Schizophrenia medications are typically antipsychotic medications. These drug treatments for schizophrenia are specifically used to treat the positive symptoms associated with psychosis, such as hallucinations and delusions. Schizophrenia medication is normally prescribed by a psychiatrist and might be taken orally or by long-acting injection. Antipsychotics for schizophrenia can allow people with this mental illness to live normal and fulfilling lives in the community.

Antipsychotics for schizophrenia consists of typical and atypical antipsychotics, also known as neuroleptics. Atypical antipsychotics are the preferred treatment today. Typical antipsychotics are considered first-generation antipsychotics and were the first medications developed to treat psychosis.

Typical or Conventional Antipsychotic Medications for Schizophrenia

Typical antipsychotics, also known as conventional antipsychotics or major tranquilizers, were first developed in the 1950s for the treatment of psychosis. Conventional antipsychotics block two types of chemical receptors in the brain – receptors for dopamine and serotonin. Chlorpromazine (Thorazine) was the first conventional antipsychotic developed for schizophrenia.

Conventional antipsychotics are measured via potency when compared to chlorpromazine (Thorazine). The potency of antipsychotic medication indicates how much medication is needed in order to achieve the desired effects to that of 100 mg of chlorpromazine (Thorazine).¹

Low potency conventional antipsychotics include:

• Chlorpromazine (Thorazine)
• Thioridazine (Mellaril)

Medium potency conventional antipsychotics include:

• Loxapine (Loxapac, Loxitane)
• Molindone (Moban)
• Perphenazine (Trilafon)
• Thiothixene (Navane)
• Trifluoperazine (Stelazine)

High potency conventional antipsychotics include:

• Haloperidol (Haldol, Serenace)
• Fluphenazine (Prolixin)
• Zuclopenthixol (Clopixol)

Side Effects of Conventional Antipsychotics for Schizophrenia

Side effects vary depending on the antipsychotic, but the side effects of major concern are those that affect something called the extrapyramidal system. The extrapyramidal system is a part of the nervous system that controls motor function. Disruption of the extrapyramidal system can cause:

• Inner restlessness and an inability to sit still (akathisia)
• Tremor, rigidity, unsteadiness (parkinsonism)
• Repetitive movements or postures (dystonia)
• Involuntary body movements that may be slow (tardive dyskinesia)

The prevalence of tardive dyskinesia with conventional antipsychotics is about 30%.²

Atypical Antipsychotics for Schizophrenia

Atypical antipsychotics, also known as second generation antipsychotics, were first discovered in the 1950s but weren’t put into clinical practice until the 1970s. Atypical antipsychotics also alter dopamine and serotonin pathways in the brain but do so to a lesser extent. The first atypical antipsychotic was clozapine (Clozaril) but it has fallen out of use due to white blood cell side-effect concerns. Other atypical antipsychotics have mostly taken its place.³

Atypical antipsychotics for schizophrenia include:

• Aripiprazole (Abilify)
• Asenapine (Saphris)
• Clozapine (Clozaril)
• Lurasidone (Latuda)
• Olanzapine (Zyprexa)
• Paliperidone (Invega)
• Quetiapine (Seroquel)
• Risperidone (Risperdal)
• Ziprasidone (Geodon)

Side Effects for Atypical Antipsychotics for Schizophrenia

As with conventional antipsychotics, side effects vary by medication. While extrapyramidal (motor function) side effects are less common with atypical antipsychotics, they still can occur. Weight gain, blood sugar (diabetes) and cardiovascular issues are also of major concern with atypical antipsychotic treatment.

article references

No Cures for Schizophrenia. Recovery From Schizophrenia Is Possible.

When one is diagnosed with schizophrenia, it’s natural to ask, “is schizophrenia curable?”. Some people even offer “cures” for schizophrenia online through pills, diets and other means. Unfortunately, there is no known cure for schizophrenia.

Schizophrenia is a disease that involves changes in brain structure and brain chemicals. And while we can see many of the differences between a schizophrenic brain and a non-schizophrenic brain, we are a long way from fully understanding the complexities of this illness to the point where schizophrenia can be cured. At this time, the best doctors can do is treat the symptoms of schizophrenia.

Recovery from Schizophrenia

Many people can, however, recover from schizophrenia. In the recovery of schizophrenia, symptoms are manageable and the person is able to live a fairly normal life. People in recovery from schizophrenia have jobs, families, friends and all the other components of a fulfilling life. Additionally, those receiving treatment for schizophrenia find significant improvement in their symptoms and are able to live on their own.

