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( ) - - To quote the Leonard Nimoy- voiced Sentinel Prime, who himself was paraphrasing Nimoy' s Spock: & quot; The needs of the many outweigh the needs of the few. & quot; That' s a philosophy that & quot; Transformers: Dark of the Moon& quot; certainly subscribes to, as it disappointed the few ( the critics who gave the film ) while satisfying the many ( the global moviegoing audience) . & quot; Moon& quot; has grossed an estimated $ 379 million worldwide through Sunday - - the third- biggest global opening ever, behind & quot; Harry Potter and the Half- Blood Prince& quot; and & quot; Spider- Man 3. & quot; Domestically, Michael Bay' s $ 195 million alien- robot threequel collected $ 116.

4 million over the four- day weekend. If the estimate holds, that' ll be the largest four- day Independence Day weekend ever, barely beating & quot; Spider- Man 2' s& quot; $ 115. 8 million opening.

And three- day weekend gross of $ 97.

5 million marks the year' s best debut - - at least until & quot; Harry Potter and the Deathly Hallows: Part II& quot; demolishes it in two weeks. After six days in theaters ( technically six- and- a- half days when including the sneak- preview screenings on Tuesday night) , & quot; Moon& quot; has tallied an estimated $ 181. 1 million.

By comparison, the second & quot; Transformers& quot; film, Revenge of the Fallen, had made $ 214. 9 million in six days. But & quot; Moon& quot; appears to be better liked, having received an overall & quot; A& quot; grade from Cinema.

Score audiences, compared to Revenge' s & quot; B+ & quot; rating. According to Paramount, & quot; Moon& quot; attracted a crowd that was 62 percent male and 55 percent under the age of 25. Showings in 3- D accounted for 60 percent of the movie' s weekend gross.

That' s a solid improvement compared to the last few 3- D movies, which have been collecting only 40 to 45 percent of their openings from 3- D screens.

But & quot; Moon' s& quot; 60- percent figure is still lacking compared to some past 3- D event movies, such as & quot; TRON: Legacy& quot; ( 82 percent) , & quot; Avatar& quot; ( 71 percent) , and & quot; Alice in Wonderland& quot; ( 70 percent) . Foreign moviegoers, on the other hand, can' t get enough of 3- D - - & quot; Moon& quot; made 70 percent of its overseas gross from 3- D theaters.

In second was Disney- Pixar' s & quot; Cars 2, & quot; which brought in $ 32. 1 million over the four- day weekend. The automotive sequel' s three- day weekend gross ( $ 26.

2 million) represented a decline of 60 percent - - the largest second- weekend drop ever in Pixar history. After 11 days, & quot; Cars 2& quot; has earned $ 123 million. That' s slightly ahead of the original & quot; Cars' & quot; $ 121.

1 million at this point, but expect & quot; Cars 2& quot; to fall behind its predecessor in the near future. The Cameron Diaz comedy was in third place with $ 17.

6 million over the holiday weekend, and has tallied $ 63 million in two weeks. And two slots lower, in fifth, was the sci- fi adventure & quot; Super 8, & quot; which continued to hold up very well with $ 9. 5 million over the four- day weekend.

Fourth and sixth place went to the frame' s other two new releases: the Tom Hanks- Julia Roberts comedy, and the Selena Gomez comedy, & quot; Monte Carlo. & quot; Neither movie generated box- office fireworks. & quot; Crowne, & quot; which was also directed and co- written by Hanks, debuted to a mild $ 15. 7 million over the holiday weekend. The $ 30 million picture drew an older audience, with 81 percent at least 35 years old, and Cinema. Score participants handed it an okay & quot; B& quot; rating. & quot; Monte Carlo& quot; opened to just $ 8. 8 million, although the globetrotting flick only cost $ 20 million to produce.

It received an & quot; A- & quot; rating from Cinema.

