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Doctors urged to advise patients about risks of abstinence-centric sex education

American Academy of Pediatricians’ new report is the clearest denouncement of the failures of not talking about STIs and pregnancy prevention

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

Across the US only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention.

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The country’s largest organization of pediatricians entered fraught political territory on Monday, with a call for doctors to use their time with patients to combat the potential health consequences of abstinence-centric sex education.

In a new report, the American Academy of Pediatricians (AAP) issued its clearest denunciation yet of sex education programs that fail to offer comprehensive information on topics such as sexually transmitted infections (STIs) and pregnancy prevention.

“This is the mothership telling pediatricians that talking about sex is part of your charge to keep children and adolescents safe,” said Dr Cora Breuner, a professor and pediatrician at Seattle Children’s research hospital and the report’s lead author.

“These guidelines give pediatricians in communities where people might say, ‘We don’t want you talking to our kids about this stuff,’ permission to say, ‘No, I can talk about this, I should talk about this, I need to talk about this.’”

The report is broadly a call for pediatricians to help fill in the gaps left by the country’s patchwork sex education programs. It urges pediatricians to teach not only contraception and the benefits of delaying sexual activity, but to cover topics such as sexual consent, sexual orientation and gender identity with school-aged children who may not receive any information in the classroom and involve their parents.

But the authors single out abstinence-heavy education, which sometimes excludes information about contraceptives, as a key concern for doctors looking to help adolescent patients avoid sexually transmitted infections and unintended pregnancy. As a result, it is likely to fuel an already contentious debate.

Groups that have advocated for sex education to emphasize abstinence instantly found fault with the new guidelines.

“A health organization like the AAP should not be affirming a behavior that can compromise the health of youth,” said Valerie Huber, the president of Ascend, a group that promotes abstinence-centric sex education and advocates for federal funding. The group was formerly known as the formerly the National Abstinence Education Association.

“They recommend ‘responsible sex’ for young adolescents. Exactly what is responsible sexual activity for adolescents? … The science is clear that teens are healthier when they avoid all sexual activity.”

Moreover, Huber said, programs that “normalize teen sex” are unpopular with many parents.

“Most communities do not support the type of sex education they recommend,” she said.

Still, others embraced the report as bringing the AAP’s recommendations more in line with the reality.

“This is a fantastic move,” said Chitra Panjabi, the president of the Sexuality Information and Education Council of the United States (SIECUS), a research group that supports comprehensive sex education. “It’s really important that our medical providers are standing up and saying, hey, the youth in our communities are coming to us because they’re not getting the information they need. And so we need to step in.”

The US does not enforce national standards for sex education and schools in many states are not required to teach it. Across the country, SIECUS estimates, only 50% of high school students receive sex education that meets the recommendations of the federal Centers for Disease Control and Prevention. The other half of students receive anything from an incomplete sex education, to education that emphasizes abstinence, to abstinence-only education, with a focus on delaying sex until heterosexual marriage.

In February, Barack Obama proposed a budget for 2017 that eliminated the $10m the department of health and human services spends on abstinence-only programs every year. But funding continues to flow to those programs from other sources. Title V, an abstinence-only program, allocates $75m a year to abstinence-only programs, money that states match by 75%.

In the last quarter-century, programs emphasizing abstinence as the optimal way to avoid pregnancy and STIs have received more than $2bn in funding from the federal government. Comprehensive sex education, by contrast, has no dedicated federal funding stream.

“It’s a political climate where people don’t want to talk about these issues,” said Breuner. “But it makes our job so much harder when we cannot coordinate our efforts with the schools. It takes time away from the other safety issues we need to be discussing. Don’t smoke weed. Don’t text and drive.”

Recently, two major surveys of existing research on sex education concluded that there was no evidence or inconclusive evidence to show that abstinence-centric programs succeeded in delaying sexual activity. One of the surveys found that comprehensive sex education was actually more effective than abstinence education at delaying sexual activity in teens. (Ascend points to select studies which show the opposite.)

A long-term study found that teens receiving abstinence-only programs were less likely to use contraceptives or be screened for STIs, although rates of infections were not elevated.

The studies helped compel the AAP to issue its first major guidance on sex education since 2001.

