Over Procrastination

We all procrastinate, and if you claim you don’t, there’s something other than blood running through your veins, as this phenomenon is simply part of the human condition. But that said, ask yourself if this sounds like you: After exhaustive research you’re still waiting on that one final scintilla of information permitting you to finally spring into action to buy a new house, a new car or accept that job you’ve recently been offered.

So what’s the problem here, after all, details are important right? Well yes, trouble is there’s always one more detail. Many people over procrastinate by demanding to know every fact – even irrelevant ones. For example, you know the car you want and have researched its track record extensively but continue to debate endlessly over paying extra for the optional seat warmers – and you live in the Deep South.

I’m dear friends with a woman who is convinced that before she can launch the speaking business she so passionately claims to want, she has to write five books and have published over 50 articles in her field. I’m not kidding here, I couldn’t make this up.

The next time you’re experiencing “paralysis by analysis,” ask yourself what’s really holding you back. The chances are pretty good that it has nothing do with the seat warmers or credibility as a speaker. Realistically maybe you can’t afford the car, and that aforementioned friend of mine, I’m not so sure she is as stoked as she claims about becoming a professional speaker. So decide already! So what if your rear end is a bit chilly on the only three very cold days of winter. You’ll survive and at the same time will have saved some money. With over procrastination, the devil truly is in the details.

Observations from my Recent Trip to Boise and Salt Lake City: Southwest Airlines

Thanks to everyone that attended my mid-June psychopharmacology seminars in Boise, Idaho and Salt Lake City, Utah. I sincerely hope that all attendees enjoyed and benefited from the trainings. More importantly, I strived to better your condition with regard to this subject matter, as all of you are entitled to a lasting return on your investment of time and money.

I rarely fly Southwest Airlines. I have no bias against this airline, I just tend to choose the other major carriers in that I am able to book a reserved seat. I’m no longer certain I will continue that policy. All of my connections to Boise,Salt Lake City and eventually back to New Orleans were via Southwest on this recent trip.

During this current recession, Southwest has remained profitable, although less so as fewer people are flying these days. When oil prices spiked last year and fuel costs subsequently escalated, the airline still operated in the black. There’s never been a hint of a discussion regarding bankruptcy with this carrier, and they have eschewed charging checked baggage fees – even at the height of the oil price crisis. Yes, fares rose, but no more than what competitive carriers – Delta, Continental and United – were charging.

Why this continuing track record of success despite often trying circumstances? I can answer it in one word: Attitude. From the baggage handlers to the pilots, these people seem as though they really enjoy what they’re doing and actually want to be at work! And how is it that 180 people can be loaded and locked on an airplane in approximately fifteen minutes when it takes the other major carriers at least thirty minutes? Attitude again. Flight attendants, with a friendly smile and a kind word, strategically position themselves in the aisles directing people to the next available seat and to the overhead bins above. Systematically the plane loads from the front to the rear. Passengers simply follow the herd and the cues. No one enters the cabin and rushes to aisle 32. Does anyone really want to be there anyway? At some point on full flights, only middle seats remain for those boarding last, but these folks seem to already know that.

Flight instructions are conducted in a tongue-in-cheek, slightly irreverent-like manner. C’mon, does anyone really not know how to buckle a seat belt or what to do with the oxygen mask that could drop down from the panel above? They make the boring FAA stuff fun.

The ubiquitous, irritating service cart – a mainstay on other carriers – is absent on Southwest flights. Drink orders are taken and simply served on trays, so the aisle is not consumed by flight personnel. This is a model of efficiency for a task that never was rocket science in the first place.

This airline has to have one heck of a training program, and when it comes to success in any business, the tried and true constants always have any always will dominate: Offer a fair price, service that distinguishes you from others, and a positive attitude that resonates with the customer, and they will come back. And on Southwest, they keep coming, and coming and coming.

Bipolar Disorder vs. ADHD: The Quick and Dirty

Irritability, frustration intolerance, aggression and inattentiveness are present in both disorders.

Did I miss anything? What are your experiences when it comes to differentiating Bipolar disorder and ADHD?

Do Antidepressants Really Deliver?

I suppose the answer to this question hinges on the definition of deliver. Let’s start up top with the bottom line: Treating depression pharmacologically is not easy!

A major study, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) is the largest independently funded clinical trial for depression. The study’s primary objective was to develop a series of evidence-based steps for guiding prescribers in making sequenced treatment choices to enhance the odds of response rates and subsequent remission. The six-year study included approximately 3,000 clients. Initial results indicated that about 30 percent of depressed clients achieve remission (that is, their symptoms essentially disappeared) on their first antidepressant trial with competent care. Subsequent trials yielded a total remission rate of approximately 60 percent. After achieving full remission though, relapse rates are high: Only 43 percent of subjects realized sustainable recovery. Also, with quality care as a given, there is no difference in outcome whether the client was treated by a psychiatrist or a primary care physician.

At least 50 percent of clients who will respond (the rate of patients that experience at least a 50 percent reduction in the severity of symptoms) to antidepressants begin to demonstrate improvement within the first few days to a week of treatment, achieving symptom remission however, may span over an 8- to 12-week period. Achieving remission is important because clients that improve, but continue to have residual symptoms, are twice as likely to relapse to depression and are at an increased risk of suicide.

Since 2002, the only new antidepressants making it to market are Lexapro, Cymbalta, Emsam transdermal and Pristiq – an active metabolite of Effexor. Effexor is no longer under patent protection.