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article about middle school teacher cover letter, book Reading for the soul (Shutterstock) 10 Life-Changing Books that Will Stay With You Forever. Head to the library or fire up your Kindle - it’s time to get inspired with this list of words for essays list best books to read. There are books that entertain, books that inform, books that enthrall - books that speak to the brain, the mind, the middle school studies teacher cover, intellect and over the yellow the emotions. And then there are books that seem to speak directly to the soul - life-changing books that make you question your core beliefs, staying with you long after you’ve finished reading. These 10 masterpieces fall into the second category. Each is school social teacher a pleasure to read, a treasure to ponder, and ultimately changes something deep inside of you - just for politics olympics, having experienced it. SYNOPSIS: Originally published in Portuguese, this inspiring tale of self-discovery follows Santiago, an studies teacher cover letter Andalusian shepherd boy who yearns to travel in search of a worldly treasure. But his quest takes him in a different - and far more satisfying - direction, to learn how to listen to his heart and follow his dreams. Skills! THAT SPECIAL SOMETHING: Easy to read and highly descriptive, this masterpiece will inspire you to brave the path to pursuing your dreams - just like Santiago.

SYNOPSIS: Essentially a self-help workbook on school teacher cover, creativity, this life-changing book coaxes readers along a spiritual, artistic path. Politics Olympics! With tasks to complete at the end of middle school social studies cover letter each chapter, reading this book is a dynamic affair. THAT SPECIAL SOMETHING: Deep and yet simple, this book has the power to flip the creativity switch in anyone - from accountants to themes essay, athletes and everywhere in between. SYNOPSIS: Pi Patel is the son of a zookeeper, with an encyclopedic knowledge of animals and a taste for philosophy. While immigrating to North America from India with his family, their ship sinks - and Pi finds himself alone in a lifeboat with a hyena, an orangutan, a wounded zebra, and Richard Parker, a 450-pound Bengal tiger - or does he?

What follows is a fantastical tale of intrigue and adventure. THAT SPECIAL SOMETHING: While this is school teacher cover not a book about religion, it does tell a tale about the importance of believing in something - be it God, Mother Nature, or your own strength. SYNOPSIS: A cross of psychology and spirituality, this non-fiction book is packed with insight and coursework wisdom about the attributes that make for a fulfilled person. With an eloquent examination of complex, human concepts such as discipline and love, Peck theorizes four distinct stages of human spiritual development along the path to self-realization. THAT SPECIAL SOMETHING: This quote says it all: Problems call forth our courage and our wisdom; indeed, they create our courage and wisdom. SYNOPSIS: This beautiful book-within-a-book tells the story of middle school teacher cover Leo Gursky and the love of cultural themes essay his life, Alma.

With an adventure across oceans and decades, the novel is fueled by school social cover the thrill of mystery and joy of connection. THAT SPECIAL SOMETHING: This book will leave you thinking about Leo and Alma nonstop for days after you finish it - and while the story will fade from the front of your mind, it’ll never really leave you. SYNOPSIS: The full name of this trilogy of books is Conversations with God: An Uncommon Dialogue - and essays over the yellow wallpaper it is middle school studies cover letter indeed an uncommon dialogue. Transition Words List! The entire series is a captivating back and forth conversation between the author and ‘God’ - on topics ranging from religion and spirituality to social teacher cover, education, love and politics. THAT SPECIAL SOMETHING: Regardless of your beliefs, these inspired and inspirational books will challenge you to think about the world around you and your own existence.

SYNOPSIS: The Giving Tree is the beautiful, poignant story of a tree who loved a little boy. The tree loves the boy and does anything she can for him as he grows older - without regard for what she’s getting in return. THAT SPECIAL SOMETHING: Ostensibly a children’s book, this parable has a clear message for readers of all ages - about the gift of giving, and accepting different the ways in with others return affection. 8. FLOW: THE PSYCHOLOGY OF OPTIMAL EXPERIENCE. About Communication! BY: Mihaly Csikszentmihalyi. School Letter! SYNOPSIS: Csikszentmihalyi’s studies over the past two decades have revealed that ‘flow’ is what makes life’s experiences genuinely satisfying - a feel of and the olympics essay deep concentration, immersion and absorption. This classic work on happiness touches on contemporary psychology, delving into studies cover letter, issues such as family, art and gcse coursework sport to ultimately answer the question - how do we make our lives meaningful? THAT SPECIAL SOMETHING: This life-changing book will help you to identify when you’re really happy - and middle school channel the ‘flow’ to maximize those good vibes. SYNOPSIS: A novel and a philosophical work in one, this life-changing book tells the about communication, story of Sophie Amundsen, a teenage girl living in Norway, and Alberto Knox, the middle-aged philosopher who introduces her to philosophy. THAT SPECIAL SOMETHING: “Who are you?” and “Where does the world come from?” are the two cardinal questions that Sophie has to answer.

You’ll ponder them too. SYNOPSIS: This novel imagines the compelling story of Dinah - daughter of Leah and Jacob and sister of Joseph. Middle School Cover! Building on hints in the Book of Genesis, the author writes about the lives of coursework women in middle studies, biblical times, touching on mothers and daughters, midwifery, love, and living in olympics essay, a foreign land. THAT SPECIAL SOMETHING: Strongly feminist and deeply touching, this story will change the way you think of biblical times. If you've already read (and loved!) the 10 life-changing books on this list, here's 10 more powerful novels, nonfiction works and poetry collections that you might enjoy: The Time Traveler's Wife by Audrey Niffenegger, The Celestine Prophecy by James Redfield, The Power of One by Bryce Courtenay, Shantaram by Gregory David Roberts, The Prophet by Kahlil Gibran, Better: A Surgeon's Notes on Performance by Atul Gawande, 1984 by George Orwell, Food Rules by Michael Pollan, Alice in Wonderland by Lewis Carroll and middle teacher letter Into the Wild by Jon Krakauer.

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panic attack essay A Comprehensive Overview. This essay summarizes current information about school studies, varieties of gcse literature panic disorder and their treatment. It is school studies cover based almost entirely on publicly available information gathered during the years 1998 through 2000 from sources (not specifically cited) that include published research papers (most available through MedScape or MedLine), published textbooks and trade books authored by qualified mental health professionals, articles in WebMD and transition and phrases for essays, the New York Times, the opinions of clinicians specialized or experienced in the treatment of panic disorders, and middle social cover, the experiences of some hundreds of individuals (patients, health care professionals, and a essay about communication, peer counselors) who have shown up in various Internet-based support communities focused on panic disorders or other anxiety disorders. The intent is to introduce the reader to the wide body of knowledge that exists today and to social cover letter integrate and disseminate a variety of emerging insights often omitted from the narrow classical view of these disorders.

This essay should not take the place of medical and psychological treatment. Individuals who believe they may have panic disorder should be evaluated by a physician familiar with the complexities of panic disorders and a essay skills, the conditions that mimic or accompany them (some of social teacher letter which are discussed herein) and should receive an appropriate combination of pharmaceutical and psychological treatment from qualified caregivers specialized in cultural themes, this family of conditions. For further background and a more detailed disclaimer, please refer to the end of this document. The online source for this essay resides at http://www.panic411.org/ This essay may be linked to or printed for limited noncommercial distribution by individuals.

Any other form of dissemination or republication must be authorized in writing. Panic Disorder is school social studies teacher cover letter a broad-brush label currently applied to and phrases a variety of conditions having clearly distinct etiologies, prognoses, and appropriate treatment strategies. Reasonably distinct causes of panic disorder include: Phobic sensitization to middle school studies letter symptoms of panic or anxiety #150; fear of the fear Prolonged stress Anxious or obsessive patterns of thinking Poor breathing habits, whether rooted in anxiety or other causes Emotional or existential turmoil (whether conscious or unconscious), often deriving from conflicting expectations, needs, desires, or external requirements and resulting in a subjective perception of helplessnes or paralysis. These first causes are the olympics best known and, together with one or two concepts such as false suffocation alarm and middle letter, separation anxiety, are considered the classic causes. However, they may in fact explain a minority of cases.

Other causes include: A hereditary defect in a essay about skills, the metabolism of cholecystokinins (CCK), endocrine substances involved with regulating both digestion and studies teacher, stress endorphins. People with this form of transition words panic disorder have likely exhibited escalating gastrointestinal symptomatology, often Gastro-Esophageal Reflux Disease or Irritable Bowel Syndrome, for middle school letter years or decades before the emergence of panic attacks. Norepinephrine and secondarily epinephrine GABA Serotonin. Each of the causes of panic disorder listed above is supported by over wallpaper, a body of school teacher published research, except as noted in the last point, where the relevance to panic disorder is more speculative and is not suggested by the researchers but is a essay communication skills suggested by the well-documented statistical association of panic disorder with schizophrenic families. Ongoing advancement in the scientific understanding of panic disorder may reveal etiological overlap among these factors beyond the middle school social studies teacher letter overlap already suggested or it may lead to further differentiation. In addition, there are a number of distinct medical conditions, some commonly recognized and others not, that mimic panic disorder or exacerbate sub-acute cases into an acute phase. Beyond the universally recognized but very rare pheochromocytoma, some of the more commonly encountered conditions are: Hypothyroidism. Screening for literature coursework TSH levels is widely regarded among first-line clinicians as sufficient screening for thyroid abnormalities; however, such limited screening consistently fails to identify a number of hypothyroid conditions that lead to middle social studies teacher letter panic attacks and other serious and sometimes life-threatening pathology. Once the condition has advanced to the stage of panic disorder, correcting the words for essays underlying imbalance may not be sufficient to bring about remission, as damage to school social teacher the nervous system can already have occurred at this point. Strictly speaking, it can be argued that panic disorder is a misdiagnosis when it is secondary to any of these conditions. On Causes Of Cold! In the real world, however, medicine most often fails to diagnose the underlying condition if the presenting symptoms have an anxious presentation to them.

As a result, the panic disorder population #150; on which all research is conducted, from which the understanding of panic disorder derives, on which treatments are tested, and to which the resulting diagnostic and therapeutic protocols are applied #150; is exactly this mixed bag of patients and causes. Middle School Social Studies Cover! A diagnosis of panic disorder carries with it a substantial likelihood that one (or more than one) of these factors is present. Studies over long periods have established that thought patterns once thought to be causative in panic disorder, such as hypervigilance, catastrophic thinking or catastrophic interpretation of sensations, among others, emerge in many patients as a result of the literature condition and cannot in fact be considered preexisting causative factors in those patients #150; that, for instance, the tendency toward catastrophic interpretation of relatively normal physical sensations typically emerges (if at all) as a gradual consequence of the normal interpretation of catastrophic physical sensations lying outside non-afflicted individuals' realm of experience. It is also critical to understand that individuals with panic disorder do not necessarily worry more, feel more stressed, or internalize or somatize more than non-afflicted individuals. They can certainly develop such traits as a result of the condition (or possess them from birth), but the distinguishing factor is that the neurochemistry of an individual with panic disorder reacts differently from that of a non-afflicted individual even to low or normal levels of stress #150; or to other, idiopathic factors not necessarily related to situational stress or worry.

This difference manifests itself in a variety of ways, some of which are well understood and some of middle cover which are not. Absolute elimination of panic attacks should be one goal of treatment, because of their kindling effect. With each panic attack, the nervous system becomes more prone to experience the about next one. This is not only middle school social teacher cover letter, a psychological process, but a neurological one as well. Absolute elimination of panic attacks is not a sufficient goal of essays of cold war treatment, much as elimination of sugar from the middle school studies urine of a diabetic is not a sufficient goal of treatment for diabetes. The insufficiencies, imbalances, and processes leading up to the panic attacks, both neurological and psychological, are far from benign. Because of the variety of causes and processes at work in panic disorder, there are few generalizations one can make that would apply to politics olympics as much as 75% of the panic population. However, subgroups and regularities do clearly exist, so there are many generalizations one can make that apply to various groups of as much as 30-40% of the middle school studies teacher letter population.

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV™) describes a panic attack as follows: The essential feature of a Panic Attack is a discrete period of intense fear or discomfort that is accompanied by at politics least 4 of 13 somatic or cognitive symptoms. The attack has a sudden onset and builds to a peak rapidly (usually in 10 minutes or less) and is often accompanied by a sense of school social studies teacher letter imminent danger or impending doom and an urge to escape. Politics! The 13 somatic or cognitive symptoms are palpitations, sweating, trembling or shaking, discomfort, nausea or abdominal distress, dizziness or lightheadedness, derealization or depersonalization, fear of losing control or going crazy, fear of dying, paresthesias, and chills or hot flashes. Attacks that meet all other criteria but that have fewer than 4 somatic or cognitive symptoms are referred to school as limited-symptom attacks. This is probably as good a rudimentary operational description as any, although it is only a committee consensus not based on any consideration of essential underlying mechanisms. (The idea of peaking within 10 minutes is now generally agreed in the panic disorder community to apply to a minority of over the yellow wallpaper cases. Full status panicus can persist for hours or even days. Presence of the 10-minute observation in DSM-IV is middle school probably a legacy from the time when panic disorder was thought to be synonymous with hyperventilation syndrome.) It is important to note that anxiety or fear, although typical, is not a requirement.

Intense discomfort, whether existential or physiological, is equally a qualifying factor. Words And Phrases For Essays List! In fact, the terms panic disorder and panic attack may do as much to school social letter obscure the true face of the literature coursework disorder from clinicians and patients as they do to make it understandable to the general public. Much additional insight can be gained from one of the pioneers in treating panic disorder before there was much medical understanding of the middle school teacher cover letter condition, Dr. Claire Weekes. She wrote of a panic attack as consisting of a first fear and a second fear. The first fear is some cluster of the yellow sensations, often untriggered, of which the patient suddenly becomes aware. Middle Letter! These would be sensations like those broadly categorized in the DSM-IV definition (and treated in somewhat more detail under later headings in this essay). We know today that the term arousal or dysautonomia is more appropriate than fear to many patients and of cold war, clusters of sensations, but Dr. Weekes' early insight is still remarkable for her time, crucial to understanding the anatomy of a panic attack, and studies teacher letter, therapeutically useful today.

The second fear is a reaction to the appearance and over the yellow wallpaper, sensations of the first fear. Competing descriptions have emerged for why this second fear comes about #150; premonition of death, fear of suffocation, resonance with primal separation trauma, catastrophic thinking, etc. #150; but basically, Weekes' premise is that the second fear is middle school social studies cover letter fear of the essays first fear. It is a rapidly escalating, possibly eruptive panic reaction that feeds back into the manifestations of the first fear or triggers new manifestations. It is Weekes' second fear that is addressed by most attempts to treat panic disorder. Patients are taught not to fear the primary sensations of the episode. This is an middle social teacher, extremely useful concept in Cognitive-Behavioral Therapy for wallpaper panic attacks. In the days before any such phenomena were recognized, patients either learned to middle school social studies do this on their own or medicated themselves with alcohol or with medications prescribed for nerves. (Or in the worst cases, they were committed to psychiatric hospitals.) The aim of such CBT is to learn and internalize the a essay about communication skills idea that the primary manifestations are benign and to learn not to middle teacher letter compound them with a panic reaction. Cultural! Antidepressant medications also primarily treat this second fear, even as some of them may exacerbate the primary manifestations of panic disorder. Nonetheless, the fact remains that the primary manifestations of a panic attack, the first fear, can be intensely unpleasant. Even without any second fear, the middle social teacher primary manifestations of a panic attack can have a distinctly paroxysmal quality of their own, akin to vomiting or a slow-motion sneeze or a slow-motion shudder or an orgasm.

They have differing causes in olympics essay, different cases. Various theories compete to school social studies teacher provide an explanation. Gcse Coursework! Some neurologists hypothesize neuroelectrical chaos. Some make an analogy to a sort of epilepsy outside the brain, while others dispute the school studies teacher cover appropriateness or desirability of such an analogy. Others find deficiencies of parasympathethic neurotransmitters.

In some patients, blood oxygen saturation drops by 25% or more, sometimes in response to politics circulatory disturbances and other times in response to underbreathing. It is likely that a relatively large number of transitory endocrinological and neurological manifestations exist but are difficult to observe in progress. And then there are patients in whom the primary manifestations are non-paroxysmal. Such patients may simply shake randomly and school social studies teacher, uncontrollably, or feel intense generalized abdominal distress, or experience a variety of alien internal sensations. These sensations can be frustratingly difficult to describe, since they often lie outside of words list shared experience, the language lacks any directly descriptive terms for them, and the non-afflicted can only try to interpret such descriptions in terms of personal experience. A further complication is that even medical doctors versed in panic disorder do not always know what is social studies happening biologically or how to observe or measure it in other than superficial terms. The experience usually looks like fear and it most often, though not always, feels like fear as well, albeit sometimes a strange fear. These manifestations may continue for hours or even days in the absence of medical intervention (despite the DSM-IV's specification of 10 minutes as a norm), and not all patients experiencing these symptoms experience the escalating or eruptive second fear to which Weekes refers. It is possible to learn not to compound one's reaction when blood oxygen saturation falls substantially, or when a drop in the availability of the neurotransmitter acetylcholine below a certain threshold causes muscles to go into random spasms, or when any of a host of other manifestations appear, but absence of a essay communication a compounding second fear by no means implies that one is well or feels well. One might well say of some cases #150; and such cases are not rare #150; that over time the panic disappears but the disorder remains. Social Studies Teacher Letter! On one level, that is a facetious statement, but on cultural themes essay another level, it captures an important truth.

So while practicing psychologists and psychiatrists largely focus (wittingly or unwittingly) on treating Weekes' second fear and studies teacher, associated complications (primarily inter-attack anticipatory anxiety, agoraphobia, or phobic avoidance), researchers and neurologists work at expanding our understanding of the a essay about first fear, or the school teacher cover primary manifestations of olympics panic attacks. The belief that most panic disorder patients are simply overreacting to middle teacher cover letter normal sensations that others ignore is rapidly being relegated to history. And The Essay! The primary manifestations of panic attacks are often anything other than normal sensations. Researchers in whom such sensations have been induced artificially have described them as harrowing. One described them as comparable in degree of trauma to wartime experiences. Hyperarousal and the Mind-Body Duality. The conditions commonly called anxiety disorders #150; Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Obsessive-Compulsive Disorder, and other less commonly diagnosed conditions #150; are all essentially disorders of hyperarousal.

In the school social studies teacher cover letter case of panic disorder, particularly of the familial variety, the hyperarousal tends to be essential (having no single, clearly identifiable cause, much like essential high blood pressure) and, at least in the early years, autonomic (expressing itself primarily or initially in physical symptoms not under conscious control). There has been a tendency in the conceptualization of these disorders (at least the first three) to think in terms of hyperarousal specifically of the fear, alarm, and essay, watchfulness circuits of the brain, but in truth the social teacher cover hyperarousal tends to be more generalized in nature. It may even lack an intuitively anxious presentation. Because typically anxious arousal is more likely to be noticed, clinicians' unawareness of the generalized nature of the hyperarousal involved can lead to underdiagnosis of hyperarousal disorders or to too narrow a focus on treatment of specific symptoms. Mental arousal comprises thoughts and feelings, both conscious and unconscious. It may express itself in many ways, some of them subjectively negative (such as worry or non-specific agitation), some of them subjectively positive (such as anticipation), some of them constructive (such as productive focus on a project), some of them destructive (such as constant worry about improbable what-if scenarios). Mental arousal resides in the higher levels of the brain, those responsible for conscious and unconscious thoughts and feelings. Autonomic arousal consists of many bodily functions that are not under volitional control, such as heartbeat, sweating, digestion, and others; and some bodily functions that are partially under volitional control, such as breathing and excretion, so that they self-regulate in normal circumstances but are subject to conscious or unconscious intervention from higher levels of the brain.

Autonomic arousal resides nearly everywhere in the body outside the politics and the higher levels of the school teacher cover letter brain, including the nervous, endocrinological, and immune systems and themes essay, the most primitive parts of the brain that regulate autonomic function. It is an axiom of psychosomatic medicine that where the mind goes, the social teacher letter body will follow. There is, however, an equally true but often neglected corollary to that maxim, namely that where the body goes, the literature coursework mind will follow. Each type of arousal disorder and each individual case has its characteristic mixture of mental and autonomic arousal and its own characteristic relationship between the cover letter two. It turns out to make little difference in panic disorder whether arousal is transition words for essays subjectively perceived as negative or positive, as anxiety or as pleasurable excitement. Social Studies Letter! It is the fact of arousal in itself that primes the body to experience panic attacks and then triggers the attacks. This is true whether the words and phrases list arousal stems from external stimulation or from internal factors, whether from primarily mental influences or primarily autonomic ones such as reactions to medication, food, heat, or panicogenic inhalants (including certain common air pollutants). The classical view of studies anxiety disorders is that mental hyperarousal is the impetus behind autonomic hyperarousal. This is an cultural essay, understandable oversimplification, because it describes what is true much of the middle school social teacher time in normally functional individuals. Of Cold! It ignores the key point, however, that these are precisely disorders of arousal, and that there are various forms of these disorders. An arousal disorder may be driven by intrinsic hyperarousal of the mind, by intrinsic hyperarousal of the social letter autonomic nervous system, or by an aberration in the way either one influences the themes essay other.

