Ah Are You Digging On My Gra

Ah, Are You Diging On My Gra Essay, Research Paper The insignificance of human life compared to the transition of clip and continuance of the life rhythm are explored in both Thomas Hardy # 8217 ; s # 8220 ; Ah, Are You Diging On My Grave # 8221 ; and John Keats # 8220 ; When I Have Fears # 8221 ; . Hardy uses the relationships between a dead adult female and her household, friends and pet to demo this insignificance, while Keats uses the magniloquence of nature. Although the verse forms use different riming techniques, similarities are found in their constructions. Hardy writes in a manner of his ain creative activity but uses four of the six poetries to foreground different illustrations of the adult female # 8217 ; s relationships with those left buttocks. The fifth is used as a edifice up of hope, and the concluding poetry is used to demo both the storyteller and the reader how shortly what we consider of import and meaningful in life, can be diminished or forgotten in the lives and day-to-day modus operandis of those left buttocks. Keats, meanwhile, uses a standard sonnet signifier, utilizing his three quatrains to each give a different illustration of what the adult male hopes to carry through in life. The concluding rhyming pair shows his credence of his life as little and undistinguished as compared to the breadth of nature and the universe as a whole ; # 8220 ; -then in the shore Of the broad universe I stand entirely, and believe Till Love and Fame to nothingness make sink. # 8221 ; These verse forms are written from different point of views ; Hardy writes as a adult female already in her grave, and Keats as a adult male still alive. Yet both storytellers come to the decision that what we consider to be of great importance in our lives, is frequently of small to no importance after we die. Time will go through, and life will travel on merely as will without us. However, both of the storytellers figure this fact out in really different ways. The adult male in Keats # 8217 ; verse forms, while alive, has given clip to halt and see how his concerns are proved fiddling, and hence forestall his badgering. Assumeably this will assist him to bask his life, and to be thankful for whatever clip he is left with. The adult female in Hardy # 8217 ; s verse form, nevertheless, is still preoccupied with her life, even after she is dead and buried in her grave. It takes the # 8220 ; day-to-day jog # 8221 ; of her Canis familiaris to do her recognize how small she genuinely has affected the lives of those around her. The insignificance of the adult female in Hardy # 8217 ; s verse form is shown in four separate illustrations. The first examines the relationship with her hubby. Alternatively of goi nanogram to her sedate site with flowers and unhappiness, he has merely wed another, richer adult female. While she lies in her grave, and still thinks of her hubby as her â€Å"loved one† , he is acquiring on with his life and giving the love that he one time had for her to another adult female. Her kids are besides seeking to travel on, recognizing that no flowers or attention for her grave will of all time convey her dorsum to life, and hence believing that there is no usage brooding on what was. Even the 1 who was her enemy in life no longer hates her, believing that to detest her is a waste of attempt. Finally, the woman’s pet Canis familiaris, the â€Å"one true heart† , who likely stuck by her loyally in life, and loved her above any other, has forgotten all about her, merely retrieving her and her grave as he by chance starts to delve a hole in her grave site to bury a bone to eat on a day-to-day walk. Meanwhile, the adult male in Keats # 8217 ; poem recognize his insignificance in a far gentler, and easier manner. When he starts to worry about deceasing before he has written down everything his head is full of, or about whether or non he # 8217 ; s traveling to see the adult female he loves once more, he takes himself to # 8220 ; the shore of the broad universe # 8221 ; , and shows himself how fiddling such concerns are. He realizes that when he is gone, the universe will maintain turning, life will go on to travel on, and it # 8217 ; s a instead demeaning experience for him. The two characters come to the realisation of there insignificance through wholly different ways. The adult female in Hardy # 8217 ; s verse form, seemed to be instead vain and likely considered her life to be unrealized. Unfortunately she was forced to recognize the truth through the fore-mentioned events. On the other manus, the adult male in the Keats # 8217 ; verse form is in awe of nature and the universe around him. He is happy that he found love, and is able to come to footings with the fact that life will travel on without him. Because of the sad and unfortunate subjects to both verse forms, I truly didn # 8217 ; t bask either of them all that much, but if I were to see one to be my front-runner over the other, it would hold to be John Keats # 8217 ; # 8220 ; When I Have Fears # 8221 ; . I found that the construction ( the fact that it was written in the sonnet manner ) , and the rhyming form, made it a drum sander and easier read. I found Thomas Hardy # 8217 ; s # 8220 ; Ah, Are You Diging On My Grave? # 8221 ; to be slightly humdrum. I had a job with maintaining my attending during the verse form and felt he could hold got his point across in a much shorter or possibly less insistent manner. 341

Eurozone Debt Crisis - What are your predictions on how this crisis Essay

Eurozone Debt Crisis - What are your predictions on how this crisis will develop in the second half of 2011 and what impact will - Essay Example Soon after this optimistic representation of the future global economy, Greece made headlines, where the investors started asking if it would be ever possible for the country to â€Å"pay off the ?259 billion in government debt it currently owes’ (Khan, ibid). Soon Ireland and Portugal followed suit, while predictions show bad signs for Spain and Italy (Lucas, Find Safe European Stocks out of Unsafe Europe , April 2011). Thus, we find that Euro has taken a deep battering from the start of the new decade, with widespread fears that this economic crises may lead to the break-up of the Eurozone. Discussion In recent news published, we find that it presents gloomy figures, â€Å"The Eurozone crisis has gone from bad to worse as debt contagion threatens to engulf Italy. With analysts predicting that Britain could lose as much as ?43 billion should the Italian economy fold, Chancellor George Osborne called on his Eurozone colleagues to take "decisive action" before the situation g ets any worse. He also warned that Britain was "not immune" from the crisis† (Clarkson, Q&A: How will the latest eurozone crisis affect the UK? 2011). Thus, we find that the economic recovery has again hit a critical roadblock, where the economist Peter Spencer on 18th July 2011 stated, "The risks to the world economy and the Eurozone are plain to see, starting with the Greek default, threatening a domino effect on Portugal and Ireland, followed perhaps by Spain