Dr. M Bhutani

Agoraphobia can be defined as the fear of being in a situation from which one cannot escape or a situation that humiliates the person. This causes people to avoid situations that they anticipate to be humiliating. Such a situation makes the person feel trapped and helpless. Everyday situations like standing in a queue, getting into an elevator, using public transport etc. can trigger Agoraphobia. 

Agoraphobia affects more women than men. It usually affects people under the age of 35, but can sometimes affect older people as well. Having a relative in the immediate family circle that suffers from this condition can also increase a person's risk of suffering from it as well. Additionally, the death of a parent or loved one or domestic abuse could also trigger such behavior. Depression and alcohol or drug abuse could also increase a person's risk of suffering from this psychological disorder.

This phobia usually develops after a person experiences panic attacks or goes through an extremely stressful experience. Some typical symptoms of Agoraphobia include:

1. The fear of being alone
2. Fear of crowded places
3. Fear of being in locked places from where you cannot escape
4. Fear of losing control of one's actions
5. Inability to leave the house alone
6. Helplessness
7. Being overly dependent on others

You may also experience symptoms similar to those of a panic attack, such as excessive sweating, breathing difficulty, dizziness, diarrhea and chest pain.

An in depth interview with a counselor or doctor can help diagnose such a condition. A physical examination can also help rule out other health conditions that could be triggering such a reaction. To be diagnosed with Agoraphobia the patient needs to present at least two of the below symptoms:

1. Severe fear of public transportation
2. Fear of being in an open space such as a parking lot or mall
3. Fear of being in closed spaces such as movie halls or elevators
4. Fear of standing in line
5. Fear of being in a crowd
6. Fear of leaving home alone

Treatment for such a condition involves medication and psychotherapy. Anti depressants and anti anxiety medications are commonly used to treat such disorders. There are a number of different types of such medication and you may need to experiment with them before finding one that suits you. Psychotherapy or talk therapy focuses on cognitive behavioral therapy that reduces anxiety symptoms and teaches patients how to deal with fears. If you fear leaving the home alone, you could take someone along with you or consult a therapist who can offer you telephonic advice, through email or meet you at your home. 

6 do's and don'ts of healthy eating habits

Do's

1. Try to eat more unprocessed foods

Use fresh ingredients like vegetables, eggs, milk, lean meat etc to prepare your meals in and try to avoid consumption of processed food as far as possible. In most cases, processed food items are loaded with preservatives, added chemical substances, sweeteners, fats and artificial colours, which should be avoided to maintain good health. Also, make sure to include lots of fresh fruits, nuts and legumes in your daily diet instead of fruit juices, instant noodles or frozen food items.

2. Include whole grains in your diet

Whole grains have a lesser glycemic index (figure that measures the ability of carbohydrates to increase glucose in your blood), which makes them a healthy food option. Whole grains keep you full for long hours while providing you with energy to concentrate at work throughout the day. When it comes to taste, the flavour and nuttiness of whole grains are superior to refined ones. So, prefer wholegrain bread, pasta or brown rice when choosing your food items.

3. Monitor your serving sizes

Monitoring the amount of what you eat is important as it helps you to limit your intake of unhealthy food. Also, ensure that the amount of food you eat for dinner is lesser than that of your lunch. Ideally, for lunch, you should ensure that half your meal consists of salad or vegetables and the other half should contain lean proteins and low-gi or whole grain carbs in equal amounts.

Don'ts

1. Skip breakfast

Breakfast is considered to be the most significant meal of the day. Make it a habit to have breakfast every day as skipping this meal can adversely affect your health by causing obesity, irritated mood, and headaches while increasing your risks of getting hypoglycaemia (deficiency of glucose in your bloodstream).

2. Eat excessively saturated fat

Try to minimise your intake of food containing saturated fats as this can lead to the accumulation of weight in different parts of your body. Instead of consuming, huge amounts of milk, cheese, butter, bacon, meat etc. Switch to low-fat substitutes like white-meat chicken, reduced-fat dairy products, soy versions of traditional meat etc.

3. Give up your entire diet plan for a small mistake

If you happen to make only one dieting mistake, don't feel disappointed and start munching on unhealthy or junk food. Just remember that eating large amounts of unhealthy food can nullify all the effects of healthy eating you have experienced so far.

If you would like to consult with me privately, please click on 'consult'.

Related Tip: Can Soup Be a Complete Dinner By Itself?

