What is the Link Between Stress and Bipolar Disorder?

Are you feeling stress? Stress exacerbates your bipolar disorder. Learn how in this post on the Bipolar Parent!

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The Link Between Stress and Bipolar Disorder - CassandraStout.com

Stress affects everything in your body, from your shoulders to your hormones, from your immune system to your mental illnesses. Stress is a physical issue, just like bipolar disorder, as both mess with your feel-good chemicals.

There are different types of stress. There’s good stress (also called eustress), which can motivate you to make dinner on time and meet deadlines at work. Good stress is infrequent, usually not repeated, and short-lived, leaving you better off than you were before you encountered the stress.

Bad stress, on the other hand, lingers. It lasts a long time and repeats frequently, leaving you much worse off than you were before.

But stress is even worse for people who suffer from mental illnesses, like bipolar disorder. People with mental health conditions tend to be unable to handle stress as well as neurotypical people. For people with bipolar disorder, even small, inconsequential decisions can stress us out. If we feel stress during everyday decisions, then the fact that stress exacerbates bipolar disorder symptoms makes sense.

Bipolar disorder and stress, especially bad stress, are a nasty combination. Stress is a known trigger for both hypomanic and depressive episodes–and sometimes even mixed episodes.

My Experience with Stress

Different types of stresses affect me in different ways. Before a long road trip or a flight, I get riled up and anxious without fail. I definitely have racing thoughts and other symptoms of hypomania, minus the euphoria. Sleeping becomes difficult, which only exacerbates the manic feelings.

On the flip side, feeling stressed about my messy house depresses me. The link between clutter and depression is very real, as having items on the floor focuses me to make decisions about them (specifically, whether to put them away or leave them there) every time you walk past them. After a full day of making many, many decisions and (usually) not taking any action on the items, I suffer decision fatigue, which for me leads to depression.

When I’m stress-depressed, I often berate myself for my inability to pick up the house. I know rationally that my laziness isn’t really laziness, but is a problem called executive dysfunction, which stress also makes worse.

Executive dysfunction is the inability to prioritize tasks, and determine the order of actions. Stress makes prioritizing and deciding on which actions to take very difficult, which is common for those of us who suffer mental illness.

(For a post on the link between bipolar disorder and executive functioning, click here.)

When I’m stressed, my ability to handle my responsibilities falters significantly, which only leads to more stress. I am reduced to a ruminating mess, turning in circles and chasing my own tail. Bad stress makes me completely incapable of acting like a functional adult.

Take Care of Yourself: Destress

If you want to improve your bipolar disorder symptoms, you need to manage your stress levels. Being constantly stressed, especially with bad stress, will lead to a mood episode.

Sometimes you can make big changes, like getting a new job or finding a new living situation. Diet also plays a role in how well you’re able to handle stress, so a lifestyle change like eating healthier foods may help you fill up your tank.

Even small changes can help. Starting a yoga or taekwondo class can help you relax. Deep-breathing techniques may also reduce your stress.

Talking to a therapist is also a good idea. You can learn coping techniques and tools for handling stress throughout the rest of your life.

Above all, practice self-care. Self-care is taking responsibility for your physical and mental well-being. That’s it. Don’t neglect to eat regularly, get enough sleep, go outside, socialize with people face-to-face, drink enough water, and exercise. If you do most of these big six tenants of self-care on a daily basis, you will be better off.

Final Thoughts

Bad stress affects me in a lot of negative ways. I’m not the best at handling stressful situations. So I plan ahead for them. I make massive to-do lists, outlining each tiny step that I need to take in order to conquer the issue. And I practice self-care.

Bad stress may affect you despite your best efforts. You may end up living through many, many stressful situations throughout your life, like moves, marriages, and births. You need to lean on your coping tools during these times.

Plan ahead. Take the times when life is relatively calm to assess your ability to handle stress, and plan how you’ll respond to changes. If necessary, you can get a prescription for anti-anxiety medications that you take on an as-needed basis.

Effectively managing your stress will help you suffer less from your bipolar disorder.