In the recovery of schizophrenia:¹

• 25% of people are in recovery within 10 years
• 25% of people are significantly improved and living independently within 10 years

Cures for Schizophrenia

Cures for schizophrenia, then, can be thought of as the ways in which people with schizophrenia obtain recovery. Recovery from schizophrenia is typically attained through the use of a combination of approaches.

The foundation of recovery from schizophrenia is medication, specifically, antipsychotic medication. This type of medication is known to treat the symptoms of psychosis and other symptoms of schizophrenia. There are many antipsychotics to choose from and a person may need to try more than one to find the antipsychotic medication that works for them.

Once a person is stabilized on medication, the first major step towards recovery from schizophrenia has been achieved. Once stable, various types of therapy for schizophrenia can be added as part of the treatment plan.

By utilizing multiple therapies and medication, recovery from schizophrenia is possible.

Future Cures for Schizophrenia

Researchers are actively working on sequencing the genes that are thought to put a person at high risk of schizophrenia. In the future, treatments that are specific to a person’s genes may be available and more effective than current treatments available today. Moreover, gene therapy may one day be available to fix any malformed genes directly.

article references

Therapy for Management of Schizophrenia

While medication is considered the primary treatment for schizophrenia, therapy for schizophrenia is also critical in the successful management of schizophrenia. Therapies that address the psychology of the individual, as well as their behaviors and skills, can all help in schizophrenia management. Therapy for schizophrenia is generally done once a person is already stabilized on medication.

There are several types of schizophrenia therapy known collectively as "psychosocial" therapies. Psychosocial refers to therapies that address the psychology of the person, as well as the way in which they interact with their social environment. Types of psychosocial therapy include:

• Substance abuse treatment – when substance abuse issues are present
• Illness management skills including education for the individual and their family
• Rehabilitation –social skills, cognitive and vocational training
• Cognitive behavioral and other types of psychotherapy for schizophrenia
• Schizophrenia self-help
• Schizophrenia support groups

Illness Management Therapy for Schizophrenia

When a person is diagnosed with schizophrenia, one of the major challenges is learning about the illness because so many people have false notions about the disease (see Myths of Schizophrenia). Education about mental illness, in general, and schizophrenia in particular, gives a person a foundation on which to build schizophrenia management techniques.

On top of this education, many skills can be taught to help a person with schizophrenia manage their own illness. Part of this therapy for schizophrenia includes:¹

• Education on the symptoms of schizophrenia
• Training on how to look for early warning signs of a relapse
• What do to in the event of a relapse
• How to create and use a treatment plan
• How to prevent a relapse
• How to manage everyday symptoms of schizophrenia

Rehabilitation Therapy for Schizophrenia

Rehabilitation therapy for schizophrenia can take many forms but its focus is on improving a person’s ability to think and interact with the world around them. Rehabilitation therapy is designed to address the deficits caused by schizophrenia.

Vocational training and support programs are one example. Because schizophrenia typically occurs during the years when people enter the job market, they may not have the skills to compete (see Schizophrenia Facts and Statistics). Vocational training aims to change that. Supported employment programs can also help a person with schizophrenia get and maintain gainful employment.

Cognitive training is designed to address the cognitive deficits created by schizophrenia. This schizophrenia management technique is based on the principle that brain cells can be encouraged to grow and this additional growth can be created through cognitive exercises. Computerized skills practice is one form of cognitive training. It’s known that cognitive training can lead to lasting improvement in functioning that continues even after the training is stopped.²

Social skills therapy for schizophrenia is also important, as those with schizophrenia are known to have trouble developing social relationships and understanding social cues.

Psychotherapy for Schizophrenia

Various types of psychotherapy can be useful in treating schizophrenia. One-on-one psychotherapy can be useful, as can family therapy, to address the issues that schizophrenia has created within the family’s dynamics.

Cognitive behavioral therapy (CBT) for schizophrenia is the most studied psychotherapy and it focuses on changing how a person thinks and behaves. Cognitive behavioral therapy can help with the management of schizophrenia symptoms that are not addressed by medication and help prevent relapse. This type of therapy for schizophrenia helps teach a person not to listen to the auditory hallucinations that are often part of schizophrenia.

