https://www.sandiegohealthdirectory.com/kb en-us "To sleep--perchance to dream," wrote Shakespeare in his masterpiece play, Hamlet. It's a nice concept. However for many men, women and children, the elusive road to slumberland is anything but a dream. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=163 Wed, 02 Aug 2006 07:57:37 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=163
Sleep is a natural part of everybody's life, but many people know very little about how important it is, and some even try to get by with little sleep. Sleep is something our bodies need to do; it is not an option. Even though the exact reasons for sleep remain a mystery, we do know that during sleep many of the body's major organ and regulatory systems continue to work actively. Some parts of the brain actually increase their activity dramatically, and the body produces more of certain hormones.

Sleep, like diet and exercise, is important for our minds and bodies to function normally. In fact, sleep appears to be required for survival. Rats deprived of sleep die within two to three weeks, a time frame similar to death due to starvation.

An internal biological clock regulates the timing for sleep. It programs each person to feel sleepy during the nighttime hours and to be active during the daylight hours. Light is the cue that synchronizes the biological clock to the 24-hour cycle of day and night.

Sleepiness due to chronic lack of adequate sleep is a big problem in the United States and affects many children as well as adults. Children and even adolescents need at least 9 hours of sleep each night to do their best. Most adults need approximately 8 hours of sleep each night.

When we get less sleep (even one hour less) than we need each night, we develop a "sleep debt." If the sleep debt becomes too great, it can lead to problem sleepiness – sleepiness that occurs when you should be awake and alert, that interferes with daily routine and activities, and reduces your ability to function. Even if you do not feel sleepy, the sleep debt can have a powerful negative effect on your daytime performance, thinking, and mood, and cause you to fall asleep at inappropriate and even dangerous times.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children's performance in school, on the playground, in extracurricular activities, and in social relationships.

For many, the road is paved with obstacles--often a sleep disorder, ranging from insomnia to restless legs syndrome (RLS) to sleep apnea--where individuals usually snore, experience fitful sleep, and may stop breathing for short periods, in some instances hundreds of times a night. The consequences of sleep deprivation, specifically the "problem sleepiness" during the day that normally follows, can have extremely serious, even life-threatening consequences.
Considering we spend nearly one-third of our lives tucked under the sheets, you would think we would know how to get a good night's rest. Not so for many. If you have sleep difficulties, you're not yawning alone--chances are some of your family members, coworkers, and neighbors also have a "sleep debt," the cumulative effect of not getting the quantity or quality of sleep that one needs. As many as forty million Americans are afflicted with more than 70 different types of sleep-related problems.

While some sleep disturbances may be linked to biological changes associated with aging or certain physical diseases, especially those that cause pain, others may be associated with a mental health disorder such as depression or anxiety. Poor sleep may also stem from "bad" habits such as napping too long or too late in the day, or doing shift work, which applies to nearly one quarter of the population, according to the National Center on Sleep Disorders Research. The Center is part of the National Heart, Lung, and Blood Institute, a unit of the National Institutes of Health (NIH). On the other hand, you may simply not be giving yourself the opportunity to acquire ample shuteye.

What we can say with certainty is that there is a pervasive nature of sleep deprivation out there--no question about it. It's part of how our society functions.

Why isn't America getting a better night's rest? "It's a two-part problem," the NIH scientist explained. "First, we have a society that's on a 24-hour cycle--with multiple jobs in many cases and multiple responsibilities both at work and home. When you're pushed for time, as many people are, the first thing that usually goes is sleep." However, when you sacrifice hours this way, you frequently end up paying for it in terms of decreased productivity and an increased risk for errors in judgment and accidents.
Further he said that the second part of the problem relates to actual sleep disorders.

Insomnia--the inability to fall asleep and remain there--affects many millions of people. "For sleep apnea, easily another 10 to 15 million. Narcolepsy, falling asleep uncontrollably during the day, perhaps 250,000. We don't even know how many people have restless legs syndrome (RLS). In general, society is not well rested, and looking at these numbers and their causes, you begin to see why," he explained.

While people of any age may be affected, there seems to be a large prevalence of sleep disturbances among elderly men and women. Sleep studies reveal that they get less REM deep - sleep over time. With aging, sleep becomes more fragile, that is, it doesn't take much disturbance to awaken the individual. Women may first notice this during menopause.

