Lupus

Posted on May 18, 2013 by admin

What is lupus?

Lupus is a chronic, autoimmune disease. It can damage any part of the body (skin, joints, and/or organs inside the body). Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years. In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and other germs (“foreign invaders,” like the flu). Normally your immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between these invaders and your body’s healthy tissues (“auto” means “self”). In lupus, your immune system creates autoantibodies , which sometimes attack and destroy healthy tissue. These autoantibodies contribute to inflammation, pain, and damage in various parts of the body.

When people talk about “lupus,” they usually mean systemic lupus erythematosus, or SLE. This is the most common type of lupus. It is hard to guess how many people in the U.S. have lupus, because the symptoms are so different for every person. Sometimes is not diagnosed. The Lupus Foundation of America thinks that about 16,000 new cases are reported across the country each year.

Although lupus can affect almost any organ system, the disease, for most people, affects only a few parts of the body. For example, one person with lupus may have swollen knees and fever. Another person may be tired all the time or have kidney trouble. Someone else may have rashes. Over time, more symptoms can develop.

Normally, lupus develops slowly, with symptoms that come and go. Women who get lupus most often have symptoms and are diagnosed between the ages of 15 and 45. But the disease also can happen in childhood or later in life.

For some people, lupus is a mild disease. But for others, it may cause severe problems. Even if your lupus symptoms are mild, it is a serious disease that needs constant monitoring and treatment. It can harm your organs and put your life at risk if untreated.

Although the term “lupus” commonly refers to SLE, there are several kinds of lupus:

  • Systemic lupus erythematosus, or SLE, makes up about 70 percent of all cases of lupus. SLE can be mild or severe and can affect various parts of the body. Common symptoms include fatigue, hair loss, sensitivity to the sun (photosensitivity), painful and swollen joints, unexplained fever, skin rashes, and kidney problems. In general the diagnosis of lupus is based off of a combination of physical symptoms and laboratory results.
  • Cutaneous lupus erythematosus can be limited to the skin or seen in those with SLE. “Cutaneous” means “skin.” Symptoms may include rashes/lesions, hair loss, vasculitis (swelling of the blood vessels), ulcers, and photosensitivity. A doctor will remove a small piece of the rash or sore and look at it under a microscope to tell if someone has skin lupus and what form it is. There are two major kinds of cutaneous lupus:
    • Discoid lupus erythematosus, also called DLE, mainly affects the skin. The discoid rash usually begins as a red raised rash that becomes scaly or changes color to a dark brown. These rashes often appear on the skin on the face and scalp, but other areas may also be affected. Many people with DLE have scarring. Sometimes DLE causes sores in the mouth or nose. A doctor will remove a small piece of the rash or sore and look at it under a microscope to tell if someone has DLE. If you have DLE, there is a small chance that you will later get SLE. Currently there is no way to know if someone with DLE will get SLE.
    • Subacute cutaneous lupus erythematosus makes up 10 percent of lupus cases. About 50 percent of the time, people with subacute cutaneous lupus also have SLE. Subacute cutaneous lupus causes skin lesions that appear on parts of the body exposed to sun. These lesions do not cause scars.
  • Drug-induced lupus is a form of lupus caused by certain medicines. The symptoms of drug-induced lupus are like those of systemic lupus, but only rarely affect major organs. Symptoms can include joint pain, muscle pain, and fever, and are mild for most people. Most of the time, the disease goes away when the medicine is stopped. However, not everyone who takes these drugs will get drug-induced lupus. The drugs most commonly connected with drug-induced lupus are used to treat other chronic conditions, such as seizures, high blood pressure, or rheumatoid arthritis. Examples include procainamide (Pronestyl®, Procanbid®); hydralazine (Apresoline®; also, hydralazine is an ingredient in Apresazide® and BiDil®); phenytoin (Dilantin®); etanercept (Enbrel®); and adalimumab (Humira®).
  • Neonatal lupus is a rare condition in infants that is caused by certain antibodies from the mother. These antibodies can be found in mothers who have lupus. But it is also possible for an infant to have neonatal lupus even though the mother is healthy. However, in these cases the mother will often develop symptoms of lupus later in life. At birth, an infant with neonatal lupus may have a skin rash, liver problems, or low blood cell counts, but these symptoms disappear completely after several months and have no lasting effects. Infants with neonatal lupus can also have a rare but serious heart defect. With proper testing, physicians can now identify most at-risk mothers, and the infant can be treated at or before birth. Most infants of mothers with lupus are healthy.

Who gets lupus?

Lupus affects young women most

More than 90 percent of people with lupus are women between the ages of 15 and 45. African‑American, Latina, Asian, and Native American women are at greater risk of getting lupus than white women.

Anyone can get lupus. About 9 out of 10 adults with lupus are women ages 15 to 45. African-American women are three times more likely to get lupus than white women. Lupus is also more common in Latina, Asian, and Native American women. Men are at a higher risk before puberty and after age 50. Despite an increase in lupus in men in these age groups, two-thirds of the people who have lupus before puberty and after age 50 are women.

African-Americans and Latinos tend to get lupus at a younger age and have more severe symptoms, including kidney problems. African-Americans with lupus have more problems with seizures, strokes, and dangerous swelling of the heart muscle. Latina patients have more heart problems as well. Scientists believe that genes play a role in how lupus affects these ethnic groups.

Apart from genetic factors, lupus can be more severe for people who aren’t getting the care they need. Studies have shown that people with lupus who have a lower household income, lower level of education, or less of a support system tend to do worse with the disease. For some people with lupus, severe symptoms of the disease leave them unable to work, which may result in low income and lack of health insurance. These factors make it hard for a person with lupus to get the right treatment — or sometimes even diagnosis — that they need.

Why is lupus a concern for women?

Lupus is most common in women, especially women in their childbearing years. Having lupus increases your risk of other health problems that are common in women. It can also cause these diseases to occur earlier in life:

  • Heart disease. When you have lupus you are at bigger risk of the main type of heart disease, called coronary artery disease (CAD). This is partly because people with lupus have more CAD risk factors, which may include high blood pressure, high cholesterol, and type 2 diabetes. The inflammation that accompanies lupus also increases the risk of developing CAD. Women with lupus are often less active because of fatigue, joint problems, and/or muscle pain, and this also puts them at risk. Heart disease is the number one killer of all women. But, women with lupus are 50 times more likely to have chest pain or a heart attack than other women of the same age.
  • Osteoporosis. Women with lupus have more bone loss and broken bones than other women. This might be because some medicines used to treat lupus cause bone loss. The disease itself can also cause bone loss. Also, pain and fatigue can keep women with lupus from exercising. Staying active is important for keeping bones healthy and strong.
  • Kidney disease. Many symptoms of lupus come from the swelling of organs in the body. Almost half of all people with lupus develop kidney problems, called lupus nephritis. Kidney problems often begin within the first five years after lupus symptoms start to appear. This is one of the more serious complications of lupus, but there are treatments if problems are caught early. However, it is important to know that kidney inflammation is not painful and you can’t feel it. That is why it’s important for people with lupus to keep up-to-date with the screenings their doctors recommend. These will include urine and blood tests.

What causes lupus?

The cause of lupus is not known. It’s not a disease you can catch from another person. Researchers are looking at these factors:

  • Environment (sunlight, stress, smoking, certain medications, and viruses might trigger symptoms in people who are prone to getting lupus)
  • Hormones such as estrogen (lupus is more common in women during childbearing years)
  • Problems with the immune system
  • Genes play an important role, but are not the only reason a person will get lupus. Even someone who has one or more of the genes associated with lupus has a small chance of actually getting the disease. And only 10 percent of people with lupus have a parent or sibling who also has it.

What are the symptoms of lupus?

The signs of lupus differ from person to person. Some people have just a few symptoms; others have more. Lupus symptoms also tend to come and go. Lupus is a disease of flares (the symptoms worsen and you feel ill) and remissions (the symptoms improve and you feel better).

Common signs of lupus are:

  • Joint pain and stiffness, with or without swelling
  • Muscle aches, pains, or weakness
  • Fever with no known cause
  • Feeling very tired
  • Butterfly-shaped rash across the nose and cheeks
  • Other skin rashes
  • Unusual weight loss or weight gain
  • Anemia (too few red blood cells)
  • Trouble thinking, memory problems, confusion
  • Kidney problems with no known cause
  • Chest pain when taking a deep breath
  • Sun or light sensitivity
  • Hair loss
  • Purple or pale fingers or toes from cold or stress

Less common symptoms include:

  • Blood clots
  • Seizures
  • Sores in the mouth or nose (usually painless)
  • Severe headache
  • Dizzy spells
  • “Seeing things”, not able to judge reality
  • Feeling sad
  • Strokes
  • Dry or irritated eyes

What are flares?

The times when your symptoms worsen and you feel ill are called flares, and they come and go. You may have swelling and rashes one week and no symptoms the next. Sometimes flares occur without clear symptoms and are only seen with laboratory tests. Even if you take medicine for lupus, you may find that some things trigger a flare. For instance, your symptoms may flare after you’ve been out in the sun or after a hard day at work. Common triggers include:

  • Overwork and not enough rest
  • Stress
  • Being out in the sun or close exposure to fluorescent or halogen light
  • Infection
  • Injury
  • Stopping your lupus medicines
  • Certain medications

Is lupus fatal?

Many men and women live long, productive lives with lupus. However, it can be fatal for some people. It depends on the severity of illness, how the body responds to treatments, and other factors. Infections are the leading cause of death in people with lupus. Studies show that people with lupus are living longer lives compared to decades past.

How can my doctor tell if I have lupus?

Lupus can be hard to diagnose. It’s often mistaken for other diseases. Many people have lupus for a while before they find out they have it. If you have symptoms, tell your doctor right away. No single test can tell if a person has lupus. But your doctor can find out if you have lupus in other ways, including:

  1. Medical history. Telling your doctor about your symptoms and other problems can help her understand your situation. Keep track of your symptoms by writing them down.
  2. Family history of lupus or other autoimmune diseases. Tell your doctor if lupus or other autoimmune diseases run in your family.
  3. Complete physical exam. Your doctor will look for rashes and other signs that something is wrong.
  4. Blood and urine tests. The antinuclear antibody (ANA) test can show if your immune system is more likely to make the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not mean you have lupus. About five to ten percent of healthy women test positive for ANA.
  5. Skin or kidney biopsy. With a biopsy, doctors perform a minor surgery to remove a sample of tissue. The tissue is then viewed under a microscope. Skin and kidney tissue looked at in this way can show signs of an autoimmune disease.

Together, this information can provide clues to your disease. It also can help your doctor rule out other diseases that can be confused with lupus.

Print out pdf icon  this table (PDF, 104 KB) and use it to make notes to take to your doctor. Put a check mark beside the symptoms you have. Note when you have them.

Symptom checklist
Symptom Where? When did you first notice? How often? Recent dates?
Example: rash face and chest 2 years ago Once or twice a month 9/17, 10/8, 10/23, 11/15
Red rash or color change
Painful or swollen joints
Fever with no known cause
Feeling very tired
Trouble thinking, memory problems, confusion
Chest pain with deep breathing
Sensitivity to the sun
Unusual hair loss
Pale or purple fingers or toes
Sores in mouth or nose
Other

Adapted from National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

How is lupus treated?

There is no known cure for lupus, but there are treatments. Your treatment will depend on your symptoms and needs. The goals of treatment are to:

  • Prevent flares
  • Treat symptoms when they occur
  • Reduce organ damage and other problems

Your treatment might include using medicines to:

  • Reduce swelling and pain
  • Prevent or reduce flares
  • Calm the immune system
  • Reduce or prevent damage to the joints
  • Reduce or prevent organ damage

Be careful with supplements

Never take vitamins or herbal supplements without talking to your doctor first. They might not mix well with medicines you use to treat lupus.

Drugs play an important role in treating lupus. Most likely, the drugs prescribed to you will change often during your treatment. Types of drugs commonly used to treat lupus include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are used to reduce pain and swelling in joints and muscles. They can help with mild lupus when pain isn’t too bad and vital organs are not affected. Aspirin, ibuprofen, and naproxen are some over-the-counter NSAIDs. You need a prescription for stronger ones. NSAIDs can cause stomach upset, heartburn, drowsiness, headache, fluid retention, and other side effects. If overused, NSAIDs also can cause problems in your gastrointestinal tract (which includes the stomach), blood, liver, and kidneys. In pregnant women, NSAIDs should be avoided after the first trimester. They should be used with caution in women who breastfeed.
  • Corticosteroids. Corticosteroids (KOR-tih-koh-STEER-oyds) are hormones found in our bodies. Manmade versions, often called “steroids,” are used to reduce swelling, tenderness, and pain in many parts of the body. In high doses, they can calm the immune system. These drugs are different than steroids used by some people who play sports or lift weights. Corticosteroids come as pills or liquids, creams to apply to the skin, and as shots. Prednisone is one that is commonly used to treat lupus. Lupus symptoms tend to respond very quickly to these powerful drugs. Once this has happened, your doctor will want to lower your dose slowly until you no longer need it. The longer a person uses these drugs, the harder it becomes to lower the dose. But stopping this medicine right away can harm your body. Make sure to use your medicine exactly as your doctor tells you to.Corticosteriods can have many side effects, so your doctor will give you the lowest dose possible. Short-term side effects can include: a round or puffy face, acne, heartburn, increased appetite, weight gain, and mood swings. These side effects typically stop when the drug is stopped. However, the weight gain will not reverse on its own, so be careful not to overeat while on steroids. Long-term side effects can include: easy bruising, thinning skin and hair, weakened or damaged bones, high blood pressure, damage to the arteries, high blood sugar, infections, muscle weakness, and cataracts. Some people may have ulcers, depression, or even congestive heart failure. Your doctor can prescribe medicines to take with corticosteroids to prevent some side effects. Corticosteroids can be used during pregnancy with your doctor’s supervision
  • Antimalarial drugs. Medicines used to prevent or treat malaria are used to treat joint pain, skin rashes, fatigue, and inflammation of the lungs. Two common antimalarials are hydroxychloroquine sulfate (Plaquenil®) and chloroquine phosphate (Aralen® phosphate). Side effects of antimalarials can include stomach upset, nausea, vomiting, diarrhea, headache, dizziness, blurred vision, trouble sleeping, and itching. People treated with antimalarials should see an eye doctor every year, because of the low risk of eye problems. Studies have found that taking antimalarials can stop flares and some help people with lupus live longer.
  • BLyS-specific inhibitors. The first medication approved by the Food and Drug Administration under this new class of drugs is called belimumab (Benlysta®). It limits the amount of autoantibodies found in people with lupus. The drug blocks the action of a specific protein in the body that is important in immune response. Two clinical studies in more than 1,600 people with lupus showed Benlysta to be safe and effective. However, the research did not have enough data showing Benlysta to be effective in African-Americans, so another study is being done. In clinical studies, people taking Benlysta reported more deaths and serious infections than those not taking the drug. Benlysta should not be given with live vaccines. The most common side effects included nausea, diarrhea, and fever.
  • Immunosuppressive agents/chemotherapy. These agents are used in severe cases of lupus, when major organs are affected by lupus and other treatments do not work. These drugs suppress the immune system to limit the damage to the organ. Examples are azathioprine (Imuran®), and cyclophosphamide (Cytoxan®), mycophenolate mofetil (Cellcept), and methotrexate (Rheumatrex® and Trexall®). These drugs can cause serious side effects including nausea, vomiting, hair loss, bladder problems, decreased fertility, and a risk of cancer and infection. These drugs can also cause birth defects. If you take these medicines, your doctor may tell you to avoid pregnancy.

