Melancholic Mood, Despair

We all feel fed up, miserable or sad at times. These feelings don't usually last longer than a week or two, and they don't interfere too much with our lives. Sometimes there's a reason, sometimes not. We usually cope - we may talk to a friend but don't otherwise need any help.

However, in depression: your feelings don't lift after a few days, they carry on for weeks or months are so bad that they interfere with your life.

What does it feel like?

Most people with depression will not have all the symptoms listed below, but most will have at least five or six.

You:
- feel unhappy most of the time (but may feel a little better in the evenings),

- lose interest in life and can't enjoy anything,

- find it harder to make decisions,

- can't cope with things that you used to …

- feel utterly tired,

- feel restless and agitate,

- lose appetite and weight, some people find they do the opposite,

- take 1-2 hours to get off to sleep, and then wake up earlier than usual,

- lose interest in sex,

- lose your self-confidence,

- feel useless, inadequate and hopeless,

- avoid other people,

- feel irritable,   

- feel worse at a particular time each day, usually in the morning,

- think of suicide.

You may not realize how depressed you are for a while, especially if it has come on gradually. You try to struggle on and may even start to blame yourself for being lazy or lacking willpower. It sometimes takes a friend or a partner to persuade you that there really is a problem which can be helped.

You may start to notice pains, constant headaches or sleeplessness. Physical symptoms like this can be the first sign of depression.

Why does it happen?

As with our everyday feelings of low mood, there will sometimes be an obvious reason for becoming depressed, sometimes not. It can be a disappointment, a frustration, or that you have lost something - or someone – important to you. There is often more than one reason, and these will be different for different people.

They include: Things that happen in our lives. It is normal to feel depressed after a distressing event - bereavement, a divorce or losing a job. You may well spend a lot of time over the next few weeks or months thinking and talking about it. After a while you come to terms with what's happened. But you may get stuck in a depressed mood, which doesn't seem to lift.

Circumstances:

If you are alone, have no friends around, are stressed, have other worries or are physically run down, you are more likely to become depressed.

Physical Illness:

Physical illnesses can affect the way the brain works and so cause depression. 

These include life-threatening illnesses like cancer and heart disease long and/or painful illnesses, like arthritis viral infections like 'flu' or glandular fever - particularly in younger people hormonal problems, like an under-active thyroid.

Personality;

Some of us seem to be more vulnerable to depression than others. This may be because of our genes, because of experiences early in our life, or both.

Alcohol;

Regular heavy drinking makes you more likely to get depressed – and, indeed, to kill yourself.

Gender;

Women seem to get depressed more often than men. It may be that men are less likely to talk about their feelings, and more likely to deal with them by drinking heavily or becoming aggressive. Women are more likely to have the double stress of having to work and look after children.

Genes;

Depression can run in families. If you have one parent who has become severely depressed, you are about eight times more likely to become depressed yourself.

What about bipolar disorder (manic depression)?

About one in 10 people who suffer from serious depression will also have periods when they are too happy and overactive. This used to be called manic depression, but is now often called Bipolar Disorder. It affects the same number of men and women and tends to run in families.

Isn't depression just a form of weakness?

Other people may think that you have just 'given in', as if you have a choice in the matter. The fact is there comes a point at which depression is much more like an illness than anything else. It can happen to the most determined of people, even powerful personalities can experience deep depression. Winston Churchill called it his ‘black dog'.

When should I seek help?

When your feelings of depression are worse than usual and don't seem to get any better. When your feelings of depression affect your work, interests and feelings towards your family and friends. If you find yourself feeling that life is not worth living, or that other people would be better off without you.

It may be enough to talk things over with a relative or friend. If this doesn't help, you probably need to talk it over with your GP. You may find that your friends and family have noticed a difference in you and have been worried about you.

Helping yourself.

Don't keep it to yourself. If you've had some bad news, or a major upset, tell someone close to you, tell them how you feel. You may need to talk (and maybe cry) about it more than once. This is part of the mind's natural way of healing.

Do something; Get out of doors for some exercise, even if only for a walk. This will help you to keep physically fit, and will help you sleep. Even if you can't work, it's good to keep active. This could be housework, do-it-yourself (even as little as changing a light bulb), or any activity that is part of your normal routine.

Eat well;

You may not feel like eating, but try to eat regularly. Depression can make you lose weight and run short of vitamins which will only make you feel worse. Fresh fruit and vegetables are particularly helpful.

Beware alcohol!

Try not to drown your sorrows with a drink. Alcohol actually makes depression worse. It may make you feel better for a short while, but it doesn't last. Drinking can stop you dealing with important problems and from getting the right help. It's also bad for your physical health.

…. and cannabis;

While cannabis can help you to relax, there is now evidence that regular use, particularly in teenagers, can bring on depression.

Sleep;

If you can't sleep, try not to worry about it. Settle down with some relaxing music or television while you're lying in bed. Your body will get a chance to rest and, with your mind occupied, you may feel less anxious and find it easier to get some sleep.

Tackle the cause

If you think you know what is behind your depression, it can help to write down the problem and then think of the things you could do to tackle it. Pick the best things to do and try them.

