Some U by Kotex Tampons Have Been Recalled for Unraveling Inside the Body

Some tampons are being recalled this week for a rather unsettling quality-related defect: falling apart inside the body and leaving behind bits of the tampon. Kimberly-Clark announced the voluntary recall this morning, which only affects lots of regular absorbency U by Kotex Sleek tampons sold throughout the U.S. and Canada.

The recall affects lots of three-, 18-, and 34-count packages of the tampons as well as 34-count multipacks that contain 17 regular absorbency tampons.

The affected tampons were all manufactured between October 7, 2016 and October 16, 2018 and were distributed between October 17, 2016 and October 23, 2018. Retailers have also been alerted to the recall and instructed to remove the products from their shelves and put up notices about the recall.

To find the lot number, check the bottom of the package. To see the full list of lot numbers check here; and to see if your specific lot is affected, you can use the company’s lot checker here.

Luckily, the recall only affects regular absorbency level products, so you can still use super and super plus U by Kotex Sleek tampons.

The recall is in response to reports that the tampons are falling apart when people try to remove them.

The company has received reports from consumers that the tampons are “unraveling and/or coming apart upon removal, and in some cases causing users to seek medical attention to remove tampon pieces left in the body,” the release states. “There also have been a small number of reports of infections, vaginal irritation, localized vaginal injury, and other symptoms.”

Anyone who uses one of the affected tampons and later experiences symptoms such as vaginal pain, bleeding, discomfort, itching or swelling as well as bladder infections, yeast infections, nausea, vomiting, or abdominal pain should check in with a medical professional.

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Length of eye blinks might act as conversational cue

Blinking may feel like an unconscious activity, but new research by Paul Hömke and colleagues at the Max Planck Institute for Psycholinguistics, suggests that humans unknowingly perceive eye blinks as nonverbal cues when engaging in conversation. The new study is published December 12, 2018 in the open-access journal PLOS ONE.

Humans blink about 13,500 times a day — much more frequently than is necessary for lubricating the eyeballs. Additionally, studies have shown that blinks often occur at natural pauses in conversation. Hömke wondered whether a movement as tiny and subliminal as blinking could act as conversational feedback, just like nodding one’s head.

To test this idea, the researchers developed a new, virtual reality-based experimental set-up where humans talk with an avatar that acts as a “virtual listener.” Volunteers answered questions such as “How was your weekend?” while researchers controlled the avatar’s nonverbal responses, using short and long blinks that each lasted less than a second.

The experiments showed that speakers perceived the subtle difference between short and long blinks, with longer blinks eliciting substantially shorter answers from the volunteers. None of the participants reported noticing any variation in the avatar’s blinking, suggesting that the speaker picked up on the different cues unconsciously.

Taken together, the findings indicate that even subtle behaviour such as blinking can serve as a type of nonverbal communication that impacts face-to-face communication. The study also reinforces the idea that a conversation is a joint activity, involving contributions from both the speaker and the listener. More generally, the discovery may add to our understanding of the origins of how humans signal their mental state, which has evolved to be a crucial ingredient in everyday social interactions.

The authors add: “Our findings show that one of the subtlest of human movements — eye blinking — appears to have a surprising effect on the coordination of everyday human interaction.”

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Teens get more sleep with later school start time, researchers find

When Seattle Public Schools announced that it would reorganize school start times across the district for the fall of 2016, the massive undertaking took more than a year to deploy. Elementary schools started earlier, while most middle and all of the district’s 18 high schools shifted their opening bell almost an hour later — from 7:50 a.m. to 8:45 a.m. Parents had mixed reactions. Extracurricular activity schedules changed. School buses were redeployed.

And as hoped, teenagers used the extra time to sleep in.

In a paper published Dec. 12 in the journal Science Advances, researchers at the University of Washington and the Salk Institute for Biological Studies announced that teens at two Seattle high schools got more sleep on school nights after start times were pushed later — a median increase of 34 minutes of sleep each night. This boosted the total amount of sleep on school nights for students from a median of six hours and 50 minutes, under the earlier start time, to seven hours and 24 minutes under the later start time.

“This study shows a significant improvement in the sleep duration of students — all by delaying school start times so that they’re more in line with the natural wake-up times of adolescents,” said senior and corresponding author Horacio de la Iglesia, a UW professor of biology.