You and your doctor should review your treatment plan often to be sure it is working. Also, you may need other drugs to treat conditions that are linked to your lupus — such as high blood pressure, osteoporosis, or blood clots. Many people with lupus are prescribed anticoagulants (“blood thinners”), such as warfarin (Coumadin®) or heparin, because of the risk of blood clots. An untreated blood clot can cause a stroke or heart attack. Pregnant women should not take warfarin.

Tell your doctor about any side effects or if your medicines no longer help your symptoms. Tell your doctor if you have new symptoms. Never stop or change treatments without talking to your doctor first.

Are there options for treating my lupus with complementary or alternative medicine?

Some people with lupus try creams, ointments, fish oil, supplements, special diets, or homeopathy, or see a chiropractor, to care for their lupus. Some people with lupus have said these help. However, research has not proven that any of these alternatives successfully treats lupus or reduces the risk of other problems. More importantly, research has not been done to show whether these therapies could be harmful. That is why you must talk to your doctor before trying any alternative remedy. Don’t stop or change your prescribed treatment without first talking to your doctor.

Should I get vaccines if I have lupus?

Vaccines that protect against pneumonia and the flu are safe for people with lupus if they are killed virus vaccines. (These vaccines have no active virus and can’t make you sick, but they can still help you make antibodies.) Your doctor may suggest that you get these vaccines to lower your risk of infection. However, they may not work as well for you as for other people who don’t have lupus, especially if you are taking steroids or other immunosuppressive drugs.

It is possible that vaccines that contain live virus — like the vaccines for measles, mumps, and rubella, and sometimes flu — may be dangerous for some people with lupus. However, people with lupus have reported receiving these shots with no problems. Ask your doctor what is best for you.

Will I need to see a special doctor for my lupus?

Depending on your symptoms and/or if your organs have been hurt by your lupus, you may need to see special kinds of doctors. Start by seeing your family doctor and a rheumatologist), a doctor who specializes in the diseases of joints and muscles such as lupus.

Your rheumatologist may ask that you also see:

  • A clinical immunologist , a doctor who treats immune system disorders
  • A nephrologist, a doctor who treats kidney diseases
  • A hematologist, a doctor who treats blood disorders
  • A dermatologist, a doctor who treats skin problems and diseases
  • A neurologist, a doctor who treats problems with the nervous system
  • A cardiologist, a doctor who specializes in the heart and blood vessels
  • An endocrinologist , a doctor who specializes in problems with the glands and hormones
  • A psychologist or psychiatrist, doctors who treat anxiety and depression
  • An occupational therapist
  • A social worker

What can I do to control my lupus symptoms and prevent flares?

The best way to keep your lupus under control is by following your treatment plan and taking care of yourself. Take these steps:

  • Learn how to tell that a flare is coming
  • See your doctors regularly
  • Maintain life balance by setting realistic goals and priorities
  • Limit the time you spend in the sun and in fluorescent and halogen light
  • Eat a healthy diet
  • Develop coping skills to help limit stress
  • Get enough sleep and rest
  • Exercise moderately with your doctor’s okay and when you’re feeling up to it
  • Build a support system made up of people you trust and can go to for help

Despite your best efforts to follow your treatment plan and take good care of yourself, there will be times when your lupus symptoms are worse. Being able to spot the warning signs of a flare can help you prevent the flare or make it less severe. Before a flare your symptoms might get worse, or you might get new symptoms, such as:

  • Feeling more tired
  • Pain
  • Rash
  • Fever
  • Stomach ache
  • Severe headache
  • Dizziness

Contact your doctor right away if you suspect a flare is coming.

Should I change my diet because I have lupus?

People with lupus may have to make changes to their diet based on their symptoms, on treatment, and other factors. Ask your doctor if you should eat a special diet because of your lupus.

For instance, people with lupus are more likely to get hyperlipidemia (high level of fats in the blood). With this condition, you will need to follow a low-fat diet. If your lupus is causing many high fevers, you may need to eat more calories. Or, steroids and other drugs might cause you to gain weight, and you will need to switch to a low-calorie diet.

Because people with lupus need to avoid the sun, they may lack vitamin D. Your doctor may tell you to take a vitamin for this reason. Herbal supplements have no proven benefit and can cause harm. Talk to your doctor before trying any vitamins or herbal supplements.

Living with lupus can be hard. How can I cope?

Dealing with a long-lasting disease like lupus can be hard on your feelings. Concerns about your health and the effects of your lupus on your work and family life can be stressful. Changes in the way you look and other physical effects of lupus (and the medicines used to treat lupus) can effect your self-esteem. Your friends, family, and coworkers might not seem to understand how you feel. At times, you might feel sad or angry. Or, you may feel that you have no control over your life with lupus. But there are things you can do that will help you to cope and to keep a good outlook. Try to:

  • Pace yourself. People with lupus have less energy and must manage it wisely. Most women with lupus feel much better when they get enough rest and avoid taking on too much at home and at work. To do this, pay attention to your body. Slow down or stop before you’re too tired. Learn to pace yourself. Spread out your work and other activities.
  • Reduce stress. Exercising with your doctor’s okay, finding ways to relax, and staying involved in social activities you enjoy will reduce stress and help you to cope.
  • Get support. Be open about your feelings and needs with family members and friends. Consider support groups or counseling. They can help you to see that you are not alone. Group members teach one another how to enjoy life with lupus.
  • Talk to your doctor. The symptoms of lupus and some medications can bring on feelings of depression. People with lupus are more likely than others to be depressed and anxious. It is important to tell your doctor about your feelings, so that if it’s needed, he or she can treat you for mental health disorders that are more common in people with lupus.
  • Learn about lupus. People who are well-informed and involved in their own care have less pain, are more active, make fewer visits to the doctor, and feel better about themselves.

I have lupus. Is it safe for me to become pregnant?

Women with lupus can safely become pregnant. If your disease is under control, pregnancy is unlikely to cause flares. But there are some important things you should know before you become pregnant:

  • Your disease should be under control or in remission for six months before you get pregnant. Getting pregnant when your lupus is active could result in miscarriage, stillbirth, or other serious problems. Planning ahead is critical if you have lupus.
  • Some women do get flares during pregnancy. The flares happen most often in the first or second trimester or in the first few months after you have the baby. Most flares are mild and easily treated.
  • Preeclampsia, or “toxemia,” is a serious condition that must be treated right away. Preeclampsia is a condition starting after 20 weeks of pregnancy that causes high blood pressure and problems with the kidneys and other organs. About 2 in 10 pregnant women with lupus get preeclampsia, though some studies say that rate is higher. The risk of preeclampsia is also higher in women with lupus who have a history of kidney disease. If you get preeclampsia, you might notice sudden weight gain, swelling of the hands and face, blurred vision, dizziness, or stomach pain. You might have to deliver your infant early.
  • Pregnant women with lupus, especially those taking corticosteroids, are more likely to have high blood pressure and diabetes, and to have kidney problems. Regular doctor visits and good nutrition during pregnancy are important to prevent these problems.
  • There are certain groups of women with lupus for whom pregnancy is very risky for the mother and the fetus. This may include women who have a very high pulmonary hypertension, lung disease, heart failure, chronic kidney failure, kidney disease, or a history of preeclampsia. It also may include women who have had a stroke or a lupus flare occur within the past 6 months.
  • Although many women with lupus have normal pregnancies, all lupus pregnancies should be considered “high risk.” This means there are certain factors that make problems during pregnancy more likely for women with lupus. It doesn’t mean there will be problems.

Planning ahead and proper medical care are very important. Remember to:

  • Find an obstetrician (OB) who manages high-risk pregnancies and who can work closely with your regular doctor.
  • Plan to have your baby at a hospital that can manage high-risk patients and provide the special care you and your baby may need.
  • See your doctor often while you are pregnant.
  • Talk to your doctor about which medicines are safe to use while pregnant.
  • Make a plan for help at home during your pregnancy and after your baby is born. Motherhood can be very tiring, and even more so for women with lupus.
  • Develop a birth control plan for after you have your baby. A pregnancy that occurs soon after giving birth has more risks even in women who don’t have lupus. It is possible to get pregnant before your period begins again or while you are breastfeeding. For more information, visit our section on getting pregnant again.

I am pregnant. How can I tell whether changes in my body are normal or signs of a flare?

It may be hard to tell the difference. You may have symptoms from being pregnant that you mistake for a flare. Here are some examples:

  • Skin. While pregnant, you may have red palms and a rash. Lupus can also cause a rash.
  • Joints. Pregnancy can cause aching in your joints. Lupus can also cause pain and swelling in your joints.
  • Lungs. Pregnancy also can cause shortness of breath. Lupus can also make it hard to take deep breaths.
  • Leg swelling. Pregnancy can cause your legs to swell. Swollen legs are also a sign of kidney problems in people with lupus.

Fortunately, recent studies show that flares are uncommon and tend to be mild during pregnancy. Some women with lupus find their symptoms improve during pregnancy. Still, it’s important to report new symptoms to your doctor. This way, flares that do occur can be prevented or controlled.

I am pregnant and have lupus. Will my baby be born healthy?

Babies born to women with lupus have no greater chance of birth defects or mental retardation than babies born to women without lupus. About one to two percent of babies born to mothers who have the antibodies for lupus will have neonatal lupus that includes congenital heart block, a serious heart defect. In most cases, neonatal lupus goes away after 3 to 6 months and does not come back. A mother who does not have lupus can still give birth to a baby with neonatal lupus. It is common for these mothers to have symptoms of lupus or Sjogren’s syndrome (another autoimmune disease) later in life.

Can I breastfeed if I have lupus?

Breastfeeding is possible for mothers with lupus. Some medicines can pass through your breast milk to your infant. Talk to your doctor about whether breastfeeding is safe with the medicines you use to control your lupus. Breastfeeding also can be very tiring because breastfed babies eat more often than formula-fed babies and your body needs energy to make milk. If the demands of breastfeeding become too much for you, think about breastfeeding only some of the time. Pumping breast milk to be used later also might help. You can also look into human milk banks. Never use milk you get directly from another woman or the Internet. You can find a human milk bank through the Human Milk Banking Association of North America External Website Policy. Talk to your doctor — you will need a prescription to get milk from a milk bank.

My child has lupus — is it different for him or her?

Lupus is the same disease in children that it is in adults. However, kids with lupus often have the disease for a longer period of time before it is diagnosed. Therefore, kids may have more problems at a younger age. They may need more aggressive treatment.

Parenting a child with lupus has many challenges. You need to make sure your child takes medications as directed by his or her doctor. You will need to teach your child how to prevent flares. And you will need to make tough choices about balancing your child’s health against his or her desire to do the things other kids are doing.

What research is being done on lupus?

Lupus is the focus of intense research. Studies are looking at:

  • The genes that play a role in lupus and in the immune system
  • Ways to change the immune system in people with lupus
  • Lupus in different ethnic groups
  • Things in the environment that may cause lupus
  • The role of hormones in lupus
  • Birth control pills and hormone therapy in women with lupus
  • Heart disease in people with lupus
  • The causes of nervous system damage in people with lupus
  • Treatments for lupus
  • Treatments for organ damage caused by lupus, including stem cell transplantation
  • Getting a better idea of how many Americans have lupus

Clinical trials are medical research studies to see whether new treatments are safe and effective. These studies help doctors learn how people respond to medicines and other new or improved treatments. Patients and families can get information about these lupus trials at http://www.clinicaltrials.gov.

More information on lupus

For more information about lupus, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

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The information on our website is provided by the U.S. federal government and is in the public domain. This public information is not copyrighted and may be reproduced without permission, though citation of each source is appreciated.

Lupus fact sheet was reviewed by:

Betty Diamond, M.D.
Head, Center for Autoimmune and Musculoskeletal Disease
The Feinstein Institute for Medical Research
Manhasset, NY

Dawn Isherwood, R.N.
Health Educator
Lupus Foundation of America, Inc.
Washington, DC

James Witter, M.D., Ph.D.
Program Director, Rheumatic Diseases Clinical Program
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institutes of Health

Content last updated July 16, 2012.

Resources last updated June 13, 2011.

 

Source: Office on Women’s Health in the Office of the Assistant Secretary for Health

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What Is Depression?

Posted on May 13, 2013 by admin

Depression

Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.

 

What are the different forms of depression?

There are several forms of depressive disorders.

Major depressive disorder, or major depression, is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally. Some people may experience only a single episode within their lifetime, but more often a person may have multiple episodes.

Depression is a common but serious illness. Most who experience depression need treatment to get better.

Dysthymic disorder, or dysthymia, is characterized by long-term (2 years or longer) symptoms that may not be severe enough to disable a person but can prevent normal functioning or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Minor depression is characterized by having symptoms for 2 weeks or longer that do not meet full criteria for major depression. Without treatment, people with minor depression are at high risk for developing major depressive disorder.

Some forms of depression are slightly different, or they may develop under unique circumstances. However, not everyone agrees on how to characterize and define these forms of depression. They include:

  • Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations).
  • Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.1
  • Seasonal affective disorder (SAD), which is characterized by the onset of depression during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not get better with light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.2

Bipolar disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes—from extreme highs (e.g., mania) to extreme lows (e.g., depression). More information about bipolar disorder is available.

What are the signs and symptoms of depression?

People with depressive illnesses do not all experience the same symptoms. The severity, frequency, and duration of symptoms vary depending on the individual and his or her particular illness.

Signs and symptoms include:

  • Persistent sad, anxious, or “empty” feelings
  • Feelings of hopelessness or pessimism
  • Feelings of guilt, worthlessness, or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details, and making decisions
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.

I started missing days from work, and a friend noticed that something wasn’t right. She talked to me about the time she had been really depressed and had gotten help from her doctor.
What illnesses often co-exist with depression?

Other illnesses may come on before depression, cause it, or be a consequence of it. But depression and other illnesses interact differently in different people. In any case, co-occurring illnesses need to be diagnosed and treated.

Anxiety disorders, such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, panic disorder, social phobia, and generalized anxiety disorder, often accompany depression.3,4 PTSD can occur after a person experiences a terrifying event or ordeal, such as a violent assault, a natural disaster, an accident, terrorism or military combat. People experiencing PTSD are especially prone to having co-existing depression.

In a National Institute of Mental Health (NIMH)-funded study, researchers found that more than 40 percent of people with PTSD also had depression 4 months after the traumatic event.5

Alcohol and other substance abuse or dependence may also co-exist with depression. Research shows that mood disorders and substance abuse commonly occur together.6

Depression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinson’s disease. People who have depression along with another medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co-existing depression.7 Treating the depression can also help improve the outcome of treating the co-occurring illness.8

What causes depression?

Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors.

Depressive illnesses are disorders of the brain. Longstanding theories about depression suggest that important neurotransmitters—chemicals that brain cells use to communicate—are out of balance in depression. But it has been difficult to prove this.

Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain involved in mood, thinking, sleep, appetite, and behavior appear different. But these images do not reveal why the depression has occurred. They also cannot be used to diagnose depression.

Some types of depression tend to run in families. However, depression can occur in people without family histories of depression too.9 Scientists are studying certain genes that may make some people more prone to depression. Some genetics research indicates that risk for depression results from the influence of several genes acting together with environmental or other factors.10 In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Other depressive episodes may occur with or without an obvious trigger.

How do women experience depression?

Depression is more common among women than among men. Biological, life cycle, hormonal, and psychosocial factors that women experience may be linked to women’s higher depression rate. Researchers have shown that hormones directly affect the brain chemistry that controls emotions and mood. For example, women are especially vulnerable to developing postpartum depression after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming.

Some women may also have a severe form of premenstrual syndrome (PMS) called premenstrual dysphoric disorder (PMDD). PMDD is associated with the hormonal changes that typically occur around ovulation and before menstruation begins.