“It’s important for pediatricians to have the backing to say, ‘Look, I can’t support telling this stuff to children,’” Breuner said. “I have to deal with the aftermath, which is a 15-year-old who’s pregnant, or a 16-year-old who has a sexually transmitted infection he’s going to have for the rest of his life.”

Breuner said a number of her patients have suffered consequences from abstinence-only education. Many of them are pregnant teenagers and girls who, in the absence of accurate information, came to believe in common myths about pregnancy prevention.

“They’ll say, ‘I thought you couldn’t get pregnant when you were having your period,’ or, ‘I thought it took two or three years after you get your period to be able get pregnant.’ It’s heartbreaking, because I know with education, this could have been prevented.”

Complete Article HERE!

Gay Sex Questions, Answered by Davey Wavey’s Doctor: WATCH

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There is a lot of misinformation out there about gay sex. In an attempt to separate the myths from the facts, blogger Davey Wavey made an appointment with his physician, Dr. Jay Gladstein, to get to the bottom of things.

Among the things that you’ll find out in this check-up with Dr. Gladstein:

Does having anal sex stretch out your anus? … Can a dick ever be too big? … Is frequent douching bad for your body, and what should you douche with? … Why are some guys physically able to bottom and some aren’t? …. Is it important to tell your doctor you’re gay? … Why can’t gay men give blood? … Does bottoming cause hemorrhoids? … Does bottoming increase risk of prostate cancer? … Is the stigma of having many sexual partners justified? … Can you get STDs from swallowing semen? … If you are undetectable what are the chances of transmitting HIV? … Why is gay sex so fun?

Watch:

Is there a doctor in the house?

Hey sex fans,

I know I promised you a Q&A podcast for today, but I’m afraid I must disappoint. I’ve been experiencing technical difficulties all weekend long, so this charming exchange between me and a nervous mother will have to satisfy you till I can pull together the next podcast…this coming Wednesday, 12/05/12, I hope.

Name: Nora
Gender: female
Age: 26
Location: Mane
My husband and I are having a little problem with our 5-year-old son. He’s very bright and inquisitive and we encourage that in him. However, we’ve caught him playing doctor with playmates, twice in two months. Once with a 4 year old neighbor girl and most recently, a 6-year-old boy from his school. How do we handle this? We don’t want to stifle his inquisitive nature, nor do we want to send him the message that sex is bad or dirty. We weren’t raised like that and we don’t want to raise our son like that either. At the same time, he can’t continue to do this. If other parents discover this, there could be trouble. What do you think? Thanks.

Ya gotta love the curiosity and innocence of children, but I certainly understand your concern.

Reading your message took me back to one of my earliest memories. I must have been about the same age as your son at the time. A neighborhood boy, who was slightly younger than me, and I were playing in a vacant lot near our homes. We made a little fort in the tall grass. And there, out of the blue, I suggested that he, the neighbor boy, pull down his pants so that I could take his temperature with this little stick I was holding. He was perfectly compliant and, like it was an everyday thing, he bent over and I stuck the twig in his bum. I remember taking careful note of his little peepee in the process. He had one, just like me, which was a totally different configuration than my baby sisters. I had taken note of that when I watched my mother change their diapers. I remember thinking to myself, my god that is so weird. But I digress. The gist of the story is that I was a very inquisitive lad, just like your son. And the opportunity check out the neighbor kid was, just that…an opportunity to satisfy my curiosity.

A couple days later, pretty much out of the blue, my dad took me aside for a little chat. He asked me about my play with the neighbor kid. I wasn’t quite sure what he was referring to. Ya see the “doctor” incident didn’t register with me as particularly significant, or all the memorable. It just was what it was. But it sure did register with a nosy neighbor lady who witnessed the whole thing. Apparently she told my mother, my mother told my father and now he was telling me. You have to remember, this was the mid-1950s, so sexual experimentation at any age was a lot more taboo than it is today, or even when you and your hubby were kids.

To my father’s credit he wasn’t hysterical, but he was very firm. I got the unambiguous message that this sort of behavior was not OK. It’s funny, had no one seen me and the neighborhood kid in our innocent play, the incident wouldn’t have registered with me at all. I probably had the same level of interest in the kid as I would have seeing an interesting bug, or catching a glimpse of a rabbit or raccoon. It filled the moment, and then it was gone.

