RECENTLY AUSTRALIAN TV ANCHOR MADDIE WRIGHT spoke about refusing to breastfeed; her post caused heated controversy – many accused the woman of selfishness. A nursing mother finds herself between two fires: on the one hand, she is asked to stay at home, because it is “indecent” to breastfeed on the street, in the subway, in a store, in a museum. On the other hand, to stop breastfeeding means admitting your own “failure” as a mother and your unwillingness to devote yourself to your child one hundred percent. This is not about the merits of breast milk or the fact that artificial feeding is better (it is not), but about the right to choose. After all, few people care about what the mother wants and how she feels.

Being a mom to a baby is not easy, and it’s not just sleepless nights. For someone in this mode, there is nothing to worry about; after all, quite a few people are used to staying up late and desperately having fun all weekend, arranging those same sleepless nights on purpose. But pressure from others, a desire to teach and give advice, passive aggression, reproaches – this is what annoys at best, and at worst makes you feel guilty. For some reason, when it comes to breastfeeding, even strangers on the street rush to convey their opinion to the mother.

From all sides, women are agitating to breastfeed, without explaining how to stop this feeding later. Theoretically, the baby’s need for milk should gradually decrease, up to complete rejection, but the key word here is “theoretically”. While the child’s body after a certain age does not really need breast milk, there are often cases of psychological attachment to the breast, when the child, having already learned to speak, consciously asks for it and is offended if he is refused. On many forums for moms, questions arise over and over again about how to wean a two-, three-, four-year-old baby.

On the other hand, many simply cannot afford to breastfeed for several years. Paid maternity leave around the world often lasts three to four months; in the USA, for example, it is not guaranteed by law at all and depends on the goodwill of a particular company. A huge number of women are forced to work soon after giving birth, because otherwise, at best, they will lose their jobs, at worst, the family will have nothing to eat.

If you make a list of the most important
things parents can do for their babies, breastfeeding will not even make
the top ten.

Those who are especially vocal in favor of breastfeeding and against artificial feeding call themselves lactivists. There is a public consensus in their favor, so it is not uncommon for a woman using formula to feel guilty for such a “vicious” choice. Courtney Jung, author of Lactivism (as you might guess about lactation activists), says that in reality, if you list the most important things parents can do for their babies, breastfeeding won’t even make the top ten. But lactivists stand their ground, explaining the importance of breastfeeding by its naturalness. They are not interested in the mother’s well-being, her state of health and, in fact, the ability to feed: even after learning that a woman has undergone a double mastectomy, they insist that they should “try”.

I breastfed my son for two months. I must admit that I was lucky, and there were no difficulties with feeding in public. I live in Barcelona, ​​and here on the street you can find more interesting characters than a woman with a topless chest and a baby (where am I to a completely naked cyclist who has a tattoo in the form of panties on his butt). I had to breastfeed Christopher in the clinic, bank, hotel lobbies, bars and cafes, on the street and in the Russian Orthodox Church, and no one made comments. The problem was different – breastfeeding was terribly uncomfortable for me. I had to choose my clothes carefully – so that I could unbutton my coat, lift my sweater, pull back my T-shirt, unbutton my bra and not get confused in all this. I was constantly throwing a fever due to fluctuations in hormone levels; I didn’t get enough sleep, because sleeping on my side next to a sucking baby was scary, it seemed to me that I could injure him. My shoulder joints ached, because for feeding at night, lying in bed, I had to raise my hand unnaturally high, first one, then the other.

Worst of all, the child was not full. He could suckle for two hours and then cry from hunger. I read articles, asked nurses, went to consultations on lactation, and everyone said the same thing: “There is never enough milk.” They explained to me that the child will definitely stimulate the production of milk in the required amount, you just need to be patient, and they said that, probably, I was not properly applying it to the breast and it did not grasp the nipple well enough. I constantly felt guilty because I was actually being told that I was doing something wrong. Not full in an hour and a half – not patient enough, feed longer. Advocates for breastfeeding repeated the same formulas word for word: “wrong grip”, “baby will take its toll”, “there is really little milk in very rare cases.” It never occurred to anyone that such a “rare case” could happen to me, although in one population study one in eight women were unable to breastfeed for more than a month and a half.

Christopher cried constantly and stopped gaining weight. And then I was lucky: at the next examination, the pediatric nurse said that since the baby suckles for an hour and a half, it seems that there is really not enough milk, and she advised me to try giving him milk formula. There was no condemnation in her tone; she explained that, of course, breastfeeding is considered preferable, because breast milk contains valuable immunoglobulins and, in general, it is maximally compatible with the baby’s body. But after all, the main task of any food is to provide a person with energy and nutrients, and if they are not enough, then it is better to feed from a bottle than to get hung up on immunoglobulins (in addition, vaccination begins at two months, and the child becomes protected from dangerous infections).

When I realized that my son wasn’t eating my milk at all, I decided not to breastfeed at all. I consider it one of the most important for the well-being of my family, as all three of them have improved. Christopher began to gain weight, sleep well and cry less. His dad had enough opportunities to do it, because the child stopped “hanging on his chest” for hours. My hands were untied: I could go to the gym for a couple of hours or go for a manicure, and drink good wine, as much and when I wanted. I began to sleep for eight hours in a row, because at night my son was fed by my father.

Women began to write to me who fed their children with milk formula
while no one saw, and felt a huge sense of guilt

However, when I talked about it on social media, there was a real wave of discontent. Well-wishers actively offered me “to help establish GW,” the aggressors accused me of selfishness. There were also mothers who tried to shift the responsibility onto the child and explained that I was just lucky, and their children would not let them stop breastfeeding (which means “they would not,” no one explained). Women began to write to me who dreamed of giving up breastfeeding and did not do it solely because of the pressure of relatives and others; women who literally fed their babies with formula until no one saw it, and felt a huge sense of guilt because of this. Even in publications like “I don’t breastfeed and I don’t regret it,” the authors seem to justify themselves and try to explain that they really could not do it physically.

In one of his books, American author Jody Picoult describes a moment when a mother and her baby are visited by a maternity hospital employee for a month and a half to make sure everything is in order: “’If you give him a bottle … anything can happen.’ “I wonder what can happen?” – I thought, but didn’t say anything. In the worst case, Max could give up the breast. My milk would be gone, and I would finally shed twelve pounds, firmly at the waist and hips, allowing me to fit into my old clothes. I didn’t understand why there was so much noise. After all, from the moment I was born, I was only fed formula. In the sixties, everyone did that. And nothing, we grew up as normal people. “

Mother’s milk is often presented as a panacea for both the baby and the mother, who will protect against infections and the risk of diabetes or malignant tumors. Indeed, WHO and other guideline writers recommend breastfeeding for at least 6 months, as many studies have shown clear benefits of breast milk. However, studies are not always reproducible, and other sources suggest that breast milk is only marginally better than formula; when comparing siblings, one of whom received breast milk and the other received formula milk, the results were the same for 10 out of 11 measured parameters. Of course, breastfeeding can bring mother and child closer and be comfortable, and besides, it is free. But still, the decision must be made by the woman and her family, so that none of them ceases to be happy and contented with life. I would like the moment to come when women will not be condemned for refusing to breastfeed, and it will be explained by a simple “I don’t want to”.

