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Dr. Thiru Vikraman S

Psychiatrist, Chennai

500 at clinic
Dr. Thiru Vikraman S Psychiatrist, Chennai
500 at clinic
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I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage....more
I want all my patients to be informed and knowledgeable about their health care, from treatment plans and services, to insurance coverage.
More about Dr. Thiru Vikraman S
Dr. Thiru Vikraman S is a popular Psychiatrist in Tambaram, Chennai. You can meet Dr. Thiru Vikraman S personally at Cosh Multispeciality Clinic in Tambaram, Chennai. Book an appointment online with Dr. Thiru Vikraman S on Lybrate.com.

Lybrate.com has an excellent community of Psychiatrists in India. You will find Psychiatrists with more than 34 years of experience on Lybrate.com. You can find Psychiatrists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.

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Cosh Multispeciality Clinic

#9, Duraiswamy Nagar, IAF Road,East Tambaram, Landmark : Near Madras Christian College, ChennaiChennai Get Directions
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Can you please mention some proper diet to curb depression and anxiety . I want to know that it is more of a mental issue and i am finding ways to deal with it . But I have heard that a proper diet plan is important too. Can you please help?

Masters in Clinical Psychology
Psychologist, Lucknow
Can you please mention some proper diet to curb depression and anxiety . I want to know that it is more of a mental i...
Yes proper deit is important but no rocket science. Avoid caffeine, have more fresh fruits- banana, green leafy vegetable, more water, avoid alcohol and tobacco, have more fry fruits- walnuts, have fish- omega 3. Do exercise daily for 1 hour. Consult with any psychologist for psychotherapy i. E psychological management of depression and anxiety it will help you all the best.
2 people found this helpful
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Respected Sir. I am excessive Addicted of Chewing Tobacco Products. I Want to Leave this because it cause Gastric Problem & Stone in Abdominal. So please can you suggest me to Quit this Habit. I will be very Thankful to you.

Reparenting Technique, BA, BEd
Psychologist, Bangalore
With the problems you are already having, you must not delay quitting this habit. If it is Hans and gutkha products, they are both very dangerous. I am so glad that your intention is to quit these habits. There are no guarantees about stopping one?s addiction. But that does not mean we should not keep at it, over and over again until we succeed. Both are tobacco products and will therefore have addictive components to them. It may feel like you can?t stop but that it really not true. If you do not try, then it will never happen. You must try and try again until you succeed. The problem with addiction is that you have two products which are both conditioned to various events in your daily life and as such it will make it difficult but not impossible. You could work with an addiction counselor to help you process the rehabilitation. It is important to first find out about the ill-effects of tobacco use to have a reason that alarms you about continuing in the habit. The information is really scary and true. The nicotine in tobacco stimulates the heart beat to raise the blood pressure in no time at all. So you must avoid it like the plague: it is just very bad medicine for you. In fact it is highly toxic too. You will need to stop consuming any tobacco related items with immediate effect. Nicotine also reduces the erectile capacity of your penis to hamper satisfying sex. You should start vigorous exercises, gradually increasing it over a period of time. You need to replace the oral urge with some healthy food substitute to satiate the need. You may also take hard candy or chewing gum. If the urge is too strong, then use nicotine chewing gum or nicotine patches, for a little while until the tobacco drive reduces, substantially. Both will help but I am inclined to favor the gum because it is an oral habit and it will occupy the mouth just as though you were still chewing tobacco. When you want it will be easier to give up the gum. Keep yourself occupied or engaged with interesting activities during the times when it is most tempting. Keep the company of non-users for some time i.e. at least for the first 21 days. Above all announce it to everyone that you have quit consuming Hans. You must persevere with the best support until you defeat this addiction. Counseling is very useful in the initial stages and when temptations are at their highest.
3 people found this helpful
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I am feeling that I have social anxiety disorder. I have fear of talking in public, meeting new people, stress has increased, my daily life is disturbed. Please suggest me some solutions to get rid of it. Pleaseeeee.