And whatever the primary impetus of the middle social studies disorder, secondary effects nearly always emerge to complicate the condition and confuse its characterization #150; effects seen in the mental and autonomic domains and in the way that the two domains influence each other. Yes, the mind can arouse the body and it can calm the body. It can even make the essays of cold war body ill, as one sees in the traditional view of middle school letter stress and of cold, psychosomatic medicine; and it can heal the body, as one sees in the response of such conditions as cancer to the influence of psychotherapy #150; although thankfully, one does not see anyone advocating treatment of the mind as the primary care for cancer patients. (One hopes that the average treatment of panic disorder will some day be so enlightened…) However, the reverse is equally true: the body can arouse the mind and it can calm the mind; and it can even make the mind ill or heal the mind. One sees one obvious example in the relaxing (or in some cases invigorating) effects of massage #150; indeed the ability of massage therapy to influence the course of mental and even physical illness. Another example is found in the mental illnesses #150; depression, obsession, anxiety #150; that frequently develop as secondary consequences of chronic organic illness.

Food reactions distinct to certain genetic groups constitute another example, as do arousal reactions to certain antibiotics and anticholinergic medications that do not act directly on higher levels of the brain. The spectrum connecting mental and autonomic arousal could be compared to a pushme-pullyou, the fictional creature from Dr. Dolittle with two front ends and two brains. Middle Social Studies Teacher Cover Letter! The beast is particularly unpredictable in individuals with anxiety/arousal disorders. The mind can be driving the cultural themes disorder with the body mostly along for the ride. Or the body can be driving the disorder, with the mind doing its best to resist. Treatment of the mind can accomplish surprising effects on biology, but this is compensation, and it does have its limits. If this were not so, then psychotherapy would be the primary treatment against for instance epilepsy, a condition with certain similarities to some forms of panic disorder and a condition that is sometimes partially responsive to psychotherapy. So a good understanding of the mind-body connection in panic disorder generally and in any specific patient is essential to intelligent diagnosis and effective treatment. Middle Studies Teacher! Notwithstanding the mind-body overlap, the a essay skills essence of each case is usually to be found in middle school social teacher letter, some intrinsic factor on and the olympics one side or the middle studies teacher other. The reader should know that the medical community currently applies the term dysautonomia to an abnormality in the self-regulation of autonomic arousal and applies the term anxiety to an abnormality in the level of mental arousal, including any manifestations of autonomic arousal presumed correctly or incorrectly to derive from conscious or unconscious thoughts or feelings.

This conceptual bias tends to hobble treatment, but it is politics important for the reader to understand the doctor's likely perspective at the outset of the relationship. Middle Social Studies! Most of the clinical progress currently taking place in over wallpaper, the medical treatment of panic disorder occurs through the process of patients exposing their doctors to the body of research relevant to cover their own variant of panic disorder. Dysautonomia and its Paroxysms. The panic attacks in panic disorders are usually just the tip of the iceberg. Just as significant as panic attacks per se is the gcse literature chronic dysautonomia present in panic disorder. A number of expressions of dysautonomia are often present for extended periods in school social studies letter, panic disorder patients, even in the absence of frank panic attacks. Gcse! Indeed panic attacks could in most cases be called dysautonomic paroxysms, and the disorder could reasonably be called paroxysmal dysautonomia. The following is a reasonably comprehensive but certainly not exhaustive list of mostly dysautonomic symptoms associated with panic disorder. School Social Teacher Letter! (Not all of these are strictly speaking dysautonomic, though most are, but this is politics olympics a convenient place to gather symptoms frequently associated with panic disorder.) Any given person is likely to experience only a handful of these symptoms, though they may be frequent and intense. The point of such an social studies teacher cover, extensive list is to provide reassurance to someone diagnosed with panic disorder who is experiencing any of these very diverse symptoms that they can indeed be merely symptomatic of gcse coursework panic disorder and not necessarily a sign that some other medical or biological condition is present.

Heart-and circulation-related: Rapid, irregular, or forceful, loud heartbeat. Middle Teacher Cover! Sensation of about communication skills skipped heartbeats. Chest pain. Low or high blood pressure, often with remarkably wide swings. Panic disorder patients are sometimes diagnosed with atypical mitral valve prolapse or mitral valve prolapse syndrome.

It is characteristic of panic disorder that symptoms from several of the groups above occur together. (panic disorder is a polysystemic condition, which is one factor leading to poor recognition, diagnosis, and treatment.) It is also normal for some varying level of these symptoms to be present much or most of the time for uncontrolled patients, but for the symptoms periodically to escalate to the point of paroxysm followed by relief of school studies teacher letter varying duration. It is common for panic attacks to occur during sleep, especially in patients with the gene for cholecystokinin-related bile reflux panic disorder. In many respects, these dysautonomic symptoms ought to be of list more concern to clinicians than the panic attacks themselves, except that patients experiencing panic attacks are at a strikingly elevated risk of suicide. Normal research subjects who have had panic attacks induced by the administration of GABA antagonists have described the teacher experience as completely unbearable and the worst experience of their lives. (It is conceptually interesting that although synthetic panic attacks can be created with some degree of a essay about communication skills success under laboratory conditions using serotonin depleters, serotonin reuptake inhibitors, cholecystokinin, sodium lactate, and norepinephrine, no class of substances but perhaps cholecystokinin comes anywhere close to the panicogenic effect of a GABA antagonist. This suggests that the old GABA-based conceptualization of panic disorder in the wild was more correct than newer serotonin-based conceptualizations.) In a significant number of school teacher cover letter patients, dysautonomic symptoms and panic attacks emerge not during periods of long-term or short-term stress, but after the cessation of such stress or during its period of essay abatement. This is probably true in particular of the patients with cholecystokinin abnormalities.

In a significant number of patients, mental/emotional anxiety waxes and wanes, and the dysautonomia waxes and wanes, but there is no identifiable pattern of correlation. Middle School Social Studies Cover Letter! It is in these patients that the neurological dimension of the themes essay disorder is the most obvious. There is an interesting minority of patients who experience severe dysautonomia, even to the point of physical incapacitation, without experiencing what they themselves would call a panic attack. This is not too difficult for studies cover letter many sufferers of panic disorder to understand, particularly after therapy or years of experience with the condition have desensitized (to varying degrees) the fear response that can be aroused by politics and the, the dysautonomia. One experiences all of the escalating dysautonomic arousal without the paroxysmal culmination that provides temporary relief. People who have not experienced a panic attack can perhaps understand this distinction by thinking of sexual arousal and orgasm as an analogy. It is possible to school cover be highly aroused without experiencing orgasm. Similarly, these non-paroxysmal dysautonomic states can be very intense #150; indeed they can be more intense than the states that would induce paroxysmal panic in other panic disorder patients or in normal individuals. Current thinking distinguishes between Generalized Anxiety Disorder (GAD) and panic disorder largely (though not entirely) on the basis of absence or presence of panic attacks.

But in some respects, these conditions appear much of the time to be differing degrees of the same biological disorder, and and the, if it is middle social studies useful to distinguish at all, it might be more diagnostically and therapeutically useful to apply a distinction at right angles to the current one, recognizing one disorder that is primarily somatic/dysautonomic and another that is primarily cognitive/emotional. Granted there is overlap, but there does appear often to be an etiological distinction in reality. It is common practice to consider panic disorder controlled when panic attacks are eliminated. Transition List! However, the school studies cover goals of treatment should actually include elimination of most or all of the words associated dysautonomia, as the dysautonomia is symptomatic of uncontrolled underlying pathology and in social teacher cover letter, some cases exacerbates the underlying pathology (just as uncontrolled panic attacks escalate through neurological as well as psychological mechanisms). Panic disorder of biological genesis is chronic and mildly progressive. And The Olympics Essay! Although some clinicians claim encouraging cure rates, usually in carefully selected groups, studies have shown that when one looks at patients over periods of time four years or longer, a preponderance of middle school social studies cover patients experience relapse in the absence of ongoing pharmaceutical treatment. Over The Yellow Wallpaper! This is not always evident to middle school studies teacher letter treating clinicians (who have been known to claim cure rates as high as a thoroughly suspicious 100%), because patients frequently change doctors if they perceive that their treatment was unsympathetic or ineffective; and relapse is readily perceived as a sign that treatment was ineffective if the treating physician has created unrealistic expectations of a permanent cure or has exerted subtle pressure to words for essays recover or to tough out minor episodes. It is often stated that panic attacks do not lead to heart attacks. This is true as far as it goes; however, sufferers of uncontrolled panic disorder are at school studies teacher letter a quadrupled risk for eventually experiencing a serious cardiac event. For instance, QT prolongation (a type of subtle heart arrhythmia) is present in cultural themes, a disproportionate number of undertreated panic disorder patients.

In fact, a variety of middle school letter arrhythmias are observed with disproportionate frequency in panic disorder patients, though many of them are only observable during an episode or during the transition lead-in to an episode. The paroxysm of the attack itself may serve to correct the arrhythmia. One of the greatest health risks for sufferers of panic disorder as they grow older is unrecognized serious illness that would be diagnosed earlier in other patients. If it is middle social cover true that a certain proportion of panic disorder patients tend toward hypervigilance and hypochondria, particularly in the years just prior to and following correct diagnosis with panic disorder, yet it is also documented that primary care physicians and many specialists tend to dismiss the complaints of patients bearing a diagnosis of panic disorder (or generalized anxiety disorder) without sufficient foundation for a essay about doing so. Panic disorder patients get organic illness just as often as other patients. They just don't get it diagnosed as often. In fact, it has been clearly shown that patients with anxiety disorders go longer before diagnosis of serious conditions than do patients without these stigmatizing diagnoses, and physicians have cause to be more concerned with the middle studies letter potential for medical error and liability. Particularly problematic is the practice in some emergency rooms of shunting panic disorder or GAD patients presenting with chest pain or other possible cardiac symptomatology into psychiatric observation without sufficient examination. There are documented instances of cultural fatalities resulting from such systematized negligence. On the other side of the same coin, emergency rooms also represent frequently missed opportunities to identify potential cases of panic disorder.

Many ER doctors are poorly trained to cover letter recognize panic disorder, particularly in its pre-emergent guise of non-paroxysmal dysautonomia. This is not surprising given the diagnostic criteria in use today. Pre-emergent panic disorder often does not look much like GAD, as it is is likely to be primarily somatic until the of cold war first string of panic attacks initiates the cycle of fear or worry and cognitive-emotional-behavioral disturbance. Unfortunately, even when ER doctors do recognize panic disorder, they are still as likely as not to dismiss it as neurosis unworthy of serious attention and middle school teacher letter, counseling or referral. Patients are still likely to be told to breathe into a paper bag next time, although this is in fact more likely to trigger than to over stave off a panic attack for a sufferer of middle social cover letter biologically rooted panic disorder. In fact, panic disorder patients are often told (not asked) that they are claustrophobic, or anxious travelers, when in fact their bodies are reacting in predictable and well-understood ways to the elevated levels of over the yellow CO2 present in poorly ventilated spaces full of middle studies cover breathing bodies. This ties in and the, with the middle school letter false suffocation alarm interpretation of panic disorder, although this theory has become less prominent in gcse coursework, the field as other mechanisms have become better documented.

This is not to say that the interpretation will prove to be wrong, merely that it is not universal. And in point of fact, it has not as yet been proven to middle school cover be anything; hypotheses and assertions relating to over panic disorder must be subjected to the same standard of studies teacher proof as other, non-psychology-related, statements of medical doctrine. One finds that clinicians who demonstrate admirable scientific rigor in making non-psychiatric diagnoses are given to comically whimsical leaps of politics olympics faith in attributing patients' symptoms to psychosomatic processes. (Hence the derisive terms psycho-so-magic and psycho-so-magical that one sometimes encounters in middle studies cover letter, patient discussions.) Note: There is ample research around the false suffocation alarm to indicate that elevated CO2 levels do in fact provoke hyperarousal and panic attacks in a subset of the panic disorder population. At issue is the essays histrionic labeling of this reaction on the assumption that all individuals ought to experience identical toxic reactions to CO2 at identical concentrations. Middle Studies Teacher Cover Letter! One might just as easily label hypoglycemic states as false starvation alarm reactions. It is not the alarm per se that is false, it is merely its characterization as one of communication skills life-threatening suffocation or starvation that is middle school teacher letter false #150; and that is essay not the middle social cover patient's error of interpretation, as the term implies, but the diagnostician's. (And when this model was extended to a population with anxiety from pulmonary disease, the alarm sadly turned out not to be so false.) There are a number of conditions frequently associated with panic disorder. Some of them may be cause or effect of the disorder, while others are merely associated. It is important for physicians to recognize the associations, because sometimes it is difficult to treat the associated condition if the underlying or associated panic disorder is left untreated.

GERD, IBS. Probably the conditions most universally present in panic disorder are Gastro-Esophageal Reflux Disease and Irritable Bowel Syndrome. In approximately 40% of panic disorder patients, both are caused primarily though not entirely by the excessive and irregular secretion of bile so characteristic of and the hereditary panic disorder. In some patients the effects are mostly upward in the GI tract, resulting in excessive stomach acid secreted to neutralize the middle school social cover bile and leading to GERD #150; sometimes with associated asthma or sinusitis that is essay not recognized as related to panic disorder or GERD. (Gastric swelling and consequent pressure on the diaphragm or a nerve center has been proposed as one possible cause of abnormal breathing in panic disorder; such a suggestion is supported by studies teacher cover letter, the fact that subjective difficulty in breathing related to a essay about communication skills panic disorder can be alleviated in some individuals by pressing fingertips downward into the abdomen not far below the middle school social studies teacher sternum.) Often patients will have had GERD or IBS for cultural years or decades, frequently even since childhood, before the emergence of panic disorder diagnosable by current DSM-IV criteria. Social Studies Cover! Even panic disorder patients who do not show overt symptoms of GERD or IBS often exhibit the characteristic abnormalities of bile secretion. The combination of Xanax and Carafate has been found to be remarkably effective in essays on causes war, treating these conditions in panic disorder patients; indeed therapeutic response of GERD or IBS to this combination can almost be regarded as a diagnostic criterion. (It is not known why Carafate is often so much more effective in middle social studies letter, the panic disorder population than newer drugs like acid blockers and proton pump inhibitors, but the phenomenon is essays over the yellow distinct.) As one follows any group of school teacher panic disorder patients over a period of years, half or more do apparently keep the diagnosis of essential panic disorder. However, every year a certain percentage are found to have an organic condition the essays diagnosis and cover letter, treatment of essay which resolves the panic disorder. Obviously the organic condition, or at least a tendency to it, was present years before it became overt enough to trigger normal diagnostic flags. A panic disorder patient should be prepared to believe and to accept the benign diagnosis of panic disorder for the rest of their life. But clinicians and patients alike should be alert to changes and should recognize that for instance normal ranges on laboratory tests apply to a statistical abstraction and not necessarily to every individual.

Often individuals experience well-being only school social cover, within a narrower range of and phrases for essays list values than the stated range (which varies from lab to middle studies letter lab in any case), and on some types of essays of cold war tests, even the optimal center point may be different for different individuals. Panic disorders, the comorbid conditions mentioned above, and the possible reasons for middle school cover letter comorbidity offer much fertile and largely unturned ground for research in the coming years. There are quite a few chicken-and-egg questions raised by just the associations discussed above, not to transition and phrases for essays list mention associations that will emerge with more research. One thing that is clear even now, though, is teacher letter that with or without statistical documentation, most of the words and phrases list associations discussed above are widely recognized in the panic disorder community. On Medicine As Biology. Those of us without a medical education tend to middle school social think of our doctor as a kind of master detective biologist. It's a natural assumption but it reflects an important misunderstanding of cultural medicine as art or science. A doctor is only a master biologist in the loose sense that an school social, architect or a structural engineer would be a master physicist. After a few notoriously rigorous courses in certain traditional elements of human biology, a medical education branches rather quickly into the study of established medical protocols for diagnosis and treatment of well-recognized conditions. When a doctor examines and diagnoses us, he is not, as we might easily imagine, unraveling the mysteries of our biological individuality. Rather he is on causes of cold comparing our presentation to a multitude of checklists that would match us to one of the standard diagnoses and middle social studies teacher cover letter, treatments he has (in the best case) mastered.

American medicine in particular prides itself in being based on statistical models of disease. The European medical tradition recognizes the statistical perspective and and the over wallpaper case-based or anecdotal perspective as complementary halves of a complete picture, halves that are roughly analogous to macroeconomics and microeconomics. Social! But the case-based perspective interests American medicine only insofar as cases reflect what is typical of the statistical perspective on a patient's illness. Literature! Doctors are explicitly trained to gloss over and filter out the idiosyncrasies that conflict with the accepted model of the condition. Middle School Teacher Cover Letter! Thus many will persist with a favored class of medication despite a patient's obvious adverse effects or lack of response. It is revealing that the doctor's impatience will be with the patient, not with the cultural themes essay medication. They will ignore patients' reports of unusual symptoms as irrelevant when in middle social teacher cover, fact they could be highly relevant to unraveling the individual mystery and finding a treatment that is effective for the individual patient. In such cases, the doctor is not treating the patient, he is treating the statistical model of the patient's diagnosis (a diagnosis which may or may not be correct) . Nowhere does this approach to medicine fail more spectacularly than in a condition like panic disorder, where it is so difficult to essays the yellow wallpaper define what is typical. But it fails in other contexts as well.

The author of this document himself was evaluated by teacher cover, 14 doctors over on causes war a span of more than 10 years before aldosteronism was finally noticed, proven, and identified as the root cause of all the school studies teacher letter symptoms that had received such a variety of diagnoses and misdiagnoses (including panic disorder) over that time. Essays On Causes! Mumblings about anxious patient and panic attacks were always somewhere in the background. In the end, he himself had to suggest the diagnosis that proved to be correct and argue vigorously for the definitive test that clinched the diagnosis. Unfortunately, the author's experience is not at social studies letter all unusual. Literature Coursework! Such outcomes are commonplace in panic disorder support groups.

They may even be more the rule than the exception. The overlooked diagnoses vary, but the experience is the same. Patients go years and even decades getting hurried, substandard and middle school social studies teacher cover, frequently condescending care from doctors (often at gcse literature premier practices or medical facilities) who jump to hasty conclusions and rush to try out the latest psychotrophic medication. Often the final and correct diagnosis is a condition thought to be rare, such as celiac disease, aldosteronism, or thyroid dysfunction, but which appears to be strikingly common in the panic disorder population. Sometimes these failures of diagnosis occur because a doctor who might recognize a single unmistakable result on a routine test or some other unmistakable clinical indicator is not good at recognizing a constellation of borderline results or suggestive indicators that must be considered in combination before they add up, as in middle social studies letter, the author's case, to a clear picture. More often such failures of diagnosis reflect a simple failure to be meticulous. Of Cold War! So patients suffer years of adverse medication reactions, stigma, and other woes that often include lost jobs, lost mobility, lost careers, lost marriages, and lost financial security.

Then a single meticulous doctor provides a correct diagnosis and middle social studies letter, correct treatment, and the neurotic symptoms magically evaporate. One truth is abundantly clear in all of this: the extent to themes which our presentation is atypical is almost precisely the extent to which our doctors will fail to correctly diagnose and treat us. They are trained to ignore the atypical, not to seek an school social teacher cover, explanation or accommodation for it. Transition For Essays List! And there are virtually no typical cases in panic disorder or the conditions that mimic it. There are only middle social letter, typical treatments. There have been studies showing that doctors almost universally overstate their treatment successes and understate their patients' adverse reactions. Essays On Causes Of Cold War! Some studies have even explored psychological reasons for middle social studies teacher letter the disconnect from reality. Olympics Essay! But it is also easy to explain by natural selection. There are many doctors who treat panic disorder ineffectively and who fail to diagnose medical conditions masquerading as panic disorder.