NETWORK INCREASINGLY FLICKERING IMAGES CELEBRITY , performing a variety of exercises in the air on long multi-colored tissue flaps, and news about the open studio and aeroyogi aerostretchinga appear one after another. Back in 2013, Gwyneth Paltrow, known for her love of a healthy lifestyle, shared on her portal a story about practicing “anti-gravity” (that is, denying the force of gravity) yoga. It was then that America was captured by the widespread love of exercises on aerial silks – literally “air silk”, that is, a long piece of fabric suspended from the ceiling at both ends. We figure out what it is, why it is needed and where to go for it.

For the first time “air silk” appeared in the late fifties in circus schools, but gained wide popularity only in the nineties, thanks to the American dancer and gymnast Christopher Harrison, who gathered a troupe of acrobats called AntiGravity. Then Harrison began experimenting with exercises in the air and realized that with the help of a hanging hammock, you can perfectly stretch your back muscles. Gradually, he developed a whole system of exercises for his troupe, and in 2007 presented it to the general public. The practice was named AntiGravity Yoga, and it was Harrison who invented aerial yoga in its current form.

Of course, the American gymnast is not the only one who thought that a cloth suspended from the ceiling could help to take a fresh look at the usual exercises: one of the most famous modern yoga masters Bellur Iyengar also practiced a similar technique, only he performed asanas not in a hammock, but on the ceiling with ropes.

Despite the fact that AntiGravity is a patented technique, many athletes and instructors, inspired by the idea of ​​training in the air, create their own exercise sets, using a silk hammock as their main tool. The AntiGravity company has a number of directions, but the most popular is aerial yoga, which we know as “yoga in hammocks” or “aeroyoga”.

The peculiarity of this yoga practice is that all exercises are performed either completely in a hammock, or with partial support on it, which allows you to align the asanas and support the body. Constant balancing loads muscles that are inactive in everyday life, helping to quickly master complex asanas, including inverted poses – they can be performed in a hammock without resting on the floor. The advantage of aero yoga compared to classical yoga is that it develops flexibility much faster, because the hammock itself helps to increase the tension and stretch the muscles.

It is important that yoga classes on a silk hammock almost completely relieve tension from the spine and allow you to maximally stretch the paravertebral muscles, which is very difficult to achieve when practicing on the ground. And of course, aerial yoga promotes relaxation and tranquility like nothing else: slow swinging in a cocoon-like hammock promotes stress relief and deep relaxation.

In Moscow and St. Petersburg, a number of studios, in addition to air yoga classes, offer programs in some other areas of air silk training, such as aero stretching. The main goal of these exercises is to stretch muscles, increase their elasticity and develop joints. As in aero yoga, the load is removed from the spine because tissue is used as support. Due to the fact that the hammock is constantly balancing, you can constantly “lower” the point of fixation of the body; for example, you can gradually sit on the split deeper, standing with one foot on the ground and resting the other on a silk ribbon, which will take your leg farther and farther. Plus, the hammock helps you hold your poses longer.

The most interesting direction of air sports, probably, is still aerofitness – strength and cardio training on a hammock (not to be confused with flying in a wind tunnel). This is an intense workout that can be compared to training on the TRX, only the body does not use the loops as support, but the hammock. Due to the unstable position of the tissue and a fairly fast rhythm, the hammock helps to work out more muscles in a short time and put a load on the whole body at once: for example, performing an exercise for the buttocks, you simultaneously use your arms, torso, shoulders and back.

Despite its fragile appearance, the hammock is able to withstand a weight of up to 200 kg, which makes it an almost universal simulator for both experienced athletes and beginners: everyone can try themselves in this type of training, regardless of the level of training. Lessons in hammocks are also great for the rehabilitation of people with disabilities, after surgery and injuries, or for children with cerebral palsy, since a hammock reduces the load on the spine. The ability to perform inverted poses has a good effect on the cardiovascular system, and the unstable position of the hammock allows you to quickly strengthen muscles, improve posture, stretch joints, and improve overall well-being.

This is not to say that anti-gravity exercise is a revolution in the world of fitness. In the end, this is just an opportunity to diversify the routine or get carried away with something new. Any physical activity is beneficial and makes you feel better. It is important that you like it and improve your mood, so it is better to choose the type of load that you like; for some it is long walks with the dog, for others badminton or swimming, for others – fitness on silk ribbons.

DIFFERENT MYTHS AND FEARS ARE RELATED TO MOTHERLANDS AND PIGMENT SPOTS. Some say that it is better not to touch them, others – that you need to remove and as soon as possible. At the same time, a typical inhabitant of central Russia has more than a dozen moles and does not have a clear understanding of how to monitor them and what risks they pose. We talked with oncologist Dmitry Kravchenko and found out what to look for, how to suspect melanoma, and when and how to get rid of moles.

What’s the problem with moles?

The problem is that sometimes moles, or, scientifically, pigmented nevi, turn into melanoma. Melanoma is a very dangerous tumor that spreads quickly and leads to death in a short (several months) period. More recently, new drugs have emerged that are effective in melanoma; True, they help only some patients, and it is too early to talk about a complete cure: even if all the symptoms of the disease have disappeared and the person remains healthy for several years, it is not known whether a relapse will occur. In any case, this is an extremely dangerous disease, which, nevertheless, can be prevented or detected at a very early stage, when the treatment has a good prognosis.

It is believed that everyone has a risk of melanoma, although it is increased in fair-skinned people with a large number of nevi (moles). The genetic factor also plays a role, so you need to be especially careful if a relative has melanoma. The most important risk factor is exposure to sunlight, primarily sunburn. It is believed that the risk of melanoma is especially increased if a person had sunburn as a child. It turns out that the main prevention is protection from the sun’s rays in all its manifestations: you need to use effective sunscreen, be in the shade if possible, do not use a solarium and avoid sunburn. And the condition of moles should be monitored regularly.

How to examine moles and on what to look for?

English-speaking authors often come up with abbreviations that are easy to remember – and in the case of examining moles, these are ABCDE: Asymmetry, Border, Color, Diameter, Evolution, that is, asymmetry, contour, color, diameter and changes. What does it mean? Any birthmark with an asymmetric shape should be suspicious, just like any mole with an uneven or indistinct outline or an uneven color. Particular attention should be paid to moles larger than 5 millimeters and to any changes in them: shape, color, size, itching or other unpleasant symptoms.

These signs are independent of each other, and often with early melanoma, only one of them is visible to the naked eye. Therefore, it is very important not to wait for multiple changes, but to go to the doctor immediately as soon as you notice any of these five signs, for example, a blurred outline or asymmetry. It is better to examine not only moles, but also the entire surface of the skin, especially if you have recently sunbathed; other types of skin cancer, so-called non – melanoma, do not develop from pigment cells, but are also associated with exposure to sunlight. Therefore, if new strange or unusual elements appear, it is better to consult a doctor.

Where and how can you get diagnosed?

Of course, it makes sense to regularly examine moles yourself and consult a doctor if you suspect any changes. This can be a dermatologist or oncologist, or a therapist who will refer you to the right specialist. In different countries and cities, days of early diagnosis of melanoma are regularly held, where you can get a check-up free of charge. In Russia, many clinics in 100 cities take part in this action, and the next such day will take place on May 22. Of course, if you are really worried about one of the moles, it is better not to wait for any action, but to see a doctor immediately.

Traditionally, it is believed that special attention should be paid to moles by those who have at least fifty of them all over their body. But in 2016, one study found that many patients with melanoma had much fewer moles, so you can’t rely solely on their number. The risk of a large number of nevi is rather that it is difficult to examine them on your own, memorizing and fixing all the changes. If you want to systematically track the condition of all moles on your body, you can use the FotoFinder system , which is available in some clinics. During the examination, the doctor will photograph all areas of the body, highlight on the screen those moles that seem suspicious, and then take microscopic photographs of each of them. All images are saved in the database, and on the next visit (after six months or a year), you will be able to see any changes, if any.

