Dr. Sudhir Hebbar

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, depressionand 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.

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.

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.

Delusional disorder refers to the condition in which an individual experiences non-bizarre delusions that are beliefs in things that aren't actually true. The delusions involve situations that take place in real life like being deceived or stalked, conspired against, etc but in actuality, these situations may be highly exaggerated or not true at all as they involve the misinterpretation of experiences or observations. This health problem tends to take place during the middle or later part of your life and is said to affect women more than men.

What are the symptoms associated with this condition?

There are certain signs that you can look out for to easily identify this condition and there are:

1. Delusional thoughts lasting one month and above
2. Lack of schizophrenia symptoms except delusions associated with the olfactory and tactile systems
3. One's behavior and normal functioning doesn't witness any kind of impairment
4. Duration of mood symptoms is short compared to the length of the delusions
5. Disorder is not brought on by the use of substances or any medical condition
6. Commencement of the disorder can vary from teenage years to later part of adulthood

What causes it to happen?
The root cause of the disorder is still not known, but experts are of the opinion that a variety of biological, genetic, environmental and psychological factors can cause it to occur. 

Some of these causes include: 

• Genetics: It's said that this disorder can be passed on from parents to children. Additionally, it's more common in individuals whose family members suffer from schizophrenia or one of its types.
• Psychological/ environmental: In addition to drug and alcohol abuse, delusional disorder can also be set off by stress.
• Biological: Abnormalities in certain parts of the brain can lead to this problem. Areas of brain associated with thinking and perception have been found to be connected to delusional symptoms.