MS - Counselling and Psychotherapy
Psychologist, Hyderabad
I am feeling that I have social anxiety disorder. I have fear of talking in public, meeting new people, stress has in...
Hello lybrate-user, I understand how distressing your problem is and I suggest you should take cognitive behaviour therapy which helps you understand the root cause and teaches and helps train you develop techniques to overcome your problem in few sessions.
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Kindly give suggestion to get rid from anxiety and depression via changing life style. Regards.

C.S.C, D.C.H, M.B.B.S
General Physician,
Kindly give suggestion to get rid from anxiety and depression via changing life style. Regards.
5 Ways to Fight Depression and anxiety. These are both related intricately and these steps will control both feelings If you feel depressed, it's best to do something about it — depression doesn't just go away on its own. In addition to getting help from a doctor or therapist, here are 5 things you can do to feel better. 1.Exercise. Take a 15- to 30-minute brisk walk every day — or dance, jog, or bike if you prefer. People who are depressed may not feel much like being active. In addition to getting aerobic exercise, some yoga poses can help relieve feelings of depression. Two other aspects of yoga — breathing exercises and meditation — can also help people with depression feel better. 2.Nurture yourself with good nutrition. Depression can affect appetite. One person may not feel like eating at all, but another might overeat. Proper nutrition can influence a person's mood and energy. So eat plenty of fruits and vegetables and get regular meals (even if you don't feel hungry, try to eat something light, like a piece of fruit, to keep you going). 3.Identify troubles, but don't dwell on them. Try to identify any situations that have contributed to your depression. When you know what's got you feeling blue and why, talk about it with a caring friend. Talking is a way to release the feelings and to receive some understanding. 4. Express yourself. With depression, a person's creativity and sense of fun may seem blocked. Exercise your imagination (painting, drawing, doodling, sewing, writing, dancing, composing music, etc.) and you not only get those creative juices flowing, you also loosen up some positive emotions. Take time to play with a friend or a pet, or do something fun for yourself. Find something to laugh about — a funny movie, perhaps. Laughter helps lighten your mood. 5. Try to notice good things. Depression affects a person's thoughts, making everything seem dismal, negative, and hopeless. If depression has you noticing only the negative, make an effort to notice the good things in life. Try to notice one thing, then try to think of one more. Consider your strengths, gifts, or blessings. Most of all, don't forget to be patient with yourself. Depression takes time to heal. If you are happy with these answers please click on "useful” link so that I can know my efforts are not wasted. If you want more clarifications or prescription for medicines consult me on this site to ask me directly and not in open questions session It's not easy to say exactly what causes depression and anxiety – it's different for everyone. Sometimes a difficult time in you or your mates' life can set off depression or anxiety, sometimes it's caused by a combination of things that has built up over time and sometimes, there's just no obvious cause at all.
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I am 21 year old. When I live in crowded area or consult a new person I am feeling very nervousness and I can't control my mind that's like hypnotized and in my right side ear continuously playing some sound like tintless problem then I have depressed. Pls help me.

Masters in Clinical Psychology
Psychologist, Lucknow
I am 21 year old. When I live in crowded area or consult a new person I am feeling very nervousness and I can't contr...
Hi lybrate-user you have agoraphobia. Agoraphobia is a condition in which a person avoids a number of otherwise ordinary activities and places, including some that the person used to enjoy before the trouble started. This avoidance usually develops in response to panic attacks. Because a panic attack can be such an upsetting and scary experience, people are naturally motivated to do whatever they can to avoid additional attacks. Unfortunately, it's precisely a person's efforts to protect himself from panic which create the greater problem of agoraphobia. Agoraphobia treatment based on cognitive behavioral methods can help you overcome agoraphobia with two key steps. First, you learn how to respond to panic attacks in ways that calm them down, rather than aggravate the situation. Secondly, as you get better with those skills, you practice them in more and more challenging circumstances, until you have regained all the territory that you previously gave up to panic. This kind of treatment is usually called exposure treatment, and it's considered the most effective treatment available for panic and agoraphobia. Consult for same.
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How to control my mind thought of the negative thinking which has been arose by my family members and friends ? I am not able to study alone even for 1 minute without thinking something and it comes in my mind automatically when I am alone anywhere.