The study collected light and activity data from subjects using wrist activity monitors — rather than relying solely on self-reported sleep patterns from subjects, as is often done in sleep studies — to show that a later school start time benefits adolescents by letting them sleep longer each night. The study also revealed that, after the change in school start time, students did not stay up significantly later: They simply slept in longer, a behavior that scientists say is consistent with the natural biological rhythms of adolescents.

“Research to date has shown that the circadian rhythms of adolescents are simply fundamentally different from those of adults and children,” said lead author Gideon Dunster, a UW doctoral student in biology.

In humans, the churnings of our circadian rhythms help our minds and bodies maintain an internal “clock” that tells us when it is time to eat, sleep, rest and work on a world that spins once on its axis approximately every 24 hours. Our genes and external cues from the environment, such as sunlight, combine to create and maintain this steady hum of activity. But the onset of puberty lengthens the circadian cycle in adolescents and also decreases the rhythm’s sensitivity to light in the morning. These changes cause teens to fall asleep later each night and wake up later each morning relative to most children and adults.

“To ask a teen to be up and alert at 7:30 a.m. is like asking an adult to be active and alert at 5:30 a.m.,” said de la Iglesia.

Scientists generally recommend that teenagers get eight to 10 hours of sleep each night. But early-morning social obligations — such as school start times — force adolescents to either shift their entire sleep schedule earlier on school nights or truncate it. Certain light-emitting devices — such as smartphones, computers and even lamps with blue-light LED bulbs — can interfere with circadian rhythms in teens and adults alike, delaying the onset of sleep, de la Iglesia said. According to a survey of youth released in 2017 by the U.S. Centers for Disease Control and Prevention, only one-quarter of high school age adolescents reported sleeping the minimum recommended eight hours each night.

“All of the studies of adolescent sleep patterns in the United States are showing that the time at which teens generally fall asleep is biologically determined — but the time at which they wake up is socially determined,” said Dunster. “This has severe consequences for health and well-being, because disrupted circadian rhythms can adversely affect digestion, heart rate, body temperature, immune system function, attention span and mental health.”

The UW study compared the sleep behaviors of two separate groups of sophomores, all enrolled in biology classes at Roosevelt and Franklin high schools. One group of 92 students, drawn from both schools, wore wrist activity monitors all day for two-week periods in the spring of 2016, when school still started at 7:50 a.m. The wrist monitors collected information about light and activity levels every 15 seconds, but no physiological data about the students. In 2017, about seven months after school start times had shifted later, the researchers had a second group of 88 students — again drawn from both schools — wear the wrist activity monitors. Researchers used both the light and motion data in the wrist monitors to determine when the students were awake and asleep. Two teachers at Roosevelt and one at Franklin worked with the UW researchers to carry out the study, which was incorporated into the curriculum of the biology classes. Students in both groups also self-reported their sleep data.

The information obtained from the wrist monitors revealed the significant increase in sleep duration, due largely to the effect of sleeping in more on weekdays.

“Thirty-four minutes of extra sleep each night is a huge impact to see from a single intervention,” said de la Iglesia.

The study also revealed other changes beyond additional shut-eye. After the change, the wake-up times for students on weekdays and weekends moved closer together. And their academic performance, at least in the biology course, improved: Final grades were 4.5 percent higher for students who took the class after school start times were pushed back compared with students who took the class when school started earlier. In addition, the number of tardies and first-period absences at Franklin dropped to levels similar to those of Roosevelt students, which showed no difference between pre- and post-change.

The researchers hope that their study will help inform ongoing discussions in education circles about school start times. The American Academy of Pediatrics recommended in 2014 that middle and high schools begin instruction no earlier than 8:30 a.m., though most U.S. high schools start the day before then. In 2018, California lawmakers nearly enacted a measure that would ban most high schools from starting class before 8:30 a.m. In 2019, Virginia Beach, home to one of the largest school districts in Virginia, will consider changes to its school start times.

7 Tips for Cleaning Up Sex Stains

No matter how fun the sex was, cleaning up after having a romp in the sack can be a real drag. There is nothing more annoying than a giant semen stain in the center of your mattress, or period blood splattered over your sheets like a crime scene. What in the heck are you supposed to do about these stains? How do you wash them? What products do you use? And, crucially, is treating a poop stain different than a semen stain?

These are questions I’m often asked as a sex educator and coach. I know a lot about cleaning sex toys, but I know very little about cleaning sex stains. So, I rounded up a few cleaning experts to get you the skinny on post-coital cleanup.