Among other things, psychotherapy for schizophrenia can help:

• Facilitate communication with others, like family and friends
• Address substance abuse issues
• Encourage healthy lifestyle choices
• Address additional disorders like anxiety and depression
• Develop social skills
• Manage stress

Self-Help and Support Group Therapy for Schizophrenia

While professional therapies centered around the person with schizophrenia have many uses, they cannot replace the community and support often found in group therapy environments. Group therapy for schizophrenia has the benefit of bringing together like-minded people and creating a space in which people know that everyone there really “gets” what the others are going through. Everyone in the group feels less alone and they can advocate and comfort each other during the more challenging parts of the mental illness.

Professional members may or may not be involved and often these groups are run by community and national organizations like the National Alliance for Mental Illness (NAMI). Support groups can also be found for the family of the person with schizophrenia.

No matter how it’s found, it’s critical to remember that therapy for schizophrenia is available and does work.

article references

Schizophrenia treatment typically consists of medication and psychological and functional counseling. While skills and other types of therapy are useful, medication is still the cornerstone of the treatment of schizophrenia. Psychiatrists, therapists, counselors, social workers, dieticians, and others may all be involved in treating schizophrenia.

Schizophrenia Treatment: Medication

Schizophrenia is treated with antipsychotic medication designed to drastically reduce and hopefully stop the symptoms of psychosis (hallucinations and delusions). Within one year, only 20% of people on antipsychotic medication will relapse compared to 80% of those who have stopped antipsychotic medication treatment.

There are no clear schizophrenia treatment guidelines about which antipsychotic to try first. However, factors that go into the decision include:

• Cost
• Availability
• Adherence likelihood
• Effectiveness
• Side effects (tolerability)
• Method of delivery (such as oral or injection)

Schizophrenia and Treatment with Antipsychotic Medication

The main choice in antipsychotic schizophrenia treatment is whether to use a first or second generation antipsychotic. Most often, the doctor will select a second-generation antipsychotic medication called an atypical antipsychotic. First generation antipsychotics (conventional, or typical antipsychotics) are not normally the first choice to treat schizophrenia due to side effects that can severely affect body movements; however, those who do not respond to second-generation antipsychotics (atypical antipsychotics) may respond to first-generation antipsychotics.¹

First generation antipsychotics are known to induce movement disorders (tardive dyskinesia) in more than 1-in-3 patients and some of these movement disorders may be permanent, even after the medication is stopped. Movement side effects can include:

• Inner restlessness
• Painful muscle cramps
• Tremor
• Involuntary and repetitive movements

First generation antipsychotics are also known to be related to high levels of prolactin (a hormone) in the blood, as well as a severe neurological side effect known as neuroleptic malignant syndrome (NMS). Blood tests are often required to check for possible problems with this type of schizophrenia treatment.

Atypical antipsychotic schizophrenia treatment is associated with weight gain as well as blood sugar and cholesterol issues. People on these medications can develop type 2 diabetes. Movement disorders can also occur with this type of schizophrenia treatment but they are far less prevalent.

Other Types of Schizophrenia Treatments

Other types of schizophrenia treatment are known as psychosocial interventions. It’s important to treat schizophrenia with this type of therapy, as medication alone isn’t normally sufficient to increase the level of functioning of a person with schizophrenia. The therapies most studied for schizophrenia include:

• Skills training
• Cognitive behavioral therapy (CBT) – a type of psychotherapy focused on building skills and changing behaviors
• Cognitive remediation – uses brain exercises to improve the cognitive impairment typical in schizophrenia
• Social cognition training – focuses on creating an understanding of social relationships and interactions

Individual and family therapy can also be useful schizophrenia treatments, as schizophrenia often affects everyone in a family. Vocational rehabilitation and supported employment are also common parts of schizophrenia treatment ("Therapy for Schizophrenia").

Schizophrenia support groups and organizations can also be helpful in schizophrenia treatment. Many communities have programs to help people with schizophrenia get access to housing and other services. This provides them with the best opportunity at successful independent living in the community. Social workers can also be helpful in this area. ²

article references

What is and what isn't an orgasm? What happens in the body? Faking an orgasm.

Orgasms
The orgasm is different for everyone and notoriously hard to define. Psychosexual therapist Paula Hall explains the physical and emotional factors involved for men and women, why quality matters more than quantity and why faking it is a waste of time.

What is an orgasm?

In 1953 a well-known therapist defined it as "an explosive discharge of neuromuscular tension". There are other definitions, but the word 'tension' comes up in most. Which suggests that when you have sex you deliberately wind yourself up just so that you can experience the pleasure of returning to normal afterward. Bizarre!

What happens in the body?

The technical stuff that creates all this tension is pretty amazing.