Keep hopeful

Remind yourself that:

Many other people have had depression. It may be hard to believe, but you will eventually come out of it. Depression can sometimes be helpful; you may come out of it stronger and better able to cope. It can help you to see situations and relationships more clearly. You may be able to make important decisions and changes in your life, which you have avoided in the past.

What kind of help is available?

Most people with depression are treated by their GP. Depending on your symptoms, the severity of the depression and the circumstances, your doctor may suggest:

- self-help

- talking treatments

- antidepressant tablets

- Guided self-help; This can include:

- Self-help leaflets or books, using Cognitive Behavioral Therapy (CBT) principles.

- Self help computer programs or the internet.

- Exercise: 3 sessions per week for 45 minutes, for between 10 and 12 weeks.

Whichever of these is right for you depends on your personality and lifestyle.

Talking treatments

There are many different sorts of psychotherapy available, some of which are very effective for people with mild to moderate depression. They include:

Counseling

Simply talking about your feelings can be helpful, however depressed you are. Sometimes it is hard to express your real feelings even to close friends. Talking things through with a trained counselor or therapist can be easier. It can be a relief to get things off your chest, and it can help you to be clearer about how you feel about your life and other people. There may be a counselor at your GP surgery with whom you can talk, or your GP can refer you to a local counseling.

Cognitive behavioral therapy (CBT)

Many of us have habits of thinking which, quite apart from what is happening in life, are likely to make us depressed and keep us depressed. CBT helps you to:

1. identify any unrealistic and unhelpful ways of thinking

2. then develop new, more helpful ways of thinking and behaving.

Problem-solving therapy

This helps you to be clear about your key problems, how to break them down into manageable bits and how to develop problem-solving skills.

Couple therapy

If your depression seems connected with your relationship with your partner, then “relate” can be helpful in enabling you to sort out your feelings, it is an organization that specializes in working with couples.

Support groups

If you have become depressed while suffering from a disability or caring for a relative, then sharing experiences with others in a self-help group may give you the support you need.

Bereavement counseling

If you are not able to get over the death of someone close to you, you need to talk about it with a specialist bereavement counselor.

Interpersonal and psychodynamic psychotherapy;

This may be more suitable if you have had long-standing difficulties with your life or relationships. This tends to be a longer-term treatment, and helps you to see how your past experiences may be affecting your life here and now.

Group therapy;

Talking in groups can be helpful in changing how you behave with other people. You get the chance, in a safe and supportive environment, to hear how people see you, and the opportunity to try out different ways of behaving and talking.

Talking treatments do take time to work. Sessions usually last about an hour and you might need anywhere from five to 30 sessions. Some therapists will see you weekly, others every two to three weeks.

Problems with talking treatments; These treatments are usually very safe, but they can have unwanted effects. Talking about things can bring up bad memories from the past and this can make you feel worse for a while. Others have reported that therapy can change their outlook and the way they relate to friends and family. Therapy can put a strain on a close relationship. Make sure that you can trust your therapist and that they have the necessary training. If you are concerned about having therapy, talk it over with your doctor or therapist. 

Antidepressants;

If your depression is severe or goes on for a long time, your doctor may suggest a course of antidepressants. These are not tranquillizers, although they may help you to feel less anxious and agitated. They can help people with depression to feel and cope better, so that they can start to enjoy life and deal with their problems effectively again. Although there is a continuing debate about how much more effective they are than placebo - dummy drug, they seem to be most helpful in more severe depressions.

If you do start taking antidepressants, you probably won't feel any effect on your mood for two or three weeks. You may notice that you start to sleep better and feel less anxious after a few days.

How do antidepressants work?

The brain is made up of millions of cells which transmit messages from one to another using tiny amounts of chemical substances called neurotransmitters. Upwards of 100 different chemicals are active in different areas of the brain. It is thought that in depression, two of these neurotransmitters are particularly affected, Serotonin, sometimes referred to as 5HT, and Noradrenaline. Antidepressants increase concentrations of these two chemicals at nerve endings and so seem to boost the function of those parts of the brain that use Serotonin and Noradrenaline. Even so, it is not certain that this is the actual mechanism that improves your mood.

Problems with antidepressants; Like all medicines, antidepressants have side-effects, though these are usually mild and tend to wear off after a couple of weeks. The newer antidepressants (called SSRIs) may make you feel a bit sick at first and you may feel more anxious for a short while. The older type of antidepressants can cause a dry mouth and constipation. Your doctor can advise you on what to expect, and will want to know about anything that worries you. 

If an antidepressant makes you sleepy, you should take it at night, so it can help you to sleep. However, if you feel sleepy during the day, you should not drive or work with machinery until the effect wears off. Alcohol can make you very sleepy if you drink while taking the tablets, so it is best avoided. You can eat a normal diet while taking most of these tablets.

Your GP, not a psychiatrist, will usually be the one who prescribes an antidepressant. At first, he or she will need to see you regularly to make sure the tablets agree with you. If they do help, it is advisable to stay on them for at least 6 months after you feel better. If you have had more than one episode of depression, you may have to stay on them for longer than this. When it is time to stop, you should come off them slowly with the advice of your doctor.

