Thursday, April 28, 2011

Do women like adult media and content as much as men?

By, Ian Kerner, a sexuality counselor and New York Times best-selling author.

If you’d asked me this question a couple of years ago, I would have said “no.” But the times they are a-changing: just as female infidelity is on the rise, women are catching up to the guys in other ways, too - including a propensity for porn.

As a sex therapist and founder of the website Good in Bed, here’s what I’m observing:

– More couples are enjoying porn together, with women often taking the lead in choosing the material.

– More women are using porn to get themselves in the mood for sex or to enjoy their sexuality on their own.

– More women are using porn to learn new sexual techniques or to explore sexually adventurous situations.

– More women are using porn to satisfy a general curiosity about sex overall, and

– More women are comfortable and confident in asserting their opinions on the subject.

In short, women are increasingly using porn for pretty much the same reasons (and pleasures) as men. Meanwhile, guys are increasingly surprised to discover that their female partners are interested in porn - and tend to be even more surprised to discover what they’re watching (I’ll get to that in a moment).

So what’s going on? Why the apparent change? To be honest, I’d always been of the mind that men and women are somewhat different when it comes to porn, for both biological and sociological reasons:

On the biological side, I’ve often said female sexual desire is more complex than male desire, and that porn rather clearly illustrates that difference: In men, visual stimulation leads quickly to sexual arousal, and with that chain of arousal often comes a desire to be stimulated to orgasm. In that sense, arousal and desire are very closely related, and it’s one of the reasons that Viagra has been so successful with men: Give a guy an erection and he basically wants to use it. In men, porn initiates the “sexual-circuit” very quickly.

That’s not to say that women don’t respond to visual stimulation either, or that that stimulation doesn’t lead to genital arousal, but that arousal doesn’t always trigger desire in women the way that it does with men.

When I talk to guys about their porn use, many describe a lack of pre-meditation. For example, a guy could be hanging out on his computer, checking out his favorite sports site, when up pops an ad with a sexy woman in a bikini and, bang, next thing he knows he’s trawling porn sites in search of sexual release.

With women, however, the use of porn or the desire/decision to have an orgasm is often less opportunistic. A woman may see something super-sexy, and recognize it as sexy, and even arousing, but that doesn’t mean she’s necessarily going to stop what she’s doing to stimulate herself to orgasm. (By the way, if you don’t agree with any of this, please chime in below in the comments - sexual desire is by no means a one size fits all model: everyone is different and topic of women and porn is a highly debated one.)

On a more sociological level, generations of women have been told that porn is evil: that it exploits, objectifies, and degrades women, and that a woman who enjoys porn is a betrayer of Women. Some may still feel this is true, (and there are plenty of women who feel uncomfortable with porn), but there are also plenty of women who would beg to disagree and look at porn as a fairly innocuous form of erotic escapism that’s a personal choice and not a big deal.

Additionally, many women have contended that porn, until fairly recently, was never really created with female customers in mind; that porn was designed to appeal to men and lacked elements that were more organic to female sexuality, such as foreplay, intimacy and erotic storylines.

Well, today there are many porn sites geared toward women. In fact, there’s even a regular Feminist Porn Awards that recognizes erotic entertainment that is smart, sexy, and appreciates women as viewers.

Combine a recognition of a female audience with the rapid proliferation of easily accessible Internet porn, and it only makes sense that more women are enjoying porn. (By the way, if you’re a woman and you’re interested in dipping a toe - or perhaps nose-diving - into the world of porn, I suggest checking out the work of Violet Blue and her book, "The Smart Girl's Guide to Porn." Or if porn isn’t your thing, but you’re interested in some hot erotic literature, take a look at the anthologies that are edited by Rachel Kramer Bussell.)

As it turns our women may be able to enjoy porn with less guilt, or at least with less grief from their male partners. In my experience, women tend to worry a lot more about their man’s porn habits and what it means to their relationship, whereas many of the men I’ve spoken with tend to be intrigued by the idea of women and porn - especially since women are much more likely to enjoy porn that does not directly reflect their sexual orientation.

