FAQs on Mental Illness

Mental/psychiatric/psychological illnesses are health conditions that affects a person’s thoughts, emotions, behaviour causing disturbances in interpersonal relationships, and daily functioning. They are associated with subjective and objective distress.
It can range from mild to severe. Mild patients are in large number in society which are not identified and they suffer due to lack of treatment.
There are host of illnesses from very common phobia to schizophrenia. Depression panic disorder, OCD, bipolar disorder are other set of illness. Children have ADHD and autism etc. addictions are other host of psychiatric illness.

Only when there is impairment in day to day living, functioning, interpersonal relationship problem, social problem, or work problem or academic problem we diagnose them as psychiatric illness. Minor issues need to be seeking help of professionally qualified and trained psychologist for counselling.

Any one or other alone or in combination of others are early signs of possible illness.

  • Confused thinking
  • Long-lasting sadness or irritability
  • Extreme highs and lows in mood
  • Excessive fear, worrying, or anxiety
  • Social withdrawal
  • Dramatic changes in eating or sleeping habits
  • Strong feelings of anger
  • Delusions or hallucinations (seeing or hearing things that are not really there)
  • Increasing inability to cope with daily problems and activities
  • Thoughts of suicide
  • Denial of obvious problems
  • Many unexplained physical problems
  • Abuse of drugs and/or alcohol

Although the exact source of mental illness is not known, research points to a mix of genetic, biological, psycho-social, and environmental factors as being the root of most conditions.
One or other factor interact in some complex way to develop illness.

Consulting psychiatrist and talking freely with him helps. If issues can be worked out with counselling, he would definitely suggest so. Early diagnosis and treatment is crucial in recovery. Longer duration of untreated illness poorer is outcome.

We are specialised in allopathic medicine. Hence it is inappropriate from us to comment on other modalities of treatment. One should consult treating psychiatrist whenever patients want to seek alternative therapies. One with gross psychosis or severe depression with suicidal thoughts should start allopathic medications.

Medication, psychotherapy electroconvulsive therapy, rTMS, are different modalities of treatment available. It depends on diagnosis, comorbid problems and patient’s choice.

After detail history and assessment, they come to diagnosis of illness. After diagnosis, a suggested treatment plan is devised that might involve different therapy models.

Brain functioning is still mystery for neuroscientist. We are evolving in regards to treatment of psychiatrist illness. Fortunately, we have plenty of good medication available after 2000 in India. Most of psychiatric medication give good improvement by end of 4-6 weeks. Sometimes it takes long. some of patients do not respond to trial of different medication. So one needs to understand that psychiatric illness are more alike chronic illness like hypertension diabetes arthritis etc.

Any psychiatric illness is founded on pillars of temperament which is not possible to change. It is also difficult to radically change environment which is many time responsible for precipitating illness. beside we cannot make changes in genes which are often instrumental in developing illness. some personality traits maintain psychiatric illness. Leaned behaviour also plays role in maintaining some residual effect of psychiatric illness. With all these factors participating in illness, it becomes difficult for cure of illness. One or other factors will pull down person with illness leading to chronicity and partial success in treatment plan.

One needs to be cautious when assimilating information. many times psychiatric illness becomes chronic. relatives feel exhausted and burnout. They try to seek quick cure for these problem. World is full of people who take ADVANTAGE of such people. they claim to cure illness. Patients fall prey to such advertising and lose money, & time. Many times this leads to worsening of illness. Few authentic sites of information are mentioned here.

FAQs on Schizophrenia

Schizophrenia is chronic debilitating severe psychiatric illness which most of time needs medication. Hence we do not have substitute of medication. Counseling can be helpful if we continue medication.

Most of patient with schizophrenia can do normal function at work and at home with new medication. Earlier medication use to have severe side effect which hampered patients functioning.

Patient with schizophrenia can become violent only in certain acute conditions otherwise they are mostly stable with medication. Research have not suggested any increase in violence with of patient with schizophrenia.

Schizophrenia is a psychiatric illness with either abnormality in certain part of brain structure or chemicals in brain or functioning of brain parts or all or some of above. In fact, all psychiatric illness has some or other brain pathology.

Risk is 1 percent in the general population, having parent or sibling with schizophrenia increases the risk to 10 percent. The risk jumps to 50 percent if both parents have been diagnosed with schizophrenia. So it is not rational to think that if I have it my children will have it.

This is common misconception that marriage cures mental illness. In fact, it might worsen it. Marriage brings with it hosts of stressors which patient with schizophrenia will find it difficult to cope. Proper treatment planning, functional assessment, is must before marriage. Disclosing illness to other party is strongly recommended for proper care of patient in future.

Schizophrenia is severe psychiatric illness. Research have said that 20 percent patients don’t need long term treatment. They get cured. 60 percent need long term treatment. 20 percent do not respond to any treatment and they carry good amount of symptoms in spite of medication. Changing pathy either homeo or ayurvedic should be discussed with psychiatrist. Pros and cons of discontinuing antipsychotic medication should be discussed. Risk of flaring up of psychotic symptoms and later management should be planned. Choosing pathy is right of patient and family members but should be well informed and planned.

