Multiple sclerosis refers to disabling disease of the central nervous system, where the body s immune system eats away the protective layer sheathing the nerve fibres and disrupts communication between the brain and the rest of your body. 

Often, multiple sclerosis is associated with impaired cognitive functioning. Cognitive changes have direct functional consequences on your quality of life, ranging from occupational activities to professional career and personal life. In addition to it, a complex interplay between cognitive impairment and mental disorders like anxiety and depression, which negatively affect the normal course of life.

Rehabilitation Psychology works through various techniques and aims to ease the impact of cognitive changes on everyday life rather than simply defining their severity and nature.

Rehabilitation Psychology Approach to Multiple Sclerosis

The goal of Psychological Rehabilitation programs is to improve and preserve mental and physical abilities, as well as help patients adapt to changes in functioning. 

A team of specialists   consisting of a psychologist, physician, physiotherapist, speech-language pathologist, and an occupational therapist   works together in order to offer you well-rounded support and care. These specialists have years of experience and expertise in the management of symptoms of multiple sclerosis.

The rehabilitation program helps you address the following problems related to multiple sclerosis  

Spasticity

Fatigue

Sleep disorders

Chronic pain

Walking difficulties

Bladder and bowel issues

Changes in movement

Difficulty swallowing food

Mood disorders, like depression

Speech problems

Cognitive changes

Anxiety and uncertainty about the disorder

How Rehabilitation Programs Can be Helpful?

Since multiple sclerosis affects each person differently, Rehabilitation Psychology provides tailor-made treatment to patients.

The team of specialists work closely with the patients to evaluate their health needs, track progress, address pain, and teach them strategies essential to cope with the chronic disease.

Occupational therapy is directed toward patients with mobility problems. The therapy helps you with daily tasks, such as dressing, cooking, and learning ways to manage personal hygiene. 

Rehabilitation strategies for speech-language problems help maximize your abilities to cope with cognitive functions.

Multiple sclerosis is a lifelong condition and can be challenging as it progresses. Many people require constant support, care and motivation to get through the tough phase. Rehabilitation Psychology is just the way to combat the psychological effects of multiple sclerosis. You should communicate your concerns to a doctor, and learn all you can about the disease. 



 Rehabilitation Psychology In Management Of Multiple Sclerosis!

Depression is a very common emotion you might have experienced at least once during your lifetime. Depression refers to a state of mind when you are feeling low due to persistent sadness and loss of interest. But if the depression is chronic and long lasting for you, then it indicates that you are suffering from clinical depression. Under clinical depression, it is preferable that you go through a proper treatment course by a certified therapist. The Most common types of depressions are:

-Major depression

Under this type of a depression you will be depressed for most days of the week and if this condition extends for a period greater than 2 weeks, then it is a case of major depression. The most common method to treat a major depression is to talk to a mental health specialist and take medications called antidepressants (only after a prescription by a certified doctor).

-Persistent depressive disorder

This is a more severe and long lasting type of depression which is identified if you are depressed over a period longer than 2 hours. The most common symptoms of this type of a disorder are - change in your appetite, too much or too little sleep, lack of energy or fatigue, low self-esteem, trouble concentrating or making decisions, feeling hopeless among others.

-Bipolar disorder

If you are experiencing extreme ups and downs of mood abruptly and without any apparent reason, then you might be suffering from this disorder. This disorder is commonly known as a maniac depression, because during an up phase you will be extremely happy, joyful outgoing and talkative but during the low phase you will be sad, tired and depressed.

-Seasonal affective disorder

This type of a depression might bother you only during the winter season. This happens whenever the days are shorter and your body is not able to get enough of sunlight. This mostly happens in the case of people who are very fond of sunlight, and they prefer the sunshine over dark periods of the night. This disorder is treated by SAD antidepressants and everyday light therapy of 15 to 20 minutes.

-Psychotic depression

Under this type of a depression, you will have a major depression along with some psychotic symptoms like - hallucinations, delusions, and paranoia. Hallucinations mean viewing things that are not there, in reality, delusions are false beliefs or misconceptions and paranoia is the constant fear that somebody is going to harm you.



5 Types of Common Depression

Borderline personality disorder (bpd) is a mental illness. A patient suffering from bpd maintains unstable relationships with other people, shows inappropriate emotional reactions and possesses suicidal or self-harm tendencies. It is purely a personality disorder caused due to multiple factors. Patients suffering from bpd may find it difficult to stay alone. They fear abandonment and loneliness. Yet they have a tendency of showing mood swings, sudden emotional outburst or anger and hostility. This prevents them from having a long lasting relationship in life.

It usually starts affecting the patient's life from early adulthood. It however seems to improve with age. The patient also has distorted self-image. He or she is unclear about what they want from life or what they are in reality. Even minor incidents can trigger intense reactions in people with bpd.

Symptoms of borderline personality disorder.

