Effect of Antidepressant Treatment on Sexual Dysfunction

Effect of Antidepressant Treatment on Sexual Dysfunction IMPROVEMENT IN SEXUAL DYSFUNCTION FOLLOWING ANTIDEPRESSANT TREATMENT IN DEPRESSED FEMALES *Dr. Abhivant Niteen N. 1, Dr. Sawant Neena S.2, ABSTRACT Introduction: Depression is associated with sexual dysfunction. As the depression improves sexual dysfunction also improves. There are not many studies on female sexuality. Aims and objectives: To find out the changes in sexual functioning in depressed females after treatment with anti-depressant drugs. Method: 41 female patients diagnosed to have depression were included in study. Becks Depression Inventory and Female Sexual Functioning Index scales were applied at the beginning and after 6 weeks to assess the improvement in sexual dysfunction and depression. Results: When scores were compared after 6 weeks of antidepressant treatment then a highly significant difference was seen on all the scores of BDI ( pConclusions: This study showed significant improvement in sexual dysfunction and different aspects of sexual dysfunctions after treatment with antidepressants for 6 weeks. Keywords: Female sexual dysfunction, Depression, SSRI, FSFI. INTRODUCTION: The issue of sexual health, once regarded as taboo subject, has been widely debated recently. Reliable estimates of incidence and severity of sexual dysfunctions in females is difficult to obtain as the patients are often unwilling to raise the issue of sexual health with health professionals and both the patient and the physician may be reluctant to discuss it. Female sexual dysfunction is multifactorial and multidimensional condition combining biological, psychological and interpersonal determinants [1]. Although sexual dysfunctions are not life threatening, they have major impact on personal relationships, physical health and quality of life. There are several studies on male sexual dysfunctions in India [2] but literature on the prevalence of sexual dysfunction among women is particularly scant [3, 4]. The prospective Zurich cohort study shows that the prevalence of sexual problems in depressed subjects is approximately twice that in controls [5]. A number of investigators have reported various sexual dysfunctions associated with depression [1, 6, 7, 8].Female sexual function is also regulated by a variety of neurotransmitters and hormones. Estrogen, testosterone and progesterone promote sexual desire; dopamine promotes desire and arousal, and norepinephrine promotes arousal [9, 10]. Prolactin inhibits arousal, and oxytocin promotes orgasm [11]. Hence a need was felt to look into the aspects of female sexual dysfunctions and it’s relation to underlying depression and drug therapy. Increased awareness of this problem in medical community will lead to further research in female sexual dysfunctions and improved treatment. AIMS AND OBJECTIVE To find out the changes in sexual functioning in depressed females after treatment with anti-depressant drugs. MATERIAL AND METHODS This study was a prospective (6 week) study conducted in a psychiatry outpatient department of a general municipal hospital. The sample consisted of 52 female patients who were diagnosed to have depression as per Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text revision, criteria after satisfying inclusion and exclusion criteria. INCLUSION CRITERIA: 1) Females diagnosed to have depression as per Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text revision 2) Those who were willing to participate in the study. 3) Language compatibility. EXCLUSION CRITERIA: 1) Females less than 18 years of age. 2) Those with past history of depression or any psychiatric illness. 3)Those who were on any other psychotropic medications. 4) Sexual dysfunction prior to depression. 52 female patients were screened of which 3 patients refused the consent and so had to be dropped out of the study. 49 female patients gave consent and so were enrolled in the study protocol. Of the 49 patients, 8 patients dropped out of the follow-up period over 6 weeks. At the end of 6 weeks, 41 patients were available for analysis. All patients were explained about the nature of study and it’s applications and informed consent was obtained from patients. A proforma was designed to enquire into the socio-demographic details, details of psychopathology, presence of sexual dysfunctions and questions pertaining to aims and objectives of study. All the patients were interviewed in presence of female co-investigator or another lady doctor or a nurse and were interviewed in drug naà ¯ve state and then they were started on any of the Selective Serotonin Reuptake Inhibitor medications viz Sertraline, Escitalopram for underlying depression. All the patients were administered Beck’s Depression Inventory and Female Sexual Functioning Index Scale in the drug naà ¯ve state and all the scales were again administered at the end of 6 weeks of anti-depressant medication to gauge the improvement in mood and sexual functioning. TOOLS: 1) BECK’S DEPRESSION INVENTORY: Developed by A. Beck [12] is a rating to measure the severity of depression in which individuals rate their own symptoms of depression. This is a 21 item scale which evaluates the key symptoms of depression including mood, pessimism, sense of failure, self dissatisfaction, self accusation, self dislike, guilt, punishment, suicidal ideas, crying, irritability, social withdrawal, indecisiveness, body image changes, insomnia, fatigability, loss of appetite, weight loss, somatic pre-occupation and loss of libido. Individuals are asked to rate themselves on a 0 to 3 spectrum [0=least, 3=most] with a score range of 0 to 63. Total score is a sum of all items. 