Sleep is the normal physiological process of our body which is as important as respiration and digestion. Sleep is vital for maintaining our physical and mental health. Normal adults require 8 hours of sleep every day, whereas it 14 to 15 hours of sleep is recommended for for infants and toddlers.

What are the different stages of Sleep

Every human has a natural circadian clock in their body, which is responsible for maintaining our sleep - wake homeostasis. The different stages of sleep include REM and NREM that is rapid eye movement sleep and non rapid eye movement sleep respectively. REM is the deep sleep stage in which it is very difficult to wake up the person as this stage includes the sensory inhibition and all voluntary muscles along with almost all interactions with the surroundings are inhibited. Therefore, a person s physical stress and tiredness also gets relieved during this stage of sleep. NREM sleep is the stage between REM and awakening and here the person may have sensory connection with his or her surroundings, but may not respond.

Sleep and its benefits
Sleep and stress have a very strong connection with each other. The best way to relieve stress and any other mental disturbance is sleep. It is essential to have knowledge about sleep psychiatry for almost all physicians as they face many sleep deprived patients in their day to day practice.

    Sleep is not only responsible for relieving mental stress and depression, but has other benefits as well
    Sleep is also essential for the normal physiological growth in early infancy and it is vital for development of normal alertness, attention and knowledge
    It also relaxes our voluntary muscles and thereby, relieves us from physical stress
    Sleep disturbance may also aggravate diseases in our body. Sleep is also the state of recovery and healing.

Sleep psychiatry also insist on meditation and ensures that people have normal pattern of sleep, in order to maintain the mental health of the person in a normal state.

Sleep Pyschiatry: Its Stages and Benefits

The most powerful and amazing organ in our body is the brain. It differs from many other organs of our body not only by its shape, but also by its special type of cell called neurons. When these cells gets affected or dead it can never be reverted or regenerated which is the most exclusive nature found only in brain cells. The cells in other parts of our body has the capacity to regenerate (can be replaced or new one can be grown or produced), but brain cells are exception. Hence any damage to the brain, injury or trauma is really a crucial thing to be considered with utmost care.

Brain surgeries really need skill, proper training, confidence and intelligence to perform this highly complicated and risky surgery.

Purpose:
Brain surgeries are performed to:

Remove the brain tissues that are grown abnormally
Aneurysm is clipped to prevent flow of blood cliff off an aneurysm
Biopsy purpose or to remove the tumour
Make a nerve free
Drain the abnormal blood or clot collection or to drain any excessive fluid collection caused by infection.
To implant artificial electronic device as a treatment for conditions like Parkinson's disease
Types:

Biopsy: A part of brain tissue is removed for the brain or whole tumour is removed.
Craniotomy: The skull bone is opened to remove tumour, an aneurysm and drain fluid or blood from infection.
Minimally invasive endonasal endoscopic surgery: Endoscopic devices are inserted through the nose to remove the lesions or tumour.
Minimally invasive neuroendoscopy: Similar to endonasal surgery but small incision is made.
Risks:

Anaesthesia risks like breathing difficulty, allergic reaction to medications, excessive bleeding or clots and infection.
Risk related to the brain surgeries are seizures, coma, swelling of brain, infection to brain or meanings, surgical wound infection that intrudes to the brain structures, abnormal clot formation and bleeding.
General risks include muscle weakness, disturbances in memory, speech, vision, coordination, balance and other functions that are controlled by the brain.

Brain Surgery - Know The Purpose Behind It!

Dementia is a dreaded psychological disorder in which the brain cells begin to deteriorate. It is different from regular senility. When the brain cells stop doing their work, it affects the brain function. This leads to a gradual loss of memory. At the same time, the person may also experience changes in personality as well as declining cognitive abilities, all of which are linked to the faculty of memory. Dementia usually affects senior citizens. However, it may happen to the young as well.

What are the Causes of Dementia?
Dementia may be prompted by -
  Alzheimer s Disease
  Huntington Disease, a degenerative disorder
  Vascular dementia
  Atherosclerosis
  HIV
  Multiple Sclerosis
  Pick s Disorder
  Parkinson s Disease
  Encephalitis, both viral and bacterial
  Lewy Body Disease
  Brain Tumour
  Progressive supranuclear palsy
  Chronic Subdural haematoma
  Wilson s Disease
  Neurosyphilis

Dementia in Siddha -
Siddha is an ancient and indigenous branch of medicinal science that was developed in Tamil Nadu. Siddha aims to get to the root of any ailment and eliminate it from the source instead of simply trying to eradicate the symptoms. Siddha believes that the human body primarily consists of three humours- Kapha, pitta and Vata. As long as the right balance is maintained, the human will be healthy. But if the balance goes out of whack or if the quantity of one humour exceeds the others, then that will make a person vulnerable to diseases.
When there is a Vata imbalance in the mind, a person s memory begins to fail him/her.