What if the doctor suspects something is wrong?

If you suspect an unfavorable process, the doctor will recommend removing the mole and be sure to do its histological examination, that is, to study the structure of cells under a microscope. Although beauty salons often offer laser removal of moles, it is a very dangerous procedure; under the influence of the laser, the tissue of the mole seems to evaporate, that is, it completely disappears, and as a result, the material for microscopy is lost. For the same reason, you should not try to “remove” moles with strong chemicals sold in pharmacies. Unfortunately, every year thousands of people die of melanoma due to not being diagnosed on time. It happens that a mole was removed with a laser, its malignancy was not revealed, and soon the patient has metastases – and it is no longer possible to save him.

Therefore, it is better not to risk and remove moles, if recommended, surgically. This procedure is not more complicated and much faster than the placement of a filling: local anesthesia, careful removal with a scalpel, application of a bandage. Then the place of the mini-operation may hurt a little, but in general it is not worse, for example, taking blood for a general analysis. However, none of the side effects of mole removal or the inconvenience of frequent sunscreen applications are as dangerous as the risk of melanoma; to protect ourselves as much as possible is in our power.

A LOT OF PLEASANT IS RELATED TO THE COMING OF SPRING: IT IS finally getting warm and the greenery is BREAKING through. But for many of us, the flowering season is hardly a reason for joy – those who are allergic to pollen, or hay fever, await the first flowers with horror. Together with the allergist-immunologist of the Institute of Immunology of the FMBA, Evgenia Nazarova, we figure out what allergens are, how hay fever manifests itself and what can be done to make life easier for yourself in this difficult period.

Why do flowers make
us suffer?

When it becomes impossible to breathe due to the awakening nature, it seems that life is unfairly punishing us. In fact, this is how the defense mechanisms of the immune system work: the body perceives certain substances – allergens – as a potential threat and produces antibodies (also called immunoglobulins E) that try to destroy this allergen. At the same time, the concentration of histamine rises in the blood, due to which swelling and general malaise occurs.

Immune responses to stimuli, or triggers, can occur throughout the year – for example, through contact with house dust or animal hair, or during a certain season when pollen is released. Pollinosis is one of the most common diseases in the world. According to the WHO, almost every third person on the planet encounters it. In Europe, pollen sensitivity is observed in 44% of people, in the United States it is 43%, and in New Zealand – 46%. In 2014, in the UK alone, according to statistics from the charity organization AllergyUK, 18 million people consulted a doctor with symptoms of hay fever.

Researchers suggest that allergies have become so widespread not only because of modern food and unfavorable ecology, but also because of too zealous hygiene. Perhaps genetic predisposition also plays a role: according to some data, the probability that children inherit the hypersensitivity of one of the parents is 30-60%, and if both parents are allergic, then 50-70%. Although it cannot yet be said with certainty that genes are to blame for everything, in recent years, many scientific experiments have been carried out that confirm the hypothesis of kinship continuity. If the allergy did not appear in childhood, it is too early to rejoice: there are no guarantees that it will not manifest itself at all. Today it has become finally clear that the disease can occur for the first time at any age, even in the elderly.

Maybe it’s still a cold?

Symptoms of hay fever are reminiscent of a common cold: the nose hurts, itches, becomes stuffy, eyes watery, itchy throat and, of course, all the time you want to sneeze. You can try to distinguish hay fever from a cold if you pay attention to when all this happens. Colds are more typical for the autumn-winter period and usually go away in about a week, but allergies can be much more stubborn and appear during the flowering of different plants. In spring, pollen from trees (birch, alder, hazel) spreads, in June-July – cereals (timothy, fescue, hedgehogs), and from July to September – weeds (quinoa, wormwood, ragweed).

Many allergy sufferers are convinced that they react to poplar fluff, but this statement is more fiction than truth. The fluff flakes are too large to get on the mucous membranes, and it itself is not an allergen: itching or sneezing can occur if the fluff literally tickled your nose. On the other hand, allergy sufferers should be afraid of poplar fluff: like a sponge, it collects pollen from other plants and carries it around. In the spring and autumn, spores of certain fungi – Alternaria, Cladosporium, Aspergillus – can also cause allergies. There are cases of sensitivity to two or more allergens, and only a special examination can give exact information about which trigger worked .

The examination can include the so-called skin tests, when allergens are applied to the skin or injected, and then the reaction is monitored after twenty minutes, five to six hours and a couple of days. This is a proven and reliable diagnostic method, to which, however, there are a number of contraindications. There is also a blood test for specific antibodies to individual allergens, including medicinal, household and construction allergens.

What to do?

If the season has already begun and the allergy has manifested itself, you can use antihistamine tablets, nasal sprays, eye drops; These remedies are sold without a prescription, but it is best to consult a doctor who will recommend therapy depending on the specific symptoms. True, this treatment option does not give a long-term effect: it allows you to reduce the manifestations of the disease, but does not completely eliminate it.

The drugs available today are effective and safe: unlike the antihistamines of previous generations, they do not cause drowsiness and practically do not affect daily life. Such drugs suppress the amount of histamine in the blood, reducing the intensity of the allergic reaction – so, swelling, itching and congestion disappear. But even they are not ideal: once you stop taking it, the histamine level is restored, and the allergic reaction not only recurs, but can also become stronger. In addition, if the drug was effective this season, it is not a fact that it will help next time. Every year the allergy progresses and the intensity of the immune response grows – the effectiveness of antihistamines, respectively, decreases.

If possible, it is best to literally avoid hay fever – to leave for another climatic zone for the period of plant dusting. For those who are forced to be in an allergic environment, there are also protective equipment: anti-allergenic masks and filters. Some studies have found filters to be even more effective in reducing hay fever symptoms than antihistamines. More than half of the participants in the experiments would like to continue using filters in their daily lives. Nevertheless, scientists are not yet ready to confidently say that nasal filters really protect against pollinosis better, and some users note that it is difficult to breathe with them. In any case, if the allergic reaction has already begun, such a remedy is unlikely to help. With nasal congestion, any mechanical obstruction will only make breathing more difficult and worsen your well-being.

Can allergies be cured once and for all?

The most effective method is allergen-specific immunotherapy, which affects the very cause of the disease and reduces sensitivity to triggers. It is carried out before the beginning of the allergic season: the doctor identifies the main allergen in order to then introduce it in small doses and observe the reaction. Such treatment is similar to vaccinations: usually it is subcutaneous injections or the intake of an allergen in a sublingual form (in tablets or drops). The latter is much more convenient and better suited, for example, to children, but some allergens are available only for injection, and then there is no need to choose.

In Russia, allergy immunotherapy is carried out for adults of any age and for children from the age of five. Of course, before starting treatment, the doctor will conduct a general examination and take anamnesis – it may be contraindicated in people with certain diseases of the cardiovascular system or the digestive tract. During pregnancy and breastfeeding, no immunotherapy is given at all. By itself, the allergen will not harm either the mother or the child, but a reaction to it can cause a number of symptoms that cannot be removed with medicines allowed during pregnancy. It’s easier to postpone and make an appointment with an allergist after breastfeeding is complete.

