Dandelion is an herbal remedy used as an appetite stimulant, digestive aid and natural diuretic. Learn about the usage, dosage, side-effects of Dandelion.

Botanical Name:Taraxacum officinale
Common Names:Dandelion

• Overview
• Plant Description
• Parts Used
• Medicinal Uses and Indications
• Available Forms
• How to Take It
• Precautions
• Possible Interactions
• Supporting Research

Overview

While many people think of the common dandelion (Taraxacum officinale) as a pesky weed, herbalists consider it a valuable herb with many culinary and medicinal uses. Dandelion is a rich source of vitamins A, B complex, C, and D, as well as minerals such as iron, potassium, and zinc. Its leaves are often used to add flavor to salads, sandwiches, and teas. The roots can be found in some coffee substitutes and the flowers are used to make certain wines.

In traditional medicine, dandelion roots and leaves have been used to treat liver problems. Native Americans also used dandelion decoctions to treat kidney disease, swelling, skin problems, heartburn, and stomach upset. Chinese medicinal practitioners traditionally used dandelion to treat digestive disorders, appendicitis, and breast problems (such as inflammation or lack of milk flow). In Europe, herbalists incorporated it into remedies for fever, boils, eye problems, diabetes, and diarrhea.

Natural Appetite Stimulant

Today, dandelion roots are primarily used as an appetite stimulant and digestive aid while dandelion leaves are used as a diuretic to stimulate the excretion of urine.

Plant Description

Hundreds of species of dandelion grow in the temperate regions of Europe, Asia, and North America. Dandelion is a hardy, variable perennial that can grow to a height of nearly 12 inches. Dandelions have deeply notched, toothy, spatula-like leaves that are shiny and hairless. Dandelion stems are capped by a head of bright yellow flowers. The grooved leaves funnel the flow of rainfall into the root.

Dandelion flowers are sensitive to light, so they open with the sun in the morning and close in the evening or during gloomy weather. The dark brown roots are fleshy and brittle and are filled with a white milky substance that is bitter and slightly odorous.

Parts Used

Dandelion leaves produce a diuretic effect while the roots act as an appetite stimulant and digestive aid.

Medicinal Uses and Indications

Dandelion is a natural diuretic that increases urine production by promoting the excretion of salts and water from the kidney. Dandelion may be used for a wide range of conditions requiring mild diuretic treatment such as poor digestion, liver disorders, and high blood pressure. One advantage of dandelion over other diuretics is that dandelion is a source of potassium, a nutrient often lost through the use of other natural and synthetic diuretics.

Fresh or dried dandelion herbs are also used as a mild appetite stimulant and to improve upset stomach (such as feelings of fullness, flatulence, and constipation). The root of the dandelion plant is believed to have mild laxative effects and is often used to improve digestion.

Some preliminary animal studies suggest that dandelion may help normalize blood sugar levels and improve lipid profiles (namely, lower total cholesterol and triglycerides while increasing HDL ["good"] cholesterol) in diabetic mice. However, not all animal studies have had the same positive effect on blood sugar. In addition, research needs to be conducted on people to know if this traditional use for diabetes (see Overview) has modern day merit.

Available Forms

Dandelion herbs and roots are available fresh or dried in a variety of forms including tinctures, prepared tea, or capsules.

How to Take It

Pediatric

To improve digestion, adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of a 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 to 25 kg), the appropriate dose of dandelion for this child would be 1/3 of the adult dosage.

Adult

Dandelion may be used in a variety of available forms.

• Dried leaf infusion: 4 to 10 g three times a day
• Dried root decoction: 2 to 8 g three times a day
• Herb (stems and leaves): 4 to 10 g three times a day
• Leaf tincture (1:5) in 30% alcohol: 100 to 150 drops three times a day
• Powdered extract (4:1) leaf: 500 mg one to three times a day
• Powdered extract (4:1) root: 500 mg one to three times a day
• Root tincture (1:2) fresh root in 45% alcohol: 100 to 150 drops three times a day

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain active substances that can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a practitioner knowledgeable in the field of botanical medicine.

Dandelion is generally considered safe. Some individuals, however, may develop an allergic reaction from touching dandelion, and others may develop mouth sores.

People with gall bladder problems and gallstones should consult a health care provider before eating dandelion.

Possible Interactions

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

Dandelion and Lithium

Animal studies suggest that dandelion may worsen the side effects associated with lithium, a medication commonly used to treat manic depression.

Antibiotics, Quinolone

One species of dandelion, Taraxacum mongolicum, also called Chinese dandelion, may decrease the absorption of quinolone antibiotics (such as ciprofloxacin, ofloxacin, and levofloxacin) from the digestive tract. It is not known whether Taraxacum officinale, or common dandelion, would interact with these antibiotics in the same way. As a precaution, dandelion should not be taken at the same time as these antibiotics.

back to: Herbal Treatments Homepage

Supporting Research

Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2002:78-83.

