Many supplement types have no real effect (besides as a placebo), because the strains don't ever make it past your stomach acid. This is why it's critical to rely on good research and, ideally, to work with professionals. They will help you determine precisely which strains you might need and which brands of supplements will be most effective to address your unique concerns and medical history. It's also important to understand that not all probiotics are created equal. Some probiotics will give better results than others, so it is critical to validate that a particular probiotic is effective and will work for you. Here are some criteria for evaluating a probiotic supplement to make sure it best fits your needs: Of course, there are certain circumstances where you're expected to take the lead in a conversation - notably in dating. No one is comfortable when meeting someone for the first time. Therefore, when you first meet someone, you should be willing to build on the conversation from any point at any time. It's not easy, but the ability to change the subject rapidly at any time will help you develop a powerful rapport with them and create a conversational strain that pretty much cannot die. Not easy, but well worth the effort. In his book "Conversationally Speaking" Alan Garner describes Active Listening as how you interpret what someone is saying and repeat it back to them so that you can make sure it is accurate. Why is this important? Because so many of us are terrified of getting it wrong. And worse yet, many people don't even consider that they may have heard someone incorrectly in the first place. What happens is that someone says something, it gets taken out of context and the entire conversation (and possibly the relationship) gets turned on its head because of a misunderstanding. Differences in sense of humor, conversational style, and general beliefs can all create this problem, so it's very important to clarify what's being said before you respond. Here's an example: Jennifer: I can't believe they gave you that promotion. John could respond in one of two ways initially - either in indignation if he thinks she is angry at him for taking the promotion or with sympathy if he feels she is upset that it wasn't her. It might even be a joke. So, to be sure that he has taken it the right way, John should say something like: John: You're frustrated that you're still in the same position?

John asks instead of assuming, giving Jennifer the opening needed to clarify. It keeps the conversation moving, avoids awkward misunderstandings and generates rapport because John appears concerned about Jennifer's plight, while deferring the conversation from his own good fortune. John listened to her problem, interpreted it in a certain way and then, through active listening, asked for clarification on what he perceived - the idea being that if he's wrong, she'll say so without getting angry. It works almost every time. Use this technique whenever you're unsure of what someone means or if the statement feels like it could be easily mistaken. Emotionally charged, seemingly angry or upset statements should always be parsed in this way. It helps you to gather your response to it, but it also ensures you don't take anything the wrong way and create an unnecessary uncomfortable situation. To consider your arousal level, notice how much activity is going on in your body. Is your heart pounding, are your palms sweaty, did your eyes go wide, are you alert? That's high arousal, which you can refer to as "H." The opposite end of the spectrum is low arousal, which you can refer to as "L." You may notice your heart rate is steady, you are moving or thinking more slowly, and you feel sleepy, relaxed, or sluggish. While it's important to keep in mind that no emotion is good or bad--even if it stinks to feel a certain way--it's helpful to consider the valence; that is, how positive or negative it is. The valence indicates what an emotion is communicating to you about your environment. Emotions form the basis of our survival. They communicate critical information that can get us to act quickly, build social resources and creativity, keep us out of danger's way, maintain our motivation to engage in the work we need to do to stay alive, and know when to shut down and conserve energy when the environment isn't reaping what we are sowing. If something is positively valenced, or "P," it's telling you something is right and safe in your environment. You may feel emotions like excitement, joy, or relaxation. If you feel negatively valenced, or "N," something is telling you the situation may be dangerous or your goals are being blocked. You may feel emotions like sadness, fear, or anger. With awareness of arousal and valence, you can easily do emotional check-ins by asking yourself if you are H or L--high or low arousal, and if you are P or N--positive or negative valence. These elements combine to produce four possibilities, described here as prototypical experiences.