Related:

The Link Between Stress and Bipolar Disorder - CassandraStout.com

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8 Easy, Frugal Self-Care Tips for a Bad Mental Health Day

When you’re suffering from a mental illness like bipolar disorder, some days are worse than others. You will have days where you wake up stressed, depressed, and feeling unloved. Your brain often tells you that you’re worthless, that you don’t deserve love, and that you shouldn’t expend the energy to take care of yourself–and that no one else will either.

So how do you get through a bad mental health day?

The answer is self-care. Self-care is the act of taking responsibility for your physical and mental well-being. That’s it. That’s all self-care is.

May is Mental Health Awareness Month. Observed in May since 1949, the awareness month aims to educate families and communities about mental illnesses, and support those who struggle with them. One of the best ways to take care of yourself during a mental illness is to practice self-care.

Here are 8 easy, frugal ways to practice self-care when you’re facing a horrible day:

How to Survive a Bad Mental Health Day - CassandraStout.com

1. Get Out of the House

I know, I know, when you’re feeling down in the dumps, you don’t want to go outside. You’d rather stay in your dark, gloomy bedroom, which is far more comfortable that going outside in a winter drizzle. But trust me, getting outside, even when the sky is overcast, is crucial for your mental health.

Sunshine entering your eyes has a huge impact on your mood. Even if the sky is cloudy, you’ll be absorbing a therapeutic amount of sun–10,000 lux, or units of light. Absorbing this lux helps lower your blood pressure and engender feelings of contentment. A therapy light box uses up to 10,000 units. During the summer, the sun shines up to 30,000 lux.

During the winter, without absorbing the sun, many people suffer from the winter blues, also known as seasonal affective disorder (SAD). For more strategies on how to combat the winter blues, click here.

So getting outside, even for a brief walk, is critical to manage a bad mental health day. Even sitting in a sun puddle in front of a window can help, though walking outside also helps because you’re getting some exercise, too. Try it today.

2. Practice Hygiene

If your energy level is so low that even showering and brushing your teeth sound like onerous chores, then at least use baby wipes or a damp rag, and mouthwash. Washing your face, arms, and the back of your neck will help you feel better. And mouthwash will enable your mouth to feel fresh for a little while.

Practicing hygiene this way only takes a few minutes. You have nothing to lose by trying.

3. Do a Full-Body Check

Performing a full body-check can help you tune into your needs. Sit in a chair or lie down on your bed. Mentally examine your whole body, starting with your toes.

How do your toes feel? Are they sore? Cold? Too warm? How about your shins? How about your hips? Belly? And so on. Keep asking these questions about each of your body parts.

Next, ask yourself how you’re feeling in general. Are you hungry? Thirsty? Tired? When is the last time you’ve eaten or drank water? Can you take a nap?

After you’re done asking questions, start addressing the problems that may have cropped up. Go feed yourself, and drink water. Take a shower if you can, or use baby wipes. Take a nap.

Doing a full-body check can help you identify issues with your body as well as solutions to those issues. Just try it.

4. Take Your Medication

This tip is more preventative than reactionary, but if you have prescribed pills and haven’t swallowed them today, make sure to take them.

If you have fast-acting anti-anxiety meds, for example, then by all means take them if you’re feeling anxious. Sleep aids can also help you take a nap or get a good night’s sleep. Don’t be afraid or ashamed that you need the extra medical help. That’s what your medication is there for.

5. Talk to Someone You Trust

Letting someone you trust know about your bad mental health day can help you feel listened to and empathized with. If the people around you understand your struggles, then you may feel less alone.

Some therapists, if you have one, offer emergency counseling sessions. For a post on how to start seeing a therapist, click here.

If you can’t get a hold of your therapist or you don’t have one, then call or text a trusted friend. If you’re truly alone, then call a warmline or visit an online support group.

6. Appeal to Your Senses

When you’re struggling with a bad mental health day, appealing to your senses is a good way to center yourself.

There are several ways to engage your senses: burn incense or a candle (scent), eat some chocolate (taste), apply lotion to your hands and face (touch), look at a beautiful picture of a forest (sight), or listen to your favorite soothing song (hearing).

