Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

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?

The feeling of instability is the crux of borderline personality disorder. This condition usually begins in early adulthood and is worst at its onset. As a person ages, borderline personality disorder usually improves and becomes easier to handle. For a person with borderline personality disorder, everything from their relationships to their moods, thinking and behaviour is unstable and constantly changing. This can be frightening but thankfully, this condition can be treated.

As with any other personality disorder or health issue, the earlier a condition is diagnosed, the easier it is to treat. Hence, it is important to understand the signs and symptoms of this disorder. This disease manifests itself in different ways in each person but some symptoms are commonly experienced. These include:

Fear of abandonment: No one likes to be alone, but people suffering from borderline personality disorder are terrified of being abandoned. Even something as simple as being stood up at a meeting, can make such a person extremely anxious. It can also lead to relationship problems by making the person seem clingy and jealous about their partner.
Unstable relationships: For a person suffering from this disorder, relationships are either perfect or failures. Hence their relationships are extremely passionate but very short lived and they often feel disappointed by their partners.
Unstable self-image: People suffering from this disorder may feel very confident one day and feel the opposite on the next. Though everyone has shifting views of their identity form time to time, for people suffering from this personality disorder, theses shifts are extreme. It can often lead to frequent changes in jobs, friend circles, relationships, goals and values. It can also cause changes in their understanding of sexual orientation.
Impulsive behaviour: People who display self-destructing and attention seeking behaviour may suffer from this condition. This disorder has been often associated with alcoholism, drug abuse and recklessness.
Suicidal behavior: People suffering from this disorder may often be associated with behaviour that physically harms them. They are also capable of following through on suicidal threats.
Mood swings: Extreme fluctuations in emotions and moods are a common experience or people suffering from borderline personality disorder. These mood swings usually start only a few minutes of a few hours unlike depression and other anxiety disorders.
Suspicion about everyone around: Borderline personality disorder can make a person struggle with suspicious thoughts about everyone around them and make them paranoid. They often feel out of touch with reality and can feel spaced out when under stress.

Borderline Personality Disorder - Signs and Symptoms!

Role of relationship problems in depression and suicides - 
Almost everyday we read about people ending their lives by committing suicides from celebrities to common man to even children . Although this is not permitted in any religion and there is a legal debate on whether it should be legalized, the fact remains that people are driven towards this unfortunate step. Let's take a look at the common reasons for suicides to become so very common.

1) Lack of intimacy- We see that although we are surrounded by people most of people are having friends only on Facebook. Even among the people we interact everyday nobody wants to open up with anyone or allow you to open up with them.The fact that you are surrounded by people who don't share themselves with you intimately starts pulling your mind downwards. Work colleagues are bothered only about work, family is only bothered about the income you are generating, partners are obsessed with how much you can spend on them, friends are occupied with what benefits you can share with them. Therefore all in all, despite having all relationships, people feel left out and alone like as if their inner self has been left unwanted and uncared of. The monotony of mechanical life hastens the culmination of this abuse into drastic steps like suicide.

2) High demands- People are often left to fend with high demands from them from their social circle. Many people cannot attempt this and some who attempt are not able to make it. This leaves them with a feeling of failure which is often frowned and looked down upon whether it is a student or a professional. It is no surprise that today even below 10 years olds are successfully attempting suicides.

3) Inappropriate planning- Planning is a key necessity for successful results whether it is financial or relationships. but unfortunately many people are unable to obtain the correct know how which will enable to implement their plans successfully.

4) Inability to cope- Many people plan to do things but are unable to cope with the harsh realities that come with the plans. To some it may be unseen to some unbearable. So although they set out on doing something the journey is not what they had expected.

5) Lack of results- Sometimes although everything is planned well, executed well and completed well it does not fetch us the rewards that may seem appropriate to the level of efforts. This is something that is very difficult to deal for most people and is a result of many unfortunate casualties.

6) Lack of desire-It is very important to have something to look forward to in life. But unfortunately in an age where drinking water and using the toilet cost s money many people cannot think of having something to look forward to and hence this unfortunate step.

Therefore, you have to be very prudent in what we are doing today because we can never predict which way our lives may go and even importantly which way you may yourself go based purely on circumstances beyond our control dependent on the choices we make today or others make for us. Although suicide is not a sensible solution to any problem it does remain a common reality. If you are feeling suicidal please remember to seek help.

