Dr. Mukesh Jha

Anger is good. It protects you. But intense, uncontrolled anger may destroy valuable relationships. Anger is a result of anxiety and fear. When we assume that our expectations will not be met, we become anxious. When we feel unsure about our own capabilities we become anxious. This anxiety creates fear. Anxiety comes from our beliefs. All beliefs can be modified.

Anger has lots of energy. Avoid arguments/confrontations when you are very angry. When you are very angry you are likely to use rough language which may damage your relations and you are likely to behave impulsively. All this you might regret later on. Following are a few techniques which will help you to manage your anger in difficult situations :

1. Sit down and have a glass of water, slowly. This will help you to calm down a little.
2. Avoid or go away from that room or situation. Tell the people concerned, that you are angry and would like to discuss it some other time.
3. Deep breathing exercises help a lot. Close your eyes, take 10 deep breaths, turn your attention towards your body. See what is happening to your body. Tell your body muscles to relax. If your heart is beating fast, if you are breathing fast, continue deep breathing, till it normalises.
4. Now understand what is making you angry. Understand your own anxiety and fear related to the issue.
5. Let the other person know how you are “feeling”. Start your statements, “I feel hurt/insulted/let down/neglected etc. when you do this”, instead of saying “You hurt/neglect me”. When you express your feeling in this manner, the other person does not feel blamed, which makes the other person more receptive.
6. Focus on the current issue, don’t bring in past situations.
7. Tell the other person, what you want or expect, instead of telling what you do not want. E.G. Instead of saying “I don’t want you to go out now”, say “I would like you to stay at home today”.
8. Listen carefully what the other person wants to tell you. Give others a chance to voice their opinions.
9. Make an eye contact and be firm but polite while communicating your point of view.
10. Understand everyone’s responsibility in the situation. Try to see, what is your share in the problematic situation? Work on that.
11. Understand what change you want.
12. Have realistic expectations from others and also from yourself.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Bipolar disorder is the medical term for extreme depression and mood swings that are abnormal or too frequent. The mood swings may go from depression to mania, where the symptoms may border on suicidal behaviour, and other such dangerous tendencies. Find out more about Bipolar Disorder with this article.

- Main Symptoms: The major symptoms of Bipolar Disorder are hypomania and depression. The patient may swing between these two states on a sudden basis. The dramatic mood swings do not have a set routine or pattern and can strike at any given time. The patient may be in a certain kind of state for a prolonged period like many weeks and months, or can even be in a certain state for a matter of days, before the next mood strikes. While hypomania is a very severe outcome of Bipolar Disorder, many people do not recognise it as a problem until it gets out of hand. This state can actually make a person feel high on energy where the patient may also achieve all-time highs in terms of productivity and a sense of wellbeing. This state can switch to a state of depression and hopelessness within a matter of days or weeks.

- Types: Bipolar Disorder can be categorised into many types, depending on the level and severity of the mood swings. To begin with, Bipolar Disorder I has full blown cycles of ups and downs in the mood of the patient. The up mood never really manifests into full fledged mania. This is a more mild form of the disease, and the symptoms are often missed. Rapid Cycling is another form of Bipolar Disease where a patient may experience at least four or even more episodes of major mood swings within a period of 12 months. Further, Mixed Bipolar is a form of the disease where the depression and elevation may come together or in rapid succession of each other. Cyclothymia is another mild form of this mood disorder and comes with subtle changes in one's mood.

- Diagnosis and Treatment: While the diagnosis is done by a clinical psychologist or a psychiatrist with the help of an examination of the symptoms, the treatment includes long term counselling and therapy as well as medication for more severe cases. The drugs and therapy aim at making the mind more stable with psychotherapy. Drugs like lithium or benzodiazepine can also be prescribed to control sleeplessness and hyperactivity as well as hostility and suicidal tendencies.

Talking and discussing things are the foremost methods used by psychiatrists when it comes to treating this disease. Persistent mood alterations must be run past a specialist in the field.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Premature ejaculation is a condition that causes a lot of stress, especially as you age. In order to know more, you should understand premature ejaculation well. It is a condition wherein one ejaculates before or immediately after sexual penetration, with little or no sexual stimulation. This leads to poor sexual performance and anxiety issues.

Causes:

There is no specific cause for premature ejaculation. Regular issues such as sex with a new partner of having sex after a long time might trigger this condition. Factors such as anxiety, stress and guilt may also result in premature ejaculation. It may also be caused by medical issues such as an injury to the genitals or other hormonal problems.

In this article, the factor that will be focused on is anxiety that most often leads to premature ejaculation. Being anxious or nervous about one’s sexual performance can result in this condition. Your mind may be preoccupied with whether your partner is enjoying the entire experience or about the proper functioning of the genitals. Both these factors bring about anxious thoughts and thus, may make one unable to control his ejaculation. One ultimately stops focusing on the entire experience and starts to overthink.

How to control anxiety before and during intercourse:

1. Go again: If it happens the first time, then shoot again. Try another round and you may find that you are able to control your ejaculation better.

2. Be honest about it: Being honest about the entire situation will reduce anxiety about the performance. Your partner may be understanding and would process the situation better. Thus, with subsequent sexual encounters, you are sure to get better.

3. Take matters in your own hands: If the partner is aware of all the limitations, one can use other methods such as oral sex or other foreplay methods (read fingering and fisting) to satisfy her.

4. Decide if you need more or less foreplay: For some guys with PE, foreplay increases anxiety, because they become more and more anxious as they wait for the event. For others, foreplay decreases anxiety, because it gives them a chance to relax before the event takes place. Find out what helps you and talk to your partner about it

If none of the above mentioned methods seem to work, you can fall back on medications.