Allergen-specific immunotherapy is carried out in courses for several years. A series of procedures begins before the beginning of the dusting season, and when it ends, they are repeated. As a rule, treatment with an allergen is carried out for three years in a row, and on the fourth, remission occurs – that is, the sensitivity to stimuli decreases. This means that during the allergic season, a person can safely be outdoors without experiencing any discomfort. Sometimes three years of treatment is not enough, and then the course of therapy is carried out additionally for the fourth or even fifth year. Improvement usually occurs after the first course of therapy, but the maximum effect, including in terms of resistance, is achieved after a few years. This allows the patient to enjoy an allergy-free life for three to five years, and then the treatment is repeated. Sometimes remission lasts even ten years, but each case is different, and it is impossible to predict how long the effect will last.

And if you do not treat?

Despite the inconvenient and costly need to resume courses of allergen-specific immunotherapy, this method has a significant advantage: it does not allow the disease to progress to more severe and life-threatening forms. The problem with allergies, whether seasonal or persistent, is that we rarely perceive it as a disease and therefore sometimes take it lightly. Even if the symptoms of hay fever are not too disturbing – a slight nasal congestion, itchy eyes – there is a risk that they will worsen over time.

Allergies, if left unchecked, can get worse; when examining up to 50% of people with allergic rhinitis, doctors diagnose bronchial asthma, for the treatment of which serious interventions are needed: special inhalers and intravenous drugs. The question of how justified is the treatment of hay fever and which way of dealing with it is better remains open. In any case, if you know about your allergies and notice a worsening of symptoms, a routine checkup with a specialist and timely therapy will protect you from more dangerous chronic ailments.

CHANGE OF SEASONS IS FRUITS OF MOOD, and many people experience exhausting fatigue after a long winter. If you are feeling unwell and your condition is not improving in any way, it is worth considering seeing a doctor. Nevertheless, you can start helping yourself right now: good habits and a comfortable lifestyle together with the advice of a specialist will insure you day after day and on the verge of life changes. Alisa Taezhnaya, who has already talked about her experience in treating depression, shared several life hacks that she came up with during and after psychotherapy.

DURING SOME PERIODS OF MY LIFE, MY mood changes several times a week, or even a day. It is impossible to keep track of him: in one state I am afraid to take responsibility, in another – it seems that I can change the whole world, and it becomes impossible to plan something realistically .

A mood diary is useful for everyone who loses their footing and have long forgotten the days when they woke up and fell asleep in the same mood; the purpose of the diary is to trace the connection between life events and mood, which we constantly lose sight of. Every day for at least three months, you will need to note the change in mood and write in the diary the events that became the reason for it: work situations, meetings with certain people, causes of stress, new acquaintances, dating and sex, communication with friends.

After a couple of weeks, you will most likely see a mood pattern: for example, you feel bad in the morning, but it gets better in the evening, you don’t like Tuesdays, but you like Fridays, some things inspire, and others make you angry. A mood diary helps you analyze different situations and build a distance in relation to mood: when you see how many times it changes in one week, it will be easier to accept its regular shifts. This is the first step to learning how to adapt to your condition and not to confuse your mood with the real state of affairs. The diary is also very helpful in psychotherapy: a good specialist needs an interested and motivated patient who looks at his mood critically and does not dissolve in it.

I love notebooks, pencils and pens and made myself a paper diary myself, but you can buy a ready-made one or use a virtual one (for example, in the form of the iMood Journal application). I bought a large calendar with spreads for three months and divided each day into four equal squares: morning, afternoon, evening and night, where I indicate mood with flowers. Everyone likes their own color scheme, and in my case these are colors from white to red. White – moments of complete calmness and confidence, pink – slight fatigue or irritability, orange – an acute feeling of upturned and anxiety, red – an SOS situation, for example, a panic attack, hysteria, quarrel, conflict, or vice versa, an attack of euphoria and flight of happiness.

WHAT IT TURNED OUT: I got a clear life schedule with the ability to plan events in advance. I learned to control the moment when mild discomfort comes to a critical point, learned to give up unnecessary things, no matter how inspiring they may be. I became more disciplined and learned to build connections between events and reactions. Psychotherapy significantly accelerated: I was able to respond to the doctor’s arguments in the case, and not relying on momentary feelings.

Eat a balanced and regular diet

LACK OF REGULAR EATING led me to overwork, which I did not fully realize. I could forget to eat until a headache reminded me of hunger. Episodes of malnutrition and overeating alternated, and the pleasure of eating was associated with a sense of shame that I finally felt good.

Unfortunately, in Russia, a calm attitude to food is not always instilled in childhood: “I don’t want to eat through”, “you will not leave the table until you have eaten”, rigid formulations that impose responsibility on the child for almost his entire family. As adults, we often do not know how to understand the moments of hunger and satiety and do not even always know what kind of food we like. Thousands of books have been written about nutrition, but the main thing to keep in mind for people with mood swings is that your diet is also impulsive and not always balanced.

The answer to many questions can be found in the results of a biochemical blood test, which will show a lack of elements, and an analysis for hormones responsible for appetite and weight gain; the endocrinologist should interpret the results. If there are no violations, do the simplest thing: buy an inexpensive multicooker and cook healthy food at home from your favorite products. Let it be the basis of your diet, not counting trips to cafes and guests. There are different versions of what is harmful and what is useful, and sometimes fat or gluten are attacked by public opinion.

Your best bet is to surround yourself with as many wholesome foods as possible, such as fresh vegetables, herbs and few fruits, whole grains, fresh meats, poultry and fish, farm dairy food with short shelf life – in general, those that have been minimally processed. Cooking food and taking care of yourself on a regular basis is key to ensuring that your body receives nutrients regardless of your mood. While eating, you should not talk about bad things, quarrel, check social networks, be distracted by work: meditate on your breakfast or dinner, smile at the one who sits with you at the table, feel the taste of every bite and do not press on yourself with diets. Healthy eating can be learned by simply listening to yourself.

WHAT IT TURNED OUT: I eat based on the feeling of hunger according to a scheme convenient to me, with a stable diet from my favorite foods, I am calm about the peculiarities of the body and its needs and do not feel guilt after the evening chocolate bar, which could have poisoned me for half a day before.

Exercise

MY DESIRE TO MOVE DEPENDED solely on my mood, and my friends running the marathon were envious. At the same time, the sporting past made itself felt: training cannot be a pleasure if you were brought up that this is overcoming, and is associated with the obligatory hours of sweating in the gym or the internal demand for a record.

Many people surmise that we were not born to sit at a desk, but it can be difficult to force ourselves to play sports. It is very important to set achievable goals. You don’t have to target the Ironman if you just want to improve flexibility and endurance. The easiest way is to walk; however, not everyone has time even for an hour of walking. Then you can carve out a day a week for a long walk, no matter what happens – once a week I walk 30-40 kilometers. In extreme cases, you can even stay at home and train with videos.

It is worth forming a habit of physical activity as early as possible: someone gets dogs for this, with whom they need to walk, someone travels by bike in the dry season, someone stands in the bar for five minutes a day. The most important thing is small steps and tiny achievements that can be used to measure progress, a habit that does not depend on mood and does not need records and approval.

WHAT IT TURNED OUT: Almost every day I play sports at home listening to YouTube videos, choosing activities that suit my mood: even the most relaxed stretching and subsequent shower is better than nothing. In three years I have improved my form and made it easier for myself to start the day – the most problematic hours. The release of hormones after training and walking helps you get started faster in a good mood.