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, Ore: Eclectic Medical; 1998:65-66.

Cho SY,Park JY, Park EM, et al. Alternation of hepatic antioxidant enzyme activities and lipid profile in streptozotocin-induced diabetic rats by supplementation of dandelion water extract. Clin Chim Acta. 2002;317(1-2):109-117.

Davies MG, Kersey PJ. Contact allergy to yarrow and dandelion. Contact Dermatitis. 1986;14 (ISS 4):256-7.

Foster S, Tyler VE. Tyler's Honest Herbal. 4th ed. New York: The Haworth Herbal Press; 1999:137-138.

Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical Economics Company; 2000:245-246.

Mascolo N, et al. Biological screening of Italian medicinal plants for anti-inflammatory activity. Phytotherapy Res. 1987:28-29.

Miller L. Herbal Medicinals: Selected Clinical Considerations Focusing on Known or Potential Drug-Herb Interactions. Arch Intern Med. 1998;158:2200-2211.

Newall C, Anderson L, Phillipson J. Herbal Medicines: A Guide for Health-care Professionals. London, England: Pharmaceutical Press; 1996:96-97.

Petlevski R, Hadzija M, Slijepcevic M, Juretic D. Effect of 'antidiabetis' herbal preparation on serum glucose and fructosamine in NOD mice. J Ethnopharmacol. 2001;75(2-3):181-184.

Swanston-Flatt SK, Day C, Flatt PR, Gould BJ, Bailey CJ. Glycaemic effects of traditional European plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice. Diabetes Res. 1989;10(2):69-73.

White L, Mavor S. Kids, Herbs, Health. Loveland, Colo: Interweave Press; 1998:22, 28.

back to: Herbal Treatments Homepage

On Letting Go of the Past

"Some people think it's holding on that makes one strong. Sometimes it's letting go."

Sylvia Robinson

Life Letters

I grew up in northern Maine where summers are short and oh so sweet, and winters are long and often relentless. Many of my most treasured childhood memories contain images of care free afternoons on the shore of Madawaska lake, with my face tilted upwards towards the northern sky, my feet dangling in the cool, clear water, lulled by the motion of the waves lapping up against the dock, and the sunlight on my skin. In looking back, it occurs to me that while I cherished the gentle months of June, July, and August, I was all too often unable to enjoy them to the fullest. Too often preoccupied by my dread of winter's return, I failed to completely embrace the beauty and freedom that belonged to me on those golden days long gone. And as I remember, I wonder now how often the gifts that are before us slip out of our focus as we unthinkingly turn away, worrying about what is beyond our control, or gazing anxiously out our rearview windows, holding onto a past that is now out of our reach and can no longer be altered.

I once knew a woman whose childhood was haunted by prophesies of gloom and doom, consequently, she spent much of her life feeling afraid. She was constantly peering around corners, searching for emergency exits, and waiting for "the light to unexpectedly change." While she was able to acknowledge that she had enjoyed a successful career, a loving family, a hefty savings account, countless contingency plans, and a clean bill of health, she also observed that she had lived in almost continuous dread and fear. It was not until the years that stretched behind her far exceeded the ones that still remained that it occurred to her that perhaps her primary task on earth was to learn as much as she possibly could from her time here, and that her major life lesson was to learn to trust in life itself. She would need to trust that each of her experiences (even the painful ones) offered her important lessons, and further, that often the ultimate value and quality of an experience is in direct proportion to what we do with it. In order for her to live fully and learn from her present, she concluded that she would need to let go of the pain from her past.

Rachel Naomi Remen, one of my favorite authors and healers, admitted that as a child of Russian Immigrants, her's was not a family that parted with things easily, and that she had grown up believing that if she were to let go of anything of value, the result would be a permanent hole in her life. Consequently, she quipped, "anything that I ever let go of had claw marks on it." I knew all too well what Remen meant. For much of my life I held on fiercely to everything, afraid of finding myself vulnerable somehow or suddenly empty handed, I deprived myself of numerous gifts and opportunities. Believe me, it's not at all easy to take hold of what's before you with clenched fists.

In "Life's Challenges as Initiation," Remen recounts her surprising reaction to losing something of great value to her one day, and how for the first time in her life she responded to the loss by feeling a sense of curiosity and adventure observing, "I had never trusted life before...I had avoided loss at all cost, like my family. This is a very important step of initiation: To come into a new relationship with the unknown, the unknown seen differently, as mystery, as possibility, as something we move towards not away from, something that gives us an increased sense of aliveness and even wonder."

I suspect that for most of us, we must first encounter and then recover from a painful and involuntary loss before we can begin to understand that letting go needn't simply be about giving up. On the contrary, it's as much about embracing as it is about releasing. In letting go 'of' what no longer serves us, we free ourselves to go 'to', to move closer towards that which sustains and nurtures our well-being and growth. In letting go of what no longer works, we make room for what does.