1. Know your ingredients.

The first thing to know is that semen is a protein stain. There are other ingredients in there, but protein is the trickiest bit to clean. If semen has landed on something that can’t be easily thrown in the washing machine—such as a couch cushion or a futon—then you can treat it by hand. “Protein stains are best treated with something like Clorox Urine Remover,” Mary Gagliardi, aka Clorox’s cleaning expert Dr. Laundry, says. “It contains hydrogen peroxide, which is a great way to get rid of protein-based stains on many types of fabrics. First, blot up as much as possible, then spray the stain(s), wait three minutes, and blot up with a damp cloth.”

One more important thing to note (especially if your sheets are shared with other people) is to be wary of bleach when cleaning up cum. Joshua Miller, director of technical training of Rainbow International, a professional restoration and cleaning services company, warns that bleach can set a protein stain like semen into sheets and upholstery. In other words, that stain is sticking around forever now.

2. Wash your cotton/poly blend sheets in hot water.

After you’re finished having sex, you may want to wash your sheets. However, there are a few things you should know before sticking them in the washing machine. Gagliardi says to wash your cotton or poly blend sheets and bedding in hot water, which won’t harm them. Vaginal fluid and semen are pretty easy stains to remove from those fabrics, and the hotter the water, the better it cleans your sheets.

For satin and silk sheets, you’ll have to clean them differently. “Don’t agitate the stain,” Gagliardi advises. “Use cool water to rinse any stains first, pretreat if you need, and then hand wash using at least two gallons of warm or hot water with detergent.”

3. Use the correct amount of detergent.

Believe it or not, you don’t want to use too much detergent. “Check the ingredient list and make sure it has enzymes and an optical whitener in addition to the cleaning agents,” Gagliardi says. “Make sure you add the right amount. Using too much can cause over-sudsing, which cushions the load and reduces cleaning performance.”

4. Clean feces with bleach.

If you’re engaging in anal play, you’re likely going to come in contact with poop. It happens. You’re dealing with the hole that poop comes out of. Get over it and move on, so you can enjoy yourself.

That being said, there are things to consider when it comes to cleaning up sheets that have fecal matter on them. “First, rinse away excess solids with cool water,” Gagliardi tells us. “Then, wash white bleach-safe fabrics with the hottest water recommended on the care label, plus a half cup of bleach. After it’s done, air dry, and check it out.”

But remember, semen and bleach don’t mix! If there is semen mixed with the fecal matter, bleach is a no-go.

5. Blood stains should be washed with cold water.

Sometimes sex comes along with a little spotting, or perhaps you simply enjoy period sex. While period sex is normal and healthy, it can do a number on your sheets. It’s best to use a rattier, older set of sheets if you have your period, or throw an old towel underneath the location where you’re having sex.

Alas, you can’t always prepare for surprises. Blood happens sometimes, especially in cases where not enough foreplay took place. It’s important to first rinse the blood stain with cold water to get as much of the blood out as possible, and then add a stain remover, such as OxiClean Versatile Stain Remover Powder. Then let it sit. “Wait 10 minutes, and then rinse in cool water,” Gagliardi says. “If the stain is fresh, repeat the process again, and then finally wash the item in warm water using detergent.”

If you happen to get period blood on your walls, here’s one of my tried-and-true tricks: A Mr. Clean Magic Eraser. It removes blood stains from wallpaper, painted walls, and drywall like a charm.

6. Clean your lube stains immediately—the right way.

Having sex without lube is like having a Moscow Mule without ginger beer—not as good and probably uncomfortable.

When the lube spills, or it drips on the sheets from your hands or body, you’ll want to tailor the cleanup to the ingredients in the lube. Water-based and oil-based lubes are pretty straightforward. “For most oil- and water-based lubricant stains, you can go about your normal laundering process,” Miller says. “Similar to cleaning bodily fluid stains, try blotting the soiled area with a damp white cotton towel using a mixture of cold water and an enzyme detergent.”

When it comes to silicone lube, things are a little more complicated but removal is totally doable. Before you wash your sheets, you’ll want to pretreat the area. “It’s recommended to pre-treat the area on dry fabric with a general stain remover, such as Shout,” Miller tells SELF. “You can then apply an enzyme detergent, or even Dawn dish soap, onto the stain.”

Lubricant should be cleaned up quickly from fabrics. If you let a lube stain set, it will likely stay put no matter how much you wash it, Miller says.