There are only a few who routinely do well at it. It is well documented that most panic patients see multiple doctors (averaging ten or more) before finally receiving effective treatment or correct diagnosis. Almost every one of social teacher cover those earlier doctors assumes that treatment has been successful, or at the very least fails to receive any feedback on the negative outcome or misdiagnosis. Gcse Literature Coursework! Thus there will inevitably be a large majority of doctors who think they are doing much better than they actually are. One could well object, in cover letter, cases of delayed diagnosis, that then it's not panic disorder. About! But if all the middle school social studies teacher letter patients who have had this experience or will have it in over the yellow wallpaper, the future could omnisciently be removed from the population that forms the core of the panic disorder industry, it's not clear that there would be many left. Certainly much that the medical community now thinks it knows about the condition would no longer be valid in social studies teacher letter, such an transition and phrases list, omnisciently sifted patient population, because most of the current knowledge (such as it is) has been derived from this heterogeneous population.

Unfortunately, all of this talk about undiagnosed and misdiagnosed conditions feeds into the worst and social studies teacher letter, most common fear in the panic disorder community, namely that some terrible condition has gone unnoticed, one that will kill us before it is discovered. The bad news is that undiagnosed medical conditions are very common in the panic disorder population. But the essays the yellow good news it that they are almost never fatal conditions. The fatal conditions do get diagnosed quickly. In fact, finding things that will kill you is the middle school social teacher letter one thing that modern American medicine does better than anything else. And Phrases For Essays! By the time a panic disorder patient has undergone EKGs, MRIs, and middle school social studies teacher, all of the other routine technological marvels requiring little initiative or detective work from a doctor, the coursework patient can be confident there is no undetected brain tumor, no undetected adrenal tumor, no potentially fatal heart arrhythmia, and no other killer lurking unseen in the background. The conditions that commonly mimic panic disorder are almost never fatal. But it is inarguably difficult to get adequate testing.

Out of middle social studies letter every 30-60 Americans with celiac disease (a common mimic of essays the yellow panic disorder), only middle school social studies cover letter, one will be diagnosed during his or her lifetime. Countless celiac patients have written in online panic support groups about the long battle for testing that they had to wage before getting the olympics essay definitive tests and a correct diagnosis. For aldosteronism, the middle school studies teacher cover figure would be around one out of about 10-30 who ever receives the correct diagnosis. And The Olympics! For autoimmune hypothyroidism, the prospect of diagnosis is middle school social studies cover letter presumably brighter, but many people write of waging long battles before the communication skills diagnosis was made. Panic disorder or the syndrome of its symptoms, even when caused by some other condition makes it hard for the patient to practice acceptance. Yet it is vital to do so. We should recognize and accept that if we had a fatal condition, it would be noticed. We should recognize and middle school social cover letter, accept that there may very well be some non-fatal condition causing our symptoms that has not yet been noticed #150; and that is not a catastrophe . We should recognize and accept that in the doctor corps, as in every other walk of essay life, there is middle school social letter a small percentage (maybe 5%?) of people who do their work really well, a somewhat larger minority who are adequate for garden-variety patients (which we are not), and literature coursework, a full 50% who are below average (not to mention inadequate). We must be our own detectives and advocates, but we should do so methodically, patiently, and school social cover, without rancor. We should ignore the condescension and hostility of doctors threatened by our persistence or our discontent.

People can only be as good as they are, and it is futile to hold anyone's mediocrity against them. We should never remain locked in conflict with an unresponsive doctor, but should undramatically find another. Essays Over The Yellow Wallpaper! We should remember that statistically, it will probably be the tenth or eleventh doctor who turns out to understand our condition and its treatment. Every new doctor is a step toward the right one. We should not be ashamed of looking for the right doctor, not be intimidated by charges of middle school teacher cover letter doctor shopping. If there is essays over the yellow wallpaper a treatable and unnoticed medical condition underlying our case, it will be our own initiative and nobody else's that leads to a doctor who can diagnose it. Middle School Studies Teacher Cover! But in a essay about skills, many cases, maybe half or more, no such underlying medical condition will ever be found, and we should accept that probability as well. The fact that panic is so hereditary (and genetically linked to a variety of other conditions) makes it clear that biology is a strong factor, but not every biological problem has found its way into the protocols of medicine. We should accept that as well. Social Cover Letter! It is very possible to live a good life with panic disorder if only we find a doctor who can practice appropriate and individualized treatment. We should seek a therapist as well, one who can teach us to essays on causes of cold use the middle school teacher mind to compensate for failings of the body.

The first resolution must be to live as well as possible within the parameters of the communication skills condition. Often correct medication and competent therapy can lead to virtual normality. The search for explanations should never become more important than making the most of the school social studies function and possibilities we have. The search for another explanation is like prospecting for gold: it is a long-term quest, one in which we must pace ourselves wisely and one in which there may never be a payoff. On Treatment Options. The most commonly used treatments for panic disorder, in and the, no particular order, are Cognitive-Behavioral Therapy (or a special variant known as Panic Control Therapy), various meditation or progressive relaxation practices, medication with tricyclic antidepressants, medication with SSRIs (selective serotonin reuptake inhibitors, another class of antidepressant agent), medication with benzodiazepines (a form of minor tranquilizer), medication with anti-epileptic agents other than benzodiazepines, and social teacher cover letter, occasionally hypnosis or medication with one or another class of monoamine oxidase inhibitors (MAOIs or RIMAs) or antipsychotic agents. Hypnosis is the yellow relatively uncommon because it is seldom effective for non-phobic panic and can easily worsen the situation. Teacher Cover! Attempts to unearth and treat the essays on causes underlying trauma are usually misguided because if the initial diagnosis of panic disorder has been rigorous, it appears that there is social teacher seldom an underlying trauma to unearth. Medication with MAOIs is relatively uncommon because of the dietary restrictions involved and the danger of hypertensive crisis.

Some clinicians are working with reversible monoamine oxidase inhibitors, but so far there appears to be little data on success. In listening to patients, it becomes apparent that there are patients who respond well to each of the transition and phrases list therapies in common use, either alone or in combination. Middle School Social Teacher Cover Letter! It appears somewhat common and highly advisable, for example, to supplement medication with CBT or PCT, but one also sees combinations of medications. Reactions to medications appear to be highly variable in panic disorder #150; less consistent, for instance, than reactions to essays the yellow wallpaper anti-hypertensive medications in middle school studies cover, the treatment of hypertension. One sees that some patients respond negatively to several medications or classes of medications, only to respond well to another. Some patients report that SSRI medications foster a return to spontaneity and exuberance, but others report a range of negative outcomes ranging from a dulling out of emotions or even physical sensations (resulting in serious accidental burns or cuts) at one extreme to unbearable agitation at the other. Similarly, some patients report a normalizing effect from benzodiazepines, but others experience negative outcomes ranging from stupefaction or emotional dulling at one extreme to awkward or even dangerous disinhibition at the other. Themes! It seems quite clear in talking to patients that reactions are highly individual, and it seems probable that this is school social due to differences in respective patients' underlying biochemical disturbances. (A number of studies have pointed out that generally speaking, antidepressants seem to work well when the primary manifestations are of a psychological character, while benzodiazepines seem to essays over wallpaper work better when the primary manifestations are of a somatic character. Here again we see evidence that there are separate etiologies underlying such a systematic difference in efficacy #150; that indeed distinct conditions are probably involved: a sort of GAD plus panic attacks and a dysautonomia with paroxysms and sometimes secondary worry.) It appears that few psychiatrists are aware of the distinct varieties of panic disorder outlined in the beginning of this essay, although the research documenting them is readily available in research journals and correct identification of the variety of school teacher cover panic disorder is critical to the correct choice of treatment.

Moreover, it appears that few cases of panic disorder are even referred for psychiatric evaluation in the first place. Instead, primary care physicians tend to feel competent to diagnose and treat the gcse condition. A typical PCP is even less aware of the complexities of panic disorder than a psychiatrist, and will almost certainly regard the condition as invariably a serotonin deficiency (which term is itself a considerable oversimplification of studies cover letter one of several serotonin-related pathologies sometimes present in depression, panic disorder, anxiety disorders generally, and some other conditions not relevant to this discussion). So while it is quite apparent that reactions to gcse panic disorder medications and the correct choice of medication vary by individual and by subtype of school studies teacher cover panic disorder, it also becomes apparent in transition words, listening to middle school social studies patients that many if not most physicians prescribe not according to what should or does work for individual patients, but according to a essay communication skills what works for the individual doctor. One doctor treats virtually all cases of panic disorder with SSRI medications; another treats virtually all cases with tricyclic antidepressants; another treats virtually all cases with benzodiazepines. Patients who respond poorly to that class of medication typically suffer through several trials of four to six weeks each before changing doctors. It is school not uncommon for and the essay a panic disorder patient to have gone through a number of physicians (with considerable personal suffering and sometimes loss of employment) before responding well to treatment. Oddly, it is the patient rather than the physician who is labeled non-responsive when one size does not fit all.

(Patients also tend to social teacher letter be unaware of the large proportion of doctors who have conflicts of interest in the form of subtle and sometimes not-so-subtle financial incentives to prescribe particular medications. In this respect, the ethical canons in medicine appear, at least based on actual practice, to be remarkably lax in politics olympics essay, comparison to those of other licensed professions.) It is unfortunate that individual response is school social typically ignored in prescribing for panic disorder, because the more one examines the evidence, the more it becomes apparent that any given individual is likely to respond really well to a benzodiazepine or to an antidepressant, but not interchangeably. Cultural Themes! Response to one of middle social studies teacher cover these classes of drugs is likely to be optimal, while response to the other will be marginal at best. A small minority of patients seem to need both, but it can also happen that the war two types of meds antagonize each other instead of complementing each other. This is contrary to the prevailing treatment practice, but at present, practice appears to be based more on agenda (or sometimes on tradition, lore, or peer pressure) than on objective evidence. Indeed most non-specialists appear to be wholly unfamiliar with the school actual evidence, which is cultural essay often at odds with the claims of the salespeople (most of whose education is in sales,marketing, or communication) on whose counsel they rely.

The first rule of treatment in panic disorder should be: If it's currently working, don't even think about changing it! It is middle teacher letter utterly appalling to see the gcse literature coursework numbers of patients who have been controlled and highly functional with one strategy of management over the course of years, only to move to a new state or change employer (and thus change insurance company) or have their doctor retire, and then have complete havoc wrought in social teacher cover letter, their medical condition, their emotional state, their marriage, and even their employment and essays the yellow, financial status, all because an inept and middle teacher cover, overly self-assured doctor sought to adhere to essays of cold war one or another of the continually emerging vogues in prescribing. One need only search MedLine to middle studies teacher cover letter see the a essay about communication skills course of these successive vogues over the last two decades, and it is clear that what is in today will be out a few years from now. There are choices to make in treating any newly emergent case of panic disorder, and teacher letter, humane, flexible, patient-responsive experimentation may be necessary. But experimentation with patients who are functional and satisfied is unconscionable, should be regarded as malpractice, and has indeed been grounds for successful malpractice litigation. Undermedication of chronic anxiety or dysautonomia is just as irresponsible and gcse, just as ripe for judicial redress as undermedication of school studies teacher cover chronic pain. On Cognitive-Behavioral Therapy.

(and Panic Control Therapy) A large proportion of patients undergoing CBT or PCT report that they have experienced significant benefits from such therapy, particularly in the area of coping with their symptoms, reducing the severity of their panic attacks, and improving their overall well-being. However, very few report that CBT or PCT alone is sufficient to eliminate or even necessarily to reduce the number of their panic attacks. Although there have been reports in the past of very high success rates with CBT alone, a recent study revisited some of the results and came to quite different conclusions. David Barlow, Ph.D., one of the leading figures in psychological treatment of politics anxiety, commented on school studies teacher cover this study with the laudable observation that The one thing that we've learned . now that more data are in, is that we're not really as good as we thought we were. This was refreshing candor and integrity in a field where professional pride has often taken priority over on causes war a dispassionate and monetarily disinterested look at the relative merits of various approaches to treatment. One would expect the best results of CBT or PCT to be achieved when the condition is rooted in anxious or obsessive patterns of middle school social teacher letter thought. However, it is essay not always easy to distinguish such cases. Certainly it seems incumbent to middle school social studies letter treat such thinking whenever it is present, whether it is a preexisting causative factor or merely a result of the disorder. Further investigation is needed into the effects of CBT and PCT on the dysautonomia associated with panic disorder.

Although a patient is transition words for essays likely to be very grateful (and at social letter a sharply reduced risk for suicide) after learning to experience less severe panic attacks in a essay about, the face of social studies teacher cover letter prolonged dysautonomia or dysautonomic paroxysm, little has been gained from a medical perspective if the essays patient nonetheless experiences prolonged and school social teacher cover letter, frequent dysautonomic episodes. There is and phrases a certain value in teaching patients to cope with the symptoms of medically uncontrolled essential dysautonomia (especially if such treatment may reduce actual symptoms), just as there is middle school studies value in teaching patients to cope with the symptoms of other chronic medical conditions. Nonetheless, such therapy should not be substituted in words and phrases for essays, whole for treatment of the medical condition itself. Meditation and progressive relaxation techniques are helpful for social teacher cover letter some people. Meditation techniques need to be undertaken with the understanding that dissociative states like those it may promote are not always desirable in panic disorder patients #150; that indeed they can trigger panic attacks in themselves or simply be more difficult to terminate for individuals with anxiety disorders. (There is a fair amount of controversy around meditation in panic disorder, with strong opinions for essays and against.) And individuals undertaking either meditation or progressive relaxation need to understand that even when the middle school letter practices are beneficial, a panic attack is most likely to occur during the transition from a state of transition words and phrases for essays list high arousal to one of lower arousal.

This appears to be true of all or most panic disorder patients, but it is especially noticeable among those who have the aberrant CCK gene. Obviously it is desirable to make the transition from high to low arousal, but most people would prefer to school social cover letter do so without triggering panic attacks in the process. Learning effective relaxation may thus be more complicated for on causes war the panic disorder patient than for other individuals. On Tricyclic Treatment. A growing number of clinicians now treat panic disorder using tricyclic medications, often after having used SSRI treatment for a number of years and then reverted to the use of tricyclics based on the number of adverse patient experiences. Tricyclics seem to work well for a minority of panic disorder patients. Statistically, some tricyclics are the most successful type of antidepressant for treating panic disorder, and those statistics were compiled in an era of less brazen manipulation of clinical trial data than we see today.

However, due to studies the parasympathetic insufficiency so frequently present in the disorder, a certain subset of panic disorder patients seem particularly prone to excessive cardiac stimulation from this class of medications, which increase the availability of norepinephrine. Tricyclics are also inherently less safe than most modern antidepressants, with substantially lower margins for dosage error or deliberate misuse. Tricyclic medications also reduce the availability of acetylcholine, and reduced availability of acetylcholine is believed to be implicated in cultural themes essay, the mechanism of panic disorder. Their overall effect is to increase autonomic arousal, so like the SSRIs, they seem to work best where the panic disorder is of psychological origin or has highly prounounced psychological manifestations. On SSRI Treatment. Among clinicians new to treating panic disorder or new to using SSRI-type medications, these medications are often regarded as the school social studies treatment of choice or even a panacea. This point of view appears to over be in retreat among more experienced clinicians, although it is social studies teacher still heavily promoted by pharmaceutical companies, whose representatives still grossly understate the side effect and withdrawal profiles while greatly overstating the about skills success rates of these medications in school teacher cover letter, treating panic disorders. Literature! However, the side effect profile for SSRI medications is much worse than initially published studies revealed, the effectiveness is highly unpredictable in treating panic disorder, and there is middle social cover letter high risk for precipitating iatrogenic crisis when using this class of medications to transition words and phrases treat panic disorder (especially during the beginning of treatment). An alarming percentage of middle school studies patients in the Internet support communities for themes essay panic disorder had never experienced or even heard of a panic attack before they were treated for depression with an SSRI, but experienced panic attacks leading to an ultimate diagnosis of panic disorder within their first week or even the first day of treatment and have not been able to rid themselves of the disorder after discontinuation of the SSRI.

Now they have depression and panic disorder, or sometimes panic disorder that persists beyond recovery from depression. Primary care physicians on the whole, and a sizable minority of psychiatrists, are unfamiliar with the true side effect profiles of various SSRI medications, are unaware of the social cover letter tolerance that develops to these medications when they are used to treat panic disorder, and are unaware of the withdrawal syndromes, despite the fact that all of these have been well documented in cultural themes, such sources as the British Medical Journal and the Journal of Clinical Psychiatry, among others. (And yes, it is called withdrawal and not discontinuation or discontinuation syndrome everywhere except in the United States.) A disturbing number of patients are not informed of the middle school social teacher letter potential long-term risks of their medications, including the significant weight gain and sexual dysfunction, both of which can persist long after discontinuation of SSRI medications. When patients report some of the politics and the essay side effects of usage or discontinuation that are typical in panic disorder, such as visual lag and sensations of random electric shock, their physicians incorrectly state that these are not recognized as attributable to SSRI medications, even though they are well documented in middle social studies letter, the psychiatric literature. Additionally, almost every recent, independent study that has looked at suicidality with SSRIs has concluded that although these medications are indeed safer in overdose than tricyclic antidepressants, a significantly greater proportion of SSRI users than tricyclic users actually attempt suicide. These people are not uninformed, either #150; they know that their SSRI is a essay not lethal, so they tend to use acetaminophen, gunshot, or hanging instead. Both anecdotal reports and systematic surveys of clinical practice reveal that a majority of physicians prescribing SSRIs do not know how to correctly taper the beginning and end of treatment with these medications, nor what reduced dosages to use in treating panic disorder, nor what protocol to middle school teacher follow in olympics, switching from one SSRI to another #150; usually a direct switch is advisable, but some physicians prescribe a washout period that is middle school both uncomfortable (if not debilitating) and dangerous to the patient #150; nor how to switch between an SSRI and another class of politics and the olympics essay antidepressant. One does see a large minority of panic disorder patients whose condition responds well to SSRI medications, even though these patients are no more exempt from the usual side effects than other patients. School Social Teacher! (Some find that the addition of Serzone [now banned], or less often Wellbutrin, can restore sexual function lost to the primary SSRI and/or reverse the perversely treatment-resistant weight gain experienced by a majority of long-term SSRI users; however, neither of these medications appears to be useful alone in over, the treatment of panic disorder.) Not all of the school studies teacher cover letter patients who respond to SSRI treatment are the ones in whom the condition seems attributable to anxious or obsessive thought patterns, so it appears likely that there is some set of patients for whom these medications correctly target some underlying abnormality or imbalance.

However, many physicians seem unaware that a significant number of panic disorder patients react very badly and sometimes very suddenly to the anticholinergic effects of about communication SSRI medications, a reaction that should not be surprising given the parasympathetic insufficiency posited to be so often present or even causative in panic disorder. Most long-term panic disorder patients who show up in the Internet support communities have been on a progression of different SSRI medications, often with a progression of different doctors, before being stabilized long-term on a regimen of Xanax, Ativan, or Klonopin. A small number end up on middle school social studies teacher letter Valium, Tranxene or other benzodiazepines. [Update: A study presented in Atlanta at the 2001 annual conference of the Anxiety Disorders Association of America made a similar observation regarding the panic disorder population as a whole.] A significant number of other panic disorder patients who show up in the Internet support communities began treatment on both an SSRI and a benzodiazepine, but were forced to themes discontinue the middle school teacher letter SSRI due to unacceptable side effects, and then found that they were well controlled on the benzodiazepine alone. One of the disturbing characteristics of essays SSRI medications is that once a particular SSRI has ceased to be effective in controlling panic disorder, it usually cannot be used effectively again in the future, not even years later #150; the cessation of effect is persistent and perhaps permanent. This raises some troubling questions about the mechanisms behind the school social studies cover well-known poop out phenomenon distinctive to SSRIs and and the, other reuptake-inhibiting medications.

Current research hypotheses with some degree of experimental foundation include depletion of social cover dopamine (though it is unclear why that would be so persistent), an excess of the otherwise therapeutic effect of desensitizing serotonin receptors (but why so persistent?), and physiological damage to cultural or destruction of serotonin receptors (in which case it is doubtful but unproven whether they can be regenerated). SSRI medications reduce the availability of nitric oxide, and middle social studies teacher letter, reduced availability of on causes war nitric oxide is suspected as a factor in the mechanism of school social studies teacher letter panic disorder. They also increase production of prolactin, which may be a factor in the high incidence of politics and the olympics essay sexual dysfunction, and alter the function of the hypothalamus, which is one of the mechanisms being studied as a possible factor in middle school social studies cover letter, the strangely treatment-resistant weight gain associated with SSRI usage. (It is gcse literature a shame that the dramatic differences in reactions to SSRI treatment are so often minimized, trivialized, or dismissed outright instead of school social cover letter being acknowledged and studied more closely. It is a shame because the differences probably provide, in their sheer starkness, some of the best clues currently available to the varieties of biochemical mechanisms underlying panic disorders #150; and to the various mechanisms underlying depression and obsessive-compulsive disorder too, for that matter. Groups of people with similar reactions to one class of of cold war drugs, particularly drugs as selective and middle studies, powerful as SSRIs, probably represent de facto classifications of people with similar variants of panic disorder or depression. And The Olympics Essay! It is possible that failure to follow up such an obvious line of investigation is due to commercial agendas. But it is also possible that it is simply easier, with current research technology, to middle social studies letter plan and study interactions between drugs and essays on causes of cold war, neurons in the laboratory than it is to look inside a living human being and school social teacher cover, observe the individual's true neurochemical processes or status at skills a given moment #150; that our ability to create drugs that act at social studies letter the neuronal level has far outpaced our ability to observe in thorough and objective ways their actual effects on essays on causes living creatures' neurochemistry. And so we rely on a priori speculation, we rely on social studies subjective reporting of sensations and feelings far removed from the biochemical processes that cause them, and we conjecture as to their meaning.

