2017 Breast Cancer News Means Serious New Conversations With Doctors Necessary

Up until November of 2017, women who reached the 5-year cancer free mark following a diagnosis and subsequent treatment of breast cancer, breathed a sigh of relief. They believed that this marked the beginning of a cancer free life. Not necessarily so, a recent report claims.

According to a November report in the New England Journal of Medicine, many of these women run the risk of developing new malignancies up to 20 years following their initial diagnosis. This information comes on the heels of a lengthy examination of 88 clinical trials. These trials involved the testing of nearly 63,000 women who were initially diagnosed with estrogen receptor positive tumors in their breasts.

The protocol in recent years has been to treat these women with chemotherapy, radiation and/or surgery—or sometimes a combination of the three. They then followed up their treatment with a five year course of tamoxifen or another aromatase inhibitor. The idea behind the ongoing treatment was to kill off any lingering cancer cells the radiation, chemotherapy or surgery may have missed. All the women in the aforementioned study were, in fact, deemed cancer free at the five year mark.

The recurrence rate for the highest risk women in the study group—those who originally had the largest tumors that had spread beyond their breasts—is raising alarms. 41 percent of those women experienced a recurrence over a 15 year period. 10 percent of those women with the lowest risk of recurrence were diagnosed with cancer again over that same period of time.

Dr. Daniel Hayes of the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan served as senior study author for this report. He doesn’t want to raise fear via this study, but instead wants both doctors and patients to become acutely aware of its findings.

“We know that adjuvant (hormone based) therapy for five years substantially reduces the risk of recurrence and mortality,” he explains. “We now have good evidence that extending adjuvant (hormone based) therapy beyond five years continues to suppress and reduce recurrence and mortality.”

Women with breast cancer and survivors should talk with their doctors about extending the course of adjuvant therapy for an additional five years. Though some may be hesitant to continue these therapies due to menopausal symptoms, it could wind up saving their lives.

Albert Farias wasn’t part of this study. A cancer researcher at the Keck School of Medicine of the University of Southern California in Los Angeles, he is in agreement with Dr. Hayes and the others involved.

“Breast cancer cells can travel from the primary tumor to the lymph nodes and can circulate throughout the body undetectable with current screening methods, and over time these circulating cancer cells can attach to other organs in the body and this is generally when there is a cancer recurrence,” he says. “One way that adjuvant breast cancer treatment works is to kill and/or stop the undetectable cancer cells from growing and dividing.”

While this new information may fill some breast cancer survivors with fear, they should use this fear to their advantage and have a serious conversation with their doctor. If they are among the high risk group that participated in this study, a new course of adjuvant therapy may be in the cards for them.

Should You Get a Flu Shot?

The question of whether or not a person should get a flu shot seems to be one asked yearly. What are the benefits? What are the risks? What are the myths? Will it help our overall general health? Hopefully after reading this article the answer will be clear whether or not you should get a flu shot.

What exactly is the flu? The influenza virus is a highly contagious virus that attacks the respiratory system. All of the symptoms you might find with the common cold (coughing, sneezing, congestion, sore throat, headache, etc.) are associated with the flu, but the flu often causes a high fever accompanied with body aches and fatigue.  These symptoms can lead to more serious issues that are certainly not good for one’s general health which may prompt an individual to consider getting a flu shot.

There are several benefits to getting a flu shot. The flu vaccination reduces the risk of getting the flu by 40% to 60%. This is especially true among children and older adults and the prevention of hospitalization caused by flu symptoms. Flu vaccination has proven to be an effective tool for people with chronic health conditions such as cardiac issues. It has lowered some cardiac events just by receiving the vaccination especially for those who have experienced heart issues within the past year. Patients who have chronic lung disease or diabetes who have received the flu shot have also shown a decrease in hospitalization. Another benefit of the flu vaccination is proven among pregnant women to not only reduce their risk of catching the flu, but reducing their baby’s risk of getting the flu after birth. If for some reason you still get sick with the flu after receiving a flu shot, chances are your symptoms will be milder.

As with any medication or vaccination, risks are always involved. Babies under the age of six months should not receive the flu shot. Any person with a severe allergy to the ingredients found in the flu vaccination, such as gelatin or antibiotics, should not consider getting a flu shot for obvious reasons. Other things to consider before getting the flu vaccination are any allergies to eggs or a history of Guillain-Barré Syndrome. Speaking with your physician is advised in either case. People may also experience a low-grade fever and a sore arm after receiving the injection.

