sweet cat

Brain-training games stop depression before it starts

It may be possible to stave off depression before it even appears using brain-training software so simplistic in its design that even the psychologist testing it once bet it wouldn't work.

Ian Gotlib's group at Stanford University, California, studies girls aged 10 to 14 years whose mothers suffer from depression. Such girls are thought to be at higher-than-normal risk of developing the condition themselves, in part because they may inherit their mothers' tendency to "amplify" unpleasant information. Although none of the girls has yet experienced a depressive episode, Gotlib has found that their brains already overreact to negative emotional stimuli – a pattern they share with their mothers and other depressed people.

Gotlib is studying whether these young subjects can use interactive software and brain-imaging hardware to "rewire" their brains by unlearning this negative bias. In a pilot experiment, eight girls used a neural feedback display to learn how to control activity in a network of interrelated brain regions that have been linked to depression – these include the dorsal anterior cingulate cortex, anterior insula and dorsolateral prefrontal cortex.

The level of activity in this network was measured using an functional MRI scan and displayed to the girls in the form of a thermometer on a computer screen. The girls were shown sad or negative pictures that might ordinarily raise their "temperature", and tried to lower that "temperature" by adopting more sanguine mental states. They were then advised to try to recreate that mindset in their daily lives.

A control group unknowingly watched someone else's scan output instead of their own, so they didn't actually learn how to control their brain activity.

Accentuate the positive

Another set of girls in the pilot experiment received their training through a simple computer game instead. In this game, a pair of faces appeared on a screen every few seconds: they would be either neutral and sad, or neutral and happy. Then a dot replaced one of the faces, and the "game" was to click on the dot. For the eight girls in the control group, the face replaced by the dot was selected at random, but for eight girls in the experimental group, the dot always replaced the more positive face in the pair. Over a week of playing this game daily, these girls were in effect being trained to avoid looking at the sad faces.

Gotlib himself originally found this concept, called attentional-bias training, so simplistic that he bet Colin MacLeod, a psychologist at the University of Western Australia in Perth who pioneered the technique, that it would not alter psychological symptoms. Gotlib lost his bet.

In his pilot study, both kinds of training significantly reduced stress-related responses – for example, increases in heart rate, blood pressure and cortisol levels – to negative stimuli. These stress responses are a key marker of depression, and they diminished one week after training. The girls in the experimental groups also developed fewer defensive responses to negative faces, such as startled blinking. Control groups showed no such improvement.

Jill Hooley, head of Harvard University's clinical psychology programme, was impressed by the findings despite the small sample size: "This is highly innovative work," she said. "Ian is breaking new ground here."

Gotlib is adding more subjects to the training programme and plans to compare their long-term mental health with a parallel cohort of 200 girls, half of whom have depressed mothers, who aren't participating in the study.

He presented his results at the annual meeting of the Society for Research in Psychopathology in Boston in September.

Let's give science a bad name in schools

Today, the UK's Royal Society announced its intention to stimulate a "world-class, high-performing education system for science and mathematics". If that's really what it wants, its members will have to give up a 60-year pursuit of a squeaky-clean image for science and scientists.

One of the biggest problems is that, although the subject fascinates elementary-school children, most lose that fascination between the ages of 10 and 14.

This is when adolescents are forming their sense of self. As young people seek to turn themselves into adults, they experiment with risk-taking, rebellion, deception, corner-cutting, questioning morality, coping with failure and suppressing self-doubt. This has strong repercussions for their response to science lessons.

Behind the scenes

Studies have repeatedly shown that teenagers lack interest in school science. Louise Archer, who researches the sociology of education at King's College London, puts it like this: there is "a mismatch between popular representations of science… and the aspirations, ideals and developing identities of young adolescents".

The key phrase here is "popular representations". The science of popular account is essentially a carefully crafted and unrepresentative distortion; as Nobel laureate Peter Medawar put it, "the postures we choose to be seen in when the curtain goes up".

