Grief is a complex emotion that may give you side effects like guilt and make you struggle as you try to get through your everyday life. It is usually caused by some loss in life which may have to do with relationships, work or any other reason like a chronic physical ailment or disability. Complicated grief disorder is a condition where the extreme level of grief impairs a person and how he or she behaves in his or her daily life. It can have a debilitating effect and make a person helpless when it comes to dealing with everyday functions. It may continue for more than six months after the loss, and may even lead to depression and anxiety, among other complications.

Let us cast a glance of how this may be dealt with.

Psychotherapy: Cognitive-behavioral therapy and other forms of therapy can often help people who are suffering from this form of prolonged grief. With this kind of therapy, a patient can actually find an outlet to discuss the various emotions that the bereavement has brought on, and how he or she is not able to cope. The therapist, in this case, is usually a psychiatrist or a psychologist, who can then help in reprogramming the attitude of the patient so as to curb the grief and move on with life by embracing daily functions.
Group Therapy: In many cases, group therapy may also work. It is a natural human tendency to be grateful for what we have when we get to hear of higher and greater adversities. And when we see people suffering from those adversities actually taking steps to get over it, we can also get hugely motivated to do the same with our own lives. This is why group therapy is a powerful mechanism that many doctors and psychiatrists recommend for dealing with complicated grief therapy. This does not even need to be a formal therapy session. It can even be a club or a get together of people who have been through a similar problem.
Medication: In some extreme cases, the patients may be prescribed some antidepressants as well as beta blockers that can put their emotions right until they can deal with them in a better manner. Such medicines also help in numbing that part of the brain so that the patient may function in a more normal manner. Yet, care must be taken that the patient does not get addicted to such kind of medication.
Change of Focus: Travelling or picking up a new hobby can also have a positive effect on the person suffering from this condition. It can help in triggering the production of dormant hormones in a more normal way so that the patient may function in a more normal way, without the debilitating grief.


How To Deal With Complicated Grief Disorder?

Depression is one of the complex physical and psychological disorders. The disease is characterized by loss of pleasure or interest, sadness, feelings of guilt, low self worth, disturbed sleep and appetite, poor concentration and feelings of tiredness. The common effect of this condition is leads to the decreased activity level in some parts of the brain. The disease is a mild one that causes little annoyance in daily life. But the extreme stages may lead to severe effects where the affected person may fail to participate in their social life. In rare cases severity of suicide is even possible.

Depression is diagnosed by these symptoms:

    Lack of interest or joy in activities
    Sadness or low mood levels
    Feel of guilt without any reason
    Pessimism
    Inferiority thoughts
    Slow thought process
    Irritability
    Slow in interpreting sensorial stimuli
    Slow physical reactions
    Slow physical processes or digestion.

Types of depression
It can be either be a single disease or the effect of other diseases. It can also be due to two or more factors. Based on the cause the disease, it has been divided into six types, which are

    Reactive depression: Caused due to psychological struggle and stress.
    Endogenous depression: Caused due to strain or lack of rest.
    Depression by physical disease: This is caused due to any physical disease such as Parkinson s disease, stroke, hypertension, heart disease, cushing s syndrome, mononucleosis, hypothyroidism neurotransmitters in the brain etc.
    Depressive consequence of unsound lifestyle: This is caused due to less exercise, too much alcohol, coffee or tea consumption, least intake of necessary nutrients, too much sugar intake and fat.
    Postnatal depression: This happens mostly in women after pregnancy and child birth.
    Seasonal affective disorder: This happen due to cold and dark seasons of the year. The lack of light is the factor for causing depression as well. 

Treatment of depression
Best way to treat depression is through Psychotherapy, also anti - depression medicines are usually prescribed to treat the effects of depression. But the intake of these types of medicines result in nervous disorder. However, the best way to treat is through environmental changes and positive and happy surrounds to the affected person along with psychological counseling.

6 Types of Depression! + How it Affects Us?

Ending one s life is terrible. But often, instead of analysing the patient s mental condition at that time, we tend to judge them. The most common cause for suicides is undoubtedly depression. Adverse social or financial conditions often contribute to the mental condition of patients. However, a recent paper published in the journal Neuropsychopharmacology might change the way we think about suicides. Lena Brundin and her co-workers have come to the conclusion in the paper titled  Role of inflammation in suicide: from mechanism to treatment,  that our immune system can trigger off suicidal thoughts and tendencies. Let us find out how.

