Unhealthy relationships can be very damaging to your sense of self-worth. But there are effective ways in dealing with an unhealthy relationship.

Are you in an unhealthy relationship? How do you know the signs of an unhealthy relationship? How do you get from the point of wondering what to do-- self-pity, or sheer devastation--to actually taking the necessary steps to get yourself back to an emotionally healthy state?

It's important to know the long-term impact of negative relationships, how to recognize the symptoms, and how to obtain the help you need to break free from a harmful association when that is the best course of action. I do fully recognize that sometimes a better course of action is changing the dynamics of the interaction within a relationship to achieve the desired level of stability and compatibility. This can be achieved through a commitment to therapeutic work on the part of either/or all of the parties involved.

Do any of the following situations strike a chord or bring back memories? That back-stabbing treacherous childhood girlfriend to whom you continue to cling because you have this subconscious desire to stay in touch with the happier times of your youth, or worse still, that lying cheating husband that has kept you from achieving your lifetime goals. Or your colleague at work who conveniently accepts your help when in need, but has no qualms about using you as a pawn in the chess game of corporate life. Or what about that parent who may have neglected or even abused you as a child, but is in complete denial and expresses great surprise about your estranged relationship. All of these types of relationships require that you make a decision. Are you going to work on changing the dynamics of the relationship with the hope of making it better, or are you going to move on?

The Effects of an Unhealthy Relationship

Some of the serious long-term effects of remaining in a dysfunctional relationship include the gradual but steady erosion of your sense of self-worth. Suddenly, you wake up one morning to find that the only identity you have is that which you have gained from your abuser. You see yourself through their eyes - often it can take years of therapy to undo the damage that has been done to the ego. It is not unusual to find individuals with serious personality disorders as a result of the insidious effect of unhealthy long-term associations.

Another important effect is the negative impact on your ability to accept the love of other well-meaning persons with whom you are in a relationship. You become suspicious of the sincerity of those with whom you relate. This is a sure guarantee to undermining all future chances for happiness. This progression occurs because as a passive participant in an unhealthy association, you have come to accept and integrate the identity, conditional love, or outright rejection you receive from the negative other person. You subconsciously expect the same treatment from others. As a result, you struggle with integrating a new identity of loving and being worthy of love and acceptance. The longer an unhealthy relationship continues, the more damaging it is, and the more difficult it is to engage in a healthy one in which there is genuine love and acceptance.

What symptoms do you look for when assessing the health of your relationships?

• Are you afraid of your spouse or significant other?
• Do you feel controlled or unable to express your true feelings and thoughts?
• Do you breathe a sigh of relief or suddenly feel much happier when this person leaves the room?
• Are you really unhappy in this relationship, but continue to hang in there because you are afraid of being alone, or because you lack an adequate support system?
• Does this person make you feel small, inadequate, or frequently belittle you in word and deed?
• Are there unresolved hurts that creep into your daily arguments on an on-going basis?

If you answered yes a few times, then there's your answer. These are symptoms indicating you're at a crossroad in your relationship and you need to make a decision about your continued involvement. It might be time to evaluate the benefits of your continued involvement versus the potential long-term effects on your psyche. We all have a responsibility to safeguard our emotional and mental wellbeing in pretty much the same way we safeguard our physical health. No one else will ever undertake that task for us.

What now?

If you just realized that your relationship is unhealthy, there are two ways to respond:

There's the immediate decision to end your association with your abusive other. This might work if you have had a chance to plan your course of action and you have adequate means and support to carry out your plan. Your decision should also depend on the severity of the situation with which you are faced. I never recommend action for the sake of drama. You may likely need some supportive therapy or counseling as you take this bold step. Your therapist or counselor should help you filter through your options, goals, and underlying motives for making this decision. Be sure to resolve any guilt and be very clear that this is the only course of action to take.