CERTIFICATION IN BACH FLOWER REMEDIES OF ENGLAND, Ph.D DOCTOR OF PHILOSOPHY IN BIOCHEMISTRY, B.S.M.S BACHELOR OF SIDDHA MEDICINE AND SURGERY,
Alternative Medicine Specialist,
How to control my mind thought of the negative thinking which has been arose by my family members and friends ? I am ...
Acid flur200x one dose weekly once. Clematis, White chest nut, Walnut, take these Bach remedies one dose once daily for a month and revert back
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Actually I had breakup with my girlfriend about a week ago. And I am very depressed about this and can't concentrate on my exams. Can you help me?

C.S.C, D.C.H, M.B.B.S
General Physician,
Actually I had breakup with my girlfriend about a week ago. And I am very depressed about this and can't concentrate ...
YOu practise meditaion, yoga, music and control mind for your sake of studies. Break up is common life and in your age you need not worry at all
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I'm rooohit, I'm very much addicted to Internet. Do to this I'm facing serious problems. I'm unable to concentrate on studies. How to over come from this problem?

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
Dear you should use your will power to come out of this addiction. Find other activities to do like reading, playing games, watching tv etc. Take care.
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I'm 17 years old but my voice is not deeper and denser and it still sounds like a 14-15 year old ones, perhaps my voice is not cracked properly, how to get a deeper denser and a manly voice, plzzzz help, thank you.

MBBS
General Physician, Jalgaon
Please do pranayam regularly give more time to bhramari and udgit pranayam do practice to hold breath take cap ashwagandha 60 1 1 for 3mths.
1 person found this helpful
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I have been diagnosed with Parkinson's disease my age is 55 years I am having the problem of less sleep and I feel dizziness whole day please guide me in the matter.

DHMS (Diploma in Homeopathic Medicine and Surgery)
Homeopath, Ludhiana
Homoeopthic medicine :LOLIUM TEMULENTUM 30 ( Wilmar Schwabe India) Drink 2 drops direct on tongue twice daily. Report me after 15 days.
1 person found this helpful
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My brain didn't work properly. I can't done mathematical problem properly. I can't remember something properly. What I do?

BHMS
Homeopath, Faridabad
Hi. -Meditate for at least 15 to 30 minutes each day physically changes your brain, making you less anxious, and more rational and empathetic. -Besides increasing your physical strength and flexibility, yoga changes your brain. Research suggests that in addition to reducing stress, anxiety, and depression, yoga protects the brain from shrinking with age. -Exercise daily as it would can help offset the cognitive decline brought on by aging and increasingly sedentary lifestyles. -Get enough sleep. On average, adults need between 7.5 and 9 hours of sleep each night. When you aren’t getting enough sleep, it affects your brain’s ability to do this, and your memory suffers. -Spend time with people whose company you enjoy, and who make you feel like the best version of you. -laughter can improve short-term memory in older adults. -Cutting down on your use of technology (i.e. sitting in front of your computer, phone, or tablet) for even 30 minutes can improve your brain health and help you think more deeply. Medication: Take homoeopathic medicine for increasing memory - Calcarea Carb. 200 and Anacardium 200/ once daily.
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I think a lot while sitting, traveling or sleeping that actually causing me a kind of disturbance. Thinking of family relationship talks etc. Pls guide me as soon as possible sir.