According to Siddha, a person who has contracted dementia will exhibit the following symptoms -
  Forgetfulness
  Difficulty with recollection and reasoning
  Confusion and disorientation
  Inability to make plans
  Impaired judgement
  Anxiety
  Depression
  Hostile behaviour
  Losing interest in everything around him/her
  Disturbed sleep
  Restlessness
  Hoarding
  Delusion or hallucinations (in advanced stages of dementia)

The approach of Siddha towards neuropsychiatry revolves around the concept of  Kayakarpam    a mode of treatment that can slow down ageing and deterioration of the brain cells. Treatment of dementia consists of -
  Skinned ginger soaked in honey
  Paddy rice mixed with ghee
  Amaranth cooked ghee, salt and pepper
  Aloe Vera
  Black nightshade

Treatment of dementia also includes  thokkanam . Medicinal oils are messaged onto certain parts of the body to activate the Varma points. This will release the  praana vayu - the force of rejuvenation. Siddha also recommends regular meditation top slow down the progression of dementia.

Allopathy has not yet come up with a cure for dementia. But, Siddha can help. Moreover, Siddha medicines are safe and can be consumed without fearing side effects.

Dementia - Getting It Treated With Siddha!

One of the common ailments in the elderly people is the Parkinson s. A progressive disorder, when left untreated, results in worsening of the symptoms. Hence, it is essential to understand the treatment options available to manage the condition effectively. You may be suggested surgical therapies if medication is not effective enough to treat the symptoms.

Surgical treatment options can be beneficial for patients who are suffering from symptoms, but they do not help with treating the disease. In the past, surgical methods like Thalamotomy and Pallidotomy were used to destroy brain cells that contributed to the symptoms. While these methods are still used, they are very rare and situational.

Deep Brain Stimulation (DBS), an FDA-approved procedure, has become much more popular as it is much safer and does not involve invasive surgery. Instead of destroying brain cells like traditional methods, DBS involves sending electric pulses to the affected brain cells to reduce the symptoms. It is not a treatment procedure, but a means of bringing down the severity of Parkinson s to allow better and more comfortable treatment.

Deep Brain Simulation   Who are the right candidates?
Deep Brain Simulation is commonly used for Parkinson  s disease, but it is not recommended for everyone. It is a preferred method of treatment for people who have had Parkinson s for at least four years but have complications which include long periods of time where medications do not work, or symptoms return, uncontrolled and involuntary movements or the freezing/stiffness in the body.

Deep Brain Simulation is not recommended for those who have Dementia as it can lead to memory problems. The general rule of thumb that neurosurgeons follow is that Deep Brain Simulation can help with symptoms that do not get better with medication. DBS can help reduce medication requirements for patients as well as reduce the side effects that may occur due to medication.

Disorder specialists and neurosurgeons can conduct tests to determine if DBS is going to be effective for a patient before going ahead with such a procedure. An extensive assessment is necessary to understand the symptoms, the effect of Parkinson's drugs and also brain imaging is done. All of the expected benefits are then evaluated for the patients, and if the procedure can help alleviate the symptoms, DBS is given a green signal by neurosurgeons and patients can undergo the procedure.

How Does Deep Brain Simulation Work?
Deep Brain Simulation is a very complex procedure. Brain cells communicate with the rest of the body through electric signal, and these become irregular and do not work properly when affected by Parkinson's. DBS smoothens the functioning of these brain cells and reduces symptoms through electric pulses through the implantation of a medical device known as neurostimulator which is also referred as brain pacemaker.

But, as with any treatment procedure, DBS has potential risks and side effects, hence discuss with neurosurgeon thoroughly to access the suitability.

Adopting Deep Brain Stimulation For Parkinson's disease

Epilepsy is a relatively common disorder. Most cases of epilepsy can be controlled with a combination of drug therapy and healthy lifestyle. In some cases, surgery may also be advised. Epilepsy affects not only the lifestyle of the patient but also that of their caregiver. Each person reacts to epilepsy in a different way and hence the type of care needed also varies from person to person. While some patients have few seizures and require care only when they're having a seizure others need round the clock care. Here are a few tips to keep in mind if a loved one suffers from epilepsy.

Know what type of epilepsy he/she is dealing with: Not all epileptic seizures are the same. Find out what type of seizures your loved one suffers from and what are the possible triggers associated with Involve yourself in their lifestyle. Epilepsy should not be a reason for your loved one to lock themselves in a room to stay safe. Participate in activities with them of you feel the activity may be a safety risk if they were to have a seizure; for example - swimming.
Notice seizure triggers: Often an epileptic patient may not remember the seizure after it has occurred. As their care giver, keep a seizure diary to track their seizures and its related triggers. Look for patterns in the triggers to their epilepsy attacks.
Keep them safe during a seizure: When experiencing a seizure, the patient will lose consciousness, experience muscle convulsions and may grit his teeth. If the person is standing, hold them so that they do not fall. If they are lying down, try turning them onto their side. Do not put anything into their mouth.
Take care of them after a seizure: After the seizure, people are most likely to be confused, tired and have a headache. Check for injuries and keep them calm till medical help arrives. Loosen clothing around their neck and ensure that there is nothing inhibiting their breathing.
Medical identification: While someone who suffers from seizures often is likely to always have someone with them, others who have rare seizures may often venture out alone. In such cases, ensure that they always have medical identification on them. Also make sure that their friends, colleagues etc are aware of their medical condition.
Help them maintain a healthy lifestyle: Staying active is essential for people with epilepsy. Avoid contact sports and pick low impact exercises like walking, running or swimming. Following a buddy system is essential when an epileptic person works out. If you wish to discuss on any specific problem, you can consult a neurologist and ask a free question.

How to Deal With 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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