What is the word that defines someone who feel superior to poorer people than him and at the same time feel inferior to wealthier people than him? (Quora)

Just kidding. I don’t know of a word that would be defined by what you write in your question. All I can say is that those worries are rather pointless as well as trivial. It may be that people who worry in that way may be displacing far more meaningful and frightening worries on to the trivial in the hope of keep real anxiety at bay.

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Does anybody approve of me at all? I don’t think I do anything right.

It’s easy for someone like me to be glib in response to your anguish. I’ll try not to do that with telling you that you should love yourself, that you’re the most important person to believe in yourself. No. Those things may be true, but how to get there is the universal rub.

I would suggest that you get hold—easily available on Amazon Books—of Mark Williams & Danny Penman’s book; Mindfulness: An 8-week plan for Finding Peace in a Frantic World. It’s a Rodale publication.

I suggest this as this is a quite easy to learn form of meditation that research has shown done some wonders with all kinds of human frailties and dilemmas such as yours. It’s a great way to see not only what you think, but also how what you think an fantasize about affects how you perceive yourself. Give it a shot. I’ve recommended this to many of my patients and all report very good results about the things with which they struggle.

I’m assuming—I hope not wrongfully— that you are a young person. I’m likely quite a bit older and more experienced which leads me to the following which you’ve no doubt heard before causing your eyes to roll back in your head; but stay with me with an open mind: These things, they ways we find ourselves so wanting and defective as a young person change as you get progressively older. You get to the point that you not only accept yourself, you may even find pride in who and what you are. Believe me, it comes, and I must say, quicker than you know. I know, my friends I have gone through it. Seems to be part of the evolutionary human condition.

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I am mentally broke. What should I do?

Yeah, were supposed to be tough guys. It’s quite an unnecessary burden for sure.
But what can you do? Here goes from my experience: Many churches, especially Unitarian-Universalist churches—I know about this group as I’ve been a Unitarian-Universalist on and off for over 45 yrs.—and others that have men’s groups where men can relate to and share themselves with other men.
Mindfully select a friend, male or female and mindfully & carefully begin to reveal the less traumatic aspects of your recent experiences. You’d be surprised how much, when they know what’s happening, they want to help.
Check out community resources for bereavement groups or groups of people living with the reality of a coming death of a loved one, family or friend.
You might also ask your physician for a referral to a therapist who is knowledgeable about terminal illnesses and grief. I do this work and have found those who come in for this type of health do quite well as they stay connected to the sick and or dying family member or friend.

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How can people with Mental Disorders Become Productive

The best answer I can offer is this: these folks a chance. Whether in designing educational programs or work programs. I realize this has been tried—though mostly abandoned as public funds have been shifted from these programs to either the military or in unjust tax windfalls for the wealthy—in the past and some even survive today.
The best thing we can do for them, ourselves and the rest of society is to protest and work against the kleptocracy capitalism and its attendant wild spending on the military. As our national treasure is consumed by an ever growing military presence around the world—in excess of 700+ military bases across the world—and as this monster metastasizes across the globe the money it sucks up comes directly from maintaining our infra structure, education, medical care, research and social programs that once constituted or security net.
This behemoth is one of the reasons why the sensible social programs like the one I’ve suggested above & once proliferated around our nation are rapidly disappearing. We need to oppose this not only for ourselves but for those among us around whom we as citizens need to rally.

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My part Jindo dog, Dylan (Quora)

We took in a part Jindo who was on the streets in a central valley city in CA. We drove 3 hours to see him and he was a mess. Frightened, wormy, coughy (kennel) and wary. He spent most of the 1st month under our bed. I would lie on the floor next to the bed and talk with him several times a day. He’d come out for his 3 daily relief walks but right back under the bed. Eventually, he appeared. He’s the most loving, intelligent, funny dog we’ve ever had the luck to own.

He soon became my “Therapy” dog. I have a serious chronic auto-immune disorder that took most of my life away. But when we got “Dylan,” (I’m a poet and one of my favorites was Dylan Thomas so my wife liked the name and it stuck).

I also suffer from a spinal cord injury sustained most likely during an 8-hour spinal surgery. When at my desk writing when we 1st got Dylan, he would lie on the bed behind me and to my left. He very quickly somehow knew when the pain was ratcheting up. He would come to the corner of the bed right behind me and gently lay his right front paw on my shoulder. I grew to learn that this was his signal that he could tell, probably by subtle variations in my posture, that the pain was getting to be too much and I should take a break.

He then learned that from the partial blindness in my left eye to growl or nudge me if I was about to “blindly” step into traffic.

When we are having friends over he rather quickly seeks out the most physically or emotionally vulnerable and sit beside them the entire evening.

He’s accepted at Northwestern Hosp. in Chicago where I’ve been a few times for severe pain problems. My son would bring him to visit and he’d jump up on the bed, snuggle into me as I slept.