Lack of sleep and its link to accidents--automobile and on-the-job--now appears to be a problem of far greater magnitude than previously believed. Fatigue leads to diminish mental alertness and concentration. Accordingly it's the resultant "near miss" such as in a motor vehicle or otherwise, that sometimes makes people recognize they have a problem and need to seek professional help. There could be as many as 1,500 fatalities and one hundred thousand sleep-related automobile accidents annually in the United States. Shift workers are especially prone to this problem. "Their biological clock is ticking at the wrong time, and they typically drive home after work when they're extremely tired. Young males under 25 also have a disproportionate number of auto accidents related to sleepiness. We want to target them through education; in fact, we're currently working on a program with the U.S. Department of Transportation that we hope will be very effective in this area," a NIH scientist said.

What about napping? In some countries, a siesta or short daytime rest is a respected, time-honored daily ritual. It may have an important role. "With older people in particular, napping is a good practice. Because their sleep is fragmented and they get less of it at night, they typically make up for it with naps during the day. Napping works, it definitely has a role," he explained, adding that it can increase productivity and help restore your ability to think.

What about waking up too early, like before the birds' first chirp? While such "early morning awakenings" may be a sign of depression or other treatable emotional disorder, the passage of time may be the culprit. "As you age, your biological clock ticks at a slightly different rate. Because of this, you run into people with an advanced sleep syndrome--they go to bed early and then wake up too early," he further explained. "Again, sleep is very fragile with age and we really don't know why." In some cases, going to bed a bit later may help reset your biological clock and allow you to sleep later.

How many hours per night should you sleep? NIH sleep experts believe you should be obtaining somewhere in the range of 7 to 8 hours of sleep a night. This figure varies considerably across the age span and from person to person. Still, if you're getting less than 6 hours of sleep per night regularly, chances are you're building up your "sleep debt," and may be compromising your health and welfare, sleep authorities contend.

If you're having chronic sleep difficulties, should you merely lie there and take it? No. However, if you've done all you can and still aren't getting good, quality sleep, talk with your family doctor. If you need additional help, ask for a referral to a sleep specialist. This may be needed, in particular, for more complex conditions such as narcolepsy. While this disease is not curable, it is treatable, though the regimen with carefully prescribed medications is complicated, and best handled by a sleep specialist.

The Greek philosopher Sophocles once remarked that "sleep is the only medicine that gives ease." As researchers seek to unravel the remaining mysteries surrounding sleep, many more men, women, and children should soon find a night in the bed a more pleasant pill to take--rest assured.

These substances disturb a variety of bodily processes. They impair a person’s ability to get a good night’s sleep. For example, alcohol may help a person fall asleep, but it interferes with one’s ability to stay asleep. If you are dependent on drugs or alcohol, let your doctor know, and seek assistance for this problem.

A child who has not obtained adequate nighttime sleep is at high risk for symptoms of physical and/or mental impairment. The child may fall asleep in school; have difficulty concentrating in school and other activities, and/or exhibit behavioral problems. Some children who are sleepy become agitated rather than lethargic and may be misdiagnosed as hyperactive. Not getting enough sleep is one cause of problem sleepiness.

Undiagnosed/untreated sleep disorders can also cause problem sleepiness. Children as well as adults can suffer from sleep disorders. Parents should talk to their pediatrician about a possible sleep disorder if their child has any of the following:
1. Snoring.
2. Breathing Pauses During Sleep.
3. Problems with Sleeping at Night.
4. Difficulty Staying Awake During the Day.
5. Unexplained Decrease in Daytime Performance.

Problem sleepiness has serious consequences – it puts adolescents and adults at risk for drowsy driving or workplace accidents. In children, it increases the risk of accidents and injuries. In addition, lack of sleep can have a negative effect on children's performance in school, on the playground, in extracurricular activities, and in social relationships.