People often worry that antidepressants are 'addictive'. Certainly, you may get withdrawal symptoms if you stop an antidepressant suddenly. These can include anxiety, diarrhoea and vivid dreams or even nightmares. This can nearly always be avoided by slowly reducing the dose before stopping. Unlike drugs such as Valium (or nicotine or alcohol), you don't have to keep taking an increasing amount to get the same effect, and you will not find yourself craving an antidepressant.

Antidepressants and young people;

There are some limits to the use of antidepressants for younger people, in their teens. There is some evidence that SSRI antidepressants can increase suicidal thoughts in young people, so there are limits on their use: Fluoxetine is the only SSRI antidepressant licensed for use with young people. It should usually be used only in addition to a psychological therapy. It should be given under the direction of a psychiatrist. The young person should be seen every week at least for the first 4 weeks.

Which is right for me - antidepressants or talking treatments?

If your depression is mild, then you probably won't need an antidepressant. But if your depression has gone on for a long time or is affecting you badly, then it may be worth trying an antidepressant at the same time as a course of talking therapy. People often find that it is useful to have some form of psychotherapy after their mood has improved with antidepressants. It can help you to work on some of the things in your life that might otherwise make you become depressed again. So, it may not be a case of one treatment or the other, but what is most helpful for you at a particular time. Both talking treatments and antidepressants are about equally effective in helping people get better from moderate depression.. 

Many psychiatrists believe that antidepressants are more effective in treating severe depression. Some people just don't like the idea of medication; some don't like the idea of psychotherapy. So there is obviously a degree of personal choice. This is limited by the fact that proper counseling and psychotherapy are not readily available in some areas of the country.

When you are low, it can be difficult to work out what you should do. Talk it over with friends or family or people you trust. They might be able to help you decide.

Will I need to see a psychiatrist?

Probably not. Most people with depression get the help they need from their GP. If you don't improve and need more specialist help, you will be referred to a specialist in the treatment of emotional and mental disorders. Therapist will have specialist training and experience in mental health problems.

The first interview with a psychotherapist will probably last about an hour. You may be invited to bring a relative or friend with you if you wish. The psychotherapist will want to find out about your general background, and about any serious illnesses or emotional problems you may have had in the past. He or she will ask about what has been happening in your life recently, how the depression has developed and whether you have had any treatment for it already. 

It can sometimes be difficult to answer all these questions, but they help the doctor to get to know you as a person and to get an idea of what would be good options for you. This might be practical advice, or suggesting different treatments, perhaps involving members of your family. If your depression is severe or needs specialist treatment, you might need to come into hospital – but this is only needed for 1 in every 100 people with depression.

What will happen if I don’t get any treatment?

The good news is that 4 out of 5 people with depression will get completely better without any help in about 4-6 months, sometimes more. So, why bother to treat depression? - Although 4 out of 5 people get better in time, this still leaves 1 in 5 who are still depressed two years later. As yet, we can't accurately predict who will get better and who will not. Even if you get better eventually, the experience can be so unpleasant that you may feel that you want to shorten the time you are depressed. Moreover, if you have a first episode of depression, you have a roughly 50:50 chance of having another one. A small number of people with depression will eventually kill themselves.

Taking up some of the suggestions in this leaflet may shorten a period of depression. If you can overcome it by yourself, then that will give you a feeling of achievement and confidence to tackle such feelings again if you feel low in the future. However, if the depression is severe or goes on for a long time, it may stop you from being able to work and enjoy life.

How can I help someone who is depressed?

Listen. This can be harder than it sounds. You may have to hear the same thing over and over again. It's usually best not to offer advice unless it's asked for, even if the answer seems perfectly clear to you. If depression has been brought on by a particular problem, you may be able to help find a solution or at least a way of tackling the difficulty. It's helpful just to spend time with someone who is depressed. You can encourage them, help them to talk, and help them to keep going with some of the things they normally do. Someone who is depressed will find it hard to believe that they can ever get better. You can reassure them that they will get better, but you may have to repeat this over and over again. Make sure that they are buying enough food and eating enough. Help them to stay away from alcohol. If they are getting worse and start to talk of not wanting to live or even hinting at harming themselves, take them seriously. Make sure that they tell their doctor. Encourage them to accept help. Don't discourage them from taking medication, or seeing a counselor or psychotherapist. If you have worries about the treatment, then you may be able to discuss them first with the doctor.

Self-Confidence, In Public Presence & Attitude

Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs (for example, "I am competent", "I am worthy") and emotions such as triumph, despair, pride and shame. Some would distinguish how 'the self-concept is what we think about the self; self-esteem, the positive or negative evaluation of the self, is how we feel about it'. A person’s self-concept consists of the beliefs one has about oneself, one’s self perception, or, “the picture of oneself”. Self concept as totally perception which people hold about him/ herself. It is not the “facts” about one-self but rather what one believes to be true about one-self. The self, as the individual identifies himself or herself, but evaluates the self by putting worthiness on it.