7. Clean your mattress with baking soda and hydrogen peroxide.

For the times when stains leak through your sheets, there are a few options for cleanup. You can use a damp cotton towel dipped in an “enzyme detergent or with a DIY stain removal paste made by combining cold water, dish detergent, baking soda, and over-the-counter hydrogen peroxide,” Miller says. (Always carefully read labels before mixing chemical ingredients at home.) He advises that you work from the outer edges of the stain inward. “Blot the area with the paste and the stain should begin to disappear,” he says. A pro tip: Get a mattress protector. You simply pull it off every few weeks or months months and toss it in the washing machine.

Whatever your sex mess might be, there is a way around it. Just pay attention to the type of stain you’re dealing with and have patience with the cleanup.

Gigi Engle is a certified sex coach, educator, and writer living in Chicago. Follow her on Twitter and Instagram @GigiEngle.

How bullying affects the structure of the teen brain

The effects of constantly being bullied are more than just psychological. Research now shows that there may be physical structural differences in the brains of adolescents who are regularly victimized, and this could increase the chance that they suffer from mental illness. This is the conclusion of a study in the journal Molecular Psychiatry which is published by Springer Nature. The research was led by Erin Burke Quinlan of King’s College London in the UK and is the first to show that chronic peer victimization during adolescence impacts mental health via structural brain changes.

Burke Quinlan and her colleagues analyzed data, questionnaires and brain scans of 682 participants from England, Ireland, France and Germany. These participants were part of the IMAGEN long-term project that assessed the brain development and mental health of adolescents. As part of this project, high resolution brain scans of participants were taken when they were 14 and 19 years old.

At the ages of 14, 16 and 19 these participants also had to complete questionnaires about whether they had been bullied, and to what extent. Overall, the results showed that 36 of the 682 young people were found to have experienced chronic bullying. The data of these participants were compared with those of the others who had experienced less chronic/severe bullying. Changes in brain volume as well as the levels of depression, anxiety and hyperactivity at age 19 were taken into account.

The subsequent findings validate and extend the literature linking peer victimization with mental health problems. But the novel finding is that bullying is linked to decreases in the volume of parts of the brain called the caudate and putamen. These changes were found to partly explain the relationship between high peer victimization and higher levels of general anxiety at age 19.

“Although not classically considered relevant to anxiety, the importance of structural changes in the putamen and caudate to the development of anxiety most likely lies in their contribution to related behaviours such as reward sensitivity, motivation, conditioning, attention, and emotional processing,” explains Burke Quinlan.

She says it is worrying that as much as 30 per cent of young people could be victimized in one way or another by their peers, with some having to endure such treatment on an almost daily basis. Burke Quinlan emphasizes that adolescence is not only a time of new experiences and stresses, but also a period of extensive brain development. Therefore, she recommends that every effort should be made to limit bullying before it becomes a severe problem that might lead to changes in a young person’s brain and the development of mental health issues.

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Subway train travel linked to spread of flu-like illnesses

Despite the commuter cold being a widely accepted concept, it has never been proven that public transport contributes to the spread of airborne infections. Now new research on the London underground commute has proven a link does exist.

The study, published on December 4, 2018 in Environmental Health, will help to inform measures to control the spread of infectious disease.

By comparing Oyster card route information and Public Health England data on flu-like illnesses, Dr Lara Goscé from the University of Bristol’s Department of Civil Engineering and Dr Anders Johansson from Bristol’s Department of Engineering Mathematics, discovered higher rates of airborne infections in Londoners that have longer tube journeys through busier terminals.

Dr Goscé explained: “Higher rates [of influenza-like cases] can be observed in boroughs served by a small number of underground lines: passengers starting their journey in these boroughs usually have to change lines once or more in crowded junctions such as King’s Cross in order to reach their final destination.

“On the other hand, lower influenza-like rates are found in boroughs where either the population do not use public transport as the main form of transport to commute to work; or boroughs served by more underground lines, which guarantee faster trips with less stops and contacts with fewer people.”

For instance, one finding highlighted that infection rates in residents of Islington, who often change lines at crowded Kings Cross St. Pancreas, were nearly three times higher than in commuters from Kensington, who mostly take direct trains.

The team hopes that their findings will inform Government epidemic policies. Dr Goscé said: “Policy makers, in particular, should address the role potentially played by public transport and crowded events and avoid encouraging the attendance of such environments during epidemics.”

Looking to the future, the group want to draw a clearer map of the spread of cold-like infections in a metropolitan environment, and so plan to combine individual level infection data with existing studies from households and schools.