During the transition into menopause, some women experience an increased risk for depression. In addition, osteoporosis—bone thinning or loss—may be associated with depression.11 Scientists are exploring all of these potential connections and how the cyclical rise and fall of estrogen and other hormones may affect a woman’s brain chemistry.12

Finally, many women face the additional stresses of work and home responsibilities, caring for children and aging parents, abuse, poverty, and relationship strains. It is still unclear, though, why some women faced with enormous challenges develop depression, while others with similar challenges do not.

How do men experience depression?

Men often experience depression differently than women. While women with depression are more likely to have feelings of sadness, worthlessness, and excessive guilt, men are more likely to be very tired, irritable, lose interest in once-pleasurable activities, and have difficulty sleeping.13,14

Men may be more likely than women to turn to alcohol or drugs when they are depressed. They also may become frustrated, discouraged, irritable, angry, and sometimes abusive. Some men throw themselves into their work to avoid talking about their depression with family or friends, or behave recklessly. And although more women attempt suicide, many more men die by suicide in the United States.15

How do older adults experience depression?

Depression is not a normal part of aging. Studies show that most seniors feel satisfied with their lives, despite having more illnesses or physical problems. However, when older adults do have depression, it may be overlooked because seniors may show different, less obvious symptoms. They may be less likely to experience or admit to feelings of sadness or grief.16

Sometimes it can be difficult to distinguish grief from major depression. Grief after loss of a loved one is a normal reaction to the loss and generally does not require professional mental health treatment. However, grief that is complicated and lasts for a very long time following a loss may require treatment. Researchers continue to study the relationship between complicated grief and major depression.17

Older adults also may have more medical conditions such as heart disease, stroke, or cancer, which may cause depressive symptoms. Or they may be taking medications with side effects that contribute to depression. Some older adults may experience what doctors call vascular depression, also called arteriosclerotic depression or subcortical ischemic depression. Vascular depression may result when blood vessels become less flexible and harden over time, becoming constricted. Such hardening of vessels prevents normal blood flow to the body’s organs, including the brain. Those with vascular depression may have, or be at risk for, co-existing heart disease or stroke.18

Although many people assume that the highest rates of suicide are among young people, older white males age 85 and older actually have the highest suicide rate in the United States. Many have a depressive illness that their doctors are not aware of, even though many of these suicide victims visit their doctors within 1 month of their deaths.19

Most older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both.20 Research has shown that medication alone and combination treatment are both effective in reducing depression in older adults.21 Psychotherapy alone also can be effective in helping older adults stay free of depression, especially among those with minor depression. Psychotherapy is particularly useful for those who are unable or unwilling to take antidepressant medication.22,23

How do children and teens experience depression?

Children who develop depression often continue to have episodes as they enter adulthood. Children who have depression also are more likely to have other more severe illnesses in adulthood.24

A child with depression may pretend to be sick, refuse to go to school, cling to a parent, or worry that a parent may die. Older children may sulk, get into trouble at school, be negative and irritable, and feel misunderstood. Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be difficult to accurately diagnose a young person with depression.

Before puberty, boys and girls are equally likely to develop depression. By age 15, however, girls are twice as likely as boys to have had a major depressive episode.25

Depression during the teen years comes at a time of great personal change—when boys and girls are forming an identity apart from their parents, grappling with gender issues and emerging sexuality, and making independent decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating disorders, or substance abuse. It can also lead to increased risk for suicide.24,26

An NIMH-funded clinical trial of 439 adolescents with major depression found that a combination of medication and psychotherapy was the most effective treatment option.27 Other NIMH-funded researchers are developing and testing ways to prevent suicide in children and adolescents.

How is depression diagnosed and treated?

Depression, even the most severe cases, can be effectively treated. The earlier that treatment can begin, the more effective it is.

The first step to getting appropriate treatment is to visit a doctor or mental health specialist. Certain medications, and some medical conditions such as viruses or a thyroid disorder, can cause the same symptoms as depression. A doctor can rule out these possibilities by doing a physical exam, interview, and lab tests. If the doctor can find no medical condition that may be causing the depression, the next step is a psychological evaluation.

The doctor may refer you to a mental health professional, who should discuss with you any family history of depression or other mental disorder, and get a complete history of your symptoms. You should discuss when your symptoms started, how long they have lasted, how severe they are, and whether they have occurred before and if so, how they were treated. The mental health professional may also ask if you are using alcohol or drugs, and if you are thinking about death or suicide.

Once diagnosed, a person with depression can be treated in several ways. The most common treatments are medication and psychotherapy.

Medication

Antidepressants primarily work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work. The latest information on medications for treating depression is available on the U.S. Food and Drug Administration (FDA) website.

Popular newer antidepressants

Some of the newest and most popular antidepressants are called selective serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) are some of the most commonly prescribed SSRIs for depression. Most are available in generic versions. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are similar to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta).

SSRIs and SNRIs tend to have fewer side effects than older antidepressants, but they sometimes produce headaches, nausea, jitters, or insomnia when people first start to take them. These symptoms tend to fade with time. Some people also experience sexual problems with SSRIs or SNRIs, which may be helped by adjusting the dosage or switching to another medication.

One popular antidepressant that works on dopamine is bupropion (Wellbutrin). Bupropion tends to have similar side effects as SSRIs and SNRIs, but it is less likely to cause sexual side effects. However, it can increase a person’s risk for seizures.

Tricyclics

Tricyclics are older antidepressants. Tricyclics are powerful, but they are not used as much today because their potential side effects are more serious. They may affect the heart in people with heart conditions. They sometimes cause dizziness, especially in older adults. They also may cause drowsiness, dry mouth, and weight gain. These side effects can usually be corrected by changing the dosage or switching to another medication. However, tricyclics may be especially dangerous if taken in overdose. Tricyclics include imipramine and nortriptyline.

MAOIs

Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications. They can be especially effective in cases of “atypical” depression, such as when a person experiences increased appetite and the need for more sleep rather than decreased appetite and sleep. They also may help with anxious feelings or panic and other specific symptoms.

However, people who take MAOIs must avoid certain foods and beverages (including cheese and red wine) that contain a substance called tyramine. Certain medications, including some types of birth control pills, prescription pain relievers, cold and allergy medications, and herbal supplements, also should be avoided while taking an MAOI. These substances can interact with MAOIs to cause dangerous increases in blood pressure. The development of a new MAOI skin patch may help reduce these risks. If you are taking an MAOI, your doctor should give you a complete list of foods, medicines, and substances to avoid.

MAOIs can also react with SSRIs to produce a serious condition called “serotonin syndrome,” which can cause confusion, hallucinations, increased sweating, muscle stiffness, seizures, changes in blood pressure or heart rhythm, and other potentially life-threatening conditions. MAOIs should not be taken with SSRIs.

How should I take medication?

All antidepressants must be taken for at least 4 to 6 weeks before they have a full effect. You should continue to take the medication, even if you are feeling better, to prevent the depression from returning.

Medication should be stopped only under a doctor’s supervision. Some medications need to be gradually stopped to give the body time to adjust. Although antidepressants are not habit-forming or addictive, suddenly ending an antidepressant can cause withdrawal symptoms or lead to a relapse of the depression. Some individuals, such as those with chronic or recurrent depression, may need to stay on the medication indefinitely.

In addition, if one medication does not work, you should consider trying another. NIMH-funded research has shown that people who did not get well after taking a first medication increased their chances of beating the depression after they switched to a different medication or added another medication to their existing one.28,29

Sometimes stimulants, anti-anxiety medications, or other medications are used together with an antidepressant, especially if a person has a co-existing illness. However, neither anti-anxiety medications nor stimulants are effective against depression when taken alone, and both should be taken only under a doctor’s close supervision.

More information about mental health medications is available on the NIMH website.

FDA warning on antidepressants

Despite the relative safety and popularity of SSRIs and other antidepressants, studies have suggested that they may have unintentional effects on some people, especially adolescents and young adults. In 2004, the Food and Drug Administration (FDA) conducted a thorough review of published and unpublished controlled clinical trials of antidepressants that involved nearly 4,400 children and adolescents. The review revealed that 4 percent of those taking antidepressants thought about or attempted suicide (although no suicides occurred), compared to 2 percent of those receiving placebos.

This information prompted the FDA, in 2005, to adopt a “black box” warning label on all antidepressant medications to alert the public about the potential increased risk of suicidal thinking or attempts in children and adolescents taking antidepressants. In 2007, the FDA proposed that makers of all antidepressant medications extend the warning to include young adults up through age 24. A “black box” warning is the most serious type of warning on prescription drug labeling.

The warning emphasizes that patients of all ages taking antidepressants should be closely monitored, especially during the initial weeks of treatment. Possible side effects to look for are worsening depression, suicidal thinking or behavior, or any unusual changes in behavior such as sleeplessness, agitation, or withdrawal from normal social situations. The warning adds that families and caregivers should also be told of the need for close monitoring and report any changes to the doctor. The latest information from the FDA can be found on their website.

Children, adolescents, and young adults taking antidepressants should be closely monitored.

Results of a comprehensive review of pediatric trials conducted between 1988 and 2006 suggested that the benefits of antidepressant medications likely outweigh their risks to children and adolescents with major depression and anxiety disorders.30 The study was funded in part by NIMH.

Also, the FDA issued a warning that combining an SSRI or SNRI antidepressant with one of the commonly-used “triptan” medications for migraine headache could cause a life-threatening “serotonin syndrome,” marked by agitation, hallucinations, elevated body temperature, and rapid changes in blood pressure. Although most dramatic in the case of the MAOIs, newer antidepressants may also be associated with potentially dangerous interactions with other medications.

What about St. John’s wort?
The extract from the herb St. John’s wort (Hypericum perforatum) has been used for centuries in many folk and herbal remedies. Today in Europe, it is used extensively to treat mild to moderate depression. In the United States, it is one of the top-selling botanical products.

In an 8-week trial involving 340 patients diagnosed with major depression, St. John’s wort was compared to a common SSRI and a placebo (sugar pill). The trial found that St. John’s wort was no more effective than the placebo in treating major depression.31 However, use of St. John’s wort for minor or moderate depression may be more effective. Its use in the treatment of depression remains under study.

St. John’s wort can interact with other medications, including those used to control HIV infection. In 2000, the FDA issued a Public Health Advisory letter stating that the herb may interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and those used to prevent organ transplant rejection. The herb also may interfere with the effectiveness of oral contraceptives. Consult with your doctor before taking any herbal supplement.

Psychotherapy

Several types of psychotherapy—or “talk therapy”—can help people with depression.

Two main types of psychotherapies—cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT)—are effective in treating depression. CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret their environment and interactions with others in a positive and realistic way. It may also help you recognize things that may be contributing to the depression and help you change behaviors that may be making the depression worse. IPT helps people understand and work through troubled relationships that may cause their depression or make it worse.

For mild to moderate depression, psychotherapy may be the best option. However, for severe depression or for certain people, psychotherapy may not be enough. For teens, a combination of medication and psychotherapy may be the most effective approach to treating major depression and reducing the chances of it coming back.27 Another study looking at depression treatment among older adults found that people who responded to initial treatment of medication and IPT were less likely to have recurring depression if they continued their combination treatment for at least 2 years.23

More information on psychotherapy is available on the NIMH website.

Now I’m seeing the specialist on a regular basis for “talk therapy,” which helps me learn ways to deal with this illness in my everyday life, and I’m taking medicine for depression.

Electroconvulsive therapy and other brain stimulation therapies

For cases in which medication and/or psychotherapy does not help relieve a person’s treatment-resistant depression, electroconvulsive therapy (ECT) may be useful. ECT, formerly known as “shock therapy,” once had a bad reputation. But in recent years, it has greatly improved and can provide relief for people with severe depression who have not been able to feel better with other treatments.

Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. He or she sleeps through the treatment and does not consciously feel the electrical impulses. Within 1 hour after the treatment session, which takes only a few minutes, the patient is awake and alert.

A person typically will undergo ECT several times a week, and often will need to take an antidepressant or other medication along with the ECT treatments. Although some people will need only a few courses of ECT, others may need maintenance ECT—usually once a week at first, then gradually decreasing to monthly treatments. Ongoing NIMH-supported ECT research is aimed at developing personalized maintenance ECT schedules.

ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes they can linger. Newer methods of administering the treatment have reduced the memory loss and other cognitive difficulties associated with ECT. Research has found that after 1 year of ECT treatments, most patients showed no adverse cognitive effects.32

Nevertheless, patients always provide informed consent before receiving ECT, ensuring that they understand the potential benefits and risks of the treatment.

Other more recently introduced types of brain stimulation therapies used to treat severe depression include vagus nerve stimulation (VNS), and repetitive transcranial magnetic stimulation (rTMS). These methods are not yet commonly used, but research has suggested that they show promise.

More information on ECT, VNS, rTMS and other brain stimulation therapies is available on the NIMH website.

How can I help a loved one who is depressed?

If you know someone who is depressed, it affects you too. The most important thing you can do is help your friend or relative get a diagnosis and treatment. You may need to make an appointment and go with him or her to see the doctor. Encourage your loved one to stay in treatment, or to seek different treatment if no improvement occurs after 6 to 8 weeks.

To help your friend or relative

  • Offer emotional support, understanding, patience, and encouragement.
  • Talk to him or her, and listen carefully.
  • Never dismiss feelings, but point out realities and offer hope.
  • Never ignore comments about suicide, and report them to your loved one’s therapist or doctor.
  • Invite your loved one out for walks, outings and other activities. Keep trying if he or she declines, but don’t push him or her to take on too much too soon.
  • Provide assistance in getting to the doctor’s appointments.
  • Remind your loved one that with time and treatment, the depression will lift.

How can I help myself if I am depressed?

If you have depression, you may feel exhausted, helpless, and hopeless. It may be extremely difficult to take any action to help yourself. But as you begin to recognize your depression and begin treatment, you will start to feel better.

To Help Yourself

  • Do not wait too long to get evaluated or treated. There is research showing the longer one waits, the greater the impairment can be down the road. Try to see a professional as soon as possible.
  • Try to be active and exercise. Go to a movie, a ballgame, or another event or activity that you once enjoyed.
  • Set realistic goals for yourself.
  • Break up large tasks into small ones, set some priorities and do what you can as you can.
  • Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.
  • Expect your mood to improve gradually, not immediately. Do not expect to suddenly “snap out of” your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.
  • Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
  • Remember that positive thinking will replace negative thoughts as your depression responds to treatment.
  • Continue to educate yourself about depression.

Where can I go for help?

If you are unsure where to go for help, ask your family doctor. Others who can help are listed below.

Mental Health Resources

  • Mental health specialists, such as psychiatrists, psychologists, social workers, or mental health counselors
  • Health maintenance organizations
  • Community mental health centers
  • Hospital psychiatry departments and outpatient clinics
  • Mental health programs at universities or medical schools
  • State hospital outpatient clinics
  • Family services, social agencies, or clergy
  • Peer support groups
  • Private clinics and facilities
  • Employee assistance programs
  • Local medical and/or psychiatric societies
  • You can also check the phone book under “mental health,” “health,” “social services,” “hotlines,” or “physicians” for phone numbers and addresses. An emergency room doctor also can provide temporary help and can tell you where and how to get further

What if I or someone I know is in crisis?

If you are thinking about harming yourself, or know someone who is, tell someone who can help immediately.

  • Do not leave your friend or relative alone, and do not isolate yourself.
  • Call your doctor.
  • Call 911 or go to a hospital emergency room to get immediate help, or ask a friend or family member to help you do these things.
  • Call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255); TTY: 1-800-799-4TTY (4889) to talk to a trained counselor.