Typically this takes place in trials where the protocol assures minimization or even outright dismissal of reactions that are not universal or at least common to a large proportion of subjects. So when something goes wrong for a minority of patients, we conjecture around variations on the presumed and intended workings of the drug at the biochemical level; but we do not know, and we have few tools to uncover, the subtleties that explain the full range of unintended effects.) There is an old saw that antidepressants cure panic disorder, whereas tranquilizers merely control it. Never mind that such a belief erroneously regards panic disorder as a single monolithic disorder. Even overlooking that point, when one looks beyond the short-term perspective of typical clinical trials, it becomes apparent that antidepressants do not cure panic disorder, other than in rare cases #150; the condition is transition words for essays chronic and often mildly progressive.

Follow-up studies show similar relapse rates in the long term, and it is dishonest and irresponsible to tell patients anything else. With CBT or PCT, one can sometimes reduce the incidence of outright attacks by reducing sensitivity to triggers, but the underlying dysautonomia persists #150; and it is the dysautonomia, not its paroxysms, that represents the most insidious threat to health and longevity. In any case, the cure/control distinction is at best misleading because very few pharmaceutical treatments cure anything. Social Studies Teacher Cover Letter! Control of symptoms is an admirable ambition and one that is deemed fully sufficient in many other medical contexts. There is no call to discriminate against the panic disorder population with a specious and condescending distinction between cure and bandaid. The fixation on SSRIs as the one-size-fits-all treatment of choice for essays the yellow panic disorders is largely attributable to a marketing campaign targeting primary care physicians and their patients that was conducted for SmithKline Beecham (as the school cover makers of Paxil were known at the time) by the Ruder Finn agency.

As Ruder Finn trumpeted until recently on a World-Wide Web site intended for advertising industry insiders, the Paxil for Panic Disorder program was one of the most spectacular successes of pharmaceutical blitzmarketing in the history of the industry. To quote from the Web site: The Paxil for Panic Disorder program leveraged a new indication of an politics and the essay, existing antidepressant for school social a relatively obscure anxiety disorder to generate unprecedented product sales growth. Seven months after the themes essay panic disorder launch, The Wall Street Journal referred to panic attacks as the hot new malady that is quickly replacing depression as the studies teacher cover letter mental illness du jour.. The objectives of the Paxil for Panic Disorder campaign are: Increase sales and overall market noise [sic] about politics and the olympics essay, Paxil by generating widespread awareness of FDA clearance of the medication's new indication as a treatment for panic disorder. Urge undiagnosed sufferers to see their physicians for a diagnosis and ask for social studies cover Paxil.

Take advantage of seasonal and other opportunities. The launch phase of the program was also supported with a Morning Drive-Time Radio Tour in 18 cities across the country. A satellite media tour was considered [but dropped]. Tie in to the stressful nature of the words list holiday season. Sales growth of Paxil since May, which SmithKline Beecham describes as unprecedented, has been attributed by the company to the sales and middle letter, public relations launch of the panic disorder indication. SmithKline Beecham saw its share of the total SSRI market share grow by 8.7% and its share of new prescriptions grow 7.7% between April and November.

Note that by Ruder Finn's published report, SKB itself attributed the success of Paxil not to scientific or medical documentation but to its savvy sales and public relations launch. A Essay About Communication Skills! The clinical trials submitted as the basis of the FDA approval and middle teacher, ensuing media blitz were three, and in essays, them the drug was successful in eliminating or reducing panic attacks in 25% (misstated as 76%*), in 51%, and in 33% of school social cover letter trial subjects on Paxil, versus 44%, 32%, and 14% of subjects on placebo. To specialists in the treatment of panic disorder, these numbers are anything but impressive #150; indeed if the drug had been promoted on numbers like these rather than the sweeping generalizations primary care physicians hear from pharmaceutical salespeople, it is unlikely that much enthusiasm would ever have developed in the first place. Of Cold War! Additionally, grave questions have since been raised about the integrity of the research itself. * The company did not cite a figure for middle cover all subjects in the first study, but instead counted only the one-third of a essay subjects who responded best #150; and who were on a dosage intolerable to many patients. Thus the 76% for best-responders actually represents 25% for the study as a whole. Middle School Social! (3/4 x 1/3 = 1/4) This little white lie is among the least of the irregularities that have emerged in court cases involving the clinical trials of Paxil. The Ruder Finn campaign aimed to broadcast the cleaner side effect profile of Paxil, although the politics and the essay sad truth is that clinicians are largely in agreement today, about three years later, that of middle school social studies teacher cover letter all the commonly prescribed SSRIs, Paxil seems to have the dirtiest long-term side effect profile and politics and the essay, the most problematic withdrawal. (The World Health Organization's statistics on complaints about withdrawal put Paxil in a very clear #1 position.) Based on the difficult-to-ignore evidence of their own clinical experiences, primary care physicians are spontaneously moving away from Paxil in social studies teacher, favor of milder or supposedly cleaner SSRIs. The plaintiffs in a California class-action lawsuit against the makers of Paxil (seeking changes to and the essay labeling, release of embargoed data, and only modest monetary damages) intend to school social cover introduce documentary and testimonial evidence: that Paxil performed significantly, indeed markedly, worse than placebo in its early trials, before statistical spin doctors were brought in to fix the problem; that when dozens of trials did not yield positive results, statisticians manipulated the numbers to a essay communication skills produce hypothetical trials in which one single patient who endured or thrived on Paxil for 365 days would completely offset 365 patients who could not endure the medication for more than one day; that the makers changed numerous reports (adding up to tens of percents) complaining explicitly of withdrawal, as distinct from relapse, to instances of relapse instead; that the company suppressed evidence of middle teacher cover a 0.77% incidence of list suicidality (considered quite high for middle school studies cover letter such a serious side effect, and cultural themes essay, later demonstrated to be even higher); that a certain identified FDA official illegally coached the makers of school social studies teacher letter Paxil in clandestine conversations on how to avoid scrutiny on words and phrases list the suicidality issue; that the company suppressed information on a 20-25% dropout rate in early trials; that the school social studies teacher cover company deliberately claimed on a essay about communication the record in an FDA hearing that it had studied withdrawal issues and found none, when in fact it had not studied withdrawal issues but had inadvertently become aware of frequent and severe withdrawal experiences; and that the company has systematically promoted the impression that the only people who become dependent on Paxil are multi-drug abusers, even though the company has abundant evidence (which it suppresses) that dependence and a pronounced neurological withdrawal syndrome are common. School Teacher Letter! As internal company documents have come to light in other civil and criminal trials regarding Paxil in the United States and other countries, it has become clear that the drug's makers possessed far more documentation of the drug's potential for adverse effects than they ever disclosed to the FDA, to the public, or to coursework the scientific community.

There is obviously a place for middle school teacher letter the discriminating use of SSRI medications in the treatment of panic disorder. They are irreplaceable, indeed life-saving for many people. However, they have been prescribed indiscriminately and even recklessly in recent years. The appropriateness of their use has been greatly exaggerated and gcse literature coursework, the long-term risks and middle studies, sometimes severe dependence and about communication skills, withdrawal effects (which bear no resemblance at all to the condition being treated) have been swept under the cover carpet for as long as humanly possible. The question is not whether there is a place for SSRIs in the treatment of panic disorder. The question is what is the proper role of an advertising agency in shaping medical opinion and practice in the treatment of neuropsychiatric disorders. On Benzodiazepine Treatment. By far the largest group of functional, well-controlled panic disorder patients who show up in the Internet support communities are those on a regimen of long-acting or short-acting benzodiazepines (or both). Essays The Yellow Wallpaper! This parallels the conclusions of recent long-term reports following up on earlier studies and in some cases coming to new conclusions.

The most common regimen among such patients is a long-acting benzodiazepine taken on studies teacher cover letter a regular schedule, with a short-acting benzodiazepine to be taken for breakthrough symptoms. However, significant numbers do well on a regimen of gcse literature coursework short-acting or long-acting benzodiazepines alone. A substantial proportion of these patients take only enough medication to manage their autonomic arousal, thus breaking the autonomic link in the arousal-anxiety-arousal-panic cycle, and normally rely on techniques learned in Cognitive-Behavioral Therapy to school social studies cover letter manage the cognitive-emotional aspects of the condition. Many clinicians are reluctant to prescribe benzodiazepines long-term for words and phrases for essays panic disorder, despite abundant evidence that panic disorder patients respond better to this class of medication than any other group of patients and that panic disorder patients are the least likely to abuse these or any other medications. The typical pattern is school studies cover that panic disorder patients require some adjustment of dosage in themes essay, the beginning of their treatment #150; either up or down #150; and then remain at or below that dosage for years. Studies! When considering research on benzodiazepines, there is every reason to look at research specifically into their use in panic disorder, because the patterns that emerge are quite different from those that emerge when this class of medication is used to treat GAD or situational conditions. It is common for panic disorder patients spontaneously to reduce their medication after six months to a year, and to words for essays list remain satisfactorily controlled at the lower maintenance dosage.

It is common for panic disorder patients to try to middle social studies teacher eliminate their medication after a considerable period free of symptoms, only to find that they must go back on their original level of medication. There may be a medication-free period of success lasting months or occasionally years, but the condition eventually returns #150; sometimes with an intensity requiring more medication than before. Panic disorder, at least in its biologically-rooted forms, is a chronic condition. Where normal individuals report a dulling of sensation from gcse literature coursework, benzodiazepine treatment, panic disorder patients typically report that they feel normal again for the first time in years. This subjective assessment is often supported by an increased level of performance at middle school social teacher cover work or in school. Such an assessment might even be regarded as a useful diagnostic factor. The baseline levels of autonomic arousal and cultural essay, of parasympathetic nervous system activity tend to be different in panic disorder patients from those found in normal individuals, and social studies teacher letter, that helps explain why benzodiazepine treatment can be not merely therapeutic but normalizing in the panic disorder patient, with a lower incidence of side effects than those experienced by the general population and an incidence of abuse so low as to be almost nil. Optimal cognitive and motor function require the nervous sytem to be within a certain functional range of arousal. Gcse! If you have just woken up from a deep sleep or you have just hopped off a treadmill after ten minutes of running your fastest, your cognitive ability in particular but also your motor ability to deal with demanding tasks are both going to be well below adequate.

Your nervous system is outside its functional range of arousal. States of depression and states of autonomic anxiety like those seen in school, panic disorder are analogous. Both may fall outside the optimal range of autonomic arousal, or even outside the functional range. This explains why people with panic disorder often demonstrate improved cognitive or motor function when taking benzodiazepines. Learning is a particularly demanding task, and the brain is biochemically inhibited from coursework, learning well when there are high levels of arousal-inducing hormones or neurotransmitters. Thus patients with panic disorder or a condition that mimics it may be unable to learn in an academic setting and school studies teacher letter, unable to benefit from Cognitive-Behavioral Therapy (which teaches the brain new patterns of thought and cultural essay, new reflexive behaviors) until an appropriate dose of a benzodiazepine is taken. The dose must be large enough to lower nervous arousal into the optimal range without being so large as to push it from over-arousal to a state of under-arousal.

Much of the middle social studies teacher cover early research on the use of benzodiazepines in anxiety and panic was conducted with dosages that today appear stunningly high. It is strange indeed to coursework read of studies using 6-10 mg of Xanax for panic disorder when today we know that the middle social great majority of patients function optimally on 1-4 mg spread across 24 hours. Some patients require as much as 6 mg per words for essays, day, but that is school social studies teacher letter so rare that even the most benzodiazepine-friendly physician would almost certainly question the politics diagnosis or consider a different type of medication. At present Xanax is the middle studies best-known benzodiazepine used against panic disorder (and the one that is FDA-approved for the condition), but perusal of early research into the use of Klonopin and other benzodiazepines against panic disorder shows the same thing: the dosages tested tended to be far higher #150; 2x, 3x, or even 4x #150; than the dosages commonly used and known to be effective today. It is of course important to taper the transition words list cessation of school social studies cover letter benzodiazepines carefully. Papers on this subject report that a three-month taper is a reasonable standard, but that six months or a year is not unreasonable for high dosages or long-term use.

In the case of panic disorder, there should not be undue pressure to get off of any class of medication, and essay, during cessation it is often difficult to social teacher distinguish withdrawal symptoms from cultural essay, symptoms of the underlying panic disorder (except in the case of discontinuing SSRIs, where the middle studies teacher letter most dramatic withdrawal symptoms are clearly neurological and bear no resemblance to and the olympics panic disorder or depression). A number of papers report that panic disorder patients are frequently withdrawn successfully from their medication only to have to middle studies letter go back on words list it at the same or a higher level half a year or a year or two later. These papers suggest that it is probably healthier to maintain panic disorder patients at a constant level of medication, if no problems emerge, than to subject them to middle school social this cycle of cessation and recommencement of medication #150; regardless of the class of medication in a essay communication skills, question. There are occasional patients who taper cessation of benzodiazepines over two weeks or less without difficulty. This is definitely the exception, however, and should not represent an expectation. Middle School Studies Teacher Cover! Such a rapid taper can be dangerous and and the olympics, even life-threatening. One sees a small number of panic disorder patients who do not tolerate benzodiazepines well.

It is widely regarded as canonical that benzodiazepines cannot be used in the treatment of patients with a history of alcohol abuse. However, with proper supervision, this is not necessarily true. In fact, it turns out that benzodiazepine treatment for panic disorder can be a key to middle social letter preventing alcoholic relapse. Abusers of alcohol who experience panic attacks may have been self-medicating for words their panic disorder, and some even lose the desire to drink at middle social cover all once the underlying state of gcse arousal is controlled. This seems particularly true in the case of middle social teacher cover measured drinkers, those who drink regular amounts at regular times of day. Both anecdotal reports and published research emphasize that the definition and manifestations of about tolerance, dependence, and addiction are commonly misunderstood among physicians and even among a surprising number of psychiatrists. Experts in the use of benzodiazepines report that tolerance normally develops to their sedative, cognitive, emotional, and motor effects, but not to the autonomically anxiolytic effects, i.e. not to middle social teacher cover their ability to interrupt the neurological panic circuit. Thus a patient may report drowsiness in the early days of transition and phrases list treatment, but the drowsiness wears off. Once an effective dosage is found in the first weeks of treatment, this dosage (or, after a while, a lower one) will eliminate panic attacks and most dysautonomia for years and decades. Patients on such a maintenance dosage should be regarded as medically dependent, just as many patients are dependent on glucophage or insulin or anti-hypertensive medications that exhibit a rebound effect on cessation #150; or on school teacher cover Paxil, for that matter #150; but should not be regarded as addicted in the absence of all the other criteria that characterize addiction. The matter of dependence is also put into a new light by cultural essay, the appearance of more and middle social studies letter, more studies (particularly, it would seem, in cultural themes, Britain) stressing the middle social cover point of view that antidepressants also promote physical dependence in anxiety disorders.

A World Health Organization report goes so far as to over the yellow wallpaper state plainly that SSRI withdrawal is a more difficult problem today than Valium withdrawal was in middle social teacher cover, its time. Reports such as these call into question whether it is well-advised after all to promote antidepressants over benzodiazepines in the belief that ADs do not cause dependence. It is after all widely recognized that benzodiazepines are often more effective and work more quickly. It is the consensus within the panic disorder community that every medication that is actually effective in olympics, treating panic disorder has the potential to create dependence. Dr. Robert DuPont, a former director of the [United States] National Institute On Drug Abuse, has stated that the concept of studies teacher cover letter using the politics essay lowest possible dose of a benzodiazepine for the shortest period of time is inconsistent with sound clinical practice. This concept needs to include the important qualification that our goal is to maximize the patient's ability to function well and to enjoy life. Benzodiazepines are among the safest and most effective treatments in all of school social cover letter medicine , including their role in the treatment of panic disorder. He is essays on causes of cold joined in his opinion by middle school studies cover, many experts of comparable stature and by on causes, a World Health Organization report entitled Rational Use of Benzodiazepines , WHO/PSA/96.11. (This consensus document from the WHO is distinct from the 1994 document Guidelines For The Rational Use Of Benzodiazepines authored by Dr.

Heather Ashton.) These medications are not a panacea and they are not without their potential drawbacks. However, they have been the school social studies teacher letter subject of such a fierce backlash from their extravagant misuse and themes, overprescription in the 1970s (similar to but exceeded by the SSRI bonanza of today), and have been the target of such unscrupulous propaganda from the promoters of middle school social studies other drugs which still, unlike most benzodiazepines, enjoy the profitability of patent protection, that most doctors are unfamiliar with the and the actual evidence that should govern their prescribing. The evidence clearly shows that at present there is no other class of middle social cover letter medication that works nearly as well, in nearly as large a proportion of the panic disorder population, as benzodiazepines; it shows that dependence is real but is cultural essay not unique to benzodiazepines and thus not a major differentiating factor; and it shows that there is no other population less prone to addiction or abuse of middle social studies cover benzodiazepines prescribed as part of a comprehensive management strategy. No discussion of benzodiazepine treatment would be complete without a brief mention of at least two quasi-cult-like self-help networks of individuals who claim that use of even very low doses of benzodiazepines for brief periods caused them permanent neurological damage and years or decades of anxiety and panic attacks a thousand times worse than anything they experienced before. (One wonders what they were experiencing before that could stand 1000-fold amplification.) With a vehemence and essays on causes, personally directed vitriol strongly suggestive of fanaticism, they reject any suggestion that they might instead be suffering from untreated anxiety or panic disorders, since the symptoms they describe when one pins them down to school studies cover letter specifics sound very much like the a essay symptoms of uncontrolled, advanced panic disorder. If this were all there were to the story, it would not be worth dignifying with mention here. However, this group cruises the Internet panic disorder support communities looking for newcomers and then bombards them with email offering self-help cures for prices that begin in the thousands of school social letter dollars and essays of cold, gradually decline, and terrorizing these vulnerable individuals with dreadful anecdotes that sound perfectly outlandish to pharmacologists and clinicians alike. Identifiable individuals who speak up against this group are deluged with organized hate mail, some of it threatening in middle teacher letter, nature. In this age when many patients research their conditions using the Internet (as well they should), physicians should know something about this bizarre phenomenon so that they can offer knowledgeable and convincing support to patients who fall prey to these groups' terroristic tactics. On Treatment With Other Classes of Drugs.

Other classes of drugs are sometimes used in treatment of panic disorder but do not represent first-line choices. Other drugs used clinically or in research include anti-psychotics, beta blockers, CCK antagonists, alpha2-adrenergic agonists, and and phrases for essays list, anti-epileptics. Although the author lacks statistical data, there are a notable number of reports from patients experiencing good results with Effexor XR (which seems for unknown reasons to behave very differently from middle studies teacher letter, its non-extended-release version Effexor), often after having bad results with SSRIs or simply having run the gamut of the major SSRIs, only to have each one in essays the yellow, turn poop out (if the reader will excuse the scientific jargon) after a period that typically begins at a number of years but tends to shorten with each successive replacement drug. Some patients are also reporting good results with the RIMA moclobemide, and social teacher cover, a few are reporting doing well with beta blockers. Reports of success with alpha2-adrenergic agonists are not common but do occur. This class of medication can be helpful in cultural themes, conjunction with other treatments. Middle Social Teacher Letter! The same observations apply to beta blockers.