Dr Goscé said: “These results are preliminary following limitations of the dataset. Empirical studies. Empirical studies combining aero-biology and pedestrian modelling would be important in improving model fidelity and devising non-pharmaceutical control strategies tackling threshold densities to minimise numbers of infections and optimal ventilation in different crowded environments.”

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Gut hormone increases response to food

The holiday season is a hard one for anyone watching their weight. The sights and smells of food are hard to resist. One factor in this hunger response is a hormone found in the stomach that makes us more vulnerable to tasty food smells, encouraging overeating and obesity.

New research on the hormone ghrelin was published on today in Cell Reports on Dec. 4, 2018, led by Dr. Alain Dagher’s lab at the Montreal Neurological Institute and Hospital of McGill University.

Previous research by Dr. Dagher’s group and others demonstrated that ghrelin encourages eating and the production of dopamine, a neurotransmitter that is important for reward response. In the current study, researchers injected 38 subjects with ghrelin, and exposed them to a variety of odours, both food and non-food based, while showing them neutral images of random objects, so that over time subjects associated the images with the odours.

Using functional magnetic resonance imaging (fMRI), the researchers recorded activity in brain regions known to be involved in reward response from dopamine. They found that activity in these regions was higher in subjects injected with ghrelin, but only when responding to the images associated with food smells. This means that ghrelin is controlling the extent to which the brain associates reward with food odours.

Subjects also rated the pleasantness of the images associated with food odour, and the results showed that ghrelin both reduced the response time and increased the perceived pleasantness of food-associated images, but had no effect on their reaction to images associated with non-food odours.

People struggling with obesity often have abnormal reactivity to the food-related cues that are abundant in our environment, for example fast food advertising. This study shows that ghrelin may be a major factor in their heightened response to food cues. The brain regions identified have been linked to a neural endophenotype that confers vulnerability to obesity, suggesting a genetically-based hypersensitivity to food-associated images and smells.

“Obesity is becoming more common around the world and it’s well known to cause health problems such as heart disease and diabetes,” says Dr. Dagher. “This study describes the mechanism through which ghrelin makes people more vulnerable to hunger-causing stimuli, and the more we know about this, the easier it will be to develop therapies that counteract this effect.”

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13 Bipolar Disorder Facts People With the Condition Want You to Know

You’ll too often hear that bipolar disorder makes a person switch moods or personality, like Jekyll and Hyde, or that it means a person is moody or manic all the time. But these descriptions of bipolar disorder are incorrect, dismissive, and stigmatizing—the types of stereotypes that so many people living with it hope to do away with.

Because so many aspects of bipolar disorder are misunderstood, we interviewed several people living with a diagnosis about their experiences in order to paint a more accurate and sensitive picture of what bipolar disorder really is, as well as the bipolar disorder facts they wish more people grasped about the mental illness.

We also spoke with Wendy Marsh, M.D., director of the Bipolar Disorders Specialty Clinic and an associate professor in the department of psychiatry at the University of Massachusetts Medical School, and Igor Galynker, M.D., associate chairman for research in the department of psychiatry at Mount Sinai Beth Israel, for their expert perspectives. Here are some of the things they want to clear up.

1. People with bipolar disorder are not always experiencing symptoms.

Individuals with bipolar disorder do experience periods of extreme changes in mood and energy levels, but not around the clock.

First, these shifts are called “episodes”—and there are a few different types, as SELF reported previously:

  • Mania: A manic episode is typically characterized by having high energy and activity levels, a reduced need for sleep, and/or feeling confident or euphoric. But someone in a manic episode may also feel irritable and agitated while also being energized.
  • Hypomania: This is a less severe version of mania but still presents generally as high energy and activity while feeling as if you don’t require sleep.
  • Depression: A depressive episode may cause a person to feel sad or down, fatigued, or they may have difficulty concentrating or think about death or suicide.
  • Mixed: A mixed episode means that a person is experiencing a manic or depressive episode with some symptoms of the opposite mood state at the same time.

The types of episodes that you go through depend on whether you have bipolar I or II (the two main types, although there are other conditions related to bipolar disorder). And how a person feels or acts during their bipolar episodes (and the length of them) can vary greatly and be quite subjective. (Mood episodes generally last at least a week.)

But bipolar episodes, regardless of what types affect you, are interspersed with periods without any symptoms—which is important to remember. “One time, when I shared that I had bipolar disorder, someone said, ‘That explains why you’re so happy all the time!’ Wrong,” Emma, a 20-year-old college student, tells SELF. “There’s a difference between my personality and my symptoms showing themselves. I’m a bubbly person—that’s my personality. But [I can also be] frantic, I overthink, and I definitely put on a mask that I have it all together. That right there is my bipolar disorder. Don’t confuse the two.”