There is proof that certain medicines that are used to treat cancer patients can affect the immune responses. This in turn can trigger off suicidal tendencies.
Certain injuries can lead to brain disorders which are related to inflammatory responses that might be responsible for some changes in behaviour often leading to suicidal thoughts.
Just like certain medications trigger of suicidal thoughts, there are some that might diminish them like Lithium. It is used to treat bi-polar disorder. What it does is decrease immune related chemicals. Another drug has proved to be very effective in reducing suicidal thoughts and tendencies   Ketamine. Ketamine, like Lithium, has been found to block certain chemicals that are related to immune response.
Though the whole topic is still under extensive research, it can perhaps be concluded that certain drugs have the ability to lessen suicidal thoughts and depression because they block some chemicals that are related to immunity.
The suicidal mentality is very complex. It requires not just medicines, but counselling, empathy, love and understanding. Often, many patients cannot come out of their depression, resulting in therapy sessions that are fruitless. In those cases, medicines that might reduce the negative thoughts and moods will come handy. It will help the patient initially to deal with the situation and start with a lot of positivity. Every year, almost one million deaths occur due to suicide. Not only does it leave behind survivors who attempt to kill themselves but also broken families that struggle to get over the death. If this research is successful, several people will benefit from it, all over the world.

Suicidal Tendencies - Can Your Immune System Influence it?

When man first started using tobacco, he probably did not know that it would grow to be an epidemic that could cause multiple health issues. Be it smoking or chewing, tobacco has severe negative effects on health. Take any of the current lifestyle diseases from diabetes to obesity, the common risk factor is tobacco abuse. In addition, depending on the form of tobacco used, specific organs are affected. For instance, chewing tobacco leads to oral cancer while smoking causes lung cancer.

The statistics around tobacco abuse are extremely startling and can be read below:

A total of about 90 trillion rupees are spent on various tobacco products.
About 1.4 trillion is spent on healthcare-related to conditions caused by tobacco abuse.
India has about 120 million tobacco users.
More than 7 million people die every year due to tobacco usage.
The Government has levied a GST of 28% on cigarettes, making them unaffordable, which is one of the ways to promote quitting.
For those who want to quit but are not able to, there is a quit-line setup, which is toll-free, 1800-11-2356 and is accessible from 8 a.m. to 8 p.m.
Tobacco is a menace in all the strata of society. The lower economic classes are adversely affected both due to lack of knowledge and healthcare facilities. Therefore, the government uses the World No Tobacco Day (WNTD) that is observed by all members of the World Health Organization as an opportunity to drive this awareness.

This is celebrated on May 31st every year. Some measures that are taken to promote 'say no to tobacco' campaign are listed below.

In 1975, the Cigarettes (Regulation of Production, Supply, and Distribution) Act was introduced, which made it mandatory for cigarette packs to have a warning stating  Smoking Kills  or  Smoking is injurious to health. 
Marketing campaigns are shown in the movie theatres at the beginning of movies which depict the hazards of tobacco
Smoking is banned in most public areas, and warnings are on display.
Children below 18 are not sold tobacco products. If in doubt, the seller can ask for age identification.
Schools and colleges do not have tobacco selling within 100 meters of the campus.
The price increase ensures that not everybody has easy access to cigarettes.
Celebrities promote quitting tobacco and smoking by talking about their personal stories.
How can a healthcare professional help you?

A healthcare professional plays a vital role in a smokers life, as it the healthcare professional that can increase the odds of quitting with guidance, medication, and support. 

What should a healthcare professional do?

Identify people who smoke 
Motivate them to quit or think about quitting
Refer a person who smokes for treatment and support
Support ongoing abstinence
What is the right smoking cessation strategy?

Ask: Every smoker to visit a healthcare professional
Advice: Urge the smoker to leave smoking
Assess: Assess whether the person is willing to quit in 30 days
Assist: Plan and help Rx Quit
Arrange: Arrange a follow-up through phone or SMS or in-person
What is that people who smoke need help with?

