Dr. Safiya M S

Psychiatric disorders like bipolar disorder or schizophrenia do not appear all of a sudden. There are small changes that happen to an individual over a long period of time until the disease fully develops. These signs and symptoms might be too subtle in the early stage for other people to notice until they become obvious. But an early detection of any irregularity proves to be more beneficial for the patient in the long run.

It is important to know the telltale symptoms of mental disorder to distinguish between what is regular and what is not.

1. Withdrawal: Everyone needs some quiet time to cool off and relax but if a person continuously withdraws him/herself from social occasions and avoids meeting or speaking to friends, it could be a sign that something is wrong. Losing interest in life, work and people are symptoms of depression and psychotic disorder.
2. Thinking problems: Having trouble concentrating, remembering, understanding and explaining oneself in a coherent manner are some common signs of mental disorder.
3. Anxiety: Excessive stress and anxious behavior for a prolonged period are not normal. Frequent heart palpitations, headache, shortness of breath, racing mind and restlessness are cries of help that need to be heard.
4. Emotional outbursts: Sudden dramatic outbursts for no apparent reason, frequent mood swings and feeling distressed are potent signs of mental illnesses. These kinds of behavior are seen as part of a person's nature and so they are often unnoticed.
5. Changes in appetite and sleeping patterns: Oversleeping may be a sign of depression and insomnia could be a sign of anxiety. Changes in appetite and not caring about oneself or the world are indicators of a mental problem.

In case you have a concern or query you can always consult an expert & get answers to your questions!

In India, crimes against women have been on the rise; they might have always happened at the same rate but today's media have become more attentive towards these crimes by bringing them to the forefront. Recently, the devastating news of an Assamese higher secondary student being raped and killed has surfaced. Her floating decomposed body was not discovered until 4th of May when the incident itself occurred on 28th of April. If a rape victim dies, it is the most unfortunate consequence that the parents and the loved ones have to live with but there are numerous victims who survive and they can lead a normal life with guidance and care. Any occurrence of sexual assault not only leaves scars on the outside but also have deeper psychological and emotional effects. The emotional scars can manifest in the form of post-traumatic disorder, depression and suicidal tendencies. If you know anyone who has undergone such an experience, then read on to find out how you can help her get back to her life.

• Medical Examination: Physical effects of rape can be adverse on the victim. Forced sexual assault causes bruising, wounds and vaginal bleeding and immediate medical attention is required to ensure safety. Subsequent medical tests should also be carried out to check for Urinary Tract infection, Sexually transmitted diseases (STDs) and uterine fibroids.
• Therapy: Wounds of the flesh heal, but it takes a lot of time to recover from emotional damage and in some cases the survivors bear the burden of psychological scars all through their lives. They may see the incident as an assault to their souls and develop depression, post-traumatic disorder, borderline personality disorder, sleeping and eating disorder. The loved ones have to be understanding and be patient with them. One-on-one therapy or group therapy sessions can be very helpful. Talking about their emotions and resolving issues of anger, regret, pain, fear, guilt in a friendly, supported and understanding environment can help them reconstruct their self-image.
• Counseling: Guilt and shame are two most common stigmas that most survivors have to deal with. They somehow blame themselves for the incident and regret any step they think that might have led to the incident. They become so consumed by the incident that they think the experience defines them, instead of their persona which is called dissociative identity disorder. In such cases counseling sessions can prove to be very beneficial. They need guidance to understand the situation and separate themselves from the incident. The survivors may feel weak and victimized, overpowered and violated; they may also think that they have lost control of their bodies. Counseling can assist to resolve such issues and help them empower themselves with time.

It is important to make the survivors realize that it is not the end of their lives. With a positive attitude, proper rehabilitation and counseling rape survivors can lead a normal, happy life.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Attention Deficit Disorder or ADD is a behavioral disorder that comprises impulsive behavior, inattentiveness and hyperactivity. This disorder tends to affect children more commonly, but the symptoms tend to disappear as one ages.

