Frequently Asked Questions on Health

Introduction: I have supported people in the Internet community for several years, with donated research and analysis on subjects that involve consumer health. Some of this service work responds to inquiries here at Giving Something Back . I've also been active at times in other Internet health forums and bulletin boards, including The Trigeminal Neuralgia Association Homepage, Intellihealth at Harvard Medical School, or various websites I have authored. Sometimes the questions I read and answer have to do with physical health, and sometimes with mental or emotional issues or family relationships. My deepest research knowledge is in the diagnosis and treatment of chronic pain. But I frequently dig out references for people dealing with a wide variety of other issues.

For about a year, I supported three "Ask an Expert" bulletin boards at Yahoo -- before the managers of that otherwise esteemed organization contracted a severe case of idiocy and tried to turn their formerly public forums into a money-making enterprise. I suspect the owners of Yahoo will eventually pay dearly for bringing in a CEO who knows more about money than he does about Internet culture. Tens of thousands of former Yahoo patrons don't go there nearly as often these days, though clearly the site is one of the most prominent resources on the Net.

This FAQ reviews questions and answers that occurred often in the Yahoo forums that I supported: the Men's Forum, Women's Forum, and Stress Management. I responded to over 800 inquiries in these bulletin boards during 2001 and early 2002. The questions below are among those which the experts saw most often.

Men's Forum	Women's Forum	Stress Management
Increasing my penis size	Side effects of medications	Symptoms of stress and ways to live stress free
Masturbation as a "sin"	Info on specific health conditions	Never enough time
Problems with erection or premature ejaculation	Weight Loss and Diet	Short temper
Increasing my height	Vaginal discharge	Coping with anxiety disorder
Rash or sores in the groin	How do I know if I'm pregnant?	Sex as stress relief
Drug testing	Increasing my breast size	Why is everybody angry?
	Mastectomy

Believe it or not, this is probably the most frequently asked question that I heard at Yahoo. It is also a question that comes from basically faulty assumptions. I never cease to be amazed by the wishful thinking of people who are smart enough to operate a computer but dumb enough to believe advertisements for miracles.

The average adult male penis is about six inches long when erect. Teens are smaller before they first enter puberty. When flaccid, the penis is an inch to two inches long. It will shrink in against the testicles when a male is cold or scared (this is the origin of the term "up tight", a phrase from the 60's describing the fearful attitude of some men). Most men have their full growth by age 20.

Despite the protestations of a few unscrupulous crooks and a tiny number of MDs who ought to know better, there is absolutely no safe or effective treatment that can make a male organ larger than a man's genes have programmed it to be. All herbal supplements advertised on the Internet are completely fraudulent. There are also no safe surgeries to make you bigger than you are born to be. If you are afraid that you are "small," then it's time for you to get over it, son. There isn't a thing you can do about it.

We can't change the size of our equipment. Size is also not the quality that attracts a partner to you and it won't be what keeps your partner with you. Your character, your conversation, and the quality of your touching have much more importance. If you want to have enthusiastic sex partners, then you need to learn to be a good sex partner, no matter what your size. That means learning how to use your MIND, your hands, lips, tongue and skin (and perhaps sex toys, videos, or books of fantasy that are comfortable for both partners) to give another person pleasure and to enjoy the pleasure they give you. There are many good books on this subject. Two of my personal favorites are by Alex Comfort and his wife: "Joy of Sex" and "More Joy of Sex." They are well written, thoughtful, and available world wide.

"I'm an unmarried man in my 20's and I have a small penis. I want to be married, but we aren't ready yet. Sometimes I wake up at night and find my seed on my bed. My religion teaches that masturbation is a sin and my religious leader says my size was caused by my self abuse. What can I do?"

Questions like this, remind us that forums like Yahoo are visited by people from all over the world. This seems to be a particular issue for men in Moslem countries, but not exclusively so. We also hear this question from rural areas, and from younger men who live in evangelical or conservative Christian homes. I don't like to insult any person's religious belief, but sometimes in the interests of truth, I am forced to do so. This is one of those times.