Meditate or do breathing exercises

IT HAS BEEN HARD TO BELIEVE that ten to fifteen minutes of meditation a day can change the way we look at things – and conversations about meditation often seem religiously colored. I didn’t believe in meditation and was skeptical about the idea of ​​enlightenment and clarity of mind, but I decided to try it anyway.

It is better to start any habit in a good mood, and not during, for example, an exacerbation of depression. I started meditating on an irregular basis a few months ago and, perhaps, because of this, I did not suffer a nervous breakdown during a very emotionally difficult enterprise for me. The road to successful meditation can be long, but the main thing is not an instant effect, but the habit of not identifying yourself with thoughts and surging feelings flickering in your head. I started with the basic and expensive Headspace app, but just do a YouTube request for “Guided Meditation” to get tons of calm voices or nature sounds.

The main property of meditation and breathing exercises is the ability to see the automatism of actions, thoughts and impulses, to look at it from the outside, to realize and give yourself the opportunity to turn off. People with many years of experience can meditate for hours, but you can start with a short meditation with audio support in the morning at least a few times a week. To keep yourself motivated, keep a mood diary – sooner or later you will see the connection between mood and physical condition on the days when you meditated and played sports, and when you did not.

WHAT IT TURNED OUT: I learned to turn off from reality at the moment when I need it, and to switch attention from the momentary to the long-term. Perhaps I have become a little more stress-reliant, although it is too early to judge about that. One of the main skills trained in meditation – not thinking and contemplating – perfectly replaces automatic scrolling through social networks, procrastination and the fear of being alone with your thoughts.

Be calm about money

IN A BAD MOOD I WERE EXPERIENCED THAT I was financially vulnerable, and I ate one buckwheat, in a good MOOD I spent a lot; until adulthood, I did not know how to save money and outline a single spending strategy. With good earnings, I had no savings for a long time ; I lived for one day, spending income on vacations and pleasure, and any stressful situation inspired fear.

Those who have money and who have already learned how to regularly replenish the “airbag” are often encouraged to take money calmly. Unfortunately, in Russia, financial literacy often suffers, even among those in their thirties. At the same time, the ability to calmly manage resources, save money and plan expenses is the foundation on which you can build both a family budget and a business strategy.

You can save 10–20% of your regular income by inquiring about interest rates on deposits and other investment options, realizing that this is not money for vacations or large purchases. It is the habit of creating savings in any conditions that can free one from the anxious feeling “I can’t do anything” if there is a question of emergency assistance, job loss or other negative events. You can and are already doing something, taking care of your financial security.

Another good financial habit is making regular charitable donations: you can set up automatic write-offs of small amounts in favor of a trustworthy foundation or respond to individual requests for help on social media. Such a small and simple action makes you feel connected with other people: it is absolutely not necessary to be a very rich person in order to manage money fairly and find small amounts for good deeds.

It is important that you cannot revise your budget without optimizing your spending and getting rid of impulse purchases. It can be nice to reward yourself for your successes with a gift or a delicious cupcake, but that shouldn’t be the main way to please yourself. There are several dozen applications for budgeting, but the main thing in this matter is not technical equipment, but awareness in relation to money. It does not negate grand gestures, beautiful gifts to others and participation in the life of loved ones, and has nothing to do with cursing.

WHAT IT TURNED OUT: I learned how to save money by planning my leisure time and making savings, deny myself instant purchases and postpone decisions about non-urgent purchases. Instead of shopping online, I spend time looking at movies and books and have set up automatic donations for charities. I have never had loans, and I do not even consider such an opportunity.

Rest without guilt

I ALWAYS HAD A confused and restless dream, and I treated it like a wasted time. Passive rest was associated with laziness and inability to spend time interestingly, and I was irritated not having thought of things to do, but fatigue imperceptibly became a background of life.

From my experience of communication, I can say that behind every second person with a prolonged low mood is an excellent student’s complex and years of unconscious workaholism. Free time makes us feel guilty, and the habit of busy schedules makes us the king of multitasking. But only until the moment you fall, when, after processing, you don’t want to get out of bed and you have to force yourself to get busy. The main reason for such a prolonged overload is hyperresponsibility, inability to allow oneself to rejoice, fear of not living up to other people’s expectations and anxious self-doubt, often implicated in the complex of an impostor.

The mode of work and rest should be changed if sometime favorite things cause a burden of obligations, and you still hardly say “no” to all counter offers. First you need to let yourself sleep without an alarm clock and understand the optimal sleep duration. Someone needs seven hours, but I need at least nine; at the same time, feeling a sense of guilt, I systematically did not get enough sleep.

It is very important to set aside time that you will only spend in your own interests, without fulfilling social roles for others – that is, perhaps, boredom and messing around. It is precisely the lack of time for oneself that is associated with the loss of inspiration, dulling of sensations to what was once so pleasant, cooling to the environment and pathological fatigue from social functions. Many of us, instead of a work schedule, need, on the contrary, to build a rest regimen. And it’s also time to understand that nothing will happen if you do not have time to do something on time, having warned about it in advance and correctly.

WHAT IT TURNED OUT: I GAVE up the feeling of guilt for my free time, learned to sit back and hover in the clouds and realized what meditators call “ being in the moment” – not to jump into activity when it is not required. I admitted to myself that I think better when I get enough sleep, and I learned to turn off my phone at night forever – and in two years of a new habit, I missed only two important calls and one delivery.

Write the morning pages

DURING THE WORKING DAY, I find it difficult to prioritize, and during the week there is no opportunity to think about what is happening strategically. I didn’t have enough moments so that I could think with a clear head about what was bothering me.

Morning Pages is a long-standing, simple and effective therapeutic practice: right after waking up, you write three pages of everything that comes to mind on a sheet of paper on a sheet of paper, without much thought. It can be dreams, memories of yesterday, the reasons for today’s anxiety, moments of doubt about making decisions – anything that sits in your head right after you woke up. You do not need to reread the morning pages, you should immediately do meditation or sports, and return to what you wrote in your free time or in the company of a psychotherapist.

This exercise is a way to quickly free your mind and subconscious mind from obsessive thoughts that can distort the perception of reality. Morning pages provide an opportunity to throw out thoughts that have not left your head for weeks, and calmly let go of expectations so as not to be distracted by them during the day.

WHAT IT TURNED OUT: THE Morning Pages helped me analyze changes in mood and well-being, observe the progress of the state, its banality and predictability. I have developed self-criticism and distance towards my diagnosis (cyclothymia) and better understand the context of my conditions.

Get rid of unnecessary things and connections

FAMOUS SITUATION: THE CABINET IS FULL OF CLOTHING, but there is nothing to put on, there are a lot of books on the shelves, and there is nothing to read. There are a lot of friends on social media, but they are not the kind of people who want to call late at night and come hugging. With all the abundance of information, connections and objects, the feeling of loneliness and alienation did not leave me for a long time.  It’s hard to live in a house with piled up things that you don’t like; It is even more difficult to be distracted by casual contacts when you want deep and solid connections. But in order for them to appear, you need to free up space – literally and figuratively. Putting things in order at home and in the workplace helped me to systematically disassemble the things around me. Why keep gifts that almost strangers gave you symbolically a long time ago? Jeans that are hopelessly small or large? Outdated technique? Getting rid of unnecessary things, you need not replace them with analogues, but focus on what is actually needed every day.

Bulky things that are difficult to part with can be taken to a paid storage and not cluttered with them. Valuables – to sell according to an ad, the rest – to donate to charity or for recycling. Things can help us at a certain stage in life, but become unnecessary after that, and regularly getting rid of unnecessary things is a healthy habit. Ideally, get rid of everything that you have not used for a year and in the presence of which you do not feel joy.