Certain medications such as antidepressants are used in the treatment of premature ejaculation. They use a two pronged approach; on one hand they reduce anxiety and on the other, this very trait leads to delayed ejaculation, which in turn helps remedy the situation.

Controlling premature ejaculation:

PE can hit you at any age. But the good news is that when your PE is caused by anxiety, it’s something you can also reduce by using the tips above to help control your anxiety and get used to the lovemaking experience. You will need an understanding partner, but most partners are understanding when they care about you, and eventually you’ll be able to fully unlock the sexual prowess inside you. Consult an expert & get answers to your questions!

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 headaches 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. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Bipolar disorder is a condition where the patient may go through certain periods of extreme happiness and joy which is known as mania. On the other hand, there may be other periods where the patient may be extremely sad and depressed and even suicidal.

What is surprising is that bipolar disorder (BD) is very common. Some facts are:

1. About 1 in 5 people being treated for depression are likely to have BD. Most cases of depression are identified as BD much later, sometimes after years.
2. Diagnosis takes time, sometimes years together, before treatment specific for BD is initiated
3. It is not a single issue but combined with multiple other psychiatric conditions (anxiety, behavioural issues, substance abuse, etc.) making it further difficult.

Symptoms:

As noted above, people with BD have two sets of symptoms. One set relates to depressive phase, and the other to a manic phase. Each of them could last for days, weeks, or sometimes months. The intensity of each is quite high, with depressive phase even leading to suicidal thoughts and the manic phase leading to grandiose ideas. Read on to know more about the symptoms, which can be classified into major categories as below.

1. Behaviour changes: The manic phase could include extreme aggression, agitation, restlessness, racing thoughts, sexual hyperactivity, and extreme impulsivity. The person gets extremely talkative, is very uninhibited, makes big claims, and has grandiose ideas, feels very superior to peers, and is very prone to risky behaviours. Depressive phase could include extreme irritability, self-harming ideas or actions, and prolonged crying spells.
2. Mood changes: The anxiety phase could include anxiety along with euphoria and elated sense of well-being. The depressive phase includes apprehension, hopelessness, lack of general interest in life, anger, apathy, and general discontent.
3. Sleep patterns: The manic phase could be including prolonged periods of sleep, while the depressive phase could include periods of sleeplessness. The person could be depressed about small things and lose sleep over it.
4. Cognitive changes: There is a false sense of grandiosity during the manic phase and racing thoughts. People could have difficulty in keeping pace with the person who has BD. The depressive phase includes lack of concentration, reduced the pace of thinking and action, and a lot unwanted, non-productive thoughts.

Bipolar disorder requires a lot of support from close associates in addition to medications. Watching out for early signs and early intervention is very helpful. If you wish to discuss about any specific problem, you can consult a Psychiatrist.

Dementia is a disorder characterized by a decline in mental capabilities in a person. It is primarily caused by Alzheimer's disease but can also be caused by damage to the brain from an injury or a stroke. The cells of the brain fail to communicate with each other in dementia. People suffering from dementia have difficulties in taking part in regular activities as their mental functioning is impaired.

The major symptoms of dementia are problems in recalling, ineffective communication, inability to concentrate and impaired reasoning abilities. It may also affect the short-term memory of a person when he/she may be unable to keep track of his/her belongings. Dementia can be progressive where the symptoms gradually increase with age.

With age, the mind also goes through slowing. Being the control organ for all other organs, this leads to issues with thinking, cognition, communication, memory, etc. Dementia is a condition which is a combination of all these; it is not a disease per se, but a symptom complex.

Causes:

1. Alzheimer’s disease, a neurodegenerative process
2. Brain injury (accidents, trauma, etc.)
3. Stroke
4. Huntington’s disease

Except in acute trauma cases, as a degenerative process, there are early symptoms of dementia which can be watched for. It is even possible to delay the progress of dementia by keeping an eye out for these symptoms.

1. Recent memory loss: A person may not be able to recall what happened a couple of days prior but can clearly recollect events from the past. This may be gradual in onset and gets progressive. There could be difficulty in recollecting things like where the TV remote is, where the phone is, where the door keys are, etc.  Some people could also ask for the same information repeatedly, as they are not able to retain information.
2. Loss of learned behaviour: Things which were taught or learned like how to arrange things at the table, how to do basic things on the computer, organising medical kits, etc., might be forgotten. The person finds these more taxing than before and requires more help in doing them. Learning new tasks slowly becomes difficult too, as they find it difficult to get orderliness or process thinking in them.
3. Mood changes: While depression with onset of dementia is very common, the person also could have drastic mood changes, which would be noticeable only to close family and friends
4. Forgetting names: It is another major symptom. Whether it is of people or objects or animals, there is difficulty in recollecting names
5. Personality alterations: Since dementia affects judgment and reasoning, a shy person could be seen to become outgoing gradually
6. Difficulty following storylines: While most elderly people are adept at telling stories, those affected with dementia could be seen to be gradually losing track of the storylines. This could be true of their own storytelling or even television serials or movies.
7. Repeating tasks: Given the short-term memory loss, they tend to repeat things which were just done, both in actions and words.
8. Feeling lost: Recent memory loss also affects things like forgetting why they headed out, spacial disorientation, whether they had a snack or not, etc.
9. Forgetting day to day things: Regular tasks like paying utility bills, reading newspaper or books, cooking up small dishes, tend to become difficult than they were. This is a combined effect of short-term memory loss and loss of orderliness. If you wish to discuss about any specific problem, you can consult a Psychiatrist.