2) FEMALE SEXUAL FUNCTIONING INDEX [13]: The Female Sexual Functioning Index is a 19 item questionnaire. It is a brief, multidimensional, self report instrument to assess the key dimensions of sexual function in females. It assesses six domains of sexual function including 1) Desire 2) Physical arousal-sensation Physical arousal-lubrication 4) Orgasm 5) Satisfaction and 6) Pain. All the scales were translated in Marathi and Hindi and were validated by the departmental staff before administration. DATA ANALYSIS: All analyses were done with SPSS statistical version 11 at 5% significance. The changes in tools (Beck’s Depression Inventory, Female Sexual Functioning Index) were analyzed pre and post treatment using the paired‘t’ test. RESULTS The mean age of this sample (n=49) was 28.9 years (+_ 3.03 yrs) with range of 23- 39 years and majority (81.6%) patients were from 25-31 years age group. Majority (63.26%) of patients had completed their secondary education and 94% were home makers with hardly 6% of them doing some job. As expected, about two-third (67.34%) were Hindus. The mean duration of depression was 2 years with standard deviation of 1.8 years with range being from 3 months to 7 years. When all the patients were assessed for improvement in their depression and areas of sexual functioning after a 6 week treatment with SSRI’s viz. Escitalopram (optimum dose 10 to 15 mg) and Sertraline (100mg), then a highly significant difference was seen on all the scores of BDI ( p On the various domains of FSFI a highly significant difference was seen on the domains of Arousal (p DISCUSSION Depressive disorders are among the most prevalent psychiatric disorders [14]. Depression is characterized by loss of interest, reduction in energy, lowered self-esteem and inability to experience pleasure, irritability and social withdrawal which may impair the ability to form and maintain intimate relationships. This constellation of symptoms may be expected to produce difficulties in sexual relationships, and depression has long been associated with sexual problems [15]. A number of investigators have reported association between sexual dysfunctions and depression [1, 6, 7, 8]. Depression is also associated with various neurotransmitter changes which may also contribute to sexual dysfunction in depression [10, 16, 17]. Our study showed that as depression improves, sexual functioning also improves which has been corroborated by Piazza [18] who had studied depressed women with greater sexual dysfunction at baseline and improvement in sexual functioning with treatment with SSRI’s in areas of improvement in sex drive, physiologic and psychological arousal. SSRI’s due to their antidepressant action improve the depression which may consequently reduce the various faulty cognitions associated with depression and enhance the person’s self esteem and energy. Also as the depression improves the various biological changes associated with it also improves which may also contribute to the reduction in sexual dysfunction. In short, with reversal of biological and psychological changes sexual dysfunction improves with SSRI treatment. There are also various studies which have linked SSRI’s with sexual dysfunction and have been discussed in critical reviews [19, 20] but Montgomery and colleagues [21] have also pointed out numerous obstacles to establishing the exact prevalence of antidepressant-related sexual dysfunction. Sex is more than a physical act. It also includes emotional and psychological dimensions. Studies have also shown that besides antidepressants many other factors influence the incidence and prevalence of sexual dysfunction in patients with depression. These include factors such as, depression itself, cultural and social factors and physical and psychiatric co-morbidities [21]. Given the scarcity of evidence-based treatments, the management of sexual dysfunction is still an art rather than a science. Even a seemingly clear-cut case of medication-associated sexual dysfunction should not be treated in a vacuum or in a strictly biological sense. The overall treatment should always take into consideration psychological factors and normal fluctuation of sexual functioning. ACKNOWLEDGEMENTS: We sincerely acknowledge the support and guidance of Dr. Shubhangi Parkar, Professor and Head, Department of Psychiatry, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai. 400012 REFERENCES: 1. Mathew RJ, Weinman ML: Sexual dysfunctions in depression. Arch Sexual Behav.1982; 11: 323–328 2. Verma K.K. et al: The frequency of sexual dysfunctions in patients attending a sex therapy clinic in north India, Arch sex behav.1998; 27: 309-314 3. Kulhara P, Avasthi A. Sexual dysfunction on the Indian subcontinent. Int Rev Psychiatry.1995; 7: 231-9 4. Avasthi A, Kaur R, Prakash O, Banerjee A, Kumar L, Kulhara P. Sexual behavior of married young women: A preliminary study from north India. Indian J Community Med.2008; 33: 163-7 5. Angst J. Sexual problems in healthy and depressed patients. Int Clin Psychopharmacol.1998; 13 (Suppl 6): S1–3 6. Clayton A H et al: assessment of Paroxetine induced sexual dysfunction using the changes in sexual functioning questionnaire: Psychopharmacol Bull.1995; 31: 397-413 7. Harvey K. V., Balon R: Clinical implications of antidepressant drug effects on sexual functioning; Ann Clin Psychiatry.1995; 7: 189-201 8. Harrison W.M. et al; Effects of an antidepressant medication on sexual function, a controlled study: J Clin Psychopharmacol.1986; 6: 144-149 9. Buss DM. The evolution of desire: Strategies of human mating. London: Harper Collins; 1994. p. 84-5. 10. Bloom FE. Brain, mind and behaviour. W.H. Freeman Co. 1985-88. p.208-17, 227-8. 11. Panksepp J. The foundfations of human and animal emotions.. New York. Oxford University Press. 12. Beck A T et al: â€Å"Psychometric properties of Beck Depression Inventory: Twenty five years of evaluation†. Clin Psychol Rev.1988; 8: 77-100 13. R Rosen et al: Journ of Sex and Marital therapy.2000; 26: 191-208 14. Rihmer Z, Angst A.; Mood disorders: Epidemiology: in Comprehensive Textbook Of Psychiatry; Sadock B J, Sadock V. A.; 8th edition, Lippincott Williams And Wilkins; 2004. 15. Baldwin DS. Depression and sexual function. J Psychopharmacol.1996; 10 (Suppl. 1): S30–34 16. Clayton A H. Sexual dysfunction in depression. Tricks of the trade in the long-term treatment of depression. Program and abstracts of the American Psychiatric Association 156th Annual Meeting; May 17-22, 2003; San Francisco, California. 17. Levin R. J. et al: The mechanism of human female sexual arousal; Ann Rev Sex Res.1992; 3: 1-48 18. Piazza L. A., Markowitz J. C., Kocsis J.H.: Sexual functioning in chronically depressed patients treated with SSRI Antidepressants: A pilot study; Am J Psychiatry.1997; 154: 1757-1759 19. Rosen RC, Lane RM, Menza M: Effects of SSRIs on sexual function: a critical review. J Clin Psychopharmacology.1999; 19: 67–85 20. Williams VSL, Baldwin DS, Hogue SL, Fehnel SE, Hollis KA, Edin HM: Estimating the prevalence and impact of antidepressant-induced sexual dysfunction in 2 European countries: a cross-sectional patient survey. J Clin Psychiatry.2006; 67: 204–210 21. Montgomery SA, Baldwin DS, Riley A: Antidepressant medications: a review of the evidence for drug-induced sexual dysfunction. J Affect Disord. 2002; 69: 119–140