Score graders, of which 82 percent were female and 52 percent under the age of 18. Check back next week as two comedies go head- to- head: the R- rated & quot; Horrible Bosses, & quot; in which three friends attempt to murder their others' bosses, and the PG- rated & quot; Zookeeper, & quot; for which moviegoers will be given a scorecard to keep track of how many times Kevin James crashes into something. 1. & quot; Transformers: Dark of the Moon& quot; - - $ 116. 4 mil 2. & quot; Cars 2& quot; - - $ 32. 1 mil 3. & quot; Bad Teacher& quot; - - $ 17.

6 mil 4. & quot; Larry Crowne& quot; - - $ 15. 7 mil 5. & quot; Super 8& quot; - - $ 9. 5 mil 6. & quot; Monte Carlo& quot; - - $ 8.

8 mil & copy; 2010 and Time Inc. All rights reserved.

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Should political debate be about jobs not debt? Lobbyists battle amid deficit cuts Gergen: Prospects for debt default above 50% Trump: Bachmann is ' highly underrated' Impact of concussions to brain Geyser of water lifts car into air Paramedics help dad watch son' s game Cops: Mom admits having teen sex parties Do we coddle female athletes? Chihuahua chases off robbers British phone hacking inquiry widened Shuttle Atlantis makes final landing If you can' t beat them, eat them! NASA: What' s next?

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Farnborough, England ( CNN) - - Global Positioning Systems ( GPS) may already guide millions of cars around the world, but airplanes are still guided by a 70- year- old radar technology.

That is changing in the United States where engineering firm ITT is building out a GPS- based system as part of a larger & quot; Next. Gen& quot; system to vastly upgrade the country' s air traffic control systems. The U. Federal Aviation Administration ( FAA) , which awarded the contract to ITT back in 2007, says the new GPS system will be nearly 10 times more accurate than radar.

It will allow controllers to have much better idea of where all planes are and allow pilots to know where other planes are. & quot; There are numerous benefits to go to a GPS- based system, including savings of fuel, less carbon- dioxide emissions and better- controlled ascents and descents, & quot; ITT Senior V. David Melcher told CNN at the Farnborough Air show outside London. & quot; The pilots will actually have better situation awareness in the cabin, they' ll have more air traffic information and climate information, & quot; he added. The disappearance of Air France Flight 477 and its 228 passengers over the Atlantic Ocean in 2009 led critics of radar- based air traffic control to call for a move to GPS- based networks that can precisely track all planes. With the current air traffic system, controllers cannot see a plane flying over an ocean on radar until it is within about 200 miles of land. Controllers often have to estimate a plane' s location based on flight plans and departure times.

Experts argue that this estimation can make planes vulnerable if they have to land in an emergency.

The infrastructure for the new GPS tracking will be in place by early 2012 says ITT but it will take much of the rest of the decade to fully implement the entire system into each and every airplane, large and small. & quot; The roll- out of the system and the capability which ITT Corporation is responsible for will occur between now and early 2012, & quot; Melcher said. By 2020, aircraft will be able to fly closer together and the system is tasked with cut down on delays. Currently some planes have to fly longer, more meandering routes across the U. S. to be seen on tracking beacons.

In all this, GPS is expected to save airlines a great deal of fuel.

The FAA says & quot; Next. Gen& quot; is expected to reduce total flight delays by about 21 percent by 2018 while providing $ 22 billion in cumulative benefits to the traveling public, aircraft operators and the FAA. In the process, more than 1. 4 billion gallons of fuel will be saved during this period, cutting carbon dioxide emissions by nearly 14 million tons.

It has not been easy. There are still questions about how much airlines should contribute to the huge cost and some people who say the introduction of GPS should not be seen as a cure all for the industry' s congestion problems. Still, there is progress on a global system. Europe has its own system, and recently struck a deal with U.

S. authorities so the two systems will work together. After that, ITT is looking for ways to allow systems already being built or planned to talk to each other.

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Editor' s note: , a native of County Clare, Ireland, records for Sugar Hill Records. Her current album is & quot; Naked With Friends. & quot; ( CNN) - - In 1992, I had the pleasure of singing at the wedding of Sen. Edward Kennedy to Victoria Reggie. I had never met him, nor was I aware that he had even heard of me. To say I was surprised would be an understatement.