The natural (or "resting") size of a man's penis is not influenced one way or another by masturbation. Period, no exceptions! Masturbation can't make you smaller. Unless you have handled yourself harshly -- with dirt or caustic soap on your hands, or for many hours at a time -- it is unlikely that you have otherwise damaged yourself or that you ever will. If you do not masturbate by day, then your body relieves the natural pressure in your genital organs by erotic dreams and "nocturnal emissions" -- you ejaculate spontaneously by night. This is normal human biology and it is not physically harmful. Masturbation is also normal human behavior. Over 90% of all males do it, and over half of all females. Anyone who says self-pleasure is evil or abnormal is either ignorant, misinformed, or just plain lying.

Unfortunately, there are many people in the real world around us who have a powerful motivation to lie about sex. Many of them are clergy who actually believe their own lies, and who resist mightily any suggestion that they reexamine the beliefs in which those lies are rooted.

In my personal opinion, the religious concept of "sin" is a morally ambiguous human notion and most often a rather foolish one. Too many people use this label as a way to control the behavior or independence of other people by manipulating them with guilt. As a western author once wrote, a lot of "sins" are just some priest's idea of other folks having too much fun.

Likewise, people in misery are much easier to separate from their tithe money than people who live with joy and emotional independence. So it's no surprise that a lot of religions seem to go out of their way to make people miserable. Any system of belief that preaches self-pleasure is a harmful activity or sex is a sin unless it produces children, is hopelessly mired in the ignorance of the Dark Ages. Such belief systems are not worth wasting your time on. They deserve to be ignored for the foolishness they believe, or prosecuted for the evils they do to unbelievers in the name of God. If God wrote out His will on the walls of the temple in letters of fire, most of his earthly priests would scramble for a fire hose, deeming the house more valuable than the message it supposedly contains.

End of sermon. For the record, I am obviously not a religionist. I am merely a man who tries to listen and watch for a Divine Spirit working in all things. I also do the best I can with the Divine guidance I derive from observation and personal experience. It's amazing how often religionists dislike or denounce that habit.

Sexual health problems are among the most frequent that men report in public forums. As men get older, a large proportion of us have prostate enlargement or tumors that impair sexual and urinary function. Medications for high blood pressure or depression can also cause erection difficulties. For younger men, problems more often have to do with not being able to "last" as long as they or their partners want.

For all men, a yearly prostate examination and PSA (prostate specific antigen) blood test are now generally accepted as appropriate preventative medicine. A significant increase in the PSA level over a period of a year may be a signal that a man needs more thorough examination for prostate tumors.

Problems with sexual potency are often helped a lot by a prescription of Viagra, or by better management of other medications. For younger men who ejaculate too quickly, there are techniques of sexual therapy that teach you how to prolong your enjoyment and that of your partner. At any age, a man can learn techniques of stimulation and play that increase your partner's passion, enjoyment, and comfort. We're never too young or too old to learn.

The most important key sexual health and being a better lover is not your biological equipment or even medicine. It is knowledge. Any bookstore offers thoughtful and well written books from well trained doctors and therapists . Read. You can never know too much about your own or your partner's sensuality. After you read, ask how your partner feels about these things too -- and listen.

"I'm eighteen and I'm only five feet, four inches tall. How can I become taller?"

To be quite direct about it, you simply can't make something like this happen. By age 20, you will have all the height you're ever going to have. There are no exercises or herbs or surgeries that can safely make you either taller or shorter than your genes have programmed you to be. You have to live with the cards that Mother Nature and Father Time have dealt you. So give up the fantasies and start learning to live with energy, joy, balance and engagement.

There's a short story I like to tell young men who ask this question. A professional colleague of mine is about your height. He also bench-presses more than his own weight, has a black belt in one of the martial arts, and holds a Ph.D. in engineering. His wife is a couple of inches taller than he is, and their daughter is taller than either of them. When his wife was asked by a neighbor how it was that she came to marry such a short man, she grinned with a mischievous glint in her eye and remarked that "we're all the same height in bed".