Behind the curtain, scientists are surprisingly colourful. The world-changing ones are, by definition, anti-authoritarian, risk-taking rebels. The history of science is littered with instances of fighting, disregard of authority, dogged determination in the face of scorn and even that staple of teenage rebellion, wilful intoxication. Such behaviour seems to be inseparable from the creative pursuit of a breakthrough.

The problem is, school students only ever hear about the breakthrough itself. The crooked path to success has been whitewashed out of sight. This is not an accident: it is the result of a long-running PR campaign carried out by organisations such as the Royal Society – the creation of Brand Science, if you will.

Bad rep

It started after the second world war, which made science look terrifying. The atomic bombs that devastated Hiroshima and Nagasaki, the V2 rockets that rained down on London, the experiments carried out in Nazi concentration camps and Japanese prisoner-of-war camps – and Allied mustard gas experiments on their own soldiers – enveloped science in a cloud of fear. That was why the geneticist Jacob Bronowski wrote in a 1956 issue of Bulletin of the Atomic Scientists: "People hate scientists. There is no use beating about the bush here."

Senior figures reacted by trying to put science in the best possible light wherever it might be on display. That is why UK organisations such as the Royal Society, the Royal Institution and the Wellcome Trust forged links with the national broadcaster, the BBC, in the late 1940s, controlling access to scientists and endorsing only those who would toe the line of Brand Science. Memos to the broadcaster, according to author Timothy Boon, forcefully suggested dropping the "perils and dilemmas angle" in its coverage of the subject, and concentrating on "the great solution wrought by the introduction of the experimental method".

Across the Atlantic, scientists were making similar public promises of the benefits that they would bring. For more than 60 years now, science has striven to be seen as trustworthy, morally upright, objective and dispassionate, and providing a well-defined path from hypothesis to experiment to deduction that will reliably deliver advances and improvements.

Introverts only

The unfortunate spin-off of this PR effort is that it made the subject look dull, inhuman and robotic. Perhaps that's why, when asked to pick out the scientists from a gallery of photographs, children chose the ones that weren't smiling – although in reality, all the photos were of scientists. Scientists are not perceived as smiley or fun, and the general population certainly does not think of them as creative or dynamic. That might explain why, as a Dutch study revealed in 2008, highly socialised, extrovert students tend to drop science subjects as soon as they can, orienting themselves instead towards more "human" areas of work, such as law, politics and economics.

Reintroducing into school curricula the humanity of science – with all its flaws, its tales of outrageous behaviour and even more outrageous characters – would give teens the opportunity to see scientists as role models. With pressing problems such as climate change and energy supply to confront, we must do whatever we can to capture the bold, adventurous, risk-taking minds of tomorrow, rather than settling for the timid ones – even if that means tarnishing the carefully nurtured public image of Brand Science.

Introduction: Teenagers

The teenager is a uniquely human phenomenon.

Adolescents are known to be moody, insecure, argumentative, angst-ridden, impulsive, impressionable, reckless and rebellious. Teenagers are also characterised by odd sleeping patterns, awkward growth spurts, bullying, acne and slobbish behavior. So what could be the possible benefit of the teenage phase?

Most other animals - apes and human ancestors included - skip that stage altogether, developing rapidly from infancy to full adulthood. Humans, in contrast, have a very puzzling four-year gap between sexual maturity and prime reproductive age. Anthropologists disagree on when the teenage phase first evolved, but pinpointing that date could help define its purpose.

There are a variety of current explanations for the existence of teenagers. Some believe that we need longer for our large brains to develop. Other explanations suggest that a teenage phase allows kids to learn about complex social behaviour and other difficult skills, or that it is even required to develop coordinated bipedal bodies adapted to travelling long distances.

Raging hormones

Scientists once thought that the brain's internal structure was fixed at the end of childhood, and teenage behaviour was blamed on raging hormones and a lack of experience. Then researchers discovered that the brain undergoes significant changes during adolescence.

According to many recent studies, teen brains really are unique (see interactive graphic). Though many brain areas mature during childhood, others mature later - such as the frontal and parietal lobes, responsible for planning and self-control.

Other studies have shown that teens fail to see the consequences of their actions, and that sudden increases in nerve connectivity in teen brains may make it difficult for teenagers to read social situations and other people's emotions.

