The Top 5 Mistakes Divorced Parents Make

Breaking up is hard to do, and it may be especially hard for kids. Kids of divorce can feel they've been hit the hardest by the end of their parents' relationship. Some are asked to broker peace between warring exes, even as they are grieving the loss of a parent who has abruptly moved out. Others must deal with parents who suddenly can't cope with everyday tasks, like making dinner or helping with homework.

Many children carry the battle scars of divorce well into adulthood -- wounds that never needed to be inflicted in the first place. But broken-up spouses can help stop the damage by managing their own behavior before the ink dries on the divorce papers. Family and divorce expert M. Gary Neuman, LMHC, gives exes pointers on how to split up without emotionally destroying their kids long term.

1. Don't make your child the messenger ...

"Too many parents attempt to communicate through their children," Neuman says, "which causes undue emotional stress on them and forces them to negotiate a situation their own parents could not handle.  Email is an excellent tool nowadays to communicate with your ex-spouse. It allows you to specifically discuss the practicalities of raising your child without detouring into negative areas and opening old wounds. It also provides a recorded message, admissible into court, so parents tend to be more careful when using it.

"If you want or need to speak with your ex over the phone or in person, be focused and stay on task, and most important, don't swallow the bait if he or she descends into anger. Simply say, 'I appreciate your feelings, but I am here to discuss our child's school assignment.' Take the high road. Your child's emotional health depends on it."

2. ... or your therapist.

"Teenagers like to feel in control, and divorce turns their world upside down," Neuman says. "Don't fall into the trap of sharing divorce details or your angry feelings about your ex with your older kids. Their own anxiety and need for control causes them to be 'understanding' of what you're going through, but you need to be the parent. Get outside help for yourself, get therapy if necessary, and maintain those boundaries. Making your child your cohort is wrong and does them damage."

3. Try to "get" your kid.

"Kids need to feel as if they are understood," Neuman says, and after a divorce their feelings may be in turmoil. "Listen to them. Don't tell them what to think. And it might be difficult, but never criticize your ex -- it's a criticism of your child, who, of course, is 50% of your ex-husband or wife. Respond specifically to what they are telling you. Say, 'It sounds like you are feeling sad/mad/upset about meeting your dad's new girlfriend, is that right?' As a parent, you don't have to have a solution. You just need to hear them.

"And don't editorialize. You can suggest your child write down his feelings and share them with your ex, but only if the child wants to do so. Stay trained on your child's feelings, not yours. Healing comes through a loving connection and from feeling understood."

4. Avoid the third degree.

"I tell parents to treat their child's weekend away with their ex-spouse as if the child has just visited an aunt or uncle," Neuman says. "Saying nothing will leave your child stressed, as if he must compartmentalize both worlds and tiptoe around this other experience. On the other hand, grilling the child puts him squarely in the middle, which is an impossible position emotionally. So ask your kid fun and general questions, which diffuses tension. And then let it go."

5. Repair the damage you've already done.

Many divorced parents reading these tips may recognize mistakes they've unintentionally made with their own kids. Is it ever too late to undo emotional fall-out from a nasty split? "No, children are remarkably forgiving," Neuman says, "at least until they reach their later teen years, when anger may be more cemented. If you've made mistakes, it's important to do the following:

• Apologize for them. Saying you're sorry goes a long way with your kids.
• Explain in detail exactly what you've done wrong, and then commit to changing your behavior from that moment on.
• Give your child a safe and specific signal -- for example, tell your child to raise his or her hand when you begin criticizing your ex -- which serves as a time-out for you, telling you in no uncertain terms you're doing it again and need to stop immediately."

Adapted from the cover story of WebMD the Magazine's February 2009 issue. Read the complete story  here .

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Managing Osteoporosis and Bone Health

If you have osteoporosis, or are at risk for it, you want to do all you can to keep your bones as strong as possible. Besides following your doctor's advice on diet and exercise, you should know that some medications are bone-friendly -- and others may have side effects that affect the bones.

Some medications prescribed for common health problems, such as heartburn or depression, could affect your bone health.

"That doesn't necessarily mean you should stop them," says Harold Rosen, MD, director of the Osteoporosis Prevention and Treatment Center at Beth Israel Deaconess Medical Center in Boston.

Rather, "it's crucial to weigh the pros and cons: the benefits of the medicine against the effect on the bones," he says.

The benefits of a drug may outweigh the risks. Or your doctor may prescribe a ''bone-maintenance" drug to offset the risk, Rosen says.

Corticosteroid Drugs and Bone Health

This type of steroid drug helps curb inflammation. Doctors prescribe them for conditions including rheumatoid arthritis, asthma, and ulcerative colitis.

Some examples include:

• cortisone (Cortone)
• prednisone (Deltasone, Meticorten, Orasone, Prednicot)

These steroids hamper bone formation and increase bone resorption, which can make a fracture more likely, notes  endocrinologist Ann Kearns, MD, a consultant at the Mayo Clinic in Rochester, Minn.

However, she says, some people need these drugs. And the ''short-term risk is not a big deal for most people," Rosen says.

How you take the drugs may also matter. Pills or shots are the most powerful, but those you inhale or put on your skin are "less concerning," Kearns says.

Anti-Cancer Drugs and Bone Health

If you've had breast cancer and are taking certain drugs that affect your bones, your doctor should monitor your bone density and may prescribe a bone-maintenance drug.