He made the call himself to my home number. My housemate hung up on him, believing it was a hoax, but he eventually left a number for me to contact. When we spoke the next day, he told me how much he enjoyed my singing and named particular songs that meant a great deal to him.

One of those songs is & quot; A Family Tie& quot; by Hugh Prestwood, which speaks to the idea of unconditional love within a family.

I can only assume that it had particular resonance for him. We discussed the song and many others that were favorites of his and, of course, I agreed to sing at the wedding. We spoke a few more times before the wedding and sounded like any other man who was delighted to be marrying the woman he loved. I was thrilled to be involved.

The Kennedys have been a huge part of the Irish psyche since I was a child. In many houses back then, there were pictures of the pope and .

The fact that he was proudly Irish was a huge boost for our national ego at the time. My family had a very special photograph that was on top of our piano all my life. It was a picture of my father with Ted Kennedy that was taken in the early ' 60s at the Shannon Airport duty free store, where my father worked at the time.

We were all very proud of that, so when I got the call about singing at the wedding, the first person I told was my dad. On the day of the wedding, my musicians Richard Mc.

Laurin and Zane Baxter and I were brought to Kennedy' s house and escorted to the senator' s home office.

There were so many iconic pictures on the walls it was disconcerting. He made time to come and visit us and was about as genial a host as I have ever encountered. He talked about his bride- to- be in glorious terms, shared the story of his proposal to Vicki, and answered questions about the various pictures around the room. He was relaxed and happy. The wedding itself was beautiful.

It was just very close family.

There was a civil ceremony and then a blessing. I sang some songs during the ceremony, and then a few afterwards. He joined in here and there, but God bless him, he hadn' t a note in his head.

He had requested that I sing the old standard & quot; You' ll Never Know& quot; which I had recorded, and he and his bride danced, looking into each other' s eyes. He gave a painting of daffodils he had painted as a wedding gift.

A few days later, a framed signed print of the painting was delivered to my home. What a thoughtful gesture.

Ever since then we kept in contact. They came to see me play at the Birchmere, a music hall in Alexandria, Virginia, a few times. I sang at various events the senator was involved in, most recently at a fundraiser for his re- election. It was not a one- sided friendship though. A few years ago I accompanied my son to Washington to take part in a young leaders of America camp.

I was a bit surprised when I found out there was to be no real interaction with any serving politician. On the day that we were to tour the major sites, I decided to call Kennedy' s office at the Russell Senate building.

I explained to his wonderful assistant, Sharon Waxman, what I was doing in Washington and asked if the senator would mind waving at the hordes from his office window. She called me back about 10 minutes later to say the senator had cleared some time in the afternoon, and he would speak to the group in the little park opposite the building. He spoke to the kids about his first time in Washington and how his brother John, a senator at the time, showed him around.

He told them how inspiring it was to see how government worked and that he knew right then that he wanted to be a public servant. He was playful, too, and told them lots of silly stories about his dog.

Afterwards he agreed to be photographed with the group. I believe that many young people gathered there may have been inspired by his stories and may prove to be the next generation of humanistic Democrats. He loved his country. He loved to serve, but most of all he dearly loved his wife and family.

I will miss him, too - - even his singing. The opinions expressed in this commentary are solely those of Maura O' Connell. All About & bull; & bull;

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Editor' s note: Amy Gahran writes about mobile tech for CNN. com. She is a San Francisco Bay Area writer and media consultant whose blog, , explores how people communicate in the online age. ( CNN) - - Lots of Twitter users have lots of followers.

For instance, according to right now Lady Gaga has over 9.

2 million; Justin Bieber has over 8. 6 million; and Britney Spears, over 7. 3 million - - just slightly ahead of Barack Obama. But published by the Association for the Advancement of Artificial Intelligence shows that simply having a large Twitter following isn' t necessarily enough to make you especially influential. On Twitter, how many re- tweets or mentions a user attracts over time also are important ways to measure influence.