For More Information

Visit the National Library of Medicine’s:

MedlinePlus

En Español

For information on clinical trials for depression

National Library of Medicine Clinical Trials Database

Information from NIMH is available in multiple formats. You can browse online, download documents in PDF, and order paper brochures through the mail. If you would like to have NIMH publications, you can order them online. If you do not have Internet access and wish to have information that supplements this publication, please contact the NIMH Information Resource Center at the numbers listed below.

Please check the NIMH website for the most up-to-date information on this topic.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or 1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431 or 1-866-415-8051 toll-free
FAX: 301-443-4279
E-mail: nimhinfo@nih.gov
Website: http://www.nimh.nih.gov

 

Source: The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U.S. Department of Health and Human Services.

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One In Five Adults Meet Overall Physical Activity Guidelines

Posted on May 3, 2013 by admin

One in five adults meet overall physical activity guidelines
About 20 percent of U.S. adults are meeting both the aerobic and muscle strengthening components of the federal government’s physical activity recommendations, according to a report published in today’s Morbidity and Mortality Weekly Report, a journal of the Centers for Disease Control and Prevention.

The data are based on self-reported information from the Behavioral Risk Factor Surveillance System; an annual phone survey of adults aged 18 and over conducted by state health departments.

The Physical Activity Guidelines for Americans recommend that adults get at least 2½ hours a week of moderate-intensity aerobic activity such as walking, or one hour and 15 minutes a week of vigorous-intensity aerobic activity, such as jogging, or a combination of both.  The guidelines also recommend that adults do muscle-strengthening activities, such as push-ups, sit-ups, or activities using resistance bands or weights.  These activities should involve all major muscle groups and be done on two or more days per week.

The report finds that nationwide nearly 50 percent of adults are getting the recommended amounts of aerobic activity and about 30 percent are engaging in the recommended muscle-strengthening activity.

“Although only 20 percent of adults are meeting the overall physical activity recommendations, it is encouraging that half the adults in the United States are meeting the aerobic guidelines and a third are meeting the muscle-strengthening recommendations,”said Carmen D. Harris, M.P.H, epidemiologist in CDC’s physical activity and health branch.  ”This is a great foundation to build upon, but there is still much work to do. Improving access to safe and convenient places where people can be physically active can help make the active choice the easy choice.”

The report also found differences among states and the District of Columbia.  The rates of adults meeting the overall guidelines ranged from 27 percent in Colorado to 13 percent in Tennessee and West Virginia. The West (24 percent) and the Northeast (21 percent) had the highest proportion of adults who met the guidelines. Women, Hispanics, older adults and obese adults were all less likely to meet the guidelines.

CDC currently funds 25 states to address nutrition, physical activity, obesity and other chronic diseases. CDC works with these states to design and improve communities so people can more easily fit physical activity into their lives. Additionally, CDC’s Community Transformation Grants program is working to create places that provide safe, accessible ways to be physically active.

For more information about the Physical Activity Guidelines for Americans, including ways to get and stay active, visit www.cdc.gov/physicalactivity.  Learn more about CDC’s efforts to promote walking by visiting http://www.cdc.gov/vitalsigns/walking.

Source: Centers for Disease Control and Prevention

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What Is Oral Health?

Posted on April 13, 2013 by admin

Oral Health
The word “oral” refers to the mouth, which includes your teeth, gums, jawbone, and supporting tissues. Taking good care of your oral health can prevent disease in your mouth. Oral health can affect the health of your entire body. Good oral health does not just mean you have pretty teeth. Your whole mouth needs care to be in good health.

What are the most common oral health problems?

The most common oral health problems are cavities and gum disease.

Cavities We are all at risk of tooth decay, or cavities. (Cavities look like chalky white and/or brown holes on your teeth). Bacteria (germs) that naturally live in our mouths use sugar in food to make acids. Over time, the acids destroy the outside layer of your teeth. Then cavities and other tooth harm occur.

Gum diseases Gum diseases are infections caused by bacteria, along with mucus and other particles that form a sticky plaque on your teeth. Plaque that is left on teeth hardens and forms tartar. Gingivitis (jin-juh-VEYE-tuhss) is a mild form of gum disease. It causes red, swollen gums. It can also make the gums bleed easily. Gingivitis can be caused by plaque buildup. And the longer plaque and tartar stay on teeth, the more harm they do. Most gingivitis can be treated with daily brushing and flossing and regular cleanings at the dentist’s office. This form of gum disease does not lead to loss of bone or tissue around the teeth. But if it is not treated, it can advance to periodontitis (pair-ee-oh-don-TEYE-tuhss). Then the gums pull away from the teeth and form infected “pockets.” You may also lose supporting bone. If you have periodontitis, see your dentist for treatment. Otherwise your teeth may loosen over time and need to be removed.

Your risk of gum disease is higher if you:

  • Smoke
  • Have a disease such as diabetes or HIV/AIDS
  • Use methamphetamine
Healthy gums and bone anchor teeth firmly in place. Plaque left on teeth hardens into tartar. As plaque and tartar build up, the gums pull away from the teeth and pockets form between the teeth and gums. Bone supporting the teeth may get infected and start to weaken. The gums recede further, destroying more bone and the ligament around the tooth. Teeth may become loose and need to be removed.

Normal, healthy gums Healthy gums and bone anchor teeth firmly in place.

Periodontitis Plaque left on teeth hardens into tartar. As plaque and tartar build up, the gums pull away from the teeth and pockets form between the teeth and gums. Bone supporting the teeth may get infected and start to weaken.

Advanced periodontitis The gums recede further, destroying more bone and the ligament around the tooth. Teeth may become loose and need to be removed.

What are some other problems I might have with my mouth?

Bad breath. Bad breath is also called halitosis (hal-lih-TOH-suhss). Bad-smelling breath can be caused by several things, including:

  • Poor oral hygiene
  • Some foods
  • Dentures
  • Gum disease
  • Dry mouth
  • Tobacco use
  • Respiratory, digestive, or other health problems
  • Some medicines

Practicing good oral hygiene and avoiding tobacco and some foods often helps people with bad-smelling breath. You may want to try using a tongue scraper to clean food from your tongue. You could also just brush your tongue with your toothbrush. But if doing so doesn’t seem to help or if you always need mouthwash to hide bad breath, talk to your dentist.

Burning mouth. People with this condition describe a burning feeling in the mouth or tongue. It is most common in postmenopausal women. The cause is unknown, but might be linked to:

  • Hormones
  • Dry mouth (which can be caused by many medicines and disorders such as Sjögren’s syndrome or diabetes)
  • Taste problems
  • Nutritional deficiencies
  • Use of ACE inhibitors (blood pressure medicines)
  • Anxiety and depression
  • Dentures that do not fit
  • Infections (especially fungal infections)

Talk to your doctor or dentist if you have burning mouth. Treatment depends on the cause — if it can be determined — and might include adjusting your dentures, vitamin supplements, or pain or other medicines.

Canker sores. These sores are small ulcers inside the mouth. They have a white or gray base and a red border. Women are more likely than men to have canker sores that recur. The cause of canker sores is unknown. Risk factors include:

  • Fatigue
  • Stress
  • Having your period
  • A cut on the inside of your cheek or on your tongue
  • Allergies
  • Celiac disease
  • Crohn’s disease

Canker sores most often heal on their own in one to three weeks. See your dentist if you get a large sore (larger than a half inch, or about the size of a dime). You may need medicine to treat it.

To help with pain:

  • Avoid hot, spicy foods
  • Use mild mouthwashes or salt water
  • Try over-the-counter pain medicines

No proven way exists to prevent canker sores. If you get them often, talk with your dentist.

Cold sores. These small, painful sores are caused by herpes simplex virus type 1. Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include:

  • Getting too much sun
  • Having a cold or infection
  • Having your period
  • Feeling stressed

Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring. You can buy over-the-counter drugs to put on cold sores to help relieve pain. If you get cold sores a lot, talk with your doctor or dentist about a prescription for an antiviral drug. These drugs can help reduce healing time and the number of new sores.

Dry mouth. Dry mouth is also called xerostomia (ZEER-oh-STOM-mee-uh). This problem happens when you don’t have enough saliva, or spit, in your mouth. Some reasons why people get dry mouth include:

  • Side effect of medicines or medical treatment, such as cancer treatments
  • Health problems, such as diabetes, Parkinson’s disease, and Sjogren’s syndrome
  • A blocked salivary gland

Dry mouth may make it hard to eat, swallow, taste, and speak. If left untreated, it can lead to cavities. This is because saliva helps break down bits of food and helps stop acid from forming plaque on your teeth. Treatment of dry mouth depends on the cause and can range from medicines to diet changes. To lessen the dryness, use artificial saliva, suck on sugarless candy, do not smoke, do not drink alcohol, and use a humidifier. Tell your doctor if you have dry mouth.

Oral cancer. This cancer can affect any part of the mouth and part of the throat. If you smoke or chew tobacco, you are at higher risk. Excessive alcohol use along with smoking raises your risk even more. However, nonsmokers can also develop oral cancer. To help protect yourself from lip cancer, use a lip balm with sunscreen (exposure to the sun can cause lip cancer).

Oral cancer most often occurs after age 40. It isn’t always painful, so it may go undetected until the late stages. Ask your doctor to check for signs of oral cancer during your regular checkup. Oral cancer often starts as a tiny white or red spot or sore anywhere in the mouth. Other signs include:

  • A sore that bleeds easily or does not heal
  • A color change in the tissues of the mouth
  • A lump, rough spot, or other change
  • Pain, tenderness, or numbness anywhere in the mouth or on the lips
  • Problems chewing, swallowing, speaking, or moving the jaw or tongue
  • A change in the way the teeth fit together

Thrush. Thrush is also called oral candidiasis (CAN-dih-dye-uh-sis). These fungal infections appear as red, yellow, or white lesions, flat or slightly raised, in the mouth or throat. It can look like cottage cheese. This fungus lives naturally in your mouth. Your risk of getting thrush increases if:

  • You have a weak immune system
  • You don’t make enough saliva
  • You take antibiotics

Treatment includes antifungal mouthwash or lozenges. If the infection spreads or your immune system is weak, you may need antifungal medicine.

Thrush is common among:

  • Denture wearers
  • People who are very young or elderly
  • People with dry mouth
  • People with HIV or other chronic disease (like diabetes)

How might problems in my mouth be linked to health problems in other parts of my body?

The health of your mouth can be a sign of your body’s health. Mouth problems are not just cavities, toothaches, and crooked or stained teeth. Many diseases, such as diabetes, heart disease, HIV, cancer, and some eating disorders are linked with oral health problems. Regular dental exams help you maintain good oral health and avoid related health problems.

Cancer. If you are being treated for cancer, you may develop sores or other problems with your mouth. Pay attention to your mouth each day, and remember to brush and floss gently. Call your doctor or nurse if you notice a mouth problem, or if an old problem gets worse.

Diabetes. People with diabetes are at special risk for gum disease. Gum disease can lead to painful chewing and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. People with diabetes can also get thrush. Smoking makes these problems worse. By controlling your blood glucose, brushing and flossing every day, and visiting a dentist regularly, you can help prevent gum disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.

Heart disease.  Before some dental treatments, patients who have certain heart conditions or joint replacements may take antibiotics. These people may be at risk of getting an infection when bacteria that lives in the mouth goes into the bloodstream during treatment. Antibiotics lower this risk. Talk to your doctor or dentist if you are not sure whether you should take antibiotics before dental treatment.

HIV. Oral problems are common in people with HIV because of a weak immune system. These problems can make it hard to eat. If mouth pain or tenderness makes it hard to chew and swallow, or if you can’t taste food like you used to, you may not eat enough. The most common mouth problems linked with HIV can be treated.

Nutrition problems. Sometimes people who are missing teeth have to limit their food choices because of chewing problems. This can lead to a lack of vitamins in the body. If you are missing teeth and have trouble chewing, check with your doctor to make sure you are eating the right foods.

I’m afraid of the dentist. What can I do to make my visit better?

Many people get nervous at the thought of visiting the dentist. Don’tlet your nerves stop you from having regular appointments, though. Waiting too long to take care of your teeth may make things worse. Here are a few tips to make your visit easier:

  • Tell the dentist and dental staff that you are feeling anxious. Getting your concerns out in the open will let your dentist adapt the treatment to your needs.
  • Try to choose a time for your dental visit when you’re less likely to be rushed or under pressure. For some people, that means a Saturday or an early-morning appointment.
  • If the sound of the drill bothers you, bring a portable audio player and headset so you can listen to your favorite music. During the dental visit you might try visualizing yourself someplace relaxing, like on a warm beach.
  • Ask your dentist if there are medications he or she can give you to help you relax (this is sometimes called “sedation dentistry”).

As a woman, why do I have to worry about oral health?

Everyone needs to take care of their oral health. But female hormones can lead to an increase in some problems, such as:

  • Cold sores and canker sores
  • Dry mouth
  • Changes in taste
  • Higher risk of gum disease

Taking good care of your teeth and gums can help you avoid or lessen oral health problems.

I’m pregnant. Do I need to take special care of my mouth?

Yes! If you are pregnant, you have special oral health needs.

Before you become pregnant, it is best to have regular dental checkups. You want to keep your mouth in good health before your pregnancy.

Also, remember that what you eat affects the development of your unborn child — including teeth. Your baby’s teeth begin to grow during the third and sixth months of pregnancy, so it is important that you eat a balanced diet that includes calcium, protein, phosphorous, and vitamins A, C, and D.

If you are pregnant:

  • Have a complete oral exam early in your pregnancy. Because you are pregnant, your dentist might not take routine x-rays. But if you need x-rays, the health risk to your unborn baby is small.
  • Remember dental work during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. In the last months, you might be uncomfortable sitting in a dental chair.
  • Have all needed dental treatments. If you avoid treatment, you may risk your own and your baby’s health.
  • Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis. Both poor oral hygiene and higher hormone levels can cause pregnancy gingivitis. Until now, it was thought that having gum disease could raise your risk of having a low-birth-weight baby. Researchers have not been able to confirm this link, but studies are still under way to learn more.

I’m a new mother. What can I do for my baby’s oral health?

You can do a lot! Below are some things you need to know about your baby’s oral health.

  • The same germs that cause tooth decay in your mouth can be passed to your baby. Do not put your baby’s items, such as toys, spoons, bottles, or pacifiers in your mouth.
  • Wipe your baby’s teeth and gums with a clean gauze pad or baby toothbrush after each nursing and feeding. This can help remove sugars found in milk that can cause tooth decay and also get your baby used to having her teeth cleaned on a regular basis.
  • If you bottle-feed your baby, try to finish bottle weaning by age 1. Avoid giving your baby bottles or pacifiers at naps and bedtime. Sucking on a bottle when lying down can cause cavities and lead to “baby bottle tooth decay.”
  • All babies should visit a dentist by age 1. The dentist will screen for problems in your baby’s mouth. You will also be shown how to care for your child’s teeth and mouth.
  • Talk with your doctor about the best water choices for infants. Fluoride is good for teeth. But too much fluoride can harm development of tooth enamel in infants.

I’m starting cancer treatment. How can I best take care of my mouth?

Cancer treatment can cause side effects in your mouth. A dental checkup before treatment starts can help prevent painful mouth problems. Serious side effects in the mouth can delay, or even stop, cancer treatment. To fight cancer best, your cancer care team should include a dentist. A dentist will help protect your mouth, teeth, and jaw bones from damage caused by head and neck radiation and chemotherapy.

I’m confused! What type of toothpaste or mouthwash should I use?

So many different kinds of toothpaste are available today. Some say they’re made for whitening, others for reducing gingivitis and plaque, and others for sensitive teeth. Before choosing toothpaste for your family, know the basics.