• Your heart pumps faster and your breathing gets heavier to fuel those tensing muscles.
• Hormones such as endorphins and oxytocin are pumped round your brain and body, telling you this is fun.
• Blood is pumped to your genitals to create the tension that will ultimately trigger a pudendal reflex (muscular spasm of the genitals).
• That reflex will result in your pelvic-floor muscles contracting between five and 15 times at 0.8-second intervals. This is an orgasm as we know it.
• A wandering neural pathway that bypasses the spine has recently been discovered, explaining why some paraplegics say they can experience orgasms.

What an orgasm isn't

An orgasm should never be the objective of sex. You can have a great time with a partner, feeling aroused, sensual, intimate and loving, and not have an orgasm. Yes, it's fun - but unless you're trying to get pregnant it shouldn't be your primary goal.

You can't make someone have an orgasm. What you can do, besides physically stimulating your partner, is create a safe, comfortable and caring environment for them in which an orgasm might happen.

Orgasm is not limited to the genitals; some people can experience orgasm without their genitals being touched. Some people describe the sensation as a "tingle"; for others, the feelings go all over the body.

Faking it

Why do some people - male and female - fake orgasms? Maybe because we tend to see orgasm as the signal to stop sex. If, for some reason, your mind or body doesn't fancy an orgasm you could be at it forever.

Most people who fake it do so to please their partner. They feel they're letting them down if they don't make it. Instead of pretending, try and create a relationship where, if you're not in the mood or you've lost the momentum, you can say so honestly.

Quality not quantity

We tend to make a huge fuss about orgasms in our society. Most articles about enhancing your sex life focus on improving orgasms or having more of them. But the intensity of an orgasm is not an indication of sexual satisfaction. If you want a good orgasm, you can do it yourself. If you want a satisfying sexual relationship, you'll need a lot more.

In psychosexual therapy, people are told about the 2-6-2 rule. Out of every ten times you have sex, the chances are that twice it'll be fantastic and mind-blowing, and the earth will move; six times it'll be nice but nothing special; and twice you'll wish you hadn't bothered.

Related Information:

• Difficulty Reaching Orgasm
• Pleasing Yourself
• G-spot

Medical, physical and psychological reasons for not being able to reach an orgasm. Discover orgasm triggers

Difficulty reaching orgasm

Research estimates 12 percent of women never reach a climax - and 75 percent don't orgasm during intercourse. Is it a physical problem, an emotional block, or both? Psychosexual therapist Paula Hall takes a closer look.

Physical reasons

The most common physical cause is lack of adequate stimulation to the clitoris. The majority of women need direct touch to achieve orgasm, which often doesn't happen through intercourse alone.

"Our bodies aren't machines - you can't get an orgasm just by pressing the right button"

The second most common factor is tiredness or general illness. Our bodies aren't machines - you can't get an orgasm just by pressing the right button. If you're feeling run-down, your body's priority is sleep and recuperation, not sexual gratification.

Medical reasons

There are some illnesses that make orgasm difficult. Broadly speaking they're vascular, neurological or hormone-deficiency disorders.

The problem could be a side effect of a particular medication. Very occasionally pelvic surgery can cause nerve damage and loss of sensation. If you think any of these conditions may apply to you, talk to your GP.

If, however, you're in good physical health and you're getting enough sleep, it's more likely there's some kind of psychological block.

Psychological reasons

Well-meaning friends may tell you to just "try to relax", but if it was that easy you'd have done it by now! The trouble is, these kinds of psychological blocks aren't rational - you can't simply "pull yourself together".

Below is a list of some of the most common types of problems women have talked about. See if any apply to you:

• Being a perfectionist. Sex has to be just right. The environment has to be just so and you have to be in the right mood.
• Fear of losing control. This is a character trait in many areas of your life, not just sexually.
• Poor self-esteem or body image. Worrying about whether your bum looks big rather than enjoying your physical sensations is a major passion wrecker!
• Shame or guilt about sexuality. This might be due to negative childhood messages or a sexual trauma.
• Distractions. Are the children asleep? Will the phone ring? Can the neighbors hear? Did I put the cat out? Did I email that report? Whatever the distraction, it means your mind is not on the job.
• Being a spectator. You know that saying, "A watched pot never boils" - well it's also true of orgasms. If you're waiting for the moment, you're not enjoying the moment.
• Relationship problems. You can't expect to have enjoyable sex with an enemy. If there's tension in your relationship, sort it out before you enter the bedroom.