Personal Portfolio Essay

My journey as a student started out as a young child. Coming from nurturing parents, I was always taught my ABC’s, 123’s and colors. I was an eager student and when it was time to go to school, I was excited and motivated. As I moved on in my educational career, I didn’t keep with the same attitude I started with when I was younger. I feel now, I’ve regained my passion to be a student with the maturity I’ve gained over just this past year. I feel that I will always be a student because I will never cease to learn. I’ve been successful and unsuccessful in my efforts in my formal education. With each new endeavor I take, I learn something new about myself and what I can handle. One of the biggest things I’ve accomplished was the completion of high school. For me, my high school years were some of my darkest. I was in regular day school or the first two years and because of personal issues spent the last two years on home instruction. Being able to graduate with a high school diploma in the allotted 4 year time span meant so much to me and still does. Another successful experience I’ve had before coming to MCC was obtaining my Medical Assistant Certification. I worked in the field for some time and decisions I made in my life, lead me to give away what I had worked so hard for. The most recent and successful thing I’ve done thus far is coming to MCC. Before enrolling here, I was in a very lost and dark place in my life. I wasn’t sure if I was ever going to get out. I was given an opportunity at a second chance and I am going to take full advantage of it this time around. I’ve encountered many challenges along the way; some of them I’ve even let stunt me in my growth as a person in society. When I was in grammar school, I lost my father suddenly, as I entered high school I fell into the wrong crowd of friends and my life took a turn down the wrong path for a while and I have a diagnosed mental illness that makes everyday life difficult sometimes. I’ve learned that I need to be open and honest with my life in order to get better. How I’ve learned cope with theses everyday challenges it to just face every day and know my limits. I attend self-help groups that have changed my life and afforded me with nineteen months clean and showed me there is a better way to live. I decided to enroll in Middlesex County College because I need a change of pace. Before coming to MCC, I was stagnant; I wasn’t sure I’d ever move from the dreary place I found myself in. When the Fall 2012 semester was about to close, I had a choice, was I going to participate in life or was another year going to pass me by? I made a decision to put all my fears aside and enroll. Honestly, the first few weeks of that fall semester were great. I felt on top of the world, things were coming so easy. Then reality started to set in. I saw that I was in remedial classes and my friends were in more advanced courses some even in universities. Life started to show up and responsibilities were beginning to knock on my door and tests were on days I wanted to have for myself. I felt trapped and on some days, I really wanted to give up. However, I kept pushing forward because I know that I came this far and wasn’t going to give up over a little pressure. Plus, I had so much support from the people that love me I was doing this more for just selfish reasons this time. I’m not sure how my professors this semester would describe me being we’ve only known each other a short period of time. Going on the opinion of last semester’s professors, I feel they would describe me as outgoing and responsible. I remain accountable for the things I do and the things I don’t do. I’m on time for classes and not shy about asking for help or staying after class to voice a concern. That is something I’ve learned in my short time as a college student and it’s taught me well. An academic goal of mine in the short term has been in the short term to complete my remedial classes and some of my basic psychology classes. In the long term I would then like to matriculate to Rutgers University to complete my Bachelor’s degree. It has always been a dream of mine to graduate from the University my mother did. Although I don’t want to follow in the medical field the same way my mother did, I still want to obtain my doctorate as she did. I feel it is in my blood to help people, just in different ways. I plan to accomplish this goal by staying focused on my plan and using my time wisely. I need to start to identify my weaknesses and work on them more thoroughly. I need to obtain better study skills begin to prepare to the weeks ahead instead of the just the week or the day. Also, I need to get out of the mindset that things will get done for me or over time just go away; in life, things don’t happen like that. In conclusion, I plan to take my new lease on life and my academic career very seriously. I have a pretty good understanding what is ahead of me of me given I keep doing the next right thing. On the other hand I know what is waiting for me if I slip and go back to the life I was leading before I made the decision to change and start this new way of life. The good thing about today is today I am free and have a choice of what I want to do. I no longer have to be dictated to on what I have to get done, it’s my life and from this point on I will decide how I will live each day.