The height (or length) of your equipment isn't what makes you a person of power. Confidence and competence grow from things you do and ideas around which you organize your life -- not from your dimensions.

"I have a skin rash / sores / bumps on my thighs / crotch /groin. What do I have and what should I do?"

First, you might start with a dose of common sense. If you are not sexually active, then one likely explanation for a rash in this area of the body is a fungus infection ("jock itch") similar to athlete's foot. Start by bathing after strenuous exercise, drying your body thoroughly, and using a mild, non-allergenic baby powder. Wear boxer shorts and loose clothing for additional ventilation. Over-the-counter anti-fungus agents are available at your drug store (consult your pharmacist). If the rash persists or develops running sores, see a doctor immediately for evaluation and treatment.

If you are sexually active and do not have a diagnosis of your rash, then CEASE all sexual activity with all partners until you do. You might have herpes, clamydia, early stage genital warts or some other sexually transmitted disease. See a doctor for evaluation. If you are treated for an STD, then plan on doing a lot of reading to improve your knowledge of sexual hygiene, and expect to make some lifestyle changes because you're creating unacceptable risks to your own and others' health.

Some people who inquire in the Men's forum want to know how they can continue acting in self-destructive ways without being caught. I generally don't offer advice of that type, because what they (and their families and the society around them) actually need is to stop taking drugs and get sober. When you become chemically dependent or addicted to a substance that you take in order to have "fun", then you are no longer using it. The drug -- and the dealer who provides it -- is using you.

I am not embarrassed to take very hard-nosed positions on drug issues. I've seen the effects of such slow poisons, up-close and personal. There simply are no such things as "recreational" drugs. There are merely some drugs that take longer to kill your relationships and your life, and some drugs that do it quickly.

I know whereof I speak. My father was an alcoholic who stopped drinking but never dealt with his rage; as a consequence, I was sometimes battered as a kid. A member of my family went through a ten-year slide into alcoholic darkness, starting about age 14. He came out the other side, but only with the help of Alcoholics Anonymous. Another relative got hooked on Pot laced with other drugs he could never identify. That poor soul is now brain damaged and will never hold a job more complicated than parking lot attendant.

So if you come to a public forum with this kind of question, my response is predictable: it's better for you to get caught before this crap kills you. Don't think you can skate at the edge of the cliff and not fall off. You're already falling. If you have a drug dependency, then see your family doctor or (in the US) contact county Family Services for referral to a specialized program. Attend AA meetings. You can quit. It's a tough journey, but people do it all the time.

"I am taking [name of medication] and I am concerned about side effects [on me or on my baby]."

Many women and a few men who inquire at Yahoo and other Internet blogs and forums seem to be looking for quick answers to fairly important medication questions. Sometimes the quick answer can kill you, especially if it's provided by an amateur. For this kind of question, I know my limitations: I usually summarize and then refer the posters to authoritative sources. One of the best references for medications is RxList. You can search this site for hundreds of drugs by name. The information is the same as given on the long information sheet that accompanies your drugs in the box (the sheet you didn't read before you logged onto the Net for helpl). You'll learn about conditions the drug is recognized to treat, in what doses, and with what side effects. Possible dangerous interactions with other drugs are also explained.

There is an important issue disguised in this question, however. It is an issue that a lot of women and men seem not to notice: why didn't your doctor tell you about this drug in the first place? Or alternately, why didn't you call his or her office and speak to a nurse about your questions? If you were so uncomfortable in your relationship to your doctor that you felt you couldn't impose on him or her, then it's time you looked for another doctor. Among the most important services that a doctor provides are advice and information. If you can't get that advice from your present doc, then you need another one.

Although there is much misinformation and fraud in the Internet concerning so-called "natural" or "herbal" treatments for various health conditions, there are also many authoritative and well-written health resource sites. For general health information and for well known disease conditions, I often recommend these:

For less well known diseases and disorders, you may need to use one of the Internet search engines to find more specialized resources in addition to those above. After you've scanned the medical abstracts at Pub Med, two engines that I use often are:

Probably not. There is a huge volume of advertisement, hype and outright fraud on the Internet concerning diets, dietary supplements that supposedly "burn off the fat" with no hunger or effort on your part, and diet plans that some unknown doctor proclaims to be effective if only you'll buy his book. But if you look carefully, you'll find that few of these programs bother to keep follow-up statistics on the weight of clients for five years or more. As they say, there's a sucker born every minute: most folks never ask to see such numbers.