There is a small but growing trend to treat panic disorder with anti-epileptic medications. Success is mixed, but these medications are successful for an indeterminate proportion of panic disorder patients. There has been a puzzling surge of reports over the last year of on causes war doctors resorting to antipsychotic medications in the treatment of panic disorder, often before even trying all of the studies teacher cover mainstay classes of medications, and often with unfortunate consequences. However, there are a few patients who do respond better to these medications and on causes of cold, need to use them despite their extensive side effects. A small number of patients have reported success with the opiate blocker naltrexone, which at least theoretically could be of help to people whose symptoms are caused by stimulation from the opioid peptides in gluten or casein.. By patient accounts, the least effective drugs commonly misprescribed for middle social studies cover the treatment of gcse literature panic disorder (although there are always exceptions), are BuSpar, Wellbutrin, and school teacher cover letter, Serzone. Serzone has the transition list particular complication, of social studies cover letter which an alarming number of prescribing physicians seem unaware, of essay substantially inhibiting the middle school social teacher cover letter metabolism of essays over wallpaper other psychotropic drugs, thus making it difficult to middle school studies letter calibrate effective dosages. This is essays not to teacher cover say that there are no panic disorder patients who benefit from these drugs, but they are a small percentage. There is a trend toward polypharmacy in olympics, the treatment of panic disorder, with drugs added to treat the side effects of middle school social studies letter drugs added to transition and phrases for essays treat other side effects. Often drugs are piled on in an attempt to avoid or make acceptable the obvious but in some circles politically incorrect choice of benzodiazepines, or in blind adherence to the doctrine that SSRI medications simply must work for school studies teacher cover letter all.

The author has not encountered much anecdotal or published evidence that a polypharmaceutical approach works better than (or even as well as) the mainstay treatments, except for rare complex cases; and and the, complex cases should absolutely be referred to a specialist in panic disorder. Complications of panic disorder can occasionally be severe and even life-threatening. Pharmaceutical industry insiders report that the middle studies letter next big push in anxiolytics will be the CCK antagonists. Already marketed successfully outside the essays over United States for this purpose (as well as for treatment of school studies teacher GERD and IBS), these are reportedly intended for an aggressive push into the American market when a favorable point is reached in the product life cycle of the SSRI medications. (It is possible that this CCK-antagonist generation of anti-anxiety medications may yet be leapfrogged by a newer class of medications under development to target GABA receptors even more finely than existing drugs do, but new patent filings for CCK antagonists quietly continue to accumulate.) For the time being, the SSRIs are still among the most profitable of pharmaceutical products in the United States and are among the least vulnerable to gcse literature competition. Their makers aggressively seek new areas of application for these flagship profit-makers.

But factors already at work to shift the market equilibrium include recently published major studies identifying the chromosomal locus and the importance in panic disorder, GERD, and IBS of defects in CCK metabolism, increasingly general awareness of SSRI complications, and the proliferation of lawsuits alleging improprieties in middle social, the conduct of clinical trials for SSRIs and the withholding of unfavorable research data. It is simply a matter of time before we see the gcse next shift in focus. On Reported Effectiveness and Side Effects. It is evident to the author that at least in the case of newer psychotropic drugs, one should trust postmarketing research and school social studies cover letter, the reports of experienced clinicians over the published results of Food and Drug Administration -supervised clinical trials for words for essays approval of new drugs. For instance, in the case of one popular medication, approval trials reported an incidence of sexual dysfunction well under 5%. Yet today experienced clinicians are in agreement that over the same length of school social cover time covered by themes, the original trials, the true incidence of sexual dysfunction is at least 60%. Some claim up to an 85% incidence in their practices. And such numbers have been substantiated in postmarketing research. How does one explain such discrepancies in the light of FDA oversight? Looking at clinical trials generally, without examining specifics of school studies cover letter this particular medication, sources of such misrepresentation can lie along a spectrum ranging from poor research protocol to outright fraud.

In the area of protocol, test subjects for the medication above were not asked about sexual dysfunction and felt reluctant to bring it up, especially given the relatively short duration of the trial. And while randomization may have been scrupulous within the trial, it has come to light that all candidates for the study, whether they ended up on placebo or the experimental drug, were carefully hand-picked for previously demonstrated tolerance of that drug's side effects. (As an aside, it is interesting to note that physicians participating in clinical trials state that the concept of double-blind placebo control is little more than a convenient fiction in the testing of psychotropic medications, and a somewhat ridiculous fiction at that. Wallpaper! They say that in most cases, the middle social studies teacher high incidence of dramatic side effects with psychotropics makes it perfectly obvious to the health care personnel, if not indeed to the patients, who is taking the communication skills medication and who is taking the placebo. For this reason, drug-against-drug trials are often more useful.)

Looking again at school studies cover the general case, there is also the question of fraud. Can this actually be a significant factor in American pharmaceutical testing? Doesn't the FDA ensure the validity and integrity of such testing? The General Accounting Office seems to think otherwise. The New York Times, in a 1999 series of articles on war fraud in middle social cover letter, drug approval trials, cited a GAO report criticizing the FDA for repeatedly failing to investigate whistle-blower reports of fraud and for colluding in some cases to cover up evidence of its commission. According to list the NYT, this GAO report concluded that the FDA was oriented toward overseeing methodological correctness and toward screening for scientific error, but was essentially helpless and disinclined to take action in the face of deliberate deception. School! As the NYT series documented, there are clinics that make a cottage industry out of transition words for essays list manufacturing patients, complete with interview results and middle school social studies teacher letter, bogus specimens to go along. Whistle-blowers have faced disbelief, systematic discrediting, and retribution comparable to any found in defense industries.

Far from ferreting out and assuring prosecution of such fraud, certain FDA employees and their supervisors seem to have facilitated its commission and cover-up, according to the GAO. This may be one reason that American pharmaceutical testing is a essay viewed with skepticism in for instance Germany and Finland, two of the thirty-odd countries consistently recognized by the World Health Organization (and other international observers) as practicing higher standards of health care and governmental oversight than the United States. The FDA is just another government agency. While it is held in peculiar veneration by middle social, the medical community, there is no reason to expect it to transition and phrases for essays be any more competent or any more scrupulous in its regulatory and studies teacher, inspection/examination activities than other agencies such as the Internal Revenue Service, the a essay about skills Department of Energy, or the Department of social studies letter Agriculture. (Nor is there reason to expect it to be worse, although that is faint reassurance.) All of politics essay these agencies have many competent, dedicated, high-minded people trying to accomplish good things, but there is only so much that individuals can do in middle school studies letter, the face of entrenched bureaucratic culture. All of these agencies, including the FDA, experience periodic scandals around competence and integrity.

The FDA comes under blistering criticism from European medical authorities (not to mention domestic sources) for themes its pattern of approving medications for which pre-approval research demonstrated serious problems, only to end up withdrawing approval under pressure from consumer organizations after unacceptable levels of school teacher letter fatality or injury appear. It is themes essay naive to exaggerate the competence or integrity of the United States' drug approval and school social studies teacher cover letter, oversight compared to themes essay taxpayer service, oversight of the middle school letter nuclear energy and weapons industries, or inspection of meat and agricultural products. Many who work in politics olympics, subordinate roles in pharmaceutical testing claim that data and school studies cover letter, conclusions are routinely and essays on causes war, unethically manipulated under the very noses of the social teacher cover FDA. Diet and Supplementation. The mainstream view in the panic disorder community is that neither diet nor dietary supplementation is sufficient for the management of panic disorder, but that both can make substantial contributions.

There is a sizable minority, though, who find that it is possible to manage their own panic disorder primarily or entirely with diet and supplementation. The four most dramatic examples of gcse dietary management are elimination of caffeine-like stimulants, adoption of a gluten-free/casein-free diet, supplementation with the amino acid taurine, and adoption of a ketogenic diet. School Social Studies Teacher! Each of these measures is helpful only to a subset of the panic-disorder population, a subset consisting of people with unusual sensitivities. Elimination of caffeine-like stimulants. Some people are exceptionally sensitive to the stimulants known collectively as xanthines, principally caffeine, theophylline, and theobromine, found in various combinations in coffee, most colas, tea (even green tea), and chocolate. The panic disorder population appears to communication include a greater proportion of these people than the general population. People who are not caffeine-sensitive have a hard time appreciating the extent to school social cover letter which the gcse literature coursework substance affects sensitive individuals. For some people, a single 12-ounce diet cola per day, the equivalent of about half a cup of American-brewed coffee, is enough to keep symptoms of panic disorder active. Quite a few people have reported that a single cup of decaffeinated green tea daily was the cover difference between experiencing heart palpitations and not experiencing them. Caffeine must be discontinued carefully. People seem to have the best success by tapering gradually #150; ounce by ounce at the end, if necessary #150; before completely quitting.

Many people take an NSAID like ibuprofen or aspirin for a few days starting the essays day before complete elimination in order to avoid the ferocious caffeine-withdrawal headaches that can otherwise result. It takes 3-8 weeks for a caffeine-sensitive individual to return to true baseline functionality and sensation after completely quitting caffeine-like stimulants. Prominent symptoms during the withdrawal phase are likely to include headache, depression, loss of school social studies teacher cover energy and initiative, muscular stiffness, constipation, temporary changes in vision, reduction in essays of cold, coordination, minor edema, sleeping several hours longer than usual, and markedly reduced athletic, physical, and mental performance. Because of the way caffeine affects biochemical production of energy to middle social studies power muscle cells and brain cells, one is literature quite literally not as strong and not as smart during caffeine withdrawal, but full function does return after withdrawal is complete. At some point there may be a day or two of unaccustomed heart palpitations as the body moves minerals around, establishing a new balance of electrolytes. But when the withdrawal phase is over, there is normally improvement over pre-withdrawal function in most of these areas. Many caffeine-sensitive people who complete withdrawal find that they are able to reduce or in some cases even eliminate their psychotropic medication. But this should not be an expectation; the reason to try caffeine-elimination and persist until withdrawal symptoms disappear is simply to middle school social studies cover letter feel better, function better, and essays, quite likely lessen some of the dysautonomia. Gluten-free casein-free (GF-CF) diet. Middle School Social Teacher! It has been known for years that some patients' panic disorder (or GAD) improves with elimination of gluten sources and milk products. Only recently has a strong theoretical foundation for such observations emerged from research abroad and at a few major American medical centers.

It also turns out that truly aggressive dietary restriction, using the same vigilance a celiac patient must practice in avoiding even minimal, hidden amounts of gluten, benefits more people than was previously apparent with avoidance of only obvious, major sources. Unfortunately there is no quantification available yet, but it is an inviting area for research. Patients who suspect gluten intolerance should have an inexpensive screening for IgG anti-gliadin antibodies before commencing the GF diet. With strict avoidance, the antibodies disappear in 3-12 months. However, one is of cold still intolerant to gluten. School Studies Cover! It may be important to know one's status in that respect, since gluten intolerance is such a strong predictor or risk factor for other serious conditions including various forms of gastrointestinal cancer and the yellow wallpaper, a variety of autoimmune conditions. If celiac disease (one particular autoimmune consequence of gluten intolerance) is suspected, additional screening should be undertaken before commencing the GF-CF diet. A large proportion of people with very high levels of anti-gliadin antibodies also have very high levels of antibodies to casein. Middle Social Studies Teacher Letter! Even without such high antibody levels, the gluten-intolerant patient is likely to experience psychotropic effects from gcse coursework, casein, although the top American experts in celiac disease note that some patients recover the ability to tolerate milk products as their digestive tract regenerates itself. The amino acid glutamine is middle social cover letter particularly helpful to patients with celiac disease, non-celiac gluten intolerance, or other GI problems that respond favorably to gcse coursework dietary elimination. The digestive tract is one of the fastest-rebuilding parts of the human body and middle studies cover, one of its principal building blocks is glutamine.

Even though glutamine sounds a little like gluten, it does not contain gluten. When pure it is a safe nutrient and actually an a essay about communication, important nutrient for gluten-intolerant individuals. Taurine supplementation. Middle Teacher Letter! Taurine was first tried in the treatment of panic disorder because it was known to be effective in the treatment of epilepsy. On Causes War! There are patients who control their panic disorder with nothing more than aggressive taurine supplementation. A number of other panic disorder patients find that they can reduce their medication with the cover letter help of taurine supplementation. Ketogenic diet. The overall healthfulness of a ketogenic diet is certainly debatable. However, it is clear that some panic disorder patients are able to control their panic disorder without medication by following a ketogenic diet, or more often a diet that is borderline ketogenic.

The reasons for the benefit of this diet are not known, although it is well established that a ketogenic diet can also reduce or eliminate the gcse literature incidence of seizure in epileptic patients. Many panic disorder patients report doing better on middle school reduced-carbohydrate diets that do not, however, go as far in this regard as many of the words and phrases for essays list currently popular low-carbohydrate or high-protein weight-loss diets. There is considerable research to suggest that this might be due to the fact that the school social insulin-glucagon axis influences a host of other hormonal and a essay about, enzymatic systems. However, there has been little direct study of middle school studies letter carbohydrate restriction in the treatment of panic disorder, and the only connection that seems obvious and likely to be uncontroversial is the adrenaline response that can be provoked by falling blood sugar levels. Further study will probably show this to themes essay be a highly simplistic interpretation. Magnesium supplementation. Some people find that supplementation with a small amount of magnesium reduces their symptoms, particular symptoms like heart sensations, muscle tics, and annoying nerve sensations. Studies Teacher! Too much magnesium will cause diarrhea and transition and phrases for essays list, exacerbate the middle school social teacher cover letter body's imbalance of minerals, but just enough can noticeably improve nervous function in of cold war, people who have a deficiency of magnesium in middle school teacher, nerve cells. (The relationship between magnesium in blood serum and magnesium in nerve cells is a bit complicated and should be interpreted by a physician who can consider the essays on causes war full picture, including medications that may influence where your body stores the magnesium it has available.) Fat restriction, supplementation with essential fatty acids.

In cases of defective cholecystokinin metabolism, fat restriction is an important but insufficient measure for the prevention of panic attacks. Middle School Letter! On the other hand, in cases of panic disorder in families where schizophrenia is present, it seems prudent to the yellow follow a diet that is sufficient in fat. There are anecdotal reports of panic disorder apparently being precipitated in such families, even relatively late in life, by adherence to the ultra-low-fat diets so recently popular, and there is solid evidence that schizophrenics do better on high-fat diets than on fat-restricted diets. While the middle social studies cover letter author has uncovered no proof that a diet relevant to the care of schizophrenia is also relevant to the care of panic disorder in families where schizophrenia is present, it seems prudent, at this point in the understanding of such panic disorder and of schizophrenia, for panic disorder patients from schizophrenic families to the yellow follow the dietary measures that should be followed in schizophrenia. These include strict avoidance of casein (a milk protein) and middle school teacher, gluten and gliadin (a family of transition for essays proteins found in wheat, oats, barley, rye, and school cover letter, some exotic grains), and the inclusion of sufficient amounts of fat, perhaps above-average amounts of fat. This has obvious implications for weight control but is documented as beneficial to schizophrenics. Some mainstream medical sources also warn against supplementation of the schizophrenic diet with sources rich in the fatty acid GLA (gamma linolenic acid), principally evening primrose oil and borage oil. However, where the author has observed such warnings, they have occurred in contexts attempting to debunk the purported benefits of these supplements, and therefore the standard of essay proof was probably lower than if the authorities in question had been asserting a benefit rather than a danger. (In other words, there is in medicine, as opposed to the body of middle school social cover science proper, one standard of proof applied to transition and phrases list a claim like substance X may cause hair to grow back on your balding scalp, but quite a lower standard of proof applied to a scare-claim like not only middle school social studies cover, will substance X not cause hair to grow back on a balding scalp, but furthermore, substance X may cause the hair you still have to fall out, and maybe your teeth, too .) Nonetheless, prudence should prevail. There is solid evidence that GLA is cultural themes contraindicated in patients with seizure disorders, and it may be wise for the panic disorder patient from letter, a schizophrenic family (or an epileptic one) to literature avoid GLA-rich supplements. Other dietary measures.

It is beyond the scope of this document to treat the full complement of dietary supplements being used in the treatment of panic disorder or investigated for such use. There are simply too many to discuss, and middle teacher cover, the results are too individual to each patient. It is clear, however, that while different individuals respond to different supplements, there are beneficial effects that go beyond what can responsibly or scientifically be attributed to a placebo effect. The supplements that prove effective are not the obvious choices #150; for themes essay instance, only a very small number of people report significant benefits from the well-known anti-anxiety supplements like Kava kava or Passionflower. Of those supplements, patients typically report no effect whatsoever or a reduction in anxiety without a corresponding reduction in dysautonomia. School Teacher Cover! This poses an interesting conundrum for researchers who consider the dysautonomia of panic disorder to be caused by anxiety, and supports those patients (and some clinicians) who claim that it seems the anxiety is politics essay actually caused by the dysautonomia. Nor does the antidepressant supplement St. John's Wort have very wide support among those who favor dietary supplementation.

One more often hears complaints of studies teacher cover exacerbation of anxiety and dysautonomia, or complaints of sleep disturbance with no effect on anxiety or dysautonomia. Gcse! These are similar to, but much milder than, the complaints one hears from many (by no means all) panic disorder patients treated with antidepressants. Valerian fares somewhat better, but when used in doses sufficient to middle school teacher exert a beneficial effect, it is reported to cause more drowsiness than its pharmacological cousins the benzodiazepines. The currently popular 5-HTP has been variously described as either useful in themes, the control of panic disorder or directly panicogenic. (Of course the school social letter same observation applies to 5-HTP's very distant cousins, the SSRI medications.) 5-HTP administered without restriction of and the olympics vitamin B6 has been linked to heart fibrosis. Very recent double-blind, placebo-controlled research suggests that Gotu Kola is somewhat effective against the variant of panic disorder arising from the middle school studies letter genetic aberration in cholecystokinin metabolism. This fits theoretical predictions, because Gotu Kola and a small number of other far eastern herbs have been demonstrated to compete with cholecystokinin at CCK receptors in the body.

So far there is a essay about little experience or consensus in the panic disorder community. Supplements more commonly reported to be mildly beneficial are those that support parasympathetic nervous system function (B-vitamins, alpha-lipoic acid, precursors or cofactors for the synthesis of acetylcholine and nitric oxide), supplements promoting cardiac stability (Q10, carnitine), supplements soothing the digestive tract (chamomile, bismuth, glutamine, MSM, occasionally peppermint - although the last can also be counterproductive)… It is school studies cover letter simply not possible to gcse do more than scratch the surface lightly in studies letter, this discussion. There is no clear consensus and there are almost no formal studies of the effects of special diets or supplementation on panic disorder. A Essay Communication Skills! However, clinicians and patients alike report that certain measures have an obvious effect for certain individuals. One might suppose that panic disorder patients would be more susceptible than most to a placebo effect; but in social cover, fact, panic disorder is about skills so difficult to control without medication, and panic disorder patients are so reluctant to resign themselves to a lifetime of middle teacher medication, that they often try many dietary supplements in war, a systematic fashion, generally rejecting the preponderance of them as ineffective.

For a panic disorder patient to report that a supplement is middle school letter beneficial, even if it is not sufficient to fully control the over condition, is an exceptional event that should usually be taken seriously #150; especially if it makes possible a lighter use of school social studies cover medication. One cannot easily feign control of panic disorder or delude oneself about doing so, and there is little incentive to try. Panic disorders are a family of over wallpaper disorders the understanding of which is still in its infancy. Much of middle school studies teacher cover letter what we thought we knew only a few years ago has been proven false. (In some cases the essays over earlier understanding directly confused cause and effect.) There is far more that is not known about panic disorder than there is that is known; however, a nascent body of research in social studies cover letter, several new directions is essay revealing some of the secrets. Panic disorder is not a monolithic condition. School Cover! Few generalities apply to coursework a majority of the panic population, but many generalities apply to middle school social teacher cover letter sizable minorities within the words list population. Some cases of panic disorder fit the classical (since 1981, that is) psychiatric interpretation. Middle School Teacher Cover Letter! Another set, quite possibly larger, does not, although this set has distinct subtypes for which it would be possible to develop a widely applicable diagnostic protocol. Nonetheless, by the time these disorders are diagnosed, they have almost invariably progressed to psychiatric dimensions. The disorders are polysystemic and themes, usually require multi-modal diagnosis and treatment. Parasympathetic insufficiency, often hereditary, is middle school social studies cover letter emerging as a new and promising direction of investigation and treatment.

Problems in a essay communication skills, CCK metabolism have been linked to panic disorder by multiple independent researchers for some time now, but 1999 saw publication of a major study that claims to middle school studies letter have identified the about communication genetic defect in question. The biological basis of panic disorder and middle social letter, the long prelude of non-paroxysmal dysautonomia that typically precedes it are only beginning to receive the attention they require. It will be a tremendous step forward when there is general recognition that treatment of panic disorder must aim not only at total elimination of panic attacks (or dysautonomic paroxysms) but at elimination of the associated chronic dysautonomia as well. Beyond this, the goal should be much earlier recognition of politics and the olympics chronic dysautonomia so that it can be treated well before it reaches a paroxysmal stage and the psychiatric complications that ensue. It is possible that focusing on the condition as chronic dysautonomia and its advanced stages as paroxysmal dysautonomia might facilitate such recognition and a shift in perception and attitude. It seems inevitable that subtypes of panic disorder will eventually receive individual recognition, naming, and treatment protocols.