Orgasm triggers

There are several ways in which you can help yourself achieve a more fulfilling sexual experience:

• Breathe deeply or pant to get oxygen to those tensing muscles.
• Arch your back or try a different position to maximize clitoral stimulation.
• Rhythmically squeeze your pelvic floor muscles.
• Escape into your favorite fantasy to block out any negative thoughts or distractions.

Further help

If some of these points have rung a bell for you, you may find that simply talking it through with your partner will help. You could also try some of the practical exercises on our site. These have tips and techniques that you can print out and try.

It may also be helpful to get advice from a sex therapist or couple counselor via Relate or the British Association for Sexual and Relationship Therapy. See related links.

Also, there are lots of self-help books available. Some recommended titles are:

A Woman's Guide to Loving Sex by Tricia Barnes and Lee Rodwell (Boxtree London) Becoming Orgasmic, Julia R Heiman, Leslie LoPiccolo and Joseph LoPiccolo (Piatkus London) Women Without Sex by Catherine Kalamis (Self Help-Direct Publishing)

Related Information:

• Get to Know Your Body
• The G-Spot
• Orgasms

Bringing back the buzz into lovemaking. Practical exercises to make sex exciting and how to go back to the good bits.

Making sex exciting

Sleeping with the same person can become predictable in time, but that doesn't mean it's all over. Sex and relationships counselor Suzie Hayman explains why the fire can fade even if you're still in love - and how to reignite the spark.

Bringing back the buzz

Once the honeymoon's over and you settle into the humdrum pattern of everyday life, it's easy to get bored. Sex might go from something you do because you can't keep your hands off each other to free entertainment on a Friday night because there's nothing on TV.

Most of us assume the sex we enjoy in the first heady days of a relationship is the best we can expect, and it's all downhill from there. But here's the good news. It can get better over time rather than worse, and it's easy to put the freshness back. In fact, if you've been together for some time, it can even become more exciting and adventurous than early-days sex.

The one big advantage an established couple has over a new one is the increased level of trust. This makes it more comfortable to ask for something different and new that might be embarrassing with a relative stranger.

To keep things exciting, you'll have to go out of your way to make romantic gestures and suggest new approaches, but it's worth it. You can put fire and excitement into an established relationship far more easily than you can put trust into a new one.

In fact, people who have affairs often say they're looking for the love and sexual satisfaction they felt they weren't getting at home. But, according to research, even couples who said their sex life was unsatisfactory tended to admit it was still better than extra-marital sex.

Going back to the good bits

The feeling that the magic is fading is caused by the adrenaline charge wearing off. Sooner or later it becomes clear which way your shared love-making is going to go, and the knowledge that you both have a well-worn repertoire of sexual practices kills expectation and excitement.

One couple I counseled had exactly this problem. They still loved each other but felt their sex life had become stale and disappointing. I recommended that they start again. They realized that all the things they did to each other when they made love were based on discoveries from the first year or so of their relationship.

Starting over

Each had found touches, techniques and preferences that the other seemed to enjoy and had developed a well-worn routine, from first kiss to final hug. But their tastes had changed. Things they once liked were now boring, and they were ready to try things they would have been too shy to suggest in the early days.

Practical exercises

The exercises I asked this couple to try are in our practical exercises section. There are lots of ideas to help you revitalize your sex life, and tips and techniques to print out and try.

Related Information:

• Have You Lost Interest in Sex?
• Get to Know Your Body
• Sexual Exercises Women
• Sexual Exercises Man
• Aphrodisiacs

New study indicates men are better at detecting their partner's infidelities than women. Discover why men are better at uncovering cheating wives.

Unfaithful women beware. Chances are your male partner is on your case. In fact, he is likely to suspect infidelities even when you have kept to the straight and narrow. The flip side is that to counter this constant vigilance, women may be better than men at concealing illicit liaisons.

Paul Andrews at Virginia Commonwealth University in Richmond and colleagues gave 203 young heterosexual couples confidential questionnaires asking them whether they had ever strayed, and whether they suspected or knew their partner had strayed. In this study, 29 percent of men said they had cheated, compared with 18.5 percent of women.

The men were better than women at judging fidelity. "Eighty percent of women's inferences about fidelity or infidelity were correct, but men were even better, accurate 94 percent of the time," says Andrews. They were also more likely to catch out a cheating partner, detecting 75 percent of the reported infidelities compared with 41 percent discovered by women. However, men were also more likely to suspect infidelity when there was none.

Andrews says this makes evolutionary sense because unlike women, men can never be certain a baby is theirs. "Men have far more at stake," he says. "When a female partner is unfaithful, a man may himself lose the opportunity to reproduce, and find himself investing his resources in raising the offspring of another man."