and Italy"(cited in, skynewsHD, July 2011). In review by the Ernst & Young group, we find that the predictions are not very optimistic for the second half of the year. In this report, it is stated that the economic forecasts show every indication of an increasing â€Å"EU sovereign debt crisis† (Ernst & Young Eurozone Forecast, 2011, 4). The review also shows that it is almost impossible to avoid the non-payment of the debt incurred by the Greece government. Similarly it would be also impossible to frame an econ omic restructuring, and in probability the country would require another bailout loan. However the review further adds that â€Å"a restructuring nor a bailout are in themselves likely to provide lasting solutions and restructuring would almost certainly carry in its wake the necessity of similar exercises for Ireland and Portugal. An additional uncertainty is whether debt restructuring comes via an orderly or disorderly process. If it is the latter, the risk of contagion to other countries increases and the Eurozone’s reasonably healthy growth prospects for 2011 and 2012 are likely to be extinguished. In fact, the economy would go backward† (ibid). Fig 1: The table below shows GDP growth rates for the European Union and select individual countries. Here we find that the 2011 and 2012 growth predictions vary from 4-5% for countries like Turkey and Poland, and an average of 1-2% for the PIIGS countries at the other end (Source: Lucas, 2011). The graph shows a picture wh ere we find that majority of the countries perform badly (economically) in 2011, with indications of a slightly better show in

Formal Writing Assignment 3 Essay Example | Topics and Well Written Essays - 1000 words

Formal Writing Assignment 3 - Essay Example it also leads to the acquisition of new ideas and languages. For one to claim that they are living in a globalised society, they must be able to see some notable changes in their society because globalisation is the umbrella term for various advancement changes that occur in a society. for example, the person must be able to identify changes in their culture, experience improvements in their technologies, increased material wealth, increased capital flow, increased immigration and increased link with other societies through transport, trade and communication. A society therefore that has remained stagnant, even in the middle of other fast changing societies, cannot be said to be globalised. The linking is important because it facilitates exchange which results to change. One may be tempted to imagine that the term globalisation is a phenomena that occurs exclusively at the societal level. The truth is that it starts at an individual level. The society is composed of people and not un less its people are willing to embrace any changes, then globalisation will never take place in it. At the same time, people in a globalised society should be able to experience changes within themselves. This brings up the important topic â€Å"Globalization Within My Life.† Globalization within one’s life is not defined by the act of travelling round the world but the ability to consume products, in form of goods, culture and language, from distant lands (Sheila 10). It is a change of behaviour, attitude and reactions towards these goods. In this case, the term goods refers to foreign ideas, products and cultures. One specific aspect of globalization that influences my life is transfer of human capital. Currently, there is massive immigration and emigration of people in and out of societies and my society happens to be experiencing the same trend. My society is America but it is not only composed of Americans or people who are already accustomed to the American cultu re. There is a significant increase of people from countries whose cultures differ significantly from that which is found in the US. Chinese, Japanese, Italians are just but a few examples. From my interactions and observations, I have noted that many of them come to America to work for international companies that have invested in the US, some are businesspeople, tourists, international students and others have come to work in various private and public sector offices. These people have different cultures from those that exist in our American culture. For example, one thing which I noted among the Chinese is that they are more conservative unlike the Americans. Americans are more liberal in their behaviour. Seeing these people flock into my society has increased cultural consciousness in me and the need to work, live, interact and conduct business with them has motivated me to learn their cultures. Colonisation is a form of suppression but globalisation requires decolonisation of o ne’s mind. It requires that the form of liberation that will allow a person’s mind to wander off and integrate with the ideas, cultures and technologies brought in or developed by others. Without bragging, I must say that I have a liberal mind or rather, an uncolonised mind and this has enabled me to transform quickly into a better-rounded person. Heizo and

The Rise of Neoliberism Essay Example | Topics and Well Written Essays - 1000 words

The Rise of Neoliberism - Essay Example The collapse of the Soviet Union was the proverbial straw that broke the forbearance of the economists and social scientists. There arose a dogma that is seldom referred to by its name of neoliberalism, that became increasing popular as a counter-revolution to the communist ideology and the centralised economic system. Neoliberalism, in its basic form, is a movement that encourages a reversion to the economic policies of the 18th and the 19th centuries, and foresees economic liberty and political development as its consequences (Wikipedia 2007). The proponents of this ideology claim it to be more than just an economic and political system; they put forward this counter-revolution as a social and philosophical change (Wikipedia 2007) that will affect all people from all walks of life in all their social endeavors. Neoliberalism aims at providing a freedom in the economic sector through free market and free trade concepts, and a reduced political intervention over the economic sector. It revolves around the privatisation of the public sector, and the transfer of public assets to a select few in the business world. Although neoliberalism aims at promoting liberty, it is of... This ideology encourages a huge rift in the society between the rich and the poor, creating two distinct classes of the people; the working class and the ruling class. In essence, it makes the rich richer and the poor poorer, a signature affect of capitalism, though it claims to be operating on a different note than capitalism.Its basic fundamentals of free market economy are in conjunction with global trade, and the two ideologies intermingle smoothly into each other, that of neoliberalism and globalization. Of late, countries all over the world are under intense pressure to succumb to this model of economics, often referred to as the American Model (Cambridge Journal of Economics 2007), allowing cross-border trade and funds transfer, and subduing the local and preferred economic systems of the affected countries. Neoliberalism, suffice it to say, is an oppressive form of political and economic system that uses force and twisted ideologies to benefit only a handful of ruling parties. It condemns union rights, stating that they come as impediments in the way of economic development. But this brings with itself the oppression of the working class in the form of low wages, under employment and unfair working environments and systems. Although claiming to be a beacon of liberty, it results in non-mobilisation of wealth and property, never letting the working class the right of ownership and governing

