"If you can't be happy where you are, maybe you need to move!"

Written by Cathy Goodwin, Ph.D.

Continued from page 1

Atrepparttar first sign of discontent, begin some reality-testing. Ask at least six people (the Goodwin Rule of Six) how they feel. Word your questions carefully: "I love it here. What do you think?" Newcomers can find themselves labeled M for "malcontent," even when they askrepparttar 126162 most innocent questions.

You may need only a quick fix. I've seen people blossom when they transfer to a new department or move six blocks away. But you may have identified a deeper discontent.

Once you've identifiedrepparttar 126163 source, find a friend you trust. Tell that friend, "If I tell you I'm tempted to move again, remind me why I was miserable here."

Most friends -- along with many professional advisors -- are reluctant to become wet blankets who smother your dreams. Yet if you're trying to avoid repeating a mistake, a large bucket of ice water may save you from drowning when you dive into your next pond.

Cathy Goodwin, Ph.D., author of Making the Big Move, offers straightforward career and business consulting to midlife professionals. *When your career means business." Your Next Move ezine: http://www.cathygoodwin.com/subscribe.html Website: http://www.cathygoodwin.com

Major Depression and Manic-Depression — Any difference?

Written by Michael G. Rayel, MD

Continued from page 1

Moreover, this type of patients doesn’t need a lot of sleep. At night, they are very busy making phone calls, cleaningrepparttar house, and starting new projects. Despite apparent lack of sleep, they are still very energetic inrepparttar 126161 morning — ready to establish new business endeavors. Because they believe that they have special powers, they involve in unreasonable business deals and unrealistic personal projects.

They also become hypersexual — wanting to have sex several times a day. One–night stands can happen resulting in marital conflict. Like depressed patients, manic patients develop delusions (false beliefs). I know a manic patient who thinks that he isrepparttar 126162 “Chosen One.” Another patient claims thatrepparttar 126163 President of USA andrepparttar 126164 Prime Minister of Canada ask for her advice.

Sorepparttar 126165 big difference betweenrepparttar 126166 two isrepparttar 126167 presence of mania. This manic episode has treatment implications. In factrepparttar 126168 treatment of these disorders is completely different. While major depression needs antidepressant, manic-depression requires a mood stabilizer such as lithium and valproic acid. Recently, new antipsychotics, for example risperidone, olanzapine, and quetiapine, have been shown to be effective for acute mania.

In general, giving an antidepressant to manic–depressed patients can make their condition worse because this medication can precipitate a switch to manic episode. Although there are some exceptions torepparttar 126169 rule (extreme depression, lack of response to mood stabilizers, among others), it is preferable to avoid antidepressants among bipolar patients.

When consideringrepparttar 126170 use of antidepressant in a depressed bipolar patient, clinicians should combinerepparttar 126171 medication with a mood stabilizer and should use an antidepressant (e.g. bupropion) that has a low tendency to cause a switch to mania.

Copyright©2004. All rights reserved. Dr. Michael G. Rayel – author (First Aid to Mental Illness–Finalist, Reader’s Preference Choice Award 2002), speaker, workshop leader, and psychiatrist. Dr. Rayel pioneers the CARE Approach as first aid for mental health. To receive free newsletter, visit www.drrayel.com. His books are available at major online bookstores.

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