If you appeal to your senses, you can ground yourself in the present moment. It’s almost like meditation. Give it a try today.

7. Get Lost in a Book

One of my favorite ways to distract myself is to get lost in an imaginative book. Being transported to another world, reading about people who solve problems that aren’t my own, is a wonderful way to focus on something other than my sad state.

If you can concentrate on reading, try getting lost in a book today. Just pull your favorite off your bookshelf, or find a free one online.

8. Lower Your Expectations of Yourself

On a bad mental health day, just getting through the day is enough. You’re not at your best, so you’re not going to be able to be as productive as you usually are. Bid goodbye to guilt about not being on the go.

Our capitalistic societies (in the US especially) expect us to perform like cogs in the machine. But you are human, and you struggle with a mental illness. You are enough just the way you are.

Final Thoughts

Everyone suffers from a bad mental health day from time to time. These 8 tips can’t cure a mental health day, but may be able to help you manage one. If you can only manage one, that’s okay.

Just pick your favorite off the list, one you can handle, and try it today.

I wish you well on your journey.

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8 Frugal, Easy Tips for a Bad Mental Health Day - Cassandrastout.com

 

 

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How to Start Seeing a Therapist

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A picture of a man in a white doctor’s coat. Credit to flickr.com user Tyler Byber. Used with permission under a Creative Commons license.

A version of this post first appeared on the International Bipolar Foundation Website, found here.

Seeing a therapist can be enormously helpful in sorting out issues you may have in your life. You can also develop coping skills in therapy to deal with serious problems, or just the less-serious issues of everyday life.

But how do you start searching for a therapist? Read on to find the solution.

Facts to Keep in Mind During Your Search

There are a few things to keep in mind before you start your search for a therapist:

  • You need to find someone you feel comfortable talking to. No therapist worth his or her salt will be offended if you decide that your relationship with him or her isn’t working out. Don’t stick around if you need to move on.
  • Secondly, if you want medication, you’ll need to see a licensed psychiatrist or nurse practitioner who is allowed to prescribe for you. You may encounter a combination therapist-psychiatrist, but those are a rare and dying breed. More likely, you’ll hire a treatment team to take care of all your needs. You don’t need to factor this into your search for a therapist, but if you need meds, you’ll have to find someone other than your therapist who can prescribe for you.
  • Third, you will find that there are all sorts of acronyms following the names of various therapists. There are Marriage and Family Therapists (MFTs), Licensed Mental Health Counselors (LMHCs), Licensed Clinical Social Workers (LCSWs), and Doctors of Psychology (Psy.Ds.), among others. Don’t be put off by the variety in titles. Rest assured that your level of care will be similar despite the different acronyms. Just make sure your therapist is licensed. Look up the meanings of some of these acronyms. It may help you narrow your search.

Step 1: Figure out What You Want and Need in a Therapist

Do you want a female therapist? Maybe someone Christian? Someone with experience with elder care? Sometimes therapists will list their specialties on their office websites, but it’s not difficult to ask before you see them a question like whether they have experience with patients with bipolar disorder or generalized anxiety.

Next, figure out what you need, not just want, which can be more difficult to pin down. Do you need someone who approaches you with tough love, or someone who indulges you a little? Do you need assignments out of the office? Do you need a shoulder to cry on?

Make separate lists of your needs and wants, and reflect on them at your first appointment, to see if the therapist you’ve chosen is meeting most of your needs and some of your wants.

Step 2: Figure Out How Much Care You Can Afford

Some mental health counselors take insurance, but many will require payment out-of-pocket. Fortunately, most therapists charge on a sliding scale, which means they will consider your ability to pay in determining the price. Determine how much you can afford to pay per month, and how many sessions you think you need. Your budget will determine what therapists you’ll think about using. Keep in mind that mental health is crucial for your day-to-day functioning, and a therapist should be able to help. If you can’t afford a therapist, then that will add strife, not help.

Step 3: Start Searching

There are several ways to find a therapist once you’re ready to search. First, ask for recommendations from your family and friends, provided they’re supportive of your mental health journey.  Next, ask for a referral from your doctor, if you have one, and your insurance company–they’ll send lists. Searching online is also an option. GoodTherapy.org allows you to search by location.