As an alternative to any drastic or sudden moves, I recommend what is in some situations a more healthy and sustainable course of action which is to decide this moment to appreciate, recognize, and reward the strengths you know you have. Assert those strengths and use them daily, gently, in your relationships. In this course of action, there is the opportunity to salvage relationships that can be salvaged. Too often we let other people relate to us on the basis of our weaknesses, faults and everything by which we judge and condemn ourselves and they come to know no other way of relating to us. It will take some relearning and reconditioning to achieve this change of relating to others through our strengths, especially if the negative relationship has been long term. Therapy and counseling; particularly using a motivational interviewing style, would be a good place to start relearning the skills necessary to achieve this goal. Again, this choice should be determined by the severity of your situation. In some circumstances ending the relationship may be the only way to go.

Finally, most people have at one point in time or another experienced an unhealthy relationship. It is what we decide to do that determines whether we continue to be dissatisfied in our associations or whether we attain a satisfactory level of stability and compatibility. It is normal and advisable to seek professional help as you struggle through what to do with a difficult relationship, especially if it has existed for a long period of time.

By Claire Arene, MSW, LCSW.

If you’re looking for a thorough list of schizophrenia medications, you’ve found it.

Medication is currently the foundation of schizophrenia treatment. Other types of treatment, such as therapy and social skills training can be helpful, but they don’t do anything for the symptoms of schizophrenia. Schizophrenia medications can and do help relieve the symptoms of this serious mental illness.

On the list of schizophrenia medications below, you’ll find each type and what it’s used for.

Schizophrenia Medications List by Category

Researchers in the fields of neuroscience and psychiatry haven’t yet discovered the cause of the brain illness we call schizophrenia. Nor have they found a cure for schizophrenia. Medication, therefore, is used to lessen the symptoms and negative effects of schizophrenia on people’s lives.

Many different medications have been developed to treat the symptoms of schizophrenia. A complete list of schizophrenia medications includes all four types.

Types of Schizophrenia Medication

The four categories of medication used in the treatment of this mental disorder are

• Antipsychotics
• Antidepressants
• Mood stabilizers
• Antianxiety medications

Regarding schizophrenia treatment, antidepressants, mood stabilizers, and antianxiety medications are considered off-label. This simply means that these medications were designed to treat something different but are now used for schizophrenia, too.

Antipsychotics

Of the four types of prescriptions, antipsychotics are by far the main form of schizophrenia treatment. This type of medication works primarily on dopamine, a neurotransmitter in the brain, but antipsychotics work on other aspects of brain chemistry as well, such as serotonin. In doing so, they treat psychosis—the separation from reality that involves such things as hallucinations and delusions (Schizophrenia vs. Psychosis: What’s the Difference?).

Most of the antipsychotics prescribed are known as second-generation medications and are sometimes called atypical antipsychotics. First generation antipsychotics, often called typical or conventional medications, are still in use. Studies show that the newer and older medications are equally effective. The advantage of the atypical antipsychotics is that they can have milder side effects (What About Side-Effects from Atypical Antipsychotics?). They are more expensive, however.

The below list of antipsychotic medications for schizophrenia includes both first- and second generation medications.

Antidepressants

To date, nothing has been able to surpass antipsychotics in reducing psychosis symptoms. While antipsychotics can be helpful in dampening hallucinations and delusions, they don’t help the negative symptoms of schizophrenia. Negative symptoms are aspects of someone’s experience as a person that are taken away. Many of the negative symptoms resemble depression; therefore, many doctors add antidepressants to the antipsychotics someone takes.

While it hasn’t been proven beyond a doubt that antidepressants help improve negative symptoms, many people have seen improvement. If you or your loved one is struggling with depression-like symptoms, it could be worth discussing the possibility of adding antidepressants to antipsychotics.

Mood Stabilizers

Mood stabilizers are used to treat bipolar disorder. They’ve also been found to help manage schizophrenia. As part of the treatment plan that includes antipsychotic medication, mood stabilizers can reduce symptoms of schizophrenia.

Anti-Anxiety Medications

Anti-anxiety medications can be helpful when symptoms of schizophrenia return or flare up after having been manageable. This type of medication can shorten a psychotic episode as well as calm anxiety that often corresponds with the symptoms of schizophrenia.

Doctors prescribe them with caution as they can be habit-forming and cause undesirable side effects such as fatigue and balance problems. Also, the dose of antipsychotics often has to be reduced while someone is taking anti-anxiety medication, which might not be the right thing for someone. Each person is different, and the effects of medication can be very different from one person to the next.

