. Mainstream physicians see FMS largely as an incurable condition (if they see it as a condition at all), so they focus on relieving pain and improving sleep—primarily with pharmaceuticals. Although both conventional and alternative healthcare providers may suggest exercise programs to improve muscle and cardiovascular fitness, along with relaxation techniques to ease muscle tension and anxiety, drugs remain at the forefront of conventional medicine's arsenal.

Conventional practitioners often recommend nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen for pain, and tricyclic antidepressants to improve sleep and mood. These drugs improve the symptoms to a certain extent but do not halt the disease. And they come with a hefty price: NSAIDs cause bleeding in the stomach lining and may affect kidney and liver function, particularly when taken long-term. Antidepressants carry a host of potential side effects, including anxiety, nausea, weight gain, and constipation. And, at the end of the day, they don't alleviate the disease or provide any hope for long-term relief. In contrast, a new breed of alternative practitioners, including Teitelbaum, thinks that FMS can be cured. They aim to get at the core issues and turn the disease around with alternative therapies.

The search for sleep

Sleep is a primary concern for anyone with FMS. Ninety percent of patients awaken multiple times a night, and even if they make it through the night, they rarely sleep deeply enough to feel rejuvenated. Other symptoms may disrupt sleep as well, such as restless legs syndrome (twitchy, cramping legs that cause pain and sleeplessness), irritable bladder, and nocturnal myoclonus (jerky muscles).

Scientists have long known that fibromyalgia involves "disregulated sleep physiology," or alpha rhythm disturbances occurring during the night and resulting in light, unrefreshing sleep. "If you don't get eight to nine hours sleep at night, your pain will simply not go away," says Teitelbaum. "Deep sleep is when you make growth hormones, recharge your batteries, and get rid of pain," he explains. Teitelbaum's first line of defense against disturbed sleep is L-theanine (it must be the "L" form). He advises 200 mg at bedtime.

"L-theanine is fantastic," Shomon says. "With L-theanine, I can sleep without waking up groggy."Teitelbaum also recommends low-dose melatonin—a maximum of 0.5 mg per night—to encourage a normal sleep cycle. Because sleep is so critical to healing, Teitelbaum may occasionally prescribe sleeping pills, but only as a last resort.

For Cabrera, sleeping and healing went hand-in-hand: "Melatonin really helped give me a deep, long sleep." After her diagnosis, Cabrera had to quit work and pretty much rested and slept for a year. "I slept 12 to 14 hours per night, plus naps," she says. "I still use melatonin every night, but now I take a small dose of 0.3 mg." Cabrera has to watch herself closely, however. "With less than ideal sleep even for one night, some FMS symptoms will return, but I now can reverse them right away," she says.

A new sugar for energy

But no matter how much they rest, people with FMS never seem to have enough energy. That's not surprising, since research shows FMS sufferers have lower levels of ATP (the body's cellular energy molecule) along with a lowered ability to make it. But exciting new research with FMS patients shows that supplementing with D-ribose (often just called ribose), the body's cellular fuel, can help the body replenish ATP.

A natural sugar, ribose occurs in all living cells. "Ribose is the key building block for making energy," says Teitelbaum. "In fact, the main energy molecules in your body are made of ribose, plus B vitamins and phosphate." Our bodies acquire ribose through diet—brewer's yeast has a rich supply—and the body also makes it from glucose in food. This is a slow process, however, that cannot always keep up with the energy lost in daily activities, so it may take several days to restore the lost ATP—and possibly much longer for those who suffer with FMS.

Scientists know that supplemental ribose can reduce muscle pain, stiffness, and exercise fatigue; that people tolerate it well; and that it has no side effects. Armed with this knowledge, Teitelbaum conducted a recent and very promising ribose study in FMS patients. They took 5 grams of ribose three times a day, for an average of 28 days. In just 12 days, 66 percent of those taking ribose had significant improvement in energy, sleep, mental clarity, and pain intensity, with a 44 percent average increase in energy and an overall 30 percent increase in well-being. Although the study is preliminary, with results this positive, look for additional research on ribose soon.

A different kind of cocktail

Could a simple injection cure FMS? As it turns out, one nutrient concoction just might. The Myers Cocktail (named for John Myers, the physician who invented it), an intravenous micronutrient treatment containing magnesium, calcium, vitamin B complex, and vitamin C, has been used to treat fibromyalgia for 20 years. Like ribose, these safe nutrients promote cellular energy production and pump up ATP production, according to a study published in Alternative Medicine Review. "We have good clinical success with this treatment to reduce pain and promote detoxification," says Virginia Hadley, RN, nutritionist at the Tahoma Clinic in Kent, Washington.