Some breast cancer patients take a type of drug called an aromatase inhibitor. These drugs include:

• anastrozole (Arimidex)
• exemestane (Aromasin)
• letrozole (Femara)

These drugs target a substance your body makes called aromatase. That leads to lower estrogen levels, which can dim estrogen-fueled cancers.

That's good news for your cancer, but lowering your estrogen levels can be bad for your bones, since estrogen stops bone resorption. That's why doctors often prescribe improved lifestyle changes such as exercise, a diet rich in calcium and vitamin D, and bone-maintenance drugs to women who are taking the aromatase inhibitors. 

Men who have been treated for prostate cancer are sometimes prescribed anti-androgen therapy. Examples of these drugs include bicalutamide (Casodex), flutamide (Eulexin), and nilutamide (Nilandron).

These drugs block the action of the hormone testosterone, usually slowing prostate cancer growth. However, these medications can decrease bones' density and increase fracture risk, so doctors may prescribe changes in lifestyle such as exercise, smoking cessation, reduced caffeine intake, and a bone-maintenance drug.

Antidepressant Drugs and Bone Health

Some drugs used to treat depression, known as SSRIs, may affect your bones. Examples of SSRIs include:

• citalopram (Celexa)
• fluoxetine (Prozac)
• paroxetine (Paxil)
• sertraline (Zoloft)

That's not to say you shouldn't take them. When weighing risks and benefits, Kearns says to remember that depression itself has been linked with poor bone health.

However, most studies looking at the effects of SSRIs on bone health have found a greater chance of fractures in people taking drugs, Kearns says.

One study, for instance, found those currently taking the SSRI antidepressants were more than twice as likely to have a fracture not in their spine than those not taking an SSRI. Another study of women with a history of depression showed lower bone density in those who had taken  SSRIs  than those who didn't take the drugs.

Kearns' advice: Ask your doctor  each time they refill the antidepressant prescription: "Is this still the right drug?" "Is this the right dose?" Make sure the doctor prescribing your antidepressant knows about your bone health concerns, and consider asking about how much calcium and vitamin D you need.

GERD Drugs and Bone Health

If you have GERD (gastroesophageal reflux disease), your stomach acid backs up into your esophagus. You may be taking a type of drug called a proton pump inhibitor (PPI), which may or may not require a prescription.  PPIs include:

• esomeprazole (Nexium)
• lansoprazole (Prevacid)
• omeprazole (Prilosec, Zegerid)

Over-the-counter PPIs include versions of Prevacid 24HR, Prilosec OTC, and Zegerid OTC.

In 2010, the FDA warned that taking high doses of PPIs for a long time may make fractures of the hip, wrist, and spine more likely. The FDA ordered a labeling change on the medicines to note the risk.

Other drugs, called H2 blockers, curb the production of stomach acid. H2 blockers include:

• cimetidine (Tagamet)
• famotidine (Calmicid, Fluxid, Mylanta AR, Pepcid)
• ranitidine (Tritec, Zantac)

These drugs may be more bone-friendly, according to Kearns, but that's not certain yet.

Diabetes Drugs and Your Bones

Research about the effect of some diabetes drugs on bone health has been accumulating, says Chad Deal, MD, head of the Center for Osteoporosis and Metabolic Bone Diseases at the Cleveland Clinic.

Many recent studies have shown that a kind of diabetes drugs known as thiazolidinediones have a negative effect on the bones, according to Deal and Kearns. Examples of these drugs include:

• pioglitazone (Actos)
• rosiglitazone (Avandia)

There are other types of diabetes drugs, so that may be something for you and your doctor to consider when you're going over all your medications.

Bone-Maintenance Drugs

Bisphosphonates are a type of osteoporosis drug. They include:

• alendronate (Binosto, Fosamax)
• ibandronate (Boniva)
• risedronate (Actonel, Atelvia)
• zoledronic acid (Reclast)

Some studies linked their long-term use to a greater chance of an uncommon fracture of the thigh bone.

If someone who's been taking a bisphosphonate for a long time has that rare type of thigh bone fracture, their doctor should switch them to another type of osteoporosis drug, Deal says.

The following drugs are among the alternatives to bisphosphonates for either treating or preventing osteoporosis:

• calcitonin (Miacalcin)
• denosumab (Prolia). This is a biologic drug that slows bone loss.
• raloxifene (Evista)
• teriparatide (Forteo). This is a type of parathyroid hormone that increases bone formation.
• Hormone replacement therapy

If you've been taking a bisphosphonate for five years, Deal says your doctor may check to see whether you should continue, stop, or switch to another bone-maintenance drug.

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5 Foods to Boost Your Child's Immune System

Could the snacks you feed your kids cut their chances of getting sick? Healthy things in everyday foods -- from yogurt to walnuts -- may help boost a kid's natural defenses.

"We know that what you eat has a clear impact on your immunity," says Leo A. Heitlinger MD, chair of the American Academy of Pediatrics section on gastroenterology, hepatology, and nutrition. So whether you're arming your kid for cold and flu season or just aiming for good, year-round health, immune-boosting snacks may help.