The biggest myth about flu shots is that the flu vaccination actually causes the flu. Prior to 2016 some vaccines contained a live virus, however, it was weakened and was specifically developed to prevent illness. Since then flu vaccinations are made from inactivated virus. The virus is essentially grown and then killed, making it impossible for a dead virus to cause the flu but instead help your body build an immunity to the live virus.

When considering one’s general health, one needs to be informed and educated. Only you can decide if getting the flu shot is best for your well-being. Compare the benefits to the risks and deduce whether or not the risks of getting the flu are better or worse than the risks of receiving the vaccination.

8 Signs that You May Have a Mental Disorder

As a society, we don’t talk enough about the issue of mental disorders. In many cases, we treat them as secret problems when really they are no different than physical disorders. As a result, it is important to be aware of any signs that you may have a mental disorder and to receive the treatment necessary for you to get better. Remember: everyone deserves to receive the help they need to maintain their physical and mental wellbeing.

  1. Suicidal Thoughts

This is one of the strongest warning signs of a mental illness. However, if you are not suffering from any of the other symptoms, it is still important to seek help if you are having suicidal thoughts, as these could potentially manifest into action.

  1. Withdrawal

If you begin to find yourself withdrawing from others (even those you care most about) and/or from activities that used to matter to you, this could be a strong sign of a mental illness. Many individuals feel they cannot connect with others and start to isolate themselves, which can make it hard for them to recover.

  1. Illogical Thinking

If you find yourself constantly thinking things that do not make sense, things that scare you, or things that are not logical, this could also be a sign of a mental disorder. Many people start to think they see hidden meanings in what others say or do or use magical reasoning the way a child might. These are strong signs something isn’t right with your ability to reason with what is happening around you.

  1. Mood Changes

One minute, you may be feeling extremely happy, and the next, extremely sad. Anger and apathy can also be included in these mood swings, especially if you suddenly switch from one to the other with little to no cause. We all feel shaky from time to time, but if you find yourself dealing with mood swings often, it may be time to seek help.

  1. Appetite or Sleep Changes

Have you found it is suddenly hard to sleep or that you are sleeping far too much? Are you eating much more or less than you used to? These can also be signs of a developing mental illness.

  1. Sensitivity

Have you often found yourself avoiding situations that could be volatile? Have you also noticed an increase in your sensitivity to sights, sounds, smells, etc.? Any type of sensitivity, if extreme enough, could potentially be a sign of a mental disorder as well.

  1. Hallucinations

Hallucinations are a strong indicator of a mental disorder. They can be visual, auditory, or tactile.

  1. Difficulty Thinking

If you often find your thinking to be fuzzy, to the point where you cannot focus on your work or concentrate, this could be a sign of a disorder. Many people also have problems with memory or logical thought processes.

While none of these symptoms alone are definite indicators of a mental disorder, several of these can clearly define one’s need for treatment. No matter what, it is best to seek help if you are struggling with symptoms that make it difficult to live your daily life.

6 Ways to Recharge Your Batteries

Everyone has a breaking point. Even when things are at their best, as women, we sometimes push ourselves too hard and experience a kind of overkill, stress-wise. We can often feel it coming, but we ignore it.

Instead, try to think of yourself as needing a moment to just recharge your batteries. Pushing yourself can only get you so far before everything—work, home life, friendships, etc.—begins to suffer. Here are 6, quick ways to take a moment and allow yourself to relax. Afterwards, you can then go back to living your fast-paced life, just with a lot less stress.

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1. Remove Yourself from Social Media

Better yet, if you can, remove yourself from all technology for as long as possible. Whether it’s refreshing our email, obsessively checking our Facebooks, or just updating the news on our phones, technology is constantly giving us new things to stress about, worries we honestly don’t need when our lives are already so hectic.

So take some time off, and plan it so the important people will know how to get in contact with you when it’s happening. Trust us, you’ll feel so much better once it’s over, and then, you can return to the world of technology like nothing happened.

2. Spend Time With Your Pet

Petting an animal can lower one’s stress levels, minimize blood pressure, and elicit a laugh, which is almost better than anything. If you don’t have a pet, try volunteering at the local animal shelter. Whatever you do, just get some cuddle time with a furry friend.

