Блог Анкара

In This Chapter

^ Understanding depression

Identifying thinking and behaviour patterns that keep your depression going ^ Recognising and reducing ruminative thinking ^ Confronting and solving practical problems ^ Using activity as an antidepressant ^ Getting your sleeping pattern back on track

Statistics show that as many as one in two people are estimated to experience depression at some point in their lives. Luckily, the problem is well-recognised and treatable.

If for the past month, you’ve felt down, lacked energy, been pessimistic or hopeless about the future, and lost interest or enjoyment in doing things, then you may be suffering from depression. If you’ve also had difficulty concentrating, had a poor appetite, been waking early, and experienced a low mood, anxious thoughts or feelings of dread in the morning, then you’re even more likely to be diagnosed with depression. If you have three or more of these symptoms, your symptoms have been present for two weeks or more, and are intense enough to interrupt your usual day-to-day activities, then we recommend that you visit your physician and investigate the possibility that you are suffering from depression.

Antidepressant medication can help to alleviate some of your depressive symptoms, although not every person diagnosed with depression needs to take medication. Depending on the severity of your depression, a course of CBT treatment may be enough to help you get better. CBT for the treatment of depression is well researched and the results show that it produces good outcomes. CBT and antidepressant medication are often used in conjunction to treat depression. Ask your doctor or psychiatrist to explain your medication and any possible side effects.

This chapter provides you with a guide to assess yourself for possible depression and offers some classic CBT strategies for defeating depression.

Understanding the Nature of depression

The sort of depression we’re talking about in this chapter is different to feeling down or blue in response to a bad event. We’re talking about an illness now ranked as one of the most common reasons for people having to have time off work.

Specifically, depression has the following symptoms, usually lasting for at least two weeks:

Appetite variation, such as eating far less or more (‘comfort eating’) than usual

Sleep disturbance, including having difficulty sleeping, wanting to sleep too much, or experiencing early-morning wakefulness

Lack of concentration and poor memory

Irritability

Loss of libido

Loss of interest in activities previously enjoyed. Engaging in these activities no longer produces pleasure

Social isolation and withdrawal from others

Self-neglect with respect to feeding or grooming

Neglecting to take care of your living environment

Decreased motivation and activity levels, often described as a feeling of lethargy

Feelings of hopelessness about the future and thinking bleak thoughts, such as ‘What’s the point?’

Strong and enduring negative thoughts about yourself Feelings of guilt

Inability to experience feelings of love, often described as a flattening of emotions or feeling numb

Suicidal thoughts, such as feeling that you no longer care whether you live or die

Another common form of depression is Bipolar affective disorder, Formerly called ‘manic depression’. People who have bipolar disorder experience periods of severe depression alternating with periods of Hypomania (feelings of euphoria accompanied by impulsive and often risky behaviour). If you think that have this disorder we advise you to seek an assessment from a psychiatrist. A psychiatrist will be able to prescribe appropriate medication and can refer you to a CBT therapist.

The techniques covered in this chapter for overcoming Unipolar depression (depression that is not accompanied by periods of hypomania) are also useful for bipolar sufferers. Keeping up a consistent day-to-day level of activity is one of the main CBT strategies for managing bipolar affective disorder. You can use the techniques in the following sections, which cover improving the quality of your sleep, solving problems, scheduling your activities, and interrupting rumination, to stabilise your mood and help you to minimise or avoid excessive highs and lows.

Looking at What Fuels depression

Unfortunately, certain things that you do, in an attempt to alleviate your feelings of depression, may actually be making your symptoms worse. When people are depressed, they often make the mistake of doing what their mood dictates.

CBT helps depressed individuals learn to override their depressed mood and to do the Opposite Of what their depression makes them Feel like doing. Here are some of the main actions and thoughts that actually stoke depression:

Rumination: Getting hooked into a repetitive, cyclical process of negative thinking, repeatedly going over problems in the past, or asking yourself unanswerable questions. (We discuss rumination in detail in the next section.)

Negative thinking: In depression, your negative thoughts about yourself are often based on beliefs that you’re helpless and worthless. Thoughts about the world being an unsafe and undesirable place to live in are also a common feature of depression.

Inactivity: Feeling that you can’t be bothered to do day-to-day tasks, not participating in activities that previously you enjoyed, and staying in bed because you don’t believe you can face the day.

Social withdrawal: Avoiding seeing other people and not interacting with the people around you.

Procrastination: Avoiding specific tasks, such as paying bills, booking appointments, and making phone calls, because you think they’re too difficult or scary to confront.

Shame: Feeling ashamed about your depression, and telling yourself that other people would judge you harshly if they knew how much your effectiveness and productivity had decreased.

Guilt: Feeling guilty about your depression, and overestimating the degree to which your low mood causes inconvenience and suffering to your loved ones.

Hopelessness: Thinking that you’ll never feel better or that your situation will never improve.

Doing only what you feel like doing when you are depressed is likely to maintain or worsen your symptoms. Instead, try doing the opposite of what your depression directs you towards doing. For example, if you feel depressed and want to stay in bed all day avoiding phone calls and seeing friends, do the opposite. Try to make the colossal effort (and it can really feel colossal!) of getting up and dressed, answering the phone, and going out of the house to meet friends. Doing this limits you ruminating on your bad feelings and thoughts, and forces your attention onto external things, such as other people and your environment.

Most people find that they feel better for having done Something, Even if they do not experience enjoyment from social interaction like they did before they became depressed.

Depression typically dulls your ability to glean enjoyment from previously enjoyed activities. Be patient with yourself and trust that your feelings of enjoyment can return over time. In the first instance, it is enough to simply do the things that you have been avoiding Forthe sake of it. Doing something is better than doing nothing. Don’t put pressure on yourself to ‘have a good time’ at this early stage in your recovery.

Going. Round and Round in \lour Head: Ruminative Thinking

Rumination is an integral process in maintaining your depression. Most people with depression are likely to engage in some rumination, even if they’re not aware that they do.

Rumination Is a circular thought process in which you go over the same things again and again. Often, the focus is on how bad you feel or doubting that you can ever feel differently or better. Your rumination may also focus on trying to work out the root cause of your depression, or on the events that

Have contributed to you being depressed. You may ask yourself questions like the following, over and over again:

I Why is this happening to me?

I What could I have done to stop this happening?

I If only X, y Or Z Hadn’t happened, I’d be okay.

Depression makes people feel compelled to ruminate. In a sense, rumination is like a faulty attempt to solve problems. Rumination is compelling because your depressed mood tells you that you must try to get to the bottom of why you feel bad. But rumination simply doesn’t work: You end up trying to solve your depression by going over the same old ground and looking for answers inside the problem. You focus your attention on how depressed you feel, which leads to you feeling more depressed.

Fortunately, you can catch yourself going into a ruminative state by using the techniques we discuss in the following sections to interrupt the process.

Catching yourself in the act

Rumination is all-consuming. It will typically absorb you quite totally. You may look like you’re simply staring blankly into space, but in your head your thoughts are going ten to the dozen. The key is to knowing when you’re going Into Rumination, so you can take steps towards Getting out Of rumination.

Early warning signs of rumination taking hold include the following:

Getting stuck. You may be in the middle of doing something and find that you’ve stopped moving and are deep in thought. For example, you may be perching on the side of the bed for several minutes (or even much longer!) when actually you intended going for a shower.

Feeling low. Beware of times when your mood’s at its lowest ebb: This is when you’re most likely to engage in rumination. Most people ruminate at particular times of the day, more often than other times (although rumination can happen at any time).