Inadequate sleep can cause decreases in:
1. Performance
2. Concentration
3. Reaction Times
4. Consolidation of Information Learning

Inadequate sleep can cause increases in:
1. Memory Lapses
2. Accidents and Injuries
3. Behavior Problems
4. Mood Problems

Other Strategies:
a. Limit substances that contain caffeine, e.g., soda, coffee, and some over-the-counter medicines.

b. Try to set a regular sleep/wake schedule:
1. A consistent sleep schedule helps to regulate and set the body’s "internal clock," which tells us when we are tired and when it is time to sleep, among other things.
2. Make your sleeping area as free from distractions as possible:
3. Aim for quiet surroundings; keep the room darkened; keep the television out of the bedroom.
c. Consider a light nighttime snack:
1. A light snack after dinner may prevent hunger from waking you up in the middle of the night.
d. Avoid over-arousal for at least 2-3 hours prior to going to sleep:
1. Try not to get your body and mind in "arousal mode." Things that may tend to do this are: heavy meals, strenuous exercise, heated arguments, paying bills, and action-packed movies.
e. Don’t worry that you can’t sleep:
1. Remember, there may be a number of reasons for your sleep problems. The first step is to talk to your doctor.

Talk to your doctor.

Let your doctor know that you have trouble sleeping. Tell your doctor exactly what the problems are; he or she can help you best if you share this information about yourself.

Let your doctor know about any physical problems that you think are contributing to your sleep problems. For example, chronic pain associated with traumatic injuries can make it difficult to sleep.

Let your doctor know about any other emotional problems you have–these may also be contributing to your sleep problems. For example, depression or panic attacks can make it hard to fall asleep or to stay asleep.

Depending on your sleep symptoms and other factors, your doctor may prescribe some medication for you.

Your doctor may recommend that you work with a therapist skilled in dealing with emotional and behavioral problems. Psychologists, social workers, and psychiatrists fall into this category. They can help you take a closer look at, and possibly change, the variety of factors that may be preventing you from sleeping well. ]]> Stress is a fact of life, but it need not be a way of life. There are many things in life that you can't control, but very few that you can't learn to manage, including the negative aspects of stress. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=151 Thu, 27 Jul 2006 06:03:39 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=151
The human body reacts to stress with a "fight or flight" response. This response evolved over the years when our ancestors came face to face with a hostile situation such as an encounter with a tiger. The body has a surge of adrenaline, which prepares the body for a physically challenging event. This physiologic response was intended to be infrequent.

Unfortunately, many people today interpret their environment as hostile the majority of the time. This causes numerous physiologic changes to occur in the body. The blood pressure increases, the pulse rate increases and over a long period of time, the immune system begins to falter. This would explain why individuals who are under a lot of stress become ill more frequently than usual. An example would be college students studying for finals. They tend to have a high incidence of colds and other infections. This is because they stay up late at night and put their bodies through a lot of stress. Stress can also play a part in the development of heart disease. The high adrenaline state accelerates the development of heart disease. The blood tends to clot more rapidly. This would explain why individuals subjected to an acute stressful event can have a heart attack. They almost always have underlying heart disease.

NOTE:
Your security office is concerned about stress in the workplace, because too much stress or chronic stress can lead to poor judgment. No employee ever exploded in violence, committed suicide, stole government property, became a spy or engaged in any other destructive or self-destructive behavior because they were happy and relaxed. They were stressed out and desperate. A safe and secure office environment is one in which employees know how to recognize and manage the negative aspects of stress.

The positive aspect of stress is that it can help you concentrate, focus, and reach peak performance. Many people do their best work when under moderate pressure. Then, when the challenge has been met, they take time to relax and enjoy their achievement. This relaxation response enables them to build up the physical and emotional reserves to meet the next challenge.

Stress becomes negative when you stay uptight and don't -- or can't -- relax after meeting the challenge. Too much stress can leave you tired, irritable, angry, tense, anxious, frustrated and depressed. Chronic, ongoing stress can lead to emotional problems and physical illness.

The first step to managing stress is to become aware of the things that cause your stress. Once you realize what causes your stress, try to focus on how your body feels under stress. "Listen" to your body for signs such as irritability, headaches, a knot in your stomach, tensed muscles, clenched teeth, cold or clammy hands, or other symptoms that tell you are under stress. There are many potential causes of stress both at home and in the workplace, and many different bodily reactions to stress. Recognizing what causes your stress and how your particular body reacts to stress is the first step to finding solutions to the problem.