"This adds to the evidence that men have evolved defenses to detect their partner's infidelity," says David Buss at the University of Texas, Austin. He adds that it demonstrates a "fascinating cognitive bias that leads men to err on the side of caution by overestimating a partner's infidelity".

Andrews suggests that women have countered this by becoming better at covering up affairs. Complex statistical analysis of the data hinted that a further 10 percent of the women in the study had cheated on top of the 18.5 percent who admitted to it in the questionnaires, whereas the men had been honest about their philandering.

Source: New Scientist

For many, communicating about sex isn't easy, but it's an important part of a relationship. Here are some guidelines for communicating about sex.

Introduction

Between men and women, there can be a lot of double meanings, confusion, and missed communication. When this happens around sexual issues, it can mean trouble - like acquaintance rape.

FACT: We have been taught to value certain kinds of communicating (pleasant and agreeable for women, tough and dominating for men) - but these are stereotypes which often lead to poor communication.

It is very important to communicate what you really want. You have the right to set sexual limits and to communicate them. It's not unfeminine to express an interest in having sex, and it's not "uncool" to make your lack of interest clear.

If you don't like what someone is saying or doing to you, tell them how you feel. Be very clear and assertive. If you mean no, say "NO!"

Be firm if necessary. You have the right to be rude and aggressive in a threatening situation.

Ask yourself, "Can I say no clearly?" before entering into a potentially dangerous situation.

Things Men and Women Often Think But Don't Say to Each Other

Men

It's very hard to always be the one to offer yourself. Some men are afraid that women say yes, but mean no. Men don't like to pretend that they always want sex. Men are afraid of being rejected and turned down.

Women

Women are socialized to believe they should always go along with what men want, in spite of what they want. Many women are afraid of hurting men's feelings. Some women don't like pretending that they don't want to have sex. They may enjoy sexual contact - hugging, foreplay - but do not want to have intercourse.

Men and Women

Do want friendship with each other. Sometimes the friendship includes sex, sometimes it does not.

Find out what constitutes an abusive relationship, the signs of an unhealthy relationship, how to get out of a bad relationship and how to help a friend in an abusive relationship.

During your teen years, you will have relationships with a lot of people. These relationships will probably include friendships and dating relationships. Most of the time, these relationships are fun, exciting, and healthy, and they make us feel good about ourselves. Sometimes, however, these relationships can be unhealthy and can be harmful to you or other people involved. Unhealthy relationships can be risky because someone can get hurt physically or emotionally. This information guide was created to help you to understand the signs of an unhealthy or abusive relationship and to learn ways to change a bad situation.

What is a healthy relationship?

In healthy relationships, you and your friend or the person you are dating feel good about each other and yourselves. You do activities together, like going to movies or out with other friends, and you talk to one another about how you are feeling about each other. These relationships can last a few weeks, a few months, or even many years. Healthy relationships are fun for both people!

In healthy relationships, there is respect and honesty between both people. This means that you listen to each other's thoughts and opinions and accept each other's right to say no or to change your mind without giving each other a hard time. Communication is also important in healthy relationships. You should be able to let the other person know how you are feeling. You might disagree or argue sometimes, but in healthy relationships, you should be able to talk things out together to reach a compromise that works for both of you.

My friend gets mad if I hang out with other people, what should I do?

Be honest and stick to your decision. Tell your friend you like spending time with him or her but that you also want to spend time with other friends and family. Whether you are in a close friendship or a dating relationship, it is important for both of you to stay involved with the activities and interests you enjoyed before you became close. In a healthy relationship, you both need time to hang out with other friends as well as time for yourselves.

What are risky or unhealthy relationships?

In a risky or unhealthy relationship, you usually feel the exact opposite of how you feel when you're in a "healthy relationship." You and your friend do not usually feel good about each other and yourselves. Not all unhealthy relationships are abusive but sometimes they can include violence or abuse—verbal, physical, emotional, or sexual. This can involve both people being violent or abusive toward each other or can involve only one person doing this to the other. Many times, a relationship is not unhealthy in the very beginning, but over time abusive behavior might show. You may feel afraid or pressured to do something that you don't want to do. If you have a feeling that your relationship is unhealthy, you are probably right!

What are the signs that I am in an abusive or unhealthy relationship?