I can't recall a time in my life when letting go of something I've truly cared about hasn't been a painful process, and it's been necessary to remind myself more than once that what I've released isn't entirely lost to me forever. You see, one thing I've learned throughout my journey in the land of loss and recovery is that very little is ever truly lost. I've slowly come to appreciate that instead of leaving me empty handed, what has come before me will undoubtedly provide me (if I allow it to) with tools to facilitate my becoming all that I hope to one day become. And while I'm by no means an expert at dealing with loss and letting go, I have learned to take comfort in the fact that each of our experiences serves to teach us, even those that wound us can be transformed into food for our souls, and fuel for our journey if only we're willing to harvest them.

next:Life Letters: The Soul of a Scientist

A mother shares her story of how enzyme therapy helped her autistic son. She explains what enzyme therapy is and how it works in treating autism.

The pounding went on all day and all night. My son was a chronic head-banger from early on. Our efforts to help him resolve this and other debilitating problems, such as extreme sensory sensitivities and socialization difficulties, led us down many roads. Enzymes provided one of the key paths.

In the past five years, enzyme therapy has emerged as one of the most successful treatments for autism-related conditions, based on a new understanding about how closely the digestive, nervous, and immune systems function together and on how to use specific enzymes. Since taking them, my older son, who was diagnosed with an autism spectrum condition (ASC), no longer bangs his head on the floor 10 to 14 hours a day. He now interacts with others around him and communicates well. His sleep and sensory problems have also improved. The rest of us took enzymes as well, and my younger son's reflux and bowel problems faded away and my chronic migraines disappeared.

My family isn't the only one to experience these outcomes. After tracking results for more than five years, I've found that 90 to 93 percent of people with ASC see improvements after trying a good-quality enzyme product. Benefits appear in a wide range of behavior, language, cognitive, and physical issues, and older children and adults experience these benefits as much as younger kids.

Food Intolerances and Allergies

Autistic children often suffer from numerous kinds of food intolerances and digestive problems. My son was so sensitive to dairy, he would begin banging his head hard on the floor about three hours after eating it. While this reaction occurred with other foods and stimuli, we knew that dairy was a specific trigger. To resolve it we found a product containing several proteases including one known as DPP IV, which breaks down dairy and gluten proteins.

Unlike many drug therapies, enzymes are a quick and relatively inexpensive option to try, with a high probability for success. You will usually see results within the first four weeks, and often with just one bottle. While we found success by focusing on specific enzymes, some ACS children respond equally well to a broad-spectrum enzyme product that focuses on the digestion of carbohydrates and fats in addition to proteins. As you plan out a course of enzyme therapy, think in terms of categories: Children who have trouble digesting proteins need proteases; amylases break down carbohydrates; problems with candida yeast respond well to fiber digesting enzymes; and those with dairy intolerance benefit from lactase and DPP IV enzymes. Ascertain which category applies best to your child's particular problem and then choose among the enzyme products within this category. Most families with children who have developmental delays tend to get best results using one of the broad-spectrum products at all meals along with one of the strong protease products.

The Bug Connection

Many children with autism related conditions also suffer from candida yeast or bacterial overgrowth in the gut. To resolve the problem try yeast-targeting products with high levels of fiber-digesting enzymes (like cellulases) to break down the outer walls of yeast cells. The product should also contain a high level of proteases to help clear out pathogenic yeast and reduce any die-off reactions. Consider combining a yeast-controlling herbal supplement such as grapefruit seed extract or oregano with the enzymes for a synergistic effect.

Underlying persistent viral infections also seem prevalent in autistic children, and when these are addressed, the children show some permanent improvements in language, socialization, behavior, and cognitive ability. Several autism specialists are turning to Valtrex, a prescription antiviral medication that provides good results. Another alternative, ViraStop, is a specialty blend of enzymes used between meals at high therapeutic doses (12 to 15 capsules per day). Two preliminary investigations using ViraStop resulted in a program that has delivered excellent results. Combining this with other supplements that have antiviral properties, such as olive leaf extract, vitamin C, or monolaurin, increases its effectiveness against viruses.

While the exact mechanisms of enzyme therapy remain obscure in the case of autism, it clearly works on underlying causes, not just symptoms. Even though not all my son's sensory problems have disappeared, he has became much more social, his grades have improved, and his general anxiety has gone away. Now when people ask me how my son is, I'm thankful I'm able to say, truthfully, "He's fine!"

Source: Alternative Medicine

back to: Complimentary and Alternative Medicine

A new look at anger management by Adam Khan, author of Self-Help Stuff That Works:

I WAS RECENTLY VISITING a friend of mine at his workplace. He looked at me with a smile that obviously wasn't full of happiness. "I hate this job," he said, "I'm getting to the place where I can't stand these customers!" He was no longer smiling. "There's no place for me to vent. I can't tell off my customers. I'd lose my job!"