The many potential solutions include:
1. Recognize when your body is telling you it's time to take a break.
2. Learn any of the wide variety of relaxation techniques such as deep breathing, stretching, meditation, Yoga, clearing your mind, progressive muscular relaxation, visualization, etc.
3. Improve work habits, such as learning how to manage your time better.
4. Avoid the circumstances that create stress.
5. Adjust your priorities; decide what is really most important in your life.
6. Adopt more realistic career goals.
7. Resolve not to let yourself be provoked or upset by others' behavior.
8. Talk out problems with a friend or supervisor.
9. Go out of your way to improve relationships with family, friends, co-workers and supervisor.
10. Develop a healthier or more positive lifestyle with good nutrition and appropriate exercise.
11. Seek professional help.

First of all, try to identify the factors that create stress in your life. Consider options to avoid the stressful situation altogether. If your job is the cause of most of your stress, consider a job change. This seems like a dramatic step, but it is an option that can really help. If you are unable to avoid certain stressful situations, then you will need to learn to cope with the situation. Avoid committing yourself to every project that comes your way. It is important to know your limitations. Learn how to say "no." Sometimes, taking a vacation can be rejuvenating.

A conversation with a friend may give you support and emotional release. You may discover that you are not the only one having a "bad day," caring for a sick child, or working in a busy office. Sharing your feelings and frustrations with friends and family may also help them better understand what you are going through. Let your family and friends provide support and guidance.

The benefits of fresh air and sunlight are great for you and the whole family. Sunshine is known to increase the levels of vitamin D in your body, and some research has shown that sunlight's effects can be helpful with some forms of depression.

Exercise cannot only help improve your physical health, but also relieves stress and allows your mind to relax. The U.S. Surgeon General recommends at least 30 minutes of exercise on most days of the week (at least 3-5 days a week).

Sleep is very important to your overall health, especially when dealing with the stress. Without adequate sleep the body functions at half speed and tires out half way through the day.

Developing healthy sleeping patterns can greatly increase your energy and may help improve your attitude throughout the day. Most adults require about 8 hours of sleep each night. If you don't "have the time" try to fit in an energizing short nap for 10-20 minutes during the day.

Regular exercise is one of the best antidotes for our stressful lives. Exercise is a natural tranquilizer. Every symptom of stress can be improved or eliminated by regular exercise. Patients frequently will say that they simply don't have time to exercise. In reality, the time invested in exercise will easily pay for itself" in improved efficiency. Concentration improves so mental tasks can be accomplished more rapidly. Sleep improves and the overall energy level is increased, which allows physical tasks to be accomplished faster.

Meditation can help us deal with our stressful lives. Yoga is a great way to reduce stress. Studies have shown that daily meditation can actually reduce blood pressure. Music therapy has been shown to have a calming effect. Caring for a pet can help us cope with the daily stressers of life.

Discussing your problems with friends can be therapeutic. If things get out of hand, you may need to seek professional help through a counselor. Sometimes the symptoms of stress can be related to the underlying chemical imbalance of depression. In this case, medication may be indicated. Lastly, try to maintain a positive attitude. This can be therapeutic in itself.]]> Battered child syndrome; Physical abuse – children. Because adults are so much stronger and bigger than children, the abused child can be severely injured or killed unintentionally. For example, shaking an infant, especially if the head hits something, even against a soft object like a mattress or pillow, can cause bleeding over the brain. This can cause permanent brain damage or death. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=146 Wed, 26 Jul 2006 06:29:17 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=146
The definition of child abuse has expanded significantly. In addition to multiple fractures with different ages, what is now called "physical child abuse" or "non-accidental child trauma" also contains numerous other signs of inflicted injury.

Abuse tends to occur at moments of greatest stress, when the perpetrator strikes out in anger at the child. Many perpetrators were themselves abused as children and they often don't realize that abuse is not appropriate discipline. Abusers also frequently have poor impulse control, which prevents them from thinking through the consequences of their actions.

Because adults are so much stronger and bigger than children, the abused child can be severely injured or killed unintentionally. For example, shaking an infant, especially if the head hits something, even against a soft object like a mattress or pillow, can cause bleeding over the brain. This can cause permanent brain damage or death.

Unfortunately, the rate of child abuse is fairly high. The most common form is neglect. Child abuse accounts for at least 1,400 deaths in children each year.

The major risk factors related to adult abusers include poverty, lack of education, single parenthood, and alcoholism or other drug abuse.