BASM, MD, MS (Counseling & Psychotherapy), MSc - Psychology, Certificate in Clinical psychology of children and Young People, Certificate in Psychological First Aid, Certificate in Positive Psychology
Psychologist, Palakkad
I think a lot while sitting, traveling or sleeping that actually causing me a kind of disturbance. Thinking of family...
Dear lybrate-user, welcome to lybrate. The duty of your mind is to think. You cannot control your mind's thinking. Once you just leave your mind without diversion, it always end up in negative territory. But certainly you can divert your thinking. You can make your mind to be always positive by engaging in creative activities, hobbies, games and passionate towards whatever you do. Thereby you can reduce your stress and tension also. Once you can do this, loss of proper sleep and stress also can be made normal. Please consult a psychologist for more advice. Take care.
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My name Abhishek .I want discuss about my personal addiction. I am addicted of drug tramadol .I want quit it and want to be out from it. Currently I am very much depressed .I am a married man .so I want live my life with my wife very smoothly .please suggest me some alternate for quit it.

C.S.C, D.C.H, M.B.B.S
General Physician,
My name Abhishek .I want discuss about my personal addiction. I am addicted of drug tramadol .I want quit it and want...
You only have to use willpower and top the drug and it is not a drug that is much addiction prone . You do meditation and yoga for mind control
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Hello, My boyfriend has deep depression and he hurts every part of body (one moment he hurts leg and in the other moment he hurts stomach). He wants to die, also he has phobias that he has some incurable diseases. Often (at least once in day) he feels lack of ability of breathing and he feels afraid of being asphyxiated. He has no heart diseases, but feels hurt in chest too. Please tell me, probably what diagnosis can be, and how can be solved this problem?

MD - Psychiatry
Psychiatrist, Guwahati
Hello, My boyfriend has deep depression and he hurts every part of body (one moment he hurts leg and in the other mom...
Your boyfriend needs professions help. The symptoms he is currentlybsuffering from including self harming behavior, desire to die, pessimistic thoughts like the fear of suffering from some incurable disease etc. May be life threatening if not taken care of immediately. Get him evaluated by a Psychiatrist at the earliest, who will do detailed mental status evaluation & physical examination, & then make the diagnosis. Then will prescribe medication &/or advice counseling sessions accordingly. With treatment he will definitely come out of the present condition. Along with, encourage him to take the following measures: 1)Lead an active life & maintain a healthy lifestyle. Go for a walk, exercise regularly, do some yoga or relaxation techniques daily. 2)Do not let him spend time alone. Encourage him to spend time with friends, family members or well wishers with whom he feels comfortable & positive. Give him support & encourage him. 3)Read motivational books & quotes. 4)Spend some time daily recollecting the good moments in his life. 5)Try to evaluate things practically & rationally. 6)Avoid people who spreads negativity or demoralize him. 7)Avoid watching or reading mind disturbing things like violence, crime, horrors etc. 8)Maintain a daily routine. 9)Motivate him to pursue his hobbies or keep a pet. 10)Every day spend some time with nature & try to feel its beauty. 11)Stay away from substance of abuse like alcohol, cannabis, inhalants, drugs etc. 12)If any problem is there in his life, encourage him to put maximum effort & try to solve it. Work to enhance his problem solving skills & coping skills. If he are not able to solve any problem himself, discuss about it & try to help him or take professional help. 13)Keep reminding him the fact that people with bigger problems exist in this world. 14)Read or watch comedies & make him laugh. 15)Above all, keep reminding him that life is precious & one is gifted with this life for once only. Every moment, every day is precious & life once lost can never be regained back.
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Hi im 20 years old boy im full of negative vibes all time depression mode anger lonely I do not know whats wrong with me all the time thinks about sexual activity I use always phone less concentration on studies headache is there chest pain breathing problem weakness is there please help me prescribe me some good medicine to get rid out of this please help me im helpless hopeless im soft hearted guy I do not have good friend circle I stay all alone at room rome around alone I cry I speak less nowadays I couldn't interact with people every one hates me please help me I feeling really low all the time.