Getting weight off and keeping it off is not an event or a temporary program. It's a life change. To make that change and stick with it, you have to realize that your body is going to fight you every inch of the way for as long as you're breathing. Food is just as addicting to a seriously obese person as alcohol is to a drunk. If you're going to recover from this addiction, you're going to need the same kind of help that alcoholics need: a community of other people who understand your difficulty and provide ongoing support for the work you're doing to stay slimmer. If you want to lose weight, the only program I know of that has an established track record of long term effectiveness is Weight Watchers. They have chapters all over the world and in most US cities. Go to a meeting and see what they have to offer.

Part of your weight watcher program will likely be recommendations for effective exercise, to help you firm up muscles and suppress the cravings your body will generate as soon as you get serious about your diet. You may find it useful to join a health club as well as attend WW meetings. But in any event, the principle is the same: you have to reduce your caloric intake below the level needed to sustain your present weight, and balance your intake with the right kinds of foods to sustain your health and mood as your body adjusts. And I don't care what anybody says, there will be times when weight loss makes you feel utterly miserable. It's in those times that you most need the support that Weight Watchers provides.

Common female health problems include vaginal yeast and fungus infections. Your pharmacist can recommend over-the-counter preparations for both. If the condition persists or is accompanied by fever, pain, irregular bleeding or running sores, then please see an internist or ob-gyn doctor promptly for assessment. If you are sexually active -- especially if you have more than one casual partner -- then you need to lay off sex, be evaluated, and then educate yourself on the use of condoms and the symptoms of common sexually transmitted diseases: gonorrhea, herpes, chlamydia, genital warts and even nastier bugs like AIDS. I have heard estimates that a quarter of the young people in the US between the age of 15 and 30 have a sexually transmitted disease. If the statistics haven't caused you to reconsider bar-hopping and one-night stands as a way to meet people, then you are likely headed for serious health trouble.

When I read a question like this one -- which is fairly often -- I am sadly alarmed. Have we done such an awful job of raising, nurturing and educating our young women that many of them must come to Internet bulletin boards for such answers? Are we still so ignorant and repressed that we can't talk to our kids about sex? Young women deserve straight answers. I try to provide such answers as calmly and supportively as I can.

        The usual first sign of pregnancy is a missed period. Sometimes a woman's breasts will also become very tender or sore. If it's been six weeks since your last period, then go to a drug store and purchase a home pregnancy test. The newest products are quite reliable, if you read and follow the directions.

        If you're a teenager and you believe you may be pregnant, then I suggest that you talk soon with a trusted member of your family. If there's nobody close that you feel you can tell, then call or walk into a local Planned Parenthood center and talk with one of their counselors about what comes next. They can help you improve your knowledge of your body, your sexuality, birth control and the realities of sexually transmitted disease -- all of which you need to understand better, if you choose to be sexually active.

        Planned Parenthood can also talk with you about your options in pregnancy: birthing and raising your child, placing a child for adoption, or abortion. I must inform you with every intention of kindness, that having a child at your age without a supportive partner is very frequently a first step toward a life of poverty and struggle. That's ultimately going to be your decision and your struggle, but no matter what you decide to do, the issues are NOT trivial and they're darned tough to sort out alone. Reach out for help. It's there for you.

"Where can I get insurance that will pay for breast enlargement? Is there an herbal supplement to make me bigger?"

You can't get insurance that pays for this service. The procedure is elective surgery. Insurance companies don't pay unless there are significant medical reasons. Reconstructive surgery is covered after injury or mastectomy, but not because you want to look like some lady playing on the beach in Bay Watch. Likewise, no herb can add permanent mass to your boobs, though some herbal preparations might give you sore and sensitive nipples for a while.