Literature review on depressive disorders

Literature review on depressive disorders Depression is one of the most prevailing medical disorders. Depression has been recognized as a distinct pathological entity from early Egyptian times (Reus, 2000). Depression is the most common psychiatric disorders. Each year, more than 100 million people worldwide develop clinical depression (Bjornlund, 2010). During a lifetime, it is estimated that between 8% and 20% of the general population will experience at least one clinically significant episode of depression (Kessler et al., 1994). Major depression causes the fourth-highest burden of disease among all medical diseases. It is expected to rise to second place, preceded only by cardiovascular disease by 2020 (Thompson, 2007). Depressive disorder has significant potential morbidity and mortality. Suicide is the second leading cause of death in persons aged 20-35 years. Depressive disorder is a major factor in around 50% of these deaths (Semple et al., 2005). A suicide attempt among patients with major depressive disorder is associated with the presence and severity of depressive symptoms. Lack of partner, previous suicide attempts and time spent in depression are risk factors of suicide attempts. Reducing the time of depression is a likely preventive measure of suicide (Sokero et al., 2005). Depression is a medically significant condition that needs to be diagnosed and properly treated. It is a severe disorder, tend to recur, and it costs the individual and society (Stefanis Stefanis, 2002). Epidemiology of Depressive Disorders Prevalence and Incidence Studies show substantial variability in the lifetime rates of depression. Lifetime rates are ranging from under 5 percent to 30 percent, but it is widely accepted that the lifetime prevalence is between 10 percent and 20 percent. The 6-month prevalence rate is considered to be between 2 percent and 5 percent based on surveys in several countries (Young et al., 2010). A cross- sectional WHO world health survey carried out in 60 countries covering all regions of the world showed a 1-year prevalence of depressive episode of 3.2 percent, with a 95 percent confidence interval of 3.0 percent to 3.5 percent (Moussavi et al., 2007). The life time prevalence of depression for adults varied from 3 percent in Japan to 16.9 percent in the US, with most countries in the range between 8 percent and 12 percent (Andrade et al., 2003). The prevalence of major depressive disorder is estimated to be about 2 percent in children (Birmaher et al., 1996). Estimates of the point prevalence of MDD in adolescence is range from 0.4 percent to 8.3 percent. Lifetime prevalence rates across adolescence range is from 15 percent to 20 percent (Roberts Bishop, 2005). In Dubai the prevalence of depressive disorders were 13.7% among women mostly neurotic depression (Ghubash et al., 1992). About 12-20% of persons experiencing an acute episode develop a chronic depressive syndrome, and up to 15% of patients who have depression for more than one month commit suicide (Reus, 2000). Risk Factors Genetics There is now substantial evidence that the genetic factors are of major importance as risk factors for vulnerability to major depression. Traditional estimates have put the heritability about 40 % (Joyce, 2003). Genetic influences are most marked in patients with more severe forms of depressive disorder and biological symptoms. The morbid risk in first-degree relatives is increased in all studies. This elevation is independent of the effects of environment or upbringing. In fewer severe forms of depression, genetic factors are fewer significant and environmental factors relatively more important (Souery et al., 1997). Gender Major depressive disorder is the twofold greater prevalence in women than in men independent of country or culture. The reasons for the difference are hypothesized to involve hormonal differences, the effects of childbirth, and differing on psychosocial stressors for women and for men (Sadock Sadock, 2007). Age Major depressive disorder occurs in all cultures and affects all age groups. Depression is common in Childhood and late adult. The mean age of onset is generally in the 30s (Dunner, 2008). Early-onset depression is associated with a higher female to a male ratio than late-onset depression. The incidence of major depressive disorder in old age is lower in both sexes. However, first incidence and prevalence of minor depressive disorder shows the opposite trend (Rihmer Angst, 2009). Personality In younger people, mild depression tends to affect anxious or dependent personalities with poor tolerance of stress. Severe depressive illness in middle age tends to affect hard-working, conventional people with high standards and obsessional traits. Obsessional personalities can find it, particularly difficult to adapt to stress or life changes, as in work or relationships, and this can come out as depression (Gill, 2007). Childhood experiences Early theorizing suggested that the loss of a parent in childhood increased the later risk for major depression. However, many studies have examined this issue; they have inconsistently found it to be a risk factor for adult depression (Tennant, 1988). Childhood sexual abuse has been established as a risk factor for adult major depression (Joyce, 2003). Marital status Rates of depressive illness is lower in the married man than in the single, widowed, or divorced. The protective effects of marriage are less marked in women. Young married women with children have high rates of depression; single women have low rates (Gill, 2007). However, those in a poor marriage with deficient intimacy are at increased risk of depression (Weissman, 1987). Social classes and occupation People of low socio-economic status (i.e. low levels of income, employment, and education) are at higher risk of depression (Semple et al., 2005). While job satisfaction can enhance mental well-being, the workplace can also be a source of stress and depression. However, the consequences of unemployment probably have far changed on mental health. The economic hardship to the unemployed and their families with depression due to long-term unemployment hindering job seeking and re-employment chances, exacerbated by loss of confidence and perceived loss of skills (Strandh, 2001). Depression is more common in urban than a rural district (Gill, 2007). Physical illness Having a chronic or severe physical illness is associated