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Treatment & Management of Stress
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My ejaculation takes place each time before the orgasm of my female partner. This leads to anxiety as if I can't satisfy her. What will I do?
Hello Dr. My concern is that lack of Vitamin D is causes for weight gain and thyroid is it true cause I have epilepsy since two years and I continuously gaining weight.
Hi, My little brother his age is 15 and hight is 5.3 ft he has a problem in memory he work very heard on his studies he get up at 4 am for his studies bt after sometimes hi forgot the answers which he related he is in 9th standard he is very disappointment and he always think that hi can not do any thing in his life and he has also a problem in eye vision his eyes numbers in (--) please help what to do for boosting his memory power or vision too please please help.
I am a sugar patient. I don't have any bad habits, other than smoking! What will be my body condition, if I continue smoking.
How does stress cause heart diseases to human? I want to know the details thereof to avoid chronic anxiety.
I have depression anxiety cholesterol hiatal hernia acidity. Im really getting tension about this. please suggest a treatment for me.
We are parents to a 14 year old daughter and 11 year old son. I am in a transferable job and the family moves with me. Our daughter started her periods when she was 9.5 years.It was the time that she stated being physically abusive towards her mother without any reason or remorse. In the last 3-4 years her behavior towards her parents, sibling has worsened. In our last relocation 3 years back, she had problems in making friends at school for which we sought professional counselling, got her enrolled in sports and things were a little better for a few days.We also took homeopathic treatment to treat the aggression in her. One day we learnt that she has infatuation for a 17 year old boy at the sports academy. The boy was suggesting sexual advances towards her as we could gather from her personal diary. We could intervene and resolve the issue. We have also been meeting the school counseller off and on. During this time she was making use of the mobile phone which we had kept for use at home ( in place for the regular landline). Last year she pestered and forced her to buy her a smartphone.Our problems aggravated manifold after we bought the smartphone. Her attention towards her studies nosedived despite taking extra tuitions. She would throw her clothes, towels etc on floor after use and listen to music on the cell all the time.Her sleep wake cycle is also abnormal. She would get up at 12 PM on holidays. For last 6 months she is friends with a 17 year old boy of her school and has been chatting with him on FB/whattsapp. The boy is making sexual advances towards her while in the school( as we could understand from her phone). We were called one day in the school to inform that she has been bunking her classes. All this while we have been very supportive /sympathetic towards our child. The teachers have suggested that we take the smartphone back from her. But her behavior is so violent and abnormal that we do not know to head in which direction.
People who suffer from severe, chronic back pain know how it can utterly disrupt and damage one's life. Chronic back pain can be cruel-making it hard to enjoy even the simplest daily activities, and certainly making it a challenge to carry out an exercise routine and other healthy activities. Moreover, chronic pain was not previously all that well understood. The medical profession used to believe that pain is always a manifestation of an underlying injury or disease. As such, doctors focused on treating the underlying cause of the pain, with the belief that once the injury or disease was cured the chronic pain would then disappear.
If no underlying cause could be found for the pain, then the patient was told that very few treatments are available, or worse, 'the pain must be in your head'. Unfortunately, some doctors still practice in this manner, having no appreciation for the unique problem of chronic pain, newer theories about chronic pain, and the many factors that influence a chronic pain problem.
The medical community is starting to understand that if pain is no longer a function of a healthy nervous system (signaling that there is a disease or underlying injury), then the chronic pain itself becomes the problem and needs to be treated as the primary pathology.
The Experience of Chronic Pain
Contrary to popular belief, all pain is real. This may seem like an obvious statement, but people with chronic pain are sometimes treated as if their chronic pain is either imaginary or exaggerated. In some cases, they feel like they have to prove their chronic pain to their friends, family, and doctors. Some patients are told by their doctor that there is no reason for the chronic pain and therefore 'it cannot be that bad'.
Chronic pain is a personal experience and cannot be measured like other problems in medicine, such as a broken leg or an infection. For instance, a broken leg can be confirmed by an X-ray and an infection by a blood test measuring white blood cell count. Unfortunately, there is no medical test to measure chronic pain levels.
To make matters more challenging for the patient, for many chronic pain problems, there is no objective evidence or physical findings to explain the pain. Thus, many chronic pain sufferers go from one doctor to the next searching for explanations. This process can lead to unnecessary evaluations and treatments, in addition to putting the patient at risk for actually being harmed or made worse by the healthcare profession.