Adult brings an injured child to an emergency room with an improbable explanation of the cause of the injury, or the injury is not recent:
1. Unusual and unexplained bone fractures.
2. Bruise marks shaped like hands, fingers, or objects such as a belt, or unexplained bruises in areas where normal childhood activities would not usually result in bruising.
3. Specific patterns of scalding, seen when a child is immersed in hot water as a punishment - particularly "glove" or "sock" burn patterns.
4. Burns from an electric stove, radiator, heater or other hot objects, usually seen on the child's hands, arms or buttocks.
5. Cigarette burns on exposed areas or the genitals.
6. Black eyes in an infant or a similar, unexplained injury in a child.
7. Human bite marks.
8. Lash marks.
8. Choke marks around neck.
9. Circular marks around wrists or ankles - indicating twisting or tying up.
10. Evidence of unexplained abdominal injury such as bruised or ruptured intestines due to punching.
11. Unexplained unconsciousness in infant.

Typical injuries in abused children include:
1. Bleeding in the back of the eye, seen with shaken baby syndrome or a direct blow to the head.
2. Internal damage, such as bleeding or rupture of an organ from blunt trauma.
3. Any fracture in an infant too young to walk or crawl.
4. Evidence of fractures at the tip of long bones or spiral-type fractures that result from twisting.
5. Fractured ribs, specially in the back.
6. Evidence of skull fracture, multiple fractures of different ages may be present.
7. Subdural hematoma collection of blood in the brain without plausible explanation.
8. Multiple bruises of different ages, especially in unusual areas of the body, e.g., not the shins or in patterns suggesting choking, twisting, or severe beating with objects or hands.
9. Other unusual skin damage, including burns or burn scars.

The following tests can reveal physical injuries:
1. Bone x-ray - a skeletal survey is done whenever physical abuse is suspected. All the child's bones, including the skull, are x-rayed to look for undetected fractures or old, healing fractures.
2. MRI or CT scan of the head or abdomen are done if there is a skull fracture, bleeding in the eye, unexplained vomiting, severe bruising of the face, skull or abdomen, or unexplained neurological symptoms, headaches, or loss of consciousness.

The following medical conditions can mimic abuse:
1. Osteogenesis imperfecta - almost all children with this condition have an abnormal (blue) coloring of the whites of the eyes. These children may have spontaneous fractures or break bones after normal accidents that would not harm the bones of a normal child.
2. Undetected bleeding disorders such as hemophilia, Von Willebrand's disease, or liver disease can lead to abnormal bruising patterns. The doctor can test for these disorders.
3. Unusual bruising and scarring patterns can also be caused by folk medicine or Oriental Medicine practices such as coin rubbing, cupping, and moxabustion such as burning herbs on the skin over acupuncture points. The doctor should always ask about alternative healing practices.
4. The specific physical injuries are treated as appropriate.

Counseling or an intervention of some type for the parents is mandatory. In some cases, the child may be temporarily or permanently removed from the home to prevent further danger. Life-threatening abuse, or abuse resulting in permanent damage to the infant or child, may result in legal action.

Counseling, including play therapy, is also necessary for abused children over age 2. Failure to help the child deal with the fear and pain resulting from abuse by adults, who should be trusted figures, can lead to significant psychological problems, such as post traumatic stress disorder (PTSD).

All states require that you report any known or suspected child abuse. Call the police and Child Protection Services.

Decisions about placing the child with an outside caregiver or returning the child to the home usually are made by the appropriate government agency through the court system. The structure of these agencies varies from state to state.

Support groups are available for survivors of abuse and for abusive parents who want to get help.

Expectations (prognosis):
The child's physical recovery depends on the severity of the injuries. Psychological recovery depends on the results of psychotherapy and whether the child can develop trusting relationships with adult caretakers.

The authorities will determine whether the abuser receives psychiatric help, such as parenting training and impulse/anger management training.
Child protection agencies generally make every effort to reunite families when possible.

Complications:
Physical abuse of a child can lead to severe brain damage, disfigurement, blindness, crippling, and death. Abused individuals may carry emotional scars for a lifetime.

Children can be removed permanently from the parents' custody if the parents are the perpetrators and the cause is sufficient to warrant termination of parental rights.

However, this experience itself can result in significant psychological problems due to feelings of rejection, or if the placement does not result in a strong, long-term attachment to new caregivers.