Two high arousal emotions or two low arousal emotions can feel similar in your body, so at first they can be confused. Are you feeling nervous or are you feeling excited? Are you feeling sad or are you feeling relaxed? Accordingly, being aware of the valence can help clarify and identify what, precisely, you are feeling. Consider what you experience in your body when you are nervous before an annual review meeting, and what you experience when you are excited because the person you're dating sent you a text message. The physical experience might seem similar: speedy heart rate, quickened breathing, fluttery feelings. But the valence is different. You're on a threat alert with the meeting and know you're feeling nervous because you fear being negatively evaluated. In contrast, you experience the opposite with the love interest, as you are open and curious about what will happen next. You know you're feeling excited because you're thinking this person might like you back and you look forward to connecting more. Now that you are clear on your top values, you can use them to gain a general sense of what activities you want to approach and not avoid. You also have a language for observing how your daily choices impact your emotions. With this foundation you can start to experiment in a small, but still important, way. Is there an activity you are dreading because it feels like a lot of effort--even if it's consistent with your values and intellectually makes sense to do? What's coming up on your schedule tomorrow or later this week that you suspect you'll procrastinate doing? For this first practice, pick something pretty minor. The point is simply to begin gaining insight into these processes. It's not unusual for your medication treatment plan to include one or more of these medicines. Your unique experiences will help determine in what direction pharmacotherapy will progress. Try to refrain from comparing your medical regime to others or placing a negative spin on the kinds of medication you are taking.

What works for one, does not work for all. The important thing is to find what works for you. Personally, I found a medication that worked well for me the first go-round. As previously mentioned in chapter 1, fluoxetine, generic Prozac, affords me symptom relief with tolerable side effects. Professionally, I've worked with children and adults who found pharmacotherapy successful the first time around as well. I've also worked with others who've had to try many different types of medications at varying dosages. Sometimes this took months, even years. The hardest cases of all are when patients experience a depression so problematic that alternative treatments have to be sought. This type of depression is treatment resistant depression (TRD). Keep in mind that many elements are required when undertaking pharmacotherapy. You need to have trust in a skilled professional, confidence in your own ability to evaluate the status of your medication, patience while this all goes on, and the resolve to move on to other possibilities if medication doesn't work. Inpatient hospitalization is a good choice for treatment of your depression if talk therapy and/or pharmacotherapy are not reducing symptoms. Also, if you're in a fragile state, contemplating suicide, or in the throes of an agitated mania, the safe setting of a hospital is vital. Hospital wards for those with mental illness vary. Generally speaking, private and parochial hospitals tend to have a more residential feel to their psychiatric departments than do state, community, or government-run hospitals. Find out the quality of hospitals in your neighborhood. If you want, use guidance from a mental-health professional. This way, you can be informed should you need this type of intervention. When inpatient hospitalization is planned, it's helpful for your practitioner to call ahead to aid in your admission. This can ease the transition for you and help professionals on staff to be prepared.

In an emergency situation, there often isn't time to set up admission. In this event, getting to the nearest hospital's emergency room is the primary goal. Many inpatient hospital wards are more like college dormitories than the sterile-white secure units portrayed in movies. Single or double rooms with beds and desks are the norm. There's a community room with welcoming chairs and sofas, television, and recreational activities--and phones for keeping in contact with loved ones. It's true that most of these hospital zones are locked and there are rules that need to be followed--like visitation times, permissible clothing, and accessories, just to name a few. These precautions keep you and others safe and enable the staff to manage the floor with continuity. The Buddha said, "By surveying the entire world with my mind, I have not come across anyone who loves others more than himself. Therefore one who loves himself should cultivate this loving friendliness." Cultivate loving friendliness toward yourself first, with the intention of sharing your kind thoughts with others. Develop this feeling. Be full of kindness toward yourself. Accept yourself just as you are. Make peace with your shortcomings. Embrace even your weaknesses. Be gentle and forgiving with yourself as you are at this very moment. If thoughts arise as to how you should be such and such a way, let them go. Establish fully the depth of these feelings of goodwill and kindness. Let the power of loving friendliness saturate your entire body and mind. Relax in its warmth and radiance. Expend this feeling to your loved ones, to people you don't know or feel neutrally about--and even to your adversaries!