This was a pretty big study. The international research team ( here' s the ) examined nearly 55 million Twitter accounts that were in use in August 2009. These users were connected to each other by 1. 9 billion social links. Over 6 million of these users were considered & quot; active& quot; in that they' d posted more than 10 tweets and had a currently valid screen name.

In all, over 1.

7 billion tweets were analyzed - - all the tweets ever posted by the nearly 55 million users being studied. The researchers examined three metrics of influence on Twitter: the number of followers, re- tweets, and mentions of Twitter users - - not direct re- tweets, but casual mentions. Not surprisingly, the most- followed Twitter accounts belong to celebrities and major media brands.

The most- mentioned accounts also tended to be celebrities. But the most- re- tweeted accounts tend to be content aggregators, news sites, and business celebrities, such as . Looking at the top 100 users in each influence category yielded a list of 233 & quot; all- time influentials. & quot; There are only 233 because there was overlap among these groups. Some of these were news organizations, some were celebrities - - but others were fairly regular people. This list has not been released, but the researchers did note that the top- 20 lists in each category only had two users in common: Ashton Kutcher and Puff Daddy.

Overall, only 7. 1% of the all- time influentials were included in all three influence categories.

So how can you gain influence on Twitter? This research suggests that focusing your tweets mainly on one topic is a good way to start. This focusing strategy can include serving as a topic curator by re- tweeting posts by others about your core topic. Keep an eye out for relevant hashtags - - keywords that start with & quot; # & quot; , a convention people use to follow topics on Twitter rather than specific Twitter accounts - - and use the most popular relevant hashtags to attract wider attention to your contributions on the theme.

It helps to keep a topical focus over time, but when big news breaks that involves a place or topic you know a lot about, get ready to turn into a reporter.

Stay glued to your computer to provide a steady curated stream of up- to- the minute updates. NPR' s has been demonstrating this approach in his much- noted Twitter coverage of the this year' s revolutions in the Middle East and North Africa. when a dam burst in Tennessee, dumping over 3 million cubic yards of coal ash from a huge power plant onto a nearby community. I launched the # coalash hashtag and stayed on the story by remote, tweeting and re- tweeting information as I found it. Yes, I' m a journalist - - but you don' t need to have a press pass to play this role when news breaks about something you know well.

I picked up over 1, 500 new Twitter followers in the days and weeks following that dam rupture. As the news subsided, many of those new followers stuck around, which to me indicates that being useful at a crucial time can translate into lasting influence - - at least on Twitter. The opinions expressed in this post are solely those of Amy Gahran.

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The Centers for Disease Control and Prevention now recommend flu vaccination for all Americans over the age of 6 months. Each year' s seasonal flu vaccine contains protection from the three influenza viruses that are expected to be the most common during that year' s flu season. The H1N1 influenza virus responsible for the 2009 pandemic will be included in the seasonal flu vaccine for 2010 to 2011.

The vaccine will be available as an injection or as a nasal spray. Controlling the spread of infection The influenza vaccine isn' t 100- percent effective, so it' s also important to take measures to reduce the spread of infection: Wash your hands. Thorough and frequent hand washing is the best way to prevent many common infections. Scrub your hands vigorously for at least 15 seconds. Or use alcohol- based hand sanitizers.

Contain your coughs and sneezes. Cover your mouth and nose when you sneeze or cough.

To avoid contaminating your hands, cough or sneeze into a tissue or into the inner crook of your elbow. Avoid crowds. Flu spreads easily wherever people congregate & mdash; in child care centers, schools, office buildings, auditoriums and public transportation. By avoiding crowds during peak flu season, you reduce your chances of infection. & copy; 1998- 2011 Mayo Foundation for Medical Education and Research ( MFMER) .