psychologist
Psychologist, Delhi
Hi im 20 years old boy im full of negative vibes all time depression mode anger lonely I do not know whats wrong with...
Dear lybrate user Rohit first stop blaming yourself that you always thinks about sexual activity, using too much phone ,not concentrating on studies,you don't have good friends ,every one hates you.at your age more than 95% youngsters do the same thing infact if you don't do this things then its the matter for concern.try some deep breathing exercise ,and every day for 10 minutes sit in the posture of yogi close your eyes and say ommmmm this will increase your concentrating power trust me it will help.if you need my help then i am always ready.
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C.S.C, D.C.H, M.B.B.S
General Physician,
Mental health: What's normal, what's not

Understanding what's considered normal mental health can be tricky. See how feelings, thoughts and behaviors determine mental health and how to recognize if you or a loved one needs help.

What's the difference between mental health and mental illness? Sometimes the answer is clear, but often the distinction between mental health and mental illness isn't so obvious. For example, if you're afraid of giving a speech in public, does it mean you have a mental health condition or a run-of-the-mill case of nerves? Or, when does shyness become a case of social phobia?

Here's help understanding how mental health conditions are identified.

Why is it so tough to tell what's normal?

It's often difficult to distinguish normal mental health from mental illness because there's no easy test to show if something's wrong. Also, primary mental health conditions can be mimicked by physical disorders. Mental health conditions are judged not to be due to a physical disorder and are diagnosed and treated based on signs and symptoms, as well as on how much the condition affects your daily life. Signs and symptoms can affect your:

Behavior. Obsessive hand-washing or drinking too much alcohol might be signs of a mental health condition.
Feelings. Sometimes a mental health condition is characterized by a deep or ongoing sadness, euphoria or anger.
Thinking. Delusions ? fixed beliefs that are not changeable in light of conflicting evidence ? or thoughts of suicide might be symptoms of a mental health condition.
What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that explains the signs and symptoms of several hundred mental health conditions.

Mental health providers use the DSM to diagnose everything from anorexia to voyeurism and, if necessary, determine appropriate treatment. Health insurance companies also use the DSM to determine coverage and benefits and to reimburse mental health providers.
How do mental health providers diagnose mental health conditions?

To determine if you have a mental health condition, a mental health provider will work with you and your loved ones to assess:

Your symptoms. Your mental health provider will ask about your symptoms, when they began and how they've affected your life. How you perceive your thoughts and behaviors and how much your signs and symptoms affect your daily activities can help determine what's normal for you. For instance, you might realize that you aren't coping well or that you don't want to do the things you used to enjoy. You might feel sad, hopeless or discouraged. If your sadness has a specific cause, such as divorce, your feelings could be a normal, temporary reaction. However, if you have symptoms that are severe or don't go away, you could have depression. You might also need to have a physical exam to rule out any underlying health conditions.
Others' perceptions. Your perceptions alone might not give you an accurate picture of your behavior, thoughts or ability to function. Other people in your life can help you understand whether your behavior is normal or healthy. For example, if you have bipolar disorder, you might think your mood swings are just part of the normal ups and downs of life. Your thoughts and actions, however, might appear abnormal to others or cause problems at work, in relationships or in other areas of your life.
When is an evaluation or treatment needed?

Each mental health condition has its own set of signs and symptoms. In general, however, professional help may be warranted if you or a loved one experiences:

Marked change in personality, eating or sleeping patterns
Inability to cope with problems or daily activities
Strange or grandiose ideas
Excessive anxiety
Prolonged depression or apathy
Thinking or talking about suicide
Substance abuse
Extreme mood swings or excessive anger, hostility or violent behavior
Many people who have mental health conditions consider their signs and symptoms a normal part of life or avoid treatment out of shame or fear. If you're concerned about your mental health or a loved one's mental health, don't hesitate to seek advice.

