Dr. Vijay Niranjan - Book Appointment, Consult Online, View Fees, Contact Number, Feedbacks | Psychiatrist in indore

Dr. Vijay Niranjan

MD - Psychiatry
1 Years Experience
400 Consultation Fee
Personal Statement
I'm dedicated to providing optimal health care in a relaxed environment where I treat every patients as if they were my own family.

More about Dr. Vijay Niranjan

He has helped numerous patients in his 1 year of experience as a Psychiatrist. He studied and completed MD - Psychiatry. Book an appointment online with Dr. Vijay Niranjan and consult privately on Lybrate.com.

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Maulana Azad Medical College, New Delhi
MD - Psychiatry
  • B.Sc. Food & Nutrition, M.Sc. Food & Nutrition

    A lot of people believe in hitting the gym during the day and then a bar at night. One feels there's no harm in drinking a little amount of alcohol now and then. Don't drink and drive isn't only for behind the wheels, it's also on the field (and the gym).

    First, let's give you a list of how alcohol can affect your body, and then we can get down to details! keep in mind these effects are within 48 hours of alcohol consumption, that too just after 2-3 standard drinks.

    Decrease strength
    Impair hand-eye coordination
    Increase fatigue (by impacting liver function)
    Mineral and vitamin depletion
    Disturbed sleep
    Impact cellular repair (since protein is affected negatively)
    Dehydration thus affecting the kidneys
    Loss of endurance
    Unwanted weight gain

    Do you really need me to go on alcohol isn't something that recommended for most people; for athlete's it just makes matters worse. While you're training or competing, it's best to stay away from alcohol! though, the best solution is to give it up completely to live a healthy lifestyle. Now let's get down to some technical details of how it impacts your organs (just so you don't think I'm talking in air.)

    So first things first. Alcohol cannot be stored as energy. This means all the alcohol in your body is converted into fat hence the term beer belly.
    Alcohol's effect on the liver can cause a problem in the production of oxygen which then interferes with the production of atp ie a direct source of energy for the muscles.
    Sadly drinking alcohol before your workout hinders the circulation of glucose which is essential for energy. It has also been scientifically proven that alcohol diminishes protein synthesis which in turn stops muscle growth by preventing the repair of damaged muscles.
    Another thing alcohol does is increase the urge to urinate which leads to loss of electrolytes. No no, I'm not done yet. I've got so much more fun facts related to alcohol.

    Since alcohol is a toxin it disrupts the normal cell function.
    Alcohol also inhibits the absorption of essential minerals like zinc, folic acid, vitamin b12 etc which are needed for metabolism and new cell growth (muscle cell included). 
    The consumption of alcohol provides only empty calories which in turn displace valuable nutrients. That's just a loss of essentials and an increase of fat!
    Do note, heavy drinking for a night can negatively affect the brain and bodily activities for 3 whole days whereas 2 nights of consecutive heavy drinking leave an impact for 5 days! evidently dehydration, fatigue, and headaches  commonly known as hangovers really don't mix well with the physical demands of our body.
    Alcohol disrupts your sleep cycle which in turn leads a reduction in the ability to learn and retain new information. This could range from new skills to studying games or even applying strategies in a game.
    Excessive alcohol can prevent the secretion of human growth hormone which is essential for muscle growth as well as recovery. For an athlete, that's bad. Bad

    It's always better to prioritize a good day's workout over a night of heavy drinking. At least the workout leaves you worn out and exhausted craving for more! alcohol just leaves you with a bad hangover which leads to false swears of never drinking again.

    Eat clean, drink healthy and stay fit!

    In case of any query or to book an appointment with dt. Silky mahajan please send us a mail at info@foodsandnutrition. In or call on 08067417780 (dial extension:778)

  • SLE, Fellowship In Diabetology, Diploma In Psychology Mental Health And Illness, PLAB (MANCHESTOR, UK), FAGE, MBBS
    General Physician

    Dissociation identity disorder (did), previously known as multiple personality disorder (mpd) is a mental disorder characterized by at least two distinct and relatively enduring identities or dissociated personality states that alternately show in a person's behavior, accompanied by memory impairment for important information not explained by ordinary forgetfulness.