with an increased risk for depression. This suggests that the stress associated with a serious or chronic physical illness may act by bringing out an individuals lifetime vulnerability to depression (Joyce, 2003). Etiology of Depressive Disorders The etiology of major depressive disorder is unknown (Dunner, 2008). Multiple etiologic factors genetic, biochemical, psychodynamics, and socio-environmental may interact in complex ways to cause major depressive disorder (Loosen Shelton, 2011). GENETIC MODELS OF DEPRESSION There is evidence to suggest a genetic basis for the major depression disorder. Occurrences of major depressive episodes are clearly cluster in families. This degree of increased risk is about three to five times that of the normal population. Twin and adoption study is consistent with a genetic contribution to major depressive disorders. However, studies suggest that other factors also are important (Schiffer, 2008). Actually, it is the tendency to become depressed in response to life events that are inherited (Hirschfield Weissman, 2002). Moreover, family and twin studies show a clear genetic component of life events themselves (Kendler Karkowski, 1997). ENDOCRINE MODELS OF DEPRESSION Neuroendocrine abnormalities that reflect the neurovegetative signs and symptoms of depression include: first, increased cortisol and corticotrophin-releasing hormone (CRH) secretion, second, an increase in adrenal size, third, a decreased inhibitory response of glucocorticoids to dexamethasone, and fourth, a blunted response of thyroid-stimulating hormone (TSH) level to infusion of thyroid-releasing hormone (TRH). Antidepressant treatment leads to normalization of these pituitary-adrenal abnormalities (Reus, 2008). Thyroid hormone may potentiate both the speed and the efficacy of antidepressant medication (Altshuler et al., 2001). Furthermore, there also evidence that patient resistant to other treatments may respond to addition of thyroid hormone (Joffe Marriott, 2000). NEUROCHEMICAL MODELS OF DEPRESSION The most famous hypotheses generated to account for the actual mechanism of the mood disorder focus on regulatory disturbances in the monoamine neurotransmitter systems, particularly that involving norepinephrine and serotonin (5-hydroxytryptamine). It has also been hypothesized that depression is associated with an alteration in the acetylcholine-adrenergic balance and characterized by a relative cholinergic dominance. In addition, there are suggestions that dopamine is functionally decreased in some cases of major depression. Original reports suggesting that patients with endogenous depression experienced either decreased noradrenergic or serotonergic activity now appear to be overly simplistic. All the monoamine neurotransmitter systems are interrelated and subject to compensatory adaptation to perturbation over time (Reus, 2000). CELLULAR MODELS OF DEPRESSION Most current hypotheses of neurotransmitter function in altered mood states have focused on changes in receptor sensitivity and second messenger systems. With a few exceptions long-term antidepressant treatment is associated with reduced postsynaptic ÃŽÂ ²-adrenergic receptor sensitivity and enhanced postsynaptic serotonergic and cyclic adenosine monophosphate activity (Reus, 2000). A number of intracellular changes which involve alterations in cellular second messenger systems and ion channels are postulated to occur in depression. Intracellular changes may involve changes in guanine triphosphate binding proteins, G-proteins on the receptor, cyclic adenosine monophosphate (cAMP) regulation, reduced protein kinase activity and brain derived neurotrophic factor (BDNF). Antidepressants as well as ECT increase BDNF and BDNF have been found to increase functioning of serotonin (Kay Tasman, 2006). NEUROIMAGING MODELS OF DEPRESSION Recent rapid advances in neuroimaging methodology have attempted to relate the phenomenological abnormalities seen in depression to changes in brain structure and function (Fu et al., 2003). There is increasing evidence that depression may be associated with structural brain pathology. Magnetic resonance imaging (MRI) has revealed decreased volume in cortical regions, particularly the frontal cortex, but also in subcortical structures, such as the hippocampus, amygdala, caudate, and putamen (Sheline Minyun, 2002). The most widely replicated Positron emission tomography (PET) scanning (PET) finding in depression is decreased anterior brain metabolism, which is generally more pronounced on the left side. In addition, increased glucose metabolism has been observed in several limbic regions (Thase, 2009). Neuroimaging has also helped in the further investigation of the neurochemical deficits in depression. The largest study to date using PET found a marked global reduction in brain 5-HT2 receptor binding (22-27%) in various regions (Sheline Minyun, 2002). There is an increasing literature using neuroimaging to understand suicidality, particularly in depression. Mann (2005) cites several imaging studies suggesting decreased serotonin function in suicidal individuals and decreased activity in associated areas of the dorsal system involved in emotion regulation, such as the anterior cingulate. A number of regions more speci ¬Ã‚ c to suicidality are also highlighted, particularly those that seem to be involved in impulsivity and aggression, such as the right lateral temporal cortex, right frontopolar cortex, and right ventrolateral prefrontal cortex (Goethals et al., 2005). This literature has as well found structural abnormalities in relevant regions of the dorsal system, particularly the orbitofrontal cortex, which has speci ¬Ã‚ cally been linked to potential decision making de ¬Ã‚ cits that could lead to suicidality. Thus, such data potentially suggest clinically important subtype differentiation in brain function for this sym ptom (Ingram, 2009). PSYCHOSOCIAL FACTORS Stressful life events more often precede first, rather than subsequent, episodes of mood disorders. Some clinicians believe that life events play the primary or principal role in depression; others suggest that life events have only a limited role in the onset and timing of depression. Data indicate that the life event sometimes associated with development of depression is losing a parent before age 11. The loss of a spouse is the environmental stressor most often associated with the onset of an episode of depression. Another risk factor is unemployment; persons out of work are three times more likely to report symptoms of an episode of major depression than those who are employed (Sadock Sadock, 2007). PSYCHOLOGICAL FACTORS PSYCHODYNAMIC THEORIES OF DEPRESSION Psychoanalytic theory as postulated by both Freud and Abraham emphasized the connection between mourning and melancholia. The melancholic patient experiences a loss of self esteem with associated helplessness, prominent guilt and self deprecation. According to the theory, these symptoms result from internally directed anger or aggression turned against the self, leading to a depressive experience (Kay Tasman, 2006). Melanie Klein understood depression