Psychiatry: Approaching Mental Health Problems

Grappling with phobias

A form of anxiety that occurs only when you’re in a certain situation is called a phobia. If you suffer from a phobia, you typically try to avoid the situation that provokes your symptoms and you may become anxious even just thinking about getting into that situation. Some examples of phobias are as follows, starting with simple phobia and followed by the more complex ones:

• Simple phobia: You’re inappropriately anxious when faced with an object such as a spider or mouse, or in certain situations such as flying or being in enclosed spaces. Simple phobias commonly start in the early years of life following a stressful situation or some frightening life event, although experts don’t always know why this type of phobia occurs.
• Agoraphobia: You feel panicky or may even faint when you’re part of a crowd, out of the house or in a situation from which escape is difficult. To avoid these situations, you may avoid going out altogether, which can sometimes lead to depression and other mental health problems. It is thought that life experiences, genetic reasons and changes of chemicals in the brain may all play a role in causing agoraphobia.
• Social phobia: You have a strong and persistent fear of being negatively seen by others, and so you try to avoid social situations such as talking to groups, speaking on the telephone or going out with friends. In contrast to just being shy, social phobia can be quite disabling. Previous anxious or intense experiences in certain social situations may cause social phobias, particularly if you’ve always been shy since childhood and haven’t been able to fully develop your social confidence.

To avoid a phobia getting out of hand, consult your psychiatrist to discuss the many forms of treatment and therapy that are available. If you’re in a situation and start to feel anxious, try to relax and take control of your breathing. Open and stretch your hands, which can help release tension – our natural reaction to stress and anxiety is to close our hands or make a fist.

Handling panic attacks

Panic attacks are when you suddenly experience an intense feeling of apprehension or impending disaster. You’re likely to become anxious very quickly – often without warning and for no apparent reason. These attacks affect a lot of people and can be very frightening. Nobody really knows why panic attacks occur, but experts think that traumatic life experiences like the death of a close family member, unpleasant childhood experiences or changes in the chemicals within your brain, for example, may play a role.

If you suffer from panic attacks, you may recognise some of the following symptoms, at least four of which typically show during an attack:

• You suffer from a fast heart rate or palpitations.
• You feel short of breath or that you’re choking.
• You notice chest pain or discomfort.
• You feel dizzy, unsteady on your feet or faint.
• You feel sick or have stomach pain.
• You feel flushed or suddenly cold.
• You feel shaky and tremble.
• You’re afraid of doing something that you can’t control or that may seem crazy to other people.
• You feel like you’re not yourself.
• You may feel as if you’re about to die.

During a panic attack, try to tell yourself that you’re not coming to any harm, and that the symptoms you experience are due to anxiety. Remind yourself that attacks will pass, and ‘ride it out’. Try not to leave the situation that is causing you to have a panic attack and ‘confront’ your fear. By staying in the situation you give yourself the opportunity to discover that nothing serious is going to happen to you.

If you feel that you may suffer from panic attacks and that these attacks impact on your life, consult your psychiatrist. She/he can then exclude any potential underlying physical causes and discuss the different management options with you.        

Anxiety: It’s Common But Can Spell Disaster

Feeling anxious can be quite normal, as long as any feelings of apprehension or tension go away again by themselves or aren’t severe enough to impact on your life. Anxiety often accompanies depression, and as with depression and stress most people feel anxious at times, particularly when confronted with a stressful situation. You can also experience symptoms of anxiety for no apparent reason, and particularly when worries seem to take over your life you may suffer from what’s known as generalised anxiety disorder. This can be difficult to distinguish from depression and stress.

Anxiety isn’t always easy to recognise, and so consider these indicators:

• You feel nervous or on edge.
• You find relaxing and controlling your worries difficult.
• You tend to worry a lot, perhaps much more than you or other people feel is ‘normal’, and tend to think the worst.
• You’re so fidgety that you find sitting still difficult at times.
• You suffer from mood swings or get easily wound up.
• Your worrying affects your day-to-day life significantly – including your social life and work.
• You often think that something bad is going to happen.
• You find your worries upsetting and stressful.
• You suffer nightmares or from increased sensitivity to noise.