Therefore, self-esteem is defined as both descriptive and evaluative self-related statements. As a social psychological construct, self-esteem is attractive. In addition, self-esteem has also been treated as an important outcome due to its close relation with psychological well-being. Self-concept is widely believed to be composed of more than just perceived competence, and this leads to the relative degree of evaluative and cognitive beliefs of the construct. Self-esteem is viewed as the most evaluative and affective of the three constructs. Overlay, self-concept is considered as the beliefs about perceived competence and self-evaluative in a specific domain.Self-esteem can apply specifically to a particular dimension (for example, "I believe I am a good writer and I feel happy about that") or have global extent (for example, "I believe I am a bad person, and feel bad about myself in general"). Psychologists usually regard self-esteem as an enduring personality characteristic ("trait" self-esteem), though normal, short-term variations ("state" self-esteem) also exist.

"self-love" is "the instinct or desire to promote one's well-being"; while La Rochefoucauld considered 'that amour-propre (self-regard) is the mainspring of all human activities'.

Definitions

The original normal definition presents self-esteem as a ratio found by dividing one’s successes in areas of life of importance to a given individual by the failures in them or one’s “success / pretensions”. Problems with this approach come from making self-esteem contingent upon success: this implies inherent instability because failure can occur at any moment. Self-esteem: in terms of a stable sense of personal worth or worthiness. Self-esteem : "...the experience of being competent to cope with the basic challenges of life and being worthy of happiness". According to Branden, self-esteem is the sum of self-confidence (a feeling of personal capacity) and self-respect (a feeling of personal worth). It exists as a consequence of the implicit judgement that every person does about, on one side, his/her ability to face life's challenges, that is, to understand and solve problems, and, on the other side, his right to achieve happiness, or, in other words, to respect and defend his own interests and needs.

This two-factor approach, as some have also called it, provides a balanced definition that seems to be capable of dealing with limits of defining self-esteem primarily in terms of competence or worth alone.

Implicit self-esteem refers to a person's disposition to evaluate themselves positively or negatively in a spontaneous, automatic, or unconscious manner. It contrasts with explicit self-esteem, which entails more conscious and reflective self-evaluation. Both explicit self-esteem and implicit self-esteem are subtypes of self-esteem proper. Implicit self-esteem is assessed using indirect measures of cognitive processing, including the Name Letter TaskSuch indirect measures are designed to reduce awareness of, or control of, the process of assessment. When used to assess implicit self-esteem, they feature stimuli designed to represent the self, such as personal pronouns (e.g., "I") or characters in one's name.

Positive self-esteem: Self Actualization; Morality, creativity, spontaneity, problem solving, lack of prejudice, acceptance of facts.

Esteem: Self-esteem confidence, achievement, respect of others. Love / Belonging. Respect by Others, Friendship, Family, Sexual Intimacy.

Safety: Security of: body, employment, resources, morality, the family, health, property.

Psychological: Breathing, food, water, sex, sleep, homeostasis, excretion.

People with a healthy level of self-esteem:

•    firmly believe in certain values and principles, and are ready to defend them even when finding opposition,  feeling secure enough to modify them in light of experience. 
•    are able to act according to what they think to be the best choice, trusting their own judgment, and not feeling guilty when others don't like their choice. 

•    do not lose time worrying excessively about what happened in the past, nor about what could happen in the future. They learn from the past and plan for the future, but live in the present intensely. 

•    fully trust in their capacity to solve problems, not hesitating after failures and difficulties. They ask others for help when they need it. 

•    consider themselves equal in dignity to others, rather than inferior or superior, while accepting differences in certain talents, personal prestige or financial standing. 

•    take for granted that they are an interesting and valuable person for others, at least for those with whom they have a friendship. 

•    resist manipulation, collaborate with others only if it seems appropriate and convenient. 
•    admit and accept different internal feelings and drives, either positive or negative, revealing those drives to others only when they choose. 

•    are able to enjoy a great variety of activities. 

•    are sensitive to feelings and needs of others; respect generally accepted social rules, and claim no right or desire to prosper at others' expense.

Importance

Psychological health is not possible unless the essential core of the person is fundamentally accepted, loved and respected by others and by her or his self. Self-esteem allows people to face life with more confidence, benevolence and optimism, and thus easily reach their goals and self-actualize. It allows oneself to be more ambitious, but not with respect to possessions or success, but with respect to what one can experience emotionally, creatively and spiritually.

To develop self-esteem is to widen the capacity to be happy; self-esteem allows people to be convinced they deserve happiness. Understanding this is fundamental, and universally beneficial, since the development of positive self-esteem increases the capacity to treat other people with respect, benevolence and goodwill, thus favoring rich interpersonal relationships and avoiding destructive ones. Love of others and love of ourselves are not alternatives. On the contrary, an attitude of love toward themselves will be found in all those who are capable of loving others.

Self-esteem allows creativity at the workplace, and is a specially critical condition for teaching professions. 

Low self-esteem

A person with low self-esteem may show some of the following symptoms: 

•    Heavy self-criticism, tending to create a habitual state of dissatisfaction with oneself. 
•    Hypersensitivity to criticism, which makes oneself feel easily attacked and experience obstinate resentment against critics. 

•    Chronic indecision, not so much because of lack of information, but from an exaggerated fear of making a mistake. 

