What is Erectile Dysfunction? It is common and in most cases, can be treated. Erectile Dysfunction can define as the inability to achieve and maintain an erection sufficient for Satisfactory Sexual activity. You would know that erectile dysfunction is a relatively common condition that affects men of all ages. However, more than 85% of men with Erectile Dysfunction don't seek treatment. It is not a disease, but a symptom of another problem, which might be physical, psychological, or a mixture of both.

How common is it?

Erectile Dysfunction is Very Common. An Australian survey showed that at least one in five men over the age of 40 has an e*ection problem, and about one in ten men is unable to have erections.

How Erection Work:

During physical arousal, nerves release chemicals that increase blood flow into the penis. Blood flows into two erection chambers in the penis, made of wet muscle tissue. The corpus cavernosum chambers are not hollow. During an e r e c t i o n, the spongy tissues relax and trap blood. The blood capillaries in the penis relax and open up, leaving the blood to fill them. Blood trapped under high pressure generates an e r e c t i o n. Ejaculation is a reflex action managed by the central nervous system.

Why Does Erectile Dysfunction Happen?

A decrease in blood flow to the p e n i s — from narrowing blood vessels — is often the cause of ED in older men. When erectile dysfunction happens, there might be several contributing issues, and it's usually a combination of physical and psychological cause. Sometimes, there's no apparent reason for erectile dysfunction.

When you aren't sexually excited, the p e n i s is soft and limp. Men may notice that the size of the penis varies with warmth, cold, or worry; this is general and indicates the balance of blood coming into leaving the penis.

Physical Causes include: 

• Vasculogenic Situations – An including disease of the heart or cardiovascular disease (CVD), high blood pressure, raised cholesterol, and diabetes.

• Neurogenic Situations – An including various sclerosis, Parkinson's disease, stroke, diabetes, and spinal injury.

• Hormonal Conditions (which affect the hormones) – An including overactive thyroid gland, an underactive thyroid gland, hypogonadism (low testosterone level), Cushing's syndrome (high cortisol level), a head or brain injury recently in the past and subarachnoid hemorrhage or radiation to the head (these may cause hormonal changes, particularly a low testosterone)

Anatomical conditions – An including Peyronie's disease.

Surgery and radiation therapy for bladder, prostate or rectal cancer

Injury to the penis

Side effect of directed medications

Recreational medicine use

Excessive alcohol consumption

Erectile Dysfunction is also more likely to occur in people who smoke, are overweight, or are not active enough.

If atherosclerosis is the cause of your ED, this narrowing is likely to impress other blood vessels in the body as well, including the arteries that supply blood to the heart. That means ED can an early warning sign of future heart problems, appearing some 3-5 years before a heart complaint. You may, therefore, be able to prevent a next heart problem from happening if you see your doctor for treatment soon after your Erectile Dysfunction starts (see our factsheet' Erectile Dysfunction and the heart').

Psychological Causes:

A Psychological cause of Erectile Dysfunction is more likely if:

• Your erection is great, except for your partner.
• You are suffering stress and anxiety from work or home (family or money).
• There are marital rows and dissatisfaction (which may also cause premature ejaculation problems).
• You are depressed
• Failure once is followed by fear of subsequent failure
• Your partner has Physical Problems.
• You are bored sexually.
• You are concerned about your sexual orientation.
• You have suffered previous sexual abuse.

• What are the Symptoms of Erectile Dysfunction?

The main symptom of (ED) is the inability to get and maintain an erection for satisfying intercourse. Or it can mean you cannot get an erection consistently, or can only get brief erections. There are three Symptoms of Erectile Dysfunction.

• Inability to get an erection:

• Failure to keeping an erection

• Reduced Sexual Desire

If Erectile Dysfunction is affect a man's well-being or his relationships, it should be treated. Treatment aims to fix or enlarge erectile function, help circulatory health, and help the quality of a man's life.

How is Erectile Dysfunction Diagnosed?
 

Diagnosis of ED may include:

•       Review of health and sexual history: This may reveal conditions that lead to Erectile Dysfunction. It can also help your healthcare provider tell the difference between problems with erection, ejaculation, orgasm, or sexual drive.

•       Physical exam to look for a main problem, such as:

• A problem in the nervous system: This may be involved if your penis does not respond as expected to specific touching.
• Secondary sex features: Things such as hair pattern can point to hormone problems, which involve the endocrine system.
• Unusual features of the penis itself: These could suggest the cause of Erectile Dysfunction (ED).