Like I said, despite my father’s mild manner, I did get the clear message that what I did crossed some line, a line that I didn’t even know existed beforehand. My father’s talk managed to instill a sense of shame where there was none before. And I remember realizing that my behavior wasn’t just wrong, like if I had hit someone, but it bad, like sinful. And even at that age, I understood to some degree what sin was. I had visions of Jesus and his blessed mother up in heaven crying their little hearts out over my indiscretion. So now, along with the shame I began to feel guilt.

Of course, even if my “doctor” play hadn’t been discovered at age 5 there certainly were dozens of subsequent opportunities for me to get the hardball message that sex was dirty and sinful — not just touching but even dwelling on the subject was enough to send one to hell. There simply was no escaping that fifty some years ago. Are things fundamentally different today? Probably not fundamentally! There are, no doubt, more parents these days who, like yourselves, are more enlightened than when I was a kid. But let’s face it; the predominant culture is still very sex-negative.

One of the biggest mistakes parents make when they are faced with the kind of situation you refer to, Nora, is they impose adult motivations onto their kid’s behavior. For the most part, young children don’t have a sense of shame about their bodies, nor do they have a highly developed sense of the personal space of another person. When their curiosity about their body and the bodies of others, both children and adults, turns to touching and exploration, it has no sexual connotation like we grown-ups understand.

Some years ago, I said much the same thing at a church sponsored workshop for parents. A mother in the audience stood up to tell me that I was all wet about this. She said she knew for sure that her pre-adolescent son had a sense of guilt about fondling himself, because when she caught him doing it one day he looked very guilty. Well, duh! But when we discussed the occurrence further, we were able to discover the truth. I asked her, to describe the situation. She said, “I happened to see my son, through the partially open door to his room. It was just after his bath. He was sitting on his bed touching himself impurely.” I had to chuckle at her vocabulary, but I asked her to proceed with her story. She said, “naturally, I threw open the door and said; ‘what in the world are you doing?’” I said, in a somewhat mocking tone; “Yes, naturally!”

I wasn’t hard to imagine the scene she was describing, because she was pretty agitated by just retelling the story. I could visualize the bedroom door flying open, her stomping into the room, hands on her hips, eyes glaring, nostrils flared, her voice pitched high. What she saw in her young son’s face was not shame; it was fright. I told her that she was the cause of the panic in his face. I explained that if she had barged in to his room that way, with her threatening body language and her “what in the world” screech while he was on his knees saying his bedtime prayers, the kid would have had the same look of alarm, which she interpreted as guilt. I also confronted the woman about the issue of privacy. Listen parents, even young children need and deserve their privacy. You don’t want to see embarrassing things? Avoid the temptation to walk in on your kids without knocking first.

The reason I tell you all of this, Nora, is I want you to realize that the way you address your son’s behavior is probably more important than what you actually tell him. If you approach the discussion all worried, or distressed, or alarmed, or agitated; you can be assured that your body language will tell him all he needs to know, even before you speak your first word.

If your son’s behavior doesn’t course correct all by itself, which it probably will, my advice is schedule a little family meeting. The key here is that you’ll want to talk about several things besides the bothersome behavior. You might bring up school, putting away his toys, playing doctor with the neighbors, and helping with some of the household chores. You’ll notice that the more difficult subject is couched between more mundane concerns. This will help keep the sexual issue properly situated…as part of everyday life.

When you ask him about his “doctor” play, and if you do it in a casual sort of way, he will probably tell you all about it as if he were telling you about his other play. My guess is he is not yet made the distinction between types of play. You might ask him why he’s playing this particular game. Maybe even ask him what he discovered, if anything. Once this part is over and you have some information about his motivation, you could add your perspective…the adult perspective. Here’s where you get to explain that some parts of our bodies are private. And now that he’s getting bigger he needs to understand the difference between public and private. You could make the distinction between bad and inappropriate — his play is not bad, just out of place. I’d be willing to guess that he already has a grasp on this concept.