Slowing down. You may be doing something and then start to move more slowly, like pausing in the aisle at the supermarket. You start to slow down because your concentration’s heading elsewhere.

Getting repetitive. The same old thoughts and questions drift into your head, time and time again. You get a familiar niggling feeling that these vague questions must be answered.

The content of your ruminations is not the problem – the process of rumination itself is. You don’t need to do anything with your thoughts other than disengage from them, as we explain in the following section.

Arresting ruminations before they arrest you

Several different tricks can help you stop the rumination process. Try some of the following:

Get busy. Perhaps one of the most effective strategies you can adopt is to make your body and mind busy with something outside yourself. If you’re vitally absorbed in an activity, you may find it harder to engage in rumination. These types of activities may include doing the housework with the radio on to hold your attention away from your internal thoughts, making a phone call, surfing the Internet, running errands, taking the dogs for a walk, and so on.

Work out. Hard aerobic exercise can exorcise those toxic thought processes. Be sure to exercise during the day or in the early morning, because exercising too near bedtime can disturb your sleep.

Get up and out. Rumination’s more difficult when you’re outside of your home or in the company of others. If you know that you’re most vulnerable to ruminating at certain hours of the day, make sure that you schedule activities for these times.

Let your thoughts go. Practice letting your negative thoughts pass by and simply observe them like pictures across a television screen. Don’t engage with your negative thoughts, judge them, or try to answer any questions – just accept their existence and let them slip by. (Check out Chapter 5 for more on this technique.)

Get good at redirecting your attention. You can strengthen your attention muscles and deliberately focus on less depressing things. Try using Task concentration training, A method of attending to external aspects of your environment, as it can successfully interrupt rumination. (See Chapter 5 for more on task concentration training.)

Be sceptical. Your depressed thoughts are a symptom of your depression, so try to take them with a sizable pinch of salt. You can resist the urge to ruminate about your depressed thoughts by deciding that they’re neither true nor important.

Keeping busy is a great technique for interrupting ruminative thinking. However, you can still end up ruminating while you’re engaged in an activity. Be aware of paying attention to whatever you’re doing. Be mindful of your actions when you’re ironing, cleaning, stringing beads, weeding the garden, or whatever.

Rumination can take hold during activities if you’re acting Mindlessly Rather than Mindfully (refer to Chapter 5 for more on this distinction).

Activating \lourse(( as an Antidepressant

Withdrawal and inactivity are the two most fundamental Maintaining factors In depression – they keep you in a vicious circle of isolation and low mood. For example, to counteract feelings of fatigue, you may be tempted (very tempted) to spend more time in bed. Unfortunately, remaining in bed means more inactivity and less energy.

If you feel ashamed of being ‘flat’, about having nothing to say, or feel guilty about burdening your friends, then keeping to yourself may seem sensible. The problem is that the less you do and the fewer people you see, the less pleasure and satisfaction you’ll get out of life, the less support you’ll receive, and the more your problems will pile up and weigh heavy on your mind.

Tackling inactivity

One of the best ways of starting to overcome depression is to gradually become more active, to steadily re-engage with other people, and to start tackling daily chores and other problems.

Use the activity schedule in Table 10-1 to start to plan each day with a realistic balance of activities and rest. Build up your activities gradually. If you’ve been in bed for days, getting out of the bedroom and sitting in a chair is a big move in the right direction. Remember: Take it step by step. Using the activity is incredibly simple; it merely involves allocating a specific time to do a specific activity. You can photocopy the blank schedule in Table 10-1 and fill it in.

Don’t overload your activity schedule, otherwise you may feel overwhelmed, sink back into inactivity, and probably berate yourself for being ineffective. It’s crucial to Realistically Plan a gradual increase in activities, starting from where you are Now, Not from where you think you Should Be.

Table 10-1 Activity Schedule

Dealing With the here and noW: Soti/ing problems

As with other aspects of your daily or weekly activities, you need to be steady and systematic in your attempts to deal with practical problems, such as paying bills, writing letters, and completing other tasks that can pile up when you’re less active.

To get started, set aside a specific amount of time each day for dealing with neglected chores. Allocating your time can help things seem more manageable. Try the following problem-solving process:

1. Define your problem.

At the top of a sheet of paper, write down the problems you’re struggling with. For example, you might consider problems with the following:

• Relationships

• Isolation

• Interests and hobbies

• Employment and education

• Financial issues

• Legal issues

• Housing

• Health

Apply the following steps to each of your identified problems. You may need to do Steps 2 through 5 on each of your different problems.

2. Brainstorm solutions to your problem.

Write down all the possible solutions you can think of. Consider the following questions to help you generate some solutions:

• How did you deal with similar problems in the past?

• How have other people coped with similar problems?

• How do you imagine you’d tackle the problem if you weren’t feeling depressed?

• How do you think someone else would approach the problem?

• What resources (such as professionals and voluntary services) can you access for help with your problems?

3. Evaluate your solutions.

Review your ‘brainstormed’ list. Select some of your most realistic seeming solutions, and list the pros and cons of each.

4. Try out a solution.

On the basis of your evaluation of pros and cons, choose a solution to try out.

You can easily feel overwhelmed when your mood is low. Even the best of solutions can seem too difficult. To deal with this, break down your solution into a series of smaller, more manageable steps. For example, if you’re dealing with financial problems, your first step may be to ask friends for a recommended accountant, or to visit a financial consultant in your area. A second step may be to get your tax returns, proof of income, and so on, together. A third step may be selecting an accountant, and contacting them for information about their fees and the services they provide.

5. Review.

After trying out a solution, review how much it has helped you to resolve your problem. Consider whether you need to take further steps, to try another solution, or move on to tackling another problem.

Taking care of yourself and your environment

One of the hallmarks of depression is neglecting yourself and your living environment, which in turn leaves you feeling more depressed.

Instead of allowing your depression to be mirrored in your appearance and your home, make an extra effort to spruce things up. Your environment can have an astounding affect on your mood, both positive and negative.

Include bathing, laundry, tidying, and cleaning as part of your weekly activity schedule.

Getting a Good Night’s Steep

Good night, sleep tight, and don’t let the bedbugs bite!

Sleep disturbance, in one form or another, can often accompanydepression. Here are some tips you can use to improve your chances of greeting the sandman.

Get some exercise. We cannot overstate the benefits of taking regular exercise. Exercise is good for your mood and good for your sleeping. You can take vigorous exercise during the day or even first thing in the morning to get your Endorphins (‘feel good’ chemicals in your brain) charging. If you want to take some exercise in the evenings to help you wind down and de-stress, keep it gentle and not too close to your bedtime. A stroll, or an easy cycle ride, is an ideal choice.

Establish a schedule. Getting up at the same time everyday and avoiding daytime naps can help you get your sleeping back on track. Catnapping may be very tempting, but ultimately it interferes with your bedtime and can actually lower your mood. If you know that you get the urge for a siesta around the same time everyday, make plans to be out of the house at this time. Make yourself busy to keep yourself awake.

Avoid lying in bed awake. If you find dropping off to sleep difficult, don’t lie in bed tossing and turning. Get out of bed and do something – ideally, something boring like sorting laundry or reading a book on something you find dull, drinking something warm and low-in-caffeine, such as milk or cocoa – until you feel ready for sleep. Try to stay up until your eyelids start to feel heavy. The same applies, if you wake in the middle of the night and can’t get back to sleep easily. Don’t stay in bed for longer than ten minutes trying to get back to sleep. Get up and do something like the above ideas, then get back into bed only when you feel sleepy.