Primarily for middle school social studies teacher cover commercial reasons, funding for panic disorder research has lately been focused far too narrowly on the role and the promise of literature coursework SSRI medications in treating panic disorder. This shift in focus to follow the availability of research funding interrupted a number of school studies cover letter other fruitful areas of earlier research. Nonetheless, the essays over biological understanding of this set of disorders has reached a stage where researchers have claimed for some time now that this reigning emperor in the pharmaceutical realm is at school studies teacher letter best scantily clad. Apparently the emperor's successor, in the form of CCK antagonists, has already been designated and is awaiting coronation, but only time and experience will tell whether the next panacea is more universally effective than the current one. The author is extremely doubtful that any panacea will ever be found for essays war what we know today as panic disorder #150; it is middle school social studies cover too clear that distinct and distinguishable disorders are being carelessly lumped together as one. There is a wide open field of research investigating panic disorder and its comorbid conditions.

There is much yet to be discovered, and some of it will revolutionize our understanding of psychosomatic medicine and somatic anxiety in particular. Panic disorder of biological origin (which probably includes all or nearly all hereditary forms of the condition) is lifelong in nature. It does not begin when panic attacks begin, but most probably began years or decades before reaching that point. Remissions may occur, but relapse should be expected. This is true regardless of the method used in treating the condition #150; it is a myth that antidepressants provide a cure, except in a essay communication, a limited subset of cases where panic disorder is secondary to another condition. Untreated or under-treated panic disorder should be considered a serious and school studies letter, sometimes degenerative condition. It puts significant strain on a number of body systems, and the goal of treatment should be not merely the elimination of literature panic attacks but the elimination of the underlying or associated autonomic hyperarousal as well. Cognitive-Behavioral Therapy or Panic Control Therapy is an important component of the treatment plan, even for panic disorder of biological origin. However, it should be recognized that such therapy is sufficient in itself only in those cases that are primarily cognitive-behavioral in nature.

Now that biological bases for panic disorder have been identified and tools are emerging for their quantification, more research is needed to cover letter determine what proportion of panic disorder cases are in fact of biological vs. psychological origin. Essays On Causes! It may prove to school social cover letter be difficult to draw a clear distinction, since each type spills over into the other, but it is already evident that such a distinction is real and meaningful. It is high time to reopen the non-specialist community's mind about panic disorders and to move them from the exclusive province of psychiatry and themes essay, psychology into middle school social teacher cover letter, the domains of neurology, endocrinology, genetic analysis, and probably other disciplines that will become apparent with further research. This is exactly what growing numbers of list researchers and practitioners are doing. This document summarizes observations about panic disorders and their treatment gathered during the years 1998 through 2000 from research papers, recent textbooks, mental health clinicians, patients, and support groups. It is not intended to provide medical advice. Nor is it intended to school social studies advocate original points of view in wallpaper, the scientific or medical arenas. Rather it is intended to integrate and disseminate a variety of emerging insights often omitted from the narrow classical view of teacher cover letter these disorders. As the 2000's roll in, the understanding and treatment of this family of disorders (and they are multiple) is in clear and dramatic transition. Ongoing research about modalities of diagnosis and treatment is olympics essay beginning to bear fruit that will profoundly influence both the medical and psychological perspectives on these conditions.

The viewpoints advanced in this paper are for the most part not of the author's own invention #150; they represent viewpoints that have arisen and show growing support in the researcher, clinician, and school social studies cover letter, patient communities. In one sense, they represent a consensus; but in words and phrases list, another sense, the term consensus is misleading because the field is still in turmoil, with different schools of thought pursuing different avenues of teacher cover letter research and fighting to on causes of cold advance different agendas. This paper represents the author's good-faith efforts to gather the points of view that appear, in middle school social studies letter, his lay judgment as a hardheaded observer and a patient himself, to have the best foundation and most correspondence to the reality that he and countless other patients live every day. Sources, which are not cited, include published research papers (most available through MedScape or MedLine), published textbooks and trade books, articles in essay, WebMD and the New York Times, the school opinions of clinicians specialized or experienced in the treatment of panic disorders, and about communication skills, the experiences of some hundreds of individuals who have shown up in school cover letter, various Internet-based support communities focused on panic disorders or other anxiety disorders. Citing of transition sources, which were not recorded during the author's odyssey through what was then unfamiliar territory, and many of which were reviewed long before the idea of writing this document was conceived, would have multiplied the complexity of compiling the document, greatly lengthening and delaying it as well. Such a format might also have given the appearance of advocacy in the scientific arena when the author's intent is instead to provide a coherent overview of the points of view advocated by professional scientists and clinicians specialized in panic disorders. Middle Studies Teacher Cover! Readers wishing to look up further information on one angle or another should not find it too difficult to do so through the resources above and through discriminating use of Internet search engines. Somewhat contrary to established practice, the essays wallpaper author has chosen to give considerable weight and exposure to consensus within the patient community. It is this community that lives the day-to-day reality of middle social cover letter panic disorders, this community that feels the effects and gcse literature, the side effects of medications and therapies every day and knows the reality and nuance of our experience. Our doctors and therapists can (and certainly do!) try to tell us what we are and are not experiencing based on the most interesting presentation they attended at a recent conference, or on the glowing reports of a new medication (this one miraculously free of all the side effects that have come to be associated with each of its predecessors), or on the doctrines that have brought recognition and prestige to their alma maters; but we as patients have only one agenda, which is a return to well-being and normality; and we have only one truth, which is the experience within our own bodies that most of our doctors and therapists will never (to their great good fortune) be able to do more than imagine.

(Note: It is true that individuals showing up in Internet support communities represent in some sense a self-selecting sample. School Teacher Cover! However, the same observation could be made with equal or greater validity about the individuals who choose to remain in treatment with a particular clinician or about gcse, those who choose not to middle cover drop out of controlled clinical trials. Indeed even a telephone book represents a self-selecting sample. Internet support communities in the aggregate do represent one of the broadest and most diverse sources of literature real-world information available and include a wide variety of teacher letter experiences. In the case of panic disorder, these groups include individuals who are well-controlled and those who are not; those who claim to be cured or in remission without ongoing treatment and those who do not; those who favor one class of treatment and those who favor another; those who agree with their doctors' assessment of successful or unsuccessful treatment and those who make a different assessment.

Absent evidence of systematic bias, the author considers Internet support communities to be a valuable source of perspective among others.) Understanding of olympics essay panic disorders is still in its infancy. The whole family of disorders was more or less stumbled upon middle school social teacher because of their severe manifestations in the psychiatric domain. But the more researchers investigate panic disorders, the more it becomes apparent that the psychiatric dimensions are merely the tip of a very complex iceberg. Essay! There is much disagreement within the researcher, clinician, and patient communities. School! The two or three orthodoxies that exist seem on closer examination to on causes of cold be illusory and shifting, and, unfortunately, are sometimes based on narrow samples or populations and are sometimes colored by commercial interests or professional vesting in school studies, certain doctrines.

Ultimately the communication skills viewpoints and school social teacher, conclusions presented here, which are meant to represent some diversity of opinion, are of the author's own selection and are not necessarily endorsed by any other individuals or institutions except where specifically attributed. So in one sense this essay is merely one person's collection of opinions. But this collection has been reviewed by researchers, clinicians, and patients alike; and a essay, while no essay could please all readers, and most especially not those who are vested in one particular point of view to the exclusion of others, the school studies teacher author feels reasonably justified in stating that in another sense, this document is about not only built largely on middle school studies teacher letter published research and teaching materials, but also does meet with general approval and endorsement from at least a substantial segment of the researcher, clinician, and a essay communication, patient communities. The online source for this document resides at http://www.panic411.org/ This document may be linked to or printed for limited noncommercial distribution by individuals.

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Sexuality and Marriage in Culture: Polygamy, Monogamy, and Inequality. Sexuality and Marriage in Culture: Polygamy, Monogamy, and Inequality. Abstract: Culture and society heavily impact one’s views on sexual relations and middle social teacher cover marriage. In this essay, societal views on polygamy, monogamy, and same-sex marriage is discussed with light criticism and personal view. Need essay sample on Sexuality and Marriage in Culture: Polygamy, Monogamy, and Inequality ? We will write a custom essay sample specifically for you for only $12.90/page. The topic of choice can be discussed anywhere in the world and still generate entirely different views: is polygamy, monogamy, or same-sex marriage right?

Many will argue polygyny is a disgusting practice, but for politics essay many it is part of their religious laws. Others argue monogamy is the school studies teacher cover, only way, but criticize and slander homosexuals in a monogamous relationship. Culture, society, and religion shape the way a person views sexuality and marriage. Polygyny, a marital practice in which a man has more than one wife (which is the most common form of polygamy), is a essay about communication sometimes seen as misunderstood in the marriage world. As an older practice, polygamy has a hard time fitting in middle social studies teacher cover letter the the modern world. Same-sex marriage, where two homosexuals are married, has hindered vast amounts of hatred, but also vast amounts of support. The fight for legal same-sex marriage around the cultural essay, globe has also created a fight for polygamy to be understood. “Why should we stop at middle social letter, same- sex marriage?

Why can’t we allow polygamy?” (NeJaime, 2012, pg247) is a question many polygamists are asking. Why isn’t their culture or religions pertaining to polygamy as accepted to be as normal as monogamy? The answer is society. Society, in combination with the cultures flourishing within it, change the way people view marriage practices. Polygyny: Where, When, Why. Polygyny, the most common- and often most criticized form of polygamy, is the marital act of which a man marries two or more wives. With this act they begin to create a family, with each of the and the, wives usually having several children. This creates a large polygynist family, with the husband as the letter, central person in the household.

Polygynist families may reside in one large house or several smaller houses, with the husbands switching to and from. Polygamy, in general, “is common in the Middle East, Africa, Asia, and Oceania, but it also occurs in Europe, North America, and other Western countries” (as cited in a essay communication skills Krenawi and Slonim-Nevo, 2008, pg745). Of those regions, most polygamist marriages are induced by religion. Judaism, Hinduism, Mormonism, and Hebrews are among religious societies that began practicing polygyny centuries ago (Polygyny, 2012). For some of these religions, all forms of polygamy have been in middle social teacher cover use regularly, and become societal ‘norms’ to transition and phrases for essays followers. Born into the understanding that you will be married into a family of one man and many women, or the social teacher cover letter, opposite, is what children of some of skills, these cultures face. But is polygyny a form of marriage that should be seen as normal? Lysiane Gagnon argues that polygamy should not be accepted as it is intensely degrading to women. Middle School Studies Cover Letter! Do women in these polygamist cultures see it as such as well? Or have they been brought up to view it as normal?

“The heart of the matter is whether polygamy respects the principle of equality between men and women – and it clearly doesn’t. Polygamy must be banned not because it is an ‘unconventional’ practice, but because it is inherently degrading to women.” (Gagnon, 2012) However, simply banning polygamy and all forms of it is really not as simple as Gagnon allows it to seem. As previously mentioned, this marital practice has been used for centuries and politics and the essay centuries, dating back to the earliest forms of religion and politics. Along with religion, society and middle social teacher cover culture influence the number of communication, spouses one is to have. a controversial issue in British Columbia was the middle school cover, polygamous community of Bountiful. Themes! The idea of polygamy was introduced with media attention, sparking people’s interests in shows such as Sister Wives, which addresses polygamy in social cover North America (Haviland et al, 2012, pg162). While illegal in transition and phrases the United States and Canada, polygyny actively flourishes in school many other parts of the world. For example, in areas of New Guinea, it is over widely accepted to have as many ways as humanly possible (161). In wealth-generating cultures, polygyny is extremely common (163). The first evidence of polygyny in Canada was among the First Nations.

Work required by school social studies cover, the fur trade era was too great for one man and wife to and phrases handle, so he would take more wives to help out (163). As stated by Liam Kilmurray, “[p]olygamy is middle social teacher letter a source of interest to anthropologists. Yet what was once studied ethnographically, typically in distant lands, has now come closer to themes essay home” (162). Same-sex Relations and Sexual Inequality. Homosexuality has been succumbed to negative discrimination from all over the world, but surprisingly has been criticized by polygamists. Middle School Social! “[T]his is in fact only to say that for many (not all) of the good reasons why same-sex marriage should be legal, so should polygamy” (NeJaime, 2012, 248) was an opinion cast by cultural, a polygamist supporter, who believes same-sex marriage has its good and bad points, but should not be put before polygamy. Further research, however, shows that while some polygamists frown upon or are unsupportive of social studies cover, same-sex marriage, it was actually a common practice of list, polygamists in Africa. “[W]omen unions” were group marriages where an older woman would take younger women as wives to middle school letter raise their children and gather their wealth (Haviland et al, 2012, pg161). Homosexuality, in most cultures and in society, is and the olympics sometimes looked at as wrong.

In many religions, such as Christianity, homosexuality is considered a sin. The Catholic Church has been especially cruel about homosexuals practicing the school studies teacher, faith. Many religious people believe that marriage equality clashes with religious freedom (NeJaime, 2012, pg1174). “All parties involved- lawmakers, Christian Right activists, religious organizations, gay rights advocates, and cultural essay legal scholars- seem to agree on one thing: marriage represents a unique and highly significant issue that promises equality for lesbians and gay men at the same time that it threatens the right of religious organizations and individuals to. NeJaime also discusses that homosexuals have a hard enough time finding their place in the world without having religious organizations and other sections of society attacking them. This is because being gay in school studies teacher letter public threatens religious freedom (1200). A Essay! But along with religion, homosexual lifestyle is also being attacked by government, which is a product of middle school studies cover letter, both culture and society. Many states in America still don’t legally allow same-sex marriage, and some cause hypocritical problems by having anti-discrimination laws with it. So why does society and culture determine what is acceptable and what isn’t?

Does it have to do with power of authority, peer pressure, or personal beliefs as well? Because of the embarrassment or fear of coming out the yellow, as a homosexual, many will suppress the need to tell someone, which can cause greater internal problems and middle teacher external harassment. For the gcse literature coursework, future, we can hope that more anti-discrimination, bullying, and harassment laws will be put into studies letter effect all over the world. And The Essay! While religious views may be harder to alter on this matter, I believe it surely can be done. Many steps to this may be harder to begin than others, “[b]ut considering and codifying religious exemptions in anti-discrimination law, rather than in middle school social studies teacher cover marriage law, is necessary for the realization of sexual orientation nondiscrimination principles” (1238). Hopefully soon homosexuality will be recognized as normal all around the world, with a strong fight for freedom of sexuality. Recognized all over the world as the most common form of marriage, monogamy is where one person marries another and they stay faithful to each other throughout the duration of their marriage. Monogamous relationships are rarely questioned and are considered the essays over the yellow wallpaper, social ‘norm’ in most countries, except for polygamous-practicing regions.

In monogamous relationships, the two marriage or unmarried partners usually have children and move in to one. house together. This is what is deemed the social studies cover letter, absolute norm in most societies. However, when you come across something different, it changes the entire perspective. Polygamy vs. Monogamy (family, education, and emotional factors) Taking a closer look at many studies conducted to understand the internal issue of polygamy, we can compare the politics and the essay, outcomes with those of monogamy and middle school social studies cover correlate what can be deemed right or wrong. An example of essays, such research was a study of 174 children from monogamous families, and 178 from polygamous families. The children were analyzed for intelligence, mental health, and middle school social studies family information, such as family type, housing, and number of cultural essay, siblings (Krenawi and Slonim-Nevo, 2008, pg 750).

The study discovered many interesting things that can lead to opinions and theories about polygamy and monogamy. It found that couples in a monogamous relationship tended to be more educated than those in a polygamous relationship, and polygamous couples have a higher unemployment rate among at least one spouse. The polygamous children in the study also reported more economic troubles than the middle social studies letter, monogamous children did. Gcse! Lastly, the study also found that children from polygamous families had more psychological, social, and emotional problems than the monogamous children did (754). These findings have led many to decide that polygamist families are wrong and unfair to the children born into them. But in school social studies cover fact are they? There have been various displays of research that have been conducted by gcse literature coursework, anti-polygamy professionals.

Instantly, if the school cover letter, majority of children are displaying negative effects from a polygamous lifestyle, the researchers may over coursework, exaggerate and instantly declare polygamy a cruel way of life for children. It is these studies and people conducting them that have given polygamous families the most discrimination, and have shaped the views of studies teacher cover letter, those outside of the matter. Typically, the focus on essays on causes of cold observing children in these families is their relationship with their father (in polygynous households) throughout the. years. It was found when the father married a second wife and teacher cover began having children with her, the first wife and gcse coursework their children would soon become of less value to the father, weakening relationships (759). This can cause self-esteem issues and school studies teacher cover psychological problems for the children, and even for the first wife. A study at the University of British Columbia even “suggests that institutionalized monogamous marriage is rapidly replacing polygamy because it has lower levels of inherent social problems” (Henrich, 2012). The goal of the study had been to find out why monogamy had become to words and phrases for essays list ultimate ‘normal’ standard of relationships. It seems as though in polygynist societies, monogamy is as strange to them as polygyny is to us.

However, no matter what study we look at, monogamy seems to ‘win’ with more positive effects on women and children than polygamist families. “Monogamous marriage also results in significant improvements in child welfare, including lower rates of child neglect, abuse, accidental death, homicide and intrahousehold conflict, the study finds. These benefits result from greater levels of parental investment, smaller households and increased direct “blood relatedness” in monogamous family households, says Henrich, who served as an middle school studies teacher letter expert witness for British Columbia’s Supreme Court case involving the polygamous community of Bountiful, B.C.” (Henrich, 2012) Outlining the events in the essay, we can begin with the discussion of essays of cold war, polygamy. We mostly discussed polygyny, in where a man marries more than one wife. This form of marriage is the one mostly discussed in the media; others forms of polygamy are usually hidden deep in middle school studies teacher letter cultural values. Polygamist culture has been pounded on for their traditions, and for statistics proving children and cultural essay wives are not better off in middle school social teacher cover these families. The legal bans to remove polygamy entirely are so far been unvictorious (March 246), but government efforts have not stopped. Whether the case is that is is degrading to woman, or that it is on causes war harmful to children, anti-polygamists have certainly researched many points for the situation at hand.

Monogamy is the form of marriage that is considered normal to most. It is middle school social teacher cover where a man marries a woman, a woman marries a woman, or a man marries a man, and each stay faithful to another. With monogamy, there are no main issues of concern; it is what people have been doing for thousands of years. But had monogamy shaped the way we look at other forms of marriage? Some say yes, it has made us more biased and less open-minded, while some say no. Same-sex marriage is most susceptible to harassment and judgement, as it is more in the public eye of a essay about, others.

Homosexuality has come a long way from school cover letter where it used to be, but there is still room for improvement of anti discrimination and same-sex marriage laws. Whether one is against or for polygamy, monogamy, or same-sex marriage, in my opinion, it’s their own decision. People can believe whatever they want about what values are right and and phrases list what are wrong, but everyone needs to school social understand that they are the choices of the culture, the choices of the religions, and the choices of the people. If people are being forced into these situations, then that can be deemed wrong, but however most are not. However you look at it, marriage is a tricky topic. What we view as normal, others might not, and it becomes a never-ending cycle. In the fashion of D. NeJaime, we can vaguely conclude with this question; “Where exactly does this leave us?” Al-Krenawi, A., Slonim-Nevo, V. (2008). Psychosocial and Familial Functioning of Children From Polygynous and Monogamous Families.

Journal Of Social Psychology, 148(6), 745-764. Gagnon, Lysiane. Cultural! “Polygamy’s Degrading to Women – End of middle school social studies cover, Story.” The Globe and Mail [Toronto] 5 Dec. 2011: n. pag. The Globe and Mail. Web. 2 Nov. 2012. Haviland, W., Kilmurray, L., Fedorak, S., Lee, R. (2012). Cultural anthropology. (4th ed.).

Toronto: Nelson Education. Henrich, Joseph. “Monogamy Reduces Major Social Problems of Polygamist Cultures.” Public Affairs [UBC] 23 Jan. 2012? Web. Essays Of Cold War! 13 Nov. 2012. March, Andrew F. (2011). Is There a Right to Polygamy? Marriage, Equality and school Subsidizing Families in Liberal Public Justification. Cultural Essay! Journal of studies teacher letter, Moral Philosophy, vol. 8, 246-272.

NeJaime, D. (2012). Marriage Inequality: Same-Sex Relationships, Religious Exemptions, and essays over wallpaper the Production of Sexual Orientation Discrimination. California Law Review, 100(5), 1169-1238.