2. Bipolar disorder is often mistaken for other illnesses.

The symptoms associated with bipolar disorder may be similar to those of other illnesses (including schizophrenia and depression), which makes bipolar disorder difficult to diagnose clinically, the National Institute of Mental Health (NIMH) explains.

People with bipolar disorder may also have other conditions concurrently, such as an anxiety disorder, and that can make it even more difficult to distinguish the symptoms of bipolar disorder from those of other diagnoses.

3. And it can take clinicians a long time to diagnose bipolar disorder properly.

“It can take 10 years in some cases to diagnose bipolar disorder correctly,” Dr. Galynker says. “Especially if you have someone who has subclinical symptoms, oftentimes in cases of bipolar II, when hypomania isn’t affecting a person’s ability to function.”

Mike, 66, was diagnosed with bipolar disorder in 1988, but he remembers recognizing his mood swings as early on as 1980, he tells SELF. “I recall keeping a calendar at work where I logged how I felt,” he says. “I was trying to track my own rhythm—my up and down time, so I knew when to plan events, like vacations.”

Emma says she was originally diagnosed with generalized anxiety disorder and mild depression. Then, last year, she was diagnosed with bipolar II. “We get help when we’re at our worst, so you get diagnosed based on the symptoms you’re evincing,” she explains. “But the thing about bipolar disorder is that it’s all dependent on patterns. If no one asks you to work backwards in your own timeline, you can’t figure out those patterns.”

4. No two people experience bipolar disorder in the exact same way.

How bipolar episodes cycle and present for an individual depends “on all kinds of things,” Dr. Galynker says. “It depends on the person, age, illness severity, which medications they are being treated with now, which medications they were treated with previously, whether they are taking their medications—all sorts of factors.”

So, as you can imagine, bipolar disorder can be very complex to treat and manage. “Part of what makes for successful treatment is keeping open and regular communication between a patient and their doctor,” he notes.

5. Not everyone’s symptoms and patterns fit neatly into the clinical guidelines for diagnosing bipolar disorder.

According to the clinical guidelines within the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person with bipolar disorder needs to present a certain number of specific symptoms to be considered manic/hypomanic or depressive. “If you have, let’s say, two or three of the four symptoms you need to clinically be having a mood elevation, we would call that partial remission, or having subdiagnostic symptoms,” Dr. Marsh says.

But Dr. Marsh emphasizes that just because a person doesn’t meet all of the clinical criteria for having a mood episode, that doesn’t mean their mood changes should go ignored or without intervention. “Our main concern as clinicians is when symptoms become dysfunctional,” she says. “When there is a clear change in thinking and behavior, we want to address that quickly and early.”

6. You can’t simply snap out of a mood episode.

If someone is already in a full mania/hypomania or depression, medication is needed to treat symptoms. “One cannot pull themself out of a mood episode,” Dr. Galynker says. “Sometimes people will have this awareness that they are in or near an episode, but not all the time depending on the person’s own level of awareness and familiarity with their symptoms as well as the severity,” he says—and this may affect whether or not they have the awareness to then take their medication.

Some medications for bipolar disorder can treat mania, hypomania, and depression, while other drugs only treat certain episode types or combinations. Some medications can prevent symptoms from becoming a full episode if taken in time.

In many cases, a person will exhibit similar early signs when a mood episode is coming on, Dr. Galynker says (e.g. changes in their voice, they start sleeping less, they are dressing differently). So ideally a person is somewhat familiar with those initial symptoms and can recognize them and implement the appropriate treatment before they tip into a full episode.

“Like all of us, for a person with bipolar, their mood can change before they’re necessarily even aware of it. We call this insight—do you have insight that you’re not behaving and thinking in your normal, healthy fashions?” Dr. Marsh explains. Level of insight is very variable, “but it tends to be that people who have insight during their early episodes keep that insight, and those who don’t have that insight are less likely to have it moving forward,” she says.

This is where psychotherapy plays an important role, Dr. Marsh says, as it helps teach a person with bipolar disorder how to spot and manage those early symptoms.