This principle also applies to social ties: you have every right to distance yourself from people with whom communication makes you tired and not very happy – follow the mood diary which meetings inspire you and which leave you devastated. Of course, there are inevitable contacts with parents or colleagues, but many other relationships can be regulated and dosed. Make time for those who listen to you without judgment (and don’t judge others), from whom you learn new things, and who even get bored with is a pleasure. In unpleasant but obligatory relationships, it is better to concentrate on their functionality, while unpleasant and unnecessary relationships can be safely thrown overboard. By removing the unnecessary, we get rid of the fear of being left in emptiness; and free space is filled with deeds, things and people that are much more relevant to us today.

WHAT IT TURNED OUT: From a set of random things and burdening connections, I came to people and objects that I love and are always glad to see. All work contacts are emotionally comfortable for me, the amount of information noise is minimized, Facebook is used to communicate with loved ones and expand my horizons. I calmly part with objects that no longer bring pleasure.

Be grateful

IN DAILY STRESS, I did not feel joy from what was happening around me, and gratitude seemed like a far-fetched ritual. The mention that some people were born to die of hunger or war a few years later did not bring me closer to realizing my own path to peace. To put it bluntly, I did not appreciate what was at my disposal.

There are two ways to practice gratitude. The first level is the realization of the colossal luck that we were born in relatively free time, received a profession and education. By default, you can be grateful that your parents were not killed in the war, you were not forced into marriage, and you were not subjected to female circumcision. You can be grateful for insurance at work, the ability to independently choose a schedule and do what you love. To feed a family or have free access to a wealth of knowledge.

Each day, it is worth writing down five such basic gratitude for your privilege in your journal. Five more things should be related to the past day and its events. Did your partner make breakfast? Have you got hold of the subway door? Did the negotiations end successfully? Did you have a great dinner? Heard the voice of a loved one? Walking through the spring city? These items may be quite small, but there should be five of them.

Practices of gratitude are often triggered automatically during the poignant moments of life, but during depressive episodes it takes time to pay attention to the good. It is worth doing this in writing to understand that the list is endless, regardless of our mood. It is best to write thanks in the evening in order to safely fall asleep, realizing that even in the most difficult day you can find a lot of good things. Playing this exercise in the head, it is difficult to achieve clarity, which is striking when it is performed in writing.

WHAT IT TURNED OUT: I learned how to gently part with recent events, see the good in the moments I just lived and realize my privileges every day. I do not need to compare myself to others in order to be grateful for my life: after all, there are joys and difficulties in it that fall only to me.

THERE IS A FEW WHO PURCHASES DARK GLASSES TO HELP HEALTHY – they have long passed into the status of a fashion accessory : beautiful, comfortable, but as if not necessary at all. Sometimes we forget that we really need sunglasses: our eyes, like nothing else, need to be protected from rays, dust and other factors. We tried to figure out exactly how glasses protect the eyes and why low-quality glasses can even be dangerous.

Why is the sun dangerous to the eyes?

To understand why hide your eyes at all, you need to understand what shines in them – and what it threatens. The solar spectrum includes ultraviolet, visible and infrared radiation. Infrared does not harm the eyes, but ultraviolet and visible can be troublesome. Ultraviolet rays damage a variety of biological molecules, including protein and DNA. Damage to collagen (it is also a skin protein) accelerates the processes usually associated with aging – loss of elasticity and sagging, and if the DNA structure is disturbed, dangerous oncological diseases, including melanoma, can develop . This also applies to the eyes: risks associated with overexposure to sunlight include accelerated wear and tear on the central retina, leading to impaired vision, and even melanoma of the eye , a rare but fatal tumor that rapidly metastasizes and is currently incurable.

And that’s not all: ultraviolet light can lead to photokeratitis (inflammation of the cornea), snow blindness (burns of the conjunctiva and cornea), retinal burns (with significant dilation of the pupil behind dark lenses of glasses), solar retinopathy and dry eye syndrome. With regard to visible radiation, it (especially light in the blue spectrum) can impair visual acuity and provoke symptoms of visual fatigue – which is why when sitting at a computer, eyes often get tired. Finally, in certain sports, it is important that the goggles protect the eyes mechanically; if you suffer from seasonal allergies or you just have sensitive eyes, then you should protect them from pollen and dust.

It is simple to protect the skin from radiation – it is enough not to be lazy and use cosmetics with SPF all year round; eyes can only be saved by glasses with a high-quality filter that does not allow ultraviolet light to pass through. Most importantly, remember: dark does not mean sun protection. At the departments of ophthalmology, students are often told a story that happened in the eighties in Odessa: someone brought there a large batch of dark glasses without a UV filter, and it turned out that almost all of them went to taxi drivers. After a couple of weeks, they reached out to the ophthalmologists’ offices. The accessory did much more harm than good: the hapless taxi drivers suffered retinal burns. In the dark, the pupil dilates, so that much more sunlight gets on the retina than usual – and if we are talking about glasses without protection, then a sad fate awaits the eyes.

How can glasses help?

The lenses of quality glasses can be made of glass or polycarbonate; Each of these materials has advantages and disadvantages, but both, when properly manufactured, reliably block UV radiation. Glass is harder to scratch and is still the most transparent material known to mankind – which is why it is still used in microscopes, cameras or binoculars. On the other hand, the glass itself does not block UV-A radiation, so the glasses require additional coating; besides, glass glasses are heavy, fog up easily and can break.

Polycarbonate lenses are ten times stronger than glass or regular plastic, making them ideal for children and athletes; they are lighter and thinner than glass and block 100% of UV radiation. True, polycarbonate is easy to scratch and is not as transparent as glass – it happens that objects in such glasses do not seem clear enough. There are other materials for specialty goggles – for example, the impact-resistant Tribrid and Trivex, the lenses of which are inserted into goggles for skiing or snowboarding.

Additional UV protection is provided either by coating or by adding certain chemicals to glass or polycarbonate during the manufacturing phase. Although the material itself blocks ultraviolet light, tinted glasses are banally more comfortable for the eyes – so they get tired of the rays of the visible spectrum less. As common sense suggests, the darker the lenses, the more suitable they are for sunny days – and vice versa, yellow or pink glasses will be nice in cloudy or foggy weather.

How to choose the degree of protection?

Lenses are divided into five types according to the degree of protection: very light lenses transmit 80-100% of the light and are suitable for use in the city in cloudy weather (category 0-1), and dark lenses transmit only 3-8% of the light and can be used, for example, high in mountains (category 4). For travel to the sea, lenses that transmit 18–43% of the light (categories 2-3) are usually suitable. Glasses should be absolutely transparent, so that they can clearly distinguish objects at different distances. Good glasses always come with a label that indicates the percentage of UVA and UVB blocking and the category of protection. Sometimes it is indicated where the glasses can be used – in the city, at sea or in the mountains. It is important that you cannot drive a car with category 4 glasses – and this should also be written about.

There are photochromic lenses, which are also called “chameleons” – they react to the intensity of light and change the degree of dimming, becoming dark in bright sunlight and almost transparent in the room. However, such glasses need to be changed regularly, because the photochromic “agents” wear out quickly and the darkening becomes weak.

Is there a point in cheap glasses?

