In our daily packed schedule, we can see so many people under mental stress and tension. A doctor comes across several such cases in his daily practice. Even though they do not specifically visit the doctor for any psychological problem it is quite obvious that they need mental health counselling or medication. We have made an attempt here to educate such patients and their caretakers about these illnesses.
There are different categories of Mental illnesses
The mild one's which can be described as 'Stress' 'tension' 'problems' 'issues', for instance work related stress, irritability, sleeplessness, some fears (like fear of dogs, lizards etc.). In such minor problems the daily routine of a patient is not affected. He can bear the discomfort and complete his responsibilities.
where the patient's routine is affected. He lack in responsibilities and his relationships are affected.
A most common of this category is Depression. According to one study, in India at most of the people have suffered from depression in some phase of their lives. In depression patient feels sad and low, does not have the desire to do anything, loose his interest in daily activities or cannot derive any pleasure from those activities he normally enjoys doing. He feels tired and exhausted. He is unable to concentrate or pay attention to his work and may feel low in confidence and self-worth. He may also feel guilty for minor issues. Such patients become loners, cry frequently and talk negatively. Feels miserable about life. Sometimes they feel that life is not worth living and may think about suicide. They may be unable to sleep, or wakes up very early. They does not feel fresh or rested in the morning. They may loses their appetite.
These patients may have palpitations, trepidation, excessive sweating, cold sweating, tingling sensation, dryness of mouth, heaviness or pain in the chest, breathlessness or suffocation, feeling heavy or light headed, dizziness, may fear that they are going to die, feel nauseated or vomiting etc.
Such symptoms that trouble him throughout the day are known as Generalized Anxiety Disorder. If these symptoms appear suddenly for only a few minutes it is then called Panic Attack.
If this occurs in certain areas, certain situations or in the presence of certain people it is called Specific Phobia. Such fears can be related to closed spaces, crowds, stage fright, people of authority, animals, height or examinations.
In such cases the patient avoids those situations, avoids going to work, stops conversing suddenly, becomes confused and makes mistakes in whatever he does, cannot put across what he wants to say assertively, becomes lonely and as his illness progresses he stops going out altogether.
Some patients' have a decreased tolerance for day-to-day stresses or tensions or the stress is beyond their control. They are unable to alleviate their stress, cannot speak out openly or the situation is such that it becomes impossible for them to do anything about it. In such circumstances their subconscious mind expresses their discomfort in a different way. These patients usually experience different somatic. They may have frequent headache, back ache, gastrointestinal problems, body ache or restlessness and this continues to happen for many years. They undergo a lot of tests like ECG, X-rays, all kinds of blood tests but their condition is not diagnosed. Some patients have a strong belief that they are sick in some way and they themselves undergo various tests.
One of the illnesses of this kind is called as Conversion /Hysteria. This in simple words means an 'outburst of emotions and feelings'. In stressful or challenging situations such patient's subconscious mind express the problem as a physical problem. This stress can cause episodes of pseudo convulsions, breathlessness, unconsciousness, being unable to speak, inability to move limbs etc. But the important part to remember is that these patients do not pretend, or act out and they are quite powerless over such symptoms. They need proper counselling and medication.
These patients have repetitive thoughts or doubts like
These thoughts make them do the same thing again and again. They may check the lock repeatedly, wash his hands repeatedly, count the notes repeatedly, will pray to God repeatedly.
A common man may also get such thoughts but he has control over them. When the he loose the control over such thought and he faces several problems in life, if he may needs more time to complete the work or unable to move on to next task, if he gets into arguments with such thoughts then he needs treatment.
Lack of sex education leads to many misunderstandings amongst our Indian society. Due to inadequate knowledge about sex and a stressful lifestyle many males are victims of sexual problems. He have problems like inability to get erection or inability to sustain the erection or have difficulty while having a sexual intercourse. This causes dissatisfaction in their life. These troubles can be handled with proper guidance and if necessary, medication. (Click here for details)
Schizophrenia is major psychiatric illness. It leads to hallucinations in which patient hear voices which are not present or see people or images which are not there. They can become suspicious due to delusions (False and firm beliefs). Patient often feel that somebody wants to harm them, or planning against him, somebody is practising voodoo or black magic on him, people are talking about him or laughing at him. He may feel someone is trying to control him or feel that his spouse is having an extra-marital relationship with someone. These thoughts make the patient irritable, they get angry over trivial things and may also become aggressive. They can be seen muttering and making gestures to themselves. They may become withdrawn, stare at something continuously for long time, stop working or try to hide themselves.