A more important question, however, is why do you want to have larger boobs? That's a question you really need to give some serious thought, with the aid of a (female) counselor or licensed clinical social worker (LCSW). Any reputable plastic surgeon will insist that you do this type of counseling before he or she will touch you. So you might as well get started. After your motives are clear to you, if you still want to go this route, you can call your county medical association and ask for referrals to three board-certified plastic surgeons. Visit their offices and get an estimate after each one examines you in person. Base your choice of physician on the combination of their fees and their personal manner in talking with you. If a doctor doesn't ask whether you've had counseling, then cross him off the list because he is more interested in your money than your personal health.

There are long term health risks for breast enlargement. Among these is the possible need for more surgery when you are older, to remove silicone or saline inserts that have begun leaking, are misshaped, or are sagging. The procedure is not trivial.

If you seek breast augmentation because you feel inadequate, then you might also discover to your horror that the inadequacy doesn't go away after you've gained your new figure. To your inadequacy may be added financial or emotional anxiety as you pay for the new wardrobe you will need in order to go to work... to pay the several thousand dollars that surgery will cost.

If you think you want to be larger because of the criticism or fantasies of a boyfriend, then it's time to show the guy the door and take in a stray cat instead. It's also time for you to inform yourself better about human sensuality and sexuality. Just as the size of a man's penis does not define his character (acknowledging that some of us don't have much of either), neither does the size of a woman's breasts define her personhood or her attractiveness to a good man.

Possibly the most sensual woman I ever met was five feet two inches tall and weighed 90 pounds dripping wet. But she knew how to enjoy the equipment the gods had given her. She helped me to heal some of the damage that my (stacked) first wife had done to my personal confidence. [Wherever you ended up, small lady, I wish you wellness and love.]

        There is no one-size-fits-all answer here. Radical mastectomy with removal of lymph nodes is major surgery, by any reasonable estimation. Physical recovery to a level where the patient feels no muscle pain can require several weeks, and some women report swelling, edema, and secondary reactions for years.

        Emotional and mental recovery very much depends on the individual and her personality, emotional needs, self-image, family situation and support, etc. Attitude plays a very large role in these issues. Some women need and benefit from supportive therapy or counseling after surgery. Others find a support group of other patients is helpful. Still others are more private in their approach to the issues, choosing no therapy at all.

        I've heard it said that for many people there is a natural grieving and healing process after any major life tragedy or personal loss -- a process that seems to last about a year after the death of a loved one. It might be appropriate to compare the alteration of your image and physical profile to a "little death", as some women writers have. It would not be surprising for a woman undergoing such a change to feel sharp grief and loss for a year, in gradually decreasing intensity. If you've had a mastectomy and are still struggling with grief that interrupts and compromises the life you want for yourself, then I'd recommend that you see a female professional in the mental health fields. A well trained LCSW can help a lot, at a somewhat lower expense than a psychologist or psychiatrist. However, if a woman is severely depressed, medication management may also require periodic visits to a psychiatrist.

What are the symptoms of stress? What is the best way to live a stress-free life?

Stress can manifest itself in many ways. What we call "stress" is simply our physical and emotional reaction to change. The body perceives any sudden change in our environment as a potential threat to our safety -- regardless of whether it's a positive or negative change. This potential threat causes the release of several hormones, particularly adrenalin, that prepare the body to "fight or flee." Stomach aches are only one of the symptoms. Also common are stress headaches, acid stomach that mimics acid reflux, occasionally diarrhea, sleep disturbance or insomnia, sweating (adrenalin reactions), emotional volatility or flat affect.

        If you have some combination of these symptoms, it is also possible that what you are dealing with is not stress, but clinical levels of depression or anxiety. There is considerable overlap in the range of symptoms. Likewise, men and women sometimes cope with stress in very different ways. For both sexes, if you are in significant discomfort, then one of your fist steps in reducing stress may be evaluation by your family doctor.