7. Bipolar disorder is something you have to learn to manage for the rest of your life.

“Bipolar is a lifelong diagnosis that starts usually in the late teens or early 20s,” Dr. Marsh says. “And, ideally, very soon after those first mood-elevated episodes, that person is getting word from the appropriate experts and clinicians that they are at risk for the rest of their lives of having another [episode].”

So, a person with bipolar will very likely be on medication and working with a therapist all throughout their life. “The symptoms don’t magically disappear because I go to therapy and I have medication and I’ve taken the time and effort to develop coping mechanisms,” Emma says. “Having a mental health disorder is like having a cold, but the cold is in your head. Sometimes I need to sleep a little more. Sometimes my appetite isn’t there. And I need my medication to help the process along.”

8. People with bipolar are not “crazy” or dangerous.

“I think people sometimes have the misconception that people with bipolar disorder are ‘crazy,’” Emma says, which is a stigmatizing term for any person living with mental illness. “And that’s simply because they don’t understand what it means or what living with it looks like,” she adds.

“People think you’re incapable of making logical, rational decisions,” Andrea, 41, who was diagnosed with bipolar II in 2010, tells SELF.

Gracie, 30, who was diagnosed with bipolar disorder this past July, points out that when a person with bipolar feels out of control, that is a result of very real health symptoms. “Wouldn’t it be nice to choose how you wanted to feel, to be able to feel in the moment and not some random time, to be able to laugh because you’re actually happy, to be able to cry because you just watched a drama that pulled at your heartstrings, to be able to be sad but not stay in that moment for what seems like forever—and to do it all without medications?” she tells SELF. “We want to be in control; we don’t like feeling this way.”

9. Mania is not necessarily a pleasant experience.

“Many people assume that mania is always this great, fantastic place to be—this ‘I can do anything’ type of experience,” Dr. Marsh says. “But mania can be really miserable or unpleasant for somebody.”

You could still be experiencing depressive symptoms simultaneously, or you could feel agitated and angry while also feeling “revved up,” she explains. (You can read more detailed accounts of what mania really feels like for a person with bipolar disorder here.)

10. It can be hard for someone with bipolar disorder to talk about it openly.

“I’d say the most frustrating thing is that I feel like I cannot admit to having [bipolar disorder] to my employers. Instead, I just say I have a chronic illness,” Joey, 41, who is diagnosed with both bipolar II and Asperger syndrome, tells SELF. “If I had cancer, my ups and downs would be accepted and people would bring casseroles to my house instead of firing me.”

Emma says that people without the diagnosis can also come off as uncomfortable discussing bipolar disorder. “People are so afraid to just talk about it,” she says. “People also think that, if you’re open to sharing your story, that means you’re brave. But I didn’t ask for this. This is just my life, my reality. I have no choice but to manage it and fight it. Because if I didn’t, I wouldn’t be here.”

11. Bipolar disorder deserves to be taken as seriously as any other chronic health condition.

“Bipolar disorder is a disease that is serious and deadly just like cancer and heart disease. People don’t understand that and dismiss the disorder as something that is easy to fix or get over—it’s not,” Mike says.

“A recent example of this is a man saying to me, ‘Watch a good movie and you’ll feel better,’” Mike recalls. “My dad would say to me when I was in my teens and 20s and showing symptoms of bipolar disorder to ‘find yourself a new girlfriend and you’ll feel better.’ This is a complex disorder and difficult to manage, but that does not register with people.”

12. You can support someone you love with bipolar disorder by educating yourself and understanding these facts.

“Learn as much as you can about bipolar disorder, Nina*, 25, who has bipolar II, tells SELF. “There are so many books for families and friends.”

Bradley, who is 54 years old and has bipolar I, first picked up on symptoms of his condition when he was 48. He tells SELF that a reliable, informed support system is key in helping a person with bipolar stay on top of their treatment. “If the person is in denial about their condition, then friends and family need to conduct a loving intervention to explain their care and the need for the person to be evaluated,” he suggests. “They need to do it together and all go with the person to see a great psychiatrist, then provide assistance in order to make sure that their [medication] is regularly taken. No exceptions.”

Mike uses his wife as a example of how family can be hugely important for someone with bipolar disorder: “[She] makes sure I take my meds. She has learned to recognize signs that I am experiencing unnatural highs and lows. She will force me to have contact with others even though I don’t want the contact. She asks how I am, and she engages me in conversation even when I don’t want to talk,” he says. “I appreciate that, and it always helps.”

Dr. Galynker agrees that family and friends can be game-changing in helping someone with bipolar disorder manage their illness. He recommends going to therapy with your loved one if they are open to that and being in the know about the specific medications they are taking and for what.

