• Low back pain (LBP) is pain arising from the spinal or paraspinal structures in the lumbosacral region. LBP extends approximately from the iliac crests to the coccyx.
• Radicular leg pain, or sciatica, may accompany low back pain but should be regarded as a separate entity with a distinct pathophysiology.
• LBP (lower back pain) is the fifth most common reason for all physician visits and the second most common symptomatic reason (upper respiratory symptoms are first).
• Fifty to eighty percent of adults experience LBP (lower back pain).
• LBP (lower back pain) is the leading cause of disability and lost production in the United States, with associated direct and indirect costs estimated to exceed $50 billion per year.
• Despite the widespread opinion that 75

We hear a lot about depression in general, but there’s a reason most of the ads we see for antidepressant medications feature women.

Women are twice as likely as men to have major depression and, like men, may experience episodes throughout their lives. Women also attempt suicide much more frequently than men, but are less likely to die from those attempts.

Here are some facts about women and depression:

* Women may develop depressive episodes at any time during their lives, but the tendency is greatest during their reproductive years. Prior to adolescence, boys and girls become depressed at about the same rate.
* Some women experience depressive symptoms in relation to their menstrual cycles (most commonly toward the end of the cycle).
* Depression may also occur during pregnancy, the postpartum months, and during the years just before and after menopause.

Despite extensive research, however, no reason for the increased risk for depression in women has been firmly established. Some hypotheses point to hormonal changes; endocrine system alterations such as elevated cortisol levels and subclinical hypothyroidism; the pressures of social and family roles; culturally determined gender expectations; and genetic influences. But we don’t know for sure how these factors combine to cause depression.

After menopause, the risk for depression in women is closer to that for men because it declines somewhat in women and increases in men in that same age range.

As do men, women certainly suffer as a result of their depression. Mood, motivation, concentration, energy, sleep, appetite, and libido all can be affected. In some women, these signs can be overlaid with feelings of worthlessness and guilt, irritability and restlessness, and thoughts of suicide.

And because women often play central roles as family caregivers, their depression can have a profound effect on all family members, especially children. This makes effective treatment especially important.

One treatment challenge that only women face is what to do about taking antidepressants and related psychiatric medications during pregnancy. All FDA-approved medications are categorized according to their relative safety during pregnancy.

The system includes ratings of A, B, C, D, and X, with “A” being proven safe during pregnancy and “X” posing a high risk. Some antidepressants apparently carry less risk than others.

Women who have had episodes of depression and either are pregnant or are considering becoming pregnant should consult with their health care providers about their treatment options.

All women need to recognize their increased risk for depression. If you believe you or someone you know may be depressed, help may come in many forms. Your first step is to talk to someone, such as another family member, a counselor or doctor, or another trusted person.

Article Source: Johns Hopkins University.

Is depression the same for men and women? Not necessarily.

Men and women both may develop major depression with persistent sadness, hopelessness, sleep and appetite disturbance, lack of sexual interest, feelings of worthlessness, and suicidal thoughts.

However, the social roles and the physical and psychological differences between men and women create some differences in their vulnerabilities to and experiences of depression.

Although the overall rate of depression is greater in women than in men, the rate of actual suicides is four times higher in men. And, when men do kill themselves, they are more likely to use violent methods.

Major depression often occurs by itself, as a primary disorder, although it is not unusual for it to develop in association with other psychiatric conditions.

Men who are abusing alcohol and other substances, or whose teen years were marked by a conduct disorder (i.e., physical aggression, verbal abuse, destruction of property), have a greater risk of depression. Sometimes, it’s difficult to identify depression as a separate disorder that should be treated.

And, of course, not all men respond to depression in the same way. Some will become more socially isolated and withdrawn. Some will turn to alcohol and drugs, perhaps in an effort to escape from their symptoms.

When depressed, some men may become more reckless and take more risks, not caring whether they harm themselves or others. Some men become abusive.

The biggest challenge for men who are depressed is recognizing that they have a problem and then going to see a health care provider to discuss their problem.

Men tend to deny their symptoms. They are less likely to describe feeling sad, but instead may discuss their low energy, motivation, poor sleep, and low interest in work and hobbies. When reviewing the past, men often minimize earlier episodes of depression, although their pattern for recurrent episodes is similar to that experienced by women.

The recommended treatment for men suffering with major depression is the same for all populations: psychotherapy and antidepressant medications.

So, men

Most polular benzodiapines drugs:

Xanax - generic name Alprazolam

Valium - generic name Diazepam

Ativan - generic name Lorazepam

Klonopin - generic name Clonazepam

Benzodiazepines are usually taken as a tablet, capsule or oral solution (liquid form), but some may also be injected or taken as a rectal suppository.

How Benzodiazepines Work

Benzodiazepines are antianxiety medications that are used to treat panic disorder. Alprazolam, specifically, is effective in reducing anxiety and nervous tension and can be helpful in easing agoraphobia. Benzodiazepines are sometimes prescribed for immediate relief of symptoms, but antidepressants are usually used for long-term treatment of panic disorder and may be prescribed along with a benzodiazepine to treat panic disorder. Benzodiazepines can be used on a daily basis or taken as needed, unlike antidepressants, which must be taken every day.

Why Benzodiazepines Are Used

Benzodiazepines may be used to treat panic disorder if:

• Antidepressants are not effective or their side effects are not well tolerated.
• Medication is needed for immediate relief of severe symptoms of panic disorder, anxiety about having a panic attack, or agoraphobia.

How Well Benzodiazepines Work

Benzodiazepines are effective in providing rapid relief of symptoms associated with panic disorder and agoraphobia.
Side Effects

Possible side effects of benzodiazepines include:

• Drowsiness.
• Lightheadedness.
• Fatigue.
• Slurred speech
• Weakness.
• Memory loss.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)
What To Think About

Benzodiazepines are associated with the risk of dependency (abuse) and the possibility of withdrawal symptoms.

It is possible for symptoms of panic disorder to return when the drug is stopped.

Complete the new medication information form (PDF) Click here to view a form. (What is a PDF document?) to help you understand this medication.

References

1. American Psychiatric Association (1998). Practice guideline for the treatment of patients with panic disorder. American Journal of Psychiatry, 155(5 Suppl): 1