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Our interest and enthusiasm for training centres has evolved with the Internet. In the early days of the Net the information on training centres was very limited. However there are now many online traders marketing and selling training centres. We have sifted through these and do not hesitate to recommend the merchants whose links appear below. As the Internet grows and expands training centres traders gain more experience in offering products for sale. One of the big advantages that online training centres traders have over shop front training centres stores is that the capital costs are significantly less. training centres
A treasure chest of training centres information.There is no doubt you and I have a great interest in training centres after all that's why you arrived at this web page and it's why I created this training centres web site. I'm actually passionate about training centres and in time will make the site one of the best resources for information. You can search around for hours looking for good training centres sites but as you have no doubt found, many of the sites that rank well in search engines for training centres are pretty hopeless. While your visit to my site is a little premature because I'm still working on it, in the not too distant future it will become one of the best sites on the net for training centres. I'm aware of the needs of people searching the net for training centres information and I plan to create a directory of valuable links to training centres sites. Every site I list, such as the examples below will carry recommended reading and I'm sure every visitor will be delighted with what they find. Here's just a small example of the links you will find in the future, I'm sure if you visit the site you will not be disappointed. Right now I'm working on making my training centres site bigger and better, it's turning out to be a much largerr task than I expected, but because I am passionate about training centres I work with great purpose so it's not really work. I invite you to call back sometime and I'm sure I'll have it completed and maybe you can pass on my url to your friends that have similar training centres interests. Depression Series: Why Don't I Respond to Medications? (Part 1) by: Michael G. Rayel, MD
Maria has been feeling depressed for at least two and a half years. About three years ago, her husband of 20 years left her for another woman. Devastated, she became despondent and tearful almost daily. Eventually, her depression got worse associated with inability to function. Her appetite, energy, concentration, and sleep became impaired. She also felt hopeless and suicidal. Her psychiatrist put her on a starting dose of antidepressant. She responded initially but after a few days, she felt just like before taking the medication. For the past two years, Maria has tried four types of antidepressants. She has taken the usual adult doses of these drugs. Although she somewhat improves, she has virtually remained the same — depressed and disabled. Maria seems to be taking the medications regularly. But why is she not responding to her antidepressants? Maria is just one of the many depressed individuals who don't feel "normal" despite treatment. Depression is a treatable disease but how come some people don't do well on medications? There are many reasons why depressed patients like Maria don't improve on antidepressants. First, is the diagnosis correct? Depression can be caused by many clinical entities. Sometimes, knowing the right diagnosis is a challenge. Medical disorders, medications such as beta-blockers and benzodiazepines (e.g. clonazepam), and various psychiatric disorders can cause depression and they all require different treatment. If your doctor fails to identify and treat the true cause of your depression, you will remain depressed despite the use of antidepressant. Second, are there co-morbid disorders? Depression can exist along with other psychiatric disorders such as anxiety disorder, alcohol or drug problems, personality disorder, dementia, and psychosis. Depression will persist if these co-morbid disorders are not treated. For instance, depressive disorder with psychosis cannot be adequately treated just with antidepressant alone. You need an antipsychotic drug added to an antidepressant to treat the illness. Third, is there an ongoing neurological or medical disorder that precipitates, aggravates, or complicates depression? Hypothyroidism, hyperthyroidism, vitamin B-12 deficiency, pancreatic cancer, brain tumor, Parkinson's disease, and stroke can all cause depression. If any of these disorders are present, antidepressants are less likely to help. The goal in these situations is to treat the underlying medical condition. A 65 year-old lady came to see me complaining of severe depression. On evaluation, she disclosed that she had been on three types of antidepressants for the past four years with minimal response. I checked her recent laboratory results which showed an abnormal thyroid! No wonder, she was not responding to the medication. Fourth, are there ongoing psychosocial issues? Financial problems, family conflict, work-related stress can all precipitate and complicate depression. Despite adequate medication treatment, some individuals will remain depressed especially if such problems are not addressed by the therapist or psychiatrist. Is there any way you can reduce the stressors? Please do so the earliest you can. The treatment of depression is frequently straightforward. Occasionally however, various factors complicate it. For antidepressant to be effective, a psychiatrist should ensure that the diagnosis is correct, that co-morbid psychiatric disorders and medical problems are treated, and that psychosocial issues are adequately addressed. Maria's doctor should explore further the real problem and provide the most appropriate intervention.
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