Calling your health care provider:
Call your health care provider, Child Protective Services, or local police if you suspect or know that someone is being abused.

Prevention:
Recognize the warning signs of potential abuse. These include when the caregiver:
a. Has previously abused a child.
b. Fails to maintain the child's proper hygiene or care.
c. Appears to lack love or concern.
d. Has alcohol or drug problems.
e. Has emotional problems or mental illness.
f. Was abused as a child.
g. Has high stress factors, including poverty.

Counseling or parenting classes may prevent abuse when any of these factors are present. Watchful guidance and support from the extended family, friends, clergy, or other supportive persons may prevent abuse or allow early intervention in cases of abuse.]]> Child neglect, also called psychological abuse, is a form of child abuse. It occurs when someone intentionally does not provide the child of the necessities of life, or do so with reckless disregard for the child's well being. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=144 Wed, 26 Jul 2006 03:40:31 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=144
Some authorities consider children witnessing violence between parental figures or severe abuse between adults is another form of psychological abuse.

The incidence of physical and emotional neglect of children is difficult to define.

Child neglect and psychological abuse appear to co-exist with child physical abuse about 50% to 75% of the time. The risk factors for both are essentially the same and may include poverty, other stresses in the family, mental illness, or substance abuse by parents or caregivers. Abused children are at risk of becoming abusers themselves as adults.

Children presenting with the syndrome of failure to thrive are at risk for various forms of neglect or emotional abuse. Failure to thrive is characterized by children who fail to grow and develop normally or who have unexplained weight loss. In such evaluations, it is appropriate to consideration of child abuse as a factor.

Psychological abuse may present with signs of childhood depression, including
vague physical complaints:
1. Sleep disorders.
2. Eating disorders.
3. Various forms of rebellious behaviors, including terrorizing or exploiting others
difficulties in school

Children with suspected emotional abuse should be evaluated by a trained mental health professional. All neglected or psychologically abused children also need to be evaluated for other forms of physical abuse. The problems often co-exist.

Treatment
Treatment of the abused child may include nutritional therapy and mental health.
1. Removing the child from the home may be necessary to protect the child from further abuse.
2. Anyone with suspicion of this form of child abuse should report the matter to Child Protective Services or the police. Health care workers, school employees and child care professionals are mandated by law to report suspected abuse.
3. The goal of child protective agencies is to reunite families after the abuser has received help.
4. Treatment for abusers may involve parenting classes and mental health and medical treatment for mental illness, alcohol, or street drugs.
NOTES:
Expectations (prognosis):
With treatment, most children and parents can be reunited as a family. Long-term outcome depends on the severity of abuse, length of abuse, success of both child and adult psychotherapy, and how well parenting classes worked.

Complications:
As in all forms of child abuse, severe injury or death are possible.
Other long-term problems may include a lack of self confidence, depression, rebellious behavior, and becoming an abuser during adulthood.

Calling your health care provider:
Call your primary health care provider if a child is appears depressed, is losing weight, or is not growing or developing normally. Remember that suspected child abuse of any form must be reported to the authorities.

Prevention:
School-based programs designed to improve parenting, communication and self-image are important in preventing future abuse and may lead to identifying abused children.

Parenting classes are very helpful. Newlywed adults without children should be encouraged to take such classes before each child is born. The dynamics in the home change with increasing numbers of children.

Home visit programs by nurses and social workers in the first two months of life may be helpful in identifying families at risk. Such programs are becoming more common in the United States and are already popular in many European countries.

Support Groups:
There are many support groups available for both abusers and abused children, including:
Prevent Child Abuse America
200 S. Michigan Avenue
17th Floor
Chicago, IL 60604-2404
312-663-3520]]> Repeated stress drains and wears down your body and mind. Stress is like starting a car engine or pushing the accelerator pedal to speed up. If you keep revving up the car, you'll burn out the starter and wear out both the brakes and the engine. https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=114 Mon, 26 Jun 2006 03:15:14 GMT https://www.sandiegohealthdirectory.com/kb/link.php?action=detail&id=114
Burnout occurs when repeated stress is not balanced by healthy time outs for genuine relaxation. Stress need not be a problem if you manage it by smoothly and calmly entering or leaving life's fast lane.