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Read more about this story from . ( CNN) - - A California bounty hunter says he will sue Casey Anthony and her defense attorney Jose Baez for misleading him when he helped search for her young daughter Caylee. Leonard Padilla said he is seeking $ 200, 000. Padilla said Anthony' s attorney allowed him to fly to Florida in 2008 and help search for Anthony' s then- missing 2- year- old daughter. Anthony left jail Sunday after being acquitted of murder charges in connection with the death of her daughter. Padilla says when he heard Baez' s opening statement during Anthony' s murder trial he felt conned. & quot; It turns out she knew where the child was all along, & quot; Padilla said. & quot; They misled me, and it is definitely fraud. & quot; At one point during the highly- publicized search for Caylee, Padilla offered a $ 25, 000 reward for the girl' s return.

He also says he spent $ 50, 000 to bond out Anthony when she was initially jailed. He said he also brought in people to help provide security. He said he talked to Anthony on many occasions during that time and that she never said she knew where Caylee was. & quot; She told me the babysitter stole the baby, & quot; Padilla said. & quot; They were both feeding us that line.

And now we know it was never true.

We lost a lot of money. & quot; Padilla says it may take a few weeks to get his lawsuit together. Johnny Griffin, a California legal expert, told that Padilla' s lawsuit may have legal merit. But he may need to do some work to prove his case, Griffin said. & quot; Casey Anthony never testified at trial.

So he needs to prove that she lied to him, & quot; Griffin told the affiliate. Baez can also claim that Padilla made more money becoming part of the Casey Anthony story than it cost him to be part of the search, Griffin said. When the lawsuit is filed, Padilla may have to get in line behind the others seeking money from Anthony. Florida officials are asking that Anthony repay the state for the enormous cost of investigating the case. In a motion filed earlier this month, the state called for a hearing so it can tally up costs and slap Anthony with the bill. & quot; The efforts and costs of the investigation were extensive and not immediately available and accordingly, the State of Florida respectfully requests this Court to set a hearing within 60 days to determine total costs, & quot; the motion says.

The motion cites a Florida law that allows the state to fine defendants in criminal cases to recoup money spent. Texas Equu.

Search, a firm that helped search for Anthony' s daughter, also wants its money back. The company said it used 4, 200 searchers and spent $ 112, 000 looking for Caylee in Florida after the girl was reported missing in July 2008. Tim Miller, the head of company, has said he is suing because he believes Caylee never was missing.

Anthony also faces a lawsuit from a woman named Zenaida Gonzalez. At the time of Caylee' s disappearance, Anthony told family members and police that the little girl was with a nanny named Zenaida Fernandez Gonzalez. That account resulted in one of Anthony' s lying convictions. Anthony also claimed Gonzalez had kidnapped the toddler. Authorities never found a nanny by that name who cared for Caylee.

They did, however, find a woman named Zenaida Fernandez Gonzalez, who denied ever meeting Anthony. Gonzalez then filed the defamation lawsuit. The judge handling the defamation lawsuit set Anthony' s deposition for October 8. CNN' s Greg Morrison contributed to this report. Watch Nancy Grace Monday through Sunday starting at 8 p. m.

ET on HLN. For the latest from Nancy Grace

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Because many broken ribs are caused by motor vehicle accidents, you may find out you have a broken rib in a hospital' s emergency department.

If your broken rib was caused by repetitive stress over time, you may seek advice from your family physician.

Your time with your doctor may be limited, so preparing a list of questions can help you make the most of your time together. For broken ribs, some basic questions to ask your doctor include: What kinds of tests do I need?

Do these tests require any special preparation? How long will I be in pain?

What treatments are available and which do you recommend? I have other health conditions. How can I best manage these conditions together?

Are there any activity restrictions that I need to follow? Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting? In addition to the questions that you' ve prepared to ask your doctor, don' t hesitate to ask any additional questions you may think of during your appointment.

Where exactly does it hurt?

When did the pain start? What happened that may explain the pain? ? Can you do anything to make the pain better or worse? During the physical exam, your doctor will press gently on your ribs. He or she may also listen to your lungs and watch your rib cage move as you breathe. & copy; 1998- 2011 Mayo Foundation for Medical Education and Research ( MFMER) .