We walk 3 or 4 miles daily in and around Lincoln Pk. & we are constantly stopped by people wanting to know more about him or take his picture. Whenever we walk by a baby or toddler and here the child squeal “Doggy” we turn around and allow the child to approach and pet him. It makes our walks wonderful as we interact with so much more people than I would walking alone.

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Is there any cure for depersonalization (from Quora)

There is, Sam. Your describing possible symptoms of depression and that your withdrawal is deepening? Contact you family physician and explain what is happening with you and then, please, Sam, follow her/his advice. The longer you let this go the more dangerous to it becomes to all areas of your life. Don’t mess around with this, Sam, it might be very dangerous to you.

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Can I ask out my son’s therapist?
Mark Maginn
Mark Maginn, Psychotherapist, poet, memoirist
Written 2m ago
Certainly can. But should you? Short answer, no. And if you did, I would hope for you son’s sake that he would say no and affirm the boundaries around s/he and you son.

Some would argue that once your son’s treatment has terminated then is would be okay. Simply stated, it would not.

Therapy often goes on in the patient after termination. Dating the therapist would throw that off and leave your son feeling taken advantage of. There may come a point when he would like to go back to his therapist for another round of Tx; not at all unusual.

Don’t disrupt your son’s therapy now or in the future. There are lots of people to date, stay with them.

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Stay Steady

I am still lining up those who would like to be interviewed by me and have their stories posted here. Bear with me, the stories are coming and I will honor those who’ve maintained their will, their purpose, and their heroism in the face of some of the worst misery visited on our species.

Stay with me as I work to bring you the stories of those who face the demonized intruder who not only disrupts a life but also disrupts the lives of those who love the innocent target of pain’s demonic monster.

This ubiquitous demon feasts on those it targets for reasons unknown, or for reasons too unbearable for humans to comprehend.

Those dragged into the pit of mindless pain struggle to find the reasons for nearly unbearable pain, unbearable suffering. We, when the pain backs off just a bit, lash out, lash in, beg and demand answers to the unknowable question: Why? Why for god’s sake me? Why rip asunder me and my family? Why, goddamnit, why?

We might as well be shouting into a black well, a well with no sides, no depth, no beginning, and no end.

We shout our anger, our strength, our love and our hate, but mostly, in time, our despair. A despair so bleak, so cold, so hot, so all encompassing it rents the very fiber of existence.

Existence brought to its knees, existence wounded is an existence out of time. Out of time we rail, we weep, weep, beg and bargain. But existence so damaged, so altered is a veil that hides nothing. A veil torn, nay ripped asunder, ripped from the fabric of breath, of beat, of rhythm, of the veil of breath that breathes independent of the lungs we so honor, we so depend.

Yes, we are ripped, rented, wounded. We touch the very scars that announce our arrival at the godhead we so adamantly refuse.

We are who we are and that we know is the limit of all that we know. Our fabric torn, our fabic burned, tattered and repaired lies before us, a panting sled dog, a bleeding beast that begs for our love, our touch.

Touched. Yes, the best we can do is touch….

Tell us…why! Why……please….

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Suffering from pain: Share Your Story

I am embarking on interviewing and writing more posts about those who struggle with the demon of pain, how they manage, what things they do to help themselves live the best way they can. I intend to do about 20 to 30 more interviews and combine them with my earlier posts, look for themes and publish all in a book form.

I am interested in anyone who would consent to a completely anonymous interview for these upcoming posts. If interested or know of someone who might be, please contact me here.

I am looking forward to doing these kinds of posts as they are usually filled with tremendous humanity and, sadly, awful behavior of those with whom pain folks sometimes have to interact.

I look forward to hearing from you.

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Post by Dr. Jeffrey Fudin, pain specialist.

Is LA Times an OXY-Moron?
Posted by Jeffrey Fudin – September 19, 2016 – Dr. Jeffrey Fudin Posts, Guest Blog, Opioids & Politics
Let’s take a look. to see if the LA Times is in fact an oxymoron.

Merriam-Webster’s online dictionary defines moron as “a very stupid or foolish person”, but since this country treats corporate entities as people, I’d say LA Times qualifies. Their legal definition is “a person with a mild or moderate intellectual disability —used formerly — see also idiot.”

