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?

A neurological disorder is characterized by sudden recurrent episodes of sensory disturbance, loss of consciousness, and convulsions associated with abnormal electrical activity in the brain.

Role of Physiotherapy in Epilepsy

It helps improve strength, mobility, and increases the range of motion and sphere of movement.
It helps improve sensory awareness, response, balance, and coordination.
It helps to improve quality of movement and physical performance.
The Goals of Physiotherapy

To develop strength enough to support one s head upright
To have balance and motor control to maintain their trunk at midline
To use many different muscle groups
To assist necessary motion in their trunk and extremities
The physiotherapists write short-term goals for each of the items on the problem list that need to be covered to help the patient achieve the long-term goals
To understand what the patient is good at and does well
To focus on what he or she capable of doing rather than on what they can t do
To educate and provide awareness with a view to prevent injury. For example, advice on special swimming equipment to prevent drowning if he/she gets seizures in the pool
Physiotherapy treatment for a healed fracture consists of strengthening muscles that have got weak from being immobilized and stretching muscles that are stiff owing to being in the cast for a long period of time.

Physical exercise improves fitness, energy, and mood and even relieves stress. Improving overall health and wellbeing in this way can help reduce seizures. It can also help people feel more in control of their health. It also helps release  feel good  hormones into the brain, helps keep the muscles active, reduces fat levels in the body, and increases oxygen flow to the brain. It can also increase the bone density. A research showed that regular sessions of aerobic exercise (for example running, walking, swimming, cycling) for 60 minutes, twice a week, for 15 weeks resulted in a significant reduction in the number of seizures they had.

Drink water, diluted fruit juice, or squash while exercising to help replace the fluids and body. Do not exercise straight after a meal.

Team sports or group activities such as walking or gardening groups can also be a good way of increasing self-confidence. Making new friends may help with any feelings of isolation. Most sports, including contact sports like football, hockey, basketball and rugby, have not shown to increase the chance of someone having a seizure, but contact sports come with an increased risk of head injuries, which could affect people with a history of epilepsy. Protective sports headgear helps to reduce this risk. 

Role Of Physiotherapy In Treating Epilepsy!

For years I have been practicing as a psychotherapist in different parts of the world and what I have noticed is that no matter what kind of relationship or marriage a couple are in, when they end up in my office it's always for the same reason: they want to be happier, healthier and more-connected even though the issues can vary - money, sex, infidelity, in-laws, children etc.

Despite this each relationship is completely subjective and no clear cut rules can be executed on it, yet following certain guidelines may help proceeding happily in a relationship.

If you are struggling in your relationship (and if you are reading this article there is a big chance you are unless you are one of my friends..or both) you might find it helpful to follow some of these ideas:

1. Love yourself

You must love yourself before you can love another. By accepting yourself and fully being what you are, your simple presence can make others happy. Accepting yourself fully as you are and showing yourself this same unconditional love will provide protection, healing, and confidence to work on your shortcomings.

2. Adopt a positive lifestyle

There are many different ways in which you can embrace a more positive lifestyle - practice affirmations, express gratitude, meditation, exercise... just find something that helps you unwind and enjoy life. And most importantly - keep doing these things repeatedly.

3. Empathize with your partner

The ability to empathize is what inhibits us from just going through life doing whatever we want, without any regard for others. It is what makes compromise in a relationship possible. If I realize that something I've done has hurt you (because I can empathize with your pain or unhappiness) I will hesitate to do that again.

4. Take responsibility: Don't try to figure out who's right

When couples come for therapy, one or both tend to think that the primary problem is their partner. Both people co-create the climate of the relationship. And both need to do some things differently to create the marriage or relationship they both really want. If your intention is to create a more positive world for yourself and those around you, it's up to you to have the thoughts, moods, and actions that will create that world.

5. Stay connected

When there is distress in the marriage or relationship, one or both usually feel some emotional disconnection. Frequently, sexual passion diminishes as well. (However, sometimes one partner will try to increase frequency of sex in an effort to feel connected.). And often, people will busy themselves with work or kids instead, or do other things to either try to feel connected or to avoid being alone with the person with whom they feel the pain of disconnection

6. Express thoughts, feelings, and wishes 

Resentment can build when couples sweep things under the rug, so be vulnerable and don't bury negative feelings, but try to express them in a respectful way.

Opening up to your partner can make you feel vulnerable and exposed, but it is the most important part of an intimate relationship. In Daring Greatly, Dr. Brene Brown defines vulnerability as uncertainty, risk, and emotional exposure. Given this definition, the act of loving someone and allowing them to love you may be the ultimate risk. Love is uncertain. It's risky because there are no guarantees and your partner could stop loving you. Exposing your true feelings may mean that you are at a greater risk for being hurt or criticized.

7. Try new things together

Boredom can be a major obstacle to lasting romantic or companionate love.

Psychological research has suggested that couples who experience the most intense love are the ones who enjoy participating in new or challenging 'self-expanding' activities together.

8. Preserve your independence

Dr Perel, in her popular TED talk explains that neediness and caretaking in long-term partnerships - which can easily result from looking to the partnership for safety, security and stability - damper the erotic spark. But if couples can maintain independence and witness each other participating in individual activities at which they're skilled, they can continue to see their partner in an ever-new light.

If after trying the above you are still struggling with your relationship, make sure you go and see a couple therapist.

Two couples talking in one couple's living room...

One says to the other, 'The work being done on your marriage.. are you having it done or are you doing it yourselves?'



8 Tips To Rev Up Your Relationship With Your Partner

Alternating between being happy and sad as you go through life's ups and downs is normal, but if you're sad most of the time, it could be a sign of being depressed.  Depression takes the joy out of all your activities, and can make merely getting through a day feel overwhelming. The first step to overcoming this problem is to understand its symptoms and causes.  Not everyone experiences depression the same way, but here are a few questions that can help tell you if you are depressed or not.

