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Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Overview
Key Takeaways
- The DSM-5 is a handbook used by clinicians to diagnose mental disorders.
- The DSM-5 eliminated the multiaxial system and introduced new and revised disorders.
- The DSM-5-TR updated criteria for some disorders and revised language for clarity and inclusivity.
What Is the DSM-5?
The Diagnostic and Statistical Manual of Mental Disorders (now in its fifth edition text revision, known as DSM-5-TR ) is the handbook clinicians and psychiatrists use to diagnose psychiatric disorders. Published by the American Psychiatric Association (APA), the DSM-5 covers all categories of mental health disorders for both adults and children.
It contains descriptions, symptoms, and other criteria for diagnosing mental health disorders. It also contains statistics such as a condition’s typical age of onset, the development and course of the disorder, risks and prognostic factors, and other related diagnostic issues.
Some government agencies and many insurance carriers require a specific diagnosis to approve payment for support or treatment of mental health conditions. Mental health professionals use the DSM-5 to classify patients for billing purposes.
This article discusses the history of the DSM-5 and how the most recent edition compares to past editions.
DSM-5 History
The Diagnostic and Statistical Manual was first published in 1952. Since then, there have been several updates issued. In the DSM-I, there were 102 categories of diagnoses, increasing to 182 in the DSM-II, 265 in the DSM-III, and 297 in the DSM-IV.
A major issue with the DSM has been validity. In response to this, the National Institute of Mental Health (NIMH) launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system they feel will be more biologically based.
In 2013, then-NIMH director Thomas Insel and APA president-elect Jeffrey Lieberman issued a joint statement saying that the DSM-5 represents “the best information currently available for clinical diagnosis of mental disorders.” They went on to say that both the DSM-5 and RDoC represent “complementary, not competing, frameworks” for the classification and treatment of mental disorders.
The National Institute on Mental Health also notes that the RDoC is not meant to be a diagnostic tool and should not be used to replace other diagnostic systems (such as the DSM). Instead, its goal is to serve as a framework for research on mental disorders in order to better understand mental health.
Recap
The DSM has gone through many changes since it was first published in the early 1950s.
The Multiaxial System
The DSM-III introduced a multiaxial or multidimensional approach for diagnosing mental disorders.
The multiaxial approach was intended to help clinicians and psychiatrists make comprehensive evaluations of a client’s level of functioning because mental illnesses often impact many different life areas.
It described disorders using five DSM “axes” or dimensions to ensure that all factors—psychological, biological, and environmental—were considered when making a mental health diagnosis.
Axis I – Clinical Syndromes
Axis I consisted of mental health and substance use disorders that cause significant impairment. Disorders were grouped into different categories such as mood disorders, anxiety disorders, and eating disorders.
Axis II – Personality Disorders and Mental Retardation
Axis II was reserved for what we now call intellectual development disorders (intellectual disability) and personality disorders, such as antisocial personality disorder and histrionic personality disorder. Personality disorders cause significant problems in how a person relates to the world, while intellectual development disorders are characterized by intellectual impairment and deficits in other areas such as self-care and interpersonal skills.
Axis III – General Medical Conditions
Axis III was used for medical conditions that influence or worsen Axis I and Axis II disorders. Some examples include HIV/AIDS and brain injuries.
Axis IV – Psychosocial and Environmental Problems
Any social or environmental problems that may impact Axis I or Axis II disorders were accounted for in this axis. These include such things as unemployment, relocation, divorce, or the death of a loved one.
Axis V – Global Assessment of Functioning
Axis V is where the clinician gives their impression of the client’s overall level of functioning. Based on this assessment, clinicians could better understand how the other four axes interacted and the effect on the individual’s life.
Recap
Up to and including the DSM-IV-TR, the multiaxial system was used to help clinicians fully evaluate the biological, environmental, and psychological factors that can play a role in a mental health condition.
Changes in the DSM-5
DSM-V includes significant changes from tDSM-IV and DSM-IV-TR. The most obvious change is the shift from using Roman numerals to Arabic numbers in the name (i.e., DSM-5, not DSM-V).
Perhaps most notably, the DSM-5 eliminated the multiaxial system. Instead, the DSM-5 lists categories of disorders along with related disorders. Example categories in the DSM-5 include anxiety disorders, bipolar and related disorders, depressive disorders, feeding and eating disorders, obsessive-compulsive and related disorders, and personality disorders.
A few other changes that came with the DSM-5 included:
While the DSM-5 is an important tool, only those who have received specialized training and possess sufficient experience are qualified to diagnose and treat mental illnesses.
Recap
While the DSM-5 is still used, a number of significant changes were made in the DSM-5 compared to previous editions. The DSM-5 eliminated the multiaxial system. Some disorders were eliminated or changed, while several new conditions were added.
Changes in the DSM-5-TR
DSM-5-TR contains revised criteria for more than 70 disorders, including prolonged grief disorder.
There are new codes added to the DSM-5-TR that allow clinicians to document suicidal behavior and nonsuicidal self-injury in patients without any other psychiatric diagnosis.
The DSM-5-TR uses more specific language to avoid reader confusion. For example:
- Criterion A in autism spectrum disorder was changed from “as manifested by the following” to “as manifested by all of the following” to indicate that all symptoms must be present for this diagnosis.
- “Social phobia,” which appeared next to social anxiety disorder, was removed.