There are many signs that you could be in an abusive or unhealthy relationship. Take a look at this list of "warning signs" and see if these statements describe your relationship:

Your friend or the person you are going out with:

• is jealous or possessive of you—he or she gets angry when you talk or hang out with other friends or people of the opposite sex
• bosses you around, makes all the decisions, tells you what to do
• tells you what to wear, who to talk to, where you can go
• is violent to other people, gets in fights a lot, loses his/her temper a lot
• pressures you to have sex or to do something sexual that you don't want to do
• uses drugs and alcohol and tries to pressure you into doing the same thing
• swears at you or uses mean language
• blames you for his or her problems, tells you that it is your fault that he or she hurt you
• insults you or tries to embarrass you in front of other people
• has physically hurt you
• makes you feel scared of their reactions to things
• calls to check up on you all the time and wants to always know where you are going and who you are with

These are just a few of the signs that you may be in an unhealthy or abusive relationship. Sometimes there are only one or two "warning signs" and sometimes there are many. If any of these statements are true for your relationship, you should speak to a trusted adult such as a parent, teacher, doctor, nurse, or counselor right away!

What is abuse?

An abusive relationship may include any of the signs listed above. Some teens and adults think that their relationship isn't abusive unless there is physical fighting. But did you know that there are other types of abuse? Below is a list of different types of abuse which can affect your friendships or dating relationships:

• Physical Abuse - is when a person touches your body in an unwanted or violent way. This may include hitting, slapping, punching, kicking, pulling hair, pushing, biting, choking, or using a weapon on you. The weapon could be a gun or knife but also includes anything that can hurt you like a shoe or a stick.
• Verbal/Emotional Abuse - is when a person says something or does something that makes you afraid or feel bad about yourself. This may include: yelling, name-calling, saying mean things about your family and friends, embarrassing you on purpose, telling you what you can and can't do, or threatening to hurt you or hurt themselves. Blaming you for their problems, or verbally pressuring you to use drugs or alcohol, or keeping you from spending time with your friends and family are all abuse.
• Sexual Abuse - is any sexual contact that you do not want. You may have said no or may be unable to say no because the abuser has threatened you or prevented you from saying no. This may include forcing you to have sex or unwanted touching or kissing.

Why are some people violent?

There are many reasons why a person could be violent or abusive to their friend or person they are dating. For example, a person who has grown up in a violent family may have learned that violence like hitting or verbal control was the way to solve a problem (which it is not!). They may be violent because they want to control the relationship or because they feel bad about themselves and think they will feel better if they make someone else feel worse. Others may get pressured by their friends to prove how strong they are. Sometimes people have trouble controlling their anger.

Drugs and alcohol can also play a part in abusive behavior. There are some people who lose control and act abusively after they have been drinking or taking drugs. But this is no excuse! Just because someone is under the influence of drugs and alcohol or has a bad temper does not mean that their abusive behavior is okay.

• No matter why a person is violent physically, verbally/emotionally, or sexually, it is important for you to know that it is not your fault! You are NOT the reason for the violence. Violence is NEVER okay!

Why do some people stay in unhealthy or violent relationships?

If abusive or unhealthy relationships are so bad, then why do some people stay in them? Why don't they just stop spending time with their friend or break up with the person and stop seeing them? Sometimes it may be hard to get out of an abusive relationship. This is because violent relationships often go in cycles. After a person is violent, he or she may apologize and promise never to hurt you again, and even say that they will work on the relationship. It may be a while before that person acts violently again. These ups and downs can make it hard to leave a relationship.

It's hard to leave someone you care about. You may be scared or ashamed to admit that you are in an abusive relationship, or you may be simply scared to be alone without that person. You may be afraid that no one will believe you, or that your friend or partner will hurt you more if you tell someone. Whatever the reasons, leaving an unhealthy relationship is hard but something you must do. You will need help to do it.

Why should I leave?

Abusive relationships are very unhealthy for you. You can have trouble sleeping or have headaches or stomach aches. You might feel depressed, sad, anxious or nervous, and you may even lose or gain weight. You may also blame yourself, feel guilty, and have trouble trusting other people in your life. Staying in an abusive relationship can hurt your self-confidence and make it hard for you to believe in yourself. If you are being physically abused, you can be the victim of injuries that could cause permanent damage. You should definitely leave the relationship if you are getting hurt, if you have bruises or pain, or if you are being threatened with physical harm in any way.

Remember that the most important reason to leave an unhealthy relationship is that you deserve to be in a relationship that is healthy and fun.

How do I get out of an unhealthy or abusive relationship?