Academic English And Academic Language - 1753 Words

Abstract All students are Academic English Learners. Academic Language is not a common natural language that we use in our daily conversations or routines. It is something we acquire step by step through the learning process. However, in the case of English Language Learners, it is more complex that students use academic language they learn or are learning because they most likely use L1 at home and they probably do not have the opportunities to practice them at home, which will make ELLs take occasionally longer to grasps these words. This is the reason why Academic English needs to be systematically taught. What Evidence Based Models Engage Students to Use Academic Language Information What do we consider Academic†¦show more content†¦While the term is most commonly applied to language-specific skills, competency in academic language also bleeds into a wide variety of related non-linguistic skills that are difficult or impossible to separate out from language ability, including foundational academic skills (organizing, planning, researching), cognitive skills (critical thinking, problem solving, interpreting, analyzing, memorizing, recalling), learning modes (questioning, discussing, observing, theorizing, experimenting), and work habits (persistence, self-discipline, curiosity, conscientiousness, responsibility), in addition to other forms of literacy required to succeed in modern schools, such as technological literacy, online literacy, media literary, or multicultural literacy, among others. In the United States, the term is often applied to English-language learners who need to develop English proficiency concurrently with academic language to succeed in schools where English is the primary language of instruction. All students, however, need to acquire academic language to thrive and succeed in academic settings, particularly students with cognitive or developmental delays, students who may live in unsupportive, dysfunctional, or unstable environments, and children from high-poverty, low-education, and otherwise disadvantaged backgrounds who enter school without basic language and literacy skills. By the time they begin school, mostShow MoreRelatedThe Academic Achievement Gaps Between Ell Students And Native English Language Learners1241 Words   |  5 PagesAccording to (),â€Å"English language learners face many obstacles when reading literature in English. Most literature is culture bound. 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Analysis of Ioi Corporation Berhad Performance Based on 5...

Background Information of IOI Corporation Berhad The group’s principal activity is manufacturing of oleo chemicals, palm oil refinery and palm kernel crushing. However, IOI divide their group activities into 5 segments; Plantation, Property Development, Property Investment, Resource-based Manufacturing, and Other operations segment. Plantation segments focus in cultivation of oil palm and rubber and processing of palm oil. Property Development is engaged in the development of residential and commercial properties. Investment in shopping mall, office complex, and others are part of Property Investment. Resource-based manufacturing segment is engaged in manufacturing of oleo chemicals, specialty oils and fats, palm oil refinery and palm†¦show more content†¦Especially from joint venture, it showed superior changes over the years by went up 6 times higher than 2007, from RM 190 million to RM 1.5 billion. It brought considerable contribution to the total assets of the com pany. In spite of the soaring of several items in non-current assets, there were numbers of tangible assets deteriorated compare to last year statement, such as property, land, and equipment, and land held property and development that caused a few impact on the total assets. In current assets, the closing stock from last year brought forward to current year assets toted up the increment of inventories closed to 83% higher than last year. IOI Corp’s engagement with numerous debtors has expanded year by year also. Nevertheless, the short term funds for this recent year didn’t progress well due to the shrinking as much as RM 300 million than last time. Furthermore, in terms of current and non-current liabilities there were two mainstreams area that need to emphasize. In long-term liabilities, IOI Corp conducted borrowing more intense in the very latest report, recognizing more than RM 1 billion. Whereas, taxation rate climbed up this year for more than 100% imposed to IO I Corp. Both these outlines pouring in valuable escalation in liabilities net figure. {text:list-item} {text:list-item} These ratios are sometimes called â€Å"liquidity measures†, the primary concern is theShow MoreRelatedPadini7800 Words   |  32 Pages1.0 Introduction This coursework ABDT 4054 Marketing required us to do research about a business organization in Malaysia and the organization name is Padini Holdings Bhd (Padini) and write a report on the following topics which includes background, analysis of the marketing environment, SWOT analysis, segmentation, targeting and positioning, marketing mix and recommendations of Padini. The reason we choose Padini is because the organization is a well known and it was listed in most valuable brand

Anne Fadimans The Spirit Catches You And You Fall Down...