- “Intellectual disability” was revised to “intellectual development disorder.”
- Terms surrounding gender dysphoria were changed significantly.
Used in DSM-5-TR
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Experienced gender
-
Gender affirming medical procedure
-
Individual assigned male at birth
-
Individual assigned female at birth
The DSM-5-TR also addressed racial and cultural biases. These revisions include:
- “Race” was replaced with “racialized” to emphasize that race is a social construct.
- “Ethnoracial” now refers to categories such as Hispanic, White, and African American.
- “Minority” and “non-White” are not used.
- “Caucasian” is not used because it is based on erroneous views about the geographic origin of people who are Caucasian.
- Latinx is used instead of Latino/Latina for gender inclusivity.
The DSM-5-TR also notes how symptoms of certain conditions manifest differently in people from varying demographic groups.
Recap
The DSM-5-TR revised criteria for 70 disorders as well as added a new diagnosis, prolonged grief disorder. This new edition of the DSM also revised language surrounding gender dysphoria and race.
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The Sensory Experience of the World
Key Takeaways
- Perception is how we use our five senses to understand the world around us.
- Paying attention to the world around you can improve your perception.
Perception refers to our sensory experience of the world. It is the process of using our senses to become aware of objects, relationships, and events. It is through this experience that we gain information about the environment around us.
Perception relies on the cognitive functions we use to process information, such as utilizing memory to recognize the face of a friend or detect a familiar scent. Through the perception process, we are able to both identify and respond to environmental stimuli.
Perception includes the five senses: touch, sight, sound, smell, and taste. It also includes what is known as proprioception, which is a set of senses that enable us to detect changes in body position and movement.
Many stimuli surround us at any given moment. Perception acts as a filter that allows us to exist within and interpret the world without becoming overwhelmed by this abundance of stimuli.
Types of Perception
The different senses often separate the types of perception. These include visual, scent, touch, sound, and taste perception. We perceive our environment using each of these, often simultaneously.
There are also different types of perception in psychology, including:
- Person perception refers to the ability to identify and use social cues about people and relationships.
- Social perception is how we perceive certain societies and can be affected by things such as stereotypes and generalizations.
Another type of perception is selective perception. This involves paying attention to some parts of our environment while ignoring others.
The different types of perception allow us to experience our environment and interact with it in ways that are both appropriate and meaningful.
How Perception Works
Through perception, we become more aware of (and can respond to) our environment. We use perception in communication to identify how our loved ones may feel. We use perception in behavior to decide what we think about individuals and groups.
We perceive things continuously, even though we don’t typically spend a great deal of time thinking about them. For example, the light that falls on our eye’s retinas transforms into a visual image unconsciously and automatically. Subtle changes in pressure against our skin, allowing us to feel objects, also occur without a single thought.
Perception Process
To better understand how we become aware of and respond to stimuli in the world around us, it can be helpful to look at the perception process. This varies somewhat for every sense.
In regard to our sense of sight, the perception process looks like this:
- Environmental stimulus: The world is full of stimuli that can attract attention. Environmental stimulus is everything in our surroundings that has the potential to be perceived.
- Attended stimulus: The attended stimulus is the specific object in the environment on which our attention is focused.
- Image on the retina: This part of the perception process involves light passing through the cornea and pupil onto the lens of the eye. The cornea helps focus the light as it enters, and the iris controls the size of the pupils to determine how much light to let in. The cornea and lens act together to project an inverted image onto the retina.
- Transduction: The image on the retina is then transformed into electrical signals through a process known as transduction. This allows the visual messages to be transmitted to the brain to be interpreted.
- Neural processing: After transduction, the electrical signals undergo neural processing. The path followed by a particular signal depends on what type of signal it is (for example, an auditory signal or a visual signal).
- Perception: In this step of the perception process, you perceive the stimulus object in the environment. It is at this point that you become consciously aware of the stimulus.
- Recognition: Perception doesn’t just involve becoming consciously aware of the stimuli. It is also necessary for the brain to categorize and interpret what you are sensing. This next step, known as recognition, is the ability to interpret and give meaning to the object.
- Action: The action phase of the perception process involves some type of motor activity that occurs in response to the perceived stimulus. This might involve a significant action, like running toward a person in distress. It can also include doing something as subtle as blinking your eyes in response to a puff of dust blowing through the air.
Think of all the things you perceive on a daily basis. At any given moment, you might see familiar objects, feel a person’s touch against your skin, smell the aroma of a home-cooked meal, or hear the sound of music playing in your neighbor’s apartment. All of these help make up your conscious experience and allow you to interact with the people and objects around you.
Recap of the Perception Process
- Environmental stimulus
- Attended stimulus
- Image on the retina
- Transduction
- Neural processing
- Perception
- Recognition
- Action
Factors Influencing Perception
What makes perception somewhat complex is that we don’t all perceive things the same way. One person may perceive a dog jumping on them as a threat, while another person may perceive this action as the pup just being excited to see them.
Our perceptions of people and things are shaped by our prior experiences, our interests, and how carefully we process information. This can cause one person to perceive the exact same person or situation differently than someone else.
Perception can also be affected by our personality. For instance, research has found that four of the Big 5 personality traits—openness, conscientiousness, extraversion, and neuroticism—can impact our perception of organizational justice.
Conversely, our perceptions can also affect our personality. If you perceive that your boss is treating you unfairly, for example, you may show traits related to anger or frustration. If you perceive your spouse to be loving and caring, you may show similar traits in return.