5 Foods That Boost Immunity

• Yogurt. Yogurt contains helpful germs called probiotics. You may already know that these critters live in your gut and can improve the way your body uses food. But they're also important in helping your body fight sickness. One study found that kids who had a yogurt drink had a 19% lower risk of colds, ear infections, and strep throat.
  
  
  
  What type of yogurt should you get? Heitlinger suggests looking for brands that say they contain live cultures. "If it's separated when you open it, and there's a little liquid on top, that's a good sign," he says.
  
• Kefir. This tart milk drink also packs lots of healthy probiotics. While the biting taste can be a surprise at first, it's catching on in the U.S. "You can buy it in single-size packages that you could pack in your kid's lunchbox," says Jennifer McDaniel, MS, RD, a spokesperson for the Academy of Nutrition and Dietetics. There isn’t much proof about kefir yet. But early research suggests it can help your immune system.
  
• Walnuts. Walnuts have healthy omega-3 fatty acids, which are good for you in lots of ways. Experts believe that omega-3s help your body fight illness. One small study found omega-3s cut the number of respiratory infections in kids. Walnuts are easy to sprinkle into a snack mix or on cereal.
  
• Fruits and veggies. To help your immune system, McDaniel suggests aiming for ones that are high in vitamin C, like citrus fruits, strawberries, bell peppers, broccoli, and sweet potatoes. Experts aren’t entirely sure how much vitamin C helps colds and flu.
  
• Lean meats. You might not think of a leftover pork chop as a snack -- or that it would boost your body’s disease fighting system. But lean meats can help. First of all, they have protein, which is important for keeping up strength. Second, lean meats also contain zinc, which seems to help white blood cells fight off infections, McDaniel says.

Tips for Boosting Immunity With Foods

• Choose a range of healthy foods. Don't get hung up on this month's hottest superfood, like a berry or grain that supposedly works miracles, McDaniel says. It may be healthy, but it's not going to be a cure-all. Instead, offer kids a range of vegetables, fruits, whole grains, and lean proteins.
• More isn't better. If one kiwi is good, that doesn't mean your kid should eat 10. Mega-dosing with foods won’t help. Once your kid's body has what it needs, the rest gets wasted. It's like pumping gas into a tank that's already full.
• Know the limits. Remember, no food can prevent colds and flu. No food can cure them, either. So if your kid gets sick, it's not a sign that you didn’t give him a diet that was healthy enough. It's just life.
• Go for whole foods. Sure, orange juice has vitamin C, but your kid is better off with an orange instead. It has vitamin C and a lot more. "You get a lot more nutrients from the whole food than you would from a juice or supplement," says McDaniel says. There are lots of healthy natural chemicals in foods that we haven't isolated in pills or juices -- or that we even know about yet.

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Foods for Your Anti-Aging Diet

You already know that eating the right foods helps keep you healthy. Here's more good news: A healthy diet can also make you look and feel young. It may even slow the aging process.   

Eating foods such as fruit, vegetables, fish, nuts, and whole grains protects against many chronic conditions that could limit your life, including diabetes and heart disease. These foods help keep your blood vessels in top shape. That’s important for your heart -- and for every organ of your body. Certain foods can protect vision and hearing. Eating healthy foods may even help preserve memory and protect against Alzheimer's.

"Even your skin will stay younger looking if you eat right," says Allison T. Pontius, MD, an expert in anti-aging and regenerative medicine at Williams' Center of Excellence in Latham, N.Y.

Help Yourself to These Age-Defying Foods

Colorful fruits and vegetables. The antioxidants in colorful vegetables and fruits, such as leafy greens, deep red tomatoes, blueberries, and carrots, help stop unstable molecules from damaging healthy cells. You cannot feel it when some cells are damaged or dying, but you can see it in the signs of aging, such as wrinkles. So at each meal, fill about half your plate with fruits and vegetables. Your goal is five to nine servings a day.

• Three particular antioxidants -- vitamin C, zinc, and beta-carotene -- help protect your vision from macular degeneration, the leading cause of blindness in adults 65 and older. If you already have macular degeneration, eating foods with these nutrients may slow its progress. Dark green leafy vegetables -- spinach, kale, collard, and mustard greens -- help the most. But you also help your eyes when you eat bright-colored produce, including corn, peppers, oranges, and cantaloupe.
• A powerful antioxidant in grapes and red wine, called resveratrol, helps reduce your risk of cancer, heart disease, and premature aging.
• Antioxidants like vitamin C can even keep your skin younger-looking. A 2010 study showed that eating lots of yellow and green vegetables was linked to fewer wrinkles.  

Whole grains. Eating whole grains rich in fiber -- oats, quinoa, barley, wheat, and brown rice -- lowers your chance of developing type 2 diabetes. A healthy diet that contains whole grains also keeps blood vessels in peak condition. Your goal is three servings of whole grains a day.

Fish. Omega-3 fatty acids in fish oil offer many anti-aging benefits. They protect your heart, reduce your risk of stroke, and may even lower your risk of Alzheimer’s disease. Help yourself to two servings a week of fatty fish such as salmon, lake trout, or tuna. If you typically get tuna from a can, choose albacore packed in water for the most omega-3s. If you don't eat fish, ask your doctor if you should take fish oil supplements. 

Help Yourself to These Age-Defying Foods continued...