•    Excessive will to please: being unwilling to say "no", out of fear of displeasing the petitioner. 
•    Perfectionism, or self-demand to do everything attempted "perfectly" without a single mistake, which can lead to frustration when perfection is not achieved. 

•    Neurotic guilt: one is condemned for behaviors which not always are objectively bad, exaggerates the magnitude of mistakes or offenses and complains about them indefinitely, never reaching full forgiveness. 

•    Floating hostility, irritability out in the open, always on the verge of exploding even for unimportant things; an attitude characteristic of somebody who feels bad about everything, who is disappointed or unsatisfied with everything. 

•    Defensive tendencies, a general negative (one is pessimistic about everything: life, future, and, above all, oneself) and a general lack of will to enjoy life. 

Theories

Two different forms of esteem: the need for respect from others and the need for self-respect, or inner self-esteem. Respect from others entails recognition, acceptance, status, and appreciation, and was believed to be more fragile and easily lost than inner self-esteem. Without the fulfillment of the self-esteem need, individuals will be driven to seek it and unable to grow and obtain self-actualization.

Modern theories of self-esteem explore the reasons humans are motivated to maintain a high regard for themselves. Sociometer theory maintains that self-esteem evolved to check one's level of status and acceptance in ones' social group. According to terror management theory, self-esteem serves a protective function and reduces anxiety about life and death. 

Self-esteem is the sum of attitudes which depend on perceptions, thoughts, evaluations, feelings and behavioral tendencies aimed toward ourselves, the way we are and behave, and our body's and character's features. In short, it's one self's evaluative perception.
 

The importance of self-esteem lies in the fact that it concerns to ourselves, the way we are and the sense of our personal value. Thus, it affects the way we are and act in the world and the way we are related to everybody else. Nothing in the way we think, feel, decide and act escapes the influence of self-esteem. 

The need for esteem, which is divided into two aspects, the esteem for oneself (self-love, self-confidence, skill, aptitude, etc.), and respect and esteem one receives from other people (recognition, success, etc.) The healthiest expression of self-esteem, “is the one which manifests in respect we deserve for others, more than renown, fame and flattery”.

The origin of problems for many people is that they despise themselves and they consider themselves to be unvaluable and unworthy of being loved; thus the importance he gave to unconditional acceptance of client. Indeed, the concept of self-esteem is approached since then in humanistic psychology as an inalienable right for every person, summarized in the following sentence:

“Every human being, with no exception, for the mere fact to be it, is worthy of unconditional respect of everybody else; he deserves to esteem himself and to be esteemed.”

By virtue of this reason, even the most evil human beings deserve respect and considered treatment. This attitude, nonetheless, does not pretend to come into conflict with mechanisms that society has at its disposition to prevent individuals from causing hurt -of any type- to others.

The concept of self-esteem has frequently gone beyond the exclusively scientific sphere to take part in popular language.

Parental influence

Parental habits, whether positive or negative, can influence the development of those same habits.

False stereotypes

Comfort is not self-esteem

For a person with low self-esteem —or “wrong”, any positive stimulus or incentive will make him feel comfortable, or, at most, better with respect to himself/herself for just some time. Therefore, properties, sex, success, or physical appearance, by themselves, will produce comfort, or a false and ephemeral development of self-esteem, but they won't really strengthen confidence and respect to oneself. 

Self-esteem and culture

“Self-esteem can be better understood as a sort of spiritual achievement, that is, a victory in psyche's evolution”.

More recent studies demonstrate both a correlation between self-esteem and life satisfaction, and that such levels of correlation are to an extent culturally relative. 
High self-esteem is not necessarily narcissistic.

A common mistake is to think that loving oneself is necessarily equivalent to narcissism.  A person with a healthy self-esteem accepts and loves himself/herself unconditionally, acknowledging both virtues and faults in the self, and yet, in spite of everything, being able to continue to live loving her/himself.

In narcissists, by contrast, an 'innate uncertainty about their own worth gives rise to...a self-protective, but often totally spurious, aura of grandiosity'- producing the class 'of narcissists, or people with very high, but insecure, self-esteem...fluctuating with each new episode of social praise or rejection'. Narcissism can thus be seen as a symptom of fundamentally low self-esteem (that is, lack of love towards oneself), but often accompanied by 'an immense increase in self-esteem' based on 'the defense mechanism of denial by overcompensation'.

The narcissist, then, is not able to acknowledge and accept his faults, which he always tries to hide: his 'idealized love of self...rejected the part of him' which he denigrates - 'this destructive little child' within. Instead, the narcissist emphasizes his virtues in the presence of others, just to try to convince himself that he is a valuable person and to try to stop feeling ashamed for his faults; unfortunately such 'people with unrealistically inflated self-views, which may be especially unstable and highly vulnerable to negative information...tend to have poor social skills'.

           Dual Displeased Relationship    

           Relationship Problems

           It's the rare couple that doesn't, sooner or later, run into a few bumps in the road. If you recognize ahead of time what those relationship problems can be, you'll have a much better chance of weathering the storm, experts say.

Ideally, a couple should discuss certain basic issues - such as money, sex, and kids - before they decide to start their life together. Of course, even when you do discuss these issues beforehand, marriage (or a long-term, live-in relationship) is nothing like you think it's going to be.

