Gender Identity Dysphoria

GID has made some news recently in the highly publicised account of Bradely/Chelsea Manning
http://abcnews.go.com/US/wireStory/convicted-wikileaks-soldier-prison-20109354
Such distress about identity, especially the sensitive field of sexuality and gender is acute and pervasive.
It was interesting to note that inter-sex disorder, children born with ambiguous genitals were a rare case of gender identity dysphoria. These issues are more easily dealt with with chromosomal analysis.
Many people feel they are in the wrong body  from early childhood but most delay seeking help until early adulthood. It can then be a complex issue to deal with reassignment from a psychological point of view. Depression, anxiety are often part of the process. Relationships and family ties, work place issues and friends all have to be coped with.
Help is available however by going to see your local doctor.

PMS

One of the most interesting things about pre-menstrual syndrome is that it is a depression (Mood disorder). The best results available are with antidepressant medications. I realise that it is hormonal and therefore logically should respond to hormone treatment. Unfortunately many women are sensitive to the oral contraceptive, implant or patches and their mood disorder becomes worse.
PMS can be very severe, not just for the sufferer but their family and friends as well. There is ample evidence that it affects cognitive functioning and the likelihood of breaking the law or precipitating significant social effects is high.
There is little data as to whether it increases the chances of a major depressive disorder. There is anecdotal evidence that it settles somewhat after having a child. but I do not see pregnancy as a 'cure'. It has been noted in Bipolar Disorder as well as unipolar depression. Anxiety symptoms have not been recorded as related to menstrual cycle although this seems unusual.
Antidepressants are the best treatment. Pulse therapy, an increased dose two weeks before a period and reduced dose on the first day of menses, has the best outcomes if mood still varies with the monthly cycle.
It is all related to the hypothalamic/pituitary/immune axis of brain function.
So there is help available. You don;t have to suffer in silence.

Controlled drinking

Recent reports have promoted controlled drinking as a more appealing prospect than total abstinence.
Alcoholism is a terrible disorder that not only robs the sufferer but their family as well. Families often leave as they cannot cope. Patients often lose their health and job. They get depression, anxiety and brain disease from alcohol abuse. The current government guidelines is for controlled drinking, that is one standard drink per 24 hours. Any more than that is an alcohol related problem drinking.
One of the major problems facing a person who is addicted to alcohol is total abstinence. it seems harsh and the pull of the alcohol makes it seem doomed to failure. Most people addicted to alcohol can tell you however that one drink is all it takes to fall into old habits again. One drink and the alcohol starts overtaking sensible thinking about the effects of too much alcohol. One drink, controlled drinking, rarely works for this reason and is actually harder to do than total abstinence.
Controlled drinking seems easier. You can continue to drink with your friends and go to all the same places. Total abstinence usually means  new places to go out to and new friends who don't drink.  It is however a continual pull towards drinking if you still go to the same places and drink with the same people where alcohol is freely available.
It is also easier to continue fooling yourself about how much you have been drinking if you do not change your environment. There will always be someone who will say, come on one more cant harm or you have been so good, you deserve a drink for that.
Therefore I suggest total abstinence is a safer and easier way to attempt to control alcohol abuse than controlled drinking. Ultimately you have to choose for yourself which way you want to take control Either way is better than not choosing at all.

Pharmacy costs

Firstly I would like to thank all my readers. Please take the time to comment or add to the discussion.
Australia is the only country in the world with its PBS, Pharmaceutical Benefits Scheme. The government buys bulk order medicines directly from the companies and then on sells then to the public at controlled prices. Mostly that means a reduced price by the government and reduced due to the benefits of bargaining for bulk orders. In other countries when you enter the pharmacy the pharmacist is a middle man between you and the pharmaceutical company. Most pharmaceutical companies are multinationals and drive profit margins high for their investors. They also have high research and development costs and huge insurance costs. As most of them have offices in the United states of America they have large litigation bills to cover. All these things drives up the cost of medicines. Protection from the government, especially with pensioner and health care plans  means that people can afford medicines.
Once the pharmaceutical company loses its rights over a medicine it has developed, about five years, anyone can copy the drug. hence the pharmaceutical company needs to drive up the costs in the first five years as it loses most of its market share after this. It is good for society as it forces the pharmaceutical companies to continually research and find new drugs and treatments. It is not so good that the whole research industry is driven by profit making companies. This skews research towards profitable. There is little money left for independent research.
This is different in the Translational centre in Brisbane, led by Professor Ian Frazer, where research is the key focus but to make it profitable and keep it in Australia, the research feeds directly to the manufacture part of the complex. This ethical approach is not the normal for most pharmaceuticals.
Of course the government want to pay less for the medicines and so pass the savings onto the consumers and the general public. Its approach is that cheaper manufacturers who essentially steal the research and development from the pharmaceutical companies can make the drugs at cheaper price. It would seem logical that the generic and the original are the same. They are not always in fact but very little research is available to test the hypothesis as no-one would pay for this research.
The government is now wanting to cut the rebate cost to pharmacists. Of course we all want to pay less. We all want quality. We all want quality services. The pharmacist is a professional who needs adequate compensation or income but the government is controlling it. Already pharmacists have to supplement their income and business viability by selling other items like cosmetics and perfumes, after hours service and discount competition. We need our pharmacies. Lets not squeeze them out of existence. Lets protect this industry which is the envy of the world. 