3. Book Some Spa Time.

Even if it’s just in your own bathtub. Give yourself a break and light some candles, use some good bath salts, and relax. If you can afford to go to the spa, do it! You deserve to be pampered.

4. Listen to Music.

We all have a favorite type of music or band. Even if you just have a favorite song, put it on repeat when no one else is home and dance along. Sing at the top of your lungs, and enjoy yourself! If you don’t have time to do this at home, do it in the car on your way to work.

5. Go for a Walk.

Yes, it seems like a sneaky way to get exercise into your day, but it doesn’t have to be if you’re enjoying the scenery. Spend some time walking but not going anywhere in particular. It will help you remember there isn’t always a finish line to sprint toward.

6. Take a Nap.

Most of us don’t get enough sleep at night, and many of us feel like taking a nap is selfish or indulgent. The truth is, though, napping is actually extremely good for you, and it’s one of the easiest, most natural ways to recharge your batteries.

So what’re you waiting for? Close this window and go get 20 minutes of shut-eye. Don’t worry, you’ve earned it, and everything will still be here when you wake up.

What Are the Best Post-Workout Snacks?

Working out feels good. It gets your body and mind in a better place, and obviously, it’s healthy and can help you lose weight. But you should never underestimate the importance of the post-workout snack. Without it, you could become lethargic, and if you eat the wrong one, it could blow your whole workout. Here are some of the best options for your snackage once you’re finished with your daily exercises.

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Protein Shakes

We know, it’s been done. But there are some great options for protein shakes you’ve never tried, many of which are as delicious as they are healthy. Here are 13 recipe options for protein shakes that are quick and easy to make. But as long as you’ve got some Greek yogurt, some protein powder, and some complimenting fruits, you can pretty much experiment with whatever recipe best suits you.

There’s a reason why protein shakes are pretty much considered the best, after-workout snack. They give you energy and help you recover from your workout. So go ahead, fire up the blender.

Rice Cakes With Peanut Butter and Fruit

If you’re tired of the liquid diet, we’ve got another option for you. Rice cakes will give you a little bit of bulk with very few calories. In order to get the protein and energy you need, it’s a good idea to give it a little slather of peanut butter. Adding banana or another kind of delicious fruit will give you some natural sugars and a burst of flavor. If you’re not a fan of rice cakes, whole wheat English muffins can stand in.

Tuna or Turkey Sandwich

These are meats that will be healthy for you to eat after your workout. Make sure to put them on whole wheat bread and, instead of reaching for a bag of chips, go with apple slices.

Hummus

Hummus is a great, protein rich, after-workout snack for those of you who want something dippable. You can pair it with pita chips or pita bread, both of which are a lot healthier than a bag of potato chips and a container of dip.

Yogurt

Yogurt is a great option as well because it keeps your body healthy and you can add anything to it. For example, granola can be a good option if you’re looking for something crunchy. If you want something sweet, try adding fresh berries to the mix. Want something a little more out there? Try yogurt, red peppers, and orange slices.

Trail Mix

Making your own trail mix can allow you to decide what will go into it. This means less butter, salt, and other ingredients your body doesn’t need. Simple trail mix can be achieved by using dry, roasted nuts, dried fruit, and some sunflower seeds for a perfect combination of different flavors and textures.

Fruit and Cheese

Many people like to get a dose of fiber and a dose of dairy after their workouts, which is a great combination. Fruit like apple slices and low-calorie cheese (like a string cheese you can find at the grocery store) are perfect.

The Cheapest Foods that Are Also Healthy

We’ve all heard (and possibly used the excuse): “I can’t eat healthy because healthy foods are so expensive.” Well, there are, in fact, healthy food options that are as inexpensive as $2 and even $1 at the supermarket. Here are the healthiest foods you can get on the cheap.

Frozen Vegetables and Fruits

Yes, fresh produce is expensive, but you can get frozen fruit and veggies (which has all the same great nutrients) for much less. Most stores put their frozen produce packs on sale often, and you can also save them and keep them longer than fresh produce. It’s a good idea to keep an eye out for a sale, but most of the time, supermarket brand vegetables can be bought for $1 or $2. Now that’s cheap!