Other OXY-morons include anti-opioid zealots in the lay press, some propagandists, and politicians who persistently call OxyContin “synthetic heroin”. One who is skilled in the art and science of pharmaceutics knows this to be untrue. In fact, oxycodone is a precursor to oxymorphone, a CYP2D6 metabolite of the former. Oxymorphone is one substituent on the tertiary amine (nitrogen) different in chemical structure to naloxone as pointed out in a previous post Breaking Bad 2.0: Is it possible to synthesize Oxycodone from Naloxone?. That said, OxyContin, oxycodone, and oxymorphone are synthetic congeners of naloxone, an opioid receptor blocker with virtually no medical dangers and an antidote to what anti-opioid zealots otherwise describe as “synthetic heroin”: morphine, fentanyl, and heroin itself. Naloxone actually saves people from respiratory depression from opioid overdose. In fact, OxyContin is more similar in chemistry to over-the-counter dextromethorphan (the ‘DM’ in Robitussin DM) than it is to heroin. Truth be told, heroin is semi-“synthetic morphine” because heroin is essentially two morphine molecules synthetically sandwiched together by an acetyl group, more commonly known as vinegar. But alas, I suppose not knowing this science doesn’t make someone a moron; professing to know something you know nothing about is certainly short-sided, idiotic, and without a doubt approaches moronism.

On May 5, 2016 LA Times printed an OxyContin dosing article, “You want a description of hell?’ OxyContin’s 12-hour dosing problem” by Rion and Girion (two potential OXY-morons).1 In rebuttal, I wrote an editorial with Drs. Mena Raouf and Erica Wegrzyn in a highly regarded refereed periodical, the Journal of Pain Research, entitled “OxyContin was submitted and justifiably approved by the Agency as a twelve-hour dosage form”, to clarify the idiocy of LA Times authors Rion and Girion and the editorial staff that allows such nonsense to be published.2

I encourage anybody that is interested to look at the JPR article mentioned above by clicking HERE. But, as an educational exercise, I thought it would be nice to engage an up and coming Student Pharmacist Lindsay Worthmann to summarize our JPR editorial and the various issues by posting a guest blog. Overseeing Lindsay’s writing was Dr. Erica Wegrzyn, my current PGY2 Pain and Palliative Care Resident. Here for your information and entertainment is what both of these young professionals had to say…

Ms. Lindsay Worthman and Dr. Erica Wegrzyn:

As we all know, just about every aspect of life is governed in some way, shape, or form by Big Brother and/or the letter of the law. Fortunately, there is some degree of leeway in medicine. Behold, the off-label use function.

When OxyContin came to market, it was intended for every 12-hour dosing (Q12H). This is how the product was approved by the FDA and what the manufacturer (Purdue Pharma) marketed and subsequently endorses. The recent article in the LA Times, mentioned above, called Purdue out for “knowing” that some patients experience an end-of-dose effect as the12-hour mark approaches.1 Now, if this is true (which it sometimes is), patients would be experiencing pain or perhaps mild opioid withdrawal before the next scheduled dose. This can result in additional immediate release medications (like oxycodone) prescribed to cover that time-span, i.e. breakthrough pain. More medications may affect other risks such as overdose, opioid craving, and the like. So what exactly is all the fuss about? It appears that the LA Times is upset that Purdue is not formally addressing this presumed “lack of efficacy”, or what is commonly known as “end-of dose failure” of a 12-hour dosing interval and isn’t promoting its use at 8-hour intervals. This is because Purdue is a pharmaceutical company and is LEGALLY prohibited from promoting off-label uses.

If a patient is experiencing this lack of benefit at Q12H dosing intervals, a Q8H dosing interval sounds like a plausible option. Logically, it makes sense: prevent return of pain, prevent withdrawal, avoid adding additional medications, and maybe even diminish the risk for diversion. The concern expressed by some, with dosing OxyContin Q8H, is that the patient could potentially experience a higher oxycodone plasma level, therefore increasing the risk for side effects such as a loss of consciousness or a decrease in respirations. There is no evidence to support this.

Off-label use is not an uncommon scenario. For example, fentanyl patches are marketed as Q72H, but may be used for Q48H as indicated in the label3. Tricyclic antidepressants (TCAs) such as amitriptyline for neuropathic pain are commonly used off-label4,5.

Can the pharmaceutical companies that make these drugs legally and openly support off-label uses? No.

Is fentanyl often dosed Q48H? Yes.

Is amitriptyline used for neuropathic pain? Yes.

Can oxycodone ER be usedQ8H? Yes.

Obviously, there are always risks associated with off-label use. There are also risks associated with any medication even when taken as prescribed. It is the responsibility of the medical provider to discuss risks vs. benefits of any treatment plan. The further a medical provider deviates from the intended use, the higher the liability. Many antidepressants and anticonvulsants without a pain indication are routinely used to treat neuropathic pain syndromes. Cancer drugs are frequently used for malignancies for which there is poor evidence. In the grand scheme of things, whether or not Purdue Pharma openly supports or endorses OxyContin Q8H is irrelevant, other than their obligation to follow the law and not promote for off-label use.

n closing, it is noteworthy that newspapers should provide accurate information by honest journalists who do their homework and provide each side of a controversial story. Perhaps the term Newspaper here is an oxymoron too, since the definition of oxymoron is “a combination of words that have opposite or very different meanings”.

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