Stress Management involves responding to major life events and everyday hassles by relaxing as well as tensing up. Relaxation actually is a part of the normal stress response. When faced with life's challenges, people not only tense up to react rapidly and forcefully, but they also become calm in order to think clearly and act with control.

Trauma can cause severe stress, which may become unmanageable despite the best efforts of good stress management. Let's look at why this happens and what you can do about it.
1. Traumatic events cause severe stress reactions that are particularly hard to manage.
2. Trauma involves a unique kind of physical/emotional shock that escalates the fight-flight stress response- feeling angry or scared into super-stress -feeling terrified, stunned, horrified, like your life is passing before your eyes, or so overwhelmed you blank out.
3. Trauma occurs when a person directly experiences or witnesses:
a. Unexpected death
b. Severe physical injuries or suffering
c. Close calls with death or injury
d. Sexual violation

If you have ever experienced or witnessed war, disaster, a terrible accident, sexual or physical abuse or assault, kidnapping or hostage-taking, or life-threatening illnesses, you know the shock of trauma.

Nothing in life ever seems quite the same again, even if everything works out for the best.

Trauma leaves a lasting imprint of terror, horror, and helplessness on the body and the mind. The world no longer seems safe, manageable, or enjoyable. People no longer seem trustworthy or dependable. Self-doubt and guilt eat away at your self-esteem. Faith and spirituality are shaken or lost.

Traumatic stress can be managed, but special steps are necessary.
Steps in Managing Traumatic Stress:
I. Step One is recognizing the signs of posttraumatic stress. Trauma is so shocking that it causes memories that are impossible to forget or sometimes impossible to recall. Trauma memories often repeatedly come back when you are not trying to think about them. Memories arise as unpleasant thoughts or nightmares. Sometimes you may feel as if you cannot stop reliving the event. The shock of trauma also may create blank spaces in your memory because it is too much for the mind to handle, and so the mind takes a time out.

Traumatic stress reactions are normal responses to abnormal events. Most people experience posttraumatic stress reactions for days or even weeks after a trauma. Usually these reactions become less severe over time, but they may persist and become a problem.

II. Step Two is recognizing the ways of coping with traumatic stress that is natural but don't work, because they actually prolong and worsen the normal posttraumatic stress reactions.
a. Trying to avoid people, places, or thoughts that are reminders.
b. Shutting off feelings or connections to other people that are reminders
c. Being hyper-vigilant or on guard.
d. Trying to avoid bad memories, trying to shut out feelings or people, or trying to stay always alert may seem reasonable. However, they don't work because trauma controls your life if you run from it.

III. Step Three trauma memories cannot be erased, but the stress they cause can become very manageable. Because everyone responds differently to traumatic events, you may have some of these reactions more than others, and some you may not have at all. Remember, it is important to see a doctor. It is important that family members be involved in the care and in their own individual care.

Keep in mind; many changes after a trauma are normal. In fact, most people who directly experience a major trauma have severe problems in the immediate aftermath. Many people then feel much better within three months after the event, but others recover more slowly, and some do not recover enough without help. Becoming more aware of the changes you've undergone since your trauma is the first step toward recovery.

Some of the most common problems after a trauma are described below.

Fear and anxiety.
Anxiety is a common and natural response to a dangerous situation. For many it lasts long after the trauma ended. This happens when views of the world and a sense of safety have changed. You may become anxious when you remember the trauma. But sometimes anxiety may come from out of the blue.

Triggers or cues that can cause anxiety may include places, times of day, certain smells or noises, or any situation that reminds you of the trauma. As you begin to pay more attention to the times you feel afraid you can discover the triggers for your anxiety. In this way, you may learn that some of the out-of-the-blue anxiety is really triggered by things that remind you of your trauma.

Re-experiencing of the trauma.
People who have been traumatized often re-experience the traumatic event. For example, you may have unwanted thoughts of the trauma, and find yourself unable to get rid of them. Some people have flashbacks, or very vivid images, as if the trauma is occurring again.

Nightmares are also common.
These symptoms occur because a traumatic experience is so shocking and so different from everyday experiences that you can't fit it into what you know about the world. So in order to understand what happened, your mind keeps bringing the memory back, as if to better digest it and fit it in.