    Let me explain this in a simple way.

    Example 1- lets say there is Mr. X and Mr. Y. Mr. X is very impressed by the personality of Mr. Y. So he starts liking him. He also tries to sepnd more time with him. He may with time start copying him or seek his help. This problem become so severe that after some time, in a flash Mr. X wakes up and become a copy of Mr. Y. However Mr. X cannot forget that he is actually Mr. X and not Mr. Y. Thus, Mr. X has developed a split personality where he and Mr. Y co exist. This may with time lead to further mental health deterioration such as depression, loss of memory, personality changes, mania, psychosis, antisocial behavior and above all a loss of control and insight in ones life.

    Example 2- Mr. X may not be impressed with Mr. Y. But here it's the reverse. Mr. Y is impressed by Mr. X and wants to be a part of Mr. X s personality. He forces himself on Mr. X until he becomes a part of Mr. X. Therefore Mr. Y has been successful in forcing himself on Mr. X although Mr. X wanted to distance himself form Mr. Y but could not due to various reasons.

    Example 3- this problem does not need to be confined to just 2 people. Any number of people can force themselves on Mr. X depending on his plotters and schemers. Therefore Mr. X loses his mental health and his personality becomes broken into several pieces which have been thrust on him.

    Some people tend to do this voluntarily because of the fact that they like Mr. Y possessions but in most cases people are victimized into this as they are struggling to make ends meet in their lives. The result is agony, despair, loss of self control. An annihilating world and an end full of shame and contempt because of loss of control depending on how erroneous Mr. Y and his associated are.

    Many marriages have been broken because of their spouses developing mpd. Spouses who were happy with each other, suddenly turn hostile and throw them out of their lives because they are now possessed with Mr. Y s who are interested in other spouses than their own. Many children also loose their parents love and care because their parents are no longer interested in them and they desert them or send them to boarding schools.

    This disease is a social evil and a menace to a justful society. But the stress on taking precaution lies with us.

    Developmental trauma

    People diagnosed with did often report that they have experienced severe physical and sexual abuse, especially during early to mid-childhood, and others report an early loss, serious medical illness or other traumatic event. They also report more historical psychological trauma than those diagnosed with any other mental illness. Severe sexual, physical, or psychological trauma in childhood has been proposed as an explanation for its development; awareness, memories and emotions of harmful actions or events caused by the trauma are removed from consciousness, and alternate personalities or sub-personalities form with differing memories, emotions and behavior.

    As of 2011, approximately 250 cases of did in children have been identified,

    Problems with diagnosis

    People with did are diagnosed with five to seven comorbid disorders on average much higher than other mental illnesses. Due to overlapping symptoms, differential diagnosis includes schizophrenia, normal and rapid-cycling bipolar disorder, epilepsy, borderline personality disorder, and asperger syndrome. Delusions or auditory hallucinations can be mistaken for speech by other personalities. Persistence and consistency of identities and behavior, amnesia, measures of dissociation or hypnotizability and reports from family members or other associates indicating a history of such changes can help distinguish did from other conditions. A diagnosis of did takes precedence over any other dissociation disorders.


    Common treatment methods include an eclectic mix of psychotherapy techniques, including cognitive behavioral therapy hypnotherapy and medications can be used for comorbid disorders and/or targeted symptom relief. Some behavior therapists initially use behavioral treatments such as only responding to a single identity, and then use more traditional therapy once a consistent response is established. Brief treatment due to managed care may be difficult, as individuals diagnosed with did may have unusual difficulties in trusting a therapist and take a prolonged period to form a comfortable therapeutic alliance. Regular contact (weekly or biweekly) is more common, and treatment generally lasts years not weeks or months. Sleep hygiene has been suggested as a treatment option,

    Legal issues

    Individuals diagnosed with did may accuse others of abuse but lack objective evidence and base their accusations solely on regular or recovered memories. There are questions regarding the civil and political rights of alters, particularly which alter can legally represent the person, sign a contract or vote. Finally, individuals diagnosed with did who are accused of crimes may deny culpability due to the crime being committed by a different identity state.

