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!

Shannon L. Alder once said,  Sensitive people usually love deeply & hate deeply. They don't know any other way to live than by extremes because their emotional thermostat is broken. 

Sometimes certain thoughts & habits become so addictive at times that even while being aware of its futility the person fails to resist from indulging in it. Obsessive Compulsive Disorders can be extremely debilitating & can easily thwart subjective well-being. The main features of this illness are obsessions and compulsions.

Obsessions are certain thoughts, doubts, images or urges that occur in one's mind. These are unwanted, repetitive by nature. Most people with OCD realize that obsessions are senseless, irrational, or excessive, but they are unable to ignore or suppress them. They would attempt to resist and control them, but would not succeed. Obsessions cause significant distress and anxiety to the sufferers and as a result cause interference in their day to day functioning.

Compulsions are repetitive acts that the person is driven to carry out in spite of knowing that they are meaningless, unnecessary or excessive. Compulsions are usually in response to obsessions. For example, a person with an obsessive fear of contamination washes hands repeatedly in order to ensure that his or her hands are clean. The person attempts to resist repeated hand-washing, but gives in to the urge so as to relieve him or herself of the anxiety or discomfort. Persons with OCD often perform certain acts repeatedly to avoid some dreaded event or to prevent or undo some harm to themselves or others. For instance, touching the floor even number of times to prevent an accident.

They are aware most of the time that the activity is not connected in a logical or realistic way with what was intended to be achieved, or that it may be clearly excessive (as in the case of hand-washing compulsions), but cannot control them as they reduce anxiety, at least transiently.

Common Symptoms in OCD:

Some common obsessions-

- Fear of getting dirty, contaminated or infected by persons or things in the environment.

- Blasphemous thoughts.

- Thoughts of harming or killing others or oneself.

- Doubts that a task or assignment has been done poorly or incorrectly.

- Recurring thoughts or images of sexual nature.

- Fear of blurting out obscenities.

- Fear of developing a serious life-threatening illness.

- Preoccupation to have objects arranged in a certain order or position.

Some common compulsions:

- Repeated hand-washing, taking unusually long time to bathe, or cleaning items in the house.

- Ordering or rearranging things in a certain manner.

- Checking locks, electrical outlets, gas knobs, light switches etc. repeatedly.

- Repeatedly putting clothes on, and then taking them off.

- Counting over and over to a certain number.

- Touching certain objects in a specific way.

- Repeating certain actions, such as going through a doorway.

- Constantly seeking approval (especially children)

What are not obsessions?

The common usage of the word obsession as in,  he is obsessed with music  is not an obsession as used in the context of OCD. Here the person indulges in the activity with complete will, has control over them and derives pleasure out of the activity.

When one is fired from a job or loses someone close to them, it is natural to brood over the event. However, these thoughts are not considered as senseless or irrational, though they may cause some discomfort. Similarly, a person appearing for an examination may feel anxious and worry about the results, which could occupy considerable amount of his time. These thoughts, though unwelcome, are under his control and not experienced as senseless. The above experiences are obviously not obsessions. The common usage of the word obsession as in,  he is obsessed with music  is not obsession as used in the context of OCD. Here the person indulges in the activity with complete will, has control over them and derives pleasure out of the activity.

Treatment:

Your clinical psychologist might subject you to anyone from a variety of treatment strategy available based on the severity of the condition and course of illness. Client specific psychological treatment is recommended according to unique triggers and patterns of obsessions/compulsions.

Cognitive Behavioral therapy comprises of a variety of techniques used to modify or replace maladaptive thoughts, emotions and behaviors with more adaptive forms of the same. Obsessions and compulsions seen in OCD are examples of maladaptive behaviors as they cause significant distress and interfere with normal functioning of an individual. Behavior therapy helps to remove obsessions and compulsions and thereby ameliorate the distress.

In treating OCD several CBT techniques are used. One of them,  Exposure and Response Prevention (ERP) , is the most effective and widely used technique.

Obsessive Compulsive Disorder (OCD) - All You Should Know!

Brain health is essential for people of all ages. Of late MIND and DASH are two popular approaches that are leading the way dietary requirement for brain health. MIND stands for Mediterranean Intervention for Neurodegenerative Delay whereas DASH stands for Dietary Approaches to Stop Hypertension. Both the approaches argue that diet plays a crucial role in maintaining overall brain health. Here is a list of 8 diet changes that can boost the brain health without having to take any other brain supplements:

Leafy green vegetables: Leafy vegetables are tried and tested source of natural brain tonic. Vegetables such as spinach, kale, collard greens and arugula should be thoroughly washed and chopped. They can be consumed with salads, pasta, and soups.
Pulses: Pulses such as lentils, beans and peas can be consumed with salads to maintain brain health. Alternatively, they can be consumed along with burgers to give it a twist. They can also be used to make patties. A mixture of black beans, onions and peppers can be mashed along with some spices to form the main entr e of the patties.
Whole grains: A batch of brown rice, quinoa, oats or faro can be prepared and consumed to upgrade brain health. While grains comprises of fibre and makes for a very fulfilling meal. Whole grain can be prepared in batches so that it can be consumed throughout the week along with salad and soup.
Home-made snacks: A snack made from walnuts, pumpkin, almonds and pistachios can serve as a quick snack during long drives and small breaks in between meetings. A small portion of these snacks will not only boost brain health but give a sense of fulfilment.
Berries: Frozen berries are known to be extremely beneficial for brain health. They can be mixed with smoothies and consumed during breakfast and or in the form of snacks. Berries are a nice addition to oatmeal as well.
Olive oil: the butter or the refine oil can be traded with olive oil while preparing vegetables and meats. It can also be used as a base for homemade vinaigrettes. Olive oil serves the purpose of good health and has hardly any side effect on the body.
Poultry items: One can become a lot creative when it comes to consuming poultry items. Chicken breasts for instance, when cooked with garlic and onion in a pressure cooker, can be a real agent for brain maintaining brain health. One can add some flavour and consume it along with sandwiches and salads.
Fish: One fish should be consumed once in every week. Salmon fish is known to have a great effect on mental health.

8 Diet Changes That Can Boost Your Brain Health

If you are a heavy drinker and consume excess alcohol, you may face severe consequences related to short-term and long-term health. Alcohol has several negative impacts and affects on your heart. Although occasional drinking does not cause much harm, excess drinking may lead to many heart complications. There are chances of the development of cardiovascular diseases in an alcoholic person.
Alcohol affects the heart in several ways. Binge drinkers are more prone to face these complications. A person who drinks alcohol regularly, drinks very fast and drinks much more than the recommended consumption limit during a single session is called a binge drinker.

Here the ways in which alcohol affects your heart:

Alcohol weakens the heart muscles: Heavy drinking for a long span of time tends to weaken the heart muscles. A condition known alcoholic cardiomyopathy may be caused. When the heart gets weakened, proper contraction gets disrupted and the heart is unable to pump sufficient amount of blood. Due to this, a person may experience certain symptoms such as tiredness, irregular heart rhythm, shortness of breath and swelling of the feet and legs. This can also lead to a heart failure.
Alcohol affects your heart beat rate: Binge drinking and regular drinking over a long period of time may affect the rate of the heart beat or how quickly the heart beats. Alcohol may cause the heart to beat too fast, and irregular beating is observed. This is a condition known as arrhythmias, which may have grave consequences on your health. If you are not a regular drinker but drink too much in a day, you could face this condition.
Alcohol can lead to high blood pressure and also cause a stroke: Binge drinking leads to increased blood pressure, also known as hypertension. The blood vessels become stiff, and this causes the pressure to rise in the arteries and veins. Heavy consumption of alcohol may also trigger several stress hormones to be released, which cause a constriction in the blood vessels. This leads to increased blood pressure. Hypertension may lead to a heart attack or stroke.
In order to reduce the negative impacts of alcohol on your heart and overall health, you must practice drinking in moderation. You must not drink more than fourteen units of alcohol in a single week. Consume these fourteen units in three to four parts instead of consuming it all at once. You should give gaps and avoid regular drinking.

Alcohol - How It Affects Your Health?

The word epilepsy brings to mind visions of people frothing at the mouth and rolling on the ground. However, epilepsy affects each patient in a different way. This can make it hard to recognize at times. In the more serious cases of epilepsy, an epileptic attack can make a patient injure himself or develop other life threatening conditions. In rare cases, epilepsy can even cause death. Thus it becomes imperative to understand how to deal with epilepsy.

Treatment options for epilepsy can be categorized as medication, surgical procedures and dietary changes.

Medication
Medication for epilepsy is prescribed on the basis of the symptoms presented and the type of epilepsy the patient is suffering from. In most cases, seizures can be controlled with a single type of medication, but in others, the doctor may need to prescribe a combination of medicines to control epilepsy. These forms of medication do have side effects and hence any reactions to the medication must be immediately brought to the doctor's notice. The dosage for epilepsy medication may need to be varied with time. An epileptic patient should never discontinue medication on their own.

Surgery
Depending on the type of seizures and the area of the brain affected, a doctor may advise surgery in cases of severe epilepsy. Surgery can help reduce the number of seizures experienced or completely stop them. Surgery to treat epilepsy is of many types. Some of the common procedures are:

1. Surgery to remove tumor of any such conditions that may be triggering the epileptic attacks
2. Surgery to remove a small section of the brain from where a seizure originates. This may also be referred to as a lobectomy.
3. Multiple subpial transaction or a surgery that involves making a series of cuts in the brain to prevent the seizures from spreading to other parts of the brain.
4. Surgery to sever the neural connections between the right and left hemispheres of the brain.
5. Surgery to remove half the brain's cortex or outer layer

Dietary changes
A diet rich in fats and low in carbohydrates can help reduce seizures. This is known as a ketogenic diet and aims at making the body break down fats instead of carbohydrates. It can cause a buildup of uric acid in the body and thus should be practiced only under the guidance of a dietician. In cases where epileptic attacks are triggered by malnutrition and birth defects, taking vitamin supplements can help lower the frequency of seizures.

How to Deal with Severe Epilepsy

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!

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