"John," I said, "Let me tell you a true story. Once upon a time, a team of researchers wanted to find the best way to deal with anger. They experimented with children at school. In one group, whenever a child got mad at another child, they had him act out his anger with toy guns. With another group, they had the child express his anger verbally. In the third group, the researchers merely gave the angry child a rational explanation for why the other child did what she did. And you know what? The method that worked the best was the last one."

"The rational explanation?" asked John, obviously needing a rational explanation.

"Yes. There's been a lot of research showing that anger isn't really something that 'bottles up' inside you, and that 'venting' doesn't help - in fact, venting increases your feelings of anger. Isn't that surprising? I didn't believe it at first. But pay attention next time you 'vent.' It makes you more angry! Anger is caused by the way you're thinking at the moment you're angry, and it seems like it's building up because you're running those thoughts through your head over and over, getting madder and madder. But it's the thoughts that make you mad, not the event itself.

"Imagine you're in a restaurant with a friend," I continued, "and you order dinner. Your waiter takes your order and goes on about his business. After awhile, you wonder where your food is. You look for your waiter but don't see him. You're getting angry. By the time your waiter walks up (empty handed), you're really mad. 'Where have you been!' you demand, 'And what happened to our dinner?

The waiter says, 'I'm sorry. I forgot to give the cooks your order until only a few minutes ago. I'm really sorry. The hostess just had an epileptic seizure, and I was calling the paramedics and trying to keep her from hurting herself.'

"On hearing this, what happens? Your anger disappears - almost instantly. Where did it go? If anger really bottled up inside you, it would still be there, right? You've had no way to 'vent it.' But you're suddenly not the least bit angry. The idea that anger builds up and needs to be released is just another generally-believed idea that's been proven wrong.

"The reason you're suddenly not angry is that your anger was being produced by the thoughts you were thinking, and you're no longer thinking those thoughts, so the anger is no longer being produced."

"So what am I supposed to do?" asks John. He isn't smiling, but he isn't frowning, "When a customer is being a jerk, do I think to myself, 'My customer is a nice person; I love my customer?'"

"Good question," I said. "No. I doubt if that would work, because saying things to yourself you don't believe doesn't do much good. Have you ever tried it?"
"Yeah."
"Did it work?"
"No."

"Right. Sometimes it does, but not very often. What you need to do is question your interpretation. Don't try to pump yourself up and tell yourself a bunch of positive stuff you don't believe. Tear apart the negative. When you're angry, you take your thoughts for granted. If you thought it, it must be so, right? You can trust your own thoughts, can't you? But if someone else came up and said exactly the same thing out loud to you, you could take the statement apart no problem. But you said it, so you just accept it.

"You should treat the thoughts in your head with as much skepticism as you would treat the words of a fast-talking salesman. 'Hold on there, buddy,' you might say, 'Slow down and say that again...(let him say one sentence)...Can you prove that? Who says? Has a study been done? Who conducted the study?' You don't take everything a salesman says at face-value. You question it. You should do the same thing with the thoughts you have that bring you down.

"As soon as you start arguing with your own thoughts, you'll find it pretty easy to tear them to shreds because the thoughts you think when you're angry are almost always exaggerations and distortions and unprovable interpretations. Almost always. Like 99 percent of the time. And when you take your thoughts apart, your anger disappears."

John looked unconvinced.
"Give me one," I said, "Tell me something you were thinking about a customer."
"Let's see..." John recalled, "This lady was being really condescending and the other people..."
"Wait," I interrupted, "Let's take one at a time. 'The lady was being condescending.' That's a good one. Do you think you could argue with that?"
"Well...I don't know."
"Was she being condescending?"
"Yes. She was."
"Are you sure? Can you read minds?"
"No. I guess it's possible she wasn't being condescending."

"Maybe she wasn't. How could you know for sure? Maybe you misread her tone of voice and body posture. It happens, you know. Don't you hate it when someone misreads your tone of voice? It happens. Maybe you misread her's. Are there other possible explanations for the way she was talking to you?"

"Yeah, I guess. Maybe she was in a bad mood when she came in and I had nothing to do with it."

"That's a good one. That's certainly possible. Give me another one."

"Uh...I remind her of her son, and she's in the habit of being condescending to him."

"That's pretty good. You're good at this. Both of those explanations have nothing to do with you. In other words, with either of those explanations, you don't have to take it personally. And if you don't take it personally, you're probably not going to get angry. Can you think of another one?

"Let's see...How about: She was actually strongly attracted to me and had a hard time controlling herself and her effort to control herself looked like 'condescension.'"

"Okay. Good. Now which explanation do you settle for?"

"Hmm...let me think..."