Unfortunately, it is almost impossible to check the authenticity of the UV protection in the display case with glasses – you just have to trust the label. It should indicate the presence of UVB and UVA blocking – however, an additional difficulty is that labeling standards are not mandatory, and it is up to the manufacturer to comply with them or not; even the FDA guidance is advisory. One exception is Australia and New Zealand, where sun exposure risks are taken especially seriously, and any sunglasses must be tested and labeled according to a mandatory standard.

Be that as it may, it is better to choose glasses on which the maximum degree of protection is indicated – for example, as a percentage (80-100%). Sometimes it is written on the label that glasses do not transmit light with a wavelength of up to 400 nm – this is equivalent to complete blocking. The European standard (CE) may also be indicated with the numbers 0, 2, 6 or 7, where 0 is zero protection, and 7 is full. If there is an ultraviolet lamp at home, then in the glasses you already have, you can carry out a simple test: shine a lamp through the glasses on banknotes. If the lens material is UV-resistant, you will not see watermarks.

A pleasant fact – even cheap glasses can provide high-quality protection from the sun if they are made of adequate materials and certified. It turns out that glasses from the mass market can be bought for eye protection, if you are sure of the quality of the glasses; it is the best choice for the beach – it will not be a pity to lose them or get scratched by the sand.

ANSWERS TO MOST OF THE QUESTIONS THAT HAVE ARE EXCITING TO US, we are all used to searching online. In this series of articles, we ask just such questions – burning, unexpected or common – to professionals in a variety of fields.

Concepts such as “cleansing” or “detoxification” are found in almost any alternative medical course. If, say, there are no complaints about the practice of meditation and “cleansing” your thoughts, then as for the physical cleansing of the body, questions arise about the need, benefits and possible harm of such a detox. We talked about this with a specialist.

Alexey Vodovozov

toxicologist, science journalist

The “slags” and “toxins” that are suggested to be cleansed in alternative medicine are a non-existent threat, and no one has ever seen them. They are not given a clear definition, they cannot be detected even with the help of laboratory devices of the latest generation, they are not visible either in optical or electron microscopes. In most cases, the postulate of their existence and regular accumulation is proposed to be taken on faith; sometimes pseudo-diagnostic techniques are called for help , designed to confirm the “terrible diagnosis”.

At the same time, “alternative people” actively use invented, but pseudo-scientific terminology – for example, they describe “seven degrees of slagging according to the classification of the World Health Organization.” It is not very clear why, in this case, hide behind the name of WHO: just go to the official website and try to find the word “slagging” with a search to get a zero result. Neither “slagging” nor “acidity” – another common diagnosis from the dark side of medicine – cannot be found on the website of the International Classification of Diseases.

A strange argument is often used: mainstream science cannot refute our claims, which means that we are right. But science does not work that way: the burden of proof lies with the approver – and this very evidence has not yet been observed. Although, to be honest, sometimes scientists still undertake to refute myths and successfully do it. Indicative in this sense is the story with stones that supposedly come out of people during the “cleansing of the liver”. The procedure is familiar to many adherents of alternative medicine: in the evening, olive oil and fruit (usually apple or lemon) juice are taken on an empty stomach. After that, you can put a heating pad on the liver area, you can not put it, you can lie on your right side, or you can lie on the left – it depends on the current to which the person being cleaned belongs. In the morning “stones” are guaranteed to come out.

The “slags” and “toxins” that are offered to be cleansed in alternative medicine are a non-existent threat, and no one has ever seen them.

In 2005, two New Zealand scientists – a clinical biochemist and a gastroenterologist – decided to test what these stones are made of. A woman came to their clinic with real stones in the gallbladder, to whom the herbalist recommended a similar “cleansing”; some formations really came out of the patient, which she collected, froze, and then brought for research. After careful analysis using various methods, it turned out that the “stones” consisted of components of olive oil and lemon juice, slightly modified under the influence of digestive enzymes. That is, the output was the same as the input; and the real stones had to be surgically removed from the gallbladder.

By the way, about surgery. Some gallstones can be lived a lifetime. But if you stimulate the liver with these alternative methods, the stones can go out on their own. It is good if they are small and pass through all the ducts and sphincters, but if they get stuck in a narrow section of the duodenum, where the common bile duct and pancreatic duct open? Stopping the outflow of bile will seem like flowers in comparison with acute pancreatic necrosis – the destruction of the tissues of the pancreas by its own enzymes. And no cleaning in such a situation will help, and doctors are not always able to cope with it.

Cleansing can also be relatively harmless, such as the popular detox diet of juices and smoothies. Bottles with multi-colored contents are unlikely to be able to directly harm, there are still food products. Passion for liquid food does not have a very good effect on the health of teeth and deeper parts of the gastrointestinal tract, but nevertheless, one should not expect large-scale problems from this side. The trouble is, people rarely limit themselves to detox bottles. Often they are “cleaned” in a complex manner. For example, with the help of hydrocolonotherapy, which is presented as a soft, natural and physiological technique, although it is not very clear what is physiological in pumping huge (tens of liters) volumes of water through the anus under pressure. Not only does the intestinal microflora wash out, much more unpleasant consequences are described. For example, the perforation of the rectum or infection amebiasis. This procedure not only fails to solve problems, but also creates new ones. Like the no less popular coffee enema, cases of rectal perforation due to burns of the mucous membrane with hot coffee, as well as deaths , have been described . And that’s not counting such “trifles” as violations of electrolyte balance and polymicrobial septicemia.

Hydrocolonotherapy is touted as a mild and physiological technique, although it is not very clear what is physiological in pumping through the anus under the pressure of huge volumes of water

“Natural” supplements, which are often included in the cleansing complex, in fact turn out to be stuffed with the very “terrible chemistry” that dietary supplements are supposed to replace. For example, just eight different “herbal” weight loss supplements found prescription sibutramine, bumetanide, phenytoin, pseudoephedrine, amfepramone, which have very severe side effects and are used under strict indications, as well as the carcinogenic and long-discontinued phenolphthalein known as purgen.

And there are a lot of such examples. Unable to prove the presence of real diseases, the apologists of alternative medicine and their adherents simply postulate: there are slags, it is necessary to cleanse them, without being puzzled by questions of the validity of such actions. As a result, people harm themselves directly or indirectly, without going to doctors in the presence of serious pathology and trying to escape from diseases by ephemeral “cleansing”.

When does the body need to be “cleaned” and from what substances? For example, in case of serious violations of the liver or kidneys, if they do not cope with their main task – in fact, the elimination of toxins and processed products from the body. Through the kidneys, metabolites arising from the breakdown of proteins are excreted, including urea, uric acid, indican and creatinine. If the kidneys do not cope with their work, these nitrogenous wastes (the official term) accumulate and begin to harm the body. The method of cleansing the body from such toxins is known: hemodialysis using the “artificial kidney” apparatus. This is a bulky stationary structure, although in 2016 the portable version of the device successfully passed the first phase of clinical trials .

A variety of toxins are also well understood. Many of them, for example toxins of microorganisms, we regularly encounter when we get infections. We can easily arrange for ourselves poisoning with some toxins: the famous hangover is nothing more than poisoning with ethyl alcohol metabolites, primarily acetaldehyde. And here, too, everything is clear with the cleaning process: methods are used that have been repeatedly tested in toxicology. Most often these are various intravenous infusions (“droppers”) with the simultaneous forcing of diuresis (excretion of substances in the urine) with diuretics, plasmapheresis or hemosorption may be involved, sometimes antidote (antidote) therapy is also required.

That is, toxins and toxins themselves are not a myth, they are known to medicine, they are well diagnosed, and there are different methods of treatment with proven effectiveness to combat them. But all this has nothing to do with the practice of “cleansing” or “detoxification” for a healthy person.