ADA accepted: American Dental Association
  • As long as toothpaste contains fluoride and its box has the American Dental Association’s (ADA) seal of acceptance, it is good for your oral health. Beyond that, choosing toothpastes is a personal choice.
  • Mouthwashes claim to freshen your breath. But they really only mask breath odor for a few hours. If you always need to use a mouthwash to hide bad breath, see your dentist.
  • You can also use a tongue scraper to freshen breath. A tongue scraper removes food particles trapped in the pits along the tongue’s surface. Brushing your tongue with your toothbrush can also remove these bits of food.

I’m not happy with the stains on my teeth. How can I safely whiten them?

There are three ways that you can whiten your teeth:

  • In-office bleaching
  • At-home bleaching
  • Whitening toothpastes

The first thing you should do before whitening your teeth is talk to your dentist. He or she will be able to help you decide the best option for you. Whiteners will not fix all kinds of stains. Also, if you have bonding or tooth-colored fillings, these will not be affected by whiteners and they may stand out if you whiten your teeth. Remember that a using a whitener does not make your mouth healthier.

In-office bleaching. This kind of whitening, called “chairside bleaching,” is done in your dentist’s office. It may require more than one office visit. Each visit may take from 30 minutes to one hour. During chairside bleaching, the dentist puts a whitener on the teeth and uses a special light to make the whitener work. Lasers are sometimes used during tooth whitening to make the whitening agent work better.

At-home bleaching. There are a few different products that can be used to whiten teeth at home. Some come from your dentist, and others can be bought over-the-counter. These contain peroxide(s), which bleach the tooth enamel. Most come in a gel and are placed in a mouth guard or tray that fits inside your mouth. They help many types of staining. Only the dentist-dispensed solutions have the American Dental Association (ADA) seal.

Other over-the-counter whitening products include whitening strips, paint-on products, gels, and trays. They have a low amount of peroxide. For better results, have a cleaning at the dentist before you use these products. These gels and trays do not have the ADA seal.

Whitening toothpastes. All toothpastes help remove surface stains through mild abrasives. “Whitening” toothpastes that have the ADA seal have special polishing agents or chemicals that remove even more stains. Unlike bleaches, these products do not change the actual color of teeth. They help surface stains only.

Products used to whiten teeth can make teeth more sensitive. They can also bother your gums. These side effects most often go away after you stop using the product.

What small, easy steps can I take to have a healthy teeth and gums?

1. Brush your teeth at least twice each day with fluoride toothpaste. Aim for first thing in the morning and before going to bed. Once a day, use floss or an interdental cleaner to remove food your toothbrush missed. Make sure you:

  • Drink water that contains added fluoride if you can. Fluoride protects against dental decay. Most public water systems in the United States have added fluoride. Check with your community’s water or health department to find out if there is fluoride in your water. You also may want to use a fluoride mouth rinse, along with brushing and flossing, to help prevent tooth decay.
  • Gently brush all sides of your teeth with a soft-bristled brush. Round and short back-and-forth strokes work best.
  • Take time to brush along the gum line, and lightly brush your tongue to help remove plaque and food.
  • Ask your dentist or dental hygienist to show you the best way to floss your teeth.
  • Change your toothbrush every three months, or earlier if the toothbrush looks worn or the bristles spread out. A new toothbrush removes more plaque.
  • If you wear dentures, be sure to remove them at night and clean them before putting them back in the next morning.

2. Have a healthy lifestyle.

  • Eat healthy meals. Cut down on tooth decay by brushing after meals. Avoid snacking on sugary or starchy foods between meals.
  • Don’t smoke. It raises your risk of gum disease, oral and throat cancers, and oral fungal infections. It also affects the color of your teeth and the smell of your breath.
  • Limit alcohol use to one drink per day for women. Heavy alcohol use raises your risk of oral and throat cancers. Using alcohol and tobacco together raises your risk of oral cancers more than using one alone.
  • Limit how much soda you drink. Even diet soda contains acids that can erode tooth enamel.

3. Get regular checkups.

  • Have an oral exam once or twice a year. Your dentist may recommend more or fewer visits depending on your oral health. At most routine visits, the dentist and a dental hygienist will treat you. During regular checkups, dentists look for signs of diseases, infections, problems, injuries, and oral cancer.
  • See your dentist right away if:
    • Your gums bleed often
    • You see any red or white patches on the gums, tongue, or floor of the mouth
    • You have mouth or jaw pain that won’t go away
    • You have sores that do not heal within two weeks
    • You have problems swallowing or chewing
  • Besides your dentist, there are other types of dental providers. Your dentist may send you to a specialist if you need extra care. Other providers include:
    • Dental hygienists: Members of the dental staff who clean gums and teeth and teach patients how to maintain good oral health.
    • Periodontists: Dentists who treat gum disease and place dental implants.
    • Oral surgeons: Dentists who operate on your mouth and supporting tissues.
    • Orthodontists: Dentists who straighten teeth and align jaws.
    • Endodontists: Dentists who perform root canals.
    • Prosthodontists: Dentists trained in restoring and replacing teeth.

4. Follow your dentist’s advice. Your dentist may suggest ways to keep your mouth healthy. He or she can teach you how to properly floss or brush. Follow any recommended steps or treatments to keep your mouth healthy.

5. If you have another health problem, think about how it may affect your oral health. For instance, if you take medicines that give you a dry mouth, ask your doctor or nurse if there are other drugs you can use. Have an oral exam before starting cancer treatment. And if you have diabetes, practice good oral hygiene to prevent gum disease.

More information on oral health

For more information about oral health, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

Source: Office on Women’s Health in the Office of The Assistant Secretary for Health External Website Policy at the U.S. Department of Health and Human Services

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Ida Bell Wells-Barnett

Posted on April 13, 2013 by admin

Ida Bell Wells-Barnett

(July 16, 1862 – March 25, 1931) was an African-American journalist, newspaper editor, suffragist, sociologist and, with her husband, newspaper owner Ferdinand L. Barnett, an early leader in the civil rights movement. She documented lynching in the United States, showing how it was often a way to control or punish blacks who competed with whites. She was active in the women’s rights and the women’s suffrage movement, establishing several notable women’s organizations. Wells was a skilled and persuasive rhetorician, and traveled internationally on lecture tours.

Early life and education

Ida Bell Wells was born in Holly Springs, Mississippi in 1862,just before President Abraham Lincoln issued the Emancipation Proclamation. Her father was James Wells and her mother was Elizabeth “Lizzie” Warrenton Wells. Both parents were enslaved until freed under the Proclamation.

Ida’s father James was a master at carpentry and a “race man” who worked for the advancement of blacks. He was very interested in politics and was a member of the Loyal League. He attended Shaw U. in Holly Springs (now Rust College) but dropped out to help his family. He also attended public speeches and campaigned for local black candidates, but he never ran for office. Her mother Lizzie was a cook for the Bolling household before her death from yellow fever. She was a religious woman who was very strict with her children.

Ida attended Shaw but was expelled for her rebellious behavior and temper after confronting the college president. While visiting her grandmother in the Miss. Valley in 1878, she received word that Holly Springs had suffered a yellow fever epidemic. At 16, she lost her parents and 10-mo.-old brother, Stanley. The ’78 epidemic swept through the South with many fatalities.

Early career

Following the funerals, friends and relatives decided that the six remaining Wells children should be sent to various foster homes. Ida resisted this solution. To keep her younger siblings together as a family, she dropped out of Shaw and found work as a teacher in a black elementary school. (The schools were racially segregated.) Her grandmother Peggy Wells, along with other friends and relatives, stayed with the children during the week while she was away teaching. Without this help, she would have not been able to keep her siblings together. She resented that white teachers were paid $80 a month when she was paid only $30 a month. This discrimination made her more interested in the politics of race and improving the education of blacks.

In 1883, Ida B. Wells took three of her younger siblings to Memphis, Tenn., to live with her aunt and to be closer to other family members. She found she could earn higher wages there as a teacher. Soon after moving, she was hired in Woodstock for the Shelby County school system.[5] During her summer vacations, she attended summer sessions at Fisk University, a historically black college in Nashville; its graduates were well respected in the black community. She also attended LeMoyne. She held strong political opinions and provoked many people with her views on women’s rights. At 24, she wrote, “I will not begin at this late day by doing what my soul abhors; sugaring men, weak deceitful creatures, with flattery to retain them as escorts or to gratify a revenge.”

On May 4, 1884, a train conductor with the Chesapeake,Ohio and Southwestern Railroad ordered Wells to give up her seat and move to the smoking car, which was already crowded with other passengers. The year before, the Supreme Court had struck down the federal Civil Rights Act of 1875, which banned racial discrimination in public accommodations. Several railroad companies continued illegal racial segregation of their passengers, especially in the South.

Wells refused to give up her seat, 71 years before the activist Rosa Parks showed similar resistance on a bus. The conductor and two men dragged Wells out of the car. When she returned to Memphis, she hired an African-American attorney to sue the railroad. She also became a public figure in Memphis when she wrote a newspaper article for The Living Way, a black church weekly, about her treatment on the train. When her lawyer was paid off by the railroad, she hired a white attorney. She won her case on December 24, 1884, when the local circuit court granted her a $500 settlement. The railroad company appealed to the Tennessee Supreme Court, which reversed the lower court’s ruling in 1887. It concluded, “We think it is evident that the purpose of the defendant in error was to harass with a view to this suit, and that her persistence was not in good faith to obtain a comfortable seat for the short ride.” Wells was ordered to pay court costs.

While teaching elementary school, Wells was offered an editorial position for the Evening Star. She also wrote weekly articles for The Living Way weekly newspaper under the pen name “Iola” and gained a reputation for writing about the race issue. In 1889, she became co-owner and editor of Free Speech and Headlight, an anti-segregationist newspaper that was started by Rev. R. Nightingale and was based at the Beale St. Bapt. Ch. in Memphis. It published articles about racial injustice.

In March 1892, racial tensions were rising in Memphis. Violence was becoming the norm. Her three friends, Thomas Moss, Calvin McDowell, and Henry Stewart, owned the People’s Grocery Company. It was doing well and was seen as competitive with a white-owned grocery store across the street. While Wells was out of town in Natchez, Mississippi, a white mob invaded her friends’ store. During the altercation, three white men were shot and injured. Moss, McDowell, and Stewart were arrested and jailed. A large lynch mob stormed the jail and killed the three men.

After the lynching of her friends, Wells wrote in Free Speech and Headlight, urging blacks to leave Memphis:

There is, therefore, only one thing left to do; save our money and leave a town which will neither protect our lives and property, nor give us a fair trial in the courts, but takes us out and murders us in cold blood when accused by white persons.

Wells emphasized the public spectacle of the lynching. Over 6,000 blacks did leave; others organized boycotts of white-owned businesses. After being threatened with violence, she bought a pistol. She later wrote, “They had made me an exile and threatened my life for hinting at the truth.”

Investigative journalism

The murder drove Wells to research and document lynchings and their causes. She began investigative journalism, looking at the charges given for the murders. She officially started her anti-lynching campaign. She spoke on the issue at various black women’s clubs, and raised more than $500 to investigate lynchings and publish her results. Wells found that blacks were lynched for such reasons as failing to pay debts, not appearing to give way to whites, competing with whites economically, being drunk in public. She published her findings in a pamphlet entitled “Southern Horrors: Lynch Laws in All Its Phases”. She wrote an article that suggested that, unlike the myth that white women were sexually at risk of attacks by black men, most liaisons between black men and white women were consensual. While she was away in Philadelphia, a mob destroyed the offices of the Free Speech and Headlight on May 27, 1892 in retaliation for her controversial articles, three months after her three friends were lynched.

Wells next spoke to groups in New York City, where her audiences included many leading African-American women. Because of the threats to her life, she moved from Memphis to Chicago. Wells continued to wage her anti-lynching campaign and to write columns attacking Southern injustices. Her articles were published in The New York Age newspaper. Her writings continued to investigate the incidents that were referred to as causes for lynching black men.

Together with Frederick Douglass and other black leaders, she organized a black boycott of the 1893 World’s Columbian Exposition in Chicago, for its failure to collaborate with the black community on exhibits representing African-American life. Wells, Douglass, Irvine Garland Penn and Ferdinand L. Barnett wrote sections of a pamphlet to be distributed there: “Reasons Why the Colored American Is Not in the World’s Columbian Exposition” detailed the progress of blacks since their arrival in America and the workings of Southern lynchings. Wells later reported to Albion W. Tourgée that copies of the pamphlet had been distributed to more than 20,000 people at the fair. After the World’s Fair in Chicago, Wells decided to stay in the city instead of returning to New York. That year she started work with the Chicago Conservator, the oldest African-American newspaper in the city.

Also in 1893, Wells contemplated a libel suit against two black Memphis attorneys. She turned to Tourgée, who had trained and practiced as a lawyer and judge, for possible free legal help. Deeply in debt, Tourgée could not afford to help but asked his friend Ferdinand L. Barnett if he could. Barnett accepted the pro bono job. Born in Alabama, Barnett had become the editor of the Chicago Conservator in 1878. He was an assistant state attorney for 14 years.

Southern Horrors and The Red Record

Cover Southern horrors.png

In 1892 she published a pamphlet titled Southern Horrors: Lynch Law in All Its Phases, and A Red Record, 1892–1894, which documented research on a lynching. Having examined many accounts of lynching based on alleged “rape of white women,” she concluded that Southerners concocted rape as an excuse to hide their real reason for lynchings: black economic progress, which threatened not only white Southerners’ pocketbooks, but also their ideas about black inferiority.

The lesson this teaches and which every Afro-American should ponder well, is that a Winchester rifle should have a place of honor in every black home, and it should be used for that protection which the law refuses to give. When the white man who is always the aggressor knows he runs as great a risk of biting the dust every time his Afro-American victim does, he will have greater respect for Afro-American life. The more the Afro-American yields and cringes and begs, the more he has to do so, the more he is insulted, outraged and lynched.

The Red Record is a one hundred page pamphlet describing lynching in the United States since the Emancipation Proclamation, while also describing blacks’ struggles since the time of the Emancipation Proclamation. The Red Record begins by explaining the alarming severity of the lynching situation in the United States. An ignorance of lynching in the U.S., according to Wells, developed over a span of ten years. Wells talks about slavery, saying the black man’s body and soul were owned by the white man. The soul was dwarfed by the white man, and the body was preserved because of its value. She mentions that “ten thousand Negroes have been killed in cold blood, without the formality of judicial trial and legal execution,” therefore launching her campaign against lynching in this pamphlet, The Red Record.

Frederick Douglass wrote an article explaining three eras of Southern barbarism and the excuses that coincided with each. Wells goes into detail about each excuse:

  • The first excuse that Wells explains is the “necessity of the white man to repress and stamp out alleged ‘race riots.’” Once the Civil War ended, there were many riots supposedly being planned by blacks; whites panicked and resisted them forcefully.
  • The second excuse came during the Reconstruction Era: blacks were lynched because whites feared “Negro Domination” and wanted to stay powerful in the government. Wells encouraged those threatened to move their families somewhere safe.
  • The third excuse was: Blacks had “to be killed to avenge their assaults upon women.” Wells explains that any relationship between a white woman and a black man was considered rape during that time period. In this article she states, “Nobody in this section of the country believes the old threadbare lie that Negro men rape white women.”

Wells lists fourteen pages of statistics concerning lynching done from 1892–1895; she also includes pages of graphic stories detailing lynching done in the South. She credits the findings to white correspondents, white press bureaus, and white newspapers. The Red Record was a huge pamphlet, not only in size, but in influence.

Rhetorical style and effect

Wells’ 1892 speech, Southern Horrors: Lynch Law in All Its Phases is important as a historical document and as the initiating event in what became a social movement; as a rhetorical work, it is significant in three respects.