13. People with bipolar disorder can live normal, happy lives.

Bradley points out that “people are not aware that there are lots of people who have the condition, including leaders of major corporations and musicians. [We’re often] viewed us as defective, yet the evidence is to the contrary.”

Emma says, “Just because I’m managing, just because I have a life where I can be a full-time college student with two jobs, doesn’t mean I don’t have bipolar disorder anymore.”

And Andrea wants to remind others that people with bipolar disorder aren’t necessarily suffering. “Don’t judge and don’t make assumptions. Many famous, talented, productive people have dealt—I hate the word suffer—with bipolar disorder,” she says. “There’s something to be said for the blasts of creativity that occur.”

*Name has been changed.

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Marketing: Putting a price on reputation

Consumers are willing to pay more for products that not only have the features they want but also are delivered by businesses with a good reputation, new research has found.

The study, by researchers at the University of Technology Sydney (UTS), puts a price on reputation and explores the trade-off between a good reputation and extra product features.

It reveals that a company evaluated by consumers as better than its competitors in terms of corporate reputation commands around a 9% premium for its products, and an even higher premium when there are desirable extra features.

“The impact of corporate reputation on consumer choices is substantial compared to the competitive advantage offered by varying product features,” says study co-author, Associate Professor of Marketing Paul Burke, from UTS Business School.

“Marketing managers need to be concerned about corporate reputation not only because it builds loyalty and trust but also because product features appear more valuable, so consumers are willing to pay more,” he says.

The research, with co-authors Professor Grahame Dowling and Dr Edward Wei, published in the Journal of Marketing Management, focused on consumers in the market for televisions. The televisions were made by Sony, Panasonic or Toshiba.

Corporate reputation encompasses a range of dimensions including how people feel about the company, the quality and innovativeness of its products, its workplace environment and workforce, its vision and leadership, financial performance and social and environmental responsibility.

Conversely, brand damage occurs when companies become embroiled in scandals and crises such as financial corruption, leadership failure or environmental destruction.

In the study, participants were first asked to give an evaluation of the corporate reputation of each of the TV makers.

Separately, the were asked to choose between televisions based on fairly standard features such as warranty, price or size, and in addition by novel features such as backlight control or dynamic range control.

The research showed consumers were willing to pay extra for a product with important features and a good brand reputation, but less willing to pay a premium for products with novel features regardless of reputation.

For example, in the case of screen size, consumers were willing to pay $121 more for a television that was 55″ over one that was 50.” This amount increased by a further 22% to $147 for a company that was one standard deviation higher on the corporate reputation measure.

“Corporate reputation is not something that can be readily controlled by marketing managers, but it is definitely something that should command their attention,” says Associate Professor Burke.

“Companies need to work hard to communicate that they are environmentally and socially responsible, support good causes, have a positive work environment, and excellent leadership and financial performance, and do their best to mitigate brand damage,” he says.

What’s behind smelly wine?

Aging often improves the flavor of wine, but sometimes the beverage emerges from storage with an unpleasant smell. One of the prime culprits is hydrogen sulfide (H2S), which can give the affected wine an aroma of sewage or rotten eggs. In a report in ACS’ Journal of Agricultural and Food Chemistry, researchers have now identified some potential sources of this stinky compound.

H2S is a volatile sulfur compound that’s produced naturally during fermentation. Most of it disappears or is removed in subsequent winemaking steps, but it can reemerge after bottling. Ironically, it might derive from polysulfanes and other sulfur byproducts created during H2S removal. Marlize Bekker and colleagues wanted to check if that theory was correct.

The researchers created a model wine containing a mixture of polysulfanes and then treated it with antioxidants such as sulfur dioxide and ascorbic acid, which are often added to wine as preservatives during bottling. The scientists then identified and measured the concentration of a variety of sulfur compounds in the wine during six months of storage. They found that polysulfanes containing four or more linked sulfur atoms per molecule tended to decompose during wine storage, correlating with a rise in H2S. In addition, the polysulfane decomposition and H2S release occurred more frequently in the wine treated with sulfur dioxide than in untreated wine or wine treated with ascorbic acid. The findings provide strong evidence that polysulfanes were the source of re-emergent H2S, though this conclusion will need to be confirmed in real wines, the researchers say. Confirming such a role for polysulfanes could help identify practical ways to manage the re-emergence of stinky sulfur compounds, one of the major faults in bottled commercial wine.

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