Risky behaviour

One study in 2004 showed that teens have less brain activity in areas responsible for motivation and risk assessment, perhaps explaining why they are more likely to take part in risky activities such as abusing drugs and alcohol, develop a hard-to-kick smoking habit or indulge in under-age sex.

Teenage pregnancies and rising rates of sexually transmitted diseases among teens are big problems - especially because today's teen generation is the biggest the world has seen: a 2003 UN report revealed that 1 in 5 people were between 10 and 19, a total of 1.2 billion people.

But not everyone agrees on the best way to tackle the problem. Some believe that comprehensive sex education is the key, while others argue for abstinence only education courses.

5 Tips for Surviving Shots

Do shots make you nervous? You're not alone. Lots of people dread them because they have a very real fear of needles. So next time your doc asks you to roll up your sleeve, try these tips:

1. Distract yourself while you're waiting. Bring along a game, book, music, or movie player — something you'll get completely caught up in so you're not sitting in the waiting room thinking about the shot. Some doctors' offices schedule "shot clinics" where they do nothing but give shots so the wait time is shorter.
2. Concentrate on taking slow, deep breaths. Breathe all the way down into your belly. Deep breathing can help people relax — and concentrating on something other than the shot can take your mind off it.
3. Focus intently on something in the room. Find a picture, poster, or a sign on the wall. Concentrate on the details: If you're looking at a painting, for example, try counting the number of flowers in the garden, cows in the field, or other images. Or create as many new words as you can using the lettering on a sign. Think about how the message on a health awareness poster might affect you. Whatever it takes, keep focusing on something other than the shot until it's over.
4. Cough. Research shows that coughing as the needle goes in can help some people feel less pain.
5. Relax your arm. If you're tense — especially if you tense up the area where you're getting the shot — it can make a shot hurt more.

Sometimes people feel lightheaded or faint after getting a shot. If you feel funny, sit down and rest for 15 minutes.
Don't hesitate to tell the doctor or nurse that you're nervous before getting the shot. Medical professionals are used to people who fear shots and they'll be able to help you relax.
Reviewed by: Kate M. Cronan, MD
Date reviewed: January 2010
http://www.kothay.com/blog/post/amin/2012/05/12/88-1336805740-84/

Taking your parents or other adults

You probably talk to friends way more than you talk to your parents. That's natural. Even if you and your parents have a great relationship, you want to find your own path and make your own choices.
Still, most of us want a parent's help, advice, and support at times. But talking to the adults in your life can seem difficult or intimidating — especially when it comes to certain subjects. Here are some tips to make it easier.

Talk About Everyday Stuff — and Do It Every Day

The more you do something, the easier it gets. Talking to the adults in your life about everyday stuff builds a bond that can smooth the way for when you need to discuss something more serious.
Find something trivial to chat about each day. Talk about how your team did at the track meet. Share something one of your teachers said. Even small talk about what's for dinner can keep your relationship strong and comfortable.
It's never too late to start. If you feel your relationship with your parents is strained, try easing into conversations. Mention that cute thing the dog did. Talk about how well your little sister is doing in math. Chatting with parents every day not only keeps an existing relationship strong, it also can help a frayed relationship get stronger.
When parents feel connected to your daily life, they can be there for you if something really important comes up.

Raising Difficult Topics

Maybe you need to break bad news to a parent, like getting a speeding ticket or failing an exam. Perhaps you're feeling scared or stressed about something. Or maybe you just really, really want to tell your parents about your new boyfriend or girlfriend, but you don't know how they'll react, how it will feel to tell them, or how to find the words.
Here are 3 steps to help you prepare for that talk.