First, as in her writings, she used evidence and argument in highly sophisticated ways, ways that prevented members of the audience from dismissing her claims as biased or untrue.

Second, the speech was an insightful and sophisticated analysis of the interrelationship of sex, race, and class.

Third, in contrast to the rhetorical acts of women, this speech contained no stylistic markers indicating attempts by a woman speaker to appear “womanly” in what is perceived as a male role-that of rhetor.

Wells’ use of evidence and argument had to overcome severe obstacles. She had to refute the cultural history of sexism that made the cry of rape (of a white woman) adequate justification for violence against Afro-Americans.

In order to prove this point, Wells’ used evidence from irrefutable sources. She used an excerpt from her own originally anonymous editorial in the Memphis Free Speech which was in response to the unlawful murders of three of her fellow townsmen, as well as two responses to her editorial from white newspapers: The Daily Commercial and The Evening Scimitar.

Nobody in this section of the country believes the old thread-bare lie that Negro men rape white women. If Southern white men are not careful, they will overreach themselves and public sentiment will have a reaction; a conclusion will then be reached which will be very damaging to the moral reputation of their women.
—Free Speech May 21, 1892

The Daily Commercial of Wednesday following, May 25, contained the following leader:

Those negroes who are attempting to make the lynching of individuals of their race a means for arousing the worst passions of their kind are playing with a dangerous sentiment. The negroes may as well understand that there is no mercy for the negro rapist and little patience with his defenders. A negro organ printed in this city, in a recent issue publishes the following atrocious paragraph: “Nobody in this section of the country believes the old thread-bare lie that negro men rape white women. If Southern white men are not careful they will overreach themselves, and public sentiment will have a reaction; and a conclusion will be reached which will be very damaging to the moral reputation of their women.”The fact that a black scoundrel is allowed to live and utter such loathsome and repulsive calumnies is a volume of evidence as to the wonderful patience of Southern whites. But we have had enough of it.

There are some things that the Southern white man will not tolerate, and the obscene intimations of the foregoing have brought the writer to the very outermost limit of public patience. We hope we have said enough.

The Evening Scimitar of same date, copied the Commercial’s editorial with these words of comment:

Patience under such circumstances is not a virtue. If the negroes themselves do not apply the remedy without delay it will be the duty of those whom he has attacked to tie the wretch who utters these calumnies to a stake at the intersection of Main and Madison Sts., brand him in the forehead with a hot iron and perform upon him a surgical operation with a pair of tailor’s shears.

Her seventeen relatively detailed examples of the lynching of African Americans allowed her audience to weigh the evidence and consider its plausibility, and the fact that much of it came from the public press, in some cases from white southern newspapers as shown above, added to the credibility of her accounts. Emotional response was prompted by the argument of these details rather than by exhortation.

By examining Wells’ speech through an application of the tradition of classical rhetoric whose principles Aristotle was the first to codify, it is obvious that by including the gruesome details of the several lynchings she uses for examples, Wells is appealing to her the ethos of her audience.

Throughout this argument there was a strong appeal to fundamental values of fairness, to the right to trial by jury, and to the right to full and careful investigation of crimes, appeals that added weight to her accusation that silent bystanders were guilty of complicity.[27] These are also examples of Wells’ appeal to logos.

Wells was remarkable for her skill in the use of argument and evidence. Further, she was a woman who assumed the role of rhetor and made no attempt to give that role a womanly cast.

In addition to remarkable skill in the use of both argument and evidence, her work was also augmented through her exceptional personal record keeping; throughout her life she kept detailed journals which are kept at the University of Chicago in special collections.[29] These journals in her own handwriting reveal notes on special events and in the drafts of her autobiography there are references made to records she kept decades prior to beginning her autobiography.

Her attention to detail in the midst of all the struggles that surrounded her adds to her historical significance as an important rhetorician. When she wrote her autobiography she referred not only to her own detailed notes in journals throughout her life, but also to newspaper and other historical clippings.

Looking at the legacy of her work as an entire collection reveals her additional noteworthy ability to adapt a message to the audience she was addressing as she wrote not only in papers, and for speeches, but also in church pamphlets and for community organizations.

Her life reveals a tenacity to push ahead despite every obstacle- to promote an idea and use every possible resource at ones disposal. Wells used her position as a teacher, a community member, a political activist, a mother, an editor, and an ordinary citizen to disseminate her rhetorical work. Her grandchildren have established a museum, a scholarship, a yearly birthday celebration, and a website to continue her work.

Wells and W. E. B. Du Bois

The lives of W. E. B. Du Bois and Ida B. Wells often ran along parallel tracks. Both used their journalistic writing to condemn lynching. Wells and Du Bois seemed to disagree on the story of why Wells’ name did not appear on the original list of NAACP founders. Du Bois implied that Wells had chosen not to be included. However, in her autobiography, Wells complains that Du Bois deliberately excluded her from the list.

Legacy

Throughout her life Wells was militant in her demands for equality and justice for African-Americans and insisted that the African-American community win justice through its own efforts. Since her death, interest in her life and legacy has only grown. Her life is the subject of a widely performed musical drama, which debuted in 2006, by Tazewell Thompson, Constant Star. The play sums her up:

…A woman born in slavery, she would grow to become one of the great pioneer activists of the Civil Rights movement. A precursor of Rosa Parks, she was a suffragist, newspaper editor and publisher, investigative journalist, co-founder of the NAACP, political candidate, mother, wife, and the single most powerful leader in the anti-lynching campaign in America. A dynamic, controversial, temperamental, uncompromising race woman, she broke bread and crossed swords with some of the movers and shakers of her time: Frederick Douglass, Susan B. Anthony, Marcus Garvey, Booker T. Washington, W. E. B. Du Bois, Frances Willard, and President McKinley. By any fair assessment, she was a seminal figure in Post-Reconstruction America.

On February 1, 1990, the United States Postal Service issued a 25 cent postage stamp in her honor. In 2002, Molefi Kete Asante listed Wells on his list of 100 Greatest African Americans.

In 1941, the WPA built the Ida B. Wells Homes in Chicago. The buildings were demolished in August 2011.

Source: Wikimedia Foundation

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Binge Eating Disorder

Posted on March 18, 2013 by admin

What is binge eating disorder?

People with binge eating disorder often eat an unusually large amount of food and feel out of control during the binges. Unlike bulimia or anorexia, binge eaters do not throw up their food, exercise a lot, or eat only small amounts of only certain foods. Because of this, binge eaters are often overweight or obese. People with binge eating disorder also may:

  • Eat more quickly than usual during binge episodes
  • Eat until they are uncomfortably full
  • Eat when they are not hungry
  • Eat alone because of embarrassment
  • Feel disgusted, depressed, or guilty after overeating

About 2 percent of all adults in the United States (as many as 4 million Americans) have binge eating disorder. Binge eating disorder affects women slightly more often than men.

What causes binge eating disorder?

Researchers are unsure of the causes and nature of binge eating and other eating disorders. Eating disorders likely involve abnormal activity in several different areas of the brain. Researchers are looking at the following factors that may affect binge eating:

  • Depression.  As many as half of all people with binge eating disorder are depressed or have been depressed in the past.
  • Dieting.  Some people binge after skipping meals, not eating enough food each day, or avoiding certain kinds of food.
  • Coping skills.  Studies suggest that people with binge eating may have trouble handling some of their emotions. Many people who are binge eaters say that being angry, sad, bored, worried, or stressed can cause them to binge eat.
  • Biology.  Researchers are looking into how brain chemicals and metabolism (the way the body uses calories) affect binge eating disorder. Research also suggests that genes may be involved in binge eating, since the disorder often occurs in several members of the same family. Neuroimaging, or pictures of the brain, may also lead to a better understanding of binge eating disorder.

Certain behaviors and emotional problems are more common in people with binge eating disorder. These include abusing alcohol, acting quickly without thinking (impulsive behavior), not feeling in charge of themselves, and not feeling a part of their communities.

What are the health consequences of binge eating disorder?

People with binge eating disorder are usually very upset by their binge eating and may become depressed. Research has shown that people with binge eating disorder report more health problems, stress, trouble sleeping, and suicidal thoughts than people without an eating disorder.  People with binge eating disorder often feel badly about themselves and may miss work, school, or social activities to binge eat.

People with binge eating disorder may gain weight. Weight gain can lead to obesity, and obesity raises the risk for these health problems:

  • Type 2 diabetes
  • High blood pressure
  • High cholesterol
  • Gallbladder disease
  • Heart disease
  • Certain types of cancer

Obese people with binge eating disorder often have other mental health conditions, including:

  • Anxiety
  • Depression
  • Personality disorders

Can someone with binge eating disorder get better?

Yes. Someone with binge eating disorder can get better.

People with binge eating disorder should get help from a health care professional, such as a psychiatrist, psychologist, or clinical social worker. As with bulimia, there are different ways to treat binge eating disorder that may be helpful for some people.

  • Nutritional advice and psychotherapy, especially cognitive behavioral therapy (CBT)
  • Drug therapy, such as antidepressants like fluoxetine (Prozac) or appetite suppressants prescribed by a doctor

CBT is a form of psychotherapy that focuses on the important role of thinking in how we feel and what we do. Therapy for a person with binge eating disorder may be one-on-one with a therapist or group-based.

Is it safe for young people to take antidepressants for binge eating disorder

It may be safe for young people to be treated with antidepressants. However, drug companies who make antidepressants are required to post a “black box” warning label on the medication. A “black box” warning is the most serious type of warning on prescription medicines.

It may be possible that antidepressants make children, adolescents, and young adults more likely to think about suicide or commit suicide.

The FDA offers the latest information, including which drugs are included in this warning and danger signs to look for, on their website at http://www.fda.gov.

More information on binge eating disorder

Read our article on Eating Disorders

For more information about binge eating disorder, call womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the following organizations:

Source: Office on Women’s Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services 

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Dating Violence Against Women

Posted on March 11, 2013 by admin

Dating Violence
Violence strikes women from all kinds of backgrounds and of all ages. It can happen at work, on the street, or at home.

 

This post deals with Dating Violence.

No excuses:
It is never okay for someone to hit you or be cruel to you. You may think alcohol or drugs make a partner abusive. Those things may increase the chances of abuse, but they never make it right.

You also may think it is your fault that your partner has hurt you. But you don’t control how your partner acts, and you can’t make someone mistreat you.

Keep in mind that if you sometimes hit your partner first, you can get help learning how to stop. Talk to a mental health professional, like a school counselor, or a doctor or nurse.

couple fightingWhat is dating violence?

Dating violence is when one person purposely hurts or scares someone they are dating. Dating violence happens to people of all races, cultures, incomes, and education levels. It can happen on a first date, or when you are deeply in love. It can happen whether you are young or old, and in heterosexual or same-sex relationships. Dating violence is always wrong, and you can get help.

Dating violence includes:

  • Physical abuse like hitting, shoving, kicking, biting, or throwing things
  • Emotional abuse like yelling, name-calling, bullying, embarrassing, keeping you away from your friends, saying you deserve the abuse, or giving gifts to “make up” for the abuse. (Read more about emotional abuse.)
  • Sexual abuse like forcing you to do something sexual (such as kissing or touching) or doing something sexual when you cannot agree to it (like when you are very drunk). (Read more about sexual attacks.)

Dating violence often starts with emotional abuse. You may think that behaviors like calling you names or insisting on seeing you all the time are a “normal” part of relationships. But they can lead to more serious kinds of abuse, like hitting, stalking, or preventing you from using birth control. Learn more about the warning signs of abuse and the differences between healthy and unhealthy relationships.

Dating violence can cause serious harm to your body and your emotions. If you are in an abusive relationship, get help.

Teen dating violence

In the United States, teens and young women experience the highest rates of relationship violence. In fact, 1 in 10 female high-schoolers say they have been physically abused by a dating partner in the past year. Learn more about leaving an abusive dating relationship.

If you haven’t dated much, it can be hard to know when a relationship is unhealthy. Some signs of teen dating abuse include:

Keep in mind that if you sometimes hit your partner first, you can get help learning how to stop. Talk to a mental health professional, like a school counselor, or a doctor or nurse.

  • Constantly texting or sending instant messages (IMs) to monitor you
  • Insisting on getting serious very quickly
  • Acting very jealous or bossy
  • Pressuring you to do sexual things
  • Posting sexual photos of you online without permission
  • Threatening to hurt you or themselves if you break up
  • Blaming you for the abuse

Teenage girls in physically abusive relationships are much more likely than other girls to become pregnant. Abuse can get worse during pregnancy, and it can harm the baby growing inside you. Never get pregnant hoping that it will stop the abuse. You can ask your doctor about types of birth control that your partner doesn’t have to know you are using.

If you are under 18, your partner could get arrested for having sex with you, even if you agreed to have sex. Laws covering this are different in each state. You can learn more about the law in your state.

Leaving an abusive dating relationship

If you think you are in an abusive relationship, learn more about getting help. See a doctor or nurse to take care of any physical problems. And reach out for support for your emotional pain. Friends, family, and mental health professionals all can help. If you’re in immediate danger, dial 911.

If you are thinking about ending an abusive dating relationship, keep some tips in mind:

  • Create a safety plan, like where you can go if you are in danger.
  • Make sure you have a working cellphone handy in case you need to call for help.
  • Create a secret code with people you trust. That way, if you are with your partner, you can get help without having to say you need help.
  • If you’re breaking up with someone you see at your high school or college, you can get help from a guidance counselor, advisor, teacher, school nurse, dean’s office, or principal. You also might be able to change your class schedules or even transfer to another school.
  • If you have a job, talk to someone you trust at work. Your human resources department or employee assistance program (EAP) may be able to help.
  • Try to avoid walking or riding alone.
  • Be smart about technology. Don’t share your passwords. Don’t post your schedule on Facebook, and keep your settings private.

If you are ending a long-term or live-in dating relationship, you may want to read our section on domestic and intimate partner violence.

Staying safe when meeting someone new

If you are meeting someone you don’t know or don’t know well, you can take steps to stay safe. Try to:

  • Meet your date in a public place
  • Tell a friend or family member your date’s name and where you are going
  • Avoid parties where a lot of alcohol may be served
  • Make sure you have a way to get home if you need to leave
  • Have a cellphone handy in case you need to call for help

Avoiding date rape drugs

Date rape drugs are drugs that are sometimes put into a drink to prevent a person from being able to fight back during a rape. These drugs have no color, taste, or smell, so you would not know if someone put them in your drink. They also make it hard to remember what happened while you were under their influence.

If you go to a club, bar, or party, here are some steps to take to avoid date rape drugs:

  • Don’t accept drinks from other people.
  • Keep your drink with you at all times, even when you go to the bathroom.
  • Don’t drink from punch bowls or other open containers.
  • If you lose track of your drink, dump it out.

You can read answers to frequently asked questions about date rape drugs. And keep in mind that drinking a lot of alcohol can make it hard to fight off an attacker, too.

More information on Dating violence

Explore other publications and websites

Connect with other organizations

Source: U.S. Department of Health and Human Services

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The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)

Posted on March 11, 2013 by admin

“…the full and complete development of a country, the welfare of the world and the cause of peace require the maximum participation of women on equal terms with men in all fields ”

The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), adopted in 1979 by the UN General Assembly, is often described as an international bill of rights for women.  Consisting of a preamble and 30 articles, it defines what constitutes discrimination against women and sets up an agenda for national action to end such discrimination.The Convention defines discrimination against women as “…any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field.”