Are Perception and Attitude the Same?
While they are similar, perception and attitude are two different things. Perception is how we interpret the world around us, while our attitudes (our emotions, beliefs, and behaviors) can impact these perceptions.
Tips to Improve Perception
If you want to improve your perception skills, there are some things that you can do. Actions you can take that may help you perceive more in the world around you—or at least focus on the things that are important—include:
- Pay attention. Actively notice the world around you, using all your senses. What do you see, hear, taste, smell, or touch? Using your sense of proprioception, notice the movements of your arms and legs or your changes in body position.
- Make meaning of what you perceive. The recognition stage of the perception process is essential since it allows you to make sense of the world around you. You place objects in meaningful categories so you can understand and react appropriately.
- Take action. The final step of the perception process involves taking some sort of action in response to your environmental stimulus. This could involve a variety of actions, such as stopping to smell the flower you see on the side of the road and incorporating more of your senses into your experiences.
Potential Pitfalls of Perception
The perception process does not always go smoothly, and there are a number of things that may interfere with our ability to interpret and respond to our environment. One is having a disorder that impacts perception.
Perceptual disorders are cognitive conditions marked by an impaired ability to perceive objects or concepts. Some disorders that may affect perception include:
- Spatial neglect syndromes, which involve not attending to stimuli on one side of the body
- Prosopagnosia, also called face blindness, is a disorder that makes it difficult to recognize faces
- Aphantasia, a condition characterized by an inability to visualize things in your mind
- Schizophrenia, a mental health condition that is marked by abnormal perceptions of reality
Some of these conditions may be influenced by genetics, while others result from stroke or brain injury.
Certain factors can also negatively affect perception. For instance, one study found that when people viewed images of others, they perceived individuals with nasal deformities as having less satisfactory personality traits. So, factors such as this can potentially affect personality perception in others.
History of Perception
Interest in perception dates back to ancient Greek philosophers who were interested in how people know the world and gain understanding. As psychology emerged as a science separate from philosophy, researchers became interested in understanding how different aspects of perception worked—particularly the perception of color.
In addition to understanding basic physiological processes, psychologists were also interested in understanding how the mind interprets and organizes these perceptions.
Gestalt psychologists proposed a holistic approach, suggesting that the whole is greater than the sum of its parts. Cognitive psychologists have also worked to understand how motivations and expectations can influence the process of perception.
As time progresses, researchers continue to investigate perception on the neural level. They also look at how injury, conditions, and substances might affect perception.
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Sarah Elizabeth’s guide to solo dating & self love
Let’s go on a solo date x #selflove #selfimprovement #sarahelizabeth.
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What Is Intimacy in a Relationship?
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Key Takeaways
- Emotional intimacy means sharing your deepest feelings with someone you trust.
- You can build physical intimacy by cuddling or holding hands, not just through sex.
- Putting down electronics can help you better connect with your partner.
Intimacy is a feeling of closeness and connection in an interpersonal relationship. It is an essential part of intimate relationships, but it also plays an important role in other relationships with friends, family members, and other acquaintances.
The word intimacy is derived from the Latin word “intimus,” which means ‘inner’ or ‘innermost.’ In most romance languages, the word for intimate refers to a person’s innermost qualities. Intimacy allows people to bond with each other on many levels. Therefore, it is a necessary component of healthy relationships.
This article covers the different types of intimacy and how you can create more of it in your relationship.
Types of Intimacy in Relationships
Upon hearing the word, you probably immediately jumped to thinking about physical intimacy, but other forms of intimacy are just as important, especially when it comes to romantic relationships. Let’s take a look at some different forms of intimacy.
Physical Intimacy
While a hug or holding a hand are both examples of physical intimacy, this type is most commonly used in reference to sex. And while sex is important in relationships, you can also demonstrate physical intimacy through kissing, holding hands, cuddling, and skin-to-skin touching.
While these small physical shows of affection may seem mundane, they can help you and your partner cultivate a feeling of closeness.
Emotional Intimacy
Emotional intimacy can be one of the most critical factors of a relationship. It is characterized by being able to share your deepest, most personal feelings with another person. When people experience this type of intimacy, they feel safe and secure enough to share and know that they will be understood, affirmed, and cared for.
Examples of emotional intimacy include having conversations about what you both want in the future, talking about things that you are worried about, and discussing a stressful event at work and being comforted.
“Emotional intimacy is based on trust,” explains Hannah Owens, LMSW. “If you can trust your partner to be attentive to your needs and react to what you are saying in a way that supports you and the relationship, it’s easy to establish emotional intimacy.”
Intellectual Intimacy
This type of intimacy involves being able to share ideas, opinions, questions, and other thoughts with another person. You might not agree on everything, but you enjoy challenging each other and are able to consider the other person’s perspective.
Talking about a book you have read and comparing your reactions is an example of intellectual intimacy in a relationship.
Experiential Intimacy
While couples don’t have to be joined at the hip, shared experiences are important in healthy relationships. They’re also often the way that relationships begin, so experiences can even add an element of nostalgia for long-term partners. Spending time together, pursuing activities together, and participating in hobbies together are just a few ways that people can deepen this type of intimacy.
“It’s hard to maintain a relationship if you feel you have nothing in common,” says Owens. “Having shared experiences, even just one or two, can lay the groundwork for a relationship that will last.”