        There is no one "best" thing for everybody, for coping with stress. Real coping may require you to do several things and make real changes to your life. To some extent, the answers that are "best" for you depend on your situation and circumstances. However, some combination of the following might be involved. You'll have to pick the elements that work for you. If you're very stressed as you start this process of choice, then it might help to talk with a counselor for a few sessions and compare perspectives.

        -- Tear yourself loose from activities or expectations forced on you by other people, that leave you feeling drained and without energy. This principal definitely includes relatives (learn to say 'no').

        -- Create activity or shared interest that connects you with good people whose thoughts you value and in whose company you feel natural and at ease (learn to say 'yes' to yourself with others).

        -- Exercise regularly and create the time you need to make this a continuing part of your life (learn to be physical, and to say 'yes' to yourself alone).

        -- Include music in your life - and the more classical the music is, the better. Mozart or Chopin or Ravel can bring you transcendent joy. Rap will bring other, less positive things into your head (learn to listen for beauty in quiet spaces).

        -- Reduce the number and variety of stimulants (i.e. caffeine) and artificial sugars in your diet and lose excess weight (learn balance in your eating).

        -- If you use any so-called "recreational" drugs then get help if needed, but get OFF them and stay off. This includes nicotine and alcohol (recognize drugs as life-killers and leave them behind you for a better life).

        -- Meditate, pray, or explore your spirituality in some meaningful way. However, this does not require that you become a "true believer" in somebody else's dogma (learn to be spiritual in ways that are natural for you, not for some preacher who should long ago have found some more honest line of work).

        -- Release the impulse to control events or other people for any purpose. Some of the greatest evils in the history of mankind were done in the name of somebody else's "own good". (Don't try to control what can not or should not be controlled. You have enough on your hands just realizing your own potential.).

        -- Invest your attention and your time in love, however you define it (love heals all wounds and makes us real).

        -- Realize that stress is our natural response to change, and we are never completely free of stress while we remain alive. But choose the changes you are prepared to accept and act upon (all of life is choice, either positive or negative).

I wish you well on the journey.

Why is it that 24 hours a day are not enough for everything I want to do?. I don't work, but I always go to sleep late, I don't study as much as I should, and I always go to sleep feeling I couldn't do all I wanted... Does someone knows about an effective way to organize life? So how to make the best of your time?

      Sometimes it is possible to get caught up in obsessive patterns of perfectionism and not even know what you're doing. If you aren't working, then what activities are keeping you up late? If you're in school working for a degree, such a pattern of avoidance can indicate problems with depression.

        Making the best of your time is partly a matter of knowing how you're spending it, and making choices about what is most important. Keeping a daily activity diary can be a useful start toward learning how you actually use your time. Writing down a "to do" list in advance, can also give you a bench mark against which to check your progress.

        Try the daily activity diary and to-do list for a month. If, at the end of that time, you find that you never seem to get to the end of your list, or the activities don't really satisfy your sense of accomplishment, then maybe it is time to sit down with a mental health professional and do a more thorough personal assessment. Your local Family Services office or mental health clinic can offer you an inexpensive place to start that process.

Why am I so short tempered when asked a question I don't know the answer to? How do I stop it? Where can I get help on the Internet?

People who aren't familiar with your circumstances and your personality probably can't answer such questions for you at a distance. We really can't begin to guess what's happening or how you can do something about it, starting only from the brief words of your question.

If you feel persistently on edge, short tempered, restless, etc., you could be feeling the effects of chronic depression -- or any of several other mental health issues. If you're having work-related problems relating to free-floating anger and aggression, or find yourself popping-off frequently at family members and then feeling terrible later, then I'd say it's time for you to work with a counselor or licensed clinical social worker.

If you need one, a counseling relationship cannot be truely effective across the Internet, for any fundamental life work. There is no substitute for face-to-face interaction with a professional trained to read your emotions and body language. Change doesn't have to be a financial nightmare, either. You can start with a weekend encounter group, a free clinic, or (in the US) a visit to the nearest office of County Family Services. Many potential sources of assistance are listed in weekend editions of local newspapers.