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Post-Secondary Russian Essay Contest. Students taking Russian in accredited colleges and universities are invited to participate in the eleventh annual National Post-Secondary Russian Essay Contest sponsored by the American Council of Teachers of Russian. All students must pay a registration fee according to the following schedule: Students whose teacher is an ACTR member - $5.00 per registration. Middle Studies Cover! Students whose teacher is not an a essay about communication skills, ACTR member - $7.50 per registration. Students may not register themselves, but can only be registered by a teacher. When registering your students, please consult the criteria below to select the appropriate level.

Teachers whose students are participating in middle school social letter the contest will receive directions and essays over the essay topic in late January 2010. Students will write their essays between Feb. 1 and Feb. School Social Cover! 15, 2010 at a time selected by themes the instructor at each institution. Middle Social Teacher Letter! Students should not receive the essay topic until the a essay about communication skills time scheduled to write the essay. Judges will review the essays in March 2010 and winners will be announced by April 15, 2010. Please note that students cannot use any books or notes and may not work together. Essays must be written legibly in blue or black ink.

The time limit for writing the essays will be one hour. The essays must be written in blue or black ink on studies teacher letter lined paper provided by teachers. Pencil is not acceptable (as it won#39;t photocopy). Essays! After the students write the essay, teachers will make four photocopies of each essay as per the directions and social studies teacher cover letter then send the originals and over three photocopies to Patricia Zody within 48 hours of the test date. All essays will be evaluated anonymously: no essay will be identifiable by the name or institution of the student who wrote it. Gold, silver, bronze and honorable mention ribbon awards (certificates) will be presented for the best essays at social teacher cover letter each level. Here are sample essay topics from previous contests: An Important or Funny Thing Happened When A Person (Real or Fictional) Who Is Important to communication skills Me and Why? My Life Changed When Write a letter to a figure from Russian history or a hero (heroine) from middle studies teacher letter, Russian literature Happy families are all alike; every unhappy family is a essay about skills, unhappy in its own way ( , -- Anna Karenina , Lev Tolstoy) Write about your favorite person or place (real or fictional) Teachers may not substitute students for those registered by the deadline. School Studies Teacher Cover Letter! No refunds are available for transition students who don#39;t show up for the essay contest. Essays will be ranked according to middle school studies cover letter levels as follows: Category 1: Non-Heritage Learners (those learners who do not and did not ever speak Russian in for essays list the home.

Please take the time to middle social studies cover letter calculate the number of a essay skills, hours that your students have studied Russian to place them in the proper category.) Level One: students who at the time of the essay contest will have had fewer than 100 contact hours of instruction in Russian (whether in college alone or in college and social studies teacher letter high school). (Please note that heritage learners of essays over the yellow, any Slavic language, including Russian, are not allowed to participate in school studies cover this level and category of the contest.) Level Two: students who at the time of the essay contest will have had more than 100 contact hours, but fewer than 250 contact hours of instruction. (This is mostly students in second-year Russian.) Level Three: students who will have had more than 250 contact hours, but fewer than 400 contact hours of instruction. (This is mostly students in a essay about communication third or fourth-year Russian.) Level Four: students who will have had more than 400 contact hours of instruction. School Studies Teacher Letter! (This is mostly students in fourth-year or fifth-year Russian.) Category 2: Heritage Learners. Heritage Learners (1) - students who speak Russian with their families and essay who have NOT attended school in middle school social studies teacher letter Russia or the former Soviet Union and have to learn reading and writing skills after emigration. The Yellow! Heritage Learners (2): students who speak Russian with their families and who have attended school for fewer than 5 years in middle Russia or the former Soviet Union and may have had to relearn reading and writing skills after emigration. Heritage Learners (3): students who speak Russian with their families and who have attended school for 5 or more years in Russia or the former Soviet Union and have not had to relearn reading and writing skills after emigration. Judges will evaluate essays according to content (the ability to express ideas in Russian and communicate information about the topic) and length, lexicon, syntax, structure (grammatical and the yellow wallpaper orthographic accuracy), and originality or creativity.

Awards will be announced in the ACTR Letter and Web site, and the AATSEEL Web site. The best gold ribbon essays will be published in the ACTR Letter. Teachers with questions about the essay contest should contact: Director, Center for Language Studies. 700 College Street. Beloit, WI 53511. REGISTRATION FORM ACTR NATIONAL POST-SECONDARY RUSSIAN ESSAY CONTEST. Name of Institution: Name of Instructor: List of Participants: 1) Name, 2) Category, and 3) Level. Send to Patricia Zody, Center for Language Studies, Beloit College, 700 College Street, Beloit, WI 53511 before January 29, 2010. Teacher Letter! Official registration forms can also be found in politics the Winter 2009 ACTR Letter. If you would like to receive a registration form by mail or electronically, please contact me at zodyp@beloit.edu. Copyright ? SRAS 1999 - 2010 | All Rights Reserved | Privacy Policy.

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Essay On Family Values Essays and Research Papers. Family Values There are so many various types of people with different ethnic backgrounds, culture and manner of living . that are the cause of middle school studies cover letter, distinct values in a family . A Essay Communication. These families have poor, mediocre or virtuous family values , however what one may consider as a mediocre family value may seem poor to someone else and vice-versa. These family values differ from family to family world-wide. The most significant values are family unity, honesty and education. Family unity, is a family. Education , Family , Father 895 Words | 3 Pages.

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Family Values Jeananne M. Bowers August 17, 2013 HSM/240 Public Policy Development in Human Services Lori Moon . Family Values In today’s society we are seeing more children disrespecting their parent’s rules and coursework, society’s rules. This is creating a very unruly surrounding in school social teacher letter, society as a whole. Technology and the need to have it all have created a society full of families that will do what they want, when they want, and how they want. Parents are forgetting the traditional and practical. 2006 singles , Family , Respect 2160 Words | 6 Pages. ? Family Values Family Values The author will explain in this paper the transition words, importance of middle school social teacher letter, . family supporting patients with End Stage Renal Disease (ESRD) who are receiving in-center hemodialysis. Describing how a family can work as a system in transition words for essays, promoting the health of its members. Recognizing the concept of family most used in school studies teacher cover, the in-center dialysis unit along with identifying if it is the gcse, most helpful concept for considering family in nursing practice. Finally, relating a nursing theory to. Dialysis , Health , Health care 975 Words | 4 Pages. ? Family Values September 10, 2012 Family Values Family nursing is . still seen as a fairly new specialty area in nursing.

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Family , Health , Health care 1377 Words | 4 Pages. 1 Values Essay Word Count 1510 Within this essay I would like to show my knowledge and middle cover letter, . understanding of values in social care and how my own personal values link in with them. I will also try and cultural themes, explain how social care values and middle school teacher cover, personal values may conflict within a care setting. Then highlighting the importance of confidentiality, anti discriminatory practice and legislation. Values are highly personal concepts that guide peoples reactions to their world. A value is a. Data Protection Act 1998 , Discrimination , International Federation of Social Workers 1681 Words | 5 Pages. ? Family Values University of Phoenix Dynamics of Family Systems NUR/542 Dr. Theresa Goodman . December 02, 2013 Family Values Although the importance of family in essay, the health of today’s society has been mentioned by many health care professionals, only since the school letter, mid-1990’s has the true significance of family in the well-being of essays, humanity been fully recognized (Friedman, Bowden, Jones, 2003). There has been “…little attention…paid to middle cover letter, the family as an object of for essays, systematic study.

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Family values, present trends in school teacher, changing family values. Family values In the past decade there has been a drastic down turn in essay, the ethical and moral standards in the western world, . especially in America. There is middle social a vicious attack on the fundamental institution our family .It is sad to see how this downward trend is leading to an increasing decay of our family life. Cultural Themes. Basic ethics is a science that evaluates and explains the values that differentiate between right and wrong or good and bad conduct. The basic tool used to destroy the moral standards in our. Conservatism , Ethics , Family 835 Words | 3 Pages. ? Family Essay I have gathered a lot of information on some family members of mine about their history, things . School Studies Cover. that affect them, and just about coursework them so I could do a family essay . While doing this research I learned so much about where I came from, what each family member has experienced throughout their life, the school social teacher letter, troubles, the good and bad, the fun and boring things, how growing up was like and so much more!

Now I am going to share with you my experience through this and the amazing things I. Family , Grandparent , High school 1165 Words | 3 Pages. This Essay is to explain the Army Values and how they pertain to the mistake I made. In the US army we are taught to live by on causes of cold the . 7 army values . They are broken down to us in the acronym ‘LDRSHIP’. Loyalty “Bear true faith and allegiance to the U.S. School Cover Letter. constitution, the Army, and transition for essays, other soldiers.” Duty “Fulfill your obligations.” Respect “Treat people as they should be treated.” Selfless Service “Put the welfare of the nation, the middle school teacher cover, Army and your subordinates above your own.” Honor “Live. Corporal , Morality , Non-commissioned officer 1012 Words | 3 Pages. that lingered throughout the house.

Nonetheless, she was able to work around it because she knew that these Saturday mornings only came once a month. My . father is a firefighter who is constantly sacrificing his life to wallpaper, better someone else’s. As a family , we knew the school social teacher cover, horrible tragedies that could happen to him or to anyone else working in the service. I learned to cherish every minute spent with my father, and learned how to cherish our relationship. Essays On Causes Of Cold War. With the turnout of events that occurred in. Family , Father , Mother 1438 Words | 4 Pages. ?Types of school social teacher cover, Values Although every family's list of values will be different, there are different categories of essays war, values . that tend to be similar. Social Values Social Values consist of things like peace, justice, freedom, equality, and bettering our community.

Examples of social values include: Not hurting others and teacher, also standing up for those who can't stand up for themselves Being respectful and courteous in transition words list, your interactions Volunteering time and skills in the community Being generous with what you. Family , Morality , Paisley Park Records 1240 Words | 5 Pages. Latin American Family Values Latin Americans seem to value the school social studies teacher letter, family above everything else. In . Essays On Causes Of Cold War. fact, many spend all their lives just trying to improve the situation for middle school social teacher letter their families . From experience, when speaking with a Latin American, the majority of the politics and the olympics, time they will say that their family is what brings them the most joy or what they are most proud of. Not only do Latin Americans work to care for their families but they also work to keep their families united. They pride themselves.

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? Families Now and Then Essay Below is a free essay on Families Now and Then from Anti . Essays , your source for free research papers, essays , and olympics, term paper examples. Families now and then Our society has been witness of middle social cover, a series of politics olympics, changes as regards the social studies letter, roles of family members during the themes, 20th century up to these days. At the beginning of the middle school studies letter, last century the idea of a family was very clear unlike the one we have nowadays. Cultural Themes. Families have changed in a lot of ways and the pace in school social studies, which they have developed. Adoption , Cousin , Family 2058 Words | 6 Pages. A Comparative Study of on causes war, Family Values Between China and America - Family Values. Family values are political and social beliefs that hold the middle school studies teacher letter, nuclear family to be the essential ethical and moral . unit of war, society. Familialism is the ideology that promotes the family and its values as an middle social letter institution.[1] Although the phrase is vague and has shifting meanings, it is most often associated with social and religious conservatives. Gcse Literature. In the late 20th and middle school studies teacher cover, early 21st centuries, the term has been frequently used in political debate, to cultural, claim that the world has seen a decline in family values. Conservatism , Dan Quayle , Family 1695 Words | 6 Pages. Differences between two family values A week ago, my professor recommended that I go to middle school social studies teacher cover letter, the art exhibition of Norman Rockwell. . Truth be told, I knew nothing about Norman Rockwell other than he was a great painter of American history but that has changed since I saw his famous and of cold war, deeply meaningful works during an art exhibition in Ulaanbaatar.

I realized how much effort and spirit the author put into his paintings and as a consequence, most of his works genuinely touch the social cover letter, audiences’ hearts and. Family , Mongolia , Norman Rockwell 1485 Words | 4 Pages. Family Values Paper Family is a term that can be defined differently by every person. A Essay About Communication. In health care, . family does not always mean individuals related by blood; instead, a family is seen as a support system to middle studies teacher cover letter, an individual that is in a state of compromised health (Friedman, Bowden, Jones 2003). The family’s role in a healthcare setting can vary depending on literature, the client’s condition. In the middle teacher cover letter, intensive care unit, the family plays a big role, especially for the patients who lose their abilities to. Health , Health care , Health care provider 1003 Words | 3 Pages. ? Family Values Paper Anitra Wilson Nursing/542 May 16, 2015 Professor Sandra Brown Introduction Over the years, . health care has been geared towards delivering patient centered care.

Unfortunately this is not always the case, the family is considered an important component in essays on causes of cold, family nursing. As nurses, it is imperative that we are capable of recognizing that all family dynamics are unique. Every family has its own values , history, rules and middle teacher, may respond different to certain illnesses or. Family , Health care , Medicine 742 Words | 5 Pages. ? Family values paper FIDELIA EDOZIEM NUR 541 AUGUST 28, 2014 PROF ARES Family values . paper Family is seen in a different way by every person built on war, individual’s understandings. Middle Studies Teacher Cover. Family , in other words, may not necessarily involve at all times persons linked by blood (Friedman, Bowden, Jones 2003). In health care organizations patients presenting to the facilities, are taken care of as well as their families . Families described in health care organization are seen as a support. Health care , Health care provider , Nightingale's environmental theory 1066 Words | 6 Pages.

Family Law Assessment Part 2: Essay ‘Evaluate the politics olympics essay, effectiveness of the middle social teacher cover letter, law in achieving justice for parties involved in . relationship breakdowns.’ Society’s changing social values towards the gcse literature coursework, notion of middle social studies teacher, ‘ family ’ has resulted in the legal system attempting to reform the law to reflect these changes. Due to the range of family types that exist today, relationship breakdowns have become complex. The legal system aims to provide a fair and equitable outcome for politics and the olympics essay parties; however, this is a challenge due. Child abuse , Child custody , Divorce 1560 Words | 4 Pages. Sociology – The Family Essay Plan Describe and middle school studies cover letter, evaluate the following views of the family ; * Functionalist . * Marxist * Feminist * Interactionist Compare these views making reference to the changing nature of family structures, gender roles and family patterns.

Introduction Introduce and explain the concept of family in politics and the olympics essay, sociology. What is the family ? What is the purpose or function of a family ? Briefly mention the perspectives which are you going to discuss and the main differences. Family , Feminism , Functionalism 365 Words | 3 Pages. Family Values Over all The relationship between the family members in the play can give the . reader motives for how some of the characters might act. Middle School Social Studies Cover Letter. The characters in Macbeth inspire each other to commit certain actions and without some character shaving the personality they possess such as Lady Macbeth or Macduff the story would have been far less exciting. List. In this story the relationships amongst members of different families is not strong. Middle School Teacher. family plays a major. Characters in Macbeth , Family , Interpersonal relationship 874 Words | 5 Pages. ? Family Values Lindsay Heller NUR/542 Dynamics of Family Systems . January 25, 2015 Tracy Kramer RNC FNP Family Values Family values are the basis for a great many decisions, especially those that may affect one’s health and the health of their family . A family’s system, support, resources and essays wallpaper, perceptions have considerable influence over health outcomes and adaptations to changes. Nurses must. Family , Family therapy , Health 1028 Words | 5 Pages.

Running head: FAMILY VALUES PAPER . Family Value Paper Katie Chieda University of school teacher, Phoenix Dynamics of Family Systems: NUR/542 February 21, 2011 Carla Diebold . Family , Health care , Health care provider 937 Words | 3 Pages. Whatever happened to family values ? Good old fashioned honesty, respect, caring and and phrases, commitment? Today, nearly half of the . families in Australia have been shattered by middle school social teacher cover letter divorce, children are home alone while single parents work, crime is commonplace and essays on causes of cold, truth is relative. Has today’s society allowed us to dictate our values and standards in our own home? In To Kill a Mockingbird, family is social studies teacher destiny. To Kill a Mockingbird tells the story of lawyer Atticus Finch, who defends a black man accused of raping. Atticus Finch , Family , Father 926 Words | 3 Pages. director who tells the story, but she`s not a part of it. This story deals with the life of an Indian family , the about communication, Patels, which have to middle school social studies teacher cover letter, . move out of politics olympics, Uganda, because the middle social teacher cover, president of Uganda, president Amin, has announced that all foreigners have to get out of the politics essay, country, unless they will get killed. They move to Britain where they can give their four daughters a good education.

But the family which had been rich and middle school social studies, respected in Uganda were threated like they were stupid in England because they. Family , Friendship , Hindu 1086 Words | 3 Pages. Change in a essay about, Family Relationships and Values. Family has many different meanings to it but it seems as though we all want the same ideal family . The ideas of the “perfect” . family come from old advertisements and television programs; they all have the same characteristics as one another. Everyone wants to live like families that lived in older times, but in reality it is school studies nearly impossible for every family to be exactly the same and transition for essays list, like old time families . Many things have influenced the change in families from how they used to school social cover, be to how they. Family , Father , Marriage 1033 Words | 3 Pages. Family Unit Essay What I have Learned When I think of the word “ Family ”, I take in everything from my life to . think of an answer. My definition of family is anyone who will be there for you through the rough times. Cultural Essay. They don’t necessarily have to be blood related, though this is the common thought when thinking about family , but they just have to be there for you. The official definition of family is the most basic unit of civilization in organized life. Experts define family in two ways.

The first. Extended family , Family , Father 1298 Words | 3 Pages. Family Values Paper Family health nursing provides the “conceptual foundations of middle school studies letter, family nursing . across the life span” (Gonzalez, 2012). A Essay About Communication. Family nursing is an idea that was formed by the World Health Organization (WHO) in Europe so that the organization could offer a way to reinforce family and social studies teacher letter, neighborhood accustomed health assistance” (Hennessy and Gladin, 2006 ). The World Health Organization defines family health nursing as presenting the and the olympics, main role within a diverse group of school social, skillful workers that. Family , Family therapy , Health 1100 Words | 4 Pages.

Moroccan Family Values . The family is the coursework, most significant unit of Moroccan life and plays an important role in . all social relations. . The individual is always subordinate to the family or group. . Nepotism is middle school social letter viewed positively, since it indicates patronage of one's family . Essays On Causes Of Cold. . The family consists of both the nuclear and the extended family . . The elderly are revered and studies cover, respected and often exert a great influence on the rest of the over the yellow, family . Gift Giving Etiquette . Social Letter. If you are invited to. Cheek kissing , Family , Gender 1165 Words | 4 Pages. English 101 25 June 2012 My Family Value Without family where do we learn values from? We are not . born with values , but learn values from our families . Cultural Themes Essay. All my values developed from my family , and as I grew into school social studies cover an adult, I made them my own values . As a child, one is dependent on his or her family for emotional, physical, and mental support. The way a person values things is determined by one’s upbringing. Essays On Causes. Family is the most important value to me. Without my family , where would I be? How would. Coco , Cousin , Extended family 795 Words | 2 Pages. How American Family Values have change on the last 20 years The values of the cozy mid-80’s American . family entertained us and sold us refrigerators, cars, and cigarettes, but they were the exception, not the rule.

This was the world of the white suburban minority that exerted media dominance over the rest of the nation. Televison took them into our living rooms, convincing us this was the American family . In reality, this was the world of teacher cover, separate but equal family values . This was the world. Conservatism , Family , Family values 1329 Words | 4 Pages. Family Values with the Cosby Show Growing up in the mid 1980’s I can remember watching the Cosby Show. My family . and I fell in love with the Huxtable family . The show was funny, witty, and dealt with serious issues at some times. It was also the gcse literature coursework, first show that portrayed a black family living a successful middle class life style. The show’s concepts were very unusual to me, because around that time we thought America dealt with majority Caucasian problems and shows. Growing up in a dysfunctional. Bill Cosby , Family , Keshia Knight Pulliam 777 Words | 2 Pages. Stacey Wilson October 14, 2011 Swrk 251 Social work value essay My mother likes to tell the story of when I was four . years old going to my reading circle. School Social Studies. While I was waiting for essays war my reading circle to start, I noticed a baby crying so I picked up toys and school studies teacher letter, started shaking them and making the of cold war, baby smile.

For as long as I can remember I have always like to help others, I got enjoyment out of making my friends happy. Social Studies Cover. Whenever one of my friends had a problem I was always there for a essay about skills them, to middle cover, listen. International Federation of Social Workers , School social worker , Social change 2231 Words | 5 Pages. Discuss the way family life has changed over words, a period of time This essay explores the change in family life over . Middle Social Teacher Cover Letter. time. The meaning of family or traditional family is considered to be a group a basic social unit consisting of parents and children, whether dwelling or not. On Causes Of Cold. The essay begins by middle school social teacher cover outlining the family structure the evolution of words for essays list, marriage and school teacher, the changes in traditional values . The way hierarchy and economical change has affected the family income. And the cultural themes, way technology has advanced over.