Mental Health Politics

Now is the time to ask the prospective new Prime Ministers of Australia and their parties, what do they plan for mental health services for Australians. How much funding will go to children and adolescents given the bed closures and mass sackings in the public sector. What programs are they going to support? How will they integrate public and private health care? What funds are going to be made available for research in Australia in the field of mental health?
What are the plans for State/ Federal cooperation and organisation? How has Australian registration worked given State mental health laws and State control of services? What about Medicare levies and PBS costs?
I hope that the real questions will be put to these would-be leaders and real answers will be given rather than character assassinations and point scoring. We have , as the public, a huge advantage at this point in time and it will only last a month, to promote our citizen rights, ask the difficult questions, force the public debate and then choose the right candidate. May the best person win because our mental health care needs are huge.

Communication Disorder

This problem is much missed and misunderstood. It is the central tenet of Autism and Asperger's syndrome. Much over diagnosing of these conditions misdiagnoses Communication Disorder without autistic features but many of these diagnoses are false because there is no communication disorder. Sadly many children/adults do not have proper speech therapy and social skills training because people do not understand the Communication problems.
There are four basic components to Communication disorder-
1. Receptive. This means that the person can hear but does not understand spoken and non-verbal language. They are often described as selectively deaf.
2. Expressive. Difficulties saying or the non-verbal component of language causes frustration. This disorder is often seen as aggressive behaviour when the frustration becomes overwhelming
3 Pragmatic. The nuances of communication with grammar, full stops, emphases, rules of turn taking and flow of language are affected. At the severe end of the scale speech is robotic with little eye regard and lack of associated movements.
4 Narrative. This is the lack of understanding context and the whole aspect of communication. It means not understanding that people cannot read your mind and you have to introduce a topic, build a story and have an ending.
Most sufferers have problems in all four areas.
One can see why these problems cause learning difficulties. They also cause social skills problems.
The diagnosis and treatment is for the speech pathologist but many children see the child psychiatrist due to associated learning and behaviour problems or concern about the autistic spectrum of illness.
There is an overwhelming number of boys rather than girls who have this disorder so probably genetic rather than birth trauma (or lack of oxygen) that these 'soft brain' signs used to be the problem. There is an increased risk however in those babies who suffer lack of oxygen, breathing difficulties which means the premature baby. These babies have difficulty sucking, the same nerves that are needed for speech.
There is an acquired form related to chronic middle ear infections and glue ear. It is thought that the loss of effective hearing in the early developmental stages of communication can mean that that part of the brain lacks stimulation to develop normally.
Help is important. These children are picked on by other kids who recognise their problems as 'nerdy'and self esteem becomes a major problem. They are often in trouble for fighting back and do not cope with school work as well as they could.

Attachment in infants

The mother and baby form an attachment during pregnancy. The mother feels the baby's movements and has dreams about the birth and holding the baby once it is born. The mother usually prepares clothes and baby gear for the baby due to this attachment. The baby hears the mother's heartbeat and voice and cues into the mother's emotional state.
This does not always happen and sometimes the attachment occurs some time after the baby is born.
The visual and tactile clues, holding and seeing the baby, make it much easier to fall in love with the baby. It is akin to a distance romance- wonderful but not as good as actually seeing someone and cuddling in reality.
In this attachment the language is emotion. The baby is keenly sensitive to emotion. It is of course a highly emotional state, the birth of a baby. There is anxiety about the job and responsibility and sadness at the loss of pregnancy, a relief for some people. There is loss of independence, loss of sleep, loss of body shape and loss of friends who do not have babies. There is often loss of work and social respect for your professional life is much more than for the role of a mother. After all the fuss and family and friends go home, it is boring and lonely to have no adult company to talk to. All these emotions, the child perceives.
The child is dependent upon the mother for everything, including emotional support. It needs the mother for safety and protection and the message that she is in charge and looking after the needs of both of them. A depressed mother finds that hard to do. The child needs to know that life is fun and people can play games with him. He needs to know that he does not need to be the centre of all attention but needs his fair share as well.
The baby needs attachment with the father but security that the parent's relationship is sturdy enough that the baby cannot take over and disrupt it. This is often the most fragile thing in a family who has to adjust to a new baby.
Through this attachment the baby learns trust, love, self esteem and the will to explore the world. Education starts here. social skills and future relationships are created in this early stage. Positive and real emotions, problem solving and creative thinking are all automatically shaped in this relationship with parents that we call attachment. The process is created in the parent's own attachment and the sense of 'rootedness' or belonging that supports the baby.
I invite comments to all my blogs. I am interested to hear your thoughts and experiences.