Step 4: Prepare for the First Appointment

Once you’ve done the research, it’s time to make appointments. If you can, try to vet more than one therapist to cover the bases of your wants and needs. Prepare for the first appointment(s) by writing down a few questions to consider when meeting with your therapist:

  • Do I feel comfortable with this therapist? Can I make a relationship with him or her?
  • Does he or she ask me enough questions?
  • Has my therapist asked me what my goals are?
  • Does my therapist meet my wants and needs?

And so on. Finding a therapist takes time and dedication, but the results are worth it. If you can establish a relationship with your therapist, then you can address the problems which are plaguing you.

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Hiatus Announcement for The Bipolar Parent

It’s time for me to take a break.

cassandra stout photo
Blogger Cassandra Stout. Protected under a Creative Commons license.

I’ve been burned out with family responsibilities and dealing with some intense conversations in therapy, and my blog has suffered for it. You may have noticed a dip in quality, for which I apologize for. I’ve only written a single post in the past six weeks. In short, while I have the motivation to blog, as I don’t want to disappoint you guys, my readership, I have lost the inspiration. I don’t want to churn out low-quality posts just to have something up on Fridays, so it is with a heavy heart that I’m announcing a hiatus until the first Friday in September, 2019. I promise to start blogging again then, and to give you the level of detail and quality you expect from The Bipolar Parent.

Thanks so much for being here with me. Until September.

-Cassandra Stout

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National Prevention Week: How I Prevent Oncoming Bipolar Mood Episodes

The week of May 12-18 is National Prevention Week, so I’d like to talk about how I try to prevent oncoming bipolar mood episodes. Because I was diagnosed at twenty-two and started medication and therapy, I have a decade’s worth of experience in managing my bipolar disorder. Read on for a roadmap discussing how to tackle the prevention of mania and depression head on.

Fight Self-Stigma

Self-stigma is when you have absorbed the negative, inaccurate messages about your mental illness around you. This affects your perception of your mental illness and your need to treat it, which in turn affects your behaviors and actions in terms of seeking treatment. In order to face taking medication every day for the rest of your life, you need to fight stigma, especially self-stigma. The way I fought it was to recognize that I needed to be my best self for my newborn son, which entailed taking medications and going to therapy. I needed to treat my disorder so I could properly mother my son. It wasn’t just about me.

If you have a reason outside of yourself, awesome, but if you don’t, you still deserve treatment. You are better than your disease. You are a human being, a precious individual. Caring for yourself, especially in the pit of depression, is one of the hardest issues you’ll ever face. But you deserve proper care, even if it’s mostly self-care for a while.

Medication

I can’t recommend medication enough. In combination with therapy, medications saved my life. When I was first diagnosed, Depakote toned down my psychotic mania, and two years later, lithium lifted me from the black sucking hole of suicidal depression. Now I’m on Risperidone and Wellbutrin, and the combination has enabled me to be stable for over six years. Taking my medication daily has prevented the dizzying spin of mania and the pit of depression. Part of this is my fighting self-stigma, as I said above.

Therapy

Another tactic that has helped me remain stable for the past half-decade is attending counseling sessions with my therapist. Therapy has helped me learn coping mechanisms to handle my day-to-day life, including emergencies. I’ve been able to treat my manic and depressive episodes, and learn how to flourish. I am thriving, and I wouldn’t have thrived so successfully without those weekly appointments with my therapist.

Sleep

Proper sleep is crucial for managing your bipolar disorder. Sleep disturbances trigger bipolar mood episodes, especially mania, and too much sleep triggers the crash of depression–usually following mania. Problems with sleep are a common symptom of bipolar disorder; in a future post, I’ll be looking at how common insomnia is for this specific mental illness.