You may not even have to tell him not to do it again. You could tell him that if he thinks he wants to play “doctor” again, he should ask for your permission. In the same way he would have to ask your permission to cross a busy street or stay at a friends house for lunch.

If after the family meeting you think you and your husband didn’t get it precisely right, just let it go. If the behavior continues you’ll have another opportunity to get it right. Here’s a tip, if you guys casually talk about body things, like personal hygiene…particularly if your son is uncut…on a regular basis you’ll have a foundation on which to build more complicated sex related discussions in the future.

Finally, keep all sex related talks firmly grounded in every day life. One good way of doing that is use examples from nature and apply it to human behavior.

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

The Doctor is IN!

Name: Paul
Gender: male
Age: 32
Location: Seattle
I hope this isn’t the first time you’ve gotten this kind of question but I’ve recently discovered that I have a urine fetish. And I guess what I want to know is if among gay men I am in a minority or what? Do you know of other guys out there who share my fetish? Also I’m in a relationship and I don’t think my boyfriend shares my interests so I was wondering if you might have some ideas on how to break the news to him. Thanks a lot.

A urine fetish, huh? Ok! Are you talking about what those in the know call watersports or golden showers, right? I think you’re telling me you like to play with your pee, or the pee of other folks, right?

40.jpgOh my god, this is like a totally popular fetish, and not just common among the gays, don’t cha know. I’m surprised that you haven’t encountered loads of other pee queens before now. Folks of every sexual stripe and persuasion are known to enjoy piss play. There’s even a scientific name for it: urophilia. Doesn’t that sound fun? Honey, guess what? I’m a urophiliac and you can be one too!

Hell, this is such a popular fetish that it has a full subset of associated fetishes. There are clothes wetting, bed-wetting and diaper fetishes, and urinal fetishes. For the BDSM crowd there are humiliation scenes and bladder control scenes just to name a few.

Historically speaking, people have been drinking their own urine as an alternative medicine for as long as…well, as long as there’s been pee to drink. Bathing in urine is also very common in some cultures.

Curiously enough, watersports is not necessarily always a sexual fetish, although it can be sexual in nature. Activities where piss is taken internally (swallowed or received anally or vaginally) can be risky. The pee-ee will no doubt ingest any and all un-metabolized drugs — pharmaceutical as well as recreational — which were consumed by the pee-er. In some societies and in some situations, this is the actual intent — for example intensifying and prolonging the effects of a hallucinogenic drug.

Prospective pee drinkers should be aware that there are a few drugs that pass through the body either partly unchanged or entirely unchanged, like those nasty amphetamines and their derivatives. So it’s all together possible to get really high from drinking a druggie’s piss.

Finally, how do you come out as a pee-queen to your boyfriend? I’m of the mind that the direct approach works best. There’s less room for misunderstandings. You could come right out and ask him for what you want. Darling, meet me in the bathroom. I want to show you something really festive and entertaining. I mean, what homo’s isn’t gonna fall for that?

A less assertive way would be to visit several golden shower oriented websites, they abound on them internets, ya know. Leave the page open for the BF to find. That will stir things up. And unless he’s as dense as a post, he’ll begin to get the message. You could also “accidentally” rent a watersports video. That would, no doubt, open the desired discussion. “Holy cow honey, look what I picked up by mistake. You wanna watch it? Isn’t this hot? Oh my god, I think I just wet my pants. Wanna see?”

Name: Maria
Gender: Female
Age: 24
Location: California
Hi Dr, My question is a little strange. My boyfriend has this weird fetish about cumming on me…not just on me but all over me. On my boobs, on my face, he likes to get it in my hair, on my feet. I’m practically swimming in the stuff. Most of the time I don’t mind it and sometimes it gets me off. But I’m just wondering what’s this all about. Why does he have this desire to cum all over me? Most of the time he wants me on my knees waiting for his gift, tongue sticking out like a dog. Any thoughts why?

Maria, darling, this is absolutely precious! I love it!

Did you ever see the brilliantly funny Mel Brooks movie, High Anxiety?