Spiritual Intimacy
While this can be referring to religious ideas and beliefs, it can also mean something more profound, like sharing actual beliefs and values. Your values and beliefs can align with religion or even health and wellness. Regardless, it’s important to share these critical aspects of your life with your partner.
Examples of spiritual intimacy include participating in religious practices, discussing spiritual topics, or spending time together while marveling at a moving sight.
Recap
Physical intimacy is just one type of intimacy in a relationship. Other types include emotional, intellectual, experiential, and spiritual intimacy.
Obstacles to Intimacy
Every relationship has its ups and downs, but sometimes certain obstacles can make intimacy difficult. Or a previously strong sense of intimacy might gradually fade without proper nourishment.
Some problems that can impair intimacy include:
- Conflict: It can be challenging to feel intimacy when you are always arguing with the other person. Feelings of resentment, anger, and lack of trust can make it more challenging to feel connected and close to that person.
- Stress: Life stress caused by work, illness, finances, children, and other issues can also chip away at a couple’s intimacy.
- Communication problems: It’s hard to feel close when you struggle to articulate your feelings and needs. Talking to your partner and listening to what they have to say is essential for building and maintaining intimacy.
- Fear of intimacy: Sometimes, people experience a fear of intimacy, often caused by past experiences or traumas, that make it difficult to form meaningful connections with other people.
“It’s a common theme in couples counseling that making space and time for physical intimacy greatly strengthens and extends long-term romantic relationships,” explains Owens. “These obstacles can get in the way of that. But if you’re able to establish a strong intimate connection despite these challenges, your chance of success in your relationship grows exponentially.”
Impact of Intimacy
Intimacy is essential in a relationship because it forms a basis for connection and communication. It ensures that each person feels understood, allows them to be themselves, and ensures that each person gets the care and comfort that they need. Other significant effects include:
- Increased sexual desire: Research has found that in long-term romantic relationships, couples that experience more emotional intimacy also experience higher levels of sexual desire and sexual activity.
- Greater relationship satisfaction: Couples with greater intimacy tend to be more satisfied with their relationships.
- Better physical health: People in intimate relationships tend to have better physical well-being. One study found that being in a happy relationship influenced health to the same magnitude as diet and exercise and lowered the risk of chronic illness and death.
- Improve mental health: Having close, intimate relationships is also pivotal for mental health. These connections provide social support that is imperative for well-being. It can also combat feelings of loneliness and help people better manage the stress they experience in life.
Recap
Intimacy has beneficial effects on many areas of life, including health, relationship satisfaction, sexual desire, and mental well-being.
How to Build Intimacy in Relationships
No matter how long you have been together, it’s always important to build your intimacy levels. Here are some easy, practical ways to strengthen your levels of intimacy in your relationship:
Improve Physical Intimacy
When it comes to sex, a part of intimacy is feeling safe enough with your partner to share your likes and dislikes. Make sure that you are asking for the same information from your partner. This way, you can facilitate a safe environment where you both feel comfortable sharing your deepest thoughts and desires.
Remember that increasing your physical intimacy isn’t always about having more sex. If you’re too tired for sex or talking, try cuddling on the couch.
Increase Emotional Intimacy
To cultivate emotional intimacy, take time to listen to and share with your partner each day. Also, make notes of special moments or things that remind you of your partner so that you can let them know you’re thinking about them.
Studies have shown that self-disclosure can build feelings of intimacy in marriages, which will make your bond stronger. A big part of intimacy is sharing your thoughts and feelings honestly and listening to your partner when they do the same.
Put down the electronics, even if it’s just during a meal or while you and your spouse watch a show together. Indeed, make sure to do this if your partner is talking to you about their day or an experience.
Deep Experiential Intimacy
If you’re looking to deepen your experiential intimacy, this is an excellent time to book a trip or try out a fun new date spot or activity in your city. Attempt to learn something new about your partner.
Plan a trip to a place neither of you has been. It’s fun to experience new things for the first time. It will also give you a sense of shared history and experience. Even something as simple as a weekly date night can be a great way to foster increased experiential intimacy in your relationship.
Boost Intellectual Intimacy
Send each other articles so that you have something fun and new to talk about. This also helps build on intellectual intimacy, and it can give you a much-needed mental break if you have kids or are a caregiver to another loved one.
Strengthen Spiritual Intimacy
This can also be a chance for you and your partner to talk about what role you want spirituality to play in your lives if you have a family. Discuss your values and beliefs and the role that you think these will play in your life, relationship, and family.
Remember that spiritual intimacy doesn’t necessarily involve religion. It often comes down to your shared values and ability to bond over experiences you find awe-inspiring, whether that involves a religious practice, meditation, or love of nature.
Keep in Mind
Whether you’ve just started dating someone or you’ve been together for years, intimacy plays a vital role in your relationships. Know that it can take time if your relationship is still new, but it’s worth the work that it takes to go through new experiences together.
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Uses, Side Effects, Dosages, Precautions
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Key Takeaways
- Wellbutrin is used to treat major depressive disorder and seasonal affective disorder.
- Common side effects of Wellbutrin include headaches, dry mouth, nausea, dizziness, insomnia, and constipation.
- Call your doctor if you experience adverse effects like difficulty breathing or swelling.
What is the most important information I should know about Wellbutrin (bupropion)?