The signs of suffering from bpd are listed below:

Intense and frantic effort to avoid abandonment or loneliness
Unstable relationships with people and changing the attitude towards them drastically. It can change from being in immense love with each other to intense hatred.
Developing paranoid thoughts and having dissociative feelings-the patient often lacks the feeling of self and suffers from identity crisis.
Suicidal feelings and attempts
Tendency to cause self harm or destruction by drug abuse, driving irresponsibly or be having unprotected sex
Reflecting intense depression
Chronic boredom
Sudden anger and hostility
Causes for borderline personality disorder.

Borderline personality disorder can be caused due to multiple reasons. Usually it has been found by researchers that it occurs to patients who have had a disturbed childhood. Complex and unpleasant happenings in the childhood may leave a deep impact on the patient's personality, which comes back as a disorder in his or her early adulthood. From mental, physical to sexual abuse in the childhood can lead to this condition in adults.

Besides, researchers have discovered recently that this illness has hereditary links. Some genes may be responsible for bpd. Improper functioning of the brain is also another factor. Especially, the portion of brain that controls emotions might not be functioning properly in co-ordination with other parts of it.

Diagnosis.

There is no particular clinical test that can diagnose bpd. It can be diagnosed by a series of interactive session with the patient by a psychiatrist.

Treatment.

The treatment of bpd involves three steps- psychotherapy, medications and support from peer and family. Dialectical behavioral therapy, cognitive behavioural therapy and psychodynamic psychotherapy are used in treating the patient. There are no specific medicines to cure identity crisis, boredom and loneliness. However, other symptoms like mood swings, depression and anxiety can be treated with anti-depressants and mood stabilizers. Antipsychotic drugs are also helpful to a certain extent. In extreme cases, hospitalization may be needed.

A Guide to Borderline Personality Disorder

Vertebroplasty means shaping the backbone i.e. vertebra for backbone and plasty is related to shape. This is an outpatient procedure done to treat compression fractures of the spinal cord. The backbone is made up of multiple small bones which are stacked one on top of the other with a filling material in between that is known as vertebrae. The stack of bones are held in place by the soft, elastic vertebral material. 

Vertebroplasty & similar procedure called kyphoplasty is a non-surgical procedure where collapsed vertebrae is brought back to shape by injecting medical bone cement under fluroscopy / image intensifier in OT, thereby relieving pressure on the spinal cord or spinal nerves with special canula directed to the core of vertebral body. Indicated in osteoporotic vertebrae, spinal fracture, metastatic tumour or primary tumour of spine. This technique has replaced major surgery done earlier to reshape & fix vertabrae.

Technique: Bone cement, in a semisolid state, is injected into the weakened or fractured bone space. Once this solidifies, it provides additional support to the spine, enabling normal movement. It also helps in reducing the pain significantly and improves the overall mobility.

Procedure:

In what takes about an hour, the following steps are done. Earlier, a few decades ago, this would be an open surgical procedure. However, with advance technology, now it is done using a small incision

Local anesthesia is given in the area that needs to be operated
A biopsy needle is inserted into the fractured space with the help of an X-ray
The acrylic bone cement is injected into the bone space with a needle to fill up the space, once it solidifies, it stabilizes the vertebral space
The needle is removed and the incision is covered with a bandage
Usually the patient is sent home in an hour s time unless the overall condition is really bad
There could be some soreness at the site where injection is given, but one can notice a significant reduction in pain from the day of the procedure
There is also improvement in mobility while doing daily chores
The pain relief can last up to 3 years after the procedure
Returning back to normal activities takes about 3 to 4 days after the procedure
When to use this procedure?

Vertebroplasty is usually done in case of non-radicular pain that is intractable. In most cases, they do not respond to traditional therapies including physiotherapy, pain medications and even surgery. The pain could be due to:

Osteoporosis
Cancer metastasis
Myeloma
Spinal hemangiomas
Traumatic fractures
Benefits of using vertebroplasty for managing pain 

Minimally invasive
Effective way to get relief
Improves mobility
Cost-effective
Reduces need for long-term use of painkillers
Stabilizes the spine and prevents further collapse

Vertebroplasty - How It Can Help Manage Pain?

Alcohol Withdrawal Syndrome is the name given to the symptoms seen in you if you consume heavy doses of alcohol frequently and then suddenly quit or reduce your alcohol intake considerably. These symptoms may surface anytime between six hours to a few days after you last drank.

Common symptoms of alcohol withdrawal syndrome:

Hallucinations
Fever
Nausea
Tremors
Anxiety
Vomiting
Immense sweating
Insomnia
High blood pressure
Sweating

All these symptoms may worsen over a few days and may even last till a few weeks.

What is the root cause?

Alcohol arouses your nervous system. In case you are a heavy drinker, your body gradually gets dependent on alcohol, and cannot adapt too easily to the lack of alcohol after you have abruptly quit. This is the root cause of Alcohol Withdrawal Syndrome (AWS).