Complete List of Schizophrenia Medication

This schizophrenia medications list will help you recognize what pharmaceutical treatments are available so you can look into them and discuss them with your doctor.

Brand names are listed first and capitalized. Generic names follow in parentheses.

List of Top Five Antipsychotics prescribed for schizophrenia (all are second generation).

• Abilify (aripiprazole)
• Clozaril (clozapine)
• Zyprexa (olanzapine)
• Seroquel (quetiapine)
• Risperdal (risperidone)

List of Second-generation antipsychotics (in addition to the five listed above)

• Saphris (asenapine)
• Rexulti (brexpiprazole)
• Vraylar (cariprazine)
• Fanapt (iloperidone)
• Latuda (lurasidone)
• Invega (paliperidone)
• Loxitane (loxapine)
• Geodon (ziprasidone)

List of First-generation antipsychotics

• Thorazine (chlorpromazine)
• Prolixin (fluphenazine)
• Haldol (haloperidol)
• Trilafon (perphenazine)
• Navane (thiothixene)
• Stelazine (trifluoperazine)

List of Injectable antipsychotics

Some antipsychotics are available in a long-lasting injectable form. This schizophrenia injectable medication list shows you which medications need to be taken, in the doctor’s office, only once or twice a month.

• Aripiprazole (Abilify)
• Olanzapine (Zyprexa)
• Invega, Xepilon (paliperidone)
• Risperidone (Risperdal)
• Haloperidol (Haldol, Serenace)
• Prolixin (fluphenazine)

List of Antidepressants

• Elavil (amitriptyline)
• Anafranil (clomipramine)
• Tofranil (imipramine)
• Lexapro (escitalopram)
• Prozac (fluoxetine)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Zoloft (sertraline)

List of Mood stabilizers

• Eskalith (lithium)
• Tegretol (carbamazepine)
• Depacon (valproate)
• Lamictal (lamotrigine)

List of Antianxiety medications

• Klonopin (clonazepam)
• Diazepam (diazepam tablets)
• Atavan (Lorazepam)

All of the medications on the above list of schizophrenia medications are approved and use to treat the symptoms of schizophrenia. While there are other antidepressants, mood stabilizers, and antianxiety medications, not all of them are approved for use with schizophrenia. The antipsychotics, taken alone or with another type of medication, are the main line of treatment for someone with schizophrenia. While they won’t cure this mental illness, they can reduce symptoms and improve the quality of someone’s life.

Antidepressant-induced sexual dysfunction affects 30% to 70% of the more than 12 million Americans treated annually with antidepressants. Since 90% of patients with antidepressant-induced sexual dysfunction discontinue use of their medication prematurely due to the adverse effects, antidepressant-induced sexual dysfunction is associated with increased relapse rates of major depressive disorder, and resultant morbidity and mortality. The seriousness of this should not be dismissed by clinicians, cautioned Christina M. Dording, MD, at a meeting on natural remedies for psychiatric disorders sponsored by Harvard Medical School and Massachusetts General Hospital.

Dr. Dording encouraged physicians to question patients about sexual functioning and explore solutions to the problem. Although augmenting existing antidepressant treatment with is the current standard of care, "The problem - is that there is a large patient population that is excluded from treatment, since sildenafil is contraindicated in cardiac patients who are being treated with nitrates,- Dr. Dording noted. These patients may benefit from herbal remedies for sexual problems caused by antidepressants, she suggested.

Other populations who should consider herbs are those patients for whom Viagra has been ineffective or who have discontinued treatment with Viagra due to adverse effects such as headache, flushing, and changes in color perception. Additionally, there are patients who are reluctant to take additional pharmaceutical agents and are more comfortable with natural remedies. "They feel that with their antidepressant therapy, they are taking enough medication already," said Dr. Dording, a psychiatrist on staff at the Depression Clinical Research Program of Massachusetts General Hospital in Boston.

Yohimbine and ginseng are Dr. Dording's first choices of herbal treatment for erectile dysfunction. "Given the literature available, these seem to be the most studied and effective remedies," she said, adding that treatment is highly individualized and will depend on the patient's reasons for seeking alternatives, and on his clinical history.