You should not take Wellbutrin (bupropion) if:
- You have an eating disorder, seizure disorder, angle-closure glaucoma, or you are allergic to bupropion.
- You are taking a substance that interacts with bupropion such as an antipsychotic, blood thinner, corticosteroid, MAOI, or another antidepressant.
What Is Wellbutrin?
Wellbutrin (bupropion) is an antidepressant used to help treat a number of health conditions. It comes as an immediate-release, sustained-release, or extended-release tablet that is taken orally.
One factor that makes Wellbutrin especially unique among antidepressants is that it doesn’t tend to affect sexual function or reduce libido, and may even increase it. In fact, Wellbutrin is often prescribed along with other antidepressants to help counter their sexual side effects, like loss of desire.
Learn more about what Wellbutrin is and how it is used. We also share what you should know before you take this medication, including the potential side effects of Wellbutrin and drug interactions.
Wellbutrin Uses
Wellbutrin is approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD) and seasonal affective disorder (SAD). It is also used off-label to help with symptoms of various other conditions.
Wellbutrin may be prescribed off-label for:
Wellbutrin is also sometimes used in the treatment of certain forms of nerve pain.
Another brand of bupropion (the active ingredient in Wellbutrin), called Zyban, is used to help people quit smoking. Research shows that taking bupropion can double a person’s chances of kicking their cigarette habit.
The FDA has also approved a medication called Contrave, which is a combination of bupropion and naltrexone, for weight loss. It is intended to be used alongside diet and exercise. It is only approved for people with a BMI of 30 or higher, or for people with a BMI over 27 who also have a weight-related condition such as high cholesterol, type 2 diabetes, or high blood pressure.
Side Effects of Wellbutrin
Some Wellbutrin side effects are merely bothersome and likely to disappear as your body gets used to the medication. Others are more serious and should prompt a call to your healthcare provider right away. If you have been prescribed Wellbutrin, here are some side effects to watch for.
Common Side Effects
During the first week or two of taking Wellbutrin, you may experience headaches, dry mouth, nausea, dizziness, insomnia, constipation, sore throat, and a fast heartbeat. Other common side effects for Wellbutrin, Wellbutrin SR, and Wellbutrin XL can include:
- Abdominal pain
- Anxiety
- Appetite loss
- Changes in the way food tastes
- Drowsiness
- Flushing
- Gas
- Hair loss
- Increased sweating
- Joint aches
- Nervousness
- Restlessness
- Ringing in your ears
- Tremors
- Urinating more than usual
- Vomiting
- Weakness
- Weight loss
Severe Side Effects
Some Wellbutrin side effects can be severe or even potentially life-threatening. Get medical help right away if you experience any of the following while taking any version of Wellbutrin:
- Allergic reaction (symptoms can include a skin rash; hives, itching; difficulty breathing; a feeling of tightness in your chest; swelling of your mouth, face, or tongue; and/or unusual hoarseness)
- Aggressiveness
- Agitation
- Changes in your menstrual cycle
- Changes in sexual desire or function
- Changes in vision
- Chest pain
- Confusion
- Dark urine
- Delusions or hallucinations
- Difficulty breathing
- Exaggerated feelings of well-being
- Fainting
- Fever, chills, or a sore throat
- Hearing problems
- Hostility
- Impulsiveness
- Inability to sit still
- Pale-colored stools
- Panic attacks
- Rapid or irregular heartbeat
- Seizures
- Severe headache
- Severe or lingering joint or muscle pain
- Severe or lingering nausea, vomiting, or stomach pain
- Severe or lingering nervousness, restlessness, or insomnia
- Swollen, blistered, or peeling skin
- Trouble concentrating
- Unusual swelling
- Worsening depression and/or suicidal thoughts
- Yellow skin or eyes
How Long Do Wellbutrin Side Effects Last?
If Wellbutrin side effects do occur, they will usually go away within a week or two of starting the medication, as your body begins to adjust. If your side effects last longer, are severe, or worsen, contact your healthcare provider right away. Your dosage may need to be changed or the medication switched to ease these effects.
Before Taking Wellbutrin
Wellbutrin is often used as a first-line antidepressant in the treatment of MDD and SAD. Your healthcare provider will evaluate your symptoms and current health status to determine if it is right for you.
You may not be prescribed Wellbutrin if you have certain health conditions.
- You should not take Wellbutrin if you have an eating disorder, angle-closure glaucoma, or a seizure disorder.
- People with bipolar disorder may be at an increased risk of experiencing manic mood episodes, mixed episodes, or hypomanic episodes after taking Wellbutrin. While bupropion is sometimes prescribed off-label to treat depressive episodes, it is not approved for the treatment of bipolar depression. Those with bipolar disorder may also have an increased risk of experiencing suicidal thoughts after taking Wellbutrin.
- Your doctor may recommend a reduced dosage of the drug if you have a history of kidney problems, kidney disease, or liver problems. Because older adults may have reduced kidney function, they may require smaller doses since the drug remains in the body longer.
- Never take Wellbutrin if you have a known allergy to bupropion. You should contact emergency services immediately if you begin to experience allergic symptoms such as rash, swelling, hives, itching, and difficulty breathing.
- Wellbutrin has not been established as safe for children.
It’s not clear whether Wellbutrin is safe to take during pregnancy. In animal studies, there has been some evidence of adverse effects on the fetus, but we don’t yet have enough data about its effect on humans. The potential benefits of continuing Wellbutrin during pregnancy may outweigh the possible risks, but this should be discussed closely with your health provider.