  • BDS, Certification in hypnotherapy, Certification in N.L.P, Certification in Gene and behavior, Psychology at Work

    Here are detail about how to live and cooperate with Schizophrenia and Bipolar Disorder. 

  • BHMS

    Depression is a clinical, mental and emotional condition that may give rise to feelings of hopelessness and chronic sadness. It slows down the way people process everyday activities and leads the patient to a sense of constant gloom and doom. It is a disabling mental condition as per who and may be caused due to reasons like genetics, changes in the balance of hormones, stress, grief, trauma and prolonged, chronic physical ailments.

    Symptoms of depression are:

    1. Sleep irregularity: It relates to either insomnia or oversleeping that is, either you sleep too much or do not sleep at all. This could be because of work or other stress in your personal or professional life.
    2. Irritation or unnecessarily getting angry: You start losing your temper easily and that too for silly reasons. You think you are losing control.
    3. Feeling hopeless and sad: The first signal or symptom is the feeling of hopelessness. In this, case the patient loses the hope in everything. They feel like being trapped in some kind of cage, from which they are not able to come out.
    4. Lack of interest in anything: Everything seems to be of no use or interest, even your daily work. You don't want to do anything; even the things, which you loved to do like your hobbies and passions, which you no longer find interesting.

    Here is a comprehensive list of homeopathic medicines which most doctors are likely to recommend for treating depression:

    1. Sepia: This medicine is beneficial to women suffering from post-partum depression (sadness or emotional conflict after giving birth) and menopause. Feeling of solitude and hopelessness with no energy to continue with life are some common symptoms that can be reduced with Sepia.
    2. Arsenicum album: This medicine is prescribed to control the symptoms like diarrhea, gastric problems, indigestion which patients often suffer from as a result of intense anxiety. Patients, appropriate for this medicine tend to be fastidious and restless. It is made of white arsenic and should be taken in prescribed potency because an overdose can cause gastroenteritis.

    The above mentioned medicines are just some of the medicines, which should only be taken only after consulting your doctor, as causes and symptoms differ for each person.

  • B.A.M.S., M.D.(A.M), EX-M.R.C.G.P., EX-M.R.S.H., EX-M.S.I.E.C.U.S, EX-M.S.S.S.S.

    Physical intimacy forms a vital part of romantic relationships, marital or otherwise. Going by the general hierarchy of human needs, the drive for sex is one of the basic urges of a human being that needs to be fulfilled before moving on to higher level needs, which include security and companionship.

    Sex in a relationship is very important because:
    1. It ensures the overall satisfaction of both the individuals in the relationship.
    2. It helps in forging a deeper emotional connect with the partner, thereby, establishing trust and understanding.
    3. Sexual intimacy helps in establishing a rather firm relationship base, thus facilitating a stronger psychological bond.
    4. Sex helps both the partners acknowledge the worth of the relationship, even more. Since, there is more clarity and transparency, sex helps both the partners come absolutely clean in terms of what they want from the relationship.

    Foreplay helps in establishing trust in the relationship by letting the partner know that the other wants to stay with him/her and it is not the act of sexual intercourse that is only important. The lack of sex in a romantic relationship reduces the psychological wellbeing of both the partners and their emotional and physical satisfaction and takeaways from the relationship.

    It is important to not use sexual act as a weapon or as an answer to disputes. This eventually results in the degradation of the relationship. In most marital or couple counselling sessions, the partners are questioned about their sex life and encouraged to enhance it, but not as a solution to their emotional problems. It is only advised to bring the couple closer. Research suggests that physical intimacy is a close second to emotional intimacy in relationships and they both go hand in hand in bettering the relationship. Needs, both sexual and emotional, require equal fulfilment to ensure a long standing relationship. However, both the types of needs need to be prioritized, and this priority varies among couples and both partners must work towards striking a balance between the two.

  • DNB (Psychiatry), DPM, MBBS

    After the advent of the internet, the availability of pornography or explicit video material has become widespread. The availability of this material resulted in a large section of the population relying on it for sexual pleasures as well as living their fantasies through the digital realm.

    Internet porn is the new drug

    The easy availability and the dependence on internet porn to get a quick fix of dopamine through sexual pleasure have resulted in patterns of addiction among many people. Porn addiction is a phenomenon which has been exacerbated by the easy availability of pornography on the internet. It has not only affected sexual habits such as masturbation, but has also caused hindrances in the daily lives of people and has become a mental disorder as well.

    A brain on porn is similar to a brain on alcohol

    While it may seem a bit far-fetched, studies of brain scans have shown that people watching porn experience the same effects or pleasure that alcohol gives them. It is a neural circuit which releases pleasure hormones when you sexually pleasure yourself by masturbating to porn. The reward circuit of the brain recognizes this pattern and starts creating please pathways where you want more of it. As you keep doing it more and more, the resistance level increases and you tend to need more. This is a classic sign of addiction.

    Healthy and unhealthy masturbation

    Masturbation is a natural and normal process that every human indulges in. However a brain addicted to porn will use it as an addict uses a substance. Masturbation is the physical act through which the dopamine would be released. Once it has become an addiction, you would either want to have the daily fix for at least a few hours which you would ensure to take out of your daily routine. This time could have been invested in other fruitful activities when it ends up going to the addiction. In some cases, studies have shown that many would rather do it a few times a week but would spend extended hours masturbating to porn.

    Effects of excess masturbation

    Some of effects of the porn addiction and excessive masturbation could be

    • Premature ejaculation

    • Erectile dysfunction when you are with a partner and in a real life scenario due to dependence on particular porn fantasies

    • Inability to have or form intimate relationships which are not just sexual but emotional and mental as well

    • Lethargy to go to work or school due to addiction related problems

    • Breakdown in relationships, even with family members and friends among many others

    It is thus, imperative that you seek sexologist help to slow down the habit and break the cycle of addiction and ensure that you are able to lead a normal life without disruptions so as to allow yourself to be able to form normal sexual relationships.

  • MBBS, DGO, MD - Obstetrics & Gynaecology, MRCOG

    Peer pressure is always difficult to deal with, especially when it comes to sex. Many girls feel the pressure from friends to have sex before they're ready, which is why it's so important to have the confidence to say no to something you don't feel ready to do.

    Just because your friends are having sex or say they're having sex doesn't mean that you have to as well! you might feel like everyone is doing it but you will soon realize that this is not the case. Your friends may talk about sex in a casual manner. If you have a good group of friends, they should not be pressuring you into doing something that you're not ready to do.

    Pressure from magazines, celebrities and peers can all contribute to the pressure that you may feel. On tv, sex is displayed in such a casual way, however you should remember that sex is actually a really big deal! you need to make sure that you're completely confident and comfortable with your decision if you do decide to have sex. Think carefully how you feel yourself about having sex, as this is the first step in handling the peer pressure. It's okay to have fun when you're a teenager, but equally you need to respect yourself enough to say no I'm not ready and your peers should respect that too. When making the decision to have sex, consider whether peer pressure is influencing your decision or if it's something that you have decided that you are ready to do. Once you've had sex for the first time you can't go back, so make sure it's a decision that you won't regret.

    Remember that there is no certain age that you are expected to have sex a lot of people wait until they're married! everybody is different and will mature and feel ready at different ages, so just because your friend is doing it and feels ready now, this does not mean that you should feel that way too. Don't ever have sex just to fit in with your friends, as they will respect you more if you stick to your morals and don't do things just because you're pressured to.

    If you're worried about peer pressure, know that you're not alone. Hang out with friends who understand you and also believe that it's okay to wait to have sex. If you're going on a first date, go along with friends so it's not just you and your date. This way, if you feel worried that you might be pressured into doing something you don't want to, you won't be alone. Think of what you would say in advance if anyone tries to pressure you in the future, so that you're not caught off guard or feel like you have to do something you don't want to. You are never obliged to have sex with someone, so even if they try to make you feel guilty never do something that you don't want to do, as it's always your decision. Sex is not something that you should rush into, so take your time until you feel 100% ready to take the next step. Respect yourself, your morals and your body and when the time is right to take the next step, you will know.

  • MBBS, Master In Health Science

    * Should I be afraid of talking to the doctor?
    No. Every doctor wants his/her patient to recover as soon as possible. If patients have the right knowledge, they are able to interpret and report their symptoms better. Having this knowledge prevents unnecessary anxiety and greatly facilitates diagnosis and treatment.

    It is the duty of every doctor to provide the right information to the patient, and every doctor tries to do this to the best of his/ her ability. Sometimes it is not possible to provide thorough information and answer all questions of a particular patient, because then the doctor will not be able to give adequate time to the next patient. Th is is the main reason behind writing this book. In many cases, patients do not want to talk to their doctor because they are afraid of knowing more about their illness. This is the wrong approach. Knowledge is power. I assure you that having the right knowledge will decrease your anxiety and help you get better.

    I do have one suggestion: before going to the doctor, write down all your questions on a piece of paper. Almost all doctors will be very happy to answer your questions if you ask them efficiently.

    * Why should I pay attention to my symptoms? just run some tests and you will know what disease I have...
    Tests can be helpful, but they cannot diagnose all diseases. Often, no test can detect the small short-circuits in the brain that are responsible for causing seizures. Until very recently, there was absolutely no test that could diagnose parkinson's disease. Tests cannot tell the doctor how you are responding to the medication. For example, in parkinson's the doctor may ask you how you feel in the morning, how long the eff ect of medication lasts, do your arms or shoulders jerk after you take medication, and so on. Each symptom is important for the correct diagnosis and treatment of your condition. You and your immediate family members can provide the doctor with this essential information. If you have difficulty remembering your symptoms, you should note them in a notebook. If you have difficulty describing some of your symptoms, you should make a video recording for 3-5 minutes using a smartphone or digital camera (android, Iphone etc). Such recordings are tremendously helpful for diagnosis and treatment.

    * What are the common tests used to diagnose brain diseases?
    The three tests most commonly used are:
    Mri, ct scan and eeg. Other specific tests have been described in the relevant chapters.
    (i) Mri (magnetic resonance imaging) scan:
    An mri scan is probably the most important test for diagnosis. It can diagnose many diseases such as a stroke, tumor and inflammation. Mri scanning is done in a big tube shaped machine which is attached to a bed. Th e patient sleeps on the bed for 30-45 minutes. Th e bed slowly moves back and forth through the machine. During this time the machine clicks very detailed pictures of the patient's brain.

    Please note that during the scan you may hear some loud whooshing and clicking sounds. Th ese are just the sounds of

    Magnets and motors inside the machine, and there is no need to be concerned by these noises. Some people may feel anxious because of the small space within the scanner, and a few people may need medications to decrease this anxiety. Mri scanning is extremely safe; there is usually no health risk. Before the scan, please inform the doctor about any metal inserts or implants (e. G. Heart defi brillator) In your body.

    Mri test machines are of various strengths such as 1.5 tesla, 3 tesla and so on. Mri machines with a higher number (for example 3 tesla) take better pictures. This book was written in 2015, at this time the highest resolution mri available in india was 3 tesla.

    (ii) Ct (computerized tomography) scan:
    The CT Scan machine looks just like the mri machine. It has a bed that moves back and forth slowly while the machine takes a picture of your brain.

    CT scan has a few advantages over mri:
    (i) It is less expensive. An mri may cost around 5000-7000 rupees, while a ct scan usually costs around 1000 inr (indian rupees).
    (ii) It can be done very quickly. An mri may take 1 hour or more, but a ct scan can be completed in 10-15 minutes.

    Unfortunately, CT scanning has some significant disadvantages:
    - The picture obtained by a ct scan is not as clear as that obtained by an mri. The difference in quality is striking: it is like the diff erence between a black-and-white tv from the 70s and the new lcd televisions available today.

    - CT-Scan exposes your body to radiation.
    Radiation is bad for your body, and especially a baby's body. Therefore, pregnant women should never have a ct scan. Ct scan is commonly used during emergencies. When a patient comes to the emergency room, a rapid ct scan may be done to look for emergencies which may need immediate surgery such as bleeding inside the brain. An mri is usually done the next day, when the patient is more stable.

    If you have already had an mri, then usually you do not need a ct scan. Th ere are a few rare conditions (e. G. Calcification in brain) which are seen better on a ct, but these are very uncommon.

    (iii) Eeg (electro-encephalo-graphy):
    Our brain functions because of electric currents traveling from one place in the brain to another. An eeg measures this electric current.

    To do this test, small pieces of wire are stuck to the head using glue. These wires are then connected to an amplifi er and the electrical activity in the brain is recorded. The machine itself does not send any current to the brain. It only records current. Therefore, there is no pain or discomfort, and this is an extremely safe test. Anyone can have this test, including pregnant women, babies and very sick patients. Th is test is most often used for evaluating seizures. An eeg is also used in cases where the patient is unconscious for a long time, without a clear reason.

    1. Doctor, my hand keeps shaking. It stops shaking only at night. Why is this happening?
    The shaking of your hands is called a tremor. There are many causes of hand tremor. Th e most common causes are essential tremor and parkinson's disease. If you have essential tremor, your hands will shake more when you try to do something. For example, writing may become very diffi cult or water may fall down when you try to drink form a glass.

    If you have parkinson's disease, the tremor is maximum when your hands are resting and doing nothing. For example, when you are sitting on a chair and watching tv comfortably, the hand starts shaking. Besides these common causes, there are other causes. For example, shaking of the hand (s) can begin after a small stroke near an important part of the brain called the red nucleus or in a condition called dystonia which causes contraction of the hand muscles without any clear reason some medications (see list), severe anxiety and very excessive tea/coff ee can cause hand shaking. Finally, there are diseases that have symptoms exactly like parkinson's disease.

    Therefore, I need to examine you carefully. Based on observing you so far, I think there is a possibility that you may have parkinson's disease.

    2. Parkinson's! I have heard this is an extremely serious illness! is this disease fatal?
    No. Parkinson's disease is not fatal. Yes, but it is important to treat parkinson's disease promptly. Th e diagnosis of parkinson's disease is often missed. If not treated on time, patients with parkinson's disease are significantly restricted in their day-to-day activities, practically becoming disabled if treatment is delayed for a long time.

    Secondly, if left untreated, patients with parkinson's disease can have frequent falls causing serious injuries including fractures and head injuries. Hence the diagnosis and treatment of parkinson's disease should be done as soon as possible.

    3. What causes parkinson's disease?
    Our brain runs on electricity and chemicals. If there is too much or too little of a particular chemical in your brain, it causes a disease. Parkinson's disease is caused by the reduction of a chemical called dopamine in our brain.

    Dopamine is produced in the back of our brain, in a part called the mid-brain. It is then transported forwards and is widely distributed throughout the entire brain. It fi res up the movement centers of our brain, and helps them communicate better with one another. In parkinson's disease the cells in the midbrain producing dopamine gradually

    Die. No one quite understands why this happens. Then effect is that the movement centers of the brain don't Communicate well with one another, and this produces the various symptoms of parkinson's disease.

    4. Ok so what are other symptoms of parkinson's?
    You already know one symptom shaking of the hands while resting. There are many other symptoms in patients with parkinson's disease and recognizing them is often very easy:
    - Their muscles are often stiff and become inflexible, but they often do not complain about it. Th ey may complain that they are not able to do some things such as comb their hair.
    - They are very slow in doing everything. They walk very slowly. They often bend forward while walking.
    - They have difficulty turning around when they are walking.
    - Sometimes they can get stuck in one position. Often this happens while walking, but may happen while doing something else.
    - In later stages, they can fall frequently.
    - Their friends may notice that their face has become expressionless and they just appear to stare off without blinking into distant space.

    All patients do not have all of these symptoms. Some patients experience just the shaking of hands; other people experience just the muscle stiffness and so on. Often as people get older, more and more of the dopamine producing cells are destroyed and