Brown Rice

Brown rice is so much healthier than the other alternatives such as white or yellow rice, and it is also incredibly inexpensive. You can get brown rice for only 18 cents per serving (or $1.75 for a 1-pound bag), according to WebMD.

Oats

You can use dry oats on your cereal or to make granola. You can also crumble them on top of some yogurt to get a crunch to your morning meal. Oats can usually be bought for about $4 per 30 servings, so you will be able to eat them for a long time after buying them.

Canned Tuna

Almost always on sale, canned tuna is fairly inexpensive even when it’s not priced down. You can get a can for about $2, and make two servings out of it: one to put on a salad at lunch or one to mix with avocado for a healthy dinner. This is actually a great way to get the nutrients you need that come from many different types of fish in a much cheaper way than buying it fresh.

Beans

Pinto beans, black beans, and even refried beans can be bought in cans for under $1 in many cases. These can be used to replace the meats you might not be able to afford (or might not want to eat because of their high fat content) while providing you with the protein you wouldn’t get otherwise.

Eggs

According to Greatest, eggs are a perfect option when you’re looking for a cheap and healthy meal. They usually cost fewer than 40 cents each and can be used in many different ways. They are also a great source of good fat as well as protein and can be prepared for breakfast, lunch, or dinner.

Cottage Cheese

Actually a much cheaper and healthier choice than most dairy options, cottage cheese can be purchased for only about $1 a cup. This can help you make a light and healthy snack that also falls under the dairy category (not an easy feat!).

Popcorn

Believe it or not, store-brand popcorn that doesn’t contain lots of butter and salt is a healthy and inexpensive snack option. Usually, it only costs about $1 per pound, and you can keep snacking for a week.

6 Habits of Highly Healthy People

We all know how important it is to be healthy, but many of us don’t really know how to do it or what habits can actually make us healthier people. Below are 6 habits of the healthiest individuals and why you should be practicing them too.

 

  1. Getting 7 to 8 Hours of Sleep Every Night

 

Sleep is perhaps one of the most important activities we engage in. If you’re not getting enough sleep, it can affect you in more ways than you would ever believe, including in your mind and body. So if you’re going to start somewhere, start here. Tonight, make sure you get at least 7 hours of sleep and then keep this up every night after.

 

  1. Physical Activity

 

Yes, yes, you’ve heard this before, but try to remember that the reason you hear about it so much is because it’s true! Regular physical activity helps you stay healthy, motivated, and focused, not to mention that it keeps your weight down. In addition, you will actually feel more energetic if you are getting regular exercise (and when you’re sleeping enough in addition, you’ll see how much more energy you can have day to day).

 

  1. Eat Healthy Foods Rather than Supplements

 

Supplements are great. They can allow us to get the nutrients we need while on the go. However, actually eating healthy foods that give you these same nutrients is better for you. Eat fruits and veggies rather than taking a vitamin C tablet. And make sure get plenty of iron in your diet rather than taking iron supplements.

 

  1. Eat at Home as Much as Possible

 

Everyone loves going out to eat, but the more you can eat at home, the healthier you will be. People who cook at home more often than not are actually proven to live longer than those who don’t. When you cook for yourself, you know exactly what’s going into your food. You can control the ingredients, the portions, everything. Plus, you’ll know how fresh the food you’re eating is because you just made it!

 

  1. Go to Regular Wellness Checkups

 

Many people avoid the doctor like the plague (which might actually cause you to catch it! Just kidding). But it is important to see your doctor at least once a year for a wellness exam. This way, any serious issues can be addressed, and if you aren’t experiencing any problems, you’ll feel reassured, making you feel better on the inside as well as on the out.

 

  1. Be Mindful

 

Mindful meditation is an extremely helpful practice that many healthy people enjoy. But mindfulness isn’t just important when you’re meditating. Eating mindfully can help ensure that you only eat when you’re hungry, and being mindful in your relationships will help you recognize when someone’s worth your time (and when someone’s not). Being mindful of your daily needs, feelings, and experiences will help you live happily and healthily, and both these qualities will improve the other.

The Healthiest Teas You Could Be Drinking Right Now

Sorry, coffee drinkers. Tea might actually be the perfect beverage. It is absolutely delicious when hot and when cold, and many teas have a number of incredible health benefits that can be extremely helpful to your entire body. Here are some of the healthiest teas you should be drinking on the regular.