Wellbutrin can be present in breast milk, so caution should be used by people who are breastfeeding. If you are lactating, your healthcare provider can help you weigh your options.
Other NDRIs
Among antidepressants, bupropion is in a category all its own—it’s the only medication in its class, called norepinephrine-dopamine reuptake inhibitors (NDRIs). NDRIs boost the neurotransmitters norepinephrine and dopamine.
By contrast, selective serotonin reuptake inhibitors (SSRIs) like Prozac (fluoxetine) and Zoloft (sertraline) affect serotonin, while serotonin and norepinephrine reuptake inhibitors (SNRIs) such as Cymbalta (duloxetine) and Effexor (venlafaxine) boost norepinephrine and serotonin.
How Long Does It Take Wellbutrin to Work?
Your condition should start to improve within the first week or two of beginning Wellbutrin. You may notice positive effects, such as that you sleep better, have more energy, or your appetite has improved, for instance. Improvement of psychological symptoms, such as those related to mood, may take a bit longer—or up to eight weeks.
If you’re taking bupropion to help you quit smoking, this medication works by reducing your tobacco cravings. Starting it about one week before you plan to quit gives it time to reach a therapeutic effect in your system.
How quickly your medication works may depend on what it has been prescribed to treat. For example, bupropion may also be prescribed for weight loss. One study involving 3,362 people found that many lost 5% of their body weight within eight weeks of starting a treatment containing bupropion, with more than half keeping this weight off a year later.
Wellbutrin Dosage
Wellbutrin is offered in three different formulations, and dosing varies for each version.
- Immediate-release: The regular formulation, simply named Wellbutrin, is an immediate-release medication. This means that it begins to work shortly after you take it. Because it acts quickly, it can be taken up to three times a day. This formulation is used to treat MDD. A starting dose of Wellbutrin is usually 100 milligrams (mg) taken twice a day, potentially increased to 100mg taken three times a day. The maximum dose is 150mg per single dose taken three times daily.
- Sustained-release: Wellbutrin SR, the sustained-release version, also treats MDD. This formulation is typically started at 150mg once a day and potentially increased to 150mg twice a day. It can be increased to a maximum of 200mg taken twice a day.
- Extended-release: Taken once a day, Wellbutrin XL is used to treat MDD and to prevent SAD. It is typically started at a dose of 150mg once a day and can be increased to 300mg or even 450mg maximum, both taken once a day.
Modifications
Your healthcare provider may prescribe a modified dosage of Wellbutrin due to possible side effects or another health concern.
- With liver impairments: Wellbutrin dosage is often lowered to a maximum of 75mg per day for those with moderate to severe liver impairment.
- With kidney problems: Your dosage or frequency of use may also be lowered if you have kidney impairments.
- After or before monoamine oxidase inhibitors (MAOIs): If you have previously taken an MAOI or are switching to one, allow 14 days between Wellbutrin and the MAOI.
Recap
Wellbutrin is available in three different formulations. Talk to your healthcare provider about which is right for you. You may require a different dosing schedule if you have certain health conditions.
How to Take and Store Wellbutrin
Always take your medications as directed. Immediate-release Wellbutrin tablets can be broken if necessary, but they are small enough that doing so is not usually needed. The drug can be taken on an empty stomach or with food and should be stored at room temperature, protected from light and moisture.
If you happen to miss a dose of bupropion, take it as soon as you remember. Any remaining doses for the day should be taken at least six hours apart. Never take two doses of Wellbutrin at once to make up for a missed dose as this can increase your risk of experiencing a seizure or an accidental overdose.
If you want to stop taking Wellbutrin, talk to your healthcare provider about tapering off of your medication gradually. If you stop suddenly, your symptoms may worsen or you may experience Wellbutrin withdrawal.
Warnings and Interactions
Seizures and suicidal thoughts are two of the most serious potential side effects of Wellbutrin. Seizures are rare with this drug but may affect up to four out of every 1,000 people currently taking Wellbutrin.
For that reason, it’s especially important to let your health provider know if you have or had a seizure disorder; you take any other medications that contain bupropion, such as Zyban (for quitting smoking); or you have or have had an eating disorder such as anorexia or bulimia, as seizures are more likely to occur with these disorders.
Antidepressant drugs like Wellbutrin may increase the risk of suicidal thoughts and behavior in children, teens, and young adults up to age 24—especially when first starting the medication or when there’s a change in dose. If you have a child taking Wellbutrin or another depression medication, keep a close eye out for signs of self-harm or suicidal thinking.
Interactions
There are a number of potential interactions that can occur when other substances are taken at the same time as Wellbutrin. Other medications may influence how bupropion works or increase the risk of side effects. These medications include:
- Antipsychotics, such as Risperdal (risperidone) or Haldol (haloperidol)
- Blood thinners
- Corticosteroids, including prednisone
- MAOIs
- Other antidepressants, including Prozac, Zoloft, and Effexor
Using Wellbutrin with alcohol may also influence the frequency and severity of side effects, including seizures and suicidal thoughts.
How to Stop Taking Wellbutrin
The most common Wellbutrin side effects tend to be the least serious and are likely to be temporary. Contact your health provider if you experience side effects that are severe, bothersome, get worse, or don’t go away. Get help immediately if you have any side effects that could be serious or life-threatening.