There are a number of symptoms for this disorder:

1. Concentration problems: People affected by this disorder have problems in staying focused on routine tasks. You may have problems in listening to conversations, get distracted easily, overlook various important things and have trouble remembering various things.
2. Being disorganized and forgetting things: You may exhibit symptoms such as having an extremely cluttered desk. You may also experience difficulties in completing projects and forgetting appointments. You may also lose track of time while doing important things.
3. Emotional problems: Various emotional problems such as mood swings, hypersensitivity to criticism, problems in staying motivated and having low self-esteem are common signs of ADD. The disorder may also lead you to be extremely short tempered and be constantly frustrated.
4. Hyperactivity: This symptom causes you to remain constantly agitated, unable to focus due to a racing mind, fidgeting constantly and talking excessively.
5. Impulsivity: You will exhibit impulsive behavior such as not being able to exercise self-control, blurting out inappropriate comments and have certain addictive tendencies.

Attention Deficit Disorder can cause various problems in your life. Most of these are related to the following domains:

1. Work related problems: You may constantly feel a sense of underachievement and will unable to meet your work responsibilities. You may be unable to meet deadlines, and face problems in filing paperwork.
2. Relationship problems: This disorder takes a toll on your relationships such as it can create a rift between you and your family. They may feel that you are not sensitive to their concerns.
3. Mental health problems: You may face various mental health problems such as drug abuse, anxiety, self-esteem issues and chronic stress.

Remedies for this disorder are:

1. Get proper sleep: You should always aim to sleep for at least 6 hours every day. If you are well rested, then you will be more energetic and stress free.
2. Regular exercise: You should exercise on a regular basis to keep yourself fit and healthy. It can also help you avoid problems such as obesity.
3. Improve your relationships: You should schedule time for your loved ones and engage with them. It may contribute to your overall mental well-being.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Body dysmorphic disorder is a type of psychiatric disorder. It is when you cannot think about one or more defects or flaws in your appearance. These flaws are usually very minor and sometimes even unnoticeable.  This is actually a much more serious disorder than many other people may think. This is because people with body dysmorphic disease may avoid many situations and also suffer from severe anxiety or shame. Here is everything you need to know about body dysmorphic disease.

Causes
Just like other psychiatric disorders, there is no known cause of body dysmorphic disease. However, there are a lot of factors, which increases your risk of developing it which include:

1. Brain disorders: Many people with abnormal brain chemistry disorders suffer from body dysmorphic disease. 
2. Genes: People whose blood relatives have this disease or have obsessive compulsive disorder are more likely to develop this disorder as well. 
3. Environment: Cultural and social influences are a major cause of body dysmorphic disorder as well.

Symptoms
There are, however a lot of symptoms of body dysmorphic disorder, most of which are psychological in nature. They include: 

1. Having a preoccupation with a flaw in the body, which is very minor or perhaps even unnoticeable.
2. Beliefs that people are mocking you in relation to your flaw.
3. Being a perfectionist

It is also worth noting that this obsession can affect any part of the body and can also include several parts of the body or different parts of the body at different times. Here are the possible treatments of body dysmorphic disorder.

Treatments
There are a variety of treatments, which a patient can opt for and a variety of methods of curing the problem. Here are the most common.
1.   Cognitive behavioral therapy: This is when a therapist tries to stop you from thinking about the flaw that you have been focusing on way too much. 
2.   SSRI: SSRI stands for Selective Serotonin Reuptake Inhibitors. They are given in cases, where body dysmorphic disorder is caused by problems related to the brain chemical serotonin. 
3.   Hospitalization: This is a severe measure, but may need to be taken if you are in danger of harming somebody or you cannot perform daily activities. Consult an Expert & get answers to your questions!

Previously known as multiple personality disorder or simply split personality disorder, dissociative identity disorder is a very serious and unpleasant form of dissociation. It is based on the lack of connection, or rather a discontinuity in thought, action, feeling, memory or even a misplaced sense of identity. It is usually considered to be a result of severe traumatic experiences in early childhood, varying from extremely physical to repeated emotional or sexual abuse. It is thought to be a self-defense mechanism where the person dissociates himself from any such experience or situation that would deem to be harmful to his or her conscious self. It is, however, not to be confused with schizophrenia.