One study at Northwestern University, for example, examined the effects of porn on genital arousal and concluded that men responded more intensely to porn that correlated to their particular sexual orientation, whereas women tended to be genitally aroused by a much broader spectrum of erotic material. Who knows –- perhaps the enormous variety of material offered by the Internet will end up playing more to the spectrum of female desire than male desire in the long run?

For the moment, it would seem that women are not watching porn nearly as much as men. Recently, a researcher from the University of Montreal set out to study whether pornography had an impact on guys’ sex lives. He searched for men in their 20s who'd never consumed porn, and guess what? He couldn't find a single one. I can still show you plenty of women who have never looked at porn - but perhaps not for long.

So do women like porn as much as men? You tell me.

Friday, April 15, 2011

Understanding what bipolar disorder is and how to diagnose if you have it.










Bipolar disorder involves periods of elevated or irritable mood (mania), alternating with periods of depression. The "mood swings" between mania and depression can be very abrupt.
Causes, incidence, and risk factors

Bipolar disorder affects men and women equally. It usually appears between ages 15 - 25. The exact cause is unknown, but it occurs more often in relatives of people with bipolar disorder.

Types of bipolar disorder:

People with bipolar disorder type I have had at least one fully manic episode with periods of major depression. In the past, bipolar disorder type I was called manic depression.

People with bipolar disorder type II have never experienced full-fledged mania. Instead they experience periods of hypomania (elevated levels of energy and impulsiveness that are not as extreme as the symptoms of mania). These hypomanic periods alternate with episodes of depression.

A mild form of bipolar disorder called cyclothymia involves less severe mood swings with alternating periods of hypomania and mild depression. People with bipolar disorder type II or cyclothymia may be misdiagnosed as having depression alone.

In most people with bipolar disorder, there is no clear cause for the manic or depressive episodes. The following may trigger a manic episode in people who are vulnerable to the illness:

Life changes such as childbirth

Medications such as antidepressants or steroids

Periods of sleeplessness

Recreational drug use

Symptoms

The manic phase may last from days to months and can include the following symptoms:

Agitation or irritation

Inflated self-esteem (delusions of grandeur, false beliefs in special abilities)

Little need for sleep

Noticeably elevated mood

Hyperactivity

Increased energy

Lack of self-control

Racing thoughts

Over-involvement in activities

Poor temper control

Reckless behavior

Binge eating, drinking, and/or drug use

Impaired judgment

Sexual promiscuity

Spending sprees

Tendency to be easily distracted

These symptoms of mania are seen with bipolar disorder I. In people with bipolar disorder II, hypomanic episodes involve similar symptoms that are less intense.

The depressed phase of both types of bipolar disorder includes the following symptoms:

Daily low mood

Difficulty concentrating, remembering, or making decisions

Eating disturbances

Loss of appetite and weight loss

Overeating and weight gain

Fatigue or listlessness

Feelings of worthlessness, hopelessness and/or guilt

Loss of self-esteem

Persistent sadness

Persistent thoughts of death

Sleep disturbances

Excessive sleepiness

Inability to sleep

Suicidal thoughts

Withdrawal from activities that were once enjoyed

Withdrawal from friends

There is a high risk of suicide with bipolar disorder. While in either phase, patients may abuse alcohol or other substances, which can make the symptoms worse.

