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

OCD (Obsessive Compulsive Disorder) is a psychological disorder where you feel compelled to perform irrational tasks in continuous patterns almost ritualistically. These compulsive thoughts may seem, upon examination that they are without any particular reason or rhyme. Naturally, a psychological disorder is not voluntary and people who suffer under this disorder don t voluntarily like to make their lives difficult contrary to some who would say  if you don t like it don t do it. 

It is not a simple matter, OCD can have a lot of underlying reasons which makes life even more difficult and wears you out. You still can t get over a particular thought until you have performed it a given number of times even if it harms your health and the relief is also short lived. For the naysayers who don t realise, how difficult life can be for people suffering from OCD here are a few reasons that you should consider:

Depression: People with OCD are also prone to suffering from depression. A sense of feeling like you are not like others, you see the world a little differently and obsessively repeat such compulsive lines of thought until it wears you out mentally. It is a side effect of OCD and deeply affects their lifestyle negatively.
Anxiety: When you have OCD you suffer from constant anxiety about things you may not have done that you must do or vice versa, or very intrusive thoughts that make you anxious wondering about the kind of person you are or becoming. It is a constant battle everyday trying not to repeatedly perform all the compulsive behaviours that may strike you and makes daily life immensely difficult.
Eating disorders: Suffering from OCD also affects your diet and food habits. You either start over eating or not eating enough resulting in huge amounts of weight gain or noticeable weight loss or just a fluctuation in weight.
Skin rashes: The outer manifestations of OCD are numerous. If you suffer from obsessive, washing of hands or clothes or any activity that requires constantly irritating your skin then you will develop rashes which will cause more anxiety in you. It s just a facet of OCD wherein you become obsessed with cleanliness and can t go without feeling anxious about the number of toxins surrounding you so you go about trying to almost sterilise yourself and end up damaging your skin.
Sleep disturbances: Your sleeping pattern gets affected if you can t build up a routine and then you can t sleep until it s a certain hour at a certain time of the day. Or if you suffer from paranoia then you are unable to sleep because you are actively worried about something or the other. Anxiety also contributes to restlessness.

5 Reasons Why OCD Makes Life Difficult!

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!

For human beings, the body is considered the temple, one that they strive to keep fit and in shape. In fact, the plethora of ailments, which people complain of suffering from, almost always deal with their physical health. In this over engagement to restore the physical health, the well being of the mental health is never considered. However truth remains that the health of the mind is equally if not more important and must be given its share of priority. With the growing age and times, depression has emerged as a gnawing problem, one that is plaguing individuals indiscriminately and one that must be eradicated as soon as possible. 
Some of the ways to combat this fatal ailment are: 

1. Exercises 
Everyday a bit of exercise not only keeps the body fit and healthy, but also goes a long way in easing and calming the mind. You need not indulge in strenuous exercises, but must make it a conscientious habit to work out a bit daily.

2. Talk to people
Though depression makes one inexorably quiet and silent, the first thing that is prescribed as a remedial measure is talk to people. Engaging in conversations with people, telling them what exactly is troubling you are proven ways to combat depression.

3. Meditate 
There is no better way to treat mental ailment than meditating.  When you suffer from depression, your body undergoes severe conflict. Meditating not only calms the mind, but also soothes away the worries.

4. Develop a support system
Depression is almost always followed by an unfathomable sense of loneliness. Talking to others does help, but at the same time try to develop a support system. Find an individual, be it parents, relatives or friends and confide in him or her. Not sharing what you are going through is never a solution and only exacerbates the fatality of the situation.

5. Change the daily routine
Monotony is never exciting and it is only time, before the humdrum of life gets to you. Changing the daily routine and incorporating something new and exciting go a long way in recuperating you from the mental dullness and fatigue.

Tips to Combat Depression

Stuttering is a type of speech disorder wherein, a person speaks slower than normal. It is quite  common in the age group of 3 to 8. The relationship between stress and stuttering has been pondered over for decades now. A lot of people seem to believe that stress and stuttering are co-related. On the contrary, recent studies show that stress is more of a consequence rather than a cause of stuttering. If you take the first theory into consideration, then according to that, children would be the greatest victims of anxiety and stress. But it is seen that the level of stress increases proportionately with the increase in age.

Social anxiety in teenagers increases due to stuttering, when they come across individuals who can speak in a normal pace. This in turn can crush their self confidence and lead them to isolate themselves from social groups and people in general. Hence, it is important to deal with stuttering in the early ages or as and when it occurs. 

Sometimes stuttering can develop due to physical or mental trauma.  Most people with stuttering do not seek therapy for it because they might not think of it to be too severe. Little do they realise that a simple process of speech therapy can help them overcome this disability and rejuvenate their level of self-confidence.

It has also come to light, that people with relapse in stuttering post therapy has shown a three-fold increase in anxiety levels than normal. Hence we cannot ignore the strong relationship between stress and stuttering. So from the above evidence, it is safe to conclude that social anxiety or stress develops as a result of chronic stuttering.

How to deal with stress related to stuttering?