Symptoms

There are innumerable indicators that point towards dissociative identity disorder. Some of them include:

1. Severe depression
2. Sleeping problems such as insomnia or sleep apnea
3. Alcohol or drug abuse
4. Anxiety attacks and phobias
5. Suicidal tendencies
6. Abnormal rituals and compulsions
7. Visual or auditory hallucinations
8. Self-persecution and self-sabotage tendencies
9. Time-loss and amnesia
10. Mood swings
11. Headaches and migraines
12. Inability to remember important personal information
13. 'Switching' of identities

Causes

The main causes of split personality disorder are unfortunately still unclear and vague, although 99% of persons who suffer from this disorder have a severe traumatic history or background. The causes need not be physical or sexual abuse. It could also stem from emotional abuse like insistent neglect. Studies have also showed that children may become dissociative, if their parents are either too strict or unpredictable. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Serious mental disorders and side effects to varied medicines may cause hallucinations in many individuals. Psychosis and Schizophrenia are the most commonly known causes that may cause this condition. Hallucinations are sensations and feelings that may appear as real to the patient, convincing him or her of the occurrence of things that are not really happening in reality. Hearing voices, seeing people, and experiencing things that no one else can, are some of the ways in which hallucinations work.

Let us find out the varied signs and symptoms of this condition.

1. Hearing voices: One of the most common signs of hallucinations includes hearing voices. You may hear voices from people who cannot be seen or heard by other people around you. In such cases, you may have the distinct feeling of hearing these voices from within or from a source outside your own mind and body. In many cases, you may feel like these voices are trying to talk to you or give you a certain message. Ringing of the ears on a persistent basis may also be experienced in such cases.

2. Visual hallucinations: These hallucinations will make the patient see things. In such cases, the patient may be witness to a scene that cannot be seen by anyone else – a scene that may not be happening in reality. In visual hallucinations, the patient may also see people that other people in the room or the area cannot see. The patient may also see objects and other creatures like insects crawling across his or her hand, and may react with fear or anxiety, when in reality, no such scene may be happening. These kind of hallucinations also cause occipital seizures where the patient will see spots, shapes and rings of brightly coloured lights that may be coming towards him or her, or even encircle him or her.

3. Feeling things: These kinds of hallucinations will make the patient feel things that may not really be happening. For example, these hallucinations will make the patient feel hot during winters or feel a blast of air even when there has been none.

4. Taste hallucinations: In these hallucinations, the patient may get a salty taste from sweet food, or vice versa. These hallucinations make the patient imagine that he or she tastes a certain flavor when in reality, this may not be true. These are also called gustatory hallucination.

5. Olfactory hallucinations: These hallucinations have to do with odd smells that the patient may get a whiff of. In these hallucinations, the patient imagines certain smells like burning, or other odours. Patients may also feel that their own bodies are letting out certain odours which may not be the actual case.  

Delusion vs. Hallucination

A delusion is a false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith).

A hallucination occurs when environmental, emotional, or physical factors such as stress, medication, extreme fatigue, or mental illness cause the mechanism within the brain that helps to distinguish conscious perceptions from internal, memory-based perceptions to misfire. As a result, hallucinations occur during periods of consciousness. They can appear in the form of visions, voices or sounds, tactile feelings (known as haptic hallucinations), smells, or tastes.

Delusions are a common symptom of several mood and personality-related mental illnesses, including schizoaffective disorder, schizophrenia, shared psychotic disorder, major depressive disorder, and bipolar disorder. They are also the major feature of delusional disorder. Individuals with delusional disorder suffer from long-term, complex delusions that fall into one of six categories: persecutory, grandiose, jealousy, erotomanic, somatic, or mixed. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Forensic psychiatry is generally identified as a specialized offshoot of psychiatry, dealing with the calculated treatment and evaluation of mentally disordered offenders in secure hospitals, prisons and in the community. This branch of psychiatry requires an indepth understanding and thorough knowledge of the connection between legality and mental health. 

Patients of Forensic Psychiatry, generally are affected with personality dysfunctions, mental illness, psychopathic disorders, organic brain damage, learning disability and other conditions, such as histories of abuse and traumatic experiences as well as substance abuse and misuse.

Nature of the work
The most important prerequisite of this branch of psychiatry is a secure and safe environment where the subjects are liable to legal restrictions. Evaluation and assessment may vary from highly secured hospitals and prisons to low secure units and community based services. Forensic psychiatrists must have a thorough knowledge of civil, criminal and case law because of their frequent dealings with criminal justice agencies and the courts. 

An important component of Forensic Psychiatry is risk assessment and evaluation. Forensic psychiatrists must be fluent and adept at handling patients during emergencies or routine situations. Moreover, they should be calm, composed and professional in their dealings, especially with patients who display instability or violent and aggressive behavior.