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( CNN) - - The reaction to Kanye West' s hijacking of the microphone from Taylor Swift during her acceptance speech at the 2009 MTV Video Music Awards came quickly and unequivocally. Celebrities and fans alike expressed their disapproval of West interrupting Swift' s win for Best Female Video to tout his appreciation of nominee Beyonce. & quot; Taylor, I' m really happy for you, & quot; West said after grabbing the microphone from a clearly stunned Swift. & quot; I' ll let you finish, but Beyonce had one of the best videos of all time! One of the best videos of all time! & quot; Elliott Wilson, founder and chief executive officer of , sat in front of members of West' s entourage at the live Sunday night awards show and said the mood quickly turned from one of surprised amusement to anger. & quot; At first, people weren' t sure if it was kind of like a gag, & quot; Wilson said. & quot; You could feel everybody being nervous and not knowing if it was a prank or something.

Then people started booing him really loud. & quot; Wilson said he believes that West - - who he said bounded on stage from his seat in the front row near Beyonce - - intended to have his say before allowing to continue but said the rapper became angered by the crowd response in a moment that wasn' t captured by the MTV cameras. & quot; The reaction to his tantrum was so strong . . . and what happened was, he gave everybody the finger, & quot; Wilson said. Stars taking to Twitter returned the sentiment with some harsh words for the sometimes mercurial rap star.

Singer Pink tweeted, & quot; Kanye West is the biggest piece of [ expletive] on earth. Quote me, & quot; and Joel Madden of the band Good Charlotte tweeted, & quot; All i' m saying is Taylor Swift is a young chic and you just walk up and grab the mic. & quot; Celebrity blogger Perez Hilton said via Twitter that & quot; Taylor Swift deserved that award, damnit. It is what THE PEOPLE voted! My heart broke for her, she looked so sad at the end of that moment. & quot; Singer Katy Perry weighed in with & quot; F- - - u Kanye.

It' s like you stepped on a kitten. & quot; VMA nominee Kelly Clarkson took to her blog to publish an open letter to West. & quot; What happened to you as a child? ? Did you not get hugged enough? ? & quot; she asked. On Monday, & quot; Taylor Swift, & quot; & quot; VMAs, & quot; & quot; Kanye' s& quot; and & quot; Beyonce& quot; were top trending topics on Twitter. Wilson, a noted hip- hop journalist, said there was a great deal of tension inside the event Sunday night before and his girlfriend, model Amber Rose, left the show. & quot; It was almost like wrestling, when the good guy turns bad and the crowd turns on him, & quot; Wilson said. & quot; Every time his name was mentioned, people booed. & quot; Wilson said he believes that alcohol may have played a part in West' s actions, given that the rapper appeared both on the red carpet and inside the arena with a bottle of cognac.

Wilson added that West is well known for such behavior. He appeared uninvited onstage at the 2006 MTV Europe Music Awards, walked out of the 2004 American Music Awards after losing in the Best New Artist category and reportedly threw a backstage tantrum at the 2007 VMAs because he did not perform on the main stage. & quot; I think Kanye came in to be the bad boy, but he obviously had an emotional spaz moment because he is cool& quot; with Beyonce and her husband, Jay- Z, Wilson said. & quot; I think the alcohol blurred his judgment. & quot; Wilson said attendees at the awards show were allowed to have drinks at their seats. Emil Wilbekin, managing editor of , said West may have gone too far with his antics this time. & quot; I think that it was not Kanye' s place to speak for Beyonce or to ruin Taylor Swift' s moment, & quot; Wilbekin said. & quot; It' s OK for Kanye to rattle off about himself, but I think he crossed the line when he decided to speak for other people. & quot; Though West is known for having a healthy ego, Wilbekin said, his actions may be damaging the very legacy the rapper claims to want to leave. & quot; He' s talked about wanting to be Elvis; he' s talked about wanting to be the new king of pop, & quot; Wilbekin said. & quot; It' s almost like he' s overshadowing himself by getting in his own way with his mouth. & quot; West apologized to Swift via his blog. As for Swift, the young singer gave her acceptance speech after Beyonce graciously invited her onstage during her win for Video of the Year.