Please feel free to consult me privately for further assistance.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Health Tip - Role of Relationship Problems in Depression and Suicides

Aphasia is a communication disability that can result from damage or injury to those parts of the brain that process language. It can happen due to stroke, brain tumors, accidents, or brain infection. A brain injury which damages parts of the brain that deal with language can also bring on Aphasia. Aphasia can also be caused by dementia such as Alzheimer s disease. Aphasia is sometimes also a symptom of epilepsy or other neurological disorders.

It s more common in older adults, especially after a stroke. What happens in Aphasia is that the affected person is unable to understand or use words. He or she may also:

Have difficulty speaking and finding the "right" words to express themselves verbally
Have problems understanding conversation
Have problems reading and comprehending written words
Have problems writing words
Is unable to calculate or use numbers
Has a tendency to use gibberish words as a part of speech
There are various types of Aphasia, differing in certain important ways from each other.
Aphasia can also be mild or severe. With mild Aphasia, the patient is able to converse, though he may not be able to find the right word or may not understand complex conversations.
However, in severe Aphasia, a person may lose his ability to communicate completely which means he can t speak or understand any conversation and may also not be able to read or write.

Three things that aid Aphasia recovery are

Speech Therapy
Family Support
Persistence
Treatment for Aphasia depends on factors like:

Age
Cause of brain injury which causes Aphasia
Type of Aphasia
Position and size of the brain lesion causing Aphasia
If the Aphasia is due to a brain tumor, surgery to remove the tumor affecting the language centre can treat Aphasia.
For a person who s got Aphasia due to a stroke, sessions with a speech-language specialist are very effective. The therapist teaches the patient ways to communicate using stuff that doesn t involve speech.
He uses the following to help the patient communicate without words:

Props
Drawings and pictures
Teaching patient to speak slowly and be calm when talking.
Treatment techniques
The speech therapist uses these two main techniques to tackle Aphasia:

Substitute skill model: This uses a prop like a writing board to help with spoken language.
Direct treatment model: This approach uses specific exercises to help patients
Copy and recall therapy (CART): This approach uses repetition and recall of certain words during speech therapy.
Visual communication therapy (VIC): This involves the use of index cards to represent various components of speech.
In addition, Aphasia patients are also trained in the use of hand gestures to aid in communication as a part of  Visual Action Therapy (VAT) .

Aphasia - Factors That Put You At Risk!

Autism is a developmental disorder that is usually diagnosed within the first three years of a child s life. Speech disorders and an inability to communicate with others are characteristic symptoms of autism. Speech therapy can be very beneficial for such children. Thus, it is often a major part of a treatment plan for autism. Some of the benefits of speech therapy for autistic children include:

Better articulation: Autistic children often find it hard to make certain sounds. Hence, they tend to babble or make harsh sounds or grunt instead of talking. A speech therapist can help the child learn to articulate sounds in a better way. For this, the therapist will help the child exercise the facial muscles and lips. This can make it easier for them to be understood by others.
Treating echolalia: Echolalia refers to a child s behaviour where he or she answers a question by repeating part of it. This may be because they find it difficult to express their own thoughts and feelings. Echolalia is very common amongst autistic children. Speech therapy is the only way to treat this condition. If left untreated, it could make the child withdraw into himself.
Better vocabulary: Autistic children often memorize words without understanding them. A speech therapist can help the child put words into context and thus help reduce their dependence on gestures. This can also make autistic children more confident. In addition to expanding their vocabulary, a therapist can also teach children the proper time and place for communication. For example, when to say good morning and good evening.
Initiate communication: When children are not confident of expressing themselves, they wait to be called on before saying anything. By helping them articulate sounds better and expanding their vocabulary, a speech therapist can help children gain the confidence needed to initiate conversations. With therapy, autistic children can also follow simple instructions and begin to answer questions independently. This will make them more independent.
Speech therapy does not follow the same techniques for all children. For therapy to be effective, the therapist must work in close collaboration with the child s parents and caregivers to set the right goals and monitor the child s progress. Some of the techniques that may be used include the use of electronic talkers, typing or signing, picture boards, facial exercise and massages, using rhyme to help construct sentences and using sounds to help the child expand speech sounds. If the child is non-verbal, the therapist may also introduce alternatives to verbal communication.

Can Speech Therapy Help Autistic Children?

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