Dairy. The calcium and fortified vitamin D in dairy foods are crucial to strong bones. They help prevent osteoporosis and keep you active into your golden years. Include 3 cups of low-fat milk, yogurt, or other dairy products a day to ensure strong bones for life. By choosing low-fat instead of regular dairy, you’ll help keep your cholesterol levels in check, making you less likely to get heart disease.

Nuts. The fatty acids in nuts are among the healthiest you can find. If you avoid nuts because you think they're high in fat, think again. In fact, one study showed that snacking on nuts reduced the risk of high blood pressure and high cholesterol by about 20%. You only need to eat 1/4 of an ounce a day to get the benefits -- that’s about 4 almonds.

Beans and lentils. These foods give you loads of plant-based protein, so they’re an age-protecting alternative to red meat with saturated fat, which is linked to heart disease and diabetes. Beans and lentils are inexpensive and easy to add to soups, casseroles, and side dishes.

Aging Foods to Avoid

For the best anti-aging diet, it’s important to limit foods that can harm your body. It’s easy if you follow these three guidelines.

• Go easy on high-fat meat, high-fat dairy, and bakery treats. The saturated fat found in these foods can clog your arteries, which can lead to heart problems.

• Limit sugar as much as possible. Eating too much sugar can send your blood sugar levels on a roller-coaster ride of ups and downs. Over time, excess calories may make you insulin resistant, which can lead to type 2 diabetes. Diabetes damages your blood vessels and often leads to heart disease. "The less sugar you eat, the healthier you'll be," Pontius says. 

• Spare the salt. Eating too much salt, a form of sodium, can raise your blood pressure. Over time, high blood pressure can damage many parts of your body, including your kidneys, your eyes, and your brain. Limit sodium to 2,400 milligrams -- about 1 teaspoon of table salt -- throughout your entire day. If you have high blood pressure, your doctor may suggest you eat even less, about 1,500 mg a day. Check labels for the sodium content in canned, frozen, and boxed foods. Packaged foods typically pack in a lot of salt -- you may be eating more than you realize.

Give Your Body the Fuel It Needs

Can you get the benefits of nutrients through supplements, instead of thinking so much about what you eat? Not really, says dietitian Manuel Villacorta, author of Eating Free.

You need calories from food to have the energy to do everything you want to do. For steady energy, Villacorta suggests you eat three modest-sized meals a day, and keep healthy snacks handy for between meals. Drink plenty of water. Becoming dehydrated can rob you of energy and cause your skin to dry out.

Also, research shows that nutrients in whole foods interact in complex ways to protect your body. Isolating a single nutrient in a supplement rarely offers the exact same benefit.

“It's smarter -- and easier -- to plan your diet around foods, not nutrients," Villacorta says. "What you eat makes a huge difference in how you age and how you feel."

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How to Boost Your Fertility

If you're like most couples who are trying to conceive, you want to get pregnantsooner rather than later.

Having intercourse as close as possible to ovulation  definitely helps. But fertilityexperts say there are other ways couples can boost their fertility. A few simple measures may make the next month the month you'll squeal: "We're pregnant!"

See When You're Most Fertile During Your Monthly Cycle

1. Her Fertility Booster: Weight Control

Being underweight or overweight can delay the time it takes a woman to conceive.

William Gibbons, director of the division of reproductive endocrinology and infertilityat Baylor College of Medicine, says weight before getting pregnant is often an overlooked factor in fertility. Keeping a healthy weight can help with conception.

In onestudy, researchers evaluated the body mass index (BMI) of 2,112 pregnant women. Women in the study who had a pre-pregnancy BMI of 25-39 – considered overweight or obese -- had a twofold increase in the time it took to get pregnant. A BMI less than 19 (18.5 to 24.9 is considered normal) is even worse, the researchers found. Time to conception was increased fourfold in women with a BMI below 19.

Gibbons tells women to stay at a healthy weight when trying to conceive.

2. His Fertility Booster: Protect Those Sperm

According to Dale McClure, president of the American Society for Reproductive Medicine, the idea that changing to boxers instead of briefs will boost fertility by keeping genital temperatures down is basically an old wives' tale. Earlier studies seemed to point to boxers as the better choice, McClure says. But more recent studies haven't shown a major difference.

What about exposing the testicles to other sources of heat? The American Society for Reproductive Medicine says controlling temperature doesn't play much of role in boosting fertility. Some doctors, though, recommend staying away from certain sources. For instance, sitting in a hot tub day after day should be avoided, McClure says, even if a man has no known fertility problems. In at least one study, repeated exposure to high water temperatures through hot tubs or hot baths was shown to affect men's fertility.

Still, no research has clearly shown a link between exposure to other sources of heat and a man's fertility. One study did show that scrotal temperatures went up in laptop users who held the computer on their laps and warned that long-term exposures to high temperatures could harm sperm. Another study found that exposure to radiation from cell phones could adversely affect sperm that had been collected from participants. Researchers in that study speculated that keeping a cell phone in a pants pocket could affect the health of a man's sperm.

While neither study was sufficient to prove that exposure to sources of heat could harm sperm enough to affect fertility, McClure still says a man who wants to be a father probably shouldn't keep his laptop on his lap for extended periods of time. But even considering the above findings, McClure says he is "more concerned about hot tubbing."

3. Her Fertility Booster: Watch the Beverages

Drinking too much coffee or too much alcohol can impair a woman's fertility.