as involving the expression of aggression toward loved ones. Edward Bibring regarded depression as a phenomenon that sets in when a person becomes aware of the discrepancy between extraordinarily high ideals and the inability to meet those goals. Edith Jacobson saw the state of depression as similar to a powerless, helpless child victimized by a tormenting parent. Silvano Arieti observed that many depressed people have lived their lives for someone else (a principle, an ideal, or an institution, as well as an individual) rather than for themselves. Heinz Kohuts conceptualization of depression, derived from his self-psychological theory, rests on the assumption that the developing self has specific needs that must be met by parents to give the child a positive sense of self-esteem and self-cohesion. When others do not meet these needs, there is a massive loss of self-esteem that presents as depression. John Bowlby believed that damaged early attachments and traumatic separation in childhood predispose to depression. Adult losses are said to revive the traumatic childhood loss and so precipitate adult depressive episodes (Sadock Sadock, 2007). Interpersonal Theory (IPT) Interpersonal theory focuses on difficulties in current interpersonal functioning. In IPT, depression is held to relate to one or more of four functional areas: grief, interpersonal role disputes, role transitions, and interpersonal deficits. In IPT, the reciprocal relationship between ones mood and interpersonal events is investigated. Stressful life events may overwhelm coping ability and produce a depressed mood, which then contributes to ongoing interpersonal difficulties. Once this relationship is identified, modifying it becomes the focus of treatment (Grunze et al., 2008). THE COGNITIVE MODEL Cognitive theories of depression hypothesize that particular negative ways of thinking increase individuals probability of developing and maintaining depression when they experience stressful life events. According to these theories, individuals that possess specific maladaptive cognitive patterns are vulnerable to depression because they tend to develop negative information processing about themselves and their experiences (Sanderson McGinn, 2001). Behavioral Models Martin Seligman developed the theory of learned helplessness as he was searching for an animal model of depression. In this formulation, individuals in stressful situations in which they are unable to prevent or alter an aversive stimulus (i.e., physical or psychic pain) withdraw and make no further attempts to escape even when opportunities to improve the situation become available (Reus, 2000). Clinical Features of Depressive Disorders Depressed mood is the most characteristic symptom, occurring in over 90% of patients. The patient usually describes himself or herself as feeling sad, low, empty, hopeless, gloomy, or down in the dumps. The physician often observes changes in the patients posture, speech, faces, dress, and grooming consistent with the patients self-report. A small percentage of patients does not report a depressed mood, usually referred to as masked depression. Similarly, some children and adolescents do not exhibit a sad demeanor, presenting instead as irritable or odd (Loose Shelton, 2008). Anhedonia manifests with a lack of interest in formerly pleasurable activities; sports and hobbies, etc. no longer arouse patients, and if they force themselves to partake, they take no pleasure in such activities. Libido is routinely lost and there is no pleasure in sexual activity (Moore, 2008). Depressed individuals frequently report cognitive changes that include impaired attention, concentration, and decision making (Woo Keatinge, 2008). Sleep may be increased or decreased. Insomnia is one of the major manifestations of depressive illness and is characterized more by multiple awakenings, especially in the early hours of the morning than by difficulty falling asleep. Young depressive patients, especially those with bipolar tendencies, typically complain of hypersomnia, sleeping as long as 12 to 15 hours a day. Obviously, such patients will have difficulty getting up in the morning. Although decreased sexual desire occurs in both men and women, women are more likely to complain of infrequent menses or cessation of menses. Decrease or loss of libido in men often results in erectile failure (Dunner, 2008). Appetite can be decreased or increased with or without weight loss or gain; the most typical pattern is a decrease in appetite with weight loss (Faravelli et al., 2005). Psychomotor disturbances include, on the one hand, agitation and on the other, retardation. Agitation, usually accompanied by anxiety, irritability and restlessness, is a common symptom of depression. In contrast, retardation, manifested as slowing of bodily movements, mask-like facial expression, lengthening of reaction time to stimuli, increased speech paucity. The extreme form of retardation is an inability to move or to be mentally and emotionally activated (stupor) (Stefanis Stefanis, 2002). The attitude and outlook of these patients may become profoundly negative and pessimistic. They have no hope for themselves or for the future. Self-esteem sinks and the workings of conscience become prominent. Patients see themselves as worthless, as having never done anything of value. Rather they see their sins multiply before them (Moore Jefferson, 2004). Suicidal ideation is almost always present. At times this may be merely passive and patients may wish aloud that they might die of some disease or accident. Conversely, it may be active, and patients may consider hanging or shooting themselves, jumping from bridges, or overdosing on their medications. Often the risk of suicide greatest as patients begin to recover. Still seeing themselves worthless and hopeless sinners, these patients, now with some relief from fatigue, may find themselves with enough energy to carry out their suicidal plans. The overall suicide rate in major depressive disorder is about 4 percent; among those with depressive episodes severe enough to prompt hospitalization, however, the rate rises to about 9 percent (Moore, 2008). Up to 15 percent of untreated or unsatisfactorily treated patients give up hope of ever recovering and kill themselves (Akiskal, 2009). Proximal risk factors for suicide include agitation, current suicidal intent or plan, severe depression and/or anhedonia, instability (e.g., alcohol abuse or decline in health), recent loss, and availability of a lethal agent. Distal risk factors include a current suicidal intent with a plan, personal or family history of suicide, aggressive or impulsive behavioral pattern, poor response to treatment for depression, poor treatment alliance, a history of abuse or trauma, and/or substance or alcohol abuse (Hawton Harriss, 2007). Paranoid symptoms can occur among patients with major depression. There are usually exaggerated ideas of reference associated with notions of worthlessness. Characteristic delusions of patients with depression are those of a hypochondriacal or nihilistic type. Hallucinations may also occur