          I was told I have Anxiety Disorder and I am having a hard time coping with it. I have a very heavy schedule and my family needs me. It's very scary when I go into an attack or if I'm having a hard time swallowing solid foods. I try to relax every moment but it's not easy. I am only 32 yrs. old. I'm on a low dose of Lorazepam 0.5MG, 1 tab three times a day... I'm also seeing a therapist I've only met with 2 times. Does any one have any helpful suggestions?

        In the forums I support at various places on the Net, I see a lot of variations on this question. The following is a representative answer that I offered one inquirer:

        If you are still having function problems under medication, then your first step is to go back to your prescribing physician and describe what you are experiencing. It may be that your meds haven't become fully effective yet (some of them build up in the blood stream over several weeks). Or your med dosage may need to be increased. Drink a lot of water both before and after you take your pills, too.

        Two sessions with a therapist is a very early stage in any journey of recovery, particularly for anxiety. However, while you are struggling with this early stage, you might consider calling the therapist and asking for a reference to a patient-to-patient support group to help the process you are starting in therapy. Many hospitals can refer you to local support groups. Talking to others who have been down this road can help a lot.

        If you have a "very heavy schedule" at this point in your life, then I suspect you may need to consider re-balancing your commitments to others against your personal needs. External time stress and the demands of others can play into the intensity of your anxiety attacks. If you are trying to meet the needs of others out of some sense of guilt or personal insecurity concerning your own value, this observation is especially pertinent. If any of your adult family does the old number on you about "you're being selfish -- what about my needs?" then I would say they need their tails kicked into next week, and you're just the person to do it.

        Little kids, of course, simply don't understand the problems of adults on whom they rely. You can try to explain, and you can enlist the aid of other adults in the family to reinforce those explanations. In any event, you're not required to be superwoman. And you don't have to go through the process alone.

        You can only do the best you can do. While you are beginning to recover from anxiety disorder and learn the skills you'll need to manage the problem over time, that "best" is probably somewhat less than you think you "should" be doing. "Should" is a punishment word that we use to drive ourselves or others insane. It needs to disappear from your vocabulary. For right now, a more healthy and balancing approach to your life is "how much do I think I *can* do right now, and what are my first two or three priorities?" Do what you can, not what somebody else thinks you should. And let the rest go.

        I wish you wellness. It will come.

        To speak of sex as "useful" in this context seems to me to be a bit off-target. I believe very few people will tend to feel better or feel relieved of a serious external stress by simply getting laid. A partner who is used deliberately in that manner might grow distinctly resentful -- with some justification.

        Sexual intimacy with a loved significant other can be very emotionally nurturing and supportive. When we go to our lover for comfort and support and are received with caring sensitivity, many times our stress level may be lowered and our ability to cope with the world generally enhanced. Sex without emotional intimacy tends to work in the opposite manner.

        It is in the nature of stress and tension, that our sexual availability and personal sensitivity can be closed down when we feel ourselves to be under extreme pressure -- whether the stress is related to our lover or not. When we've been severely stressed, it can be difficult to open up to our own sensations and to the desire of our lover to nurture and reinforce us. In this situation, even a caring request for sex by one's partner can produce increased rather than decreased stress.

        Thus, I think the implied logic here is somewhat inverted. Sex won't relieve usually you of stress by itself. It is far more constructive to start doing something about the causes of your stress and tension -- freeing up emotional and physical energy for a rewarding sensual and sexual life.

What makes people angry? All walks of life are angry -- from the poor to the wealthy, from the healthy to the sick.

        It seems to me that a related way to phrase this question might be "why are so many people angry and frustrated so often, these days?" That question has a number of answers. One that is frequently overlooked is that anger is Mother Nature's way of telling us that something in our experience needs to be changed -- RIGHT NOW. Anger is a motivator and mover. And for a lot of us, a lot of things need changing.

        When we are unable to change something (or many things) in our lives in an effective way, our anger can mushroom into frustrated rage, directed at either ourselves or others. The crowding of our environment -- whether with more people or more activity or more personal expectations and demands -- tends to hem us in and limit our freedom to move and change. We feel powerless and out of control, and therefore scared half to death and even more angry than before.