Experts say that drinking more than five cups of coffee a day -- the equivalent of about 500 milligrams of caffeine -- is associated with lower fertility. But don't give up your daily cup of coffee just yet. Moderate caffeine consumption, Gibbons says, seems to be OK. Having one or two cups a day is fine. His advice for women who are coffee or soda drinkers: "Stay under 200 to 250 milligrams of caffeine a day."

Studies on alcohol intake and women's fertility have produced mixed findings. But Swedish researchers have found that women who drank two alcoholic beverages a day decreased their fertility by nearly 60%. Once again, moderation is key. Although higher levels of alcohol -- two drinks or more a day -- should be avoided when trying to get pregnant, there is no evidence to show that moderate alcohol consumption adversely affects fertility.

You will, though, want to cut out alcohol completely once you are pregnant. Drinking while pregnant increases the risk of serious birth defects.

4. Couple's Fertility Booster: Stop Smoking

Smoking cigarettes can impair both a woman's and a man's fertility. Smokingaffects how receptive the uterus is to the egg. And in men, smoking can reduce sperm production and damage DNA. Experts also strongly suggest quitting smoking before you’re pregnant. Smoking while pregnant boosts the risk of miscarriage.

5. Couple's Fertility Booster: The Fertile Window

Taking advantage of what doctors call the "fertile window" can boost your chances of pregnancy. The fertile window is the six-days that end on the day of ovulation. Pregnancy is most likely to occur with intercourse within the three days before ovulation.

Richard Paulson, chief of the division of reproductive endocrinology and infertility at the University of Southern California Keck School of Medicine, says that couples often wait until the day of ovulation or later to have intercourse. But if you really want to get pregnant, “Err on the early side,” he says.

Paulson also advises keeping close track of ovulation -- either by the calendar method, figuring ovulation occurs about 14 days before the menstrual period is due, or by using an ovulation predictor kit, widely sold online and in drugstores.

6. Couple's Fertility Booster: Have Frequent Sex

Delaying lovemaking -- or as some couples say, ''saving up'' -- isn't going to boost the chances of pregnancy, McClure says.

"After about a week, the [sperm] count goes up a bit, but the motility decreases," he says. Not having sex for more than five days may affect sperm counts adversely. But intervals as short as two days don't harm sperm density.

Although daily intercourse produced the highest pregnancy rate in one study, it may pose too much stress for some couples. The same study showed that having sex every other day produced nearly as good a pregnancy rate.

7. Couples Fertility Booster: Choose Lubricants Wisely

With more frequent intercourse, couples may turn more to vaginal lubricants. That's OK, doctors say, if the lubes are picked wisely. Some lubricants can actually decrease fertility.  When you're trying to get pregnant, be sure to avoid products that have spermicidal agents.

So what is a good lubricant to use? "Canola oil," Gibbons says.

"Even peanut oil is good," McClure says. But impromptu household lubes may not be good. "I had a patient yesterday with a great sperm count and no motility [swimming ability]," McClure says. When he asked a few more questions, he got to the root of the problem. "He was using soap for a lubricant," and soap was killing the sperm.

You also want to avoid commercially available water-based lubricants. Water-based lubricants, such as Astroglide, KY Jelly, and Touch, may inhibit sperm motility by 60% to 100%.

8. Couple's Fertility Booster: Avoid Pesticides and Other Harmful Exposures

Exposures to pesticide, especially agricultural pesticides, may harm both men and women's fertility. And exposure to some solvents and toxins -- including those used in printing businesses and dry cleaning establishments -- can adversely affect women's fertility.

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Are You in Love? 6 Tips for Teens

Love can take you to new highs -- and new lows. You may have the strongest feelings of your life, which is great when things are good. But if things go bad, it’s devastating. Here are six dating tips to help you keep your head during this exciting time.

Dating Tip 1: Take Your Time

Some teens date, some don’t. “Girls need to feel good about themselves before they start to date,” says Charles Wibbelsman, MD, chief of adolescent medicine at Kaiser Permanente in San Francisco. His advice: only date if you know yourself and know you want to date. If you’re not ready, it’s cool to stay single and hang out with your close friends.

Dating Tip 2: Find Someone Who Likes You Back

Feelings that aren’t returned can make you question everything about yourself. Did you say something wrong? Were you wearing the wrong things? In a healthy relationship, the feelings are mutual. You respect each other and have fun together. If this doesn’t describe your situation, there’s nothing wrong with you, but you probably do need to keep looking.

Dating Tip 3: Know When to Move On

Sometimes you have to admit it, the relationship isn’t working. Maybe the love of your life has turned mean and selfish. Maybe you realize you want something better. “If a boyfriend doesn’t give you what you need, walk away,” says Danielle Greaves, MSW, who works with girls at The Guidance Center in Cambridge, Mass. She tells girls all the time, “It hurts now, but you can get through this.”

Dating Tip 4: Talk About Facebook Before You Talk on Facebook

Social media puts the ups and downs of dating out there for everyone to see. If you like a guy or he likes you, it’s perfectly OK to ask him not to post things about you online, including pictures. Some things don’t have to be shared with the whole world.

Dating Tip 5: Protect Yourself From Pressure

Pressure is not love, and it’s not even normal. Most teens say they’ve never felt pressured to be in a relationship before they were ready. Still, a little mental preparation never hurts. Decide ahead of time what your values are and how far you want to go. That way, you won’t have to figure it out in the heat of the moment.