Everyone experiences and expresses pain differently. Two people with the exact same injury will feel and show their pain in unique ways depending on a number of things such as:
- The situation in which the pain occurs
- Thoughts about the chronic pain, such as 'this is nothing serious' versus 'this pain could kill me'
- Emotions associated with the chronic pain, such as depression and anxiety versus hopefulness and optimism
- Cultural influences determining whether a person is to be more stoic or more dramatic in showing pain to others
The newest theories of chronic pain can now explain, on a physiological level, how and why people experience pain differently.
Types of Back Pain: Acute Pain, Chronic Pain, and Neuropathic Pain
Understanding how pain is defined is important in order to learn how to better control it. For the purposes of research and medical practice, pain can be separated into three categories:
One common type of pain is acute pain, currently defined as pain lasting less than 3 to 6 months, or pain that is directly related to tissue damage. This is the kind of pain that is experienced from a paper cut or needle prick. Other examples of acute pain include:
- Touching a hot stove or iron. This pain will cause a fast, immediate, intense pain with an almost simultaneous withdrawal of the body part that is being burned. More of an aching pain might be experiencing a few seconds after the initial pain and withdrawal.
- Smashing one's finger with a hammer. This pain is similar to that of touching a hot stove in that there is an immediate pain, withdrawal and then 'slower' aching pain.
- Labor pains. The pain during childbirth is acute and the cause is certainly identifiable.
The longer pain goes on the more susceptible it is to other influences and developing into a chronic pain problem. These influences include such things as the ongoing pain signal input to the nervous system even without tissue damage, lack of exercise (physical deconditioning), a person's thoughts about the pain, as well as emotional states such as depression and anxiety.
There are at least two different types of chronic pain problems - chronic pain due to an identifiable pain generator (e.g. an injury), and chronic pain with no identifiable pain generator (e.g. the injury has healed).
Chronic pain due to an identifiable pain generator
This type of chronic pain is due to a clearly identifiable cause. Certain structural spine conditions (for example, degenerative disc disease,spinal stenosis and spondylolisthesis can cause ongoing pain until successfully treated. These conditions are due to a diagnosable anatomical problem.
If the pain caused by these types of conditions has not subsided after a few weeks or months of conservative (nonoperative) treatments, then spine surgery may usually be considered as a treatment option.
Chronic pain with no identifiable pain generator
This type of pain continues beyond the point of tissue healing and there is no clearly identifiable pain generator that explains the pain. It is often termed 'chronic benign pain'.
It appears that pain can set up a pathway in the nervous system and, in some cases, this becomes the problem in and of itself. In chronic pain, the nervous system may be sending a pain signal even though there is no ongoing tissue damage. The nervous system itself misfires and creates the pain. In such cases, the pain is the disease rather than a symptom of an injury.
The term 'chronic pain' is generally used to describe the pain that lasts more than three to six months, or beyond the point of tissue healing. Chronic pain is usually less directly related to identifiable tissue damage and structural problems. Examples of chronic pain are: chronic back pain without a clearly determined cause, failed back surgery syndrome (continued pain after the surgery has completed healed), and fibromyalgia.
Chronic pain is influenced by many factors, such as ongoing pain signal input to the nervous system even without tissue damage, physical deconditioning due to lack of exercise, a person's thoughts about the pain, as well as emotional states such as depression and anxiety. Chronic pain is much less well understood than acute pain.
Neuropathic pain has only been investigated relatively recently. In most types of neuropathic pain, all signs of the original injury are usually gone and the pain that one feels is unrelated to an observable injury or condition. With this type of pain, certain nerves continue to send pain messages to the brain even though there is no ongoing tissue damage.
Neuropathic pain (also called nerve pain or neuropathy) is very different from pain caused by an underlying injury. While it is not completely understood, it is thought that injury to the sensory or motor nerves in the peripheral nervous system can potentially cause neuropathy. Neuropathic pain could be placed in the chronic pain category but it has a different feel then the chronic pain of a musculoskeletal nature.
The neuropathic pain feels different than musculoskeletal pain and is often described with the following terms: severe, sharp, lancinating, lightning-like, stabbing, burning, cold, and/or ongoing numbness, tingling or weakness. It may be felt traveling along the nerve path from the spine down to the arms/hands or legs/feet. It's important to understand neuropathic pain because it has very different treatment options from other types of back pain. For example, opioids (such as morphine) and NSAID (such as ibuprofen, COX-2 inhibitors) are usually not effective in relieving neuropathic pain. Treatments for neuropathic pain include certain medications, nerve 'block' injections, and a variety of interventions generally used for chronic pain.