First and  the foremost challenge are the withdrawal symptoms 
Urge to smoke and borderline depression with a possibility of relapse
People who have high pre-abstinence nicotine intake
How to get over the initial withdrawal discomfort?

Behavioural support is of proven efficacy
Can be delivered in different formats
Face-to-face
Telephone
Internet
Nicotine replacement therapy and nortriptyline are of proven efficacy
Facts On Nicotine Replacement Therapy (NRT)

There are no real contradictions related to NRT
No drug interactions 
Side effects, if there are any are localized e.g.
Taste of oral products
Hiccups with the mouth spray 
Skin irritation with patch 
Treatment for quitting Nicotine  - Medications: Medicines which are useful adjuncts in the determined but unsuccessful quitters are Varenicline and Bupropion. 

Though smoking out in the open has reduced, there are miles to cover when it comes to eradication of tobacco. 

World No Tobacco Day - Making An Effort To Control Tobacco Usage!

When is your pain chronic?

Your pain is chronic if it last for more than a period of six months. Chronic pain is a long-term pain whose nature can vary from mild to excruciating, and it may trouble you either continuously or at short and regular intervals. Chronic pain is so dangerous that it does not only cause discomfort and inconvenience but also robs you entirely of your capacity to work for a long time.

Chronic pain can occur in a number of organs of the human body like head, joints, back, shoulders, neck etc. In fact, pain in any part of your body can turn into chronic pain. Here are a few symptoms that can help you identify if what you are going through is, in fact, chronic pain:

- persistent and severe body pain

- burning sensation accompanied by the body pain

- fatigue and sleeplessness

- weak immune system

- stiff and sore joints

The 4 types of chronic pain disorders that you should be aware of are:

1. Nociceptive pain

The pain that affects the soft tissues of the body such as the skin and the muscles or the organs that have sensory nerves present in them is called nociceptive pain. The sensory nerves, known as nociceptors can detect the stimuli of pain and send information to the brain and the spinal cord for interpretation. The pain could be either somatic (originating in the outer body) or visceral (originating in the internal organs).

2. Neuropathic pain

This pain is caused when the nerves stop functioning normally. It is caused due to nerve disturbances that result in pain stimuli being spontaneously transmitted to the brain and spinal cord. If you are suffering from this type of chronic pain disorder, you will feel a sharp, shooting and stabbing pain. Neuropathic pain can also be caused due to the formation of neuroma (abnormal growth of the nerve tissue).

3. Psychogenic pain

The pain that is caused by psychological disorders like depression and anxiety is known as psychogenic pain. Sometimes this pain can be accompanied by physical complications like fatigue, body pain and muscle weakness.

4. Idiopathic pain

The pain that exists even though there is no physical or psychological cause for it is known as idiopathic pain. This pain is more common in people who have suffered from a pre-existing painful disorder. Some common examples of idiopathic pain are fibromyalgia (intense pain all over the body) and tmj disorders (pain in the jaw area).

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Why does PAIN occur? Understand the Mechanism of Pain

Your Pain is Chronic if it Falls Under These 4 Types of Chronic Pain Disorders!

Treatment of frozen shoulder varies depending on the stage it is at, and how severe is the pain and stiffness. There is no outright cure and the aim of treatment is to keep the joint as mobile as possible. The most effective treatment is that which maintains a good range of movement until the shoulder starts to heal. 

Treatment may Include the following:

1. Shoulder exercises: Regular, gentle exercise can help to keep the shoulder joint mobile. If your shoulder is very stiff, exercise may hurt, and it should only be carried out with the guidance of your doctor or physiotherapist. If you are able to, continue using your shoulder as normal saving' the shoulder can cause the muscle to waste and may make stiffness worse.
2. Painkillers: Over-the-counter painkillers such as paracetamol or prescription-only drugs such as codeine may be taken to ease pain and you should discuss this with your general physician or pharmacist.
3. Anti-inflammatory painkillers: Such as ibuprofen and diclofenac, are often prescribed to ease pain and inflammation. Any medication that you take should be discussed with your general physician or pharmacist.
4. Steroid injections into or near the shoulder joint may be effective at relieving pain and inflammation for a few weeks. However, injections are not a cure, and symptoms may return.


Treatment of frozen shoulder

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