In the movie Mel Brooks plays Dr. Richard H. Thorndyke, the new administrator of the Psychoneurotic Institute for the Very, VERY Nervous. He goes to San Francisco for a conference where he is framed for a murder. Mid-way through the movie there’s a scene where Thorndyke is on the lam. He phones his new friend, Victoria Brisbane, (played by the amazing Madeline Kahn) from a phone booth to ask for her help. Victoria is in her hotel room when she answers the phone. Just at that moment, the real killer attacks Dr Thorndyke and has him by the throat. Because of all the heavy breathing and choking sounds on the Thorndyke end, Victoria thinks she getting a prank sex call. She protests but then is drawn into the call. It’s comic genius. Dr Thorndyke’s struggle comes to an end when his attacker is impaled on a shard of glass. His death gasp makes Victoria think her caller just shot his wad. She responds with disgust, “You animal!

That’s where my mind went, Maria when I got your call. The description of your boyfriend’s spooge fetish made me think of Victoria Brisbane and her exclamation, “You Animal.”

p10.jpgYa see, Maria, us boys think all the world is as enamored with our spunk as we are. And so we think we’re doing everyone a big favor by spreading our junk around. We’re particularly fond of getting as much of our joy-juice as possible on our partners and the messier the better. We’ll tell you that we do this because we love you and we just whipped up this tasty little batch of seed just for you. That’s bullshit of course.

What we’re really doing is marking our territory. Did you ever notice how pleased with himself a male dog is when he’s blissfully lifting his leg to pee on everything in site? I’d be willing to bet you’d see a similar shit-eatin’ grin on the BF as you’d see on that dog. Your BF is marking his territory, but he’s marking you with his jizz.

The upside of this is that our little nut concoction is heavily protein laden, so you’ll not find a better skin emolument. Just make sure he doesn’t get any in your eyes. That shit burns! Enjoy!

Name: Jim
Gender: male
Age: 23
Location: Sydney
I’m addicted to porn. I look at porn for hours and hours at a time at work at home on my cell phone whatever. I am noticing that the more porn I look at the more I want and now I’m searching out some real weird shit the weirder the better. I’m afraid this is taking over my life, but I can’t stop. What should I do?

Listen Jim, there’s no such thing as an addiction to porn! PERIOD!

Nowadays people bandy about the term addiction as if it could be applied to any and all obsessive behaviors. I have an addiction to chocolate, I’m addicted to shopping, or I’m a sex addict. NONSENSE!

Let’s be clear about this. An addiction is a very specific condition. It denotes a dual dependency, physical as well as a psychological. A physical dependency occurs when a substance is habitually used to a point where the body becomes reliant on its effects. The substance must be used constantly, because if it is withheld it will trigger symptoms of withdrawal. Psychological dependency occurs when the substance habitually used creates an emotional reliance on its effects. There is no functioning without it. Its absence produces intense cravings, which if not fed will trigger symptoms of withdrawal.

What you report about yourself, Jim, is not an addiction. Your behaviors, however, are a classic example of a severe fixation or obsession. Just because out of control behavior isn’t an addiction, doesn’t mean it’s not serious.

You may say to yourself, “What the fuck, doc, fixation, addiction it all sounds the same to me.” Well, sounding alike and being the same are two very different things. Besides, if one doesn’t properly identify the problem; how will one find the proper intervention? And you, my friend, need an intervention ASAP.

n.jpgYour relentless pursuit of pornography, your obsession with more and more graphic and extreme depictions of sex is clearly interfering with you living a normal life. And at such a tender age, what’s up with that? This has got to stop, pup. You can’t continue to take refuge in fantasy material in lieu of having healthy interpersonal relationships.

I’d also challenge your suggestion that you are enjoying the porn you consume. When consumption of anything — porn, food, whatever — is this unrelenting, there is no enjoyment factor anymore.

If you have the psychological capacity to limit your porn consumption on your own, great — Do it! Be strict with yourself. Deny yourself access to the materials that fuel your fixation. Channel that energy into connecting with other LIVE humans.

If you are unable to monitor your behavior on your own — seek professional help right away. Look to a sex-positive therapist who will assist you in creating boundaries for yourself. Your therapist will help you learn how to reward your successes and not reward your failures. You will, in time, be able to put this obsession behind you. But you must act now. Your humanity hangs in the balance.

Good luck, ya’ll!