"None!!!" I say a little too loudly. "You have effectively destroyed your original interpretation - the one that was making you angry. You've proven to yourself that there are other equally possible theories to explain what you experienced besides, 'She's being condescending.' Since you don't know what the 'real' explanation is, you can just leave it at that. It is unknown. And when there are several equally possible theories to explain things, you won't be too upset by any one of them. And you'll feel better. And you'll act more effectively because of it.

"This is good," he says, looking a little hopeful.

"It works really well. How do you feel now."

"What do you mean?"

"Do you feel angry?"

"No."

"See, it's working already!" MOST OF THE MEANINGS we make automatically are given to us during our upbringing. We're using the meanings we've been given without ever suspecting we have a choice. We're somewhat passive receptacles of the culture we grew up with.

We don't realize our power to make meanings, so we don't exercise it. But the meanings we make have a tremendous impact on our lives.

If you think when you and your spouse get mad at each other it means your marriage is on the rocks, that meaning will affect the outcome of your life. It will affect how you feel. If you become afraid of conflict because you think it means The End, and you avoid conflict (maybe you don't speak the straight truth in order to avoid conflict), you'll create misunderstandings. Things s/he doesn't know about you will start accumulating. Confusion and distrust will accumulate right along with it. This, in itself can lead to what you feared: the eventual demise of your marriage.

The meanings you make have an impact on your life. By experimenting with different meanings, you can improve your attitude and ability to handle problems in your life because a different meaning gives you different feelings and different actions, and that gives you different results in your life.

Meanings are not facts. When a meaning causes you dysphoria or ineffectiveness, question it.

Make up other meanings. You're in the driver's seat.

Here's a completely unconventional anger management technique, and really whole new way of life that prevents much of the anger and conflict from ever starting:
Unnatural Acts

Here's a way to deal with conflict without getting angry, and coming to good solutions:
The Conflict of Honesty

Would you like a little encouragement and practical techniques for living your life with honor? Would you like to know some secrets of personal integrity? Check this out:
Forging Mettle

How about a little inspiration on your path to greater wisdom, goodness, and honor? Here it is:
Honest Abe

next: Recommended Reading

Chapter 115 of the book Self-Help Stuff That Works

by Adam Khan

RONALD RIGGIO, PHD, HAS BEEN doing research at the California State University at Fullerton for over seventeen years. He's been trying to find out what makes a person attractive to other people. He officially studies charisma. One important factor Riggio has discovered is the importance of "emotional expressivity": the ability to show your emotions on your face so people can easily read how you feel. People who don't show much emotion on their faces don't attract us very much. That's one of his findings
that seems pretty obvious.

But Riggio found something that's not so obvious: Charisma also requires the ability to not show emotions. He calls it "emotional control." It's what I'm calling a "poker face" because when you play poker and you get an exceptionally good hand, you don't want anyone else to know. Likewise, if you get a poor hand, you don't want them to know - it gives your opponents an advantage in betting against you. While you're playing poker, the basic rule of thumb is to not ever register your feelings overtly. The only thing that might give you away is the look on your face, so you have to show as little emotion on your face as you can.

Improving your ability to have a poker face when you need it (and only when you need it) can increase your effectiveness with people. Why? Because emotions are contagious when they can be seen. When you look at someone who is laughing, it tends to make you feel like laughing, doesn't it? Sure. And when you see someone crying, it can make you feel a little sad. Naturally. That's why good actors are so highly valued. They can make us feel emotions. We all have a tendency to experience the emotion we see on someone's face.

But, you may ask, what's wrong with that?

Nothing really, except sometimes. The problem is that there are some emotions you wouldn't want another to have. Two examples are anger and social awkwardness. When you're angry and you show it, the other person will probably become angry or defensive or afraid to some degree - they can see on your face your blood pressure is up, and their body will respond by increasing their own blood pressure. This rising intensity tends to interfere with communication.

Something similar happens when a person feels socially awkward. When you talk with someone who feels awkward because they don't quite know what to do and it shows, you feel somewhat awkward, too, don't you? Or how about when someone giving a speech feels uncomfortable up there in front of the group? Don't you also squirm in your seat a little just watching?

In these kinds of circumstances, the people would be better off and the people they're talking to would be better off if they would learn to conceal those particular emotions when they feel them.

We have all learned there are times when it is not appropriate to say certain things. You don't say to a widow at the funeral "the dude owed me money." At certain times and for certain situations, we all know some things are better left unsaid. Well, the emotion on your face is nonverbal, but it is still communication, and sometimes it is counterproductive to say nonverbally "I'm angry" or "I feel awkward."

The good news is that you can learn to put on a poker face when you need it. I'm not suggesting phoniness or pretending you're happy when you're angry. But there are times it helps to show no emotion on your face. It's a skill like any other, and it can be improved with practice.

Practice having a "poker face" when you feel negative emotions.