        I personally believe that such feelings are at the heart of what has been called "Road Rage." Sitting behind the wheel of a car, frustrated by our inability to move and anxious that we are failing to accomplish all that is expected of us, some people simply "snap". It's called a psychotic break, and it's a real phenomenon in modern life. Such people ram their vehicles into the perceived "roadblocks" of other people or property. Some of them pick up a gun or a baseball bat, and act out their violence even more graphically.

        The crowding of modern life with activities that we do not choose but feel we "must" do anyway, can be a powerful part of such free-floating anger and frustration. Such feelings become a kind of background noise that we don't really hear anymore, but which profoundly affects our ability to hear and perceive clearly, never the less. Some of the crowding in modern life is a function of too many people in too little urban space. Other elements of the problem have to do with too many activities that crowd out our time for rest and reflection. The complexity of modern life and its many stimuli are also a part of the matrix. One of the most pervasive negative influences on us is simply the idiot box -- television, a medium that conditions us for passive consumerism, shortened attention spans, simplified or irrational thinking, and un-chosen knee-jerk responses to ever more stimuli (advertising).

        If you personally want to be less angry and frustrated in your life, then you will face interesting and difficult challenges. To be less angry, you will need to release the urge to control things that you really can't control, and learn how to control other things that people around you may not WANT you to control: particularly your own time, energy, and moods. (And yes, you CAN and DO control your moods, by choosing how you spend your time and attention).

        Such lessons are difficult to learn when you're all by yourself. You'll find it goes better if you're engaged with a group of other people who are similarly interested in releasing their anger and living more productively. That can be a therapy group, a meditation circle, a community service organization, a church group, a Tai Chi school, a ballroom dance group, or any of a dozen more.

        If you want to feel less anger and more joy, then the first step may be to learn to use your time consciously for purposes that you choose, rather than letting others choose for you. And the first step in using time, is to first learn how you are spending it now. Keeping a daily journal can be a terrific help. But of course, writing will also take time -- and it has to come from somewhere, doesn't it? My suggestion would be to cut out all television and music CDs -- cold turkey, no excuses, just drop the visual mind candy and walk away. Use the time you gain to do your journal, READ some good books, TALK with your spouse or significant other, TALK with a clergyman or counselor about guides for productive living.

        When you begin to own your time again, you will be far less fearful and therefore less angry toward others.

Any time you receive advice across the media of the Internet, you are entitled to know something about the person giving the advice. The following information is updated from my original profile at Yahoo:

Biography: I have assisted chronic pain patients for fifteen years as a researcher and information miner in the medical literature, and as webmaster on two patient support websites and author of a third. I frequently deal first-hand with issues of depression in this community service. I am familiar with a range of Internet information sources on medications and therapies, though nobody knows them all. I regularly support the Chronic Neurological Pain forum at WebMD. I've also done personal counseling, encounter and Gestalt theater as a client. In my profession, I am called upon to do situational assessment and professional decision support as a group facilitator. Though I am not trained as a professional caregiver, I am reasonably well read in the counseling field, and have been personally tested by experience. I also once served part-time as a workplace sexual harassment intake interviewer, and retain a life-long interest in the professional concerns of women in the workplace.

I've seen and lived a lot in 63 years. After a divorce at age 28, I lost a daughter whom I found again 15 years later. She is now emotionally closer to me than anyone in the world except my second wife, to whom I have been married for 29 years.

email address:	webmaster@lawhern.org
Real Name:	R. A. "Red" Lawhern, Ph.D.
Location:	Fort Mill, SC
Age:	64
Marital Status:	Married 29 years
Gender:	Male
Occupation:	Senior Systems Engineer

More About Me
Hobbies: Sailing, landscape photography (work sold in 6 countries and several US states), gems (former broker), science fiction, writing, Internet village elders and experts.

Favorite Quote
"For every problem there is at least one solution that is simple, plausible... and wrong. [attributed to H. L. Menkin]"