Consult your family doctor, make an appointment with a counselor or psychologist, or encourage your loved one to seek help. With appropriate support, you can identify mental health conditions and explore treatment options, such as medications or counseling.

Regarding online consultation there are certain points which all should know and follow.
1) The description of the diseases should be complete in all respects, including any tests done and any medicines already taking. Just saying I have diabetes since 10 years and taking Metformin cannot help a discerning doctor a scientific advice.
2) Your place and name and mail id and phone number should be in the question. It is necessary at times to know where you stay to give a good advice. (For example if there the climate is warm or cold and many other factors)
3) It is necessary to keep in regular touch for some diseases like diabetes and hypertension. So make it a point to be in touch by asking private questions. And repeat the essential point of the previous question to give a continuing answer. All these are said with intention to give a scientifically correct answer and talk as if in a regular consultation about which I am very keen to.
4) For personalised attention and follow up ask privately and it is better to make online payment if you are asked to by the doctor. It involves his time and dedication to give you expert advice after studying your problem. Ask personally in case of doubts about any medical matter. Www.Lybrate.Com/drsajeev

If you are willing to accept me as your regular health care giver / doctor I can give you regular, prompt,
well studied and scientific answers for all your medical problems, which you ask me privately in this site. Sorry to say I will ask for a small payment for my efforts and intelligently studied answers. Regards. Www.Lybrate.Com/drsajeev
Ask privately. It is essential and useful to have a doctor answer your doubts online as it time spent in going to a clinic. Majority of diseases can be treated by online by consultation with an experienced doctor and does not need physical examination. You can use this site and ask me privately


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Sir, I think that whatever I had studied is not getting it at proper time. What is the reason for that.

B.Sc(hons), Physics, B.H.M.S., PGDIT (software Engg)
Homeopath, Delhi
Ur weight please give up bad habits. 2 boiled eggs daily morning ferrum phos 3x / 6tabs 3 times a day / 2 weeks report after 2 nd week fruit juice daily 2 times chicken soup daily evening.
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I am a 25 old female. I feel like I am depressed and feel anxious at times in everyday life situations. Is this normal or should I seek help?

MD - Psychiatry
Psychiatrist, Chennai
I am a 25 old female. I feel like I am depressed and feel anxious at times in everyday life situations. Is this norma...
You should seek help, if the naxiety and depression are within normal limits or mild, you will be evaluated and given CBT (Cognitive behavior therapy), if moderate or severe a course of medications followed by CBT. Consult a psychiatrist, all the best.
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stop it, speak without a abnormal break...

Master of Hospital Administration, Bachelor of Audiology & Speech Language Pathology (B.A.S.L.P)
Speech Therapist, Gurgaon
What is stuttering?

Stuttering affects the fluency of speech. It begins during childhood and, in some cases, lasts throughout life. The disorder is characterized by disruptions in the production of speech sounds, also called" disfluencies" most people produce brief disfluencies from time to time. For instance, some words are repeated and others are preceded by" um" or" uh" disfluencies are not necessarily a problem; however, they can impede communication when a person produces too many of them.

In most cases, stuttering has an impact on at least some daily activities. The specific activities that a person finds challenging to perform vary across individuals. For some people, communication difficulties only happen during specific activities, for example, talking on the telephone or talking before large groups. For most others, however, communication difficulties occur across a number of activities at home, school, or work. Some people may limit their participation in certain activities. Such" participation restrictions" often occur because the person is concerned about how others might react to disfluent speech. Other people may try to hide their disfluent speech from others by rearranging the words in their sentence (circumlocution), pretending to forget what they wanted to say, or declining to speak. Other people may find that they are excluded from participating in certain activities because of stuttering. Clearly, the impact of stuttering on daily life can be affected by how the person and others react to the disorder.

What are signs and symptoms of stuttering?