Self-Help Stuff That Works makes an excellent gift. It's a classy hardbound with a sewn binding that says practical stuff in a way that's easy to hear. You can now order it from any of twelve online bookstores. These are the most popular:

• http://www.amazon.com

• http://www.barnesandnoble.com

• http://www.borders.com

Close friends are probably the most important contributor to your lifetime's happiness and your health.
How to Be Close to Your Friends

If you have hard feelings between you and another person, you ought to read this.
How to Melt Hard Feelings

Is it necessary to criticize people? Is there a way to avoid the pain involved?
Take the Sting Out

Would you like to improve your ability to connect with people? Would you like to be a more complete listener? Check this out.
To Zip or Not to Zip

If you are a manager or a parent, here's how to prevent people from misunderstanding you. Here's how to make sure things get done the way you want.
Is That Clear?

Most the people in the world are strangers to you. Here's how to increase your feeling of connectedness to those strangers.
We're Family

next: TRUE Love

Find out about the risks, impact and effects of undertreated or untreated bipolar disorder.

Bipolar is commonly undiagnosed or diagnosed as another condition for an average of 8 years, patients do not seek help for up to ten years after the first appearance of symptoms, and over 60% of patients are untreated, undertreated or inappropriately treated at any given time.

The vast majority of patients with bipolar disorder have multiple recurrences (Keller et al, 1993), and it is very rare for patients to have a single episode of hypomania or depression in bipolar disorder over a lifetime. The length of symptom-free intervals often decreases with age. The presence of first-rank symptoms may predict chronic psychosocial dysfunction, while the risk of relapse is high in the presence of mood-incongruent psychotic features (Tohen et al, 1992).

Untreated bipolar disorder is commonly associated with substance use, abuse and dependence (Tohen et al, 1995); school and work failure; interpersonal dysfunction and relationship breakdown; personality dysfunction could be the result of a turbulent clinical course at crucial stages of development; the lifetime risk of suicide is 10-15% (Tsuang et al, 1978); and there is an increased risk of violence and homicide, especially with poorly controlled psychotic bipolar disorder.

The average female with bipolar disorder with an onset at age 25 will lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health compared with normal controls (US DHEW, 1979). This is in addition to the risk of suicide.

next: Early Warning Signs of a Bipolar Relapse or Oncoming Episode Is Bipolar Disorder A Biochemical Problem or Something That's Inherited?
~ bipolar disorder library
~ all bipolar disorder articles

References:

Keller MB, Lavori PW, Coryell W. 1993. Bipolar I: A Five Year Prospective Follow-Up. J Nerv Ment Dis. 181:238-245

Narrow WE, Regier DA, Rae DS. Use of Services: Findings from the NIMH Epidemiologic Catchment Area Program. Arch Gen Psychiatry. 1993. 50:95-107.

NDMDA. National Survey of NDMDA Members Finds Long Delay in Diagnosis of Manic Depressive Illness. Hosp Commun Psychiatry. 1993. 44: 800-801

Tohen M, Tsuang MT, Goodwin DC. 1992. Prediction of Outcome in Mania by Mood Congruent or Mood Incongruent Psychotic Features. Am J Psychiatry. 149: 1580-1584.

Tohen M, Zarate C, Turvey C. 1995. The McLean First-Episode Mania Project Proceedings of the 148th Annual Meeting, American Psychiatric Association, Miami, Fl.

Tsuang MT, Woolson RF. 1978 Excess Mortality in Schizophrenia and Affective Disorders. Do Suicides and Accidental Deaths Solely Account for this Excess? Arch Gen Psychiatry. 35: 1181-1185.

US DHEW Medical Practice Project 1979. A State of the Service Report for the Office of the Assistant Secretary for the US Dept of Health, Education and Welfare. In: Policy Research.

next: Early Warning Signs of a Bipolar Relapse or Oncoming Episode Is Bipolar Disorder A Biochemical Problem or Something That's Inherited?
~ bipolar disorder library
~ all bipolar disorder articles

P-YMRS (Young Mania Rating Scale) helps parents assess whether their child might have the symptoms of bipolar disorder.

The P-YMRS consists of eleven questions that parents are asked about their child's present state. The original rating scale (Young Mania Rating Scale), was developed to assess severity of symptoms in adults hospitalized for mania. It has been revised in an effort to help clinicians such as pediatricians determine when children should be referred for further evaluation by a mental health professional (such as a child psychiatrist), and also to help assess whether a child's bipolar symptoms are responding to treatment. The scale is NOT intended to diagnose bipolar disorder in children (that requires a thorough evaluation by an experienced mental health professional, preferably a board-certified child psychiatrist). This version has been tested in a pediatric research clinic with a high number of children with bipolar disorder. The child's total score is determined by adding up the highest number circled on each question. Scores range from 0-60. Extremely high scores on the P-YMRS increase the risk of having bipolar disorder by a factor of 9, roughly the same increase as having a biological parent with bipolar disorder. Low scores decrease the odds by a factor of ten. Scores in the middle don't change the odds much.