Watch your caffeine and stimulant intake. Avoid caffeinated drinks from mid – to late-afternoon. Caffeine can stay in your system for a long time. Remember that as well as tea and coffee, many soft drinks, chocolate (although not so much), and various energy drinks contain caffeine. Even some herbal teas contain stimulants, such as matte and guarana.

Establish a bedtime routine. Going through the same pre-bedtime procedures each night can help your mind realise that it’s getting near to shutdown time. Your routine may include having a warm bath, listening to a soothing radio programme, or having a warm, milky drink, or whatever works for you. Sometimes, having a very light, easily digestible snack before bedtime is a good idea to prevent sleep disturbance associated with going to bed hungry.

Setting realistic sleep expectations

During the day and while you try to fall asleep, you may well have thoughts like ‘I’ll never be able to get to sleep’, or ‘I’m in for another night of waking up every two hours’. Understandably, you may have these expectations if your sleep has been disturbed for some time, but such thinking is likely to perpetuate your sleep disturbance. Be aware of your worrying thoughts about sleep problems, such as ‘I’ll never be able to cope on such little sleep’, or ‘I’ve got to get some sleep tonight’. Trying to force yourself to go to sleep is rarely successful, and doing so contradicts the concept of Relaxation, Because you’re making an Effort To sleep.

Although it may sound like a tall order, try to take the attitude that you Can Cope with very little, or poor-quality, sleep. Also, answer back your sleep expectations by briefly telling yourself that you don’t know for definite how you may sleep tonight and that you’re just going to see how it goes.

Making your bedroom oh so cosy

Your bedroom should be used for sleeping and nothing else, apart from sex. When you’re trying to settle your sleep pattern, you should avoid even reading in bed. The idea is to help your fatigued mind build helpful, sleep-inducing associations with your boudoir. So, you definitely don’t want to be watching telly in bed, working on your laptop, talking on the phone, eating in bed, or any other activity, apart from slumbering or making sweet lurve.

Take care to make your bed and bedroom a relaxing, soothing place to be. Get yourself some very nice bed linen, remove clutter from the room, maybe put out some candles, hang some relaxing pictures on the walls, and make the temperature right for you. Smells can carry strong associations, so consider using a pleasant fabric softener on your linen or a special-purpose pillow spray. Just the smell of a soothing fabric softener on your linen can be enough for you to associate your bed with sleeping.

You can buy several natural essential oils from herbalists and health food shops that are thought to have relaxing properties. Try having an aromatherapy massage, or add essential oils to your bath, heat them in a burner to fragrance your room, or sprinkle them diluted on your bedclothes. You might want to try some of the following oils:

Chamomile Clary sage

Geranium and rose geranium Lavender (always popular)

Palma rosa (also said to be good for depression) Ylang ylang (also claimed to have an aphrodisiac effect)

Always get advice from a qualified herbalist about how to use essential oils correctly and safely. Most good quality health food shops may either have some qualified staff or be able to recommend an herbalist or aromatherapist. Undiluted essential oils are very strong, and you shouldn’t apply them directly

To your skin. If you’re taking medication, are pregnant, or have any allergies or medical conditions, you should always consult your doctor before using any aromatherapy or herbal remedies.

Managing Suicidal Thoughts

The most dangerous element of depression is that the feelings of hopelessness you can experience may become so strong that you try to take your own life. Don’t panic about having suicidal thoughts if you’re depressed. Such thoughts are very common and having them doesn’t necessarily mean that you’ll act on them.

If you’ve been feeling very hopeless about the future and have started to make plans about how to kill yourself, You must immediately seek medical assistance. Go to see your regular doctor as a first point of call, or attend Accident and Emergency (Casualty) if you feel at risk of suicide outside of surgery hours.

Famous and depressed

One of the most crucial aspects of recovering from depression is shedding any feelings of shame that you have about the problem. Something that can help with this is realising that No one Has a guarantee that they won’t get depressed. Depression has affected all kinds of people, from all kinds of walks of life, and from all kind of creeds, colours, and levels of intelligence.

Dozens of famous people have publicly reported or discussed their battles with depression during their lives. Celebrities are now’coming out’ about their suffering from depression or bipolar affective disorder (formerly known as manic depression). We hope that their actions can help to remove the stigma of mental health problems and enable more people to identify and seek help for depression.

Here are just a few famous types who’ve suffered from depression or bipolar affective disorder:

Buzz Aldrin (astronaut)

Ludwig van Beethoven (composer)

William Blake (poet)

Winston Churchill (British Prime Minister)

John Cleese (comedian, actor and writer)

Charles Dickens (writer)

Germaine Greer (writer and journalist)

Spike Milligan (comedian, actor, and writer)

Isaac Newton (physicist)

Mary Shelley (writer)

Vincent Van Gogh (artist)

Lewis Wolpert (embryologist and broadcaster)

Here is some advice on managing suicidal thoughts:

Recognise your feelings of hopelessness about the future as a Symptom Of depression, not a fact.

Remember that depression is a temporary state and there’s lots of ways to treat it. Decide to tackle your depression for, say, six weeks, as an experiment to see whether things can improve.

Tell a friend or family member how you’re feeling.

See a doctor and/or a therapist, or join a support group for further help and support if you’re finding it difficult to overcome your depression alone.

Try instigating the problem-solving process we outline in the previous section in this chapter, for any problem you currently see as hopeless.

5th By Rich Tennant

CL Don’t think the crackling sound coming Јrow your lo\Ker back is as serious as you – thought. Just relax and I’ll have this ‘Rice Krispie Square out Oi Your back pocket in no trnie."

In this part. . .

This is the part that gets physical. Chiropractic, osteopathy, and massage are all very popular complementary therapies, and in the following chapters I tell you all about them and offer advice on how to find a good practitioner.

Delve into this part if you want to know your Alexander technique from your Bowen therapy, and explore body therapies from applied kinesiology to zero balancing.

In This Chapter

^ Translating from the written language to math-speak ^ Putting the operations in their places in the equations ^ Choosing which types of equations and inequalities ^ Doing a reality check with solutions

His chapter contains lots of rules, hints, tidbits, and procedures for you

W To use when changing from the written language to letters — variables that represent the unknown quantity — and operations in the mathematical language. The equations you write are usually quite easy to solve — after you manage to write them.

Changing from words to equations involves identifying what the variables (the X‘s or y’s or Fs) Represent and how to arrange them in an equation. Solving an equation requires algebraic know-how, but, if your equation is nonsense or doesn’t fit the problem, then the answer to the equation will get you no closer to the answer to the problem than you were before you started.

You’ll see how sometimes more than one option exists for writing an equation. Sometimes one way is better than another. Other times it makes no difference which format you use. And, unfortunately, you’ll see that some problems are just unsolvable — no method or means will ever answer the question.

This chapter also allows me to cover some word-problem topics that just don’t seem to fit anywhere else. You can call this the miscellaneous chapter — it contains word problems that you’re likely to come across but that don’t have any particular place with all the others. These problems are great for illustrating some more of the techniques that are helpful when solving math word problems.

Assigning the Variable

When translating from the written language to an algebraic equation, one rule that absolutely must be followed is that the variable (letter) that you choose to solve for in the equation has to represent a number. The letter X Might represent Jack’s age or the number of chickens in the yard, but the X Can’t represent Jack or the chickens themselves. Getting past this hurdle (of assigning the variable to be a number) sets you off on the right track toward solving an equation and answering a question.