The interviews in Anne Fadiman’s The Spirit Catches You and You Fall Down and Joshua Reno’s Waste Away both have their fair share of barriers to overcome, even though their research could not be more different. Anne Fadiman conducts interviews in two drastically different topics, Hmong culture and medicine. Joshua Reno favors a landfill in Michigan; interviewing residents living next to Four Corners Landfill. However different these two areas of research may be, both books show that interviewing individuals is a research method incredibly valuable when working to determine a person or group’s feelings and ideas. Both anthropologists use interviewing as a method to gain information, but are careful to align with the culture of each of the†¦show more content†¦Without an interpreter present, Fadiman would not be able to ask questions and get responses from most of the Hmong people she interviewed. Fadiman confronts another interviewing barrier when she works with the medical staff of Merced County Medical Center, the hospital where Lia Lee was taken and treated many times. Fadiman constantly reviewed Lia’s medical records, as well as consulted and interviewed many of the physicians and nurses who worked with Lia and her family. Fadiman had to alter her interviewing style and the way in which she planned the interviews while interviewing the staff of Merced County Medical Center. These individuals did not require an interpreter because they were native English speakers. Because of this, Fadiman had an easier time communicating with the interviewees, but had to remember the culture they were used to. The resident doctors and nurses Fadiman was discussing Lia’s case with worked at the Family Practice Residency, which receives most of its payment through government programs like Medi-Cal or Medicare (Fadiman 1997:24). Because of this, most patients this staff was use d to seeing were low-income, and many of them were Hmong refugees, who had differing styles of treating the sick than Fadiman was used to in Western medicine. The background of the staff Fadiman interviewed colored their medical opinions, as they were personally invested in many of the cases

My Cultural Identity Free Essays

string(145) " the concept underlying the word aâ‚ ¬\? patriotismaâ‚ ¬\? is not that easy, but I am sure that patriotism is a great source of misunderstandings\." Defining my own cultural identity by Stefanie A–ttl Culture is one of the most difficult concepts in the human social sciences and there are many different ways of defining it. It is often argued that culture is a learned behaviour pattern shared by a specific group of people. Culture is about shared meanings, and language is the privileged medium in which meaning is produced and exchanged. We will write a custom essay sample on My Cultural Identity or any similar topic only for you Order Now People sharing one culture interpret the world in roughly the same way. Defining my own cultural identity seems to me quite difficult. I actually have to admit that I am not quite sure which culture I belong to. I was born in Austria but my father comes from South Tyrol, the northern part of Italy, where Italian and German are spoken. Therefore I have Italian nationality but I have only some basic knowledge concerning the language. Although I live in Austria, there are still some traditions and cultural aspects in my family that are not Austrian. Not only is there some Italian influence, but also Canadian due to the fact that my motheraâ‚ ¬Ã¢â€ž ¢s stepmother is British but emigrated to Canada. I havenaâ‚ ¬Ã¢â€ž ¢t got Canadian nationality, but I was brought up bilingually (German/English). Furthermore I spent half a year living in Chile and therefore I was influenced by the Chilean way of life. Understandably I sometimes get quite confused about which culture I really belong to. There are several parameters for defining oneaâ‚ ¬Ã¢â€ž ¢s culture, such as nationality, language, the country you live in, gender, social class, occupation, interests, educational levelaâ‚ ¬Ã‚ ¦. But the question is, which of these parameters is to be considered the most important. I have Italian nationality, but due to the fact that I donaâ‚ ¬Ã¢â€ž ¢t really know the language I donaâ‚ ¬Ã¢â€ž ¢t really feel Italian or aâ‚ ¬? Southern Tyrolianaâ‚ ¬Ã¢â€ž ¢. And although I am not Canadian by citizenship I sometimes feel more at home there because of the language. Still, concerning some traditional aspects, I am more familiar with the aâ‚ ¬? South Tyrolianaâ‚ ¬Ã¢â€ž ¢ ones but I donaâ‚ ¬Ã¢â€ž ¢t really feel that I belong there because I donaâ‚ ¬Ã¢â€ž ¢t know Italian nor do I really speak German with a aâ‚ ¬? South Tyrolianaâ‚ ¬Ã¢â€ž ¢ accent. I believe that not knowing the language could be seen as a barrier keeping me from really experiencing Italian culture. I strongly believe that one can somehow adopt a culture by learning specific behaviour patterns, values, moralities or more precisely, a certain way of life. I experienced this while living in Chile and I can say for sure that it was far more difficult to adjust to a new way of living and learn how to react in certain situations than learning the foreign language. Despite all these influences of different cultures, I still feel very Austrian due to the fact of actually living in this country. The parameters which I believe to be very important in order to define your culture are first of all the is the country you live in because your culture depends very much on what is happening around you. The second important aspect is language through which thoughts, ideas and feelings of a certain culture are represented. The least important thing in my opinion is the nationality because I believe this to be a very official way of defining your culture. But, as I already mentioned, I sometimes donaâ‚ ¬Ã¢â€ž ¢t really know which culture I really belong to. I believe I am a mixture of all of them. Understanding home by Michael Pelitz â€Å"the night is your friend, your only friend the center stage, a moonscape as you walk. alk your head is a thread; your head’s a thread the eye of the needle becomes indistinct we’re just a sadder song away we’re