By accepting the Convention, States commit themselves to undertake a series of measures to end discrimination against women in all forms, including:

  • to incorporate the principle of equality of men and women in their legal system, abolish all discriminatory laws and adopt appropriate ones prohibiting discrimination against women;
  • to establish tribunals and other public institutions to ensure the effective protection of women against discrimination; and
  • to ensure elimination of all acts of discrimination against women by persons, organizations or enterprises.

 The Convention provides the basis for realizing equality between women and men through ensuring women’s equal access to, and equal opportunities in, political and public life — including the right to vote and to stand for election — as well as education, health and employment.  States parties agree to take all appropriate measures, including legislation and temporary special measures, so that women can enjoy all their human rights and fundamental freedoms.

The Convention is the only human rights treaty which affirms the reproductive rights of women and targets culture and tradition as influential forces shaping gender roles and family relations.  It affirms women’s rights to acquire, change or retain their nationality and the nationality of their children.  States parties also agree to take appropriate measures against all forms of traffic in women and exploitation of women.

Countries that have ratified or acceded to the Convention are legally bound to put its provisions into practice.  They are also committed to submit national reports, at least every four years, on measures they have taken to comply with their treaty obligations.

INTRODUCTION

On 18 December 1979, the Convention on the Elimination of All Forms of Discrimination against Women was adopted by the United Nations General Assembly. It entered into force as an international treaty on 3 September 1981 after the twentieth country had ratified it. By the tenth anniversary of the Convention in 1989, almost one hundred nations have agreed to be bound by its provisions.

The Convention was the culmination of more than thirty years of work by the United Nations Commission on the Status of Women, a body established in 1946 to monitor the situation of women and to promote women’s rights. The Commission’s work has been instrumental in bringing to light all the areas in which women are denied equality with men. These efforts for the advancement of women have resulted in several declarations and conventions, of which the Convention on the Elimination of All Forms of Discrimination against Women is the central and most comprehensive document.

Among the international human rights treaties, the Convention takes an important place in bringing the female half of humanity into the focus of human rights concerns. The spirit of the Convention is rooted in the goals of the United Nations: to reaffirm faith in fundamental human rights, in the dignity, and worth of the human person, in the equal rights of men and women. The present document spells out the meaning of equality and how it can be achieved. In so doing, the Convention establishes not only an international bill of rights for women, but also an agenda for action by countries to guarantee the enjoyment of those rights.

In its preamble, the Convention explicitly acknowledges that “extensive discrimination against women continues to exist”, and emphasizes that such discrimination “violates the principles of equality of rights and respect for human dignity”. As defined in article 1, discrimination is understood as “any distinction, exclusion or restriction made o.1 the basis of sex…in the political, economic, social, cultural, civil or any other field”. The Convention gives positive affirmation to the principle of equality by requiring States parties to take “all appropriate measures, including legislation, to ensure the full development and advancement of women, for the purpose of guaranteeing them the exercise and enjoyment of human rights and fundamental freedoms on a basis of equality with men”(article 3).

The agenda for equality is specified in fourteen subsequent articles. In its approach, the Convention covers three dimensions of the situation of women. Civil rights and the legal status of women are dealt with in great detail. In addition, and unlike other human rights treaties, the Convention is also concerned with the dimension of human reproduction as well as with the impact of cultural factors on gender relations.

The legal status of women receives the broadest attention. Concern over the basic rights of political participation has not diminished since the adoption of the Convention on the Political Rights of Women in 1952. Its provisions, therefore, are restated in article 7 of the present document, whereby women are guaranteed the rights to vote, to hold public office and to exercise public functions. This includes equal rights for women to represent their countries at the international level (article 8). The Convention on the Nationality of Married Women – adopted in 1957 – is integrated under article 9 providing for the statehood of women, irrespective of their marital status. The Convention, thereby, draws attention to the fact that often women’s legal status has been linked to marriage, making them dependent on their husband’s nationality rather than individuals in their own right. Articles 10, 11 and 13, respectively, affirm women’s rights to non-discrimination in education, employment and economic and social activities. These demands are given special emphasis with regard to the situation of rural women, whose particular struggles and vital economic contributions, as noted in article 14, warrant more attention in policy planning. Article 15 asserts the full equality of women in civil and business matters, demanding that all instruments directed at restricting women’s legal capacity ”shall be deemed null and void”. Finally, in article 16, the Convention returns to the issue of marriage and family relations, asserting the equal rights and obligations of women and men with regard to choice of spouse, parenthood, personal rights and command over property.

Aside from civil rights issues, the Convention also devotes major attention to a most vital concern of women, namely their reproductive rights. The preamble sets the tone by stating that “the role of women in procreation should not be a basis for discrimination”. The link between discrimination and women’s reproductive role is a matter of recurrent concern in the Convention. For example, it advocates, in article 5, ”a proper understanding of maternity as a social function”, demanding fully shared responsibility for child-rearing by both sexes. Accordingly, provisions for maternity protection and child-care are proclaimed as essential rights and are incorporated into all areas of the Convention, whether dealing with employment, family law, health core or education. Society’s obligation extends to offering social services, especially child-care facilities, that allow individuals to combine family responsibilities with work and participation in public life. Special measures for maternity protection are recommended and “shall not be considered discriminatory”. (article 4). “The Convention also affirms women’s right to reproductive choice. Notably, it is the only human rights treaty to mention family planning. States parties are obliged to include advice on family planning in the education process (article l) and to develop family codes that guarantee women’s rights “to decide freely and responsibly on the number and spacing of their children and to hove access to the information, education and means to enable them to exercise these rights” (article 16.e).

The third general thrust of the Convention aims at enlarging our understanding of the concept of human rights, as it gives formal recognition to the influence of culture and tradition on restricting women’s enjoyment of their fundamental rights. These forces take shape in stereotypes, customs and norms which give rise to the multitude of legal, political and economic constraints on the advancement of women. Noting this interrelationship, the preamble of the Convention stresses “that a change in the traditional role of men as well as the role of women in society and in the family is needed to achieve full equality of men and women”. States parties are therefore obliged to work towards the modification of social and cultural patterns of individual conduct in order to eliminate “prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women” (article 5). And Article 1O.c. mandates the revision of textbooks, school programs and teaching methods with a view to eliminating stereotyped concepts in the field of education. Finally, cultural patterns which define the public realm as a man’s world and the domestic sphere as women’s domain are strongly targeted in all of the Convention’s provisions that affirm the equal responsibilities of both sexes in family life and their equal rights with regard to education and employment. Altogether, the Convention provides a comprehensive framework for challenging the various forces that have created and sustained discrimination based upon sex.

The implementation of the Convention is monitored by the Committee on the Elimination of Discrimination against Women (CEDAW). The Committee’s mandate and the administration of the treaty are defined in the Articles 17 to 30 of the Convention. The Committee is composed of 23 experts nominated by their Governments and elected by the States parties as individuals “of high moral standing and competence in the field covered by the Convention”.

At least every four years, the States parties are expected to submit a national report to the Committee, indicating the measures they have adopted to give effect to the provisions of the Convention. During its annual session, the Committee members discuss these reports with the Government representatives and explore with them areas for further action by the specific country. The Committee also makes general recommendations to the States parties on matters concerning the elimination of discrimination against women.

The full text of the Convention is set out herein

CONVENTION ON THE ELIMINATION OF ALL FORMS OF DISCRIMINATION AGAINST WOMEN

The States Parties to the present Convention,

Noting that the Charter of the United Nations reaffirms faith in fundamental human rights, in the dignity and worth of the human person and in the equal rights of men and women,

Noting that the Universal Declaration of Human Rights affirms the principle of the inadmissibility of discrimination and proclaims that all human beings are born free and equal in dignity and rights and that everyone is entitled to all the rights and freedoms set forth therein, without distinction of any kind, including distinction based on sex,

Noting that the States Parties to the International Covenants on Human Rights have the obligation to ensure the equal rights of men and women to enjoy all economic, social, cultural, civil and political rights,

Considering the international conventions concluded under the auspices of the United Nations and the specialized agencies promoting equality of rights of men and women,

Noting also the resolutions, declarations and recommendations adopted by the United Nations and the specialized agencies promoting equality of rights of men and women,

Concerned, however, that despite these various instruments extensive discrimination against women continues to exist,

Recalling that discrimination against women violates the principles of equality of rights and respect for human dignity, is an obstacle to the participation of women, on equal terms with men, in the political, social, economic and cultural life of their countries, hampers the growth of the prosperity of society and the family and makes more difficult the full development of the potentialities of women in the service of their countries and of humanity,

Concerned that in situations of poverty women have the least access to food, health, education, training and opportunities for employment and other needs,

Convinced that the establishment of the new international economic order based on equity and justice will contribute significantly towards the promotion of equality between men and women,

Emphasizing that the eradication of apartheid, all forms of racism, racial discrimination, colonialism, neo-colonialism, aggression, foreign occupation and domination and interference in the internal affairs of States is essential to the full enjoyment of the rights of men and women,

Affirming that the strengthening of international peace and security, the relaxation of international tension, mutual co-operation among all States irrespective of their social and economic systems, general and complete disarmament, in particular nuclear disarmament under strict and effective international control, the affirmation of the principles of justice, equality and mutual benefit in relations among countries and the realization of the right of peoples under alien and colonial domination and foreign occupation to self-determination and independence, as well as respect for national sovereignty and territorial integrity, will promote social progress and development and as a consequence will contribute to the attainment of full equality between men and women,

Convinced that the full and complete development of a country, the welfare of the world and the cause of peace require the maximum participation of women on equal terms with men in all fields,

Bearing in mind the great contribution of women to the welfare of the family and to the development of society, so far not fully recognized, the social significance of maternity and the role of both parents in the family and in the upbringing of children, and aware that the role of women in procreation should not be a basis for discrimination but that the upbringing of children requires a sharing of responsibility between men and women and society as a whole,

Aware that a change in the traditional role of men as well as the role of women in society and in the family is needed to achieve full equality between men and women,

Determined to implement the principles set forth in the Declaration on the Elimination of Discrimination against Women and, for that purpose, to adopt the measures required for the elimination of such discrimination in all its forms and manifestations,

Have agreed on the following:

PART I

Article I

For the purposes of the present Convention, the term “discrimination against women” shall mean any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field.

Article 2

States Parties condemn discrimination against women in all its forms, agree to pursue by all appropriate means and without delay a policy of eliminating discrimination against women and, to this end, undertake:

(a) To embody the principle of the equality of men and women in their national constitutions or other appropriate legislation if not yet incorporated therein and to ensure, through law and other appropriate means, the practical realization of this principle;

(b) To adopt appropriate legislative and other measures, including sanctions where appropriate, prohibiting all discrimination against women;

(c) To establish legal protection of the rights of women on an equal basis with men and to ensure through competent national tribunals and other public institutions the effective protection of women against any act of discrimination;

(d) To refrain from engaging in any act or practice of discrimination against women and to ensure that public authorities and institutions shall act in conformity with this obligation;

(e) To take all appropriate measures to eliminate discrimination against women by any person, organization or enterprise;

(f) To take all appropriate measures, including legislation, to modify or abolish existing laws, regulations, customs and practices which constitute discrimination against women;

(g) To repeal all national penal provisions which constitute discrimination against women.

Article 3

States Parties shall take in all fields, in particular in the political, social, economic and cultural fields, all appropriate measures, including legislation, to en sure the full development and advancement of women , for the purpose of guaranteeing them the exercise and enjoyment of human rights and fundamental freedoms on a basis of equality with men.

Article 4

1. Adoption by States Parties of temporary special measures aimed at accelerating de facto equality between men and women shall not be considered discrimination as defined in the present Convention, but shall in no way entail as a consequence the maintenance of unequal or separate standards; these measures shall be discontinued when the objectives of equality of opportunity and treatment have been achieved.

2. Adoption by States Parties of special measures, including those measures contained in the present Convention, aimed at protecting maternity shall not be considered discriminatory.

Article 5

States Parties shall take all appropriate measures:

(a) To modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women;

(b) To ensure that family education includes a proper understanding of maternity as a social function and the recognition of the common responsibility of men and women in the upbringing and development of their children, it being understood that the interest of the children is the primordial consideration in all cases.

Article 6

States Parties shall take all appropriate measures, including legislation, to suppress all forms of traffic in women and exploitation of prostitution of women.

PART II

Article 7

States Parties shall take all appropriate measures to eliminate discrimination against women in the political and public life of the country and, in particular, shall ensure to women, on equal terms with men, the right:

(a) To vote in all elections and public referenda and to be eligible for election to all publicly elected bodies;

(b) To participate in the formulation of government policy and the implementation thereof and to hold public office and perform all public functions at all levels of government;

(c) To participate in non-governmental organizations and associations concerned with the public and political life of the country.

Article 8

States Parties shall take all appropriate measures to ensure to women, on equal terms with men and without any discrimination, the opportunity to represent their Governments at the international level and to participate in the work of international organizations.

Article 9

1. States Parties shall grant women equal rights with men to acquire, change or retain their nationality. They shall ensure in particular that neither marriage to an alien nor change of nationality by the husband during marriage shall automatically change the nationality of the wife, render her stateless or force upon her the nationality of the husband.

2. States Parties shall grant women equal rights with men with respect to the nationality of their children.

PART III

Article 10

States Parties shall take all appropriate measures to eliminate discrimination against women in order to ensure to them equal rights with men in the field of education and in particular to ensure, on a basis of equality of men and women:

(a) The same conditions for career and vocational guidance, for access to studies and for the achievement of diplomas in educational establishments of all categories in rural as well as in urban areas; this equality shall be ensured in pre-school, general, technical, professional and higher technical education, as well as in all types of vocational training;

(b) Access to the same curricula, the same examinations, teaching staff with qualifications of the same standard and school premises and equipment of the same quality;

(c) The elimination of any stereotyped concept of the roles of men and women at all levels and in all forms of education by encouraging coeducation and other types of education which will help to achieve this aim and, in particular, by the revision of textbooks and school programmes and the adaptation of teaching methods;

(d ) The same opportunities to benefit from scholarships and other study grants;

(e) The same opportunities for access to programmes of continuing education, including adult and functional literacy programmes, particulary those aimed at reducing, at the earliest possible time, any gap in education existing between men and women;

(f) The reduction of female student drop-out rates and the organization of programmes for girls and women who have left school prematurely;

(g) The same Opportunities to participate actively in sports and physical education;

(h) Access to specific educational information to help to ensure the health and well-being of families, including information and advice on family planning.

Article 11

1. States Parties shall take all appropriate measures to eliminate discrimination against women in the field of employment in order to ensure, on a basis of equality of men and women, the same rights, in particular:

(a) The right to work as an inalienable right of all human beings;

(b) The right to the same employment opportunities, including the application of the same criteria for selection in matters of employment;

(c) The right to free choice of profession and employment, the right to promotion, job security and all benefits and conditions of service and the right to receive vocational training and retraining, including apprenticeships, advanced vocational training and recurrent training;

(d) The right to equal remuneration, including benefits, and to equal treatment in respect of work of equal value, as well as equality of treatment in the evaluation of the quality of work;

(e) The right to social security, particularly in cases of retirement, unemployment, sickness, invalidity and old age and other incapacity to work, as well as the right to paid leave;

(f) The right to protection of health and to safety in working conditions, including the safeguarding of the function of reproduction.

2. In order to prevent discrimination against women on the grounds of marriage or maternity and to ensure their effective right to work, States Parties shall take appropriate measures:

(a) To prohibit, subject to the imposition of sanctions, dismissal on the grounds of pregnancy or of maternity leave and discrimination in dismissals on the basis of marital status;

(b) To introduce maternity leave with pay or with comparable social benefits without loss of former employment, seniority or social allowances;

(c) To encourage the provision of the necessary supporting social services to enable parents to combine family obligations with work responsibilities and participation in public life, in particular through promoting the establishment and development of a network of child-care facilities;

(d) To provide special protection to women during pregnancy in types of work proved to be harmful to them.

