That might make a difference in whether a person would do better with varenicline or bupropion or with a nicotine patch. Research is under way here as well. We know that cortical controls are weakened by the chronic use of many substances, resulting in the diminution of executive functioning, including constraint and judgment. Might there be ways to stimulate specific areas, such as the prefrontal cortex, with light that activates certain genes (called optogenetic stimulation) to reduce the compulsive behaviors seen in addictions? Some promising work is under way in mice, which may point the way to its application in humans. Transcranial magnetic stimulation (TMS), as discussed earlier, already has beneficial uses in people with severe depression. Might TMS energize the frontal lobes of people who have developed a reduced capacity to control impulses, thereby enabling them to think and thus behave in more adaptive ways? We do not yet know and need research to separate placebo effects from true therapeutic actions. Deep brain stimulation (DBS), as well, has proven utility in Parkinson's disease and severe depression, as exemplified by the work of Dr. Helen Mayberg. Studies of rats administered DBS have shown transient improvements in their compulsive behaviors. Pairing DBS in these same animals with a dopamine antagonist not only helped behaviors, but was also associated with reversing cocaine-induced synaptic plasticity, which we have recognized as one of the basic pathogenic processes in addiction. This is science at its most miraculous, though it is basic research and still far from translation. Perfectionism, as it relates to procrastination, is the need to have everything proper before taking action. While there's nothing wrong with planning and preparing for action, if you can't get past those initial stages, then you'll almost certainly get stuck in the mud and muck of procrastination. For example, a perfectionist might say, "Why ruin the opportunity to do an outstanding job, when the outcome could be ruined in the haste of rushing?" This leads us back to the need of developing patience from within in order to have the mental strength to focus on and then deal with our tasks. Perfectionism often comes disguised as "making a smart move" through the withholding of action in order to prepare for any and all circumstances; however, it can also prevent us from taking action, such as when a prior requirement must be fulfilled in order to act on a task. For example, Fred won't have a guest over to his place unless it's absolutely spotless, but spotless is a relatively rare condition for his living space to be in, so much so that it prevents him from looking for a girlfriend. However, as long as Fred's place doesn't look spotless, he won't have guests over. You might think that with this condition Fred would spend practically all of his free time cleaning up his place--yet he never finds the time to clean and he's never in the mood to clean either, so his procrastination continues unabated.

The truth is that we all daydream from time to time; however, some of us do it a lot more than others. So, where does one draw the line between a pleasant diversion, and something that gets in the way? While it's natural to tear yourself away from everyday life, even if it's only in your head, some people procrastinate by engaging in daydreaming to such an extent that it can add up to a significant amount of time spent during an average day. When a person decides to change something in his or her life, whether it's going back to school, joining a gym, or reducing the amount of time he or she spends procrastinating, that person seeks to transform him or herself. As you start your journey toward changing away from the habit of procrastination, it's important to keep an open mind in order to discover which characteristics you incorporate into your present procrastination. While cases of mothers killing their children due to postpartum psychiatric problems are mercifully rare, well-known examples reported in the news have made us more aware of how vulnerable some women can be to problems such as depression after giving birth. Up until relatively recently, however, women have been afraid to talk about their postpartum symptoms for fear of being thought of as crazy or that they might pose a danger to their children. This often leads to needless suffering and a sense of shame that might prevent women from seeking help until it is too late in many cases. Many other familiar symptoms of depression also appear including loss of libido, appetite changes, lack of energy, loss of interest in activities that used to be enjoyed, social withdrawal, and insomnia. People suffering from postpartum depression can also develop cognitive problems such as poor concentration, impaired decision-making ability, and distractibility. Persistent worries can develop, including an overwhelming fear of becoming violent or suicidal. Along with worrying about possibly harming their children, people with postpartum depression may also worrying about injuring a spouse or other family member, or even committing suicide. While postpartum depression can become life threatening if the symptoms persist long enough, there is also a more severe form known as postpartum psychosis. This means, along with symptoms of depression, sufferers can also develop psychotic symptoms such as visual or auditory hallucinations (i.e., hearing voices ordering them to kill their baby or commit some other violent act), delusions, or grossly distorted thinking patterns. While postpartum psychosis is relatively rare (occurring in about one out of every thousand pregnancies), it can be especially dangerous, as it can often appear even in women with no prior history of mental health problems. Still, there can be warning signs that might indicate that some women are at risk for postpartum depression. One of the strongest of these is prenatal depression, which can occur in 7 to 20 percent of all pregnancies. Symptoms for prenatal depression are very similar to those seen in postpartum depression and can be triggered by pregnancy stress, relationship problems, financial worries, medical complications, or trauma. Despite the link between mental and physical health, the importance of mental health is still being overlooked and, unfortunately, mental illness is still often seen as a taboo subject. Out of the twenty-eight OECD countries, South Korea ranks twenty-seventh when it comes to the consumption of antidepressants; Denmark ranks seventh.