•       Lab tests:These can include blood counts, urine tests, cholesterol tests, and measurements of creatinine and liver enzymes. When low sexual desire is a feature, checking testosterone in the blood can show problems with the endocrine system.

•       Penile ultrasound: This is used to scale the blood flow in the penis.

•       Psychosocial exam:That is done to help find psychological causes that may be affecting your performance. They may also interview your sexual partner.

• Other Tests:  Inquiries are often used by health specialists to rate your ability to initiate and keep erections, gauge your satisfaction with sex, and help identify any problems with orgasm.

What Treatments are there?

Usually, there won't be one special treatment that helps. For some men, there is a reversible underlying cause that can be treated. For others, the erectile dysfunction problem can't be cured, but it can be managed.

Some of the ED Treatments that may be used include:

Oral Drugs (PDE5 inhibitors): Drugs or Medicine are known as phosphodiesterase type 5 (PDE5) inhibitors that enhance penile blood flow. These are the only oral agents established in the U.S. by the Food and Drug Administration for the treatment of Erectile Dysfunction. In England, four phosphodiesterase (PDE-5) inhibitors are available for treating erectile dysfunction. They are:

• Sildenafil Citrate:  Sold Under the Brand name Generic Viagra
• Tadalafil:  Sold Under the Brand name Cialis
• Vardenafil: Sold Under the Brand Levitra
• Avanafil:  Sold Under the Brand Stendra

Sildenafil (Fildena Tablets), Vardenafil, and Avanafil Work for about 6-8 hours, and they are designed to work 'on demand.' Tadalafil (Cialis) lasts for up to 36 hours. And it's Also Called "Weekend Pills." These medications are triggered by sexual stimulation, so you also need to be aroused for it to work.

Lifestyle Changes:  Erectile dysfunction can often be developed by making changes to your lifestyle, such as: Losing Weight, Stop Smoking, cutting back your alcohol consumption, not taking illegal drugs, exercising regularly, reducing stress.

Psychotherapy: This may be used to help reduction the stress and anxiety that may be linked to sex.

Vacuum devices: These can be applied to create an e r e c t i o n by using a partial vacuum to draw blood into the penis. Then an elastic ring is put on the base of the penis to keep the blood there during penis.

Testosterone therapy. This may enhance energy, mood, and increase physical interest in older men who have low testosterone. It is not informed of men who have normal testosterone levels for their age. That is because there is a risk of prostate enhancement and other side effects.

Penile implants: These can be surgically placed if other medicines do not work. The types of implants used to treat Erectile Dysfunction include:

• Inflatable implants: A pump is put in the scrotum, and two cylinders are placed in the erection chambers of the p*nis. The pump gait a saline solution into the cylinders to cause an erection. It also removes the solution to deflate the penis.
• Semi Rigid (Rod) implants: Two Semi Rigid (Rod) but bendable rods are placed in the erection chambers of the penis. This lets the man bend his penis into an erect or no erect position.
• Key points about Erectile Dysfunction:
• 
  • Erectile Dysfunction (Sexual Dysfunction) or impotence means you can't get an erection. It can also mean you are not happy with the size or hardness of erections or how prolonged erections last.
• 
  • Organic reason are usually the result of an underlying medical condition affecting the blood vessels or nerves supplying the penis.
• 
  • There are many various types and causes of Erectile Dysfunction. Mental health problems, physical, psychological problems, certain diseases, and health situations, certain prescription medicines, and lifestyle choices have all been linked to Erectile Dysfunction.
  
  • Numerous prescription medications, recreational drugs, alcohol, and smoking can all factor ED.
• 
  • Erectile Dysfunction can be a strain on a couple, and many times the man's partner is involved in the diagnosis and treatment of Sexual Dysfunction (Impotence).

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Childhood disorders frequently marked as formative issue or learning issue, regularly happen and are analyzed when the youngster is of school-age. Albeit a few grown-ups may likewise identify with a portion of the manifestations of these disarranges, normally the turmoil's side effects need to have originally showed up sooner or later in the individual's adolescence. To cope with mental health in children conselling is one of the best options. For best Counsellor in South West London, Sustainable Empowerment is one the best organization.   There are few mental health disorder which affect the children to deeply as:

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• Autism Spectrum Disorder: Autism is a psychological issue that starts in childhood that is characterized by diligent hindrances in being to participate in social correspondence and communication with others. An individual with mental imbalance regularly has confined redundant examples of practices, interests, or exercises. The side effects are available since adolescence, and affect an individual's ordinary living. Autism exists on a range or spectrum. Individuals with extreme types of autism may have a troublesome time with ordinary exercises that fundamentally limit the sorts of things they do as a grown-up. Individuals with less serious types of autism may seem, by all accounts, to be superbly typical, aside from in certain social circumstances where the debilitation turns out to be increasingly obvious. Mental imbalance may exist with or without going with scholarly and language weaknesses.