Step 1: Know What You Want From the Conversation

It takes maturity to figure out what you want to get out of a conversation. (Most adults aren't so good at this!)
What you hope to achieve can vary. Most often you'll probably want the adults in your life to do one or more of these things:

• simply listen and understand what you're going through without offering advice or commentary
• give permission or support for something
• offer you advice or help
• guide you back on track if you're in trouble — in a way that's fair and without harsh criticism or put-downs

Why think about this before you begin talking? So you can say why you want to talk in a way that communicates what you need. For example:

• "Mom, I need to tell you about a problem I'm having, but I need you to just listen, OK? Don't give me advice — I just want you to know what's bothering me."
• "Dad, I need to get your permission to go on a class trip next week. Can I tell you about it?"
• "Grandad, I need your advice about something. Can we talk?"

• Difficult Topics (Continued)

  Step 2: Identify Your Feelings

  Things like personal feelings or sex are awkward to discuss with anyone, let alone a parent. It's natural to be nervous when talking about sensitive topics.
  Recognize how you're feeling — for example, maybe you're worried that telling parents about a problem will make them disappointed or upset. But instead of letting those feelings stop you from talking, put them into words as part of the conversation. For example:
  
• "Mom, I need to talk to you — but I'm afraid I'll disappoint you."
• "Dad, I need to talk to you about something — but it's kind of embarrassing."

What if you think a parent may be unsupportive, harsh, or critical? It can help to defuse things by beginning with a statement like, "Mom, I have something to tell you. I'm not proud of what I've done, and you might be mad. But I know I need to tell you. Can you hear me out?"

Step 3: Pick a Good Time to Talk

Approach your parent when he or she isn't busy with something else. Ask, "Can we talk? Is now a good time?" Driving in the car or going for a walk can be great opportunities to talk. If it's hard to find a good time, say, "I need to talk to you. When is a good time?"
Difficult conversations benefit from good planning. Think ahead about what you want to say or ask. Write down the most important ideas if you need to.

How to Talk So Parents Will Listen

As most of us know, talking and listening don't go smoothly every time. Emotions and past experiences can get in the way.
Will parents take you seriously, believe what you say, listen to and respect your opinions, and hear you out without interrupting? A lot depends on your parent. Some parents are easy to talk to, some are great listeners, and some are harder to approach.
But some of what happens depends on you, too. Since communication is a two-way street, the way you talk can influence how well a parent listens and understands you.
So here are some guidelines to consider when talking to parents:

• Be clear and direct. Be as clear as you can about what you think, feel, and want. Give details that can help parents understand your situation. They can listen better or be more helpful if they understand what you mean and what's really going on.
• Be honest. If you're always honest, a parent will be likely to believe what you say. If you sometimes hide the truth or add too much drama, parents will have a harder time believing what you tell them. If you lie, they'll find it hard to trust you.
• Try to understand their point of view. If you have a disagreement, can you see your parents' side? If you can, say so. Telling parents you understand their views and feelings helps them be willing to see yours, too.
• Try not to argue or whine. Using a tone that's friendly and respectful makes it more likely parents will listen and take what you say seriously. It also makes it more likely that they'll talk to you in the same way. Of course, this is hard for any of us (adults included) when we're feeling heated about something. If you think your emotions might get the better of you, do something to blow off steam before talking: Go for a run. Cry. Hit your pillow. Do whatever it takes to sound calm when you need to.

• What If Talking to Parents Doesn't Work?

  Your parents won't always see things your way and they won't always say yes to what you ask. They might listen respectfully, understand your point of view, and do everything you need except say yes. It can be hard to take no for an answer. But gracefully accepting a no can help you get more yeses in the future.
  What if it's more than just saying no to something, though? What if you really need your parents to be there for you but they can't? Some parents have troubles of their own. Others just can't be available in the ways their kids need and deserve. Others have a hard time being flexible.
  If you can't talk to your parent, seek out other adults you can trust. Find a relative, a teacher, or a counselor who will listen, understand, encourage, believe in you, and care. Then follow all the tips above to get the most from your conversation with that person.
  Acting respectfully demonstrates maturity. Parents are more likely to think of their children as grown up (and, as a result, capable of making more important decisions) when they see them acting maturely. Give these tips a try and you'll come across that way — maybe even more mature than your parents!
  Reviewed by: D'Arcy Lyness, PhD
  Date reviewed: August 2009
   

•  

Why Are Some Relationships So Difficult? ..i am in healthy relationship...