Green Tea

Everyone pretty much already knows about the health benefits of green tea, but it is still worth mentioning. Green tea is loaded with antioxidants (something you probably already knew), but the type of antioxidants you’ll find in the beverage is called catechins. One of the subgroups in cetechins, EGCG, may potentially be able to help prevent cancer and heart disease, according to a recent study.

White Tea

Now, here’s something you may not know. White tea has the same antioxidants that green tea contains, except there are more of them in the former. White tea can also help lower your risk of cardiovascular problems and high cholesterol, which makes it a great secondary option if you’re getting tired of the taste of green tea. In addition, white tea has been said to help promote weight loss in those who drink it often.

Oolong Tea

Oolong tea is another, lesser-known variety of tea that can be extremely beneficial for your health. Women who drink oolong tea have a much lower risk of developing certain cancers, specifically ovarian cancer; studies have shown that drinking 2 cups of tea daily, including oolong tea, seems to cut the risk of ovarian cancer by about half. Diabetics can also drink oolong tea to help reduce their blood sugar.

Herbal Teas

Herbal teas, like ginger, ginseng, Echinacea, hibiscus, and rooibos, are made from herbs, seeds, or fruits and steeped in water. These are actually extremely healthy for those who drink them regularly, as they can help facilitate weight loss, decrease issues with insomnia, and boost your immune system.

Hibiscus tea has actually been found to lower blood pressure in those who have chronically high levels of such, and chamomile tea can be helpful to those who are already suffering from cancer and diabetes to mildly slow the process of these diseases. Echinacea was once thought to be the cure for the common cold, but while it is decidedly less effective than this, it can actually be helpful when brewed as a tea for those suffering from constipation. Those with rheumatoid arthritis can also benefit from drinking Echinacea tea regularly.

Black Tea

We know; black tea is full of caffeine, so you may be wondering why it’s even on this list. However, studies have shown that black tea can actually decrease your risk of stroke by 21 percent, and drinking black tea regularly can also lower your risk of diabetes, high cholesterol, Parkinson’s disease, and kidney stones. In addition, research has shown that black tea may be helpful for preventing atherosclerosis, or the hardening of the arteries, especially in women. So go ahead, have another cup.

 

 

Understanding and Recognizing Depression­­––And Finding Help

If you are a woman––or, let’s face it, a person who cares about women at all––it’s important to be able to understand and recognize the signs of a depressive disorder and to be able to find help for yourself or someone you care about when these signs become serious.

Women Are More Affected by Depression in General

According to a study published in the Journal of Psychiatry and Neuroscience in 2015, “The prevalence of major depression is higher in women than in men.” In 2010, the disorder was found in 5.5 percent of women and 3.2 percent of men respectively. But that’s not all. The National Institute on Mental Health states there are certain types of depression that are considered unique to women. These can include

  • Premenstrual dysphoric disorder (PMDD), a condition that causes serious, debilitating symptoms before and around the time of a woman’s period
  • Perinatal or postpartum depression, a condition that causes pregnant women or women who have just given birth to experience severe mood swings, feelings of unworthiness, and fatigue
  • Perimenopausal depression, a condition that causes women who are going through menopause to experience depression, anxiety, irritability, and other severe emotional symptoms that are, in fact, not normal and potentially dangerous

Because depression is so prevalent in the female population and because 12 percent of women in the United States will experience depression at some point in their lives, according to Health Line, it is necessary for us to understand this disorder as well as to be able to recognize it.

Recognizing the Symptoms of Depression

Though there are many reasons why a depressive syndrome may occur, it is possible for you to be able to recognize depression in yourself or someone you love, even if you don’t know the cause of it.

If you or someone you love has been…

  • Experiencing sad, empty, and anxious feelings that persist and will not go away
  • Acting or feeling irritable often
  • Feeling or expressing more hopelessness or pessimistic thoughts than usual
  • Experiencing thoughts of suicide, death, or a desire to die
  • Exhibiting a decrease in energy or an increase in fatigue
  • Exhibiting altered sleeping patterns like sleeping too much or not enough
  • Restless and unable to sit or lie still for a period of time
  • Losing interest in things that used to matter to them like hobbies, school, work, etc.
  • Exhibiting appetite changes and/or weight loss
  • Complaining of cramps, aches and pains, or headaches constantly that medicine does not seem to fix for which no cause can be found

 

then there is a strong likelihood that some type of depressive disorder could be the culprit. Once you begin to understand and look for the signs and symptoms of depression, you can easily see when yourself or someone you love is experiencing issues with this very common disorder.