The average scores in children studied were approximately 25 for mania (a syndrome found in patients with Bipolar-I), and 20 for hypomania (a syndrome found in patients with BP-2, BP-NOS, and Cyclothymia). Anything above 13 indicated a potential case of mania or hypomania for the group that was studied, while anything above 21 was a probable case. In situations where the odds of bipolar diagnosis are high to begin with (a child with mood symptoms with 2 parents having bipolar disorder), the P-YMRS can be extremely helpful. But for most groups of people, the base rate of bipolar disorder is unknown but low. Then, the most that a high score can do is raise a red flag (similar to having a family history of bipolar disorder).

Even a high score is unlikely to indicate a bipolar diagnosis. The P-YMRS is performing similar to the screening test for prostate cancer, where it will identify most cases of bipolar, but with an extremely high false positive rate. The P-YMRS is presently being studied in a community pediatrics practice to determine its validity in that setting. The P-YMRS is provided here for educational purposes only, and should not be used as a substitute for evaluation by mental health professionals.

Reference: The P-YMRS was revised from the Y-MRS originally developed by Young et al and was presented at the First Annual International Conference on Bipolar Disorders, Pittsburgh, June, 1996 (Gracious BL et al). Exploration of its statistical properties are outlined in: Discriminative Validity of a Parent Version of the Young Mania Rating Scale. Gracious, Barbara L., Youngstrom Eric A, Findling, Robert L, and Calabrese Joseph R et al. Journal of the American Academy of Child and Adolescent Psychiatry (2002) 41(11): 1350-1359.

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If you have a mental illness, what can you do to better cope with war, terrorism and other types of traumatic events?

With ongoing war in Iraq and the continuing terrorist threat here at home, Americans are experiencing many powerful emotions. For most people, feelings of anxiety, sadness, grief and anger are healthy and appropriate. But some people may have more profound and debilitating reactions to the war. This could be especially true for those who live with serious mental illnesses, such as schizophrenia, bipolar disorder, depression, substance abuse problems, anxiety or post-traumatic stress disorder.

It is important to remember that everyone reacts differently to trauma and each person has his or her own tolerance level for difficult feelings. When confronted with a crisis, a person with a mental illness may experience the symptoms of his or her disorder or see new ones emerge.

Some consumers who have experienced this say that there are warning signs. Here are some common warning signs of an oncoming relapse:

• Stopping your usual routines, such as attending school or joining family activities
• Changing your sleeping pattern or eating habits, not caring about your appearance, difficulties with your coordination, lapses in short-term memory
• Experiencing mood swings, feeling out of control or very agitated, thinking about suicide or violence
• Doing things that make others think you're out of touch with reality
• Hearing or seeing things that other do not
• Being unable to let go of an idea, thought or phrase
• Having trouble thinking or speaking clearly
• Deciding not to take your medications or to follow through with your treatment plan (missing appointments, etc.)
• Feeling unable to enjoy things that are usually pleasurable
• Being unable to make even routine decisions

Different people can have different warning signs, so be aware of anything that seems out of the ordinary for you. If people around you notice changes, listen to what they say. You could be totally unaware of changes in your behavior. Be sure to report any changes, especially any talk or thoughts of suicide or self-inflicted injury, to your doctor or treatment team.

Even in uncertain times such as these, you must take an active role in managing your illness. Continue to follow the treatment plan you've developed with your doctor or treatment team:

• Take your medications just as your doctor prescribed
• Keep your therapy appointments
• Avoid alcohol use
• Do not use illicit drugs or any that are not prescribed specifically for you
• Keep a journal or diary
• Have prescribed laboratory and psychological tests
• Stay connected with or get involved in a support group
• Report any signs of a relapse to your treatment team

To get through the current crisis, take advantage of the people and tools that are available to you:

• Involve family and friends. Don't be afraid to ask for help.
• Keep your doctor and treatment team informed about how the war is affecting you.
• Make contact with self-help groups and support organizations that help people with serious mental illnesses and related problems.
• Access peer support and other programs, ranging from drop-in centers to housing, employment and recreational opportunities, that can help you better manage your illness.
• Learn all you can about your illness and what you have to do to move to recovery.
• Use the computer to get information about your illness, and to contact and exchange views and experiences with others who share your experiences.
• Stay in touch with your spirituality, if you find that comforting. Be optimistic about the challenges that lie ahead.

Find what works for you. The process of moving toward recovery, especially in times or war or crisis, is not a simple one. Stay fully involved in the process by following your treatment plan and seeking the support you need, when you need it.

For More Information:

For more information, contact your local Mental Health America affiliate or the national Mental Health America office.

Source: Mental Health America

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A short essay about investing yourself in a relationship, then the person leaves and you have to let go.