Yohimbine

Yohimbine has been approved by the Food and Drug Administration for the treatment of erectile dysfunction. Studies of yohimbine, an alkaloid derived from the bark of the Central African tree Coryanthe johimbe, have shown it to be significantly superior to placebo in the treatment of erectile dysfunction. Adverse effects can include agitation and anxiety, headaches, and sweating.

Yohimbine can be an excellent choice for men who are seeking a natural alternative to Viagra for reasons of personal preference or lack of medication efficacy, Dr. Dording advised. However, it is contraindicated in those with a history of cardiac conditions, as it increases adrenergic flow. And because yohimbine has been associated with panic attacks, it should also be avoided in psychiatric patients with a history of panic disorders.

Findings concerning use of yohimbine are unclear, Dr. Dording noted. "I recommend a dosage of 5 mg, three times daily," she said.

Ginseng

Both American ginseng (Panax qinquefolium) and Asian ginseng (Panax ginseng) have been shown to enhance libido and arousal in male rats and mice. Results from human studies are also promising, Dr. Dording noted. She cited a double-blind crossover study by Hong et al of men with erectile dysfunction. After eight weeks of treatment, the group treated with ginseng showed significant improvement in scores of erectile function, sexual desire, and intercourse satisfaction, in contrast to the placebo group.

Some of the adverse effects of ginseng include hypertension, nervousness, insomnia, and headache. "Though not an absolute contraindication, there is a theoretical risk in using ginseng for patients with certain cardiac problems, so they should check with their primary care physician before starting therapy with ginseng," Dr. Dording added. She recommended a dosage of 900 mg of ginseng, three times daily.

Other Natural Remedies

The herbs ginkgo biloba and maca root have also been studied for their effects on erectile dysfunction. The evidence is weaker to support the use of these agents, Dr. Dording noted. However, she added, maca appears to have no downside. "The people in Central and South America use maca root liberally in cooking, they sprinkle it in their cereal, and they use it as a beverage flavoring. It appears to be safe, although this has not yet been clinically proven in studies" she said.

Further Investigation Required

Herbal remedies may provide safe and efficacious alternatives for those who cannot tolerate , but "we need many more double-blind, placebo-controlled trials," Dr. Dording acknowledged. Additionally, psychiatrists need to be proactive in investigating whether patients on antidepressants are experiencing sexual dysfunction. Dr. Dording cited a poll of 500 American adults that showed that 71% of participants did not initiate discussion of erectile dysfunction with their physician because they thought clinicians would dismiss sexual concerns, and 76% thought there would be no medical treatment. "You need to directly question patients and tell them that there are treatments available," she said.

Such discussions can cover conventional as well as herbal agents, Dr. Dording noted. However, she does not recommend adding an herbal remedy to treatment with (Viagra) sildenafil, because there may be drug/herb interactions. "If you don't get a response from sildenafil, then you can try something else, and if that doesn't work, then try something else," she advised.

Schizophrenia has preliminary, or early, symptoms and signs that can signal that this mental illness is developing. These early symptoms of schizophrenia are known as prodromal symptoms, and the period of time during which someone experiences them is called the prodromal stage of the illness; however, someone’s symptoms or stage is described as prodromal only after the fact, once schizophrenia has fully developed and the symptoms can’t be mistaken for something else.

When do schizophrenia symptoms appear? The average time frame for schizophrenia to develop once prodromal symptoms begin is two years (DeLisi, 2011). However, schizophrenia is a very individualized illness, and the length of the prodromal phase varies. Prodromal signs can begin anywhere from months to years before the illness develops into schizophrenia.

First Early Warning Signs of Schizophrenia

The early warning signs of schizophrenia can be vague and mild. Family and friends of someone in the prodromal stage have described that it seemed that their loved one was “gradually slipping away” (American Psychiatric Association, 2000).

This sensation that a loved one is slowly slipping away is quite accurate, for essentially the person developing schizophrenia begins to undergo changes that involve turning inward into a world unknown to others.