just a sadder song away the mountaintops, the rainbow drops the fires from the temples and palaises. hurray the hierarchy that swallows me the pavement emptied out by night we’re just a sadder song away we’re just a sadder song away we’re off to understanding home we’re off to understanding home we’re off to understanding home we’re just a sadder song away† Just as I reached Radetzkyplatz, passing by the Hotel Garni Lind, aâ‚ ¬? Understanding Homeaâ‚ ¬? ept rotating in my disc player. aâ‚ ¬? aâ‚ ¬Ã‚ ¦The center stage, a moonscape as you walkaâ‚ ¬?. The display warns: aâ‚ ¬? BATTERY LOWaâ‚ ¬? , but Alexaâ‚ ¬Ã¢â€ž ¢ apartment is right across the square, so I decided not to worry about it. I suddenly remembered a letter I read on the internet, written by an Austrian social worker after his return from his social service year at the Holocaust Memorial Center in Detroit: aâ‚ ¬? When being abroadaâ‚ ¬? , he wrote, aâ‚ ¬? you become a true patriotaâ‚ ¬?! He stayed in the U. S. during the international crusade against the Austrian government in 2001. I started to remember all these artists who cancelled their concerts in Austria, and every single e-mail I had to send to my American friends, explaining aâ‚ ¬? the situationaâ‚ ¬?. And I had to think about all these desperate and aggressive anti-Moslem e-mails my mum received from a friend of hers who lives in Virginia, fearing that her son might not return from Iraq safely. I glanced over my shoulder to check on the traffic lights. Red. Suddenly I was confused, even a bit aggressive. I felt terribly blank despite the music, or maybe, because of the music. The whole world (including me) seems to be talking about sending, I thought! Sending e-mails, sending troops, sending messages, sending money, sending support, sending social workers. Mobility is the keyword of our times. Nobody seems to be talking about the sense of belonging. aâ‚ ¬? You become a true patriotaâ‚ ¬? , returns to my mind. I thought of how much I detest the concept of patriotism. To me, patriotism leads to flag-waving, flag-waving gives beautiful pictures, beautiful picture are very likely to be shown in the news, satellites enable worldwide broadcasts within milliseconds, and the media have an incredible manipulating impact. I know the concept underlying the word aâ‚ ¬? patriotismaâ‚ ¬? is not that easy, but I am sure that patriotism is a great source of misunderstandings. You read "My Cultural Identity" in category "Papers" The next moment I pictured myself at the soccer stadium singing the national anthem. Again, it leaves me confused. I felt exhausted. It has been a long day. An estimated 750 metres, the way from the U4-metrostation LandstraAYer HauptstraAYe to here, lay behind me. Another two and a half miles to the 23 rd district, where Iaâ‚ ¬Ã¢â€ž ¢ve parked my car, 102 kilometres to MA? zzuschlag, my hometown, an additional 87 kilometres to Graz, the city where I live, and yet another 8944 km to Portland/Oregon, the place where I spent the most wonderful year imaginable, describe my route. I think about my travels, the times I was sent, the times I mobilized. The batteries ran out on the final lines of the song. I would have loved to listen to the outro and the repetition of the chorus. I pushed the doorbell and heard the buzzing of reality. Maybe all of this is not as contradictory as I thought. Maybe the understanding of our cultural identity needs to aâ‚ ¬? travel lightaâ‚ ¬? in order to find its way back home. And in its backpack it carries all the concepts we fear, detest or treasures so much. aâ‚ ¬? Weaâ‚ ¬Ã¢â€ž ¢re off to understanding homeaâ‚ ¬? , I repeated, as suddenly the front door opened and I entered the building. Cultural Identity by Ana Flac A couple of years ago I found myself wandering between cultures, customs and different traditions. At the beginning of this â€Å"cultural voyage† I was torn between contradictions which forced me to ask myself: Who am I? What makes me a Croatian? Six years ago a specific incident happened in Osijek which triggered off these thoughts . Morete mi reci da ide vlak za Cakovec? (Could you tell me when the next train goes to Cakovec? ), I asked a railway man as I was on my way home, after I had taken my entrance exam at Osijek University in 1998. The friendly man smiled and begged my pardon. He did not quite understand me. At this point I realized that I was no longer in my home town in Medjimurje and that all the competence I had in speaking my dialect which I’m so proud of could constitute a burden rather than a merit. This was the first time I perceived myself as being different from other people in Croatia. Some of my fellow students in Osijek rejected their dialect but I was proud of it and it made me somehow stand out from the crowd so I could be easily identified by it. I realized that my Medjimurian dialect was a part of my cultural identity. As time passed by I got to know many different people from the Slavonic region, their customs and their way of living. Since this region was greatly affected by the war, a very critical attitude towards Serbs had developed there. Most of the inhabitants often expressed their fury mostly against Serbs and emphasized Pan-Croatian nationalism. I noticed I wasn’t prepared to emphasize a Pan-Croatian position and I didn’t want to perceive the whole Serbian nation so destructively. I just couldn’t identify myself with all this Pan-Croatian nationalism and I mainly disagreed with people who had this kind of attitude. I kept my distance and withdrew into my regional cultural frames. After having spent two years in Osijek, I continued my studies in a completely different country, in Austria. I was very much excited about the new faces and new culture I was about to meet. And then one day I encountered a girl on the campus and we started talking. I found the conversation quite neat. Apart from other things, she wanted to know where I come from so I told her I was from Croatia. Ah, aus Kroatien.. those were the next words she said. They sounded strange, as if she got the whole picture of me when she found out about my origin. At this moment I realized there was not only no place left for