After you’ve solved an equation for the value of the variable, then you either have the answer directly or you may have to do some additional steps to completely answer the question that’s been posed.

Getting the answer directly from the variable

It’s always nicest to have the answer just plopped in your lap as soon as you come up with the solution to an equation. It isn’t always possible to easily create equations that behave this way, but, when you can, take advantage of the situation.

The Problem: Ken, Kyle, and Keith worked on a project and kept track of how much time each spent. They determined that the total was 48 hours. Keith worked 3 hours longer than Ken, and Kyle worked 9 hours less than Keith. How many hours did Ken work?

To have this problem work out so that the solution of the equation is the answer of the question, you let the variable represent the number of hours that Ken worked. Then you write the number of hours that Kyle and Keith worked in terms of Ken’s hours. If you let X Represent the number of hours that Ken worked, then X + 3 represents the number of hours that Keith worked. Using Keith’s hours, you write that the number of hours that Kyle worked is X + 3 – 9 = X - 6 hours. The total number of hours is 48, so X + (x + 3) + (x – 6) = 48. Simplifying on the left, you get 3x – 3 = 48. Add 3 to each side, and the equation becomes 3x = 51. Dividing by 3, X = 17. So Ken worked for 17 hours. To check the answer, just figure out how many hours Keith and Kyle worked, and see if the sum is 48. Keith worked three hours longer than Ken, so Keith worked for 20 hours. Kyle worked nine hours less than Keith, so he worked for 11 hours. The men worked for 17 + 20 + 11 hours which is, indeed, 48 hours.

The Problem: It cost $12 for a man to drive his van to work every day, but he had passengers, so he divided this cost equally among the passengers and himself. After a few weeks, two more passengers were added, which reduced everyone’s cost by $1 per day. How many people are now riding in the van?

Look at the last sentence and the final question: "How many people. . . ?" To have the solution of the equation come out to be the final answer, you let the variable, X, Be equal to the number of passengers now riding in the van. The cost per person now is $1 less than it used to be, so the equation you write will be something to the effect that $12 divided by the number of riders now is equal to $1 less than $12 divided by the number of riders that there used to be. Math speak is much easier to write: $12.00 $12.00

Number now in van number used to be in van

$1.00 becomes

$12.00 $12.00

- = -

X x — 2

$1.00 when you let X Be the number in the van now and

Let X - 2 be the number who used to ride to work. To solve this equation, multiply each term in the equation (even the 1) by the common denominator of the fractions, X(x - 2), and then solve the quadratic equation that results.

12

X

12

X (x — 2):

12

X — 2

12

1

X——2

12 (X — 2) = 12x — X (x — 2) 12x — 24 = 12x — X2 + 2x

12X—24 =14X—x2 —2X—24=0

X A X—2 K — 1 X X (x — 2)

Factoring the quadratic, you get that X = 6 or X = -4.

X2—2X—24

(X — 6)(X + 4 ) = X

0 0

6or X

Fly away fly

I’m sitting at a table, and 12 flies land in front of me. I use a fly swatter and smash 4 flies. How many remain on the table?

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Only the positive value makes sense — you can’t have a negative number of people. If X = 6, then that’s the number of people now in the van. Dividing the $12 by 6, each person is paying $2. There used to be only X - 2 or 4 people in the van. Each paid $3 then, or $1 more than now.

Adding a step to get the answer

It’s not always convenient or easy to write your equation so that the variable is equal to the answer. Sometimes you have to write an equation that makes sense, and then figure out the answer to the question from the solution of the equation that you construct and solve.

The Problem: A landlord wants to have a total of $42,000 income from the monthly rents in his apartment complex. Right now, he gets $400 per month for each of his 100 apartments, giving him a total of $40,000. For every $20 he raises the rent, he loses three tenants who don’t want to pay the higher rent. He will get more income, to offset the vacant apartments, but he can’t raise the rent too high, or he’ll lose too much money. What should he charge per unit to get to that goal of $42,000?

^VLA/V You compute the total amount of the money collected by multiplying the rent charged per apartment times the number of apartments. The amount of rent and the number of apartments keep changing, depending on how many times he raises the rent by $20. So let X Represent the number of $20 increases he adds to the rent of $400. This way, the rent per unit is written as 400 + 20x. For every $20 increase, the number of tenants is going to decrease by three. Write the number of apartments that will be paying rent as 100 – 3X. You write the income from rents as the money charged times the number of units, so now you can write an equation setting the total rent money goal of $42,000 equal to the new rent amount, 400 + 20X, Times the new number of apartments being rented, 100 – 3X.

42,000 = (400 + 20X)(100 – 3X)

Multiplying the binomials on the right and combining terms, you get a quadratic equation that is solved by setting everything equal to 0 and factoring.

42,000 = (400 + 20x )(100 — 3x) 42,000 = 40,000 + 800x — 60×2 60×2 — 800x + 2000 = 0 20 _3x2 — 40 + 100) = 0 20 (3x — 10)( X — 10) = 0

Making an interesting purchase

A man went to a hardware store and found out, from the clerk, that it costs $3 for 600, which meant that each part cost $1. How much does it cost for 601?

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The solution of the quadratic equation results in two different numbers, X = -3

And X = 10. You check the solutions to see if either one or both work to answer the question.

The landlord wants. The main problem with this answer is that the amount charged per apartment is a fraction that can’t be changed into an exact number of cents. Rounding the rent amount to $467 or even $470 would make sense, resulting in just a little more total income than the $42,000.

Trying the other solution of the quadratic equation, when X = 10, then the rent charged is (400 + 20 X 10) = 400 + 200 = 600, and the number of apartments that will be rented is (100 – 3 X 10) = 100 – 30 = 70 apartments. Multiplying the rent of $600 times 70 you get exactly $42,000. The rent is higher, but fewer apartments will be occupied. That would probably cut down on the cost of maintenance and upkeep, but there are a lot of vacant apartments. Now it’s up to the landlord (and his conscience).

Writing Operations and Using Sentence Structure

Many hints, clues, and downright instructions are available from the wording of math problems. When the problem talks about a Total Or Increase Or uses the word Altogether, The operation of addition is suggested. You look for a

Subtraction problem when Decrease Or Less Or How many left Are part of the problem description. Multiplication is suggested with Twice Or Times Or the obvious Multiply. And the word Half Can create a division problem or a multiplication problem, depending on how you want to handle the computations. In general, you try to replace the verbs Is And Are With an equal sign, and you align the different expressions created for the equation on either side of the equal sign, in the same positions as the words they came from on either side of the verb.

Making the most of addition

Problems involving addition are nice in several respects:

E* They’re fairly easy to spot, and the expressions to algebra translations are usually straightforward.

E* The terms in addition problems are reversible, because addition is Commutative (you can add two terms in either order and get the same answer).

E The equations that you create are relatively easy to solve.

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The Problem: A service club is selling Super Bowl coffee mugs for a fundraiser. The setup charge for creating the design that goes on the mugs is a flat $75. The mugs will cost the club 90<t each if they order no more than 200 mugs, 85<t each if they order between 201 and 500 mugs, and 80<t each if they order more than 500 mugs. What is the total cost for 100 mugs, 300 mugs, and 1,000 mugs?

A Cost function Or equation consists of the Fixed Part and the Variable Part. Each of the three cost schedules in this problem has a fixed cost of $75, but the variable part changes, depending on the number of mugs ordered. An efficient way of writing the equations in this problem is to use a Piecewise Function, which lists each rule and the input associated with each. The C In this function represents the total cost, and the X Represents the number of mugs.