West' s disruption wasn' t the only one the evening offered, Wilson said. During a performance by Jay- Z and Alicia Keys, rapper Lil Mama rushed the stage.

Wilson said that from his vantage point in the audience, the female rapper, who also serves as a judge on MTV' s & quot; America' s Best Dance Crew, & quot; was neither expected nor wanted as part of the performance. The stars' behavior might have long- lasting consequences, Wilson added. & quot; I wouldn' t be surprised if MTV banned alcohol [ at the event] next year, & quot; he said. All About & bull; & bull;

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auto How long will my postpartum depression last? -

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Dear Sheeza, I am sorry to hear of your difficulties - - you are far from alone in your struggles with postpartum depression. Indeed, up to 20 percent of women become depressed in the six months following delivery, but company doesn' t help much when it comes to depression - - or at least the company we typically provide in the U. Traditional cultures understood the vulnerability of new mothers and would often surround them with family and friends to help with the significant emotional and practical burdens of coping with the newborn. I am going to make some general recommendations about what you might want to consider doing, based only on the information you have provided above. As always, this should not be taken as specific advice for your actual situation.

That kind of advice can come only from a clinician who knows you and is involved in your care. First and most important, it is very important to continue medication when one is still depressed, so given what you describe, I would counsel against stopping the antidepressant. It is not clear how long you have been on the Paxil ( generic: paroxetine) , but let' s assume you' ve been on it for at least six weeks. You are on a low dose.

A reasonable first step would be to talk with your doctor about raising the dose to 40 mg a day and trying this dose for at least several weeks. If you see no benefit, there are in general two paths your doctor might recommend ( and I say doctor in the generic sense, given that many folks nowadays see physician assistants or nurse practitioners who often - - in my experience - - do a better job diagnosing and treating depression than do MDs) . First, your doctor might add a second antidepressant or an atypical antipsychotic to your Paxil.

Although they are called & quot; antipsychotics, & quot; these agents ( for example Seroquel, Abilify, Zyprexa) are also widely used to help with severe depression and anxiety and are often quite effective. Second, your doctor might switch you from the Paxil to another antidepressant. Unfortunately, we have no scientific way of knowing which agent you should switch to - - our best data suggest that they are all about equal. But one thing is clear: Many people who don' t do well with one antidepressant will have a great response to a different one.

Anxiety and panic are quite common when one has a bad depression, and they can be more miserable to endure than the feeling of depression itself. It is unlikely that the low dose of Buspar ( generic: buspirone) you are taking is of much benefit.

You might want to discuss with your doctor raising the dose to at least 10 mg three times a day or discontinuing it. The best immediate way to relieve disabling anxiety is through the use of benzodiazepines ( for example lorazepam or clonazepam) .

These medications can be lifesavers, but if you take them for more than three or four weeks your body will become dependent upon them, and should you want to stop, you will have to reduce them slowly under the supervision of a doctor.

Let me say a word about exercise.

Yes, exercise has been shown in many studies not only to raise a person' s mood immediately, but also to work over time as an antidepressant.

Therefore, I strongly recommend adding regular exercise to your treatment regimen. Try to exercise in the morning, especially when it is sunny. To get the best effect you will need to work up a sweat. I find that it is even better if you can exercise in a place with some natural beauty - - as being in nature is itself quite comforting for most of us.

I don' t have an answer to your question about how long the depression will last and whether it will ever go away. Everyone is different. We do know, however, that the longer one stays depressed and/ or the more episodes one has had, the harder it is to treat the condition. This is just the frightening truth of the disease, and it really highlights how important it is for you to really get aggressive about your treatment.

My sincere hope is that whatever specific treatment route you follow, you will start feeling like yourself again as quickly as possible. Finally, whenever I talk about specific pharmacologic treatments I need to disclose that in addition to my academic work I have given lectures for two pharmaceutical companies in the last year: Lilly and Wyeth. I have also served on an advisory board for Lilly in the last 12 months.

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