When Acute Pain Becomes Chronic Pain
It is critical for a doctor and a patient to have an understanding of the difference between acute pain and chronic pain. With acute pain, the pain is a symptom of injured or diseased tissue. When the injury has finished healing, the correlating pain will subside. For example, with a herniated disc, once the pressure on the nerve is alleviated the acute pain stops. For this reason, medical treatment for acute pain focuses on healing the underlying cause of the pain.
Additionally, with acute pain, the severity of pain directly correlates to the level of tissue damage. This provides us with a protective reflex, such as to stop an activity when it causes pain. However, chronic pain does not serve a protective or other biological function. Treatments will be different depending on the underlying cause of the pain.
Chronic Pain Development
Not all pain that persists will turn into chronic pain. Different people experience chronic pain very differently. Likewise, the effectiveness of a particular treatment for chronic pain will often differ from person to person. For example, a particular medication or injection for a herniated disc may provide effective pain relief for some people but not for others.
One problem is that not all patients with similar conditions develop chronic pain, and it is not understood why some people will develop chronic pain. Also, a condition that appears relatively minor can lead to severe chronic pain, and a serious condition can be barely painful at all.
As pain moves from the acute phase to the chronic stage, influences of factors other than tissue damage and injury come more into play and influences other than tissue input become more important as the pain becomes more chronic.
Pain medicine and pain management as a medical specialty is relatively new. However, now that chronic pain is becoming recognized as a primary problem, rather than always being a symptom of a disease, the specialty of pain management is starting to grow.
Hlo sir next month my exam I want to study in night night but I cannot concentration on my study and I get bore very easily I want to take sleep how I can reduce my habits.
My grand mother is suffering from Parkinson but the bigger problem is that she gets fainted when she walks or sits. Is there any thing by which she can walk properly or even sit properly. Her age is about 75 years. She has problem of even getting up from bed.
A particularly stressful situation or event that has created terror or been overly dramatic or dangerous can lead to stress and anxiety long after the individual has physically come out of the situation. This kind of a traumatic condition is usually what characterises Post Traumatic Stress Disorder (PTSD).
In simple words, PTSD is a neurological disorder which affects individuals after experiencing severe traumatic situations.
Symptoms of PTSD:
- Mood symptoms: Mood swings are the most common outcome of these symptoms. The patient may experience a complete lack of enthusiasm and drive to indulge in activities like hobbies and socialising. Also, the patient may end up harbouring feelings of negativity towards family, friends and strangers, besides going through phases of guilt and self blame for the occurrence of the traumatic event.
- Re-experiencing symptoms: These symptoms include flashbacks and life like re-imagination in the form of dreams and nightmares. In many cases, the patient may remember and re-experience the entire scene or series of events that have led to the trauma in the first place. This can be triggered by a memory or association with words, events and other such things that have to do with the memory of the traumatic episode.
- Arousal symptoms: Arousal or reactivity symptoms may trigger the same reactions that the person showed during the traumatic experience. These may include being on edge constantly in anticipation of a reoccurrence, or even getting startled by the slightest thing since the mind is already occupied with thoughts of the event, constantly. Anger and emotional outbursts may also be caused due to these symptoms.
- Avoidance or rumination: Those suffering from PTSD avoid being reminded of the trauma, such as people, situations or circumstances associated with the event. They try to suppress memories associated with the event.- Many others ruminate excessively and prevent themselves from coming to terms with it.
Treatment for PTSD:
Mindfulness meditation (not a treatment option) helps in recognizing cognitive dissonances and affected thought patterns and aids in recognizing and overcoming their influence. Other therapies, including Cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are also done depending on the patient's condition.
How do medications help regulate these responses?
The medications prescribed for treating PTSD symptoms act upon neurotransmitters related to the fear and anxiety circuitry of the brain including serotonin, norepinephrine, gamma-aminobutyric acid (GABA), excitatory amino acids. There is great interest in developing agents with novel and more specific mechanisms of action than are currently available to target the PTSD symptoms described earlier while also minimizing potential side effects.
Studies show that a number of medications are helpful in minimizing PTSD symptoms. Most of the time, medications do not entirely eliminate symptoms but provide symptom reduction and could be more effective when used in conjunction with an ongoing program of trauma specific psychotherapy for patients.
Several types of medications can help improve symptoms of PTSD:
- Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
- Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
- Prazosin. If symptoms include insomnia with recurrent nightmares, a drug called prazosin (Minipress) may help. Although not specifically FDA approved for PTSD treatment, prazosin may reduce or suppress nightmares in many people with PTSD.
You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks. If you wish to discuss about any specific problem, you can consult a psychiatrist.