Family and friends often describe changes in behavior and mood, such as developing different routines, withdrawal from activities and people, and low mood. Many of these early symptoms of schizophrenia resemble depression. The early warning signs of schizophrenia can be mistaken for not just depression but for an extended bad mood, a “phase” or teen angst (in the case of schizophrenia developing in adolescence), or substance use.

Other prodromal signs are mild forms of the hallucinations, delusions, and disorganized behavior and speech that are symptoms of schizophrenia. Someone might vaguely sense the presence of an unseen person; later, this might become a full hallucination, with the person hearing, seeing, or feeling someone who isn’t actually real. Likewise, in the early stage, the person might begin to form beliefs that are odd but not quite delusional.

Someone might experience a variety of specific early warning signs of schizophrenia throughout the prodromal period. Changes in behavior, emotions, thoughts, and cognitive functions can indicate impending schizophrenia.

Behavioral Early Symptoms of Schizophrenia

Friends and family of someone in the prodromal stage of schizophrenia often notice that their loved one is beginning to act differently. Changes in behavior are a significant warning sign. Such changes can involve:

• Withdrawal from friends, family
• Dropping out of activities once enjoyed
• Total isolation
• Lack of motivation
• Change in routines
• Unusual behavior, such as mumbling and talking to him/herself in public
• Potentially harmful behavior, like walking in traffic
• Neglecting personal hygiene
• Sleep disturbances, sleeping too much or too little
• Preoccupation with unusual ideas, such as extreme religious ideas, the occult, etc.
• Sensitivity to touch
• Increasing irritability

As with all warning signs of schizophrenia, these begin as mild and slowly intensify in the months or years leading to full-blown schizophrenia.

Emotional Warning Signs of Schizophrenia

Schizophrenia is an all-encompassing serious mental illness. Behavioral symptoms abound, but they’re not the only symptoms. Prodromal symptoms of schizophrenia involve emotions, too, and involve:

• Loss of pleasure in life (anhedonia)
• Loss of interest in things once enjoyed
• Blunted emotions
• Inappropriate emotions, such as loud laughter in serious or quiet situations
• Unexpected hostility

Behavioral and emotional symptoms serve as important early warning signs of schizophrenia. It’s also important to watch for changes in thoughts and cognitive functioning, as changes in these areas are also precursors to schizophrenia.

Early Symptoms of Schizophrenia Involving Thoughts, Cognitive Changes

Thoughts involve what someone is thinking about. Cognitive functioning refers to the way the brain processes and responds to information. Schizophrenia interferes in the contents of someone’s thoughts as well as her cognitive processing abilities.

Early schizophrenia symptoms in the areas of thoughts and cognitive processes make functioning difficult in many ways, such as:

• Focusing on and doing tasks that require focusing, such as reading, working
• Memory problems
• Difficulty making logical connections
• Struggles with math
• Absence, failure in school or work because of increasing cognitive difficulties
• Using incorrect words
• Vague, but understandable, speech
• Thoughts and ideas that are odd but not completely delusional or disorganized

All of these early symptoms of schizophrenia can, together, signal that something more serious is on the horizon. It’s important to keep in mind that any single—or even just a couple—symptom is not a sign of schizophrenia. Someone must have a combination of these early signs and symptoms, and these must gradually increase in number, intensity, or both until they are severe enough to be considered schizophrenia.

The early symptoms of schizophrenia are helpful warning signs for loved ones and doctors to monitor so a diagnosis can be made and schizophrenia treatment began as soon as possible.

article references

Massaging each other can make you and your partner feel relaxed, sexy, valued and wanted. Follow sex counselor Suzie Hayman's top tips on preparing for a massage, the best oils to use and the most sensual techniques.

Preparation

• Find somewhere warm and comfortable where you won't be disturbed.
• Spread out a large towel or sheet for your partner to lie on.
• Make sure your hands are warm - dunk them in hot water to take away any surface chill.
• You'll need a base oil and perhaps add a few drops of an essential oil for scent.

The benefits

Massage can be used as part of foreplay, or to help you get rid of stress. Just taking the time to touch and be touched can be a pleasure in itself.