Stuttered speech often includes repetitions of words or parts of words, as well as prolongations of speech sounds. These disfluencies occur more often in persons who stutter than they do in the general population. Some people who stutter appear very tense or" out of breath" when talking. Speech may become completely stopped or blocked. Blocked is when the mouth is positioned to say a sound, sometimes for several seconds, with little or no sound forthcoming. After some effort, the person may complete the word. Interjections such as" um" or" like" can occur, as well, particularly when they contain repeated (" u- um- um") or prolonged (" uuuum") speech sounds or when they are used intentionally to delay the initiation of a word the speaker expects to" get stuck on"

Some examples of stuttering include:

" w- w- w- where are you going" (part-word repetition: the person is having difficulty moving from the" w" in" where" to the remaining sounds in the word. On the fourth attempt, he successfully completes the word.)
" ssss ave me a seat" (sound prolongation: the person is having difficulty moving from the" s" in" save" to the remaining sounds in the word. He continues to say the" s" sound until he is able to complete the word.)
" i'll meet you - um um you know like - around six o'clock" (a series of interjections: the person expects to have difficulty smoothly joining the word" you" with the word" around" in response to the anticipated difficulty, he produces several interjections until he is able to say the word" around" smoothly.)
How is stuttering diagnosed?

Identifying stuttering in an individual's speech would seem like an easy task. Disfluencies often" stand out" and disrupt a person's communication. Listeners can usually detect when a person is stuttering. At the same time, however, stuttering can affect more than just a person's observable speech. Some characteristics of stuttered speech are not as easy for listeners to detect. As a result, diagnosing stuttering requires the skills of a certified speech-language pathologist (slp).

During an evaluation, an slp will note the number and types of speech disfluencies a person produces in various situations. The slp will also assess the ways in which the person reacts to and copes with disfluencies. The slp may also gather information about factors such as teasing that may make the problem worse. A variety of other assessments (e. G, speech rate, language skills) may be completed as well, depending upon the person's age and history. Information about the person is then analyzed to determine whether a fluency disorder exists. If so, the extent to which it affects the ability to perform and participate in daily activities is determined.

For young children, it is important to predict whether the stuttering is likely to continue. An evaluation consists of a series of tests, observations, and interviews designed to estimate the child's risk for continuing to stutter. Although there is some disagreement among slps about which risk factors are most important to consider, factors that are noted by many specialists include the following:

A family history of stuttering
Stuttering that has continued for 6 months or longer
Presence of other speech or language disorders
Strong fears or concerns about stuttering on the part of the child or the family
No single factor can be used to predict whether a child will continue to stutter. The combination of these factors can help slps determine whether treatment is indicated.

For older children and adults, the question of whether stuttering is likely to continue is somewhat less important, because the stuttering has continued at least long enough for it to become a problem in the person's daily life. For these individuals, an evaluation consists of tests, observations, and interviews that are designed to assess the overall severity of the disorder. In addition, the impact the disorder has on the person's ability to communicate and participate appropriately in daily activities is evaluated. Information from the evaluation is then used to develop a specific treatment program, one that is designed to:

Help the individual speak more fluently,
Communicate more effectively, and
Participate more fully in life activities.
What treatments are available for stuttering?

Most treatment programs for people who stutter are" behavioral" they are designed to teach the person specific skills or behaviors that lead to improved oral communication. For instance, many slps teach people who stutter to control and/or monitor the rate at which they speak. In addition, people may learn to start saying words in a slightly slower and less physically tense manner. They may also learn to control or monitor their breathing. When learning to control speech rate, people often begin by practicing smooth, fluent speech at rates that are much slower than typical speech, using short phrases and sentences. Over time, people learn to produce smooth speech at faster rates, in longer sentences, and in more challenging situations until speech sounds both fluent and natural" follow-up" or" maintenance" sessions are often necessary after completion of formal intervention to prevent relapse.
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