Seeking help is a great start to tackle your disability. If your stuttering is prominent enough to warrant therapy, you must seek professional help for the same. You must also learn to control your anxiety by dismissing any anxious thought or make sincere efforts in controlling physical anxiety.

You can also try to increase your social skills by participating in events, such as public speaking that can reduce your stress levels and make yourself more confident about yourself. One must also remember that a person is defined by what he does rather than what he says. So never let a minor disability come in the way of your self worth!

Stress and Stuttering - How to Deal with It?

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. A person s mood and emotions can be altered drastically due to bipolar disorder, but they do not have more than one personality. Split personalities problem is more commonly seen in those with personality/dissociative disorders. 

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely  up,  elated, and energized behavior (known as manic episodes) to very sad,  down,  or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I Disorder  defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
Bipolar II Disorder  defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
Cyclothymic Disorder (also called cyclothymia)  defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
Other Specified and Unspecified Bipolar and Related Disorders  defined by bipolar disorder symptoms that do not match the three categories listed above.
The disorder has two strong phases: 1) Bipolar Mania and 2) Depression.

Mania-

Mania is a state of heightened energy and euphoria - an elevation of mood. It is in direct contrast to depression. Mania can vary in severity from hypomania, where, in addition to mood and energy elevation, the person shows mild impairment of judgement and insight, to severe mania with delusions and a level of manic excitement that can be so exhausting that hospitalisation is required to control the episode.

The mood, energy and other related symptoms define both mania and hypomania, with psychotic features being an 'add on' component experienced by a sub-set of individuals. 

You have an intense sense of well-being, energy and optimism. It can be so strong that it affects your thinking and judgement. You may believe strange things about yourself, make bad decisions, and behave in embarrassing, harmful and - occasionally - dangerous ways.
 
Like depression, it can make it difficult or impossible to deal with day-to-day life. Mania can badly affect both your relationships and your work. When it isn't so extreme, it is called 'hypomania'.
 
If you become manic, you may notice that you are:

Emotional:

very happy and excited
irritated with other people who don't share your optimistic outlook
feeling more important than usual. 
Thinking:

full of new and exciting ideas
moving quickly from one idea to another
hearing voices that other people can't hear.
Physical:

full of energy
unable or unwilling to sleep
more interested in sex.  
Behaviour:

making plans that are grandiose and unrealistic
very active, moving around very quickly
behaving unusually
talking very quickly - other people may find it hard to understand what you are talking about
making odd decisions on the spur of the moment, sometimes with disastrous consequences
recklessly spending your money
over-familiar or recklessly critical with other people
less inhibited in general.
If you are in the middle of a manic episode for the first time, you may not realise that there is anything wrong   although your friends, family or colleagues will. You may even feel annoyed if someone tries to point this out to you. You increasingly lose touch with day-to-day issues   and with other people's feelings. 

Depression- 

The feeling of depression is something we all experience from time to time. It can even help us to recognise and deal with problems in our lives. In clinical depression or bipolar disorder, the feeling of depression is much worse. It goes on for longer and makes it difficult or impossible to deal with the normal things of life. If you become depressed, you will notice some of these changes:

Emotional:

feelings of unhappiness that don't go away
feeling that you want to burst into tears for no reason
losing interest in things
being unable to enjoy things
feeling restless and agitated
losing self-confidence
feeling useless, inadequate and hopeless
feeling more irritable than usual
thinking of suicide.  
Thinking:

can t think positively or hopefully
finding it hard to make even simple decisions
difficulty in concentrating. 
Physical:

losing appetite and weight
difficulty in getting to sleep
waking earlier than usual
feeling utterly tired
constipation
going off sex. 
Behaviour:

difficulty in starting or completing things   even everyday chores
crying a lot   or feeling like you want to cry, but not being able to
avoiding contact with other people.
Causes:

Biological Causes: Experts say that patients with bipolar disorder often show physical changes in their brains. Nobody is sure why the changes lead to the disorder.
Genetic Traits: Researchers are involved in finding out whether or not the causes of bipolar disorder arise out of genes and other hereditary factors. If you have a first-degree relative or a sibling who is/was affected by this condition, you would probably have it too.
Neurotransmitters: Mood swing disorder is caused by an imbalance in brain chemicals known as  neurotransmitters .
Treatment Methods:

Initial Treatment: The initial treatment method is to take medications to balance and control the mood swings. After the symptoms are in control, one has to start working with his/her trusted doctor for chalking out an effective and practical long-term treatment procedure.

Recovery from substance abuse: Problems related to excessive alcohol and drug abuse are solved by this therapy. Failing this step, this disorder can be unmanageable.

Day care treatment: Day care treatment programs can be recommended by your doctor. This treatment method includes counseling and support which keep the bipolar traits under control.

Hospitalization: Hospitalization or immediate medical support is recommended in case of suicidal thoughts or when a person starts exhibiting erratic behavior (being psychotic).

Medications: Medications include the administration of antipsychotics (such as ziprasidone, olanzapine), antidepressants (usually in combination with a mood stabilizer or an anti-psychotic), mood stabilizers (such as valproic acid, lithium, divalproex sodium) and anti-anxiety medications.

Bipolar Affective Disorder - Symptoms and Treatments

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