Sometimes there is an overlap between the two phases. Manic and depressive symptoms may occur together or quickly one after the other in what is called a mixed state.
Signs and tests

A diagnosis of bipolar disorder involves consideration of many factors. The health care provider may do some or all of the following:

Ask about your family medical history, particularly whether anyone has or had bipolar disorder

Ask about your recent mood swings and for how long you've experienced them

Observe your behavior and mood

Perform a thorough examination to identify or rule out physical causes for the symptoms

Request laboratory tests to check for thyroid problems or drug levels

Speak with your family members to discuss their observations about your behavior

Take a medical history, including any medical problems you have and any medications you take

Note: Use of recreational drugs may be responsible for some symptoms, though this does not rule out bipolar affective disorder. Drug abuse may itself be a symptom of bipolar disorder.
Treatment

Spells of depression or mania return in most patients, in spite of treatment. The major goals of treatment are to:

Avoid cycling from one phase to another

Avoid the need for a hospital stay

Help the patient function as best as possible between episodes

Prevent self-destructive behavior, including suicide

Reduce the severity and frequency of episodes

The doctor will first try to determine what may have triggered the mood episode, and identify any medical or emotional problems that might interfere with or complicate treatment.

Drugs called mood stabilizers are considered to be the first-line treatment. The following are commonly used mood stabilizers:

Carbamazepine

Lamotrigine

Lithium

Valproate (valproic acid)

Other antiseizure drugs may also be tried.

Other drugs used to treat bipolar disorder include:

Antipsychotic drugs and anti-anxiety drugs (benzodiazepines), which can be used to stabilize mood

Antidepressant medications can be added to mood-stabilizing drugs to treat depression. People with bipolar disorder are more likely to have manic or hypomanic episodes if they are put on antidepressants. Because of this, an antidepressant is only used in people who are also taking a mood stabilizer.

Electroconvulsive therapy (ECT) may be used to treat the manic or depressive phase of bipolar disorder that does not respond to medication.

ECT is a psychiatric treatment that uses an electrical current to cause a brief seizure of the central nervous system while the patient is under anesthesia.

ECT is the most effective treatment for depression that is not relieved with medications.

Transcranial magnetic stimulation (TMS) uses high frequency magnetic pulses that target affected areas of the brain. It is most often used as a second-line treatment after ECT.

Patients who are in the middle of manic or depressive episodes may need to stay in a hospital until their mood is stabilized and their behaviors are under control.

Doctors are still trying to decide the best way to treat bipolar disorder in children and adolescents. Parents should consider the potential risks and benefits of treatment for their children.

SUPPORT PROGRAMS AND THERAPIES

Family treatments that combine support and education about bipolar disorder (psychoeducation) appear to help families cope and reduce the odds of symptoms returning. Programs that emphasize outreach and community support services can help people who lack family and social support.

Important skills include:

Coping with symptoms that are present even while taking medications

Learning a healthy lifestyle, including getting enough sleep and staying away from recreational drugs

Learning to take medications correctly and how to manage side effects

Learning to watch for early signs of a relapse, and knowing how to react when they occur

Family members and caregivers are very important in the treatment of bipolar disorder. They can help patients seek out proper support services, and help make sure the patient follows medication therapy.

Getting enough sleep is extremely important in bipolar disorder, because a lack of sleep can trigger a manic episode. Psychotherapy may be a useful option during the depressive phase. Joining a support group may be particularly helpful for bipolar disorder patients and their loved ones.

A patient with bipolar disorder cannot always reliably tell the doctor about the state of the illness. Patients often have difficulty recognizing their own manic symptoms.

Mood variations in bipolar disorder are not predictable, so it is sometimes difficult to tell whether a patient is responding to treatment or naturally emerging from a bipolar phase.

Treatment strategies for children and the elderly have not been well-studied, and have not been clearly defined.

Expectations (prognosis)

Mood-stabilizing medication can help control the symptoms of bipolar disorder. However, patients often need help and support to take medicine properly and to ensure that any episodes of mania and depression are treated as early as possible.

Some people stop taking the medication as soon as they feel better or because they want to experience the productivity and creativity associated with mania. Although these early manic states may feel good, discontinuing medication may have very negative consequences.

