Dr. Vikas Jain

Sleep is one such time when people usually are expected to lie down still and get rest. However, we have all heard of sleepwalking, a condition where a person walks during the sleep. Though it may sound strange, there is a deeper explanation for it both from a causative point of view and from managing it.

Things you should know?

1. Sleepwalking happens when a person moves back from a deep sleep to a light sleep or awakening state.
2. The person who is sleepwalking is usually not aware of it.
3. Activities may range from simply getting up and sitting up in bed to walking around the room. They could also open the door and walk out to the neighbourhood. Moving furniture, changing dresses or driving a car, may also be some of the actions Most of these activities happens completely without their knowledge.
4. Mostly happens in children up to the age of 12, but can be seen in adults also, where it assumes a more severe form.
5. The person who is sleepwalking has a fixed stare with glassy eyes. They may appear dazed and lost when they are awakened.
6. They may not respond when they are actually sleepwalking, or respond very slowly
7. They can be brought back to bed and put back to sleep without being disturbed. Most children would go back to sleeping when this is done
8. Though the parents can be very worried when they see children sleepwalking, reassurance is required, as it usually disappears as they cross teenage.
9. There could be chances of small injury like tripping or fall during the sleepwalking episode
10. Sleepwalkers may be more restless compared to other children during their waking hours
11. Bedwetting is also quite common in children who sleepwalk

Causes

1. Inappropriate sleep pattern with lack of sleep for prolonged periods is one of the main reasons for sleepwalking
2. Stress
3. Excessive drinking
4. Medical conditions like heart rhythm problems, acidity, gastric reflux, and seizures
5. Psychiatric conditions like panic attacks and post-traumatic stress disorder can also lead to sleepwalking

Management

1. For a parent to see their child walking around in their sleep can be quite disturbing.
2. Reassurance is required stating that it is just a temporary phase and will not stay beyond the teenage years
3. Most people do not require any intervention unless accompanied by severe symptoms like going out of the house or driving
4. Once established, it is advisable to avoid by not drinking too much alcohol, avoiding stress and anxiety and taking precautions like extra-secure locks to prevent sleepwalking and/or other side effects. If you wish to discuss about any specific problem, you can consult a psychiatrist.

Feeling tired all the time? Do you feel that you can’t focus on things anymore? Have you lost interest in things and people you once loved spending time with? Does your temper fly off the hook at the drop of a hat? If it is a ‘yes’ to the questions above, then you might be slowly but steadily succumbing to depression. Depression is a psychological disorder that is characterized by symptoms of extreme sadness, worthlessness and hopelessness over a prolonged period of time.

Symptoms

1. Lack of Interest: This is probably the starkest of all the symptoms. Hobbies or activities that you used to enjoy once no longer catch your fancy. You do not find little or no pleasure in social activities or any other hobby of yours anymore.
2. A constant Feeling of Hopelessness: You tend to develop a negative outlook towards life in general, as you feel that the current situation will never get better and will only worsen.
3. Loss of Appetite: Loss of appetite is a common feature of depression; it can also lead to rapid weight loss. If engulfed by depression, one generally tends to ignore food completely, remain hungry, both of which contribute to the vicious cycle that depression is.
4. Changes in Sleep Patterns: Insomnia is a condition that is marked by a sheer inability to sleep, no matter how physically exhausted one is. Depression tends to exhibit this particular symptom in maximum cases. However, oversleeping, or sleeping more than the sufficient hours is also common.
5. Reckless Behavior: Depression makes one more prone to reckless behavior; one generally develops an angry and irritated persona; this in turn, may make one to exhibit reckless and rash behavior.
6. Lack of Energy and Focus: Depression causes one to feel fatigued and sluggish the entire day. Factors such as a total loss of appetite contribute to this particular symptom. Stemming from these symptoms are two other major occurrences; an inability to focus on anything and an inability to decide on anything.

Self-help, Coping tips and Treatment-

1. Connect with different people: Being isolated from the rest can and usually aggravates symptoms of depression. So, reach out to other people and your loved ones; talk to your loved ones and try to empty your mind when you are having a one-to-one with them. Interacting and talking to others will make you feel better and should go a long way in taking that huge rock off your chest.
2. Try to ditch that sedentary lifestyle; go out in the open: An early morning jog can feel daunting at first but the benefits are immense. Exercising regularly has been proven to be as effective as anti-depressants in combatting depression. Even a 20 minutes jog early in the morning releases ‘endorphins’ in the body, also known as the ‘feel good hormones’. These hormones induce a feeling of happiness and relaxation, thus taking your mind off any particular event or circumstance that has been ruining your sanctity of late.
3. Avoid Alcohol and Drugs: Avoid alcohol and drugs to come out of your sadness; they have never helped and will never help. Taking these substances provides a temporary solution to depression, as it will again show up once the effects of the intoxicants wear off. It will also interfere with other medications that you may be taking to combat depression, thus reducing their potency.
4. It’s high time you bought the meditating mat: Sleep has a beneficial effect on your mental health as it has been proven to improve memory and other cognitive and brain functions. Another way to improve brain function and be more relaxed is to meditate regularly. Meditation induces a state of relaxation, and if done on a regular basis, can be an effective treatment for depression. Meditation also helps with an improved focus and reduced anxiety.
5. Medications can always help: Medications such as anti-depressants are administered to treat depression. Selective Serotonin Reuptake Inhibitors (SSRIs), including citalopram, fluoxetine and sertraline are the most commonly administered medications to cure this condition. However, it is advised to try the abovementioned methods first so that you do not have to depend on medications alone; the reason being that these medications do have their fair share of side effects.