Do you feel helpless?
It is common for depressed people to feel helpless and that everything around them is out of their control. As a result, the person may either stop participating in activities all together or try to control things they can't. Both situations are cyclic and lead to further depression.

Have you lost interest in daily activities?
The feeling of helplessness is one of the main reasons depressed people lose interest in activities. Another reason is that activities that were once enjoyed now do not seem interesting enough. In most cases, this leads to the person isolating himself and withdrawing from all his family and friends.

Do you often feel angry or irritated?
Depression is almost always accompanied by irritability and anger. Small annoyances that would usually be overlooked quickly, take on an inappropriate significance. This can lead to poor impulse control, substance abuse and anxiety disorder. In most cases, anger and depression are related by the person trying to take accountability for things that are out of his control and hence feeling helpless.

Is there a change in your sleep pattern?
Your sleep quality is very closely related to the way you feel. Depressed people often suffer either from insomnia or oversleeping. Depressed people can have trouble going to sleep as well as staying asleep. This can cause drowsiness and lethargy during the day. Sleep apnea is also linked with depression. As you can imagine, if this is left untreated, it will only worsen your depression.

Do you feel tired?
When the body does not get adequate sleep, you begin the day feeling tired. Thus, depressed people often feel fatigued and complain of a number of muscle and joint pains.  This is because the body has not had enough time to regenerate cells during the night. This is usually complemented by complains of persistent headache and stomach aches, both of which are emotionally connected to the way you feel.

The nature of depression is such that it lowers a person's self-esteem to the point of interfering with his ability to seek help. Hence, if you have a positive response to the above questions, it is time to address your problem before it worsens.

How To Recognize Depression In Adults

Dementia cannot be singularly regarded as a specific disease, but rather indicates a group of symptoms associated with your memory, cognitive thinking, and social abilities, up to the point where daily functioning gets affected. In most cases, dementia steadily worsens over time (progressive dementias). Dementia is not to be confused with memory loss alone; because it is natural with old people to experience memory loss, but that does not necessarily mean they have dementia. If the reason is dementia, then you may require medical treatment.

Causes

Dementias are generally caused either by damage to or changes in the nerve cells operating in the brain. The causes can be grouped differently based on the type of dementia experienced and the part of the brain affected. While some causes can be reversed with effective treatment, others, unfortunately, cannot.

The most common causes of dementia which cannot be reversed include:

1. Alzheimer's disease
2. Vascular dementia
3. Parkinson's disease
4. Frontotemporal dementia
5. Dementia with Lewy (dementia which is neurodegenerative and progressive in nature) bodies
6. Severe head injuries

Other irreversible causes which are relatively rarer than usual include:

1. Huntington's disease (breakage of the brain's nerve cells)
2. Creutzfeldt-jakob disease (irreversible and fatal brain disease)
3. Multiple sclerosis or amyotrophic lateral sclerosis
4. Infections like syphilis
5. Leukoencephalopathies (diseases affecting the brain's'white' areas)
6. Brain injuries
7. Multiple system atrophy

Causes of dementia which can be treated include:

1. Hypothyroidism
2. Heavy metal poisoning
3. Certain brain tumors
4. Chronic alcoholism
5. Hiv/aids
6. Vitamin b12 deficiency
7. Medicinal side effects or abnormal drug reactions
8. Normal pressure hydrocephalus
9. Certain cases of encephalitis

Symptoms

Symptoms of dementia include:

1. Memory loss
2. Difficulty finding the right words
3. Difficulty exercising judgments, especially during emergencies
4. Inability to recall particular events or to recognize people and places
5. Depression or other mood disorders, in addition to symptoms like uncontrolled aggression or constant agitation.

Causes and Symptoms of Dementia

Like everyone else, teenagers are susceptible to anger. When this gets out of control, it can lead to problems at school as well as at home. One of the major reasons for this is that teenagers do not know how to channel their anger and control it. When teaching teenagers how to manage their anger, it is important to understand that each child is different and will respond to anger differently. Here are a few tips that could help.

Recognize triggers and warning signs: Most anger outbursts are triggered by common factors. This could include feeling disrespected, feeling misunderstood, being refused permission or something or feeling as though too much were expected. It is important for teenagers to recognize these triggers so that they can deal with them in a better way. An anger outburst is also often preceded by certain physiological changes. For example, a person s breath could quicken or they may begin to clench their muscles before getting angry. Recognizing these early signs can help teens control their anger and not allow the situation to escalate.
Develop a vocabulary: Most teenagers throw tantrums and slam doors because they do not have words to express their anger and end up getting more and more frustrated with themselves and the situation. Hence, help your teenager develop a vocabulary to express what he or she may be feeling. This could include words like angry, mad, furious, irritated, tense, apprehensive, etc. Encourage them to talk out their anger instead of letting it simmer inside them. When your child does say things like  you re making me angry  etc do not immediately discipline him but instead talk it out. They may also be encouraged to write out their anger or find other creative outlets for it.
Deep breathing: Deep breathing is an anger management technique that helps adults and children alike. Teach your child how to take a few deep breaths before lashing out at someone. Show your child how to inhale slowly, hold the breath and exhale slowly while counting to five. This can help him or her calm down and handle the situation in a better way.
1+3+10: This is a golden rule of anger management. When your teen feels angry he or she needs to tell himself or herself to calm down. This is step 1. Next, they should take 3 deep breaths. This should be followed by counting to ten slowly. This can help them gain control of the situation and prevent an anger outburst.
The above mentioned tips can help in anger management of teen. However, if the condition seems out of control, you can always seek professional help to deal with the situation.

How To Handle Angry Teenagers?

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