Yale researchers recently tested the Myers Cocktail on a group of 40 patients ages 18 to 75 in a double-blind, placebo-controlled, randomized trial. They gave one injection a week for eight weeks through a large syringe containing 37 ml (about 7 teaspoons) of nutrient solution. The mixture was injected slowly over about 20 minutes. The yet-to-be-published study measured tender points, depression levels, and quality of life. "This three-month pilot study showed significant improvements in all pertinent outcome measures with the Myers Cocktail and none with the placebo solution," reports David L. Katz, MD, associate clinical professor of epidemiology and public health at Yale University. The study participants still had less pain a month after the last injection. "Our results strongly suggest that Myers Cocktail may well offer therapeutic benefit in fibromyalgia. In the interim, we will continue to offer it to our patients," says Katz.

Take a little needling

Many people with FMS get hooked on acupuncture, and for good reason. Numerous studies show the positive benefits of acupuncture for pain relief. One landmark study appeared in the June 2006 Mayo Clinic Proceedings. This randomized, controlled trial, led by David P. Martin, MD, an anesthesiologist from the Mayo Clinic College of Medicine in Rochester, Minnesota, reports on 50 FMS patients, half of whom received acupuncture; the remaining 25 received sham acupuncture, which involved needles inserted at non-therapeutic points. After just six treatments spread over three weeks, the acupuncture patients reported significant improvement in symptoms, particularly fatigue and anxiety, lasting up to seven months. One month after treatment, those treated with "true" acupuncture had less fatigue and fewer anxiety symptoms than the sham acupuncture group.

Exercise more, stress less

A regular, gentle, exercise routine stands out as indispensable for FMS—to increase flexibility and reduce pain and stress. The severe pain that usually accompanies FMS makes it difficult for many sufferers to begin and maintain an exercise program. That's why programs with gentle stretches and movements, such as therapeutic yoga, Pilates, and t'ai chi, are often a good fit for FMS patients.

Shomon finds tremendous relief with Pilates. "My body was often a knot of aches and pains—especially in my neck, shoulders, and lower back," she says. "But I started Pilates for two one-hour sessions a week. It was life-changing. Gradually, I gained strength, my constant body pain faded, and I was able stop my daily doses of ibuprofen." Shomon has been doing Pilates for about four years and says she rarely has body pain.

Yoga also eases muscle pain and stiffness. In a six-week randomized pilot study, researchers looked at a yoga program modified for FMS chronic back pain. The program improved balance and flexibility and diminished disability and depression.

Electrical help

Then there's some shocking news. According to Carolyn McMakin, a chiropractor in Portland, Oregon, and an active proponent of microcurrent therapy, electricity can help zap FMS. Microcurrent therapy increases the rate of healing for injuries and fractures and controls muscle pain. According to McMakin, delivering microamperage (50 to 100 microA) electrical current to a patient increases ATP concentrations up to fivefold in the body.

Electricity can relieve pain in other ways, too. Transcutaneous electrical nerve stimulation (TENS), which first appeared in scientific literature around 1975, relieves pain by sending low-voltage electrical signals to nerves with a battery-powered device. TENS, used mainly by physical therapists but also by some MD pain specialists, is thought to work because the electricity stimulates the nerves in an affected area and scrambles normal pain signals. It also may help the body produce natural endorphins. One 2005 study looked at 218 chronic pain patients. After receiving TENS twice a week for six weeks, the patients had substantial improvement in disability and pain, which they maintained at a six-month follow-up exam.

While everyone hopes for a cure for FMS, that magic bullet that puts an end to the disease, all these different therapies and a number of lifestyle adjustments make the disease manageable. "People must change their lifestyles to make any progress," Cabrera says. "Fibromyalgia involves a host of factors and an internal complex of concerns. Even though I am an herbalist, and I know herbs help, the entire answer doesn't lie in substances."

And Shomon adds, "There's clearly no conventional medical cure or just one surefire treatment. What seems to work the best is a combination of customized tactics that focuses on ensuring quality sleep, reducing pain, increasing flexibility, improving metabolism, and reducing stress."

Do You Have It?

Although an official diagnosis of fibromyalgia involves identifying pain and tender-point sites (see illustrations on pages 68 and 69), below are the most common symptoms associated with this disorder.

Source: Alternative Medicine

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