Stuttering is a type of speech disorder wherein, a person speaks slower than normal. It is quite  common in the age group of 3 to 8. The relationship between stress and stuttering has been pondered over for decades now. A lot of people seem to believe that stress and stuttering are co-related. On the contrary, recent studies show that stress is more of a consequence rather than a cause of stuttering. If you take the first theory into consideration, then according to that, children would be the greatest victims of anxiety and stress. But it is seen that the level of stress increases proportionately with the increase in age.

Social anxiety in teenagers increases due to stuttering, when they come across individuals who can speak in a normal pace. This in turn can crush their self confidence and lead them to isolate themselves from social groups and people in general. Hence, it is important to deal with stuttering in the early ages or as and when it occurs. 

Sometimes stuttering can develop due to physical or mental trauma.  Most people with stuttering do not seek therapy for it because they might not think of it to be too severe. Little do they realise that a simple process of speech therapy can help them overcome this disability and rejuvenate their level of self-confidence.

It has also come to light, that people with relapse in stuttering post therapy has shown a three-fold increase in anxiety levels than normal. Hence we cannot ignore the strong relationship between stress and stuttering. So from the above evidence, it is safe to conclude that social anxiety or stress develops as a result of chronic stuttering.

How to deal with stress related to stuttering?

Seeking help is a great start to tackle your disability. If your stuttering is prominent enough to warrant therapy, you must seek professional help for the same. You must also learn to control your anxiety by dismissing any anxious thought or make sincere efforts in controlling physical anxiety.

You can also try to increase your social skills by participating in events, such as public speaking that can reduce your stress levels and make yourself more confident about yourself. One must also remember that a person is defined by what he does rather than what he says. So never let a minor disability come in the way of your self worth! If you wish to discuss about any specific problem, you can consult a Psychiatrist.

A panic attack is the result of a sudden enormous burst of fear and anxiety. The heart tends to beat faster and breathing becomes difficult. A person gets a feeling of going crazy and dries up. If the treatment is not taken on time, this condition can aggravate to panic disorder and such other problems. It is totally curable if the symptoms are addressed properly. 

Symptoms of panic disorder:
Panic attacks can lead someone to panic in any place. It takes only 10 minutes to reach its peak and typically lasts for 25-20 minutes. A patient is a prime candidate of a panic disorder if he frequently suffers from the following symptoms:

1. The discomfort of the chest
2. Profound sweating
3. Hyperventilation
4. Fear of losing control of life
5. Feeling of detachment from the surrounding
6. A choked feeling
7. Heart palpitation
8. Sudden cold flashes and tingling sensation

Apart from the above symptoms, if a patient suffers from anxiety in between panic attacks in anticipation of another panic attacks, he could be suffering from panic disorders. it is often witnessed that patients suffering from panic disorder avoid certain situations and places.

What causes panic disorder?
Panic disorder results from frequent panic attacks and the cause of the latter are not very clear. It is believed that certain life transitions such as divorce, getting married, acute stress, the death of loved one can result in panic attacks. A person has higher chances of getting this disease if it runs in the family. Some medical conditions that can cause panic disorder are hyperthyroidism, use of stimulants such as cocaine, caffeine and mitral valve prolapse.

How it can be treated?
Behavioral treatment: Cognitive behavioral therapy is widely considered as one of the effective treatments for panic attacks. This form of treatment effectively focuses on thinking patterns and behavior that triggers panic attacks. It helps you to look at your apprehensions in a better light. Another method of treatment for panic disorder is called exposure therapy. This method exposes a patient sensation of panic in a controlled environment. The trick is to deal with it in a much better way. For instance, you might be asked to cross the road. When you successfully manage to do it without getting crashed, you are less likely to panic in foreseeable future.
Medication Treatment: Medication can address the problem temporarily, but is not a good solution for long term. Certain medication such as antidepressants and Benzodiazepines are prescribed by doctors with time duration of every 1-2 hours. These are anti-anxiety drugs and gives immediate relief from panic attacks. However, it should be ensured that these medicines are only consumed once a doctor prescribes it.

A psychological disorder, which is marked by abnormal eating patterns is known as an eating disorder. Eating disorder, commonly known as anorexia nervosa in medical circles, is often a combination of both abnormal eating and weight gain patterns.

Yet, on general diagnosis, eating disorders are categorized into three types, namely, anorexia nervosa, bulimia nervosa and binge eating. 