PROBLEMS IN THE SEXUAL SPHERE CAN BE JUSTIFIED BY both physical illnesses and mental characteristics, as well as the consequences of various traumas and shocks. The situation is complicated by the fact that people are often embarrassed to talk about such concerns, and more often they simply do not know which specialist to turn to. One such condition is vaginismus, which is a contraction of the vaginal muscles that blocks penetration. We talked about vaginismus with experts – the head of the gynecological department of the ATE clinic, Oksana Bogdashevskaya, and the sexologist and psychotherapist of the Mental Health Center clinic, Amina Nazaralieva.

Penetration fear

Vaginismus is a state of tension in which penetration into the vagina becomes impossible. It is important to understand that we are talking about a reflex reaction, which is difficult to track and even more so to control. Vaginismus can be accompanied by a feeling of fear, tension of the pelvic floor muscles, painful sensations in the vulva when trying to penetrate. At the same time, often the manifestation of vaginismus does not at all mean a reluctance to have sex or a lack of arousal – it is penetration that causes fear. There are different degrees of severity of this syndrome: if in the most severe cases no penetration is possible – a woman cannot even insert her own finger into the vagina – then in other situations she can react painfully only to one type of penetration.

Women who recovered from vaginismus and talked about it in Cosmopolitan and Jezebel admitted that they wanted sex, but could not control the reactions of their own bodies. The heroine of one of the publications faced vaginismus after a long struggle with the psychological consequences of rape. “I was raped when I was a student, and now my body does not allow me to have sex,” she said. “To be honest, I could never even insert a tampon – it seems to me that I do not know at all where the entrance is, and I do not think that anything can penetrate there at all; pain scares me, ” says the heroine of a post on the website of Israeli sexologist Tilly Rosenbaum.

“I remember the only time in high school when I tried to use a tampon. I took one from my mom’s box, sat on the toilet and tried to get it inside. It didn’t work out. I remember how unpleasant it was for me, and it seemed that everything inside was tight. I didn’t understand what was the matter, and I felt rather stupid – what kind of girl am I, if I don’t even know how to insert a tampon? Since then I have only used pads, ” writes the author of Feministing.

Vicious circle

According to Amina Nazaralieva, who helps couples suffering from vaginismus, in some cases painful sensations can appear from the very thought of penetration. She notes that women describe it as a sharp pain or burning sensation in or around the vaginal opening. These sensations cause a kind of “block”, which prevents penetration, and it seems to them that they are abnormal from the point of view of anatomy, that the vagina is too small and narrow, that the penis “does not fit”. These thoughts make them feel ashamed and inferior, and have an aversion to genitals.

As Oksana Bogdashevskaya notes, gynecologists most often encounter manifestations of vaginismus when trying to examine a patient on a gynecological chair. In severe cases, examination becomes almost impossible, and attempts to obtain at least some information in order to solve the patient’s problem can significantly aggravate the manifestations of vaginismus and turn the problem from a difficult to a difficult one.

The manifestation of vaginismus does not at all mean a reluctance to have sex or a lack of arousal – it is penetration that causes fear

There is still no consensus among researchers about what exactly causes vaginismus. Traditionally, it has been attributed to psychological reasons such as conservative religious upbringing, lack of premarital sexual experience, negative attitudes associated with sex, ignorance, and lack of sexual education. Other hypotheses attribute vaginismus to dysfunctional relationships within a couple, sexual and physical abuse, or trauma. Unfortunately, vaginismus is poorly researched, and there is not enough evidence to support one cause or another, according to Amina Nazaralieva.

The problem is often aggravated by the vicious circle of its mechanisms: the girl anxiously awaits penetration, which she is terribly afraid of, associating with terrible pain. During the first attempt in life to penetrate, most often it is about the introduction of a tampon, the pelvic floor muscles involuntarily contract and, if these attempts are continued, against the background of muscle tension, real pain arises. Of course, this increases the anxiety of waiting for the next penetration. As a result, avoidant or protective behavior, catastrophization in thoughts and muscle tension are formed; the anxiety and anticipation of pain increases and a vicious circle ensues.

Who can help

In patriarchal countries, vaginismus is a more common complaint than in sexually liberated societies. However, the true scale of this problem is difficult to assess: according to various estimates, from 0.49 to 10% of women suffer from vaginismus . It is difficult to accurately determine the prevalence of vaginismus, not least because it is a taboo problem, and many patients hesitate to discuss it with a doctor.

True psychogenic vaginismus is different from the fear and avoidance of penetration that results from gynecological conditions such as postpartum trauma or infections that make penetration painful. Vaginismus associated with psychological problems requires an interdisciplinary approach, and gynecologists treat it together with psychotherapists. “In our clinic there are up to ten such patients a year,” says Oksana Bogdashevskaya, “while we do not treat true vaginismus, but only help those whose pain from penetration is associated with other gynecological pathologies. We refer patients with real vaginismus to other specialists. “

At the initial stage of therapy, it is important for a specialist to understand what thoughts visit a woman before, during and after an attempt to penetrate: what she thinks about herself, about her disease, about the attitude of men towards her, about her partner. This is important in the work of the therapist, as judgments and thoughts influence emotions and bodily responses, leading to appropriate behaviors. For example, catastrophic thoughts are accompanied by fear, which can both force you to avoid dangerous situations and cause reflexive protective muscle contraction. But the more a person avoids what makes him afraid, the more he is afraid, since the brain has no way to make sure that it is not really that dangerous.

How is vaginismus treated?

Currently, there are several treatments for vaginismus: for example, since the 1970s, vaginismus has been treated with paired behavioral sex therapy. Most often, dilators are used in such therapy – a set of plastic tips of different sizes, reminiscent of dildos, which should gradually wean a woman from being afraid of penetration into the vagina.

As Nazaralieva notes, the most effective is the method of gradual exposure (exposure) – an approach traditionally used in behavioral therapy for various kinds of phobias. Within the framework of this method, the patient is asked to build a hierarchy of fears associated with penetration. This is a scale from 0 to 100, where 0 is not scary at all, and 100 is the worst thing that can be. For example, inserting your little finger can be scary by 20 points, a tampon by 30, inserting a husband’s finger – 40, inserting two fingers – 60, wiggling two inserted fingers – 70, inserting a dildo – 90, and inserting a penis by 100 points.

The more a person avoids that
which causes him to fear, the more he is afraid. The brain has no way of knowing that it’s not really that dangerous.

The partner is asked to measure the diameter of his erect penis in order to be guided by this figure when choosing dilators. Then 1–3 sessions are carried out in an office equipped with a gynecological chair, lasting 150 minutes. During these sessions, the woman consistently goes through the scales from 0 to the maximum possible (ideally 100). Then she gets her homework – to train the same at home with the participation of a partner. Specialized dilators, from very small to very large, can be purchased at the clinic or online to practice at home on your own.

There are other treatments, including injecting Botox into the muscles surrounding the vagina and pelvic floor physiotherapy. All of these methods are aimed at achieving one goal: to enable a woman to have penetrative sex. This is not about getting an orgasm or pleasure – these goals are achieved in other ways. According to the sexologist, some of her patients have a positive attitude to sex from the very beginning and enjoy it both before and after the treatment of vaginismus. For others, sex is not associated with pleasure, but is important only for the preservation of the family and procreation. And yet, attitudes towards sex are not directly related to vaginismus and will not necessarily change with the cure of this ailment.