C (x )■

75 + 0.90x if X < 200

75 + 0.85x if 201 < x < 500

75 + 0.80x if X > 500

Use the top rule to determine the total cost of 100 mugs. C(100) = 75 + 0.90(100) = 75 + 90 = 165. Use the middle rule for 300 mugs. C(300) = 75 + 0.85(300) = 75 + 255 = 330. And the bottom rule works for finding the total cost of 1,000 mugs. C(1,000) = 75 + 0.80(1,000) = 75 + 800 = 875.

Oranges in a crate

There are 24 oranges in a crate, and there are you have to still have an orange left in the crate. 24 people in the room. You need to distribute the How can you do this? oranges so that everyone gets one orange, but

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Subtracting and multiplying solutions

The word Less Implies subtraction. You can even make a case for More Indicating subtraction, although addition is usually an easier way to go with those problems. In any case, be careful when you write the algebra indicating subtraction. The terms need to be in the correct order. Subtraction is not Commutative. The order that you subtract numbers makes a huge difference. When multiplying shows up in a word problem, it’s often an outright instruction to multiply by two or three or one-half. Otherwise, it may be disguised as Twice Or Thrice. The next problem has a little of each of these operations.

The Problem: The number of boys in a high school senior class is ten less than twice the number of girls. Also, six fewer than half the students in the class have cars. If 202 students own cars, then how many boys are in the class?

Write an equation letting X Represent the number of girls. You can solve for the number of boys (to answer the question) after solving the equation for X. The number of boys is represented by 2x – 10, which is ten less than twice the number of girls. Note the order of the subtraction. Next, write the total

Number of students as girls plus boys: X + 2x – 10. Multiply the total by >2 and subtract 6. Set that expression equal to 202. Then simplify the equation and solve for X.

2 [ X + 2x — 10] — 6 = 202

2 [ X + 2x — 10] = 208 X + 2x — 10 = 416 3X —10 =416 3X = 426 X = 142

The solution X = 142 tells you that there are 142 girls in the class. The number of boys is ten less than twice that, so 2(142) – 10 = 284 – 10 = 274 boys.

Dividing and conquering

You use division in problems when you want to break some total amount of stuff into equal shares. After setting up the division problem, though, the best course of action for solving the equation is usually to get rid of the division operation. Do this by multiplying each term in the equation by some common denominator; then solve the simpler equation that’s been created.

The Problem: A man bought two apartment buildings for $210,000 apiece. If there are a total of ten apartments in the two buildings, and if the apartments in one of the buildings cost $40,000 more than the apartments in the other building, then what did he pay for the apartments in the two buildings?

,?UAiV Assume that each apartment in a building costs the same amount. You determine the cost of one apartment in the building by dividing $210,000 by the number of apartments. Let X Represent the number of apartments in one of the buildings. Then, since the total number of apartments in the two buildings is 10, you write the number of apartments in that building as 10 – X. Divide 210,000 by X On one side of the equation. On the other side of the equation, divide 210,000 by 10 – X And add 40,000 to the result to show that the first apartments are $40,000 more.

210,000 210,000 ,AAAA

-x-= TrT-+ 40,000

X 10 — X

Multiply each term by the common denominator, x(10 – x).

210,000 /1A, 210,000 /1A, ,AAAA /1A, —x— x X (10 — X) = 10 — X x x (10 — X) + 40,000 X X (10 — X)

210,000 210,000

-t— X X(10 — X) = ‘ ^ x x (10—x) + 40,000 X X (10 — X)

210,000 (10 — X) = 210,000x + 40,000x (10 — X)

Before multiplying out and simplifying the terms, make life easier for yourself by dividing each term by 10,000. You don’t want to work with such huge numbers. Then set the equation equal to 0, factor, and solve for X.

21(10 — X) = 21x + 4x (10 — X) 210 — 21x = 21x + 40x — 4×2 4×2 — 82x + 210 = 0 2 (2×2 — 41x + 105) = 0 2 (2x — 35)( X — 3) = 0

The two solutions of the quadratic equation are X = ^ And X = 3. The first

Solution is equal to 17.5 which makes no sense — there are only ten apartments. So discard that solution. When X = 3, though, you get that one

Apartment building has three apartments costing $210,000 3 = $70,000 each. The other apartment building has $210,000 7 = $30,000 each. The more expensive apartments are $40,000 more than the less expensive apartments.

Tackling an earlier problem

In Chapter 10, I suggest that you can solve for the base and height of a triangle if you’re given enough information. Just having the area of a triangle doesn’t tell you the length of the base or the height, you need to know one or the other measure, or you need to know something about how the measures relate to one another.

The Problem: The area of a triangle is 20 square inches, and the base is 6 inches longer than the height. What are the measures of the base and height?

V£.?LA/v Use the formula for the area of a triangle, and write the base and height, B And H, In terms of one or the other of the variables. If you let H Represent the height, then the base is written as 6+h. (If you had chosen to use B Instead of H, You’d represent the height with B - 6.) Now let the area, A, Be equal to 20 and solve for H.

4)

The solutions of the quadratic equation are H = -10 and H = 4. The negative answer doesn’t really make sense in the measure of a triangle, so you go with the height being 4 inches. The base is 6 inches longer than the height, so it measures 4 + 6 = 10 inches.

Solving for Answers from Algebraic Solutions

When algebraic equations or inequalities are used to find the answer to a question or problem, you write the equation or inequality carefully, you solve the algebraic equation or inequality using all the correct rules, and then you check to be sure that the solution from the algebra really answers the question that’s been posed.

Comparing the types of algebraic expressions

Many different types of equations and inequalities are used to solve math word problems. Each type has its own methods for solution, and many have some quirks to watch out for when solving. Here are some more frequently used equations and inequalities:

Linear equations: Ax + B = C, With one possible solution

Quadratic equations: Ax2 + Bx + C = 0, with two solutions

Rational (proportions) equations: A = b, with one solution

Absolute value linear equations: I Ax + B I = C, With two solutions

Linear inequalities: Ax + B > C Or Ax + B < C, With infinite solutions

Systems of linear equations: Ax + By = C And afx + Ey = /, with one possible solution (see Chapter 17)

Using linear equations ax + b = c to find answers

The variable, X, In a linear equation has an exponent of 1. That’s why you’ll only get one solution from these equations. You solve the equation by isolating the variable on one side of the equation.

The Problem: A realty manager gets a base salary of $4,000 per month plus 3 percent of whatever his agents earn in commissions. In February, the manager had total earnings of $11,050. What did his agents earn in commissions?

The equation used to determine the manager’s salary any month is T(x) = 4,000 + 0.03x, where T Is the total earnings by the manager, and X Is the amount of commissions earned by his agents. Substituting in the values you know, the equation becomes 11,050 = 4000 + 0.03x. Subtract 4,000 from each side to get 7,050 = 0.03x. Now divide each side by 0.03, and X = $235,000.

Quibbling over quadratic solutions to answer questions

Quadratic equations can, and often do, provide two completely different solutions. Sometimes both solutions work in the problem. Other times only one or even neither works. You need to check to determine which situation applies in each case. (Refer to "Checking to see if a solution is an answer" later in this section for more on the checking.)

The Problem: If you add 5 to a number and multiply that by what you get if you subtract 4 from the same number, then the answer is 36. What is the number?

Let the number be represented by X. Adding 5 gives you X + 5, and subtracting 4 is written X - 4. Multiplying (x + 5)(x - 4) and setting the product equal to 36, you get a quadratic equation that’s solved by setting everything equal to 0 and solved by factoring.

