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parents and ask them for their suggestions. She would need to have the energy to communicate well.

Progress in problem solving was slow because Carla s mood swings seemed to get in the way. She had resumed medication and it was starting to help, but a mix of worry, shame, insignificance, Definition Electroconvulsive therapy (ECT) is a medical procedure in which a small, carefully controlled amount of electric current is passed through the brain to treat symptoms associated with certain mental disorders. The electric current produces a convulsion for the relief of symptoms associated with such mental illnesses as major depressive disorder, bipolar disorder, acute psychosis, and catatonia. Purpose al are no longer routinely recommended for the treatment of insomnia because of their ability to cause dependence, tolerance, and withdrawal. These drugs also have significant side effects when taken in large doses and can cause respiratory failure and death. Description historical factors, such as a person s prior attempts, remain a risk factor even decades later. Having a serious head injury or neurological disease also raise risks. Other factors, especially those that affect teens, will be discussed in other chapters. The important thing to remember is that there is help.side effects include fever, headache, anemia, allergic reactions, and liver damage. Interactions Patients should always tell their doctor and dentist when they are taking barbiturates. Barbiturates should generally not be taken with other drugs used to treat mental disorders. There are a number of drugs that barbiturates should not be combined with because the barbiturates may increase the metabolism of these drugs and thus, reduce the amount of these drugs available to be of benefit. These drugs include oral corticosteroids such as predisolone, methylprednisolone, prednisone, or dexamethasone, estrogen and oral contraceptives, blood-thinning medications such as warfarin (Coumadin), the antibiotic doxycycline (Vibramycin), and anticonvulsants such as phenytoin (Dilantin). Barbiturates should not be combined with alcohol because the combination produces additive depressant effects in the central nervous system. Barbiturates may lower the amount of absorption of the vitamins D and K. Resources BOOKS Consumer Reports Staff. Consumer Reports Complete Drug Reference. 2002 ed. Denver: Micromedex Thomson Healthcare, 2001. Ellsworth, Allan J., and others. Mosby s Medical DrugAbuse is a complex psychosoci al problem that affects large numbers of adults as well as children throughout the world. It is listed in the Diagnostic and

Statistic Manual of Mental Disorders (DSM-IV-TR) under the heading of Other Conditions That May Be a Focus of Clinical Attention. Although abuse was first defined with regard to children when it first received sustained attention in the 1950s, clinicians and researchers now recognize that adults can suffer abuse in a number of different circumstances. Abuse refers to harmful or injurious tlude not only the direct costs of immediate medical and psychiatric treatment of abused people but also the indirect costs of learning difficulties, interrupted education, workplace absenteeism, and long-term health problems of abuse survivors.