Breathing is essential for life and seems fairly automatic. However, when we are stressed we often will hold our breath [briefly] and then have shallow and more rapid breaths. Our brains are preparing us for action to avoid some danger.  Often, there is no real danger, just our anxious or feaful reaction to something that might remind us of a past dangerous situation.  Our breathing change indicates that we have shifted into crisis mode and the stress that goes along with this.  If we can keep our breathing calm and even, we will be calm.  Many different spiritual practices promote relaxed, deep breathing as part of their meditation practices.

Learning to breathe more slowly can help us to calm down. Of course, when we are stressed and worried, it can be very difficult to calm our breathing.  Focusing on making our hands and feet feel warmer can help us to feel calmer.  This requires that we focus on our hands and feet, seeking a sensation of warmth in them.  If we do this, our breathing will automatically be calm, without having to focus on our breathing.  Then, during times when we are not feeling stressed, we can practice taking slow deep breaths while being aware of the air moving through your nostrils and into your lungs and out again. Focusing on our breathing and just being aware of it can help us to feel calm and not worried. Exhaling more slowly than you are inhaling can add to your sense of being calm and relaxed.

If we just breathe, we'll like it.



How do you know what is the right dose of medication?  I've already talked about the fact that doses are often established based on statistical averages.  This means that a percentage of people [32%] are more than one standard deviation above and below the mean.  These people will need doses that may not fit the usual dose range for a medication. Also, even if your dose is within the normal dose range, your specific dose is still important to determine as the success of the medication will depend on determining the optimal dose for you.  

So, what can you do to help your physician find the best dose of medication for you? You can write down symptoms you are having and check the internet to match your symptoms with specific diagnoses.  You can then share this information with your Doctor and then see which symptoms your Doctor feels are related to your diagnosis. Then you can keep track of the symptoms as you take the medication. You can then see if there is a dose that reduces or eliminates your symptoms.  If no dose is helpful, let your Doctor know so you can try a different dose until you find the right dose for you. Sometimes you might need to go down again with a dose and then raise it again to determine the best dose.  As a 23 year old patient of mine said recently: "I'm the best person to determine the optimal dose for me because I'm the only person who is me."  

The optimal doses of the vast majority of medications are based on the clinical response to the medication.  Your clinical response is what we've been talking about.  Your role in determining your response to medications is critical.  If your Doctor does not listen to your input regarding your response to medications, you may need to change Doctors.



The above was recommended in a children's book ; Wonder, by R.J. Palacio, that I read recently.  The book is about a boy with a severe craniofacial anomoly.  In other words, his face is very distorted, startlingly so. The boy is teased and the book portrays how he and his family, friends and classmates deal with his different appearance. The boy at one point wishes every day were holloween so that everyone could wear a mask everyday. This book reminded me of the short film ; "Butterfly Circus" where a man born with no limbs learns how to believe in himself and no longer feel ashamed of himself.  In this film, the limbless man is called "magnificent."" I asked my son about this and he said that "we are all magnificent."

How often do we lose sight of this regarding ourselves and others?   Do many of us even believe that we are magnificent?  There is something wonderful about all living things, including us.  Maybe we are able to see this about ourselves and others when we are in the presence of people who are different.  Maybe if we all are a little kinder than necessary, we will be able to see how wonderful we are.



Reverence is a feeling of profound awe and respect.  Albert Schweitzer felt that having a reverence for all life was ethical and moral, while anythng that destroys, harms or hinders life is wrong.  Schweitzer believed that alll life was sacred.  He spoke out against war and nuclear weapons as well as speaking out against our destruction of the environment.   At this time of deep sadness as we open our hearts to the families and classmates of the students who were killed at their elementary school in Connecticutt, I am reminded that all life is precious.  I also believe in people and their ability to choose good over evil.  

Why don't we take this time to honor those children who died and our own children, by valuing life and reaching out to others, while resisting putting others down or judging them.   



It is difficult to assess the risk of suicide and suicide attempts in children and adolescents although it is possible to identify risk factors.  

One risk factor that seems to be important involves how a parent talks to their child or adolescent.  If statements are mostly negative that are directed to the child or adolescent, this increases the risk of suicidal behavior.  This clearly indicates that children and adolescents are influenced by what and how parents talk to them.  It is also clear that negative communications are damaging and not effective in achieving behavior change.  Being encouraging and supportive with our children and adolescents will lead to positive behavior change and increased self-confidence.  A study looking at what indicates whether a child will be successful as an adult [be able to function successfully independent of their parents] correlated significantly with the amount of positive communication parents directed to their children during their preschool years.  Successful children were talked to more and with a much higher percentage of positive and encouraging comments. It is never to late to start emphazing positive and encouraging statements to our children, yet it is just better if it starts out that way from birth.

Other risk factors related to suicidal behavior in male and female adolescents include: if they disobey their parents; don't talk to their parents; have had a recent argument with their parents; and if there is a family history of depression or substance abuse/alcohol problems. Risk factors for female adolescents include: death of a family member or illness in a family member.  Risk factors for male adolescents include: parents separated or divorced; parent recently lost a job; the adolescent is adopted; or a parent has been jailed.

It is important to pay attention to a child or adolescents statements about suicide and also important to ask your child or adolescent if they are thinking about suicide or have ever thought of it.  If you are concerned about a behavior change in your child or adolescent, ask about suicidal thoughts or impulses. Just talking about suicidal thoughts/impulses will reduce the risk of your child or adolescent acting on them.  In addition, talking about how to handle feelings and stress and offering your support to listen to your child or adolescent, can be very helpful.  Listening without immediately offering suggestions, is very supportive.  Finally, talking about a safety plan with your child or adolescent is important with a focus on ways that your child and adolescent can ensure that they will be safe.