As the illness progresses the patient neglects himself, neglect bathing, diet and personal hygiene. In advance stages some patients collect garbage or may maintain a posture like a statue for several hours.
This condition is exactly opposite to that of depression. The patient feels euphoric. He is animated, he has racing thoughts, flight of ideas or wants to start a new business. These stormy thoughts are seen when he talks because he speaks too much, and drifts away from the subject. Often the patient feels that he is somebody very influential or famous, talks big, he becomes authoritarian, indecent, overspends, abruptly sings or dances, will wear gaudy makeup and flashy clothes or too many ornaments. If somebody tries to stop or convince him against it, he becomes impatient irritable, aggressive or assaultive and also finds it difficult to sleep.
These patients suffer from depression or mania at intervals.
There are many types of addictions. Some of the mostly used ones are alcohol, tobacco, cigarette, cannabis, bhang, hashish, caffeine and heroine. The user never realizes when his experimental use becomes an addiction. It becomes impossible to live without it. It becomes a daily compulsion, there is loss of control, and he is unable to stop even if he tries to. In order to experience the same high, he has to keep on increasing his quantity of use. He starts disregarding his hobbies. In spite of knowing the extent of his losses he cannot stop. As the disease affects the patient it also starts affecting his functioning. He avoids his personal, family and social responsibilities. When he starts neglecting his responsibilities it means that he has the disease of addiction.
Alcohol hijacks the brain of an alcoholic. It is dangerous for such a patient to stop drinking suddenly without consulting a doctor. His brain becomes hyperactive if alcohol is withdrawn suddenly. He has tremors, he goes into delirium, he hallucinates and may see animals, insects, snakes or people which are not there. He is very afraid and misinterprets things. In this state he may harm himself or others. Hyperactivity of brain can induce 'fits'.
In case of other addictions similar type of withdrawals can be seen. That is why it is always advisable to consult a doctor when you want to stop substance use. (Click here for details)
Milder forms of children's illnesses consist of enuresis (passing urine in his bed while sleeping), irritability, cannot concentrate on studies, forget fulness, stammering, lisping, becoming very stubborn, fear of exams, biting nails, loss of sleep or inability to write. The major forms of illnesses are convulsions, hyperactivity, missing words or syllables while reading, inability to recognize letters, cannot learn maths and are unable to write too. If these complaints are treated timely, children can be saved from facing problems later on in life.
Old people suffer more from depression. Similarly, they suffer from dementia as a result of changes in the brain. Dementia causes memory problems and as a result they cannot remember things like who has met them, names of their relatives, whether they have had lunch or any meal, forget about having taken tablets, cannot find their things etc. This makes them irritable, suspicious, and they start feeling that somebody has stolen their things or have simply hidden them. This condition progresses with age and after a few months or years he forgets the way home, defecates or urinates anywhere and he may get lost if he goes out alone. As the disease progresses he may hallucinate or become deluded. If treated at an early stage, it is possible to slow the progression and reduce behavioural problems.
The common people or some educated people and even some doctors believe that psychiatrists only prescribe sleeping tablets and keep the patient sedated.
This is a myth. Our brain processes thoughts and perceptions with the help of various chemicals. Imbalance in these chemicals cause mental illnesses.
Observing the patient’s behaviour, speech and a history from the relatives enables the psychiatrist to know which chemical has decreased or increased in which part of the brain. Eg. an increase in dopamine causes auditory or visual hallucinations, misunderstandings or delusions. A drop in the level of serotonin causes depression and thus the proper medication is prescribed. The important thing to remember is that most of these medicines induce drowsiness and sleep. But all medicines do not cause sleep and if the patient is very drowsy, the medication can be changed accordingly by the psychiatrist.
Another myth is that psychiatric medicines can be addictive. We must remember that just as deficiency of insulin is compensated by tablets or injections, psychiatric medicines too are necessary to balance the chemicals in the brain. If thirsty we drink water but we do not claim that we have become addicted to water because of the simple reason that our body needs it. Sometimes symptoms of the illness are not visible for a while if medicines are stopped, but this burdens the brain and the illness might become even more severe than it is presently.
There is one more myth that medicines can never be stopped and the patient can never be cured.
This is only a half truth. If the patient is diagnosed at an early stage and treated regularly and properly he can recover to a great extent and his medicines too can be withdrawn.
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