3. Protective legislation relating to matters covered in this article shall be reviewed periodically in the light of scientific and technological knowledge and shall be revised, repealed or extended as necessary.

Article 12

1. States Parties shall take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning.

2. Notwithstanding the provisions of paragraph I of this article, States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation.

Article 13

States Parties shall take all appropriate measures to eliminate discrimination against women in other areas of economic and social life in order to ensure, on a basis of equality of men and women, the same rights, in particular:

(a) The right to family benefits;

(b) The right to bank loans, mortgages and other forms of financial credit;

(c) The right to participate in recreational activities, sports and all aspects of cultural life.

Article 14

1. States Parties shall take into account the particular problems faced by rural women and the significant roles which rural women play in the economic survival of their families, including their work in the non-monetized sectors of the economy, and shall take all appropriate measures to ensure the application of the provisions of the present Convention to women in rural areas.

2. States Parties shall take all appropriate measures to eliminate discrimination against women in rural areas in order to ensure, on a basis of equality of men and women, that they participate in and benefit from rural development and, in particular, shall ensure to such women the right:

(a) To participate in the elaboration and implementation of development planning at all levels;

(b) To have access to adequate health care facilities, including information, counselling and services in family planning;

(c) To benefit directly from social security programmes;

(d) To obtain all types of training and education, formal and non-formal, including that relating to functional literacy, as well as, inter alia, the benefit of all community and extension services, in order to increase their technical proficiency;

(e) To organize self-help groups and co-operatives in order to obtain equal access to economic opportunities through employment or self employment;

(f) To participate in all community activities;

(g) To have access to agricultural credit and loans, marketing facilities, appropriate technology and equal treatment in land and agrarian reform as well as in land resettlement schemes;

(h) To enjoy adequate living conditions, particularly in relation to housing, sanitation, electricity and water supply, transport and communications.

PART IV

Article 15

1. States Parties shall accord to women equality with men before the law.

2. States Parties shall accord to women, in civil matters, a legal capacity identical to that of men and the same opportunities to exercise that capacity. In particular, they shall give women equal rights to conclude contracts and to administer property and shall treat them equally in all stages of procedure in courts and tribunals.

3. States Parties agree that all contracts and all other private instruments of any kind with a legal effect which is directed at restricting the legal capacity of women shall be deemed null and void.

4. States Parties shall accord to men and women the same rights with regard to the law relating to the movement of persons and the freedom to choose their residence and domicile.

Article 16

1. States Parties shall take all appropriate measures to eliminate discrimination against women in all matters relating to marriage and family relations and in particular shall ensure, on a basis of equality of men and women:

(a) The same right to enter into marriage;

(b) The same right freely to choose a spouse and to enter into marriage only with their free and full consent;

(c) The same rights and responsibilities during marriage and at its dissolution;

(d) The same rights and responsibilities as parents, irrespective of their marital status, in matters relating to their children; in all cases the interests of the children shall be paramount;

(e) The same rights to decide freely and responsibly on the number and spacing of their children and to have access to the information, education and means to enable them to exercise these rights;

(f) The same rights and responsibilities with regard to guardianship, wardship, trusteeship and adoption of children, or similar institutions where these concepts exist in national legislation; in all cases the interests of the children shall be paramount;

(g) The same personal rights as husband and wife, including the right to choose a family name, a profession and an occupation;

(h) The same rights for both spouses in respect of the ownership, acquisition, management, administration, enjoyment and disposition of property, whether free of charge or for a valuable consideration.

2. The betrothal and the marriage of a child shall have no legal effect, and all necessary action, including legislation, shall be taken to specify a minimum age for marriage and to make the registration of marriages in an official registry compulsory.
PART V

Article 17

1. For the purpose of considering the progress made in the implementation of the present Convention, there shall be established a Committee on the Elimination of Discrimination against Women (hereinafter referred to as the Committee) consisting, at the time of entry into force of the Convention, of eighteen and, after ratification of or accession to the Convention by the thirty-fifth State Party, of twenty-three experts of high moral standing and competence in the field covered by the Convention. The experts shall be elected by States Parties from among their nationals and shall serve in their personal capacity, consideration being given to equitable geographical distribution and to the representation of the different forms of civilization as well as the principal legal systems.

2. The members of the Committee shall be elected by secret ballot from a list of persons nominated by States Parties. Each State Party may nominate one person from among its own nationals.

3. The initial election shall be held six months after the date of the entry into force of the present Convention. At least three months before the date of each election the Secretary-General of the United Nations shall address a letter to the States Parties inviting them to submit their nominations within two months. The Secretary-General shall prepare a list in alphabetical order of all persons thus nominated, indicating the States Parties which have nominated them, and shall submit it to the States Parties.

4. Elections of the members of the Committee shall be held at a meeting of States Parties convened by the Secretary-General at United Nations Headquarters. At that meeting, for which two thirds of the States Parties shall constitute a quorum, the persons elected to the Committee shall be those nominees who obtain the largest number of votes and an absolute majority of the votes of the representatives of States Parties present and voting.

5. The members of the Committee shall be elected for a term of four years. However, the terms of nine of the members elected at the first election shall expire at the end of two years; immediately after the first election the names of these nine members shall be chosen by lot by the Chairman of the Committee.

6. The election of the five additional members of the Committee shall be held in accordance with the provisions of paragraphs 2, 3 and 4 of this article, following the thirty-fifth ratification or accession. The terms of two of the additional members elected on this occasion shall expire at the end of two years, the names of these two members having been chosen by lot by the Chairman of the Committee.

7. For the filling of casual vacancies, the State Party whose expert has ceased to function as a member of the Committee shall appoint another expert from among its nationals, subject to the approval of the Committee.

8. The members of the Committee shall, with the approval of the General Assembly, receive emoluments from United Nations resources on such terms and conditions as the Assembly may decide, having regard to the importance of the Committee’s responsibilities.

9. The Secretary-General of the United Nations shall provide the necessary staff and facilities for the effective performance of the functions of the Committee under the present Convention.

Article 18

1. States Parties undertake to submit to the Secretary-General of the United Nations, for consideration by the Committee, a report on the legislative, judicial, administrative or other measures which they have adopted to give effect to the provisions of the present Convention and on the progress made in this respect:

(a) Within one year after the entry into force for the State concerned;

(b) Thereafter at least every four years and further whenever the Committee so requests.

2. Reports may indicate factors and difficulties affecting the degree of fulfilment of obligations under the present Convention.

Article 19

1. The Committee shall adopt its own rules of procedure.

2. The Committee shall elect its officers for a term of two years.

Article 20

1. The Committee shall normally meet for a period of not more than two weeks annually in order to consider the reports submitted in accordance with article 18 of the present Convention.

2. The meetings of the Committee shall normally be held at United Nations Headquarters or at any other convenient place as determined by the Committee. (amendment, status of ratification)

Article 21

1. The Committee shall, through the Economic and Social Council, report annually to the General Assembly of the United Nations on its activities and may make suggestions and general recommendations based on the examination of reports and information received from the States Parties. Such suggestions and general recommendations shall be included in the report of the Committee together with comments, if any, from States Parties.

2. The Secretary-General of the United Nations shall transmit the reports of the Committee to the Commission on the Status of Women for its information.

Article 22

The specialized agencies shall be entitled to be represented at the consideration of the implementation of such provisions of the present Convention as fall within the scope of their activities. The Committee may invite the specialized agencies to submit reports on the implementation of the Convention in areas falling within the scope of their activities.

PART VI

Article 23

Nothing in the present Convention shall affect any provisions that are more conducive to the achievement of equality between men and women which may be contained:

(a) In the legislation of a State Party; or

(b) In any other international convention, treaty or agreement in force for that State.

Article 24

States Parties undertake to adopt all necessary measures at the national level aimed at achieving the full realization of the rights recognized in the present Convention.

Article 25

1. The present Convention shall be open for signature by all States.

2. The Secretary-General of the United Nations is designated as the depositary of the present Convention.

3. The present Convention is subject to ratification. Instruments of ratification shall be deposited with the Secretary-General of the United Nations.

4. The present Convention shall be open to accession by all States. Accession shall be effected by the deposit of an instrument of accession with the Secretary-General of the United Nations.

Article 26

1. A request for the revision of the present Convention may be made at any time by any State Party by means of a notification in writing addressed to the Secretary-General of the United Nations.

2. The General Assembly of the United Nations shall decide upon the steps, if any, to be taken in respect of such a request.

Article 27

1. The present Convention shall enter into force on the thirtieth day after the date of deposit with the Secretary-General of the United Nations of the twentieth instrument of ratification or accession.

2. For each State ratifying the present Convention or acceding to it after the deposit of the twentieth instrument of ratification or accession, the Convention shall enter into force on the thirtieth day after the date of the deposit of its own instrument of ratification or accession.

Article 28

1. The Secretary-General of the United Nations shall receive and circulate to all States the text of reservations made by States at the time of ratification or accession.

2. A reservation incompatible with the object and purpose of the present Convention shall not be permitted.

3. Reservations may be withdrawn at any time by notification to this effect addressed to the Secretary-General of the United Nations, who shall then inform all States thereof. Such notification shall take effect on the date on which it is received.

Article 29

1. Any dispute between two or more States Parties concerning the interpretation or application of the present Convention which is not settled by negotiation shall, at the request of one of them, be submitted to arbitration. If within six months from the date of the request for arbitration the parties are unable to agree on the organization of the arbitration, any one of those parties may refer the dispute to the International Court of Justice by request in conformity with the Statute of the Court.

2. Each State Party may at the time of signature or ratification of the present Convention or accession thereto declare that it does not consider itself bound by paragraph I of this article. The other States Parties shall not be bound by that paragraph with respect to any State Party which has made such a reservation.

3. Any State Party which has made a reservation in accordance with paragraph 2 of this article may at any time withdraw that reservation by notification to the Secretary-General of the United Nations.

Article 30

The present Convention, the Arabic, Chinese, English, French, Russian and Spanish texts of which are equally authentic, shall be deposited with the Secretary-General of the United Nations.

IN WITNESS WHEREOF the undersigned, duly authorized, have signed the present Convention.

Source: United Nations

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19th Amendment to the U.S. Constitution: Women’s Right to Vote (1920)

Posted on March 11, 2013 by admin

Women’s right to vote

The 19th amendment guarantees all American women the right to vote. Achieving this milestone required a lengthy and difficult struggle; victory took decades of agitation and protest. Beginning in the mid-19th century, several generations of woman suffrage supporters lectured, wrote, marched, lobbied, and practiced civil disobedience to achieve what many Americans considered a radical change of the Constitution. Few early supporters lived to see final victory in 1920.

Beginning in the 1800s, women organized, petitioned, and picketed to win the right to vote, but it took them decades to accomplish their purpose. Between 1878, when the amendment was first introduced in Congress, and August 18, 1920, when it was ratified, champions of voting rights for women worked tirelessly, but strategies for achieving their goal varied. Some pursued a strategy of passing suffrage acts in each state—nine western states adopted woman suffrage legislation by 1912. Others challenged male-only voting laws in the courts. Militant suffragists used tactics such as parades, silent vigils, and hunger strikes. Often supporters met fierce resistance. Opponents heckled, jailed, and sometimes physically abused them.

By 1916, almost all of the major suffrage organizations were united behind the goal of a constitutional amendment. When New York adopted woman suffrage in 1917 and President Wilson changed his position to support an amendment in 1918, the political balance began to shift.

On May 21, 1919, the House of Representatives passed the amendment, and 2 weeks later, the Senate followed. When Tennessee became the 36th state to ratify the amendment on August 18, 1920, the amendment passed its final hurdle of obtaining the agreement of three-fourths of the states. Secretary of State Bainbridge Colby certified the ratification on August 26, 1920, changing the face of the American electorate forever.

Source: National Archives of the United States

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More Women in the U.S. Die From Lung cancer than any other type of cancer

Posted on February 25, 2013 by admin

Health Consequences of Smoking

Smoking causes harm to nearly every part of your body. Quit for your health.

You breathe in more than 4,000 chemicals each time you smoke a cigarette. All forms of tobacco are harmful and even deadly. Both women and men are hurt by these poisons.

Cancers

Smoking causes cancers of the lung, esophagus, larynx (voice  box), mouth, throat, kidney, bladder, pancreas, stomach, and acute  myeloid leukemia.1 Female smokers also have an increased risk of cervical cancer.

More women in the United States die from lung cancer than any other type of cancer. Your chance of getting lung  cancer goes up the longer you smoke and the more you smoke two or more packs of cigarettes a day than among women who do not smoke. This means that if you  smoke two or more packs of cigarettes a day, you are much more likely to die of  lung cancer than your friends who do not smoke.

Good News… Once you are smoke-free for 5 years, you are less likely to die from lung cancer and other lung  diseases than if you were still a smoker. The longer you stay smoke-free, the  lower your chances of getting these diseases.1 Women of all ages who  quit smoking can largely lower their chance of getting diseases such as cancer.  For smokers who do get cancer, quitting smoking helps their bodies to heal and to respond to cancer treatment. Quitting also lowers their chance of  getting a second cancer.

Heart Disease and Stroke

More women die of heart disease than anything else. Smoking causes heart disease in women. A woman’s chance of getting heart disease goes up with the number of cigarettes she has smoked and how  long she has been smoking.

Good News… Your chance of getting heart disease greatly goes down within 1 or 2 years of quitting smoking. Once you are  smoke-free for 10 years, your risk of heart disease is the same as if you had never been a smoker.

Women who smoke are more likely to have a stroke than non-smokers.

Good news… You can lower your chance of having a stroke by quitting smoking. Five to 15 years after quitting, your  chance of stroke is the same as that of a woman who has never smoked.2

Lungs

Cigarette smoking is the #1 cause of COPD (chronic obstructive pulmonary disease) among women. Emphysema and chronic bronchitis are two kinds of COPD. Your chance of getting COPD goes up the more you smoke and the longer you smoke. Among women in the United States, cigarette smoking causes about 9 out of every 10 deaths from COPD.

Teen girls who smoke have lungs that  don’t grow as much as non-smokers’ lungs, and adult women who smoke have lungs that don’t work as well as non-smokers’ lungs.2

Women’s Health

Some studies show that women who smoke get more irregular or painful periods.

Smokers are more likely than nonsmokers to go through menopause at a younger age, and they may have worse symptoms  of menopause.2

Women who smoke may have a harder time getting pregnant.

Pregnant women who smoke have a higher chance of losing their baby before it is born.

Studies show smoking is linked to the risk of SIDS (sudden infant death syndrome, also called “crib death”) in babies of women who smoked during pregnancy.

Good news… If you quit smoking before or during pregnancy, you can lower the chance of:

  • Smoke harming the baby.
  • Having the baby early.
  • Having a baby who weighs less than 5½ pounds.

Learn more about the benefits of quitting when you are pregnant.

Other Health Problems for Women Who Smoke

Women who have gone through menopause and who smoke have lower bone density. This means they have a higher chance of fracturing a hip than women who do not smoke.2 They are  also more likely to get rheumatoid arthritis and eye cataracts.1,2

Smoking is linked to gum disease,  which may lead to bone and tooth loss. Smokers are more likely to get ulcers in the stomach, which can lead to death.1,2

Smokers have worse survival rates after surgery, and they are more likely to have problems after surgery. This is because their bodies take longer to heal and their immune systems are weaker than non-smokers’.1

It is important for women to know about the link between smoking and depression because they are more likely than men to be diagnosed with depression. For more information about depression, visit the Depression section.

Source: smokefree.gov

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