in major depression. These commonly involve accusatory voices or visions of deceased relatives associated with feelings of guilt (North Yutzy, 2010). Adolescent-onset depression often takes on a more chronic course associated with dysthymic symptoms. In adolescence, MDD appears to be associated with greater fatigue, worthlessness and more prominent vegetative signs. The sequelae of depression in children and adolescents are sometimes characterized by disruption in school performance, social withdrawal, increased behavioral disruption and substance abuse (Kay Tasman, 2006). Among the elderly, agitation and hypochondriacal concerns are common, and indeed the patient may deny feeling depressed at all. Memory and concentration may be so impaired in demented elderly. In the past, this has been called a pseudodementia, presumably to distinguish it from other kinds of dementia. However, a better, more recent term is dementia syndrome of depression (Moore Jefferson, 2004). Elderly people are more likely than younger adults to have a depressive illness that goes undetected and thus untreated, which may contribute to the high risk of suicide among older patients. The suicide rate of this population is higher than for any other age group, and the attempts are serious: One out of four succeeds, compared with one out of two hundred for young adults (Bjornlund, 2010). Diagnosis and Classification of Depressive Disorders Depression conceives a variety of psychic and somatic syndromes, and the diagnosis is derived from diligent clinical observation (Grunze et al., 2008). Depression as a term in popular use is mostly considered to be synonymous with low mood or grief. Depression mental (and medical) disorder, however, is different, and besides low mood, is characterized by a variety of additional symptoms (Grunze et al., 2008). Depressive disorders are defined by clinically derived standard diagnostic criteria of emotional, behavioral, cognitive, and somatic symptoms, and associated with functional impairment. They are assessed through structured clinical interviews and observation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 2000) and International Classification of Diseases 10 (ICD-10; World Health Organization, 1992) use the same criteria to diagnose depressive disorders in children, adolescents, and adults (Roberts Bishop, 2005). The term affect usually refers to the outward and changeable manifestation of a persons emotional tone, whereas mood is a more enduring emotional orientation that colors the persons psychology (American Psychiatric Association, 1984). Subtypes of Depressive Disorders: Major Depressive Disorder (MDD) According to DSM-IV-TR, a major depressive disorder occurs without a history of a manic, mixed, or hypomanic episode. A major depressive episode must last at least 2 weeks. Typically, a person with a diagnosis of a major depressive episode also experiences at least four symptoms from a list that includes changes in appetite and weight, changes in sleep and activity, lack of energy, feelings of guilt, problems thinking and making decisions, and recurring thoughts of death or suicide (Sadock Sadock, 2007). Table 1.1.1 shows DSM-IV-TR criteria for major depressive episode. Unipolar and Bipolar Depression When a person develops an episode of mania they are conventionally identified as suffering from bipolar disorder. Patients with depressive episodes only are diagnosed as having unipolar depression (Baldwin Birtwistle, 2002). Melancholic Depression Individuals with melancholic depression experience a loss of pleasure in all or almost all activities or are nonreactive to usually pleasurable activities (American Psychiatric Association, 2000). In addition, according to the DSM-IV-TR, the individual must display three or more symptoms from a list of six, such as worsening depression in the morning, early morning awakening, significant weight loss or anorexia, and the perception that ones mood is qualitatively different from that experienced in other contexts. Melancholic depression is considered a severe form of affective illness (Woo Keatinge, 2008). Self-belittlement, an exaggerated sense of guilt, a feeling that life is pointless and that one has failed in everything are very often accompanied by severe recurrent suicidal thoughts and thoughts about death. However, the risk of suicide usually first becomes prominent when the patient is in the process of improvement and the psychomotor inhibition decreases while, at the same time, expectations about the capacity to cope with the psychosocial situation are still very negative (Wasserman, 2001). Table 1.1.1 DSM-IV-TR criteria for major depressive episode Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. insomnia or hypersomnia nearly every day psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down) fatigue or loss of energy nearly every day feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide The symptoms do not meet criteria for a mixed episode. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one. The symptoms persist for longer than two months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. Source. Reprinted from American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000. Masked Depression About 50% of major depressive episodes are unrecognized because depressed mood is less obvious than other symptoms of the disorder. Alexithymia, or inability to express emotions in words, can focus a patients attention on physical symptoms of depression, such as insomnia, low energy, and difficulty concentrating, without any awareness of feeling depressed. Common masked presentations of major depression include marital and family conflicts, absenteeism from work, poor school performance, social withdrawal, loss of a sense of humor, and lack of motivation (Joska Stein, 2008). Seasonal depression Seasonal depression is a condition in which depressed mood accompanied by lethargy, excessive sleep, increased appetite, and irritability recurs each winter. It was believed to respond exclusively to light treatment. However, recent studies indicate it can be just as effectively managed with standard methods of treatment, such as medication (Gill, 2007). Psychotic Depression The term psychotic depression (or delusional depression) refers to a major depressive episode accompanied by psychotic features (i.e., delusions and/or hallucinations). Most studies report that 16%-54% of depressed patients have psychotic symptoms. Delusions occur without hallucinations in one-half to two-thirds of the adults with psychotic depression, whereas hallucinations are unaccompanied by delusions in 3%-25% of patients. Half of all psychotically depressed patients experience more than one kind of delusion (Dubovsky Thomas, 1992). Dysthymic Disorder Dysthymia refers to symptoms of mild depression, which have persisted for at least two years. Symptoms fluctuate more than in major depression, and they are typical including insomnia, lack of appetite, or poor concentration (Bech, 2003). Double Depression Double depression characterized by the development of MDD superimposed upon a mild, chronic dysthymic disorder (DD). Individuals with double depression often demonstrate poor interepisode recovery. Furthermore, 25% of the depressed individuals manifest double depression (First Tasman, 2006). Table 1.1.2 shows DSM-IV-TR criteria for dysthymic disorder. Table 1.1.2 DSM-IV-TR diagnostic criteria for dysthymic disorder Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year. Presence, while depressed, of two (or more) of the following: poor appetite or overeating insomnia or hypersomnia low energy or fatigue low self-esteem poor concentration or difficulty making decisions feelings of hopelessness