Diagnostically stated, a person suffering from:

1. Anorexia nervosa is usually characterized by low body weight as well as a disturbed perception of one's weight.
2. Bulimia nervosa on the other hand includes, persistent binge eating along with loss of self-control and a psychological overvaluation of one's body shape or weight.
3. The third category, which is binge eating, is marked by anxiety, consistent overeating, stress and drastic loss of self-esteem.

Although, eating disorder is a commonplace disorder worldwide, the cause of it still remains unknown. A recent research has found that due to the fact that eating disorders reflect a physiological anomaly between the need to eat and the drive to eat, a hypothesis is developed stating the cause to be a disturbing appetite pattern on the most fundamental level. This proposition has been further delved into using brain imaging that shows emotions, rewards and eating inhibitions are linked to neural pathways.

Current treatments, which include forms of psychotherapy and pharmacotherapy have limited capacity in reducing and normalizing eating disorders. Furthermore, various psychological interventions used to treat eating disorders are variations of psychiatric treatments, which are not particular to the needs of the patient in such disorders. Empirical researches have linked inhibitions, rewards and maladaptive eating behaviors to alterations in the circuitry of the brain. Furthermore, abnormal metabolistic behaviors are also linked to eating disorders.

Although no concrete remedy exists, a person suffering from eating disorders could get their symptoms minimalized to a certain extent through rehabilitation clinics and therapies.

Eating disorders can be defined as conditions that influence your eating behaviour significantly and which may give rise to serious health issues. Eating disorders are associated with behaviours like compulsively counting calories, puking after meals, living on a rigid diet etc. which often leads to a feeling of self-loathing and obsessive thoughts about food and weight.

Here are the three most common eating disorders and the symptoms by which they can be identified.

1. Anorexia nervosa - This disorder is considered to be a mortally dangerous condition in which the body weight reduces drastically. An individual is terrified about gaining weight and can take extreme steps to maintain their weight and shape, often leading to starvation, vomiting and many other health problems.

Common symptoms include:

-Reducing the amount of food to be consumed to cut down the calories
-Exercising beyond capacity to burn calories
-Recurrently monitoring your shape, weight and appearance
-Skipping meals
-Avoiding social gatherings where you will be offered food
-Irregular menstrual cycles in women
-Erectile dysfunction in men

2. Bulimia nervosa - Mostly observed among people in their mid-teens, Bulimia nervosa is a serious type of eating disorder associated with episodes of bingeing and purging with the individual being unable to regulate their eating habits. Moreover, the person suffering from this disease often feels guilty and horror-struck about weight gain and forces himself/herself to vomit.

Normally, people suffering from this condition exhibit the following habits:

-Binge eating
-Use of laxatives or throw up forcibly to get rid of calories
-Feeling exhausted and guilty
-Experiencing irregularity in their menstrual cycles
-The inability to maintain normal weight, in spite of trying to eliminate calories

3. Binge-eating disorder - This disorder is characterised by overeating, eating even when you don't feel hungry and continuing to eat even after feeling full. People suffering from this disorder cultivate a feeling of guilt inside them for overeating but do not try to nullify its effect by vomiting or exercising intensely. Some of the most prominent symptoms of this disorder include:

-Eating alone to hide the embarrassment caused due to overeating
-Eating quicker than normal people
-Being overweight
-Binge eating at minimum one instance every week

Related Tip: Eating disorders - What do they even mean? And what are its causes? 

How to identify you or your loved one might be struggling with Depression?

Most of us have faced the feeling of being weighed down by life's harsh realities and have been sad or low for a long while. It is very common to be upset for some time and most people recover from this feeling and start smiling again in a short span of time. But, if you or any of your loved ones are almost always very sad and this spirit is affecting your daily life considerably, then chances are you might be undergoing a phase of depression.

Here are certain signs to watch out for to determine whether you are struggling with depression.

1. Cultivation of a pessimistic approach about everything in life - You feel a sense of hopelessness and that your situation in life will always be the same without any improvement is a sure shot sign that you are suffering from depression.

2. Sudden variation in weight or appetite - If you suddenly find that you've lost or gained a significant amount of weight without any substantial reason, then chances are high that it is happening because of your depression.

3. A significant change in sleeping patterns - If you've been experiencing insomnia lately or have got a habit of oversleeping, then these might be symptoms of depression.

4. Feeling of guilt without any particular reason - If you have started feeling guilty or constantly blame yourself for everything you've done in the past then the reason behind this may be your state of depression.

5. Anger or irritated mood - Having a low level of tolerance, getting angry quickly or always being in an irritated mood can be a prominent sign of depression.

6. Displaying an uninteresting behaviour towards regular activities - If you no longer feel pleasure in pursuing your favourite activities or things from daily life like hobbies; socialising doesn't interest you anymore then it can be a warning sign for you. In such cases, you can visit a psychiatrist to get treatment for depression.

'Consult'.

Related Tip: Can Depression Really Increase Creativity?

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