About 80 percent of people all across the globe experience lower back pain at some stage in their lives. It is one of the most common reasons why people miss their work and appoint a physiotherapist. But lower back pain is an ailment that can be avoided with proper knowledge and some back exercises. In case your lower back pain is not under control and you have been neglecting it, you are susceptible to acute pain, sciatica, nerve pain and pain in other regions caused from a pinched nerve. Long-term pain in the back portion can lead to permanent ailments like degenerative disc disease or spinal stenosis.

Probable causes of lower back pain: Severe pain in the lower back region can be caused due to a herniated disc, back muscle pain, ligament strain or any other non-specific pain. An individual may also suffer from lower back pain due to systemic conditions like rheumatoid arthritis, fibromyalgia or ankylosing spondylitis. Though these causes are very common in most people suffering from lower-back pain, the diagnosis varies from person to person and to ensure the best care to alleviate the pain, you must consult a responsive musculoskeletal physiotherapist.

Stages for assessing and treating lower back pain: Managing the back pain is the primary objective of physiotherapy. In reality, back pain is the final symptom that is developed and the first thing that must be addressed.

• Stage I: Back pain relief: The physiotherapist is going to use different types of tools and items to help the pain subside along with the inflammation. These include electrotherapy, acupuncture, ice application, soft-tissue massage and deloading taping techniques. Sometimes the physiotherapist may also recommend an anti-inflammatory drug if the pain is intolerable.
• Stage II: Restoring normal strength: With the settling of pain and inflammation, you are more susceptible to injury because though your pain has subsided, your ligaments and muscles are weak. Your doctor will aim at restoring normal motion of lumbar spine, muscle endurance and strength, proprioception, balance and walking abilities.
• Stage III: Restoring full body function: Depending on your daily chores and activity, your physiotherapist will aim at restoring the function of your back portion to keep you safe while performing the chosen activities. For some, it may be taking a slow walk around the park while for others it may mean taking part in some sports activity.
• Stage IV: Preventing recurrence: Your physiotherapist will rehabilitate you to prevent further occurrence of this excruciating pain by suggesting proper postures, exercise and core muscle workout.

Each of these stages are important to help you get rid of severe back pain and with daily exercise, you can regulate your body and spare yourself from recurrence of this lower back pain.

Quinoa is considered to be one of the world's healthiest foods. It is gluten free and high in protein. It is among the few plants which contain all 9 essential amino acids. Quinoa is also rich in fiber, iron, potassium, phosphorus, Vitamin E, vitamin B and other beneficial antioxidants.

Here are 11 health benefits of quinoa:

1. Quinoa comes in red, white and black colors. It is an edible seed and becoming very trendy among the people who are health conscious. It is loaded with the richness of many important nutrients.
2. There are many trace nutrients present which are very healthy for the body. These include flavonoids which are basically the plant antioxidants which have beneficial effects on the health. Quercetin and Kaempferol are flavonoids and are found in large amounts in quinoa. Both these molecules have anti viral, anti inflammatory, anti cancer and anti depressants effects.
3. Very high in fiber, much higher than most grains: It is high in fiber, but boiled quinoa has less fiber in it as it is absorbed by the water. It has almost 17-27 grams of fiber per cup.
4. Gluten-free and perfect for people with gluten intolerance: A gluten free diet is considered to be healthy as long as the starches are not refined as this causes a problem. If gluten foods with refined sugars are consumed they are equal to consuming junk food. Quinoa is a natural gluten free product and is used in gluten free recipes. This increases the nutrient value and the antioxidants of the gluten diet.
5. Amino acids make up the protein. Some of these amino acids are known as essential as we need to get them through diet. Many plant foods are deficient in some essential amino acids like lysine. But quinoa is an exception, as it contains all the nine amino acids.
6. The glycemic index is usually done to measure the blood sugar levels. On eating foods high in glycemic index, it can stimulate the hunger and leads to obesity. The glycemic index of quinoa is 53 which is low.
7. Certain nutrients like magnesium, potassium, zinc and (for women) irons go missing from the diet. Quinoa is very high in all these minerals, especially magnesium.
8. Quinoa can lower blood sugar and triglyceride levels thus improving metabolic health.
9. Quinoa appears to be very high in antioxidants, which are increased even further after the seeds are sprouted.
10. Helps in losing weight as quinoa is high in fiber, protein and has a low glycemic index.
11. Quinoa is very easy to include in diet.

If you wish to discuss about any specific problem, you can consult a dietitian-nutritionist and ask a free question.