Usher and Red Death Essay -- essays research papers

Run From Death and You’ll End Up Finding It   Ã‚  Ã‚  Ã‚  Ã‚  Edgar Allen Poe is famous for his gothic stories and poetries. In The Fall of the House of Usher, the narrator visits his old childhood friend, Roderick Usher. The Usher family is a noble family that is well known for their incestual behavior, which leads to multiple deformations for their offspring. The only living heirs of the Usher family are the twins, Roderick and Madeline Usher, forever chained to the decrepit house they live in with no chance of escape. In The Masque of the Red Death, a plague is reeking havoc upon the country and Prince Prospero can only do one thing: lock himself and his noble subjects in the abbey to party and not worry about death. In both of the short stories, the characters are stationed inside their house, trying to forget all miseries, but death still occupies the back of their minds. The characters within the short stories are trying to prevent death by running away, but they end up rounding the corner to meet up with Death again.   Ã‚  Ã‚  Ã‚  Ã‚  In The Fall of the House of Usher, the noble Roderick and Madeline Ushers are the remaining children of the family line. Since they have been keeping their bloodline pure, they have developed some unusual traits that prevent them from leaving their decaying house. As Madeline lives with a life-threatening disease that will soon take her life one day, Roderick refuses to see his twin sister die in that painful man...

American Women

Human sexuality can be seen as the way human beings experience their sexuality and express it. This results from their individual awareness as indicated by their biological sex and how they respond to erotic experiences. Human sexuality has however appeared as a thorny issue with many societies either ignoring to talk about it or shying away of the whole topic of sexuality. Due to the negative impacts that have resulted from this behavior, governments have come up with policies that are aimed at addressing human sexuality related problems.The increase in the number of HIV/AIDS victims in the world has triggered the discussion amount human sexuality. Research indicates that women are mo vulnerable to contracting venereal diseases including HIV/AIDS. Efforts to minimize the spread of the diseases have not actually succeeded as expected. The most neglected groups of people in matters of human sexuality in America includes single women and women in cohabiting relationships. The fear to c ontract to avoid unexpected pregnancies has led to masturbation with others engaging in homosexuality.This paper examines single motherhood, cohabitation, STD’s, masturbation and sexual preferences among American women. According to a research carried out by Lindberg L. D and Singh S, single American women exceed eighteen million in number. Statistics further reveal that in the age bracket of women between 19 and 45 are single. Ninety percent of these single ladies â€Å"are sexually experienced†. Shockingly, 22 percent of the single women and 2 percent of the married engage in sex with more than one partners.Over 50% of single American women get pregnant unintentionally. For those single women, getting health insurance is more difficulty for them as compared to the married. This indicates that single American women greatly indulge in sex. Despite all these findings â€Å"reproductive health care needs† of American women has not been upgraded to cater for the in creased needs. Furthermore, the American society lacks appropriate counseling services. The government effort to discourage single women to abstain and wait until the time they get married has proved to be futile.It has therefore been realized that proper policies to address the issue are yet to be put in place. Single women have been ignored in matters of sexual behaviors and the needs for quality reproductive health care. As a result these single women are at risk of contracting STD’s and AIDS, having unplanned pregnancies and births (Knox & Schacht 2009, pg. 279). Impermanence of marriage has made cohabiting to be one of the marriage alternatives. Research indicates that over nine percent of those women cohabiting have more than one sex partners.This is very shocking because the same women who are cohabiting rarely get health insurance in America. They are however better of as compared to the single women since in terms of accessibility to important services. This is howev er a short term alternative since soon or later, the cohabiting couples will separate and once again lead a single life. It is therefore important to note that cohabiting American women become single at different periods of their life.Increase in the number of single women has led to rise in cohabitation. This has been triggered by impermanence of unions that include marriage and cohabitation. Kail and Cavanaugh 2008, pg. 408 argue out that cohabitation has increased over ten times over the last 30 years. Statistics show that in 1970, only 523,000 people cohabited as compared to the year 2000 when a whooping five and a half million American were reported to cohabit. Most of them cohabited to facilitate sexual convenience and at the same time sharing expenses.Such couples have no intention of establishing a long lasting relationship and their goal is not marrying. The others engage in cohabitation to try whether marriage can work for them. The other group of cohabitors purely uses co habitation as a substitute to marriage. This has been highly reported in older women and men as compared to the other two previously mentioned which are highly practiced by young adults (Kail and Cavanaugh 2008, pg. 408). One of the major problems affecting women in America is the issue of STD’s including HIV.Women reproductive health has been given adequate attention in America however single women have been side looked. The danger of ignoring reproductive health services to single women has been reflected by the increase in the number of unplanned births and sexually transmitted diseases that include HIV. This is because their sexual relationships are unstable. According to O'Leary and Jemmott 1995, pg. 14, most of the women who live to the south of United States contract HIV through heterosexual transmission. This has been high among minority groups.In a report printed in the Jet magazine April 2008, pg, 53 indicated that over 50% of African American teenage women were suf fering from a sexually transmitted disease as compared to the white