Suicide is a very real risk during both mania and depression. Suicidal thoughts, ideas, and gestures in people with bipolar affective disorder require immediate emergency attention.
Complications

Stopping or improperly taking medication can cause your symptoms to come back, and lead to the following complications:

Alcohol and/or drug abuse as a strategy to "self-medicate"

Personal relationships, work, and finances suffer

Suicidal thoughts and behaviors

This illness is challenging to treat. Patients and their friends and family must be aware of the risks of neglecting to treat bipolar disorder.
Calling your health care provider

Call your health provider or an emergency number right way if:

You are having thoughts of death or suicide

You are experiencing severe symptoms of depression or mania

You have been diagnosed with bipolar disorder and your symptoms have returned or you are having any new symptoms

References

Moore DP, Jefferson JW. Bipolar disorder. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier;2004:chap 80.
Schiffer RB. Psychiatric disorders in medical practice. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 420.
Benazzi F. Bipolar disorder -- focus on bipolar II disorder and mixed depression. Lancet. 2007;369:935-945. [PubMed]
Morriss RK, Faizal MA, Jones AP, Williamson PR, Bolton C, McCarthy JP. Interventions for helping people recognise early signs of recurrence in bipolar disorder. Cochrane Database Syst Rev. 2007;24;(1):CD004854. [PubMed]
Sachs GS, Nierenberg AA, Calabrese JR, et al. Effectiveness of adjunctive antidepressant treatment for bipolar depression. N Engl J Med. 2007;356:1711-1722. [PubMed]

Wednesday, April 13, 2011

7 tips for moving past a rotten childhood

Author Tracy McMillan knows a thing or two about getting over a bad childhood. Her father was a drug-dealing pimp and convicted felon who spent most of his daughter's life behind bars. Her prostitute mother gave her away.

Here's what she wants you to know about getting over your past.

1. Get a new story

There are two ways for me to look at my childhood story. In one, I'm a person who is so unloved and unwanted, my own mother gave me away.

In the other, I was born, took a look around at my prostitute mother and criminal father, and said to myself, "I can totally do better than this. Get your stuff, we're leaving." In one I'm a victim, in the other, I'm in power.

2. Realize blame = same

Blame is awesome. It feels good, right? It feels righteous. It feels powerful. It feels like someone's going to pay for what they did to you.

The only problem is -- as long as you're blaming -- nothing can ever change. Why? Because in order for your life to change, you have to want things to be different.

And if it feels good to blame, you have to admit that you like it. And if you like it, you have to admit that you don't really want it to change. Which is why blame just gets you more of the same.

3. Pretend you work at a retail store

Sometimes, I look at my bad childhood like it's an unruly customer and I'm working customer service the day after Christmas. It'll be acting up, moaning and complaining about how hard everything is, and how unfair it all is.

I just have to say to it, "Yes, I see you, ma'am. I know you have a problem. But right now I'm busy, so please have a seat. I''ll be with you just as soon as I can."

Then I do something productive that will actually change my situation, like go to work.

4. Accept the fact that some don't really want you to succeed

This sounds harsh, and it is. But it's true.

Some of your family and friends "support" you by cosigning all your b.s. about how hard you have it, because if you succeed, two things will happen:
1) You will leave. And 2) They will be left behind.

This doesn't mean you have to get rid of your friends and family, you just have to remember that they love you so much, they're perfectly happy for you to stay exactly where you are right now.

5. Decide to KSA (Kick some ass)

When my 13-year-old said he hated science class, I told him that getting a 95 on the test was the equivalent of getting in the face of his least favorite teacher and saying, "Have some!"

In other words, kicking ass on the test is just like playing a video game. Needless to say, he's getting As now. Channeling your anger will get you a long, long way in life.

6. Hoard your money

The number one way to end your bad childhood is to save money. I have a very simple rule about money: If I never spend everything I make, I will always have money. And money is power.

All those commercials you see are a big, rich company's attempt to get you to give them your power. Don't do it! Think of every dollar you save as one step away from the people and places that have kept you down.

7. Get a paper route

In fifth grade, I wanted a 10-speed bike like all the other kids had. So I started delivering papers when I was 11. In Minnesota. In the winter.