To ensure I sleep as well as I can, I practice what’s called good sleep hygiene. I don’t drink water or caffeinated beverages right before bed. I wind down before bed, taking a bath every night. I wake up every morning at 8:30am, if not earlier. I try to go to bed at the same time. I wake up frequently in the middle of the night with a racing mind, but I try to calm myself by praying or meditating. Generally, that works, and I’m able to get back to sleep within fifteen to thirty minutes; I recognize that I am lucky in that manner. Try to practice good sleep hygiene, and you, too, might be able to prevent oncoming bipolar mood episodes.

jessi RM
A picture of a smiling woman next to a frowning woman, in black and white. Credit to fliclr.com user Jessi RM. Used with permission under a Creative Commons license.

Final Thoughts

Fighting self-stigma, getting proper treatment for your disease (including medication and therapy), and sleeping properly are some of the best ways to prevent oncoming bipolar mood episodes. If you’re looking for a post on how to manage the most common bipolar triggers, click here.

You can do this.

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Gene Breakthrough on Lithium Treatment for Bipolar Disorder

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Credit to flickr.com user Berkeley Lab. Used with permission under a Creative Commons license.

Genes linked to schizophrenia in psychiatric patients suffering from bipolar disorder are the reason why such patients don’t respond to the “gold standard” treatment for bipolar – the drug lithium – according to international research led by the University of Adelaide.

Lithium has been widely used as a treatment for bipolar disorder since the 1950s because of its mood stabilising effect. It has unique protective properties against both manic and depressive episodes, and an ability to decrease the risk of suicide.

However, about 30% of patients are only partially responsive, more than a quarter show no clinical response at all, and others have significant side-effects to lithium.

Until now, researchers have not understood why these patients have not responded to the common treatment, while others have responded well to the drug.

Published in the journal JAMA Psychiatry>, an international consortium of researchers led by the University of Adelaide’s Professor Bernhard Baune reports a major discovery that could affect the future quality of treatment for people with this significant mental health condition.

Known as the international Consortium on Lithium Genetics, the group has studied the underlying genetics of more than 2500 patients treated with lithium for bipolar disorder.

“We found that patients clinically diagnosed with bipolar disorder who showed a poor response to lithium treatment all shared something in common: a high number of genes previously identified for schizophrenia,” says Professor Baune, Head of the Discipline of Psychiatry at the University of Adelaide and lead author on the paper.

“This doesn’t mean that the patient also had schizophrenia – but if a bipolar patient has a high ‘gene load’ of schizophrenia risk genes, our research shows they are less likely to respond to mood stabilisers such as lithium.

“In addition, we identified new genes within the immune system that may play an important biological role in the underlying pathways of lithium and its effect on treatment response,” Professor Baune says.

Understanding the underlying biology of people’s response to lithium treatment is a key area of research and urgent clinical need in mental health.

“These findings represent a significant step forward for the field of translational psychiatry,” Professor Baune says.

“In conjunction with other biomarkers and clinical variables, our findings will help to advance the highly needed ability to predict the response to treatment prior to an intervention. This research also provides new clues as to how patients with bipolar disorder and other psychiatric disorders should be treated in the future.”

Text provided by the University of Adelaide.

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Light Therapy Helps Bipolar Disorder Patients Function

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Credit to flickr.com user Richard Leeming. Used with permission under a Creative Commons license.

Daily exposure to bright white light at midday significantly decreased symptoms of depression and increased functioning in people with bipolar disorder, a recent Northwestern Medicine study found.

 

Previous studies found morning bright light therapy reduced symptoms of depression in patients with Seasonal Affective Disorder (SAD). But patients with bipolar disorder can experience side effects such as mania or mixed symptoms from this type of depression treatment. This study implemented a novel midday light therapy intervention in an effort to provide relief for bipolar depression and avoid those side effects.

Compared to dim placebo light, study particpants assigned to bright white light between noon and 2:30 p.m. for six weeks experienced a significantly higher remission rate (minimal depression and return to normal functioning). More than 68 percent of patients who received midday bright light achieved a normal level of mood, compared to 22.2 percent of patients who received the placebo light.

The group receiving bright light therapy also had a much lower average depression score of 9.2 compared to 14.9 for the placebo group and significantly higher functioning, meaning they could go back to work or complete tasks around the house they hadn’t been able to finish prior to treatment.