How Can I Find Help?

It isn’t easy to admit that you are struggling with depression and that help from a professional will be necessary, but if you have accepted this fact, you are already much closer to getting better. You can find help by using Healthfinder.gov to locate professionals who will be able to guide you through your recovery and create a treatment plan that will allow you to gradually start to feel like your old self again.

Remember: depression isn’t just something you can shake off. It isn’t like a bad mood that can be fixed with a pep talk or tough love. It is a real disease that requires real treatment, and once you seek it, you will be able to see a genuine difference in your life.

Stopping the Epidemic of Teenage Suicide

Death at any age is always hard to take, but the unexpected death of a teenager is always labeled tragic.  So, what then is a label that is suitable for a young person feeling so hopeless and alone they feel there is no other choice but the one to end their life? Anyone close to a victim of hopelessness is left behind with the sickening wonder of what they could have done to change the horrible outcome. Suicide is preventable and there are steps we can take to be informed and to take action to help the teens in our life who are troubled and feeling hopeless with the thought they have nowhere to turn—before the unspeakable happens.

Cyberbullying Victim Speaks from the Grave

From the time when the word of the death of Port Coquitlam bullying victim, Amanda Todd, got out to the public—people were outraged, saddened and sickened by the fact that bullying and her repeated attempts to get away from the abuse failed miserably; resulting in the young girl taking her own life.  Amanda repeatedly tried to get help and tragically she did not get the peace she so deserved. The number of deaths related to bullying and cyberbullying have shockingly skyrocketed with the advancement of technology.

The Cold Truth about Teen Suicide

It is rare for children to commit suicide; the numbers go up a great deal during adolescence years. According to the latest from the CDC, the second leading cause of death for ages ten to 24 is suicide.  Another all-too common method of teen overdose is from pharmaceuticals and medications. Whether they are non-prescription, prescription, or over-the-counter; meds should always be closely monitored in your home. Be aware of any medications that your teen may receive from friends as well. Educate your children about the dangers of taking meds. Boys and girls have different methods of suicide and while girls attempt suicide and think about it more often, boys are more prone to go through with their suicide plan.

Teenage Worry and Depression is Real

Sometimes as people age they tend to forget what it was like being a teenager. Fighting to be accepted as part of the group by their peers, trying to live up to standards people have set for them and all the while showing how they can be responsible young adults are just a few of the obstacles teenagers are trying to overcome. Mental health problems also contributes to thoughts of suicide while depression, bipolar disorder and anxiety disorders also cause teens to be at higher risk of suicidal thoughts than their peers. These are just some of the reasons to stay alert and keep an eye out for the warning signs of depression or suicide that any teenager around you exhibits.

Learn the Warning Signs of Suicide

Warning signs are definitely something to be get familiar with recognizing, and don’t put it off. Learn all the signs today. Signs include talking about suicide, talk of hopelessness and worthlessness or making statements like they won’t be around much longer. If they start to isolate themselves and drop out of normal activities, talk and seem fascinated by death or start participating in a lot of risk taking activities; take the immediate hint to step in and open the lines of communication with your teen. Help is needed right away for any person that gives beloved personal belongings away to friends and family. If they seem to not want to talk to you or don’t feel comfortable then bring in a counselor or neutral person to help. It is very important to get help immediately in dealing with someone who is thinking of suicide.

Don’t Think—Call Right Now for Help

If you have a friend that you think needs help or someone to talk to or you have questions about your own child then please call your healthcare provider right away or the National Suicide Prevention Lifeline at 1-800-273-8255 now. If you are a teen, you can text for help with the word “Teen” to the number 839863 (6-9pm PST), email, chat or start a discussion with other teenagers at the Teen Line.  Don’t think about it if you suspect something is wrong, just make the call or send the text now. If you are considering suicide yourself, please take a deep breath and call the hotline number to speak with a person who is compassionate, non-judgmental and here for you right now because ending your life is never the answer; no matter how big, bad or hopeless a problem is in life.