It also helps you to learn about your partner's body and their responses to contact and reminds you of your connection and commitment to each other.

What to do

Spread a sheet or towel on the floor or bed and toss a coin to see who'll be first to have the massage.

If you're giving the massage, pour out a generous handful of oil, warm it up in your hands and begin by stroking and rubbing the neck, shoulders and back.

Base oils you could use:

• almonds
• sunflower
• apricot kernel

Essential oils you could use:

• rose
• jasmine
• sandalwood
• ylang-ylang

Pass the oil all over your partner's body, kneading and pressing as you go.

You can also try lightly scratching, slapping and nipping.

Listen to and feel their reactions to get directions about what feels good.

When you're being massaged

Pay attention to the sensations you feel when being massaged - you may be surprised by which parts of your body react and what types of stimulation lead to arousal. Make mental notes for later.

Related Information:

• Pleasing Yourself
• Orgasms
• Make an Aphrodisiac Meal

When you've been with someone for a long time, it's easy to take each other for granted. But, as sex counselor Suzie Hayman explains, you can bring the excitement back to your relationship by making a regular date with your partner.

Preparation

• Have a diary or calendar to hand.
• If your date is taking place at home, remember to turn off your phones.

Taking it for granted

Friends, family, work commitments and chores all make claims on your time and often the first thing to fall by the wayside is a special time spent alone as a couple.

Seeing each other every day, spending evenings in the same living room and sharing the same bed can mean you forget the importance of making time for each other.

Set time aside

It may feel silly and inappropriate as a live-in couple to make a date as though you've just met, but it really helps to keep your relationship alive and vital. Once a week, you should set aside time to be with each other on your own.

Where to go

Your date can be anywhere you like. You can go out, to the cinema, pub, restaurant or just for a walk. Or you can set aside some special time at home to watch a film, make a meal together or just relax on the sofa.

Just make sure no one else will be around to interrupt your evening.

Make an effort

Put as much care and effort into your weekly date with your partner as you did when you first knew them - and never cancel just because something else comes up. Take care over your appearance and present yourself smelling, looking and feeling as attractive as you can.

On the actual date, talk to your partner as if getting to know them for the first time. Tell them about your day, your thoughts and feelings, and ask for and listen to theirs.

Related Information:

• Making sex exciting
• Sensual touching
• Give a Massage

Erectile dysfunction (ED), or impotence, is what most people think of when they hear the term "male sexual problem." However, other forms of sexual dysfunction can affect men. These include:

Hypoactive sexual desire disorder: Men with this disorder have a persistent lack of sexual desire or appetite, absence of sexual fantasies and complete lack of interest in and avoidance of sexual contact with a partner. The National Institutes of Health estimates 15 million to 30 million American men do suffer from erectile dysfunction and need drugs to have sexual intercourse. It may be caused by boredom or unhappiness in a long-standing relationship or result from traumatic events in childhood or adolescence. Depression also may play a role. Possible physical causes include drug side effects and hormonal deficiencies. Sometimes, boosting abnormally low testosterone levels may help.

Male orgasmic disorders: Also called ejaculatory disorders, they include inhibited ejaculation (orgasm does not occur) and premature ejaculation (when ejaculation occurs before, during or soon after penetration and before the man desires). Inhibited orgasm is usually caused by a psychological disorder such as depression or anxiety, or use of substances like alcohol or drugs. The man's emotional state and feelings such as guilt, boredom or resentment also may play a role. The cause of premature ejaculation is unclear but is thought to result from a combination of psychological and physical factors. Both problems are typically treated with therapy that teaches the man and his partner techniques for either producing or slowing down orgasm. In some cases, premature ejaculation can be treated with small doses of an SSRI, an antidepressant such as Prozac®, Paxil® or Zoloft®, taken either daily, or one to two hours before a sexual encounter.