(x + 5)(X – 4) = 36 X2 + X – 20 = 36

X2+x-56 =0

(x + 8)(X – 7) = 0

The two solutions you get are X = -8 and X = 7. Letting X = -8, the number you get when you add 5 is -3. Subtracting 4 from -8, you get -12. The product (-3)(-12) = 36. So -8 is an answer. Checking on X = 7, (7 + 5)(7 – 4) = (12)(3) = 36. Both answers work.

Rationalizing with rational equations

A rational equation has one or more fractions in it — usually with the variable appearing in more than one numerator or denominator. In the "Dividing and conquering" section, earlier in this chapter, you see how to clear the equation of fractions by multiplying everything by the common denominator. Another type of rational equation is one in which you have two fractions set equal to one another. This is called a Proportion. (Refer to Chapter 7 for a full description of what you can do with proportions.) One of the nicest features of proportions is that their cross products are always equal.

The Problem: In an orchard, it requires 3 workers for every 16 trees to keep them pruned and cared for during the summer. How many trees could be tended by 40 workers?

Write a proportion in which one fraction is 3 divided by 16 and the other fraction is 40 divided by X. This keeps the number of workers across from a number of workers, in the numerators, and trees across from trees, in the denominators. Then cross-multiply and solve for X.

_3_ = 40 16 X

3X = 640

X = 630 = 2133 33

A worker isn’t going to take care of a fraction of a tree, so the best answer is probably 213 trees.

Being absolutely sure with absolute value

The absolute value operation I AI takes the number A And measures its distance from 0. Another way of putting this is that the absolute value of any number is positive. So I3I = +3 and I-3I = +3. When solving absolute-value equations, you have to take into account the fact that what’s inside the operation could be either positive or negative, so there could be more than one answer.

The Problem: Mike’s salary and Matt’s salary differ by $10,000. If Mike makes $165,000, then what does Matt make?

You aren’t told if Matt makes more or less than Mike. Letting Matt’s salary be represented by X, You write the absolute value equation I X - 165,000I = 10,000. Solve two different linear equations. One equation assumes that the result in the absolute value operation is positive, and the other assumes that it’s negative. The first equation is written X - 165,000 = 10,000. Solving for X, You get X = 175,000. The other equation is formed by negating the expression inside the absolute value. You get -(x – 165,000) = 10,000 which becomes – x + 165,000 = 10,000. Subtract 165,000 from each side and divide by -1, and you get X = 155,000. So Matt makes either $175,000 or $155,000.

Lingering a while with linear inequalities

Linear inequalities are solved using almost all the same rules as those you use with linear equations. The one big exception is that when you multiply or divide each side of the inequality by a negative number, you have to switch the sign around from > to < or vice versa.

The Problem: Jennifer has grades of 87, 95, 99, 83, and 100 on her first five exams. What does she have to get on her next exam to end up with an average of at least 92 on all six exams?

Fickle friend

It’s found in Minnesota, but Wisconsin it will always into me. With anything so fickle, what, avoid. It’s always in the timber, but not in woods, oh what then can it be? so they’re annoyed. It’s never into you, but it’s

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^VLA* An average of 92 on all six exams means that the total number of points has to be at least 92 X 6 = 552 points. Let X Represent the next test grade and solve the inequality: 87 + 95 + 99 + 83 + 100 + X > 552. Simplify on the left by adding up the tests to get 464 + X > 552. Subtract 464 from each side, and you get X > 88. Jennifer has to get a score of 88 or better to have a minimum average of 92.

Checking to see if a solution is an answer

You get that feeling of satisfaction when an algebraic equation or inequality works out and you get one or more solutions. The next step in word problems is then, of course, to see if the solution of the equation or inequality is an answer to the problem. If the solution doesn’t work, then you go back to see if you’ve done some miscomputation. But sometimes, no amount of good mathematics is going to get you an answer. It could be that the question just doesn’t have an answer.

Several problems in this chapter illustrate how there can be two answers that work or just one of two solutions that works for an answer. How can it possibly be that there is no answer?

The Problem: Ted and Jeff were comparing how many Christmas gifts they got. If Ted got 10 less than 3 times as many as Jeff, and if the total number of gifts they got is equal to the number of Jeff’s gifts minus 13, then how many gifts did they each get?

Vjf.VLA/y Let the number of gifts that Jeff got be X. Then Ted got 3x – 10 gifts. Add the two numbers of gifts together and set it equal to X - 13. So the equation to solve is X + 3X - 10 = X - 13. Simplifying, you get 4X - 10 = X - 13. Subtract X From each side and add 10 to each side, and the equation becomes 3X = -3. Dividing each side by 3, you get X = -1. Oops! How can Jeff get a negative number of gifts? The equation accurately represents the problem that’s presented. It’s just that the problem posed is impossible. There’s no answer to the problem, even though the equation has a solution.

Chapter 14

In This Chapter

► Utilizing self-massage

► Following a self-massage mini-routine

► Recognizing carpal tunnel syndrome

Mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm

L^ou’re not always going to be able to convince somebody else to give you Jr A massage. Like it or not, at times you’ll be sore, achy, tired, emotionally ^needy, and just plain crying out for a massage, but the people around you will be much more interested in the football game on TV, or in going to lunch.

Don’t despair. There are some simple massage techniques that you can use on yourself, without the need for anyone else’s participation — or sympathy. And, coincidentally, those very techniques appear in this chapter!

These moves work equally as well at home, of course, but I’m including them here in the massag&at-work section because that’s where so many people end up all stressed-out, with no outlets to relax. Sure, you can stand up in your cubicle and sing the Frank Sinatra tune, "I did it My Way," to take a slight edge off the tension, but wouldn’t quietly engaging in a few self-massage techniques be easier — and a little more discreet?

Some of these moves not only feel good, but can actually make quite a difference in your productivity level, which should make your boss happy, too. The techniques to fight carpal tunnel syndrome, for instance, can help keep you tapping away at the computer for years, and spare your company some expensive worker’s comp bills at the same time.

So, limber up those fingers (use the massage-muscle building tips from Chapter 10 if you’d like) and get ready for a treatment from one of the most talented, and reliable, massage masters around — you.

Setf-Massage: The Basics

Say you’re sitting at your desk. Your neck is killing you, but you don’t want to ask a co-worker to massage it because the other people in your office may get nervous, jealous, or both. What’re you gonna do? Well, you can grab that nifty massage gizmo that you have stashed in your bottom drawer, but it makes a loud, buzzing noise. Instead, sitting right there in your chair, you can give yourself an entire mini-massage, get some good relief, and be relatively discreet.

Self-massage is as easy as following a few simple guidelines. Don’t stress the rest of your body out while trying to relax one spot. Use correct Body mechanics (see Chapter 10) while applying self-massage moves, just as you do for partner massage. Here are the basic rules for self-massage:

I I> Keep breathing: This rule holds true whether you’re massaging a part-I ner or yourself.

I Focus on the sore spots that you find and be willing to experience a I Little "pleasurable pain": At the same time, don’t overdo it — self -

Iinflicted, black-and-blue marks are hard to explain. Be intuitive: Nobody knows better than you where that tight spot is. Using the routine in this chapter as a mere template; follow your own inner guidance.

Setf-Massage Mini-Routine

Keeping the points from the preceding section in mind, you can move straight into„a ten-minute mini-routine right at your desk. If you’re at home, you can do this on a sofa or a stool just as easily as you can on your chair at work. In fact, you can do this routine anywhere you can sit down, although you may look a little funny massaging your own feet on a city bus.