Compared to that, every job I've had since has been easy. While there may not be papers to deliver in the snow, the point is to do the thing you don't want to do.

Get a hard/crappy job and do it until the voices in your head stop telling you that you can't take it another minute. Everything after that will be cake, and your bad childhood will be over. I promise.

Monday, April 11, 2011

Sexual side effects: A silent epidemic?

By, Ian Kerner

Are meds zapping your mojo? Is a prescription inhibiting your passion? If so, you’re far from alone. More than 27 million Americans take antidepressant drugs and research suggests that 37 percent of those people experience sexual side effects. And that’s just in the category of antidepressants! When you consider that millions of drugs are prescribed for common medical conditions, such as high blood pressure, and that many of those drugs can lead to sexual dysfunction of some sort, it’s no wonder that nearly 40 million Americans describe themselves as being stuck in sexless marriages. Many of us may be grappling with a sexual problem and not even realize that a drug or drug combination could be the underlying cause. In this sense, sexual side effects could be a silent epidemic.

But for many people going off their medications simply isn’t an option. In the case of antidepressants, most people who take them are actually happier than they were before they went on the drugs, and while they may be dealing with sexual side effects such as erectile disorder or loss of desire, they weren’t necessarily interested in sex before the medication either. “After addressing your depression, anxiety, or other mental health concern, you're interested in sex again—enough to worry about how the medication is affecting your sex life,” explains my Good in Bed colleague, psychiatrist Dr. Ed Ratush. “You may be bothered by what you think is a lower sex drive, but consider how you felt before. In a way, your libido has actually increased!”

Sexual side effects don’t have to destroy your sex life, but they may mean that you have to change your approach to sex. In the case of low desire (a very common sexual side effect), you may have to put your body through the motions in order to get your mind to follow. Or you may have to spend a lot more time on foreplay and getting yourself physiologically aroused. Ratush suggests trying a sexual warm-up, a technique that helps generate arousal but intentionally does not lead to climax or ejaculation. “The idea is that the process of getting aroused will increase the person's ability to generate more of the sex hormone testosterone later in the day or later in the week,” he says.

And remember that mental stimulation plays a big role in sexual arousal, so you may have to try some new things and develop some new routines.

What are some other things you can do?

  • Talk to your doctor. Sounds simple enough, but many people are uncomfortable talking about sex with their doctors and, believe it or not, many doctors are uncomfortable as well. Not all doctors are adequately trained in human sexuality, and many don’t take the time to discuss all of a patient’s needs. It can be challenging to start a conversation about sex, but it’s worth it: Your doctor may be able to switch you to a similar medication with fewer side effects. Some people find that switching from Celexa to Lexapro, for example, helps treat their depression without affecting their sex life.
  • Reduce your dose. It’s possible that you can still achieve benefits of medication, but at a lower dose that may not induce sexual side effects.
  • Have sex at a different time. Sexual dysfunction may be significantly higher two hours after a dose of medication and may be less problematic two hours before the next scheduled dose, so time your rendezvous accordingly. Or have morning sex: Testosterone levels are generally highest in the morning and decline throughout the day.
  • Add a sexual enhancer. Some medications can improve excitement by increasing either desire or blood flow. In the case of erectile disorder, for example, a physician may prescribe a medication such as Viagra, or in the case of low desire he or she may recommend a drug like Wellbutrin. It may sound a little strange to deal with the sexual side effects of one drug by adding another, but under the supervision of a physician who is familiar with your medical history, drugs can be combined in creative ways.
  • Focus on diet and exercise. Your lifestyle and overall fitness plays a big role in your sexual health. For example, many people end up gaining weight once they go on an SSRI antidepressant, which also contributes to low libido and erectile disorder.

Dealing with sexual side effects can be tricky and frustrating, but the point is to not just give up. Go on the web and do some research. Be proactive in communicating with your doctor and your partner. Try new things in the bedroom. When you have to say “yes” to drugs, don’t say “no” to sex.

Tuesday, April 5, 2011

Too Old To Hold

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