Cohabitation , Common-law marriage , Demography 1109 Words | 3 Pages. Hannah Montana is a sitcom that shows a Teenage superstar with down-to-earth Family Values . Hannah Montana, the television . series, demonstrates the social teacher letter, complications of attempting to maintain established family values , while being a teenage girl who has become famous and wealthy. Miley Stewart, also known as Hannah Montana, is repetitively attempting to politics, balance her Tennessee, down-to-earth family values with the temptations of financial and celebrity success and how that reproduces greed. School Social Studies Teacher Letter. In the. Ethics , Hannah Montana , Hannah Montana: The Movie 726 Words | 2 Pages. With respect to family , assess the ability of the legal system to respond to differing issues concerning values . Family law is the most complex aspect of the words, Australian legal system as it is middle school teacher cover constantly under review and cultural essay, reform pursuing to adopt society’s continual change in values and principles. The changing of middle studies teacher cover, laws in an attempt to be parallel with society is politics and the essay a strenuous process. Nevertheless, legislations are reflective of contemporary society’s values and ethics. Numerous legal issues arise. Divorce , Family , Family law 1498 Words | 5 Pages.

THE CHANGE IN FAMILY STRUCTURES essay. ? THE CHANGE IN THE FAMILIES FORMS AND FUNCIONS IN SOCIETY STUDENT’S NAME: TN ID: 1066385 INSTRUCTOR: GLORIA MICHALCHUK ESL 140 – COURSE . # 7052-1 NOVEMBER 25th, 2003 THE CHANGE IN THE FAMILIES FORMS AND FUNCIONS IN SOCIETY Society is composed of school social studies cover, many elements based on values , traditions, cultures, government’s policies etc.; and family is one of the main basic ingredients, forming the society. Therefore, as the society changes its element, family is also forced to change the. Extended family , Family , Marriage 2680 Words | 8 Pages. Antigone: Views and Values Essay In Sophocles’ ‘Antigone’, set in the city of gcse, Argos in Ancient Greece, Antigone lives through . the momentous providence from defying law for the sake of middle school cover, her family . Through Creon, who rules as a tyrannical misogynist, Sophocles symbolizes the concepts of autocracy and the solidity of coursework, fate which is inevitable and school social teacher, the prime religion of the Ancient Greeks and gods would have no plod in it. This expounds that Sophocles, is a man of authority, power and conviction. Sophocles. Ancient Greece , Antigone , Creon 1143 Words | 3 Pages. Essay on Joint Family vs Nuclear Family. 6/14/13 E E E E E Essay on joint family vs. nuclear family system E E E E E GUIDELINES About Site Content . Gcse. Quality Guidelines Terms of Service Privacy Policy Disclaimer Copyright Recent Articles Essay on middle school social studies cover letter, joint family vs. nuclear family system ATUL JOSHI Preserve Articles is politics home of thousands of articles published and preserved by school teacher cover letter users like you.

Here you can publish your research papers, essays , letters, stories, poetries, biographies, notes, reviews, advises and allied information with. Agriculture , Extended family , Family 918 Words | 4 Pages. ? Cultural Family History Research Essay – Assimilation of themes, Ancestors Shaina Wood GS221 . Social Studies Teacher Cover. Professor Edmund Pries, Professor Bina Mehta Wilfrid Laurier University Sto lat, sto lat, Niech zyje, zyje nam. Sto lat, sto lat, Niech zyje, zyje nam, Jeszcze raz, jeszcze raz, Niech zyje, zyje nam, Niech zyje nam! As a child I heard this jumbled collection of of cold, words flying out of middle teacher letter, my family’s mouths in song, directly after the celebration jingle. Culture , Family , Family history 2158 Words | 6 Pages. The Effect of the Information Age on Family Values. Information Age on cultural essay, Family Values By Dennis M. Parker The Effect of the Information Age on Family . Values The world might be increasingly reliant on high-tech gadgets and new-media information sources, but, contrary to popular belief, that has only seemed to strengthened traditional family values . What we need to realize is that “traditional family values ” is a very hard thing to define, because it means different things depending on middle school studies teacher cover letter, different families ’ traditions. “The Family ” idealized by many. Communication , Extended family , Family 2955 Words | 7 Pages. The Family of Woodstock By Gail Hall Professor Mai Green BSHS 355 March 17, 2015 The founders of family of . Woodstock Organization has specialized to meet many of the about, needs in the community around them. Preparing an organization is hard, understanding the social studies teacher cover, needs of others and what they have more of is cultural themes even harder, unless one has a heart for it.

As an school teacher organization of family of Woodstock began, the founders found numerous factors that led them to create the family of Woodstock. In. Canned Heat , Domestic violence , Emergency shelter 908 Words | 6 Pages. Student's Report on Family Values Reduced. Viet Nam. Politics And The Olympics. I am studying Advance D. My FIN No. is G1139539L. Middle Studies Cover Letter. Today I’m going to cultural essay, talk about the decline of family values in society . Middle School Social Studies Cover Letter. today. Slide 2: Before I start I will show you the outline of my presentation. Themes Essay. For the introduction, i will say in general about the decline of family values . After that I will show main points and explain the greed and other reasons which led to middle social studies teacher, family values decrese.

Lastly, I will sum up my presentation with summary, prediction and recommendation. Slide 3: . Family , Morality , Philosophy of and the essay, life 1316 Words | 4 Pages. Traditional Family Values And How They Are Changing. American family has been changing rapidly. Not only the structure but also, the family values have been changing as . Studies Teacher Cover Letter. well. Moreover, these two changes have, in a way, played off each other.

The structural changes in marriage, the basic household composition, and literature, childbearing have encouraged a new shaping of traditional values and perspectives. The structural and value change make the family of the 1990's fundamentally different from the school studies cover, family of the past generation. The American family has undergone. Adultery , Family , Family values 1218 Words | 4 Pages. Importance of Family- Personal Essay.

Importance of Family Families are a basic foundation in all human communities around the world. Healthy individuals within . these healthy families are at words for essays list the centre of a healthy society. It is therefore in everyone’s best interest to help create a positive environment for all families . The family unit has changed over the years but its importance is social cover still quite relevant. Both success and failures are faced with much more love and intensity when you have a family unit to fall back on. Family is the staple. Emotion , Family , Identity 798 Words | 3 Pages. ?To what extent does the gcse, dark side of the family life challenge the functionalist view on family ? Functionalists such as Murdock . (1949) would define family as a social group made up of common residence, economic cooperation, reproduction, adults of both sexes, who engage in a socially approved relationship, and that the education system is school teacher important. Olympics. Functionalists believe that the nuclear family is the best type of family for middle studies teacher letter individuals and society.

Functionalists believe that sexual relationships. Abuse , Child abuse , Domestic violence 1057 Words | 3 Pages. A Family Supper The Japanese fighter pilots in WWII committed suicide attacks on allied forces aka kamikaze; it was considered an honorable . service to the Empire of Japan. Death instead of defeat and literature coursework, shame is the primary tradition in middle school social teacher cover, the Japanese samurai culture. They lived with the bushido code: “Loyalty and Honor before death”. The short story in discussion is “A Family Supper” written by Kazuo Ishigoru. This story tells us about an evening when the son-the protagonist and essays war, the narrator of this. Family , Fiction , Kamikaze 1199 Words | 3 Pages. Essay : Discuss the values that are important in family life.

What exactly makes up a strong . Middle Studies Letter. family that possess good family values ? A strong family units a safe, positive and supportive place for all members to about communication, thrive. They are able to utilise resources and to live together in a fairly healthy manners. Family is more than a place where we eat and sleep; it is the place where we learn what matters the most. If all we do in families is middle social studies manage groceries and sleeping space, we have missed the great. 2000s American television series , By the Way , Education 461 Words | 2 Pages. Family Definition with Classification Essay. ?My Definition of Family with Classification The definition of “ family ” may differ from one person to the next.

Even the . various dictionaries have multiple definitions for the simple yet ever so complex word. The Oxford English Dictionary’s etymology of the word family comes from the Middle French famile, beginning in 1337 with family being defined as a group of people living under the same roof, household, in 1442-44 included a group of people related by blood, 1580 a group of people related. Definition , Extended family , Family 1311 Words | 6 Pages.

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Essay: T. S. Eliot: The Man in the Mirror. “For I saw with own my eyes the middle school social letter, Sibyl hanging in essays a jar at Cumae, and when acolytes said, ‘Sybil, what do you want’? she replied, T.S. School Cover! Eliot was an American poet living in England, forced to Oxford University because of the outbreak of essays wallpaper, World War I (Ramazani 460). Social Teacher Cover! Several factors, such as Eliot’s new, foreign home, as well as the fact that Eliot had to suffer firsthand through a war-torn Europe, increasingly influenced his poetry and writing style; Eliot’s poetry directly mirrors not only essays over the yellow wallpaper his surroundings during the time of World War I, but his poetry also mirrors how all of the middle school studies cover, turmoil in and phrases his life were affecting him. Eliot used his poetry as a self-reflection; poems such as The Waste Land and The Love Song of J. Social Studies Teacher Cover Letter! Alfred Prufrock are two examples that mirror Eliot’s own fears and a essay communication skills anxieties, and middle school social teacher cover letter allowed him an outlet from a essay communication his sorrowful life. T.S. Eliot sought to create a world in his poetry that mimicked his own somber reality, something that author Carolyn Holber points out. ‘The ‘metaphoric structure’ of’ The Waste Land’ uses ‘bits and pieces of history, myth and literature to create a dismal contemporary world” (Holber 2). As reviewer Eloise K Hay has said of Eliot’s Life, from the works of Peter Ackroyd, noting that Eliot often considered himself a ‘resident alien’, whom was often viewed as someone who was ‘not merely compensating for his undefined tradition but overcompensating on the side of a factitious Englishness’ (Hay 486). Eliot was always in a situation he was unfamiliar with, he was always in a metaphorical wasteland. School Studies! ‘Perhaps Eliot alone understood the complex fate of being an American poet in an era when no one was sure if such a thing as ‘American Literature’ existed’ (486).

So not only was Eliot constrained by trying to find his way in a world that was seemingly imploding upon itself, but he was also constrained in the fact that he hadn’t a clue where his place was in the world of literature. Even though The Waste Land is arguably Eliot’s most famous poem, the Norton Anthology of Modern and Contemporary Poetry, first presents Eliot’s The Love Song of essays on causes, J. Alfred Prufrock (Ramazani 463). From the start, the poem exhibits ideas of time, distance and an internal suffering in an attempt to placate Eliot’s inner feelings of dread and detachment from the world. Let us go then, you and I. When the evening is spread out against school social, the sky. Like a patient etherised upon a table; Let us go, through certain half-deserted streets (Prufrock 1-4).

Every poet is about communication always seeking something, and these four very poignant lines mirror exactly what Eliot is middle school social cover letter feeling during his stay in gcse coursework England. Middle Social Studies Teacher! ‘Lets us go then, you and I’ demonstrates an overwhelming desire of and the olympics, Eliot to find something, because when a person goes somewhere, they are always seeking something; however, Eliot is school social teacher letter a helpless patient that has been administered ether upon an operating room table. This ether that Eliot talks about, is the exact same feeling he has in real life – a loss of sensation, a loss of essay, being able to feel because he doesn’t know who or what he needs to be in life, and this numbing sensation is only intensified by the fact that everywhere Eliot turns, he sees lifeless, war torn, ‘half-deserted’ streets (4). Eliot wants to middle school social studies teacher cover letter, find his way into the world of poetry, but because of a medium that was heavily English, coupled with the gcse, fact that Eliot has been etherised through the social teacher cover, constant turmoil in his life, and living in a country that is fighting for literature, its proverbial life, the task is seemingly impossible. Also ether is middle social teacher cover letter highly flammable, and not only over the yellow wallpaper does this mirror the fiery world in which Eliot lives, but it also shows how incendiary the elements of social teacher letter, his life had become. To further expound upon about communication the ideas illustrated in social teacher The Love Song of J. Alfred Prufrock, a backtracking to the very beginning of the poem is needed. Eliot first starts out by quoting a part of Dante’s Inferno, using the quote to draw parallels between not only transition and phrases for essays himself and his own inferno, but one between Prufrock and Dante, which ultimately ties back to middle school studies teacher cover letter, Eliot. Dante is similar to Prufrock in the fact that both are paralyzed, or etherised, by politics and the olympics essay, a cowardice in the beginning of each piece, mirroring the same feelings Eliot has with his place in modern poetry. ‘But for this one moment, he is similar to Prufrock in his doubt and fear, and in justifying his weakness by contrasting himself with recognizable heroic figures’ (Hollahan 93).

So not only do we see how Eliot seems to use archaic figures to illustrate a point he is trying to make, but we also see how Eliot tries to justify his own hesitance in the world by pointing fingers at Dante as one who has had the very same timid feelings that he had felt. ‘Both men find themselves unworthy in their own eyes as well as in others’ eyes. School Studies Teacher! Both fearfully anticipate failure and shame’ (93). T.S. Eliot’s most famous poem, The Waste Land, is essays on causes war a summation of everything that has been presented so far; The Waste Land represents Eliot’s feeling of being an school studies cover letter, outside not only in gcse literature country but also in profession, doing so by using his archaic examples as well as his environment to shape this epic poem. As the studies letter, Norton Anthology implies, The Waste Land was the poem that was the child from all of Eliot’s personal problems. The main problems, aside from the constant strain with trying to fit into some sort of of cold war, niche, include the mental problems he faced, as well as with his family. In 1932, Eliot and his wife separated, and was eventually sent to a mental asylum, and died several years later.

The passing of Eliot’s father in 1919 also contributed to this barrage of negative emotions, especially since his father ‘died thinking that Eliot had wasted his ability’ (Ramazani 461). One of Eliot’s closest acquaintances, Jean Verdenal, also died during World War I, and was the person he dedicated his first set of school studies teacher letter, poetry books to cultural essay, (461). The Waste Land is middle school studies cover such a somber and magnificent poem, because it reflects everything that Eliot was feeling during his lifetime, all wrapped up into one epic story. The Waste Land is a collection of themes, everything that he was seeking, everything that had happened to him, and middle school studies his way of trying to mirror his reflection outwards towards the world in a negative manner. ‘To me it was only the relief of a personal and wholly insignificant grouse against life; it is just a piece of rhythmical grumbling’ (Ramazani 474). Even Eliot himself recognized that this poem was a mirror for his emotions. The Waste Land starts out with more archaic symbolism, this time from an ancient Greek myth in which the Sibyl is granted eternal life, yet fails to ask for eternal youth and ends up shriveling and living forever in a decrepit form (474). This idea of eternal life mirrors what Eliot desires, especially after the death of his father, the war and essays on causes of cold war also the condition of his mentally declining wife. The forgetfulness of the Sibyl directly correlates to what Eliot seeks; the estranged poet wants to forget the terrors he has had to face during his time on earth, which to him, feel like an eternity. April is the cruelest month, breeding. Lilacs out of the dead land, mixing.

Memory and desire, stirring. Dull roots with spring rain. Winter kept us warm, covering. Earth in forgetful snow, feeding. A little life with dried tubers. (Waste Land 1-7). These first few lines in the first part of The Waste Land, which bear the title, The Burial of the Dead, shows the pain Eliot suffered in the past few years before the finishing of the poem. The death of his father and Verdenal outline the first act of this epic, brought together by school social cover letter, the desire of essays on causes, Eliot to forget these terrible memories and attempt to ‘breed lilacs out of the dead’. Another desirous idea that Eliot inserts in this first section is dealing with the hardships of dealing with his sickening wife, and how her mental illness brought him suffering and yet a desire to fight through. And I was frightened. Middle School Studies Teacher Cover Letter! He said, Marie,

Marie, hold on tight. And down we went. (15-16). ‘The first female whom we encounter in the final edition of The Waste Land is Marie, whom the and the olympics, European speaker recalls from his childhood in a mingling of middle social teacher cover letter, memory and desire’ Marie is linked with the ‘awful daring of a moment’s surrender’ that the speaker invokes near the end of the poem. She describes overcoming her fear, holding on tight” (Sicker 421). This desire can be related back to Eliot’s estranged wife, and times when her sickness brought on moments of essay, surrender for school social studies teacher letter, him, and it seems as if this point of view is her’s, and cultural themes essay how she is urging him to hold on tight and overcome his fear. Even the others sections of this epic poem can be deduced and interpreted as allusions to Eliot’s own life. First, Eliot undergoes a stage in which he has to physically and emotionally bury his dead: his father, Jean and his mentally declining wife. Eliot then plays a game of chess with himself, a game in which he desires to cover over the burial of his dead with lilacs, and cover himself in a forget layer of allusionary snow. Eliot seeks a rebirth much like the rebirth Philomel takes on in the second part: The change of social letter, Philomel, by the barbarous king.

So rudely forced; yet there the nightingale. Filled the desert with inviolable voice. And still she cried, and still the world pursues (Waste Land 99-102). Eliot had terror forced upon him many times in his life, and now he just wants to war, fill his deserted life with beauty, yet he still manages to school social teacher cover letter, realize that even though he may find inner peace, that the world will still be there to tear him down in the end. The third section, The Fire Sermon, relates back to The Love Song of the yellow wallpaper, J. Middle Social Studies Cover Letter! Alfred Prufrock, with fire representing the transition words and phrases, fiery surroundings in which Eliot lives his life, and the incendiary life that is school social studies cover letter constantly burning him at every turn. Yet, fire has another important purpose: cleansing. Eliot seeks a cleansing from his past and a rebirth through the emotional chess game he’s faced. To Carthage then I came. Burning burning burning burning.

O Lord Thou pluckest me out. O Lord Thou pluckest. burning (Waste Land 307-311). Eliot seeks rebirth, to be plucked into life after burning and the yellow wallpaper burning, much as ‘Phlebas’s drowning has been read as a sacrificial death before rebirth’ (Ramazani 483). The Waste Land is Eliot’s step-by-step guide to himself, on how to gain some sort of catharsis from the tumultuous life he has had to endure. But, Eliot realizes that in the end, the chess game never ends, and the pain will always pursue him. ‘And still she cried, and still the world pursues (Waste Land 102). This is where the final section comes into play, Death by Water. The cycle finally comes full circle, and after burying his dead, struggling with desires and hardships throughout his life, the school social studies teacher, chess match is gcse literature coursework over, and life once again takes ahold of T.S. Eliot. A current under the sea. Picked his bones in whispers.

As he rose and fell. He passed the stages of his age and youth. Entering the whirlpool (Waste Land 315-318). T.S. Eliot was a master of mirroring his own emotions and life through such works as The Love Song of J Alfred Prufrock, and most notably, The Waste Land. He endured many harsh realities during his life, such as the passing of his father and one one his best friends, Jean Verdenal, and school teacher cover he even had to witness the mental breakdown of coursework, his wife, reflecting this idea heavily in the latter piece.

Every author is social studies seeking something, an idea that Eliot tried to express through the the yellow, use of archaic symbolism, and social studies teacher letter a reflection of his own ordeals in his poetry. Hay, Eloise K. “T. S. Of Cold War! Eliot: A Life.” Rev. of T. Studies Letter! S. Eliot: A Life by Peter Ackroyd, by politics olympics essay, Peter Ackroyd. T. S. Eliot: A Life by Peter Ackroyd Sept. 1985: 485-90. Middle School Studies Cover! JSTOR. Essays On Causes Of Cold War! Web. Middle School Studies Cover Letter! 2 Mar. Cultural! 2015.

Holbert, Carolyn. “”Stranded in the Wasteland:” Literary Allusion in middle social teacher The Sharpest Sight.” Studies in essays on causes American Indian Literatures 2nd ser. 14.1 (2002): 1-25. Middle School Studies Letter! JSTOR. University of a essay about communication skills, Nebraska Press, 2002. Web. 02 Mar. 2015.

Hollahan, Eugene. “A Structural Dantean Parallel in Eliot’s “The Love Song of J. Alfred Prufrock”” American Literature 42.1 (1970): 91-93. JSTOR. Duke University Press. Web. 02 Mar. 2015. Ramazani, Jahan, Richard Ellmann, and Robert O’Clair.

The Norton Anthology of Modern and Contemporary Poetry. 3rd ed. Middle School Studies Cover! New York: W.W. Norton, 2003. Print. Sicker, Philip. “The Belladonna: Eliot’s Female Archetype in The Waste Land.” Twentieth Century Literature 30.4 (1984): 420-31. JSTOR. Hofstra University. Web.

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