my Medjimurian identity, which I am extremely proud of, but there was also hardly even any left for my Croatian identity. I was differentiated from other students by labels such as another ex-Yugoslavian or inhabitant of the Balkans. For the first time in my life I felt ashamed of my nationality. And from that moment on I was somehow torn between my Medjimurian pride and the feeling of shame for who I was in Austria. I was trapped in some generalized prejudices about myself that I did not want to have anything to do with. My identity was on the verge of being formed by some stereotypic views which I could not accept. But inspite of all these confrontations and contradictions I had to face and which scared me and disoriented me at first, they were also the one that gave me strength and motivated me to figure out who I really am. My Cultural Identity by Camilla Leimisch If someone asked me if I was proud to be Austrian or Finnish, I would not answer aâ‚ ¬? Yesaâ‚ ¬Ã¢â€ž ¢ right away. Iaâ‚ ¬Ã¢â€ž ¢ve always felt that proud was not the appropriate word to describe my feelings towards the country where I was born or the country where I grew up, because I find it hard to be proud of something that I did not decide or that I did not achieve on my own. But I do not want to be misunderstood: I am proud of my parents to whom I owe my bilingualism and who introduced me to both cultures right from the start (Finnish from my mother and Austrian from my father). I am also happy to have kept this bilingualism and I consider myself lucky to have two native countries. Although I was born in Finland and I was only two years old when my family moved to Austria, I have never considered Finland to be my second home country, in the sense of second best. This is because I have a family there, too, and I spend every summer in Finland. This is also because my mother took care that I did not forget my Finnish roots in Austria, so I could develop feelings of the same value for both of the countries, as well as an understanding of cultural awareness that is closely connected to the feeling of home. As I see it, not only my nationality is an important part of my cultural identity, but also what I have done and what I am doing in my country and in its society. Austria is the country where I live and study. As my main subject is music, and Austria is a country of great musicians, music has become a big part not only of my personal but also of my cultural identity. I also appreciate Austrian folk music which I consider a very relevant and unique cultural tradition in the country. With Finland, itaâ‚ ¬Ã¢â€ž ¢s different. Iaâ‚ ¬Ã¢â€ž ¢d rather identify myself with Finnish people than with Austrian people. It is not easy to explain why. All I can say is that Finnish people are very attached to nature, and that I often share their moments of melancholy which are even more intense when they are far away from their own country. Iaâ‚ ¬Ã¢â€ž ¢ve already said that I am happy about my bilingualism. In fact, language is an important parameter for defining my cultural identity, because other people also define or identify you by the way you speak. Certainly you become most aware of your language when you find yourself in a foreign country where no-one speaks your language. What Iaâ‚ ¬Ã¢â€ž ¢ve noticed is that if you are among people who do not only speak differently, but also behave differently and look different from you, you suddenly distinguish yourself culturally from the others, and your cultural identity becomes much more evident. The frequently asked question about whether I feel more Austrian or more Finnish is not easy to answer. I am not 100% Austrian and not 100% Finnish. But I think that this diversity which has shaped my personality is also the key to my cultural identity. How to cite My Cultural Identity, Papers

Great Gatsby Confusions and Complexities Essay Example For Students

Great Gatsby: Confusions and Complexities Essay Novelists are often concerned with exploring the confusions and complexities of social relationships. In the context, confusions refer to puzzling relationships, which are confusing to comprehend. Whereas, complexities relate to complicated and intricate issues. The different social relationships discussed in F.Scott Fitzgeralds novel, THE GREAT GASTBY, are business colleagues, lovers and married partners. The characters involved in these relationships consist of, Jay Gatsby, Daisy and Tom Buchanan, Myrtle and George Wilson, Jordan Baker, Mr Wolshiem and Nick Carraway. Each character interacts with others, establishing either confusions or complexities within their social relationship. A complex social relationship explored in this novel is between Wolshiem and Gatsby. The two are business colleagues who work together, however the nature of their business is rarely discussed. During lunch between Gatsby, Wolshiem and Nick, Wolshiem mistakes Nicks reason of invitation, which Gatsby quickly states, I told you wed talk about that some other time. (p69) This suggests to the audience that their business is not above board, as Gatsby does not wish to discuss their business dealing in front of company. Throughout the novel, their business relationship is kept very vague. On the surface it appears to be a normal business relationship, however due to the uncertainty of their dealings, it is established to the audience that there is a complex relationship existing between the two characters. Thus showing how complexities can be explores through the social relationship of business colleagues. Another example of a social relationship explored in the novel, containing complexities, is between Wolshiem and Gatsby from Wolshiems point of view. In the final chapter, Wolshiem sends Nick a letter in regards to Gatsbys death. He states that he is, tied up in very important business cannot get mixed up in this thing now. (p157)This reinforces that their relationship was strictly business and there was not a very strong friendship existing between the two characters. It appears that Wolshiem has very little respect for Gatsby, as he doesnt have the courtesy to attend his funeral. It is portrayed that all Gatsby