The study was published Oct. 3, 2017 in the American Journal of Psychiatry.

“Effective treatments for bipolar depression are very limited,” said lead author Dr. Dorothy Sit, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. “This gives us a new treatment option for bipolar patients that we know gets us a robust response within four to six weeks.”

Patients also experienced minimal side effects from the therapy. No one experienced mania or hypomania, a condition that includes a period of elation, euphoria, irritability, agitation, rapid speech, racing thoughts, a lack of focus and risk-taking behaviors.

“As clinicians, we need to find treatments that avoid these side effects and allow for a nice, stable response. Treatment with bright light at midday can provide this,” said Sit, also a Northwestern Medicine psychiatrist.

The study included 46 participants who had at least moderate depression, bipolar disorder and who were on a mood stabilizer. Patients were randomly assigned to either a 7,000 lux bright white light or a 50 lux placebo light. The light therapy patients were instructed to place the light box about one foot from their face for 15-minute sessions to start. Every week, they increased their exposure to the light therapy by 15-minute increments until they reached a dose of 60 minutes per day or experienced a significant change in their mood.

“By starting at a lower dose and slowly marching that dose up over time, we were able to adjust for tolerability and make the treatment suitable for most patients,” Sit said.

Sit and her colleagues also observed a noticeable effect of bright light therapy by four weeks, which is similar to other studies that test light therapy for non-seasonal depression and depression during pregnancy.

Light therapy has conventionally been tested using morning light at awakening because previous research has suggested that morning light helps reset circadian rhythms and can be helpful in the treatment of SAD, Sit said. However, the mechanism of response is unclear in bipolar disorder. To understand the possible effects of midday bright light on circadian rhythms in patients with depression and bipolar disorder, Sit and colleagues are planning new studies to investigate.

Text provided by Northwestern University.

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What Types of Therapies Are Right For You?

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Credit to flickr.com user John Graham. Used with permission under a Creative Commons license.

Therapy is a crucial part of treatment. There are several different types of therapies that your mental health professional may encourage you to take.

 

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is one of the most common types of psychotherapy, and is often preferred by many mental health professionals. During CBT, you work with a therapist to challenge negative thinking and develop constructive beliefs. That’s the cognitive part. The behavioral part helps you act on these beliefs.

CBT can be conducted one-on-one, or along with family, or with other people who have similar issues in a group setting. During CBT, you will learn about your mental illness and practice relaxation techniques and coping methods.

Interpersonal Therapy (IPT)

Interpersonal therapy focuses on the relationships you have with others, being based on the principle that relationships affect your moods. IPT also helps you express your emotions in healthy manners. The therapy is highly structured, and intended to finish in 12–16 weeks. IPT and CBT are the only therapies that are mandated for mental health professionals to be trained in.

Family Therapy

Family therapy goes by many names. To wit: it’s referred to as couple and family therapy, marriage and family therapy, family systems therapy, and family counseling. The driving force behind family therapy is the thought that involving family members benefits patients. People undergoing the therapy learn how to communicate with each other and solve problems.

Psychodynamic Therapy

Psychodynamic therapy operates on the principle that you have unconscious habits and emotions which developed early in life and cause difficulties in daily functioning. The therapy focuses on revealing and resolving these unconscious problems. Dream interpretation and free association are often used. This therapy is a treatment of choice for post traumatic stress disorder (PTSD), but largely used to treat personality disorders.

Art Therapy

Art therapy uses art such as music and painting to help you resolve problems and reduce stress. Art therapists will work with you to help tease out messages from your art. They are trained in artistic practices and psychological theory. You do not need to be artistically talented or trained to make use of art therapy.

Psychoeducation

Psychoeducation is just as it sounds: education about your mental illness from a mental health professional. Psychoeducation can occur in a one-on-one setting or a group session, where several people are informed about their illnesses at once. Family members can also benefit from learning about your mental health condition, and are encouraged to sit in on psychoeducation sessions.

There are several therapies out there, and not every therapy works for every person. Stick with your therapy at first, to see if it works, and if it doesn’t, don’t be afraid to try another.

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