Increased arousal is also a common response to trauma.
This includes feeling jumpy, jittery, and shaky, being easily startled, and having trouble concentrating or sleeping. Continuous arousal can lead to impatience and irritability, especially if you're not getting enough sleep. The arousal reactions are due to the fight or flight response in your body. The fight or flight response is the way we protect ourselves against danger, and it occurs also in animals. When we protect ourselves from danger by fighting or running away, we need a lot more energy than usual, so our bodies pump out extra adrenaline to help us get the extra energy we need to survive.

People who have been traumatized often see the world as filled with danger, so their bodies are on constant alert, always ready to respond immediately to any attack. The problem is that increased arousal is useful in truly dangerous situations, such as if we find ourselves facing a tiger. But alertness becomes very uncomfortable when it continues for a long time even in safe situations. Another reaction to danger is to freeze, like the deer in the headlights, and this reaction can also occur during a trauma.

Avoidance is a common way of managing trauma-related pain. The most common is avoiding situations that remind you of the trauma, such as the place where it happened. Often situations that are less directly related to the trauma are also avoided; such as going out in the evening if the trauma occurred at night. Another way to reduce discomfort is trying to push away painful thoughts and feelings. This can lead to feelings of numbness, where you find it difficult to have both fearful and pleasant or loving feelings. Sometimes the painful thoughts or feelings may be so intense that your mind just blocks them out altogether, and you may not remember parts of the trauma.

Many people who have been traumatized feel angry and irritable. If you are not used to feeling angry this may seem scary as well. It may be especially confusing to feel angry with those who are closest to you. Sometimes people feel angry because of feeling irritable so often. Anger can also arise from a feeling that the world is not fair.

Trauma often leads to feelings of guilt and shame. Many people blame themselves for things they did or didn't do to survive. For example, some assault survivors believe that they should have fought off an assailant, and blame themselves for the attack. Others feel that if they had not fought back they wouldn't have gotten hurt. You may feel ashamed because during the trauma you acted in ways that you would not otherwise have done.

Sometimes, other people may blame you for the trauma.

Feeling guilty about the trauma means that you are taking responsibility for what occurred. While this may make you feel somewhat more in control, it can also lead to feelings of helplessness and depression.

Grief and depression are also common reactions to trauma. This can include feeling down, sad, hopeless or despairing. You may cry more often. You may lose interest in people and activities you used to enjoy. You may also feel that plans you had for the future don't seem to matter anymore, or that life isn't worth living. These feelings can lead to thoughts of wishing you were dead, or doing something to hurt or kill yourself. Because the trauma has changed so much of how you see the world and yourself, it makes sense to feel sad and to grieve for what you lost because of the trauma.

Self-image and views of the world often become more negative after a trauma. You may tell yourself, "If I hadn't been so weak or stupid this wouldn't have happened to me." Many people see themselves as more negative overall after the trauma "I am a bad person and deserved this."

It is also very common to see others more negatively, and to feel that you can't trust anyone. If you used to think about the world as a safe place, the trauma may suddenly make you think that the world is very dangerous. If you had previous bad experiences, the trauma convinces you that the world is dangerous and others aren't to be trusted. These negative thoughts often make people feel they have been changed completely by the trauma. Relationships with others can become tense and it is difficult to become intimate with people as your trust decreases.

Sexual relationships may also suffer after a traumatic experience. Many people find it difficult to feel sexual or have sexual relationships. This is especially true for those who have been sexually assaulted, since in addition to the lack of trust, sex itself is a reminder of the assault.

Some people increase their use of alcohol or other substances after a trauma. There is nothing wrong with responsible drinking, but if your use of alcohol or drugs changed as a result of your traumatic experience, it can slow down your recovery and cause problems of its own.

Many of the reactions to trauma are connected to one another. For example, a flashback may make you feel out of control, and will therefore produce fear and arousal. Many people think that their common reactions to the trauma mean that they are "going crazy" or "losing it." These thoughts can make them even more fearful. Again, as you become aware of the changes you have gone through since the trauma, and as you process these experiences during treatment, the symptoms should become less distressing.

There are several types of education and treatment for PTSD that has proven helpful to persons with PTSD and their family members. These include classes on dealing with PTSD symptoms, stress, anger, sleep, and personal relationships. Individual, group, and family counseling and selected medications have also been helpful. ]]>