Peyronie's disease: Thought to affect about 1 percent of men usually between the ages of 40 and 60, Peyronie's disease is characterized by the formation of a hard, fibrous layer called plaque under the skin on one side of the penis. This disorder usually starts out as inflammation, leading to a hardened scar that causes the penis to bend sharply when erect. If hardening occurs on both sides, indentations and shortening may result. The scarring or hardening can make erections painful and intercourse difficult or impossible. The bent or misshapen appearance of the penis can lead to emotional distress, which in turn worsens any sexual difficulties. Doctors are not sure what causes Peyronie's disease. But in many cases, the condition resolves itself. A physician will usually monitor the man closely for about a year, watching the plaque development and checking erectile function. Medications that might help to alleviate plaque buildup include topical vitamin A, collagenase ointment, B-complex vitamins or calcium channel blockers. If these treatments don't work and the condition doesn't go away on its own, surgery may be necessary. Surgeons have developed various techniques for removing the plaque without affecting penile function.

Dyspareunia: Men who experience dyspareunia, or pain during intercourse, usually have an underlying problem such as prostatitis (inflammation of the prostate gland) or some kind of nerve damage.

Conducting a long distance relationship can be a real challenge. Here are some tools to help maintain a healthy and successful long distance relationship.

The first key to success with long distance relationships is effective communication. It is important for both parties to be able to feel that if they need to talk or write to the other person, communication will be welcomed and met with active communication from the other. The quality of the relationship is more likely to increase if both people develop the ability to share feelings openly with each other.

The second key to a successful long-distance relationship is a demonstrated commitment to the relationship by both parties. What kind of commitment, and how serious or light it is, will be different for different couples. Being so far apart can be a scary and risky endeavor for most couples.

The third and fourth keys are a willingness to take risks, and the presence of a solid and secure trust between the two people. This doesn't mean that each person needs to skydive from a plane, but rather, that each will trust that the other person's social life in his or her own town will not be a threat to the relationship. Trust is so important that if it isn't strong, you can make a conscious effort to work on it, both on your own and together.

This point leads to the fifth point: independence for each person, with a healthy level of dependence upon each other. When these are present, there is a balance of power in the relationship between both people, and each person can be autonomous but still get emotional needs met by the other person. Furthermore, with an appropriate balance of independence and dependence, each person is allowed, even encouraged, to grow and change as an individual; which everyone needs. It is, therefore, wise not to expect that your partner or yourself will always stay exactly the same as when the relationship started./p>

When these aspects of the relationship are healthy, the sixth key element tends to be naturally present - mutual respect. Finally, none of these other elements can offer the relationship success if the seventh key element is not there - clear expectations on the part of both people. It is so very important that you figure out your own personal expectations of the other person and the relationship, and then discuss them with the other person so that both of you are clear and/or can work out differences in expectations. Without this, each person is working on a very different relationship than the other, and problems are likely.

One last thing to keep in mind about long distance relationships is the need for quality time together and build in some "alone time" during visits. Do things that draw the two of you closer, rather than emphasize the distance between you.

Strategies for Coping in Long-Distance Relationships

Pro-active things to be doing as on-going maintenance for yourself:

• Get involved in organizations or causes that you personally believe in. Put meaningful things in your life other than your significant other.
• Help those who have challenging life circumstances. For example, volunteer at a nursing home or orphanage.
• Make sure there are supportive people and places in your life.
• Every once in a while, do something that is atypical of yourself, although not self-defeating. For example, go to a movie on a weeknight or get your hair cut.
• Tend to your spiritual needs.

Specific strategies to try when the depression of missing someone hits you:

• Let out the emotions: cry, scream, sing, exercise, go for a run, play a sport, take a walk
• Write a letter to the person, whether you send it or not, letting her/him know how you are feeling
• Write poetry or a journal entry or both
• Go watch a sporting event
• Come into the Counseling Center to talk about it
• Go see a movie: comedy to make you laugh, adventure to take you away, tearjerker to help you cry
• Go to the TV lounge or study lounge to have other people around you; don't stay alone in your room
• Call, visit, or study with a friend
• Take homework to a restaurant and do it over coffee or a meal

As if relationships weren't complicated enough, having them across a long distance is extremely challenging. However, throughout time, couples have had to be miles apart and have been able to maintain a solid, happy, successful relationship until they could be together again. In order to find success, there are some key elements that are necessary, which have been explained above. Without these key elements, relationships may endure, although they may not be healthy or fulfilling ones.