In either case, don’t stop taking Wellbutrin until you’ve checked with your health provider first. Going “cold-turkey” with any antidepressant can cause your symptoms to come back or get worse.
Stopping abruptly can also lead to discontinuation syndrome, an array of flu-like symptoms such as stomach upset, headache, strange sensations, and muscle aches. If you need to stop taking Wellbutrin, your provider can guide you in gradually tapering off.
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3 Secrets Disney Princesses Would Get FIRED For Revealing
3 Secrets Disney Princesses Would Get FIRED For Revealing Spoiler alert: Disney Princesses have secrets… and I’m about to …
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Icky Threes of Smoking Cessation: Hardest Days After Quitting
Key Takeaways
- After quitting smoking, you might face extra challenges on day 3, week 3, and month 3.
- Common side effects include flu-like symptoms, cravings, and feeling tired, but they will pass.
- Staying educated and patient can help manage urges and maintain your smoke-free life.
When you quit smoking, you may experience the “icky threes”: extra challenges on day 3, week 3, and month 3 of not smoking. In other words, you may experience additional side effects at the third day, third week, and third month after quitting smoking.
Not everyone experiences the icky threes. And if you do, they might happen at slightly different time intervals. But these tough times are common enough to take note of and be prepared for in case you experience them.
3 Days After Quitting Smoking
The first three days of smoking cessation are intense for most ex-smokers, and day 3 is when many people experience the discomforts of physical withdrawal.
During this time, the adrenaline felt from taking the initial plunge into smoking cessation begins to be replaced by the intensity of nicotine withdrawal, which can include flu-like symptoms, irritability, anxiousness, insomnia, and increased appetite.
What to Do
They key to surviving day three is to understand the symptoms of nicotine withdrawal and what you can do to keep them at bay.
- Eat five small meals per day to prevent mistaking hunger for a cigarette craving.
- Drink lots of water. Limit coffee, soft drinks, and alcohol, which are often associated with lighting up.
- Take a walk or do a short bout of exercise to boost your mood and sweat out some of the angst of nicotine withdrawal. A long walk prior to bedtime might also help fend off quit-related insomnia.
- Close your eyes and breathe through your cravings, which generally subside about three to four weeks after quitting.
- Take a quick nap during the day or go to bed a little earlier than usual if you’re feeling fatigued, which is common during this phase of smoking cessation.
3 Weeks After Quitting Smoking
At three weeks, you’ve likely gotten through the shock of physical withdrawal. Now you’re beginning to tackle the mental side of nicotine addiction, or psychological withdrawal. This turn of events often triggers cravings to smoke that can feel like you’re back at square one.
Be aware that even though nicotine might be out of your system by this point, psychological cravings can produce real physical reactions, making a mental trigger feel like physical withdrawal.
Thinking about that smoke break you used to take at a certain time of the day can cause tension that makes your stomach churn and leaves you on edge. It feels like a physical craving, and in a way it is… but the source is a thought, not a physical need for nicotine.
What to Do
One of the first (and perhaps simplest) steps to survive the side effects you’ll feel 3 weeks after quitting smoking is to remind yourself of the reasons why you decided to quit in the first place.
Better yet, take a piece of paper and jot down all the reasons that quitting will benefit you and your life. This quick exercise will help you fend off any addictive thought patterns, which involve romanticizing smoking or rationalizing one last cigarette.
You can also try these strategies to help combat thoughts of smoking and build a strong mindset for smoking cessation.
- Put negative thoughts on ignore. While you can’t control your thoughts, you can make a choice to ignore them or redirect your attention to something more healthy or productive, like a hobby or household project you enjoy.
- Identify your triggers. Use the acronym H.A.L.T, which stands for hungry, angry, lonely, and tired, to help decipher what is driving your urge to smoke.
- Stay committed, but have patience. Healing from nicotine addiction is a gradual process, so be patient with yourself and the way your recovery unfolds.
- Seek support. Get a dose of encouragement from a trusted friend or visit an online smoking cessation support group.
3 Months After Quitting Smoking
At three months, the novelty of the quit program is wearing off. Many ex-smokers are left thinking “Is that all there is?” In other words, the blahs hit around this time. They usually trigger cravings to smoke, often quite intensely.
This is a time period when relapse is common. It can be discouraging to have strong smoking urges surface after months of cessation.
For those who don’t know why it’s happening, it can feel like nicotine addiction will never let go of us and there’s no use in trying to quit.
What to Do
Quitting smoking and preventing a relapse takes a lot of mental work on your part, especially during the first year of smoking cessation.
- Stay educated. Learning everything you can about what to expect during smoking cessation as well as the health benefits of quitting can help make the change permanent.
- Practice positive self-talk. As you power through this phase, remind yourself that your feelings are temporary and normal. If you find yourself romanticizing smoking or questioning your decision to quit, talk yourself out of it. It takes time to heal from addiction and reprogram the way your brain thinks about smoking.
- Manage cravings. If you’re feeling the urge to smoke, turn to the five Ds: delay, distract, drink water, deep breathing, and discuss.
- Stay committed. Comfort with the new smoke-free life you’re building will continue to grow with time, but only if you don’t smoke. If you do, you’ll be right back where you started three months ago.
Other Questions About Quitting Smoking
Quitting smoking can be rough, but it helps to know what you can expect in terms of side effects during the days, weeks, and months after you smoke your last cigarette.