was to Wolshiem was a business colleague, nothing more. Wolshiem doe not want to further their relationship as friends. Within the letter, Wolshiem refers to Gatsby as a thing. This represents Gatsbys death as an inconvenience on Wolshiems behalf. As Wolshiem was involved in some very important business, this once again reinforces the idea that their business relationship wa s below board. Therefore, this shows how complexities can be explored in social relationships such as business colleagues. In contrast to a complex relationship, the social relationship between Daisy, Tom and Gastby from her point of view, is a confusion. In a conversation between the three characters, Daisy is speaking to Gatsby in regards to her love for both men. She states, I did love him once but I loved you too. (p126) Daisy is unsure of her love for both Tom and Gatsby. She is confused about her own feelings and does not wish to hurt either of them. Daisy wants the best of both worlds. She wants what both men can offer her. By marrying Tom, she was given class, wealth, success and social acceptance. These were things in which she valued and desired. However, Gatsby offered her love and affection. Daisy is unsure of who she truly loves and is not strong enough to chose between the two. This establishes to the audience, that this social relationship existing is a confusion, as she is unable to state her true feeling towards either men. Thereby demonstrating, how novelists can explore confusions of a social relationship. In addition, the social relationship between Nick and Jordan from his perspective, was a confusion. He, too, was in unsure of his love for Jordan. This is evident when he states, Angry half in love tremendously sorry. I turned away. (p169) Nick has mixed emotions towards Jordan. He is confused of his feelings and their relationship. He is unable to express himself and resolve their problems satisfactory, so he is turning and walking away. Nick in angry, in love, but yet sorry that it didnt work out. This reflects his confusion. Nick never loved Jordan enough to keep him in West Egg. This once again reinforces his confusions towards love. Nick realised that its time to move on. Their relationship has ended and he is walking away from Jordan. Thereby indicating, how novelists can explore the confusions of social relationships such as lovers. .ue1816247c1faeced333a3fc973351c63 , .ue1816247c1faeced333a3fc973351c63 .postImageUrl , .ue1816247c1faeced333a3fc973351c63 .centered-text-area { min-height: 80px; position: relative; } .ue1816247c1faeced333a3fc973351c63 , .ue1816247c1faeced333a3fc973351c63:hover , .ue1816247c1faeced333a3fc973351c63:visited , .ue1816247c1faeced333a3fc973351c63:active { border:0!important; } .ue1816247c1faeced333a3fc973351c63 .clearfix:after { content: ""; display: table; clear: both; } .ue1816247c1faeced333a3fc973351c63 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ue1816247c1faeced333a3fc973351c63:active , .ue1816247c1faeced333a3fc973351c63:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ue1816247c1faeced333a3fc973351c63 .centered-text-area { width: 100%; position: relative ; } .ue1816247c1faeced333a3fc973351c63 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ue1816247c1faeced333a3fc973351c63 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ue1816247c1faeced333a3fc973351c63 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ue1816247c1faeced333a3fc973351c63:hover .ctaButton { background-color: #34495E!important; } .ue1816247c1faeced333a3fc973351c63 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ue1816247c1faeced333a3fc973351c63 .ue1816247c1faeced333a3fc973351c63-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ue1816247c1faeced333a3fc973351c63:after { content: ""; display: block; clear: both; } READ: Autonomy Vs. Paternalism In Mental Health Treatment EssayIn comparison, the social relationship between Myrtle and Tom is one of complexity. During the party held by Tom and Myrtle, Nick is having a conversation with Catherine who states, Neither of them can stand the person theyre married to. (p35) Both Tom and Myrtle are looking for certain desires. Tom desires love, but by marrying Daisy he established class and wealth. Myrtle, on the other hand, is searching for class, social acceptance and wealth, but by marrying George Wilson, she received love. Both characters are searching for their special desire that they cannot find in their marriage, but in each other. This is why they find it necessary to have an affair with each other, so they can fulfil their desires. Thus showing, how social relationships, such as lovers, can be used by novelists to explore complexities. An example of a confusing relationship is between Daisy and Tom, from her point of view. During their early years of marriage, Daisy was madly in love with Tom. This is evident when Jordan recalls to Nick, never seen a girl so mad about her husband. (p75) They shared their memories and wonderful nights together. They were both young and in love. However, when Gatsby, and ex-lover, is re-united with Daisy, her love for Tom is not as strong. This is evident in New York when Daisy states to Tom, Youre revolting, (p125) After the five years they were apart, their love was strong enough to allow Daisy and Tom to become distant. Her views and opinions changed of Tom, due to her love for Gatsby. She was then confused of her won feelings, as to whom she really loved. Therefore, showing how Daisy and Toms relationship was confusing. Thereby demonstrating how novelists can explore confusions through social relationships. F.Scott Fitzgeralds novel, THE GREAT GASTBY, discusses many social relationships. These include business colleagues, lovers and married partners. Novelists often explore confusions and complexities through these different social relationships expressed in the novel. Interactions among characters, allow the social relationships to occur. These characters consist of Jay Gatsby, Daisy and Tom Buchanan, Myrtle and George Wilson, Jordan Baker, Mr Wolshiem and Nick Carraway. Each character is significant when establishing the confusions and complexities of social relationships.