Life Letters

To a friend who is hurting,

You are saddened, hurt and angry that you have put so much energy into yet another relationship, given unselfishly of yourself to one more wounded soul. And now that she is nourished, comforted, and healed, she's walked out of your life, abandoned you. I watch this strong woman whom I have come to care deeply about weep bitter tears. As is so often the case when I am with you, I am once again at a loss. Words of comfort seem inadequate just now. I have only my compassion and understanding to offer. I sit quietly for a time, holding you in my heart.

Then I remember the squirrel. And you, the weaver of words and worlds, quietly listen while I tell you a story...

I had been working on a case summary when I heard just out my window, a soft and pathetic wailing. When I looked outside, I discovered, to my distress, a tiny animal struggling in what looked very much to me like death throws. Its tiny body was writhing and quivering in apparent and absolute agony. I turned away from the window in horror, but I couldn't block out the creature's cries. My first impulse was to turn the music on loudly and return to my work, allowing nature to take its course. Within minutes though, I was reluctantly stepping outside.

It was a squirrel. Its little body was gyrating so rapidly that I couldn't even begin to assess the damage. Satisfied that I was helpless, I ran off down the road to my neighbor's house where I began pounding on the door. Basil appeared in the doorway looking anxious, understanding instantly that I was distressed. I blurted out my story and then took off towards my cottage, trusting Basil to follow. Bless him, he did. As we stood beside the squirrel, I asked him what we should do. "Jeez, Tammie, I don't know." He sounded irritated. "I could chop off its head," he offered unenthusiastically. "Oh, No!" I exclaimed, horrified. "Can you help me get it into a container so I can take it to the vet?" I whined. He clearly didn't want to, but he said he would. I ran into our storage shed and brought out a lobster pot with a lid. Basil, grim faced, proceeded to prod the squirrel into the pot with a stick. I placed the pot on the passenger seat and sped out of the driveway. I had just gone a short distance when the squirrel began his dramatic attempts to escape. The lid began clattering, the pot began bouncing, and I was struck by two thoughts. One, I didn't know where the nearest vet was, as we used one in another town; and two, what if the squirrel had rabies, managed to escape and bit me! I could see the headlines now, "Local woman attacked by rabid squirrel while driving!"

I was a nervous wreck, attempting to drive with one hand and keep the lid on (literally and figuratively) with the other. I pulled into a gas station, saw a young man, blew my horn and motioned him over. "Where's the nearest vet?" I practically yelled to the poor kid. He looked leery as he peered into the blazer window at a wild-haired, wild-eyed woman, desperately struggling to hold a cover on a pot which contained a screaming, unidentified object. He told me how to get to the vet, glancing uneasily over at my captive pot as he recited the directions. I thanked him and was off again. The squirrel seemed to be unbelievably strong, and I was terrified that I was going to lose the battle. I fought with the lid, drove, and devised a plan of retreat should the squirrel win.

Finally, I made it to the animal hospital. I was not well received. The receptionist informed me coldly that they did not treat wild animals. I begged her. I promised I would pay whatever the fee was. The vet, a young and kind looking woman, agreed to take a look at the squirrel as soon as she could, and suggested I come back just before closing time.

When I returned, I was handed a cat carrying box which contained a pretty eyed, anesthetized squirrel, resting peacefully. I was informed that he had sustained what looked to be a pretty serious head injury, and had been infested with fleas. He had been treated for both conditions. I was told to keep him safely in the box for 24 hours, and that if he survived the night, he would probably recover, and it would then be safe to release him. I was presented with a ninety-dollar bill, which I gratefully paid, and off we went home.

I watched the squirrel until late into the night. He cried pitifully and I vacillated between fearing he would die one moment, and wishing for us both to be put out of our misery the next. I barely slept all night and was thrilled to find him wide-eyed and alive the next morning. After seeing Kristen off to school, I reluctantly went to work, hating to leave him alone. On the way to my office, I began to consider keeping the squirrel for a pet. I thought about him off and on all day - about my investment in his rescue, and my growing attachment to and sense of ownership of him. I vacillated back and forth and by the end of the day, I reluctantly accepted what I had to do.

That night, I watched with sadness and with pride, as Kevin set my squirrel free. As my little friend scampered away, I watched him disappear with both a sense of longing as well as satisfaction.

My story was over. We sat again in silence for a time. Then I added, "When you invest a huge part of yourself into something or someone, it almost begins to seem as though some part of them belongs to you, even though you know realistically that we belong only to ourselves. Sometimes, all we get to do is care for something or someone and then have to let go." I paused for a moment, searching for what I would say next and then continued. "We usually feel a significant loss in the letting go, we can even feel abandoned. We might even begin to wonder why we bothered in the first place. What we don't always recognize is that we're never left empty handed. We can hold on to the satisfaction and pride that comes from knowing that we've participated in someone's growth or healing, that our lives have made a difference. "

You smiled at me, and I knew immediately that you understood. It seems my friend that you always do.

Yours Always, A Fellow Traveler

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