Physical symptoms commonly develop when you suffer from anxiety, and so you may also notice the following:

• Your hands are shaking and you may notice strange sensations such as tingling or numbness.
• You easily get a dry mouth or find swallowing difficult.
• You get headaches or feel dizzy.
• You experience chest discomfort or palpitations.
• You pass urine or open your bowels frequently.

If you feel that you may be suffering from anxiety – particularly if you’ve had symptoms of anxiety for a few months or longer – visit your psychiatrist for further assessment and to discuss the treatment options. If appropriate, your psychiatrist may want to exclude other possible causes that can also lead to symptoms of anxiety, such as:

• Formation of an overactive thyroid gland.
• Drinking too much coffee or tea.
• Experiencing low blood sugar.
• Withdrawing from drugs or alcohol.

Anxiety is incredibly common, but many people with symptoms of anxiety struggle to summon up the courage and seek professional help because they’re anxious or because they’re ashamed or embarrassed about the way they feel and think. Remember that your psychiatrist is well trained in dealing with anxiety, and that lots of other people also have these symptoms.

Watch that peg! It might kill you

Do you drool over alcohol while enjoying the weekend party? Just think of this when you ponder over next time; alcohol is responsible for six deaths per minute across the globe! Shocked? Wondering what it can do to you? Alcohol kills because people get addicted and ring bells for other diseases such as cancer, violent behaviour, liver problems, injuries and more. The latest WHO report found that people consuming alcohol frequently are vulnerable to disorders like tuberculosis and pneumonia.

The quantity of alcohol consumption

Approximately, individuals (aged 15 or above) drink 6.2 litres of pure alcohol each year but since only 38.3% of the population actually drinks, those who are regular drinkers drink 17 litres per year. The study also revealed that men are likelier to die of alcohol addiction but women are more susceptible. Lower income group is most affected by the health hazards of alcohol consumption.

Where India Stands

Conventionally, India follows a non-drinking culture. However, in the last decade, the consumption has gone up with 32% men and 10% women above 15 drinking alcohol. The situation is worrisome in Delhi. As per a new survey, 64.6% girls and 83.8% boys in Delhi start drinking before age 18. Additionally, 11.1% boys and 2.1% girls spend around Rs.8000 on alcohol per month.

The survey was conducted among the youngsters of Delhi stated that 34.5% males and 28% females consume alcohol at least 2-4 times a week and 77% boys and 46% girls drink more than five glasses at one go.

India reports the highest number of road casualties (138,000) in the world and underage drinking attenuates the situation. The results showed 75% males and 12.3% females have indulged in drunken driving and none of them was ever asked about the age proof. It is high time the management takes stringent action.

How alcohol affects you?

Being high on calories, alcohol promotes weight gain and interferes with your fitness programme. There are some long term effects as well. Excessive alcohol impacts liver functionality and in worse case, damages it.

However, there’s light in the dark. If you want to rid yourself of excess alcohol consumption, always consult an experienced psychiatrist. 

What Happens When We Are Depressed

When you suffer from depression, you may not just feel low; a number of other symptoms can also affect you:

1. Appetite: You may lose your appetite or develop a tendency for overeating.
2. Concentration: You may have difficulty focusing on things such as listening to music, watching television, reading books, or talking to other people.
3. Energy: You may feel tired all the time, have little energy and not be bothered to do things, or do them only with a lot of effort on your part.
4. Interest: You may lose interest in hobbies and sex, and find that nothing really gives you pleasure anymore.
5. Movement: You or other people may notice that you’re moving or speaking much slower than you used to. Or, you may be more fidgety or restless, moving around much more than usual.
6. Self-worth: You may feel that you’ve let yourself or other people down and feel bad about yourself. You may see yourself as a failure.
7. Sleep: You may find getting to sleep difficult, or you wake up once or more times in the middle of the night or too early in the morning. Alternatively, you may find that you sleep too much, and struggle to get up.
8. Thoughts of self-harm: You may have thoughts that you’d be better off dead, that the world would be better off without you or that life is just not worth living anymore. Or, you may think that you want to hurt yourself in some other way. Such thoughts can be very distressing.

If you recognise any of the above symptoms in yourself-particularly if they’ve been going on for a couple of weeks or longer, or they’re severe, consult your psychiatrist without delay. Various treatments, including talking therapies and medication, are available to you and can be very effective in getting you back on track.