and teenage girls of Mexican origin with less than 20% of them who have at least one STD. The report indicated that there was poor communication between the teenage girls and the other members of the society on sexuality issues. Education on STDs was identified as one of the best methods of reversing the trend of STD infection.Early testing was also said to reduce the risk of spreading these diseases. Research indicates that most of the American women underestimate the risk for contracting HIV and other sexually transmitted diseases. This was confirmed by the research carried out by American medical women’s association in 1994 which indicated that 73% of all American women aged between 16 and 60 years strongly believe that they are safe from sexually transmitted diseases. This research further indicated that 67% of American women have no idea of other STDs apart from AIDS.33% of them have no idea about AIDS. Over 67% of the total engages in unsafe sex and less than 33% of them believe monogamy can reduce the risk of spreading HIV/AIDS ( O'Leary & Jemmott 1995, pg. 14). Greenberg, Bruess, and Conklin 2010, pg 475-477 found out that 40% of American women masturbate. This includes 45% of American married women. This was found to be directly proportional to the practice of vaginal sex, oral sex and anal sex among American women implying that those women who widely engage in virginal sex, oral sex and anal sex are great funs of masturbation.Wingood and DiClemente 2002, pg. 55 identified two main reasons why women masturbate. In their research, 63% of American women admitted that masturbation was a way of relieving sexual tension while 42% did it to acquire physical pleasure (Wingood and DiClemente pg. 55). Researchers have confirmed that masturbation does not cause any disease, infertility or dysfunction and this has encouraged many people to practice it as an alternative to sex. This practi ce has been influenced by a change in American culture in which sex was believed to be for procreation only, not for pleasure.Majority of then engage in sex for pleasure and whenever a partner is not readily available, women prefer to masturbate. This has led to a drastic increase in the demand for abortion among American women. It is a clear indication that sex is not only for procreation but largely for pleasure. This practice is mostly common among those people who are not deeply entrenched in religious practices as most of American religions view masturbation as unreligious practice. Though masturbation has not been associated with major physical problems many women have been reported to suffer from Psychological problems as a result of masturbation.Littleton & Engebretson 2002, pg. 339 pointed out that the media has largely influenced American women on the way they view their sexuality. This has been directly translated to their mode of dressing and their use of grooming produc ts. Sexual preference among American women can be viewed in three perspectives; sexual identity, sexual behaviors and sexual desires. Peplau and Garnets, 2002, pg. 333 are of the opinion that American women have a high erotic plasticity. In their argument, they pointed out that women have diverse forms of attraction with each other.They also noted that women sexual preference is highly affected by culture and social forces. This is because social identities and social institutions are provided and shaped by the society. All newly introduced practices may be accepted or rejected and either way, the women are mostly affected. Homosexuality was not exposed in American society. This has however changed with more women and men coming in the open to declare their sexual orientation as either being lesbians or homosexuals.Majority of American women are heterosexuals however â€Å"statistics indicate that heterosexual women face greater danger than heterosexual men in casual sex†. St atistics indicate that the number of lesbians in America is on the rise and this has raised many questions in regard to gay and lesbian marriages. Religious groups especially the majority Christian groups in America have expressed their concern about this trend however research indicates that homosexuality is slowly being accepted in American society. With the rise in the number of lesbians, bisexuality is also spreading its roots in America.Sexual preference has however faced a great challenge due to the increase in sexual dysfunction among American women. It is very important to realize that Sexual dysfunction is posing a great threat to sexuality has been highly reported among American women. The main causes have been cited as; depression, long term stress, negative attitude towards pregnancy especially for single women, increased demand to be a new mother, problems associated with women’s negative body image, culture and religious inclination and emotional distress. Other causes include physical conditions and hormonal causes.Conclusion Single mothers should be involved in policy formulations and implementation especially on matters that involve human sexuality. Neglecting them will create a gap that will impact negatively on their lives and the lives of entire American society. Cohabiting couples should be educated on the dangers of engaging in such relationship. This trend , if not checked may destroy the family which is the basic social institution. Sexual preferences should not be used to justify discrimination especially when it comes to heath care services and health care insurance covers.Masturbation should not only be viewed in terms of how safe it is. The focus should be directed to its negative psychological effects. Since most women issues have been ignore and the issue of human sexuality has been ignore for a long time, a thorough research should be conducted to establish the impact of single motherhood and cohabitation on sexual prefere nces. Scientific and psychological evidence concerning masturbation should be established in order to establish whether masturbation can be used to fight HIV/AIDS without negatively affecting the those who practice it.References Jet magazine; Apr 2008; Why African-American Teenage Girls Are Infected With STDs At higher rates 14 – Page 53, Vol. 113, Johnson Publishing Company Jerrold S. Greenberg, Clint E. Bruess, Sarah C. Conklin. (2010). Exploring the Dimensions of Human Sexuality Jones & Bartlett Learning Knox, D. , Schacht, C. (2009). Choices in Relationships: An Introduction to Marriage and the Family. Cengage Learning Littleton, L. Y. , Engebretson, J. (2002). Maternal, neonatal, and women's health nursing. Cengage LearningNEW YORK MAGAZINE. What are the risks to heterosexuals? 23 Mar 1987, Vol. 20, No. 12 New York Media, LLC. O'Leary, A. , Jemmott, L. S. , (1995). Women at risk: issues in the primary prevention of AIDS Springer Peplau,L. A. , Garnets, L. D. (2002). Wome n's Sexualities: New Perspectives on Sexual Orientation and Gender. Wiley-Blackwell Robert V. Kail, John C. Cavanaugh. (2008). Human Development: A Life-Span View. Cengage Learning Wingood, G. M. , DiClemente, R. J. , (2002). Handbook of women's sexual and reproductive health. Springer