Here are a few concrete things you can do to keep yourself out of the pressure chamber:

• Avoid situations where a guy might expect more than you want to give.   
• Go out with boys close to your age. Girls who go out with older guys are more likely to have sex before they’re ready.

Dating Tip 6: Give Love Time to Grow

Sometimes the idea of love is better than love itself. How do you know if you’re really in love?

If you’re infatuated, need constant reassurance, and have trouble thinking about anything else, these are signs you’re not really in love. It’s fun for now, but in time you’ll probably feel disappointed.   

Mature love grows stronger with time. The more you get to know each other, the stronger your feelings. And you don’t have to be someone you’re not. You like each other for who you truly are. If you’re like most people, finding mature love takes more than one try, but it’s definitely worth it.

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The Truth About Antidepressants

If you are being treated for moderate to severe depression, a doctor or psychiatrist has probably prescribed an antidepressant medication for you.  When they work properly, they help to relieve symptoms and, along with other approaches such as talk therapy, are an important part of treatment.

One way antidepressants work is by altering the balance of certain chemicals in your brain. And, as with all medicines, this change can cause side effects. Some, like jitteriness, weird dreams, dry mouth, and diarrhea typically go away after a week or two -- if they don’t, it’s probably best to switch to another drug. Others, like decreased sexual desire, may last longer.

Not everyone has the same side effects. And a particular antidepressant doesn’t cause the same side effects in all people. Many things, including your genetic makeup or existing health conditions, can affect the way you respond to taking an antidepressant.

It’s important to keep track of side effects and discuss them with your doctor. Together, you and your doctor can safely manage your antidepressants so they work with minimal side effects.

Common Side Effects of Antidepressants

Antidepressants can sometimes cause a wide range of unpleasant side effects, including:

• nausea
• increased appetite and weight gain
• loss of sexual desire and other sexual problems, such as erectile dysfunction and decreased orgasm
• fatigue and drowsiness
• insomnia
• dry mouth
• blurred vision
• constipation
• dizziness
• agitation
• irritability
• anxiety

Antidepressants and Sexual Problems

One of the more common “though not frequently talked about” side effects is decreased interest in sex or decreased ability to have an orgasm. As many as half the patients who get SSRIs report a sex-related symptom, says Bradley N. Gaynes, MD, MPH, associate professor of psychiatry at the University of North Carolina.

One way to address such symptoms is to add a different type of antidepressant or even a medication for erectile dysfunction, Gaynes says. But it’s also possible that switching to another antidepressant will make these symptoms go away. Never stop taking the antidepressant without discussing it with your doctor. Stopping abruptly could cause serious withdrawal-like problems.

Antidepressants and Weight

Another, less well-documented side effect of antidepressants is weight gain. Go on any health message board and you’ll read accounts of patients disturbed by the amount of weight they’ve gained -- or in a few cases, lost -- since going on an antidepressant.

One of the problems, says Gaynes, is knowing how much of the weight gain or loss can be attributed to the drug and how much can be attributed to other factors, such as a person’s normal behaviors around food.

Yet some reliable medical studies have shown that long-term use of antidepressants can raise the risk of weight gain and related illnesses -- type 2 diabetes and hypertension.

“Weight gain and loss of sexual interest and performance are the main things I hear about,” says Myrna Weissman, PhD, a clinician and epidemiologist at Columbia University. “The new drugs typically claim to have fewer side effects, but I don’t know that the data supports that. Sometimes there are pretty striking weight gains.”

Some studies and anecdotal evidence suggest that bupropion (Wellbutrin), which works on both the serotonin and dopamine chemicals in the brain, may be less likely to cause weight gain than commonly prescribed selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa), sertraline (Zoloft), and paroxetine (Paxil).

Antidepressants and Sleepiness

Certain antidepressants are more energizing, which may be right for someone who feels sleepy often. Other antidepressants tend to have drowsiness as a side effect, which may be good for people who are often anxious.

For example, drugs like mirtazapine (Remeron), which can cause weight gain and sleepiness, may be the right drug for patients who have trouble sleeping, or gaining weight.

If you feel sleepy on your antidepressant, talk to your doctor. You have many options.

Antidepressants, Talk Therapy, and Challenges

In addition to physical symptoms, recovering patients may experience new challenges as the wool of depression is pulled from over their hearts and eyes.

“People sometimes get worse in therapy before they get better,” says Gabrielle Melin, MD, clinical psychiatrist at the Mayo Clinic in Minnesota. “Talk therapy takes work. It takes emotional energy. It can be physically draining, too. But sometimes you’ll feel worse in the process of getting to where you want to be and who you want to be.

“Depression can mask a lot of things. You get so wrapped in a fog and feel so awful that you don’t have the energy to deal with real problems. Sometimes depression is self-protective because it limits the energy you have to go to certain places.”

To a lesser extent, even taking a pill can create an environment of new stresses. “You’re feeling better, more aware, more focused – sometimes you’re more able to recognize things you were doing wrong,” says Melin. “Your attention and focus can be profoundly affected.”

When her patients feel better, Melin says, she may encourage them to work on feelings and behaviors in talk therapy. If a drug helps a patient lift the veil of listlessness and hopelessness, he or she will have more energy to work on fixing problems in life and relationships.