It Feels Like Love - But Is It?

Sometimes it feels impossible to find someone who's right for you — and who thinks you're right for him or her! So when it happens, you're usually so psyched that you don't even mind when your little brother finishes all the ice cream or your English teacher chooses the one day when you didn't do your reading to give you a pop quiz.
It's totally normal to look at the world through rose-colored glasses in the early stages of a relationship. But for some people, those rose-colored glasses turn into blinders that keep them from seeing that a relationship isn't as healthy as it should be.

What Makes a Healthy Relationship?

Hopefully, you and your significant other are treating each other well. Not sure if that's the case? Take a step back from the dizzying sensation of being swept off your feet and think about whether your relationship has these seven qualities:

• Mutual respect. Does he or she get how cool you are and why? (Watch out if the answer to the first part is yes but only because you're acting like someone you're not!) The key is that your BF or GF is into you for who you are — for your great sense of humor, your love of reality TV, etc. Does your partner listen when you say you're not comfortable doing something and then back off right away? Respect in a relationship means that each person values who the other is and understands — and would never challenge — the other person's boundaries.
• Trust. You're talking with a guy from French class and your boyfriend walks by. Does he completely lose his cool or keep walking because he knows you'd never cheat on him? It's OK to get a little jealous sometimes — jealousy is a natural emotion. But how a person reacts when feeling jealous is what matters. There's no way you can have a healthy relationship if you don't trust each other.
• Honesty. This one goes hand-in-hand with trust because it's tough to trust someone when one of you isn't being honest. Have you ever caught your girlfriend in a major lie? Like she told you that she had to work on Friday night but it turned out she was at the movies with her friends? The next time she says she has to work, you'll have a lot more trouble believing her and the trust will be on shaky ground.
• Support. It's not just in bad times that your partner should support you. Some people are great when your whole world is falling apart but can't take being there when things are going right (and vice versa). In a healthy relationship, your significant other is there with a shoulder to cry on when you find out your parents are getting divorced and to celebrate with you when you get the lead in a play.
• Fairness/equality. You need to have give-and-take in your relationship, too. Do you take turns choosing which new movie to see? As a couple, do you hang out with your partner's friends as often as you hang out with yours? It's not like you have to keep a running count and make sure things are exactly even, of course. But you'll know if it isn't a pretty fair balance. Things get bad really fast when a relationship turns into a power struggle, with one person fighting to get his or her way all the time.
• Separate identities. In a healthy relationship, everyone needs to make compromises. But that doesn't mean you should feel like you're losing out on being yourself. When you started going out, you both had your own lives (families, friends, interests, hobbies, etc.) and that shouldn't change. Neither of you should have to pretend to like something you don't, or give up seeing your friends, or drop out of activities you love. And you also should feel free to keep developing new talents or interests, making new friends, and moving forward.
• Good communication. You've probably heard lots of stuff about how men and women don't seem to speak the same language. We all know how many different meanings the little phrase "no, nothing's wrong" can have, depending on who's saying it! But what's important is to ask if you're not sure what he or she means, and speak honestly and openly so that the miscommunication is avoided in the first place. Never keep a feeling bottled up because you're afraid it's not what your BF or GF wants to hear or because you worry about sounding silly. And if you need some time to think something through before you're ready to talk about it, the right person will give you some space to do that if you ask for it.

• What's an Unhealthy Relationship?

  A relationship is unhealthy when it involves mean, disrespectful, controlling, or abusive behavior. Some people live in homes with parents who fight a lot or abuse each other — emotionally, verbally, or physically. For some people who have grown up around this kind of behavior it can almost seem normal or OK. It's not! Many of us learn from watching and imitating the people close to us. So someone who has lived around violent or disrespectful behavior may not have learned how to treat others with kindness and respect or how to expect the same treatment.
  Qualities like kindness and respect are absolute requirements for a healthy relationship. Someone who doesn't yet have this part down may need to work on it with a trained therapist before he or she is ready for a relationship. Meanwhile, even though you might feel bad or feel for someone who's been mistreated, you need to take care of yourself — it's not healthy to stay in a relationship that involves abusive behavior of any kind.
  