Does this mean that Danes are more depressed than the Koreans? No, it just means they are getting some sort of treatment. Whether medication is the right sort of treatment is up for discussion, but it is a good thing to be a society in which treatment for mental illness is available and affordable (subsidized by the government) and in which the stigma around mental illness has been reduced sufficiently that people feel able to seek treatment. To fight the stigma that surrounds mental illness, we need to listen more and learn more. We need to end the misunderstanding and the prejudice. We need to end whispering about mental illnesses behind closed doors. We need to say the scary words out loud, so they lose their power, and so no one has to struggle on in silence. We should salute those who are working against the idea that mental illness is something that should be covered up. A couple of years ago, a number of Danish writers, models and movie directors participated in a series on national television about the mental illnesses they had been dealing with. More recently, Prince Harry has been open about the challenges he has faced. He said he had been very close to a complete breakdown on numerous occasions' and is now encouraging more people to reach out to others in times of need and to normalize conversation about mental health. <a href='https://orangejuicy.hatenadiary.jp/entry/2019/09/01/205353'>The experience I have had is that, once you start talking about it, you realize that actually you're part of quite a big club,' he said to the Telegraph in April 2017. It is because of actions like this that the UK and Denmark rank first and third when it comes to reducing stigma and increasing awareness, according to the Economist Intelligence Unit's Mental Integration Index. It is time for every society to become much more open about mental illness, just as it is about other illnesses. So, let me just add my two cents and tell you that my mother also suffered from depression. There is no reason not to be open about that. The silver lining for South Korea here is that the young man who lost his mother to depression is now heading the Stella Foundation, which aims to create awareness and openness about depression in South Korea. He gave me a frame that holds three Korean masks, as a symbol of the fight against the masks we hide behind. The frame now stands next to my desk in my office at home. When I need to add to my calendar, I can add it using any device, it's backed up in case I lose my phone or computer, and I can access it from anywhere.

Again, don't exert yourself trying to commit events and to do's to memory. This is where it's ok to be lazy and take a shortcut. Strict schedules keep you sharp, precise, and on top of everything. Eric Thomas says, "The difference between those who are successful and those who are broke is how they spend their 24 hours. It doesn't matter if you're Bill Gates, Oprah Winfrey, Ted Turner, etc., you only get 24 hours a day and how you use your 24 hours makes the difference. The difference between you and Oprah is Oprah uses her time wisely. I went from being broke to selling 6,000 copies of my book in 6 months. What happened? I changed how I use my 24 hours." Live by the clock. Respect your 24 hours. Every minute wasted is gone forever. Account for every minute. Assign times and time limits for your activities and then stick to a schedule as closely as you can. It creates clearer, more focused, and more aggressive action. You know what needs to happen, when it'll get done, and how long it'll take. Kevin Kruse asked over 200 billionaires what their best time management tips and secrets were and, across the board, they said very specific schedules work better than anything else. They schedule EVERYTHING and if it's not worth scheduling, it's a waste of time. Specific schedules keep them in line and on track. Specific meaning, literally, minute by minute. They account for every single minute of the day and get more done than everyone else.

From the time they wake up to the time they go to sleep, they know exactly where they'll be, what they'll be doing, when they'll be doing it, and how long it will take. No time is wasted. They manage time wisely and use their 24 hours as much as they can. Starting today, schedule every single thing you do and force yourself to stick to the schedule. Fill up your calendar. Schedule your sleep, breaks, lunch, leisure time, etc. Schedule each step of each task, project, and goal. Track every single minute of your day and don't deviate from it. There has also been research into alleviating the effects of chronic stress, a terrible enemy to us humans. Chronic stress fosters compromised immunity, which leaves us at greater risk for infection and cancer. It also produces persistent levels of organ and blood-vessel inflammation, which promotes heart disease as well as stroke, diabetes, depression, arthritis, autoimmune diseases, PTSD, and many other chronic conditions. Chronic stress further does some of its deleterious work through the well-known hypothalamic-pituitary-adrenal axis (HPA). The HPA axis is our internal governor, responding to and seeking to control stress reactions in the body. It is perhaps best known for the fight-or-flight reaction. But it also has a considerable role on our immune competence, through the release of cortisol and other corticosteroids; on our digestive processes; on libido; and on mood. The diagram on the next page shows the key elements of the HPA, and how their continuous feedback is meant to sustain homeostasis, or balance, in the body. The hypothalamic-pituitary-adrenal axis is our "internal governor" and controls the fight-or-flight response. "Damned if I do, damned if I don't, and damned if I do something else." This seems to be the habitual procrastinator's mantra. As previously mentioned, many of us experience difficulty staying on track until a task's completion. One of the ways we engage in distracting ourselves from a task is by second-guessing ourselves with statements like, "There are more important things that I need to be working on right now." When we do this, we cause doubt to grow in our minds, and we are then apt to put a halt to our work by picking up another task.