What About the Risk of Suicide on Antidepressants?

Many people have heard about the suicide warnings that the Food and Drug Administration ordered antidepressant manufacturers to post on their package inserts. The package inserts note that children, adolescents, and young adults with major depression or other psychiatric disorder who take antidepressants may be at increased risk of suicidal thoughts and behavior, especially during the first month of treatment. They should be monitored carefully.

No increased risk has been seen in older adult patients. And if you are over the age of 65, you may actually have less risk of suicide when taking antidepressants.

Having suicidal thoughts while taking an antidepressant is a serious side effect. It needs the attention of your doctor as soon as possible. Please don’t try to deal with those feelings alone.

Remember, most people with depression get better. You may need to try a few different antidepressants to find the right one for you. And getting talk therapy at the same time is the most effective treatment for depression, studies show. Work closely with your doctor, and give your treatment time to succeed.

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How to Handle Bad Sex

The lights are low. A fire smolders in the fireplace. Two wineglasses sit, half empty, on the nightstand. Your clothes lie in a heap on the floor. You reach for each other. The two of you tumble to the bed, and...

Blah.

No explosions of passion. No breathy proclamations of desire. No tumultuous climax. Then you wonder: How can everyone in movies and romance novels be having fiery, combustible sex when you and your partner barely create a spark?

Sexologist Logan Levkoff, author of the eBook How to Get Your Wife to Have Sex With You, says, "TV shows and movies give us this very skewed representation of what sex is supposed to be like.  Everyone seems to be climaxing and having orgasms all the time from whatever they're doing. When you grow up on a diet of that, and when your real life doesn't match, you think, 'There's something wrong with me,' or, 'There's something wrong with my partner.'"

Real-life sex can almost never measure up to the passion portrayed on the screen, sex therapist Isadora Alman says. "People don't talk about the fact that it's likely that in an odd position you'll pass gas or the love of your life will take you in his arms and have bad breath."

Sex in the real world isn't perfect, and it doesn't always end with an earth-shattering climax -- but it doesn't have to, Levkoff says. "Good sex doesn't necessarily have to be about an orgasm. It can just be an emotionally fulfilling experience between partners."

Getting What You Want in Bed

Even when everything else in the relationship is working, sexual styles aren't always compatible. You like long foreplay sessions. Your partner is ready to go in an instant. You long for wet, sensual kisses. He prefers dry, chaste pecks. "Sex is not just naturally perfect," Alman says. "There is the energy of a new relationship that is positive -- the excitement and the eagerness and the passion. And the negative is that you bump noses or knees because you just haven't learned how to dance together yet."

But even long-term couples can struggle in the bedroom. Though we can easily tell our partner what shirt we'd like him to wear, or what we'd like to cook together for dinner, we tend to get tongue-tied when it comes to the topic of sex.

"People tend to be very sensitive when it comes to talking about sex," says relationship and family therapist Rachel Sussman. "They're afraid of hurting their partner's feelings, so they don't tell them what they like or don't like. But you're not going to get it unless you ask for it."

So how do you tell your partner what you want without bruising his or her ego? "I think it's really in how you bring up the statement," Levkoff says. "'I would love it if we...' or, 'Could we try this?' You don't want to make them feel bad about what they've done or haven't done."

Getting What You Want in Bed continued...

You can have the conversation whenever and wherever it's most comfortable for you. But before you talk, you need to know exactly what it is about your sex life that bothers you. Is it a question of technique? Personal hygiene? Timing? "Once you know what isn't working for you," Alman says, "there are things you can suggest that can mitigate those circumstances."

For example, if something about your partner's smell is turning you off, suggest taking a bath together before making love. If you crave more foreplay, ask for slower segues into sex.

Before you can tell your partner what you want him or her to do in bed, you need to know what you like. "I think especially for women, they've got to explore their own bodies," Sussman says. "You have to masturbate. Get a vibrator. Get some books. Teach yourself how to orgasm."

When It's Just Not Working

After you've tried talking and the sex still isn't working, what then?

"Experiment together," Sussman says. "Learn to get to know each other's bodies."

Try some sex aids. Read books with pictures (such as The Joy of Sex), or watch an educational video together, Alman says. Not porn, but explicit videos in which a voice-over explains what's happening in the scenes.

Sometimes, the problem is a physical one, such as premature ejaculation. Or it may be that the stress from your job is bleeding over into the bedroom and disrupting your sex life. In those cases it can help to see a sex therapist. "We unravel why you two are not getting along," Alman says. "And then we try to remedy that."

If you're still unsatisfied, is it ever OK to fake it in bed?

"If you're faking it, you're doing yourself a disservice because you're not learning what really turns you on," Sussman says. "I think eventually, it takes a toll. Your partner's going to realize that you're disconnected."

Can sex ever be bad enough to consider ending a relationship over? Possibly. "You might really love somebody and the sex is never going to be better than OK. You have to decide whether you can live with that," Alman says.  

Whenever you're considering a breakup or divorce, you need to weigh every element of the relationship and not just the sex. "You can't have everything in life," Sussman says. "If you have a wonderful relationship and you love each other and you have kids but the sex isn't great, maybe you can live with that."