First, if you think that you are in an unhealthy relationship, you should talk to a parent, friend, counselor, doctor, teacher, coach or other trusted person about your relationship. Tell them why you think the relationship is unhealthy and exactly what the other person has done (hit, pressured you to have sex, tried to control you). You may want to look back at the list of "warning signs" to help you to explain the situation to an adult. If necessary, this trusted adult can help you contact your parents, counselors, school security, or even the police about the violence. With help, you can get out of an unhealthy relationship.

Sometimes, leaving an abusive relationship can be dangerous so it is very important for you to make a Safety Plan. Leaving the relationship will be a lot easier and safer if you have a plan. Here are some tips on making Your Safety Plan:

• Tell a trusted adult like a parent, counselor, doctor, teacher or spiritual leader.
• Tell the person who is abusing you that you do not want to see him or her or break up with this person over the phone so they cannot touch you. Do this when your parents or guardians are at home so you know you will be safe in your house.
• Go to your doctor or hospital for treatment if you have been injured.
• Keep track of any violence. A diary is a good way to keep track of the date the violence happened, where you were, exactly what the person you are dating did, and exactly what effects it caused (bruises, for example). This will be important if you need the police to issue a restraining order against the person.
• Avoid contact with the person.
• Spend time with your other friends and walk with them and not by yourself.
• Think of safe places to go in case of an emergency like a police station or even a public place like a restaurant or mall.
• Carry a cell phone, phone card, or money for a call in case you need to call for help. Use code words. You should decide on the code words ahead of time with your family so that they will know that your signal means that you can't talk easily and you need help.
• Call 911 right away if you are ever afraid that the person is following you or is going to hurt you.
• Keep domestic violence hotline numbers in your wallet or another secure place, or program them into your cell phone.

What do I do if a friend tells me that she is in an abusive relationship?

If your friend tells you that she is in an abusive relationship, listen very carefully to what she says. It is important that you listen without judging or blaming your friend. Tell your friend that you believe what she is saying and that you know that it is not her fault. Tell her that you are always there for her when she wants to talk about it. Remind her of all her friends and family who care about her and want her to be safe. Let her know that you are worried about her safety and that you want to help her to tell a parent or other trusted adult right away. Offer to go with her. Give her information on how to make a safety plan and give her phone numbers of counselors and domestic violence hotlines. You may even want to suggest that your friend take a self-defense class. Be sure not to take this on alone. Talk with a trusted adult such as a school counselor about how to help your friend.

Should I have my friend talk to her parents or another adult?

Yes! The most important thing that you can do for your friend is to encourage her to talk to an adult right away. This adult could be a parent, coach, teacher, school counselor, doctor, nurse, or spiritual leader. Tell your friend that you will go with her to see an adult about her abusive relationship. If your friend is nervous about going to talk to adult, here are some things you could remind her of:

• An adult will listen to her problem and give her advice on how to handle the situation.
• An adult can help to protect her if she feels that she is in danger.
• An adult can help her contact the right people, such as the police, her principal, or a counselor.

What if my friend won't listen to me and wants to keep the abuse a secret?

After you encourage your friend to talk to someone like a trusted adult about the abuse, you can tell an adult also. It is too much for you to handle alone. Even though you want to keep your friend's secret, it is important for you to tell a trusted adult especially if you are afraid that your friend could get hurt or if you are worried that she won't tell anyone. Your friend will need help even if she says that she can handle it alone.

Do not tell your friend to choose between the person that she is dating and you. This could make your friend feel that she can't talk to you if she decides to stay in the relationship. Don't spread your friend's secrets to others. Let her be the one to tell other friends that she trusts.

What else do I need to know?

Abuse is a problem that some people experience in their relationships. At least 1 in 10 teens experience physical violence in their relationships. Even if you have not experienced physical, sexual, or verbal and emotional abuse, one of your friends may be in an unhealthy relationship with another friend or dating partner. If you are in an unhealthy relationship or if your friend is, it is important that you get help right away before someone gets hurt! Relationships are an important part of life and are supposed to be fun and special!

Who can I call for help?

There are hotlines that you can call 24 hours a day to get help and advice on how to leave an unhealthy relationship. There may be some local resources in your community including batter women's shelters or through your church, school, or doctor's office that you can call. Here are some toll-free hotlines you can call:

• National Teen Dating Abuse Helpline: 1-866-331-9474
• The Youth Crisis Hotline: 1-800-HIT-HOME (448-4663)
• The National Sexual Assault Hotline: 1-800-656-HOPE (4673)
• The National Domestic Violence Hotline: 1-800-799-SAFE (7233)