Who is at risk?

You are at the maximum risk of AWS if you are an alcohol addict, or you cannot gradually cut down on its intake.

How do doctors diagnose AWS?

Usually, doctors will search for a few symptoms in you, like irregular heart rate, dehydration, fever, and tremors or minor fits. A toxicology screen also helps your doctor finding out the levels of alcohol in your body.

How is AWS treated?

Treatment depends on the severity of the symptoms. Usually are:

1. Home Care-

Mild symptoms of AWS can be treated at your home. You need to go for your regular routine checkups and tests. You may also have to go to rehabilitation programs for recovering alcoholics.

2. Hospitalization-

If your symptoms are more severe, you may have to be treated in a hospital, where you will be monitored and kept on a fluid diet to help prevent dehydration.

3. Medications

You can also be treated with sedatives.

Do you recover fully?

Usually, chances are that you will fully recover from AWS. If you quit drinking, take your medicines on time, and lead a healthy life thereafter. However, sleep disturbances and fatigue may persist. But, if you have severe symptoms of AWS, you should seek medical care as soon as possible to prevent any further fatal complications.

All you need to know about Alcohol Withdrawal Syndrome (AWS)

The risk of developing depression is found by the means of various researches to be two to three times higher in individuals suffering from a chronic disease than in normal individuals. Type 1 and type 2 Diabetes are chronic diseases that can prove to be very challenging to manage due to various setbacks and complications that can come in the way. Regular monitoring of the blood sugar levels is essential in managing the blood sugar. Navigation of the health care facilities, side effects caused by medications, and other related health conditions or even diabetic complications can cause an increased risk of developing depression. If left undiagnosed and untreated, depression can give way to a poor lifestyle choice that can further deteriorate the physical health of a person. 

Various risk factors that are associated with diabetes and depression are as follows- 

lack of physical activity
poor social environment
poverty
stress during pregnancy
Depression in diabetes can occur simultaneously due to a variety of factors. These include the psychological and psychosocial impact of the disease on an individual, a potential common genetic susceptibility and certain common pathophysiological abnormalities that involve neuro-immunological and neuro-endocrinal pathways, as well as microvascular brain lesions due to diabetes mellitus. However, issues concerning pathogenesis and causality of this high co-occurrence are not fully determined yet. Still, the presence of depression in patients with diabetes mellitus is of vast importance, as it is usually associated with poor disease control, adverse health outcomes and quality of life impairment.

When an individual is suffering from diabetes, the awareness of risks of developing depression is essential. It has been widely researched and found that these two conditions can occur simultaneously, where depression is usually undiagnosed. Diabetes, specifically type 2, and depression affect each other in a bi-directional manner, which means that each of the disease can prove as a risk factor for the other. In a state of depression, it is common for a person to consume high calorie foods and also to lead a sedentary lifestyle. This tendency can prove to be a risk factor for developing type 2 diabetes. 

If an individual already has type 2 diabetes, the stress experienced during the management of disease can cause depression. Type 1 diabetes develops as result of the defect of pancreas in production of insulin. 

People with type 1 diabetes can also develop depressive symptoms due to difficulties in the management of the disease. If the symptoms of depression develop in the patient already suffering from diabetes, management of diabetes also becomes difficult. This can lead to cause various diabetes related complications and also decrease the life expectancy. 

Various signs that can be observed in a state of depression are as follows: 

Complete lack of interest in doing any activity
Irritation or mood swings
Depressed mood
Disturbed sleep pattern
Changes in the appetite
Constant feeling of despair
Guilt Fatigue, weakness
Difficulty in concentration, transient memory loss
Suicidal tendency
There is a certain risk observed between the consumption of antidepressant medicines and development of diabetes. It has been researched and concluded that consuming antidepressants should always be on physician recommendation, with a prior advice on the risks of developing diabetes. It has also been found that the people with type 2 diabetes, who are using insulin regularly, are at higher risk for developing depression as compared to the people on non-insulin medications or following only diet or lifestyle modification habits. An additional stress experienced in managing diabetes and accessing the health care services can cause such complication in insulin users. 

Common treatment protocol for depression includes psychotherapy or the cognitive behavioral therapy. It helps people to correct destructive thought patterns and behaviors that tend to increase the depressive symptoms. Other interventions like a structured problem solving approach, motivational interviewing, and interpersonal approach towards the patient is also effective in management. Certain medications can also help in mood-lifting and the management of symptoms of depression.

In diabetics, the treatment options that are available in addition to the standard medical healthcare provision includes self-management training sessions that help the people to increase healthy habits and improve control on their blood sugar levels. Diabetes as well as depression can improve with complete focus on lifestyle changes, like proper diet management and exercising regularly.

How Diabetes Can Lead To Depression?

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