Men, Depression and Sex

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As anyone who has been depressed will tell you, depression isn’t just about feeling blue.

Man and woman with pensive expression --- Image by © Ocean/Corbis

It is an incredibly complex condition which brings with it a whole slew of emotional, mental and physical symptoms with it. For men and women both, part of the problem can revolve around their sexuality – and this in turn can cause problems in a relationship at the time when the depressed person most needs the support.  Fortunately, there are ways to help treat this particular problem and restore intimacy and pleasure to a relationship.

Depression and Male Sexuality

It is common for both men and women to experience sexual problems as part of their depression – but the ways in which this presents itself can be different.  Healthline notes that in men, depression will often express itself as feelings of low-esteem, anxiety and guilt and this, in turn, can cause problems with erectile dysfunction, delayed orgasm, premature ejaculation or just a loss of interest in sex itself.

There is still a lot we just don’t know about exactly how depression affects the brain. But according to Net Doctor, researchers have learned that the chemical changes which take place when someone has this condition can lead to an increase in emotional withdrawal and low energy levels so that activities like sex, which require a connection to your partner as well as physical energy to perform, can become a challenge.  This can be hurtful for the person’s partner and make them feel unwanted or unloved, putting a strain on the relationship that can, in itself, be difficult to deal with.

To make matters worse, many antidepressants are notorious for their side effect of causing sexual dysfunction or loss of interest.  Included in this group are MAOI inhibitors, SSRI’s and SSNRI’s and both tetracyclic and tricyclic antidepressants. 

What to Do

So the long and short of it is, both depression itself and some of the treatments for depression can both put a damper on a guy’s sex life. So what are some solutions to the problem?

Get the Treatment You Need

Depression is not a choice that people make – and it is usually not a problem that goes away by itself. If you have not yet been diagnosed, talk to your doctor about the symptoms you are having and get started on a plan of care that involves the combination of medications, therapy and lifestyle changes that are right for you.

If you are already being treated for depression and suspect that your anti-depressants might be putting the kybosh on your sex life, find out if you can switch medications. While it might take a little time to take effect, there are some drugs which do not seem to effect one’s libido, including Wellbutrin and Remeron.

Exercise

Both Healthline and Everyday Health recommend regular exercise – preferably with your partner – as part of a program to help reconnect sexually. First, it gives you and your partner time together doing something enjoyable and this alone can be good for a relationship. It also helps to release feel-good chemicals like endorphins that help fight depression naturally and keeps you in good shape so that you feel good about yourself and the way you look. All this can go a long way to enhancing your sex life.

Take Your Time

According to Everyday Health, sex therapist Dr. Sandra Caron also has a few tips for couples who are struggling to overcome the barrier that depression has placed on their sives.  She recommends, first of all, that couples engage in more foreplay and other physical expressions of intimacy – hand holding, caressing, massage – before engaging in intercourse itself.  Depression tends to slow down all responses, so taking this extra time to achieve arousal can help enhance the pleasure for both partners.  She also recommends the use, if needed, of estrogen creams or lubricants and even erotica (like lingerie or sexy movies) to help sparthe mood.

Open Up

Probably the most important advice for men who are trying to reconnect with their partner sexually is to open up and communicate with your partner. This can be more difficult for men to do in general, but is even more of a challenge when it comes to talking about intimate issues like sexuality, desire and arousal. But being honest about how you are feeling and letting your partner know that it is the depression that is a problem and not a loss of interest or a loss of love can be an incredibly powerful way to overcome this challenges and get support from your loved one at a time when you need it the most.  Also, partners can be more understanding and supportive if they understand more about what is going on – otherwise, it is easy to interpret a low mood or lack of responsiveness as being hostile or unloving.

In short, depression is a difficult condition with a whole slew of symptoms that go far beyond just feelings of sadness or being blue.  And when depression begins to affect a person’s sexuality, this in turn can lead to a strain on intimate partner relationships.  However, while there are no quick solutions to this problem, getting on a treatment program that is tailored to someone’s individual needs as well as exercising regularly, spending time with a partner to engage in more foreplay and simply opening up and talking about the problem can all help to reignite the sexual spark in a relationship – and hopefully make the battle against depression that much easier.

Complete Article HERE!