           In spite of the fact that every marriage experiences relationship issues, successful couples have learned how to manage them and keep their love life going, says marriage and family therapist Mitch Temple, MS, author of The Marriage Turnaround. They gain success in marriage by hanging in there, tackling problems, and learning how to maneuver through the complex issues of everyday married life. Many do this by reading self-help books, attending seminars, browsing articles on the Web, going to counseling, observing other successful couples, or simply by trial and error.

           Relationship Problem: Communication

           All relationship problems stem from poor communication skills. "You can't communicate while you're checking your BlackBerry, watching TV, or flipping through the sports section," she says.

•   Make time ... yes, an actual appointment with each other. If you live together, put the cell phones on vibrate, put the kids to bed, and let voicemail pick up your calls.

•   If you can't "communicate" without raising your voices, go to a public spot like the library, park, or restaurant, where you'd be embarrassed if anyone saw you screaming.

•   Set up some rules ... like not interrupting until the other is through, banning phrases such as "You always ..." or "You never ..."

•   Remember that a large part of communication is listening, so be sure your body language reflects that. That means, don't doodle, look at your watch, pick at your nails, etc. Nod so the other person knows you're getting the message and rephrase if necessary, such as, "What I hear you saying is that you feel as though you have more chores at home, even though we're both working." If you're right, the other can confirm, and if what the other person really meant was, hey, you're a slob and you create more work for me by having to pick up after you, perhaps they'll say so but in a nicer way.

           Relationship Problem: Sex

           Even partners who love each other can be incompatible sexually. Compounding these problems is the fact that men and women alike are sorely lacking in sex education and sexual self-awareness. Yet, having sex is one of the last things we should be giving up. "Sex brings us closer together, releases hormones that help our bodies both physically and mentally, and keeps the chemistry of a healthy couple healthy".

•   Plan, plan, plan. Make an appointment -- not necessarily at night when everyone is tired. Maybe during the baby's Saturday afternoon nap. Or perhaps a "before-work quickie". Or ask Grandma and Grandpa to take the kids every other Friday night for a sleepover. "When sex is on the calendar, it increases your anticipation," Adding that mixing things up a bit can increase your sexual enjoyment as well. Why not sex in the kitchen? Sex by the fire? Sex standing up in the hallway?

•   Learning what truly turns your partner on by asking him or her to come up with a personal "Sexy List." And, of course, you do the same. What do each of you truly find sexy? "The answers may surprise you." Swap the lists and use them to create more scenarios that turn you both on.

•   If your sexual relationship problems can't be resolved on your own, it is recommended to consult a qualified sex therapist, who can help you both address and resolve your issues.

           Relationship Problem: Money

          Money problems can start even before the wedding vows are said, from the expenses of courtship to the high cost of weddings. Couples who have money woes take a deep breath and have a serious conversation about .

•   Be honest about your current financial situation. If things have gone south, continuing the same lifestyle that was possible before the loss of income is simply unrealistic.
•   Don't approach the subject in the heat of battle. Instead, set aside a time that is convenient and non-threatening for both parties.

•   Acknowledge that one partner may be a saver and one a spender, understanding that there are benefits to both, and agreeing to learn from each other's tendencies.
•   Don't hide income or debt. Bring financial documents, including a recent credit report, pay stubs, bank statements, insurance policies, debts, and to the table.

•   Don't blame.

•   Construct a joint budget that includes savings.

•   Decide which person will be responsible for paying the monthly bills.

•   Allow each person to have independence by setting aside money to be spent at his or her discretion.

•   Decide upon short-term and long-term goals. It's OK to have individual goals, but you should have family goals, too.

•   Talk about caring for your parents as they age, and how to appropriately plan for their financial needs, if necessary.

           Relationship Problem:  Struggles Over Home Chores

           Nowadays, most partners work outside the home -- and in today's economy -- often at more than one job, so it's important to equitably divide the labor at home.
•   Be organized and clear about your respective. "Write all the jobs down and agree on who does what." Be fair: Make sure each partner's tasks are equitable so no resentment builds.
•   Be open to other solutions: If you both hate housework, maybe you can spring for a cleaning service. If one of you likes housework, the other partner can do the laundry and the yard. As long as it feels fair to both people, you can be creative and take preferences into account.

           Relationship Problem:  Not Prioritizing Your Relationship

           If you want to keep your love life going, making your relationship a focal point does not end when you say "I do." "Relationships lose their luster". "So make yours a priority."
•   Do the things you used to do when you were first dating: Make gestures of appreciation, compliment each other, contact each other through the day, and show interest in each other.

•   Plan date nights. Schedule time together on the calendar just as you would any other important event in your life.

•   Respect one another. Say "thank you," and "I appreciate ... ." It lets your partner know that he/she matters.

           Relationship Problem: Conflict

Occasional conflict is an inevitable part of life, but if you and your partner feel like you are starring in your own nightmare version of the movie Groundhog Day, it's time to break free of this toxic routine. Recognizing these simple truths will lessen anger and enable you to take a calm look at the underlying issue.

Conflict resolution skills can help you and your partner learn to argue in a more constructive manner:

•  You are not a victim. It is your choice whether to react and how to react.
•  Be honest with yourself. When you're in the midst of an argument, are your comments directed toward resolution, or are you looking for payback? If your comments are blaming and hurtful, it's best to take a deep breath and change your strategy.
• Change it up. If you continue to respond in the same way that has brought you pain and unhappiness in the past, you can't expect a different result this time. Just one little shift can make a big difference. If you usually jump right in to defend yourself before your partner is finished speaking, hold off for a few moments. You'll be surprised at how such a small shift in tempo can change the whole tone of an argument.

• Give a little; get a lot. Apologize when you're wrong. Sure it's tough, but just try it and watch something wonderful happen.

"You can't control anyone else's behavior". "The only one in your charge is you."

Relationship Problem: Trust

Trust is an essential part of a relationship. Are there certain behaviors that are causing you to not trust your partner, or do you have unresolved issues that are hindering you from trusting others?

You and your partner can develop trust in each other by following these tips.
•   Be consistent.

•   Be on time.

•   Do what you say you will do.

•   Don't lie -- not even little white lies, to your partner or to others.

•   Be fair, even in an argument.

•   Be sensitive to the other's feelings. You can still disagree but don't discount how your partner is feeling.

•   Call when you say you will.

•   Call to say you'll be home late.

•   Carry your fair share of the workload.

•   Don't overreact when things go wrong.

•   Never say things you can't take back.

•   Don't dig up old wounds.

•   Respect your partner's boundaries.

•   Don’t be jealous.

•   Be a good listener.

Although relationships have their ups and downs, there are things you can both do that may well minimize marriage problems, if not help avoid them altogether. Be realistic. Thinking your mate will meet all your needs -- and will be able to figure them out without your asking -- is a Hollywood fantasy. "Ask for what you need directly".
Use humor -- learn to let things go and enjoy one another more. And be willing to work on your relationship and to truly look at what needs to be done. Don't think that it will be better with someone else; the same problems you have in this relationship because of lack of skills will still exist.

Relationship counseling

Relationship counseling is the process of counseling the parties of a relationship in an effort to recognize and to better manage or reconcile troublesome differences and repeating patterns of distress. The relationship involved may be between members of a family or a couple (see also family therapy), employees or employers in a workplace, or between a professional and a client.

Couple therapy (or relationship therapy) is a related and different process. It may differ from relationship counseling in duration. Short term counseling may be between 1 to 3 sessions whereas long term couples therapy may be between 12 and 24 sessions. An exception is brief or solution focused couples therapy. In addition, counseling tends to be more 'here and now' and new coping strategies the outcome. Couples therapy is more about seemingly intractable problems with a relationship history, where emotions are the target and the agent of change.

Marriage counseling or marital therapy can refer to either or some combination of the above.

The methods may differ in other ways as well, but the differences may indicate more about the counselor/therapist's way of working than the title given to their process. Both methods also can be acquired for no charge, depending on your needs. For more information about getting the care that may be required, one should make a call to a local hospital or healthcare professional.

Principles
Before a relationship between individuals can begin to be understood, it is important to recognize and acknowledge that each person, including the counselor, has a unique personality, perception, set of values and history. Individuals in the relationship may adhere to different and unexamined value systems. Institutional and societal variables (like the social, religious, group and other collective factors) which shape a person's nature, and behavior are considered in the process of counseling and therapy. A tenet of relationship counseling is that it is intrinsically beneficial for all the participants to interact with each other and with society at large with optimal amounts of conflict. A couple's conflict resolution skills seems to predict divorce rates. 

Most relationships will get strained at some time, resulting in their not functioning optimally and producing self-reinforcing, maladaptive patterns. These patterns may be called negative interaction cycles. There are many possible reasons for this, including insecure attachment, ego, arrogance, jealousy, anger, greed, poor communication/understanding or problem solving, ill health, third parties and so on.

Changes in situations like financial state, physical health, and the influence of other family members can have a profound influence on the conduct, responses and actions of the individuals in a relationship.

Often it is an interaction between two or more factors, and frequently it is not just one of the people who are involved that exhibit such traits. Relationship influences are reciprocal - it takes each person involved to make and manage problems.
A viable solution to the problem and setting these relationships back on track may be to reorient the individuals' perceptions and emotions - how one looks at or responds to situations and feels about them. Perceptions of and emotional responses to a relationship are contained within an often unexamined mental map of the relationship, also called a love map. These can be explored collaboratively and discussed openly. The core values they comprise can then be understood and respected or changed when no longer appropriate. This implies that each person takes equal responsibility for awareness of the problem as it arises, awareness of their own contribution to the problem and making some fundamental changes in thought and feeling.
The next step is to adopt conscious, structural changes to the inter-personal relationships and evaluate the effectiveness of those changes over time.

Indeed, "typically for those close personal relations there is a certain degree in 'interdependence' - which means that the partners are alternately mutually dependent on each other. As a special aspect of such relations something contradictory is put outside: the need for intimacy and for autonomy."

"The common counterbalancing satisfaction these both needs, intimacy and autonomy, leads to alternately satisfaction in the relationship and stability. But it depends on the specific developing duties of each partner in every life phase and maturity".

Practices

Two methods of couples therapy focus primarily on the process of communicating. The most commonly used method is active listening,. More recently, a method called Cinematic Immersion has been developed. Each helps couples learn a method of communicating designed to create a safe environment for each partner to express and hear feelings.

Active listening does a better job creating a safe environment for the criticizer to criticize than for the listener to hear the criticism. The listener, often feeling overwhelmed by the criticism, tended to avoid future encounters. We are biologically programmed to respond defensively to criticism, and therefore the listener needed to be trained in-depth with mental exercises and methods to interpret as love what might otherwise feel abusive. Cinematic Immersion.

Healthy couples almost never listen and echo each other's feelings naturally. Whether miserable or radiantly happy, couples say what they thought about an issue, and "they go angry or sad, but their partner's response is never anything like what people do in the listener/speaker exercise, not even close. "

By contrast emotionally focused therapy for couples (EFT-C) is based on attachment theory and uses emotion as the target and agent of change. Emotions bring the past alive in rigid interaction patterns, which create and reflect absorbing emotional states. 

Forget about learning how to argue better, analysing your early childhood, making grand romantic gestures, or experimenting with new sexual positions. Instead, recognize and admit that you are emotionally attached to and dependent on your partner in much the same way that a child is on a parent for nurturing, soothing, and protection.

Research on therapy

The most researched approach to couples therapy is behavioral couples therapy It is a well established treatment for marital discord This form of therapy has evolved to what is now called integrative behavioral couples therapy. Integrative behavioral couples therapy appears to be effective for 69% of couples in treatment, while the traditional model was effective for 50-60% of couples . 

Relationship counselor or couple's therapist

The duty and function of a relationship counselor or couple's therapist is to listen, respect, understand and facilitate better functioning between those involved.
The basic principles for a counselor include:

•   Provide a confidential dialogue, which normalizes feelings

•    To enable each person to be heard and to hear themselves

•   Provide a mirror with expertise to reflect the relationship's difficulties and the potential and direction for change

•   Empower the relationship to take control of its own destiny and make vital decisions
•   Deliver relevant and appropriate information

                 As well as the above, the basic principles for a couples therapist also include:
•   To identify the repetitive, negative interaction cycle as a pattern.

•   To understand the source of reactive emotions that drive the pattern.
•   To expand and re-organize key emotional responses in the relationship.

•   To facilitate a shift in partners' interaction to new patterns of interaction.
•   To create new and positively bonding emotional events in the relationship
•   To foster a secure attachment between partners.

      Common core principles of relationship counseling and couple's therapy are:
Respect - Empathy - Tact - Consent - Confidentiality - Accountability - Expertise -
Evidence based - Certification, ongoing training and supervision.

In both methods, the practitioner evaluates the couple's personal and relationship story as it is narrated, interrupts wisely, facilitates both de-escalation of unhelpful conflict and the development of realistic, practical solutions. The practitioner may meet each person individually at first but only if this is beneficial to both, is consensual and is unlikely to cause harm. Individualistic approaches to couple problems can cause harm.

The counselor or therapist encourages the participants to give their best efforts to reorienting their relationship with each other. One of the challenges here is for each person to change their own responses to their partner's behaviour. Other challenges to the process are disclosing controversial or shameful events and revealing closely guarded secrets. Not all couples put all of their cards on the table at first. This can take time.

Novel practices

A novel development in the field of couples therapy has involved the introduction of insights gained from affective neuroscience and psychopharmacology into clinical practice. There has been interest in use of the so-called love hormone – oxytocin – during therapy sessions, although this is still largely experimental and somewhat controversial. 

Popularized methodologies

Although results are almost certainly significantly better when professional guidance is utilized, numerous attempts at making the methodologies available generally via self help books and other media are available. In the last few years it has become increasingly popular for these self help books to become popularized and published as an e-book available on the web, or through content articles on blogs and websites. The challenges for individuals utilizing these methods are most commonly associated with that of other self help therapies or self-diagnosis. 

Relationship counseling with homosexual / bisexual clients

"Marital Therapy" is now referred to as "Couples Therapy" in order to include individuals who are not married or those who are engaged in same sex relationships. Most relationship issues are shared equally among couples regardless of sexual orientation, but LGBT clients additionally have to deal with heteronormativity, homophobia and both socio-cultural and legal discrimination. Individuals may experience relational ambiguity from being in different stages of the coming out process or having an HIV serodiscordant relationship. Often, same-sex couples do not have as many role models of successful relationships as opposite-sex couples. In many jurisdictions committed LGBT couples desiring a family are denied access to assisted reproduction, adoption and fostering, leaving them childless, feeling excluded, other and bereaved. There may be issues with gender-role socialization that do not affect opposite-sex couples.

A significant number of men and women experience conflict surrounding homosexual expression within a mixed-orientation marriage. Couple therapy may include helping the clients feel more comfortable and accepting of same-sex feelings and to explore ways of incorporating same-sex and opposite-sex feelings into life patterns. Although a strong homosexual identity was associated with difficulties in marital satisfaction, viewing the same-sex activities as compulsive facilitated commitment to the marriage and to monogamy.