  Warning Signs

  When a boyfriend or girlfriend uses verbal insults, mean language, nasty putdowns, gets physical by hitting or slapping, or forces someone into sexual activity, it's an important warning sign of verbal, emotional, or physical abuse.
  Ask yourself, does my boyfriend or girlfriend:
  
• get angry when I don't drop everything for him or her?
• criticize the way I look or dress, and say I'll never be able to find anyone else who would date me?
• keep me from seeing friends or from talking to any other guys or girls?
• want me to quit an activity, even though I love it?
• ever raise a hand when angry, like he or she is about to hit me?
• try to force me to go further sexually than I want to?

These aren't the only questions you can ask yourself. If you can think of any way in which your boyfriend or girlfriend is trying to control you, make you feel bad about yourself, isolate you from the rest of your world, or — this is a big one — harm you physically or sexually, then it's time to get out, fast. Let a trusted friend or family member know what's going on and make sure you're safe.
It can be tempting to make excuses or misinterpret violence, possessiveness, or anger as an expression of love. But even if you know that the person hurting you loves you, it is not healthy. No one deserves to be hit, shoved, or forced into anything he or she doesn't want to do.

Why Are Some Relationships So Difficult?

Ever heard about how it's hard for someone to love you when you don't love yourself? It's a big relationship roadblock when one or both people struggle with self-esteem problems. Your girlfriend or boyfriend isn't there to make you feel good about yourself if you can't do that on your own. Focus on being happy with yourself, and don't take on the responsibility of worrying about someone else's happiness.
What if you feel that your girlfriend or boyfriend needs too much from you? If the relationship feels like a burden or a drag instead of a joy, it might be time to think about whether it's a healthy match for you. Someone who's not happy or secure may have trouble being a healthy relationship partner.
Also, intense relationships can be hard for some teenagers. Some are so focused on their own developing feelings and responsibilities that they don't have the emotional energy it takes to respond to someone else's feelings and needs in a close relationship. Don't worry if you're just not ready yet. You will be, and you can take all the time you need.
Ever notice that some teen relationships don't last very long? It's no wonder — you're still growing and changing every day, and it can be tough to put two people together whose identities are both still in the process of forming. You two might seem perfect for each other at first, but that can change. If you try to hold on to the relationship anyway, there's a good chance it will turn sour. Better to part as friends than to stay in something that you've outgrown or that no longer feels right for one or both of you. And before you go looking for amour from that hottie from French class, respect your current beau by breaking things off before you make your move.
Relationships can be one of the best — and most challenging — parts of your world. They can be full of fun, romance, excitement, intense feelings, and occasional heartache, too. Whether you're single or in a relationship, remember that it's good to be choosy about who you get close to. If you're still waiting, take your time and get to know plenty of people.
Think about the qualities you value in a friendship and see how they match up with the ingredients of a healthy relationship. Work on developing those good qualities in yourself — they make you a lot more attractive to others. And if you're already part of a pair, make sure the relationship you're in brings out the best in both of you.

von Willebrand Disease

Everyone has to deal with bruises and bloody noses from time to time. But excessive or prolonged bleeding can be a sign of a disorder known as von Willebrand disease.
For many people, the symptoms are so mild that they never even know they have the disorder. For those with more severe forms of the disease, though, getting the proper diagnosis and treatment usually makes them less likely to have problems.

What Is von Willebrand Disease?