What day is the hardest when you quit smoking?
While a challenging day can happen at any time, most smokers agree that day 3 of not smoking is the hardest because that’s when symptoms of physical withdrawal tend to peak.
What happens to your body when you quit smoking?
When you quit smoking, changes in your body can occur within minutes, hours, and days. For example, your blood pressure lowers, your pulse rate reduces, your body temperature returns to normal, your taste and smell receptors begin to heal, your circulation improves, and your lung function improves.
How long does nicotine withdrawal last?
Not everyone experiences nicotine withdrawal the same way. That said, nicotine withdrawal symptoms are typically at their worst on day 3 and then gradually taper off over the course of three to four weeks.
How long do cravings last when quitting smoking?
Just like nicotine withdrawal, the severity of your cravings will often depend on how long and how frequently you smoked. In general, cravings will subside about three to four weeks after quitting.
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How to Become a Great Leader: 10 Tips
Key Takeaways
- Transformational leaders are enthusiastic and inspire their team’s full potential.
- Encouraging creativity helps people stretch their limits and not feel discouraged.
- Motivating followers can be done by recognizing and rewarding their work.
How would you describe a strong leader? One study cited leadership qualities such as assertiveness, adaptability, intelligence, and conscientiousness as the most important.
Transformational leaders are positive, empowering, and inspiring. They value followers and inspire them to perform better. So, what can we do to embrace these valued leadership qualities and become stronger and more effective leaders?
Start by Understanding Your Leadership Style
Understanding your current leadership style is essential. What are your strengths? Which areas need some improvement? One way to start assessing your skills is to take this leadership style quiz to get a general idea of how you lead.
This leadership styles quiz was reviewed by Rachel Goldman, PhD, FTOS.
Once you have completed the quiz, read about the major characteristics of your dominant style. Are these qualities helping or hindering your leadership? Once you’ve determined which areas need work, you can look for ways to improve your leadership abilities.
Encourage Creativity
Intellectual stimulation is one of the leadership qualities that define transformational leadership. Followers need to be encouraged to express their creativity. Effective leaders should offer new challenges with ample support to achieve these goals.
One way to foster creativity is to offer challenges to group members, making sure that the goals are within the grasp of their abilities. The purpose of this type of exercise is to get people to stretch their limits but not become discouraged by barriers to success.
Serve as a Role Model
Idealized influence is another of the four key components of transformational leadership. Transformational leaders embody the behaviors and characteristics that they encourage in their followers. They walk the walk and talk the talk. As a result, group members admire these leaders and work to emulate these behaviors.
Research suggests that leaders are able to foster a specific belief and then transmit that inspiration to their followers. As a result, followers are optimistic and have high standards for performance and achievement.
If you want to become a better leader, work on modeling the qualities that you would like to see in your team members.
Be Passionate
Would you look to someone for guidance and leadership if they did not truly care about the goals of the group? Of course not! Great leaders are not just focused on getting group members to finish tasks; they have a genuine passion and enthusiasm for the projects they work on.
You can develop this leadership quality by thinking of different ways that you can express your zeal. Let people know that you care about their progress. When one person shares something with the rest of the group, be sure to tell them how much you appreciate such contributions.
Listen and Communicate Effectively
Another important quality of transformational leadership involves a focus on providing one-on-one communication with group members. Transformational leadership is effective when leaders are able to communicate their vision to followers, who then feel inspired and motivated by this vision.
Good leaders should express sincere care and concern for the members of their group both verbally and nonverbally.
By keeping the lines of communication open, these leaders can ensure that group members can make contributions and receive recognition for their achievements.
Have a Positive Attitude
Transformational leaders have an upbeat, optimistic attitude that serves as a source of inspiration for followers. If leaders seem discouraged or apathetic, members of the group are likely to also become uninspired.
Even when things look bleak, and your followers start to feel disheartened, try to stay positive. This does not mean viewing things through rose-colored glasses. It simply means maintaining a sense of optimism and hope in the face of challenges.
Encourage People to Make Contributions
Let the members of your team know that you welcome their ideas. Leaders who encourage involvement from group members are often referred to as democratic or participative leaders. While they retain the final say over all decisions, they encourage team members to take an active role in coming up with ideas and plans.
Research has shown that using a democratic leadership style leads to greater commitment, more creative problem-solving and improved productivity.
Motivate Your Followers
Transformational leaders also provide inspirational motivation to encourage their followers to get into action. Of course, being inspirational isn’t always easy. Fortunately, you don’t need motivational speeches to rouse your group members.
Some ideas for leadership inspiration include being genuinely passionate about ideas or goals, helping followers feel included in the process and offering recognition, praise, and rewards for people’s accomplishments.
Offer Rewards and Recognition
Another important quality of a good leader involves knowing that offering effective recognition and rewards is one of the best ways to help followers feel appreciated and happy. It may also come as no surprise that happy people tend to perform better at work.
Keep Trying New Things
Who says leadership is a one-way relationship? As you work toward developing some of these leadership qualities, don’t forget to look to your followers for feedback and inspiration. Pay attention to the things that have been effective in the past and always be on the lookout for new ways to inspire, motivate, and reward group members.
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Dating Manual For Men: The Ultimate Dating Advice For Men Guide! – Dating Success Secrets On How To
Listen to this audiobook in full for free on https://hotaudiobook.com Title: Dating Manual For Men: The Ultimate Dating Advice For …
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