• Attachment Disorder: Responsive emotional issues can create when a kid neglects to get satisfactory solace and sustaining from parental figures. It is assembled under "Injury and-Stressor-Related Disorders" in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Be that as it may, even in populaces of seriously disregarded youngsters, the turmoil is unprecedented, happening in under 10 percent of such cases. A fundamental element is that the youngster displays a missing or horribly immature degree of connection towards providing care grown-ups contrasted with what is ordinary or anticipated. For instance, a newborn child or extremely small kid would be seen as infrequently or negligibly going to their grown-up parental figures for comfort, backing, security, or nurturance.

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Risk Factors for Mental Illness in Children: Similar to the case with most psychological wellness issue at any age, such issue in kids doesn’t have one single complete reason. Or maybe, individuals with these diseases will in general have various natural, mental, and ecological hazard factors that add to their advancement. Organically, dysfunctional behaviors will in general be related with irregular degrees of synapses, similar to serotonin or dopamine in the mind, a decline in the size of certain territories of the cerebrum, just as expanded action in different regions of the cerebrum. Doctors are bound to determine young ladies to have state of mind issue like sadness and uneasiness contrasted with young men, while scatters like consideration shortfall hyperactivity issue and chemical imbalance range issue are all the more frequently relegated to young men. Sexual orientation contrasts in psychological maladjustment are the aftereffect of, in addition to other things, a mix of organic contrasts dependent on sex, just as the distinctions in how young ladies are urged to decipher their condition and react to it contrasted with young men. There is believed to be in any event a mostly hereditary commitment to the way that youngsters and youths with a rationally sick parent are up to multiple times bound to grow such a sickness themselves. The way of dealing with mental health disorder is counselling and psychotherapy, if you are looking for best Consellor in Chiswick Youngsters who build up a psychological issue are likewise increasingly inclined to having had other natural difficulties, similar to low birth weight, inconvenience dozing, and having a mother more youthful than 18 years of age at the hour of their introduction to the world.

Mental hazard factors for psychological maladjustment in kids incorporate low confidence, poor self-perception, an inclination to be profoundly self-basic, and feeling powerless when managing negative occasions. Youngster mental issue are to some degree related with the pressure of body changes, including the fluctuating hormones of pubescence, just as adolescent inner conflict toward expanded autonomy, and with changes in their associations with guardians, companions, and others. Youngsters who experience the ill effects of direct issue, consideration deficiency hyperactivity issue (ADHD), clinical nervousness, or who have subjective and learning issues, just as issue identifying with others are at higher danger of additionally building up a psychological issue.

Thanks to NetGalley and to Orion for providing me an ARC copy of this book that I freely chose to review.

Being a doctor (although I’d always had the same interest, even before studying Medicine), I’m always intrigued by books with the word “patient” (or doctor, hospital, or similar healthcare-related terms) in the title. Being a psychiatrist and having worked in forensic psychiatry in the UK, the description of this book seemed right up my alley. (And yes, in case you’re curious, I have treated patients who presented as temporarily mute, more than once, although not in circumstances quite as shocking as those in the book. Even one of the characters in one of my own thrillers is totally unresponsive after she is accused of a crime, but that’s another story). So I requested this book and it went into my very long list of books to read and review. Then, I started seeing great reviews, recommendations, etc., and grew curious, to the point where it jumped up to the top of my list.

Now, it’s quite difficult to review this book without revealing any spoilers, and this is a book where the twists in the plot are quite important, so I won’t be able to say much, as I’m sure many people will enjoy it and I don’t want to ruin it for them.

What can I tell you? What did I think? Well, I know this is a work of fiction, rather than a treatise in psychiatry or psychotherapy. (Theo Farber, one of the main characters, is a psychotherapist, a psychologist by training, not a medical doctor and, let’s say, he is not too enamoured with psychiatrists, anyway). But still, having work experience in high secure units in the UK, and also in low and medium secure units, both NHS and private, I couldn’t help but find so many things wrong with the characterisation of the professionals involved in the care of the other main character, Alice Berenson —the silent patient of the title— and also with the procedures followed and the way the unit is run, that it shattered my suspension of disbelief and made the rest of the book difficult to judge in its own right, for me. Despite the great reviews the book has had, I’ve noticed some other people have also had issues with the characterisation of the therapist and with other details of the novel, so if you are somebody who likes mysteries and thrillers to be realistic and tight when it comes to details, I’d say you should give it a miss.