Irrigate your head

One of the biggest causes for all of your problems, whether you know it or not, is a non-irrigated head. Think about it. All day long you’re walking or standing or sitting, and your head is the highest point on your body. Your heart has to pump the blood against gravity to supply your brain, which can leave you feeling foggy-headed at times. Have you ever experienced that in the middle of a long day at work? Why not help your brain stay sharp by irrigating it with extra oxygen-rich blood?

A great way to start the self-massage routine is to simply lean forward in your chair, getting your head somewhere in the vicinity of your knees. Keep your feet flat on the ground and clasp your hands behind your back, as shown in Figure 13-1. If you feel limber enough, raise your hands up toward the ceiling for a nice stretch.

Figure 13-1:

To start the self-massage, lean forward In your chair and bring some fresh blood to your brain.

Stretch your arms and upper back

Sitting upright once again, continue your warm-up by reaching across your body with one arm and grasping it at the elbow with the opposite hand. Pull the elbow in against your chest (see Figure 13-2), which should create a stretching sensation across your shoulder. If you don’t feel a stretching sensation, either you’re super-limber, or you’re not pulling on the elbow firmly enough.

Repeat with the other arm.

Reach around to the back of your neck this time, grasp your elbow once again and pull to the opposite side (as shown in Figure 13-3), which stretches your upper arm and further opens your shoulder joint. For an extra stretch, bend toward the side you’re pulling with at the same time.

Repeat with the other arm.

Figure 13-2:

Sitting up straight again, reach across your body to stretch the shoulder and upper back.

Figure 13-3:

With one hand behind your head, raise the elbow, grasp it with the opposite hand, and pull for another stretch.

Massage your temples, face, andjauf

Time to start the actual massage moves. Reach up and apply circular rubbing — see Chapter 10 — to your temples, as Figure 13-4a shows. This move is a good way to combat tension headaches. Make your circles slow, deliberate, and firm, staying in contact with one area on the skin while you move over the bones below.

Sliding your fingers up on to your forehead, continue the circular rubbing until your fingers meet in the middle above the nose (see Figure 13-4b). Then push in with the fingertips and glide back toward the temples again, keeping firm pressure against the skin the whole time. Repeat two more times.

You may be surprised at how much tension gets lodged in your jaw muscles. Tension hides out there like an enemy soldier wearing camouflage gear, especially while you’re sitting at your desk, straining forward to concentrate on the computer screen. With the proper pressure and sensitivity, you can flush this tension out.

Using your fingertips, press in at the angle of your jaw, and while you’re pressing, open and close your mouth slightly, which allows you to find the exact point that feels like it’s holding the most tension. Apply slow deep circular rubbing to that spot, plus a little pinpoint pressure (both moves are described in Chapter 10), until you feel your jaw start to relax and drop (see Figure 13-4c).

Use enough pressure with these moves to sink your fingers into the jaw muscles slightly but not so much that you feel pain. Be careful; the jaw’s a sensitive area.

Using your thumbs, "hook" them in to press up against the bone just beneath your eyebrow, right next to your nose, as shown in Figure 13-4d. This is another good headache point. Hold the pressure for about 5 seconds.

Figure 13-4:

Massaging all around the face.

218 Part ,V: Massase at Work •_

Rub that neck

Reach around to the back of your neck with both hands and hook your thumbs up under the base of the skull (see Figure 13-5a). Press in firmly and hold for 5 to 10 seconds. This move alone should leave you feeling more alert and relaxed.

Now drop your head forward and pick a hand, any hand (probably your dominant one), to perform kneading on the back of your neck as you see in Figure 13-5b. Squeeze from the base of your neck up to your head and then back down again. Repeat twice.

Turn your head to the left and reach across with your left hand to knead atop your right shoulder and up onto your neck, using your thumb to press into any knots you find along the way (see Figure 13-5c). This move also provides a good stretch for your neck. Repeat on the opposite side.

Squeeze your arms and hands

Starting at your shoulder, begin squeezing down your arm, as shown in Figure 13-6. When you reach a tender spot, hook your thumb in and hold for a moment. Stop when you reach your wrist, glide lightly back up to your shoulder, and repeat one more time.

Repeat on the opposite arm.

Pinch the webbing between your thumb and forefinger of your opposite hand (see Figure 13-7). Hold for 5 to 7 seconds. This spot may be quite sensitive. You can also do some coin rubbing on the fingers, circular rubbing on the wrists, and-any of the other moves featured in the hand massage section of Chapter 11 —modified, of course, to be performed by one hand on yourself.

Figure 13-5:

Getting rid of that pain in your neck.

Massage your (outer back

Scoot forward to the front of your chair and reach around to your lower back. Using your thumbs, press into several points along the muscles beside your spine (see Figure 13-8). Then lift and press onto the base of your spine (the sacrum) itself, hitting several more points. You can also use your knuckles quite effectively in this area by balling your hand up into a fist and "rolling" it over the area.

Figure 13-6:

Squeeze down your arm from shoulder to wrist.

Figure 13-7:

Press firmly with your thumb. This spot sometimes helps relieve headaches.

Squeeze your tegs

Bring one foot up onto your knee and use both hands to squeeze down all the way from your upper thigh, across the knee, and to your ankle, pressing in with your thumbs along an imaginary line down the inside of your leg. (See Figure 13-9).

Figure 13-9:

Bend one leg and place your foot on your opposite knee to massage down your leg.

If you’re in an area where you can take your shoes off, by all means do so and apply as many of the foot massage moves from Chapter 14 as you can.

When you finish the self-massage mini-routine, take a couple of deep, relaxing breaths (see the "Breathing lesson" sidebar in Chapter 7) before you dive into whatever activity you have lined up next.

222 Part ,V: Massa9e atWork

Why massaging yourself feels different

You may notice that even when you apply self-massage techniques with an incredible amount of verve and enthusiasm, they still don’t feel quite as good as when somebody else applies the very same moves on the very same parts of your body. But why?

The reason is simple. Massage, like tickling (you can’t do that very well to yourself either), is primarily a social interaction. Studies (yes, actual tickle studies by serious researchers) have shown that preschool children couldn’t be

Tickled when they were in a bad mood or by someone whom they didn’t like. They were poked in the ribs and brushed on their feet, but the reaction was completely negative. It seems that tickling is as much about relationship and context as it is about contact. And so it is with massage. A large part of the enjoyment of a massage is the social interaction with another person, which actually causes the sensations to feel different.

Carpal Tunnel Syndrome (CTS)

YouVe probably heard the phrase Carpal tunnel syndrome (CTS for short), and you know it has something to do with pain in the hand and wrist area, right? That’s the "syndrome" part of the phrase. But what is the carpal tunnel anyway? An underground passage for carp? A tube running through your hand somewhere? No, the carpal tunnel is actually an area in your wrist, surrounded on three sides by the little bones of the hands (carpal bones) and on one side by the transverse carpal ligament, as shown in Figure 13-10. Several tendons pass through this "tunnel," along with the Median nerve, A very important nerve that supplies sensation and action to most of your hand.

Inflammation or swelling of the tendons and tissues that surround the median nerve can compress it within the carpal tunnel’s constricted space. This decidedly un-fun experience can cause pain, numbness, tingling, burning, and loss of hand strength, amongst other problems. Repeating the same wrist-intensive activity, such as typing on a computer keyboard, over and over and over again, triggers this inflammation.