Common reasons for feeling low

If you feel low, this doesn’t necessarily mean that you suffer from depression. Here are some other common causes of low mood-which may at times turn into a ‘full’ depression:

1. Bereavement and major life events: A time of mourning is a natural reaction to the death of someone close, and you’re bound to feel low for a while, often for weeks, months or even years. Sometimes, other life events such as getting divorced or losing your job can lead to a period of feeling low. Seek medical advice when the death of a close person is affecting you more than you’d expect or when you find that getting back on with your day-to-day life is difficult.
2. Illness: Many infectious diseases and chronic conditions such as diabetes, heart disease and osteo- or rheumatoid arthritis can be accompanied by symptoms of depression. If your depressive symptoms last for longer than a couple of weeks or they’re very severe, consult your psychiatrist.
3. Medication: Certain drugs such as the oral contraceptive pill and blood pressure lowering medication can sometimes make you feel depressed. Check the information sheets that come with any medication that you take for possible effects on your mood, and consult your psychiatrist if you’re concerned.
4. Stress: Feeling overworked or under pressure at home or work can bring on stress and low mood, particularly when this situation has been going on for a while.

Taking the first step towards getting help if you suffer from symptoms of depression can take a bit of courage. You’ve got a very good chance of getting better after receiving appropriate treatment, and your psychiatrist should be the first port of call.

Bipolar Disorder: Symptoms, Causes and more

Bipolar disorder, often known as manic-depressive disorder is related with mood swings ranging from depression to the extremity of mania. When you are feeling low, you may lose interest in certain activities and cut out from the rest of the world. When your mood’s pendulum shifts to the other side, you may feel ecstatic and full of energy. Mood swings may vary from time to time. They can happen only a few times or several times. In certain cases, bipolar depression symptoms of depression and mania can happen simultaneously.

Even though bipolar disorder is a disturbing and long-term health issue, you can always keep a tap on mood swings by following a proper treatment plan. Most of the time, bipolar disorders can be easily managed with the help of medications and psychotherapy.

Symptoms

Bipolar disorder is specified into categories each having different set of symptoms including:

• Bipolar disorder 1: Mood swings are associated with bipolar 1 disorder and can cause immense loss in relationships, jobs and studies. Freaking attacks can be extreme and treacherous.
• Bipolar disorder 2: As compared to bipolar 1 disorder, bipolar 2 disorder is less extreme. You can occasionally suffer from frustration, irritability but largely you can carry on your day-to-day activities without much of a hassle. Instead of suffering from intense mania, you suffer from hypomania- a less severe form of mania. In this disorder, duration of depression lasts longer than duration of hypomania.
• Cyclothymic disorder: Cyclothymic disorder is a lighter form of bipolar disorder. With cyclothymia, depression and hypomania can be troublesome but mood swings can be easily managed as they are with other types of bipolar disorders.

The precise symptoms of bipolar disorder differ from individual to individual. For some people, depression can cause much worries, for other people maniac situations are main worries. Symptoms of hypomania and depression can occur together. This is called mixed episode.

Listed below are some of the signs that Maniac Phase show:

• Poor judgment
• Fast speech
• Behavior becomes aggressive
• Frequent altercations
• Decreased sleep
• Use of drugs or alcohol
• Regular absence from work
• Frustration
• Reduced performance at work  

Signs and symptoms of distressing phase of bipolar disease:

• Sleep issues
• Tiredness
• Despair
• Difficulty in concentration
• Low appetite
• Felling cut out from the world
• Anxiety problems

Causes

The precise cause of bipolar disorder is still unknown. However, there are certain factors believed to be associated with the disease:

• Patients with bipolar disease tend to develop physical changes in the brain. How these changes happen and why they appear, is unsure.
• Unevenness in the brain chemicals plays an important role in causing bipolar disorder and other mood disorders.
• Hormonal imbalance is also attributed to bipolar disorder.
• Bipolar disorder is seen more in people who have inherited this disease from a sibling or parent. 

Risk Factors

Factors that may increase the development of bipolar disorder are:

• Someone in the relation carrying the bipolar disorder gene.
• Taking high levels of stress.
• Inadequate drug intake.
• Early age, especially early 20s. 

When to see a psychiatrist

When you start experiencing symptoms of depression, stress or hypomania, see your psychiatrist immediately. Bipolar disorder does not heal itself. Getting help from a medical service provider will do a great deal managing your symptoms.