Von Willebrand disease, or vWD, is an inherited disorder — meaning it's passed from parent to child through genes — that affects the blood's ability to clot properly. It takes its name from Dr. Erik von Willebrand, who first described the condition in 1926.
As a group, bleeding disorders (including one you might have heard about — hemophilia) are rare. Von Willebrand disease is the most common inherited bleeding disorder, affecting about 1% to 2% of people. Unlike hemophilia, which usually affects only guys, vWD affects both guys and girls.
Normally, bleeding usually occurs when a blood vessel is cut or torn. Platelets (small cells that float in the blood) plug the hole in the blood vessel to stop blood from leaking out. With the help of calcium, vitamin K, and a protein called fibrinogen, the platelets create a mesh to hold the plug in place and close the wound. As this mesh dries, it hardens and forms a scab to protect the wound as it heals.
A substance in the blood known as von Willebrand factor helps platelets stick to damaged blood vessels. Special proteins known as clotting factors are also needed to help blood clot. Von Willebrand factor carries one of these clotting factors, called factor VIII, in the blood.
People with von Willebrand disease have bleeding problems because the levels or function of these blood components needed for clotting are abnormal.

The Types of von Willebrand Disease

As with many conditions, there are various forms of vWD:

• In type 1, a person has less von Willebrand factor in the blood than normal. Although the condition can be made worse by taking aspirin and other nonsteroidal anti-inflammatory drugs (these drugs can block blood from clotting), the symptoms might be so mild that the person isn't ever diagnosed. People with type 1 vWD usually don't bleed spontaneously, but they can have significant bleeding with injuries, surgery, or when they have a tooth pulled. Type 1 is the most common and the mildest form of vWD.
• In type 2, the person's body makes von Willebrand factor that is abnormal, leading to bleeding problems.
• Type 3 patients have severe bleeding problems. The person has no measurable von Willebrand factor and very low factor VIII levels.
• In pseudo, or platelet-type, von Willebrand disease, the person's platelets are abnormal, making them stick to von Willebrand factor too well. This causes clotting problems due to low numbers of platelets and levels of von Willebrand factor.

What Causes It?

Like hemophilia, vWD is a genetic disorder that is passed from parent to child. The child of a man or a woman with vWD has a 50% chance of getting the gene for the condition. In types 1 and 2, a child has inherited the gene from one parent. In type 3, the child has inherited genes for the disease from both parents.

Signs and Symptoms

The symptoms of von Willebrand disease may include:

• bruising easily
• unusually heavy periods or other abnormal menstrual bleeding in girls
• bleeding from the gums, nose, and lining of the intestines
• prolonged oozing of blood from cuts or bleeding too much or for too long after a tooth is pulled or tonsils are removed

• Diagnosis and Treatment

  Because its symptoms can be mild, vWD can be difficult to diagnose. In addition to doing a physical examination, the doctor will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues, such as bleeding problems in other family members. This is called the medical history.
  A number of lab tests may be done to diagnose the condition and to determine the specific type of von Willebrand disease the person has. These will include of von Willebrand factor antigen, von Willebrand activity (ristocetin cofactor), and factor VIII. Measuring von Willebrand multimers help to determine the type of von Willebrand disease. Sometimes tests need to be done more than once because a person's levels may change over time.
  For many teens with vWD, the condition doesn't require big lifestyle changes. Teens with more severe vWD should avoid unnecessary trauma, including contact sports like football and hockey, but other sports and activities are usually OK.
  If bleeding does occur, applying pressure to the area may be all that's needed. Someone who gets a nosebleed should put pressure on the bridge of the nose to help stop the bleeding.
  Girls with vWD who have started their periods might want to carry extra pads or even a change of clothes in case of accidents. Sometimes, the doctor may prescribe birth control pills to help control heavy menstrual bleeding.
  If these measures aren't enough to prevent or control bleeding problems, additional types of treatment may be needed. The most common treatment used for type 1 von Willebrand disease is the drug desmopressin, which causes a temporary increase in the von Willebrand factor level in the blood. It can be given by injection or intranasally (into the nose). Desmopressin may or may not be helpful for treating people with some forms of type 2 von Willebrand disease.
  People with type 3 (and some with type 2) disease require treatment with a medication, called Humate P, that contains both factor VIII and von Willebrand factor. This medication is given intravenously (injected into a vein). Patients with type 1 also might need Humate P in certain situations, such as after major trauma or major surgery, although they can generally be treated with desmopressin.
  Other treatments can include the use of a medication like Amicar to inhibit the breakdown of a clot.
  Reviewed by: Gregory C. Griffin, MD
  Date reviewed: May 2010