With advent of new medication hospitalisation is limited. Treatment is mostly community based.

FAQs on Electro-convulsive Therapy

Electroconvulsive therapy is a type of treatment in which we pass electric pulse through temple of brain for less than a second Under general anesthesia. It has shown to improve few of psychiatric illness.

Nobody knowns how Electro-convulsive therapy brings about improvement in psychiatric or psychological illness. May theories are floated to explain improvement but nothing is concretely established yet.

Severe depression, bipolar disorder mania and depression, active suicidal patients, non-cooperative/or violent schizophrenia patients. non responding schizophrenia.

Patient needs to undergo pre anesthetic blood investigation, ECG & if require fitness from physician. Patient are kept without food and water for 8 hrs. separate consent is taken for Electroconvulsive therapy.

Nothing is rules out in procedure but it is very rare that such event could happen.

The immediate side effects of the procedure may include:

  • Headaches, which are commonly relieved with medication.
  • Nausea
  • Muscle aches: These tend to occur in the first and second treatments and tend to resolve thereafter.
  • Disorientation and confusion: Some patients develop memory problems associated with ECT. Memories developed around the time of ECT have a greater chance of not being recalled while those formed long before ECT generally are not altered. The ability to form new memories can be impaired during and after an acute series of ECT treatments but this ability makes a full recovery in about 2 weeks from the last treatment.

IV is placed in the arm. the patient receives a brief-acting aesthetic, which puts the patient to sleep for approximately 5 minutes. A muscle relaxant is given shortly after the anaesthesia to loosen the patient’s muscles so that there are no motor convulsions during the therapeutic seizure. Patients are not awake for the actual seizure as they are under anaesthesia. The seizure itself tends to last 20 to 60 seconds. Patients wake up several minutes after the seizure stops. They stay until blood pressure and alertness have returned to normal, which usually takes about 20 minutes.
Patient can be gives sips of waters after 1hr. if patient do not have vomiting sensations, he can consume normal food.

An ECT session takes about 30 min. patient can move normally after one or two hrs.
Patient can be gives sips of waters after 1hr. if patient do not have vomiting sensations, he can consume normal food.

Generally, ECT is given three times a week for a total of eight to twelve sessions. Some patients may need more or fewer treatments.

False information is spread about ECT from movies and old methods of ECT. Movies shows ECT given to conscious patients many times in a day. Its dramatization make it look scary. It was once used by Nazis as experimental method for brainwashing. All these data make it look barbaric. current use of ECT is for therapeutic purpose under general anaesthesia. Beside electric pulse passed is for less than second as opposed to many minutes shown in movies. Standard international protocol of twice or thrice weekly is mostly adhered by all psychiatrist. pre aesthetic check-up and fasting make it one of safe alternative treatment for many patients.

FAQs on Depression

Everyone experiences a range of emotions over the course of days and weeks, typically varying based on events and circumstances. When disappointed, we usually feel sad. When we suffer a loss, we grieve. Normally these feelings ebb and flow. They respond to input and changes. By contrast, depression tends to feel heavy and constant. People who are depressed are less likely to be cheered, comforted or consoled. People who recover from depression often welcome the ability to feel normal sadness again, to have a “bad day,” as opposed to a leaden weight on their minds and souls every single day.

Of people diagnosed with major depressive disorder, who are treated and recover, at least half are likely to experience a recurrent episode sometime in their future. It may or may not be triggered by a life event. After several episodes of major depression, a psychiatrist may suggest long-term treatment.

It is individual choice to seek type of treatment. If already on antidepressant a detail discussion with mental health professional about this needs to done. Pros and cons of leaving antidepressant will be discussed. Tapering of antidepressant is advisable. Possibilities of early signs of relapse need to be understood. Pt with Severe depression is not advisable to seek alternative therapies.

Self-help books help us in recovering from depression but one needs to rationalise our expectation. One should not expect easy and quick fix solution from such books. Beside no single solution works for everyone. One can get good small ideas to implement from such books which help in long run. It should be part of treatment strategy and not whole treatment.

Psychotherapy is seen to be useful if done by professionally trained therapist. In India we have plenty of so-called counsellors doing talk therapy. In such situation u get what u mention above. If done by untrained it can sometimes be harmful. so be careful in choosing therapist. Good therapist will have assessment during first two session (most of time) with plan ready later. One needs to be patient with psychotherapy as it is slow but effective way to recover from depression. No quick fix in any form of treatment.

Many antidepressant medications have side effect. One needs to discuss with mental health professional about intolerable side effect. He will change medication to help u. sometimes one need to trade-off between side effect and efficacy.

Yes. Recent rise in depression among children is raising alarm among mental health professional. Irritability is more a presenting symptom rather than depressed mood. It leads to poor academic performance and future career underperformance.

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