Compression of the median nerve was recognized as a problem as far back as 1854; in 1947, Dr. George Phalen made his first diagnosis of "carpal tunnel syndrome." Today, this condition debilitates people at an alarming rate. It now affects approximately ten percent of all workers who engage in repetitive activities with their hands.

Da you fuu/e CTS)

If you’ve been experiencing some funky sensations in your own hands and arms lately, don’t panic. You may just have some normal aches and pains caused by overwork. A nice vacation and some well deserved wrist-rest will put you right back in shape. However, CTS is not something to take lightly. Many people end up having to undergo surgery, endure considerable pain, and lose valuable time at work because of this condition.

As with any health problem, early detection is the key to effective treatment. If you notice any of the symptoms in the following bulleted list, immediately seek medical advice, in addition to trying the exercises and massage techniques in this section:

You wake up in the middle of the night or first thing in the morning with numbness, tingling, and an achy feeling in your hands.

V0 Your little finger seems to be unaffected while the rest of your fingers experience pain and numbness.

You begin losing strength in your hands: Your grip becomes weak; you begin dropping things.

I \^ You experience pains shooting down your forearms.

M X* Your hands and wrists become swollen.

^MEfy One way to test yourself for CTS is to take Phalen’s test, Which is quite easy to

/ rxi. KJ \ Without force — for 60 seconds (see Figure 13-11). Any numbness, tingling, or pain, indicates a positive test, and you should seek a physician’s opinion.

Figure 13-11:

Phalen’s test for CTS. The backs of

Your hands are together,

But without pressure, for

60 seconds.

What you can do about CTS

At first, you don’t have to do much to combat CTS. Simply shaking out your hands vigorously relieves the initial numbness or tingling. But the pain can progress to a point that makes your work unpleasant or even impossible. (CTS is not uncommon, by the way, in massage pros who’re using their hands all day in quite intensive ways.)

The best strategy at this early stage is, of course, to stop doing what’s causing the pain. However, because your pain-causing activity is often your money-making activity as well, the pain is often overruled. If you must continue the activity, you can do several things to try and improve the situation. Just one or a combination of the suggestions listed here may help you:

Take breaks: Even short breaks during the work day help relieve the repetitive stresses you’re putting on your hands.

Get ergonomic: Make sure that your wrists are as straight as possible while working and that your back is upright. Use wrist rests for your keyboard and mouse. Don’t press weight onto your wrists while working.

Immobilize it: Use inexpensive splints and braces (available in drug and medical supply stores) to immobilize your wrist while working and even while sleeping.

^ Ice your wrist: An ice pack on your wrist helps reduce the inflammation of tendons and tissues in your carpal tunnel.

Apply heat: Heat helps soothe tightened muscles in your upper arms, shoulders, and neck that often accompany CTS.

V0 Seek treatment

• Chiropractic: Spinal adjustments may help relieve pressure on the nerves of your arm and hand, reducing pain.

• Acupuncture: This therapy balances the entire system and may help heal the injured nerve.

• Ultrasound: High-frequency sound waves may help relieve pain and inflammation.

• Physical therapy: Physical therapy includes many types of therapy that can help rehabilitate the wrist area after treatment.

• Massage therapy: Certain massage therapists are experts in CTS relief.

• Homeopathy: Some good anti-inflammatory ointments and creams are available that can be used alone or in conjunction with any of the other treatments. Homeopathy utilizes minute amounts of a remedy that would cause symptoms (in this case inflammation) in a healthy person.

• Surgery: Surgery involves cutting (and sometimes severing) the transverse carpal ligament that surrounds your wrist, which is a pretty dramatic step to take. Pressure is taken off the median nerve, and eventually scar tissue grows in to fill the gap. Sometimes, in later stages, it’s the only thing that will help. But then you run the risk of re-experiencing the pain as the scar heals and the tissues tighten around the carpal tunnel once again.

I> Use the exercises and self-massage techniques in this section.

Exercise and setf-massage for CTS

The following are simple techniques that are meant to help, not cure, CTS. Remember, always seek the advice of a physician when treating any serious health problem.

If you want some up-to-date information on CTS, visit Www. sechrest. com/ mmg/cts/ctsi ntro. html, where you can even view an animation of what CTS surgeries look like.

Chinese exercise hafts

Steve Chagnon, a massage therapist who studied in China and the U. S., has developed a treatment program for CTS sufferers, and he offers a simple approach for people who want something they can do for themselves. According to him, Chinese exercise balls are an effective, consistent way to treat this situation.

Chinese exercise balls are inexpensive and widely available in department stores, specialty shops, and Chinese grocery stores. They’re a little smaller than a golf ball, and they come in pairs. To use them, you put them both in one palm and rotate them around each other, using only the one hand to create the movement (see Figure 13-12).

Most squeeze-gizmos get all your muscles flexing and extending at the same time, but with the exercise balls you’re only flexing one muscle at a time, in rotation, which helps to pump your lymph fluids. Traditionally, the exercise balls are said to stimulate reflex points in the palm, but this lymph-pumping action is a more important factor in addressing CTS, according to Chagnon, who believes that a build-up of lymph fluids in the wrist area is a major contributing factor to the condition (see the explanation of the lymph system in Chapter 1).

Just using the exercise balls five minutes a day will help. You may want to keep them nearby and pick them up during computer downloads or while booting up. Warming up your arm and hand muscles in this way at the beginning of a work session is especially important.

Easy way to relieve some CTS pain.

Figure 13-12:

Using the Chinese exercise balls is a

Quick and

Self-massage for lymphatic drainage

"Once you realize how it works," states Chagnon, "CTS can be looked at as a plumbing problem with the lymph fluids." Since 60 percent of lymph flow is in the top % inch of your skin, all massage moves lymph. His technique, called Specific lymphatic massage Clears superficial tissues of excess lymph fluids and in doing so reduces the volume of lymph fluids in the extremities as well.

When your hand and wrist hurt, the natural tendency is to start massaging at the site of the pain, but starting at the "lymph drain" (a point just under your right collar bone where your lymph empties back into your circulatory system) and working your way back along to the problem is actually more effective. Leave direct manipulations of your painful wrist to a massage pro instead of jabbing in there yourself, no matter how tempting it is.

Ft

Although you’re working far from the painful area itself, this move helps unclog the main lymphatic drain where it all dumps out into the circulatory system at the junction of the Subclavian vein And jugular vein. Lymph drainage massage in this area reduces hydraulic pressure on all the tissues down the arm into the wrist and carpal tunnel.

Using very light pressure (about the amount you feel when a nickel rests on your skin), lay your hand on the opposite side of your chest with your palm down and your fingers alongside the lower edge of your collar bone. Then slide your skin up over your collar bone with a very short stroke of only % to % inch long (see Figure 13-13). Continue with this move for about 5 minutes on whichever side of your body is affected or 5 minutes on each side if you’re experiencing pain in both of your hands. Then you may want to drink a glass or two of pure water to help flush your system of toxins.

Figure 13-13:

A light pressure on the skin up over your collar bone helps drain lymph from the arm, improving CTS.

Just this one move itself will offer some relief by beginning to drain lymph from the area. For more information on the technique, visit Chagnon’s Web

Siteatwww.carpaltunnelmassage. com.

Another technique you can use is some self-kneading on your forearm, as shown in Figure 13-14. Overuse of the muscles in this area can be a main contributing factor to CTS, and releasing some of the tension there may help reduce pain.

Figure 13-14:

Kneading on your forearm loosens muscles and aids circulation.

Chapter 14