The probation service, the prison service and the courts generally rely on forensic psychiatrists for expert advice, precisely because of their familiarity with preparing reports for mental health review tribunals and criminal justice agencies.

Imperatives: 

1. Quintessentially, the obligatory role of a forensic psychiatrist requires:
2. Ability to treat others with understanding and respect
3. Ability to work flexibly
4. Emotional resilience along with the ability to empathize with patients
5. Anticipation and an inherent initiative to work in challenging situations
6. Good communication skills
7. A scientific and analytic approach and assessment
8. Good leadership qualities

If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Nicotine addiction or tobacco addiction refers to an acute dependence upon tobacco products primarily due to the presence of the nicotine drug. In other words, nicotine addiction refers to an inability to stop using tobacco products despite the knowledge and awareness that it is harmful to you. While nicotine only induces addiction, it is the presence of other substances in tobacco which makes it damaging and injurious to health.

Nicotine has the tendency to produce effects in the brain, both physical as well as mind altering, that give temporary satisfaction. This is precisely why people get hooked into the habit of tobacco consumption, which eventually leads to addiction. Unfortunately, stopping tobacco use immediately can also lead to several withdrawal symptoms, like agitation and restlessness.

Causes
The main reason why tobacco is so addictive is due to the fact that nicotine releases neurotransmitters such as dopamine in the reward centre of the brain, which in turn improves your mood and gives you temporary pleasure.

Causes of nicotine addiction can either be physical or behavioral, for instance situations or feelings, which make you crave for tobacco. These include:

1. Specific times during the day, say after every meal or during breaks at work
2. While defecating
3. While drinking alcohol
4. Stressful or depressive situations
5. At the sight or smell of a burning cigarette
6. Peer pressure
7. While driving

Symptoms
Symptoms of nicotine addiction include:

1. You are unable to quit smoking despite frequent attempts.
2. You experience withdrawal symptoms after attempting to quit.
3. You continue to smoke despite the awareness that it is injurious to your health.
4. You forego social as well as recreational activities because of your need to smoke. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Bipolar disorder is also known as manic depression. This usually sets in low and high moods in a person along with changes in energy and sleep.

People with bipolar disorder tend to have periodical changes; sometimes they are over happy and other times they might feel sad, depressed and hopeless. Between these changes they are normal. The highs and lows are considered as extreme poles of moods, thus the name bipolar disorder.

Manic term is used when a person with bipolar disorder is highly excited and feels confident. Also, feelings of irritability and recklessness along with irrationality might occur. Some people with mania might have a hallucinations that is they see and hear things that are not there, along with delusions.

The term hypomania is used to describe mild symptoms of mania, in which a person does not have hallucinations and delusions and the symptoms do not interfere with their daily life. Similarly, the term depressive is used to describe a person's time when they feel depressed or sad.

Symptoms of Bipolar Disorder

• The highs and lows in a bipolar disorder do not follow any set pattern. One might feel manic or depressed for hours or days or weeks, months and even years together, before they actually switch to a happy mood. The severity depends from person to person and also changes with time by becoming less or more severe.
• Symptoms of mania or the high are extreme excitement, change from being happy to angry and irritable along with restlessness, speech is rapid with low concentration, less sleep and increased energy, grand plans, alcohol and drug abuse and impulsiveness.
• Symptoms of low or depressive phase are lethargy, worthlessness, feeling of sadness and hopelessness, lowered concentration, irritability, loss of sleep or excessive sleeping, loss of appetite and suicidal tendencies.

Diagnosis of Bipolar Disorder

• In case someone exhibits symptoms of bipolar disorder, then talking to a psychiatrist or a doctor helps. Doctors ask questions related to the mental illness and the associated concerns. Diagnosis is basically recognizing the symptoms of the person, whether they are due to some underlying cause or mood swings because of excessive alcohol. The symptoms have to be noted and the duration, for which they last along with the severity should all be noted. The most obvious symptoms are that of lows and highs in mood and changes in behavior, energy, sleep and thoughts.
• Consulting a doctor or talking to family and friends helps to differentiate the symptoms of bipolar disorder from unipolar disorder.

Treatment

• Medicines that have mood stabilizers, such as lamotrigine, valproate, lithium, carbamazepine and antipsychotics such as olanzapine, quetiapine should be taken. Psychotherapy is also recommended.