Sussman says that every couple has the potential to have good sex if you’re willing to put a little effort into it. "If you're two emotionally and physically healthy people, you should be able to work with what you've got. Not everybody needs to be hanging off the chandelier," Sussman says. "You can get better. But you have to practice, and you have to be open to discussing it and getting help when you need it."

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Why Do People Have Sex?

Your partner may come up with a dozen excuses to say "Not tonight, dear, I have a ____," but how many reasons can the two of you name for wanting to have sex?

One? Two? Twenty? How about 200? Some college students have cited as many as 237 different reasons for having sex.

From pleasure to procreation, insecurity to inquisitiveness -- today's reasons for taking a roll in the hay seem to vary as much as the terms for the deed itself. A 2010 Sexuality & Culture review of sex motivation studies states that people are offering "far more reasons for choosing to engage in sexual activity than in former times." And we're doing it more often too. It’s a stark contrast from historical assumptions, which cited only three sexual motive: To make babies, to feel good, or because you're in love.

Today, sexual behaviors seem to have taken on many different psychological, social, cultural, even religious meanings. Yet, some sexologists say, at the most basic level, there is only one true reason people seek sex.

Wired for Sex

"We are programmed to do so," sex therapist Richard A. Carroll, associate Northwestern University psychiatry and behavioral sciences professor says. "Asking why people have sex is akin to asking why we eat. Our brains are designed to motivate us toward that behavior."

The idea that humans are hard-wired for sex reflects an evolutionary perspective, according to University of Hawaii psychology professor Elaine Hatfield. "Evolutionary theorists point out that a desire for sexual relations is 'wired in' in order to promote species survival," she says. "Cultural theorists tend to focus on the cultural and personal reasons people have (or avoid) sex. Cultures differ markedly in what are considered to be 'appropriate' reasons for having or avoiding sex."

What's Your Motive?

Why do you seek sex? Motivations generally fall into four main categories, according to psychologists at UT-Austin who asked more than 1,500 undergraduate college students about their sexual attitudes and experiences:

• Physical reasons: Pleasure, stress relief, exercise, sexual curiosity, orattraction to a person
• Goal-based reasons: To make a baby, improve social status (for example, to become popular), or seek revenge
• Emotional reasons: Love, commitment, or gratitude
• Insecurity reasons: To boost self-esteem, keep a partner from seeking sex elsewhere, or feeling a sense of duty or pressure (for example, a partner insists on having sex)

The Difference Between the Sexes

Generally speaking, men seek sex because they like how it feels. Women, although they very well may also derive pleasure from the act, are generally more interested in the relationship enhancement that sex offers. Researchers describe these differences as body-centered versus person-centered sex.

• Body-centered sex is when you have sex because you like the way it makes your body feel. You aren't concerned with the emotions of your partner.
• Person-centered sex is when you have sex to connect with the other person. You care about the emotions involved and the relationship.

  The Difference Between the Sexes continued...

  "Men often start out being body centered," says University of Hartford adjunct psychology professor Janell Carroll. "But that changes later on. As men reach their 40s, 50s, and 60s, their relationship becomes more important."

  Richard Carroll has been counseling couples with sexual issues for more than two decades. "Women actually become more like men over time in that often, early on, sex is about initiating, developing, strengthening, and maintaining relationships, but in a long-term relationship they can actually focus on pleasure."

  Despite these general observations, research also suggests that there has been a big convergence in sexual attitudes among men and women in recent years. In 1985, Janell Carroll and colleagues found that most college-aged males had casual sex for physical reasons without emotional attachments. She repeated many of the same study questions to a new audience in 2006.

  "Instead of men and women being at opposite ends of the sexual spectrum, they are now coming together," she says. "More women might be having sex for physical reasons, but many more men were more likely to say they had sex for emotional reasons."

  20 Reasons People Have Sex

  Stressed out? Have sex. Stress reduction is one of the leading reasons Americans, particularly men, say they have sex, Richard Caroll says. The review, published online in Sexuality & Culture, shows other most frequently cited reasons for having sex include:

  • Boosting mood and relieving depression
  • Duty
  • Enhancement of power
  • Enhancement of self-concept
  • Experiencing the power of one’s partner
  • Feeling loved by your partner
  • Fostering jealousy
  • Improving reputation or social status
  • Making money
  • Making babies
  • Need for affection
  • Nurturance
  • Partner novelty
  • Peer pressure or pressure from partner
  • Pleasure
  • Reducing sex drive
  • Revenge
  • Sexual curiosity
  • Showing love to your partner
  • Spiritual transcendence

  
  

  Why Study Sex?

  Understanding why people seek sex is not always a simple task. Most studies have involved college undergraduates, a "sample of convenience" for university researchers but one that is often very limiting. Young men and women typically haven't been in very committed relationships and are in the process of discovering their sexuality. Their answers to "why do you have sex" are often greatly tied to the image of themselves and their social relationships, says Richard Carroll. This can change over time.

  But such knowledge can improve a couple's sex life.

  "Understanding these differences in motivations is very important. It helps us understand what's going on in the sexual relationship and treat sexual disorders. Very often, you find the source of the problem can be traced to the particular motivation," Richard Carroll says.

  If you need help, you can find a qualified sex therapist in your area through organizations such as the American Association of Sexuality Educators, Counselors and Therapist (AASECT) or The Society for Sex Therapy and Research.

  
  

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