The actual mystery side of the story… Well, as I said there are twists, more than one, red herrings, and some people have described it as original. Others, not so much. How well the twists work depends on how much you engage not only with the story, but also with the main characters. The story is narrated from two points-of-view, both in the first person, one the therapist’s, and one the patient’s, although, as must be evident from the title, the patient mostly does not talk, and what we get are entries from her diary, the diary she wrote before the events that landed her in the psychiatric unit. I like unreliable narrators, and they can work very well for mysteries, indeed. Here we have two. If Alice might be seen as an unreliable narrator due to her mental state, Theo seems to be very good at not applying his therapeutic insights (such as they are, but I’ve already said my piece on that and won’t insist) to himself and his own situation. But, I’m sure you won’t be surprised if I tell you that things are not quite as straightforward as they seem, even if you suspect they are far from straightforward.

My inkling is that people who don’t read tonnes of thrillers or mysteries are likely to enjoy this book more than people who mostly read thrillers and are used to smelling a rat from afar. Because of the issues I had with the novel, I included the editorial reviews, so you can get a sense of what the official line is on it. When I read the negative reviews I saw that some readers felt cheated by the twist (and yes, I understand that point of view, although,  as I said, I had other issues with the book); there were complaints about not liking any of the characters (other than the two main characters, none of the rest are drawn in much detail, I agree); some readers found the descriptions of therapies and the use of psychotherapeutic terms over the top (too much telling and not enough showing, and some complained they slowed the action); some reviewers objected to the use of swear-words (as this was mostly by one of the patients, from personal experience I’d say that bit is not unrealistic); and also some comments about a somewhat prejudiced depiction of a couple of characters (the Greek professor running the clinic comes out of it much better than the Turkish patient, it’s true). I mention those as a warning for people who are thinking about reading it and the concerns might resonate with them.

After reading the whole book, and with the caveats I’ve mentioned, personally, I was intrigued by the reference to a play by Euripides I hadn’t heard about, Alcestis, and I want to explore it further. I also enjoyed the references to Alice’s paintings and her creative process.

If you aren’t familiar with psychiatric care (particularly forensic psychiatric care in the UK), don’t regularly read tonnes of mysteries, and prefer books with enticing plots rather than those focused on a strong and psychologically consistent depiction of, you are likely to enjoy this book. Otherwise, my recommendation would be to check a sample of the book and see if it hooks you and you feel compelled to keep reading.

Are you feeling extremely sad but don’t know what the real reason is? Never prolong the distress by searching for the right treatment for depression and anxiety. You need to straighten up your emotions before they consume you. There is one way to help you solve such abhorrent feeling, and it’s best done with consultations from a psychoanalyst named Patrick Mahony.

So, what is depression? It’s actually a feeling of being sad or in a low mood. Many people often feel such emotions, and it can turn more potent with sadness that it becomes unbearable. This is when it is classified as clinical depression where someone experiencing it will need professional help.

When you suffer from such illness, your cognitive, emotional somatic and behavioral components are combined to create a feeling of fear, nervousness and too much worry. This will affect the body by creating headaches, chest paint, nausea and heart palpitations.

Although they are different, Patrick Mahony recommends that depression and anxiety be treated in the same manner. It is believed that those experiencing depression are sometimes anxious. The treatment from a psychoanalyst will make the patient relax sometime and develop trust with the expert. After which, he may need to visit his clinic a number of days a week or months or even years, until he’s fully recovered.

As a medical practitioner, Patrick Mahony is the best person to tell you what type of treatment is most suited for depression and anxiety. Some may be given antidepressant drugs for those suffering the two illnesses. His therapy sessions will guide the patient to help himself or herself cope with his or her condition. The patient is aided to overcome his or her lowest points where he is asked to calm down physically until everything turns normal.

If you start feeling the depression or anxiety, or is in the healing stage, you need Patrick Mahony to advise you with some suggested relaxation techniques and exercises to keep you focused and balanced. You should also watch out what you eat especially those chemicals that trigger such emotions. Be careful in what you choose to consume for your body. The best ways are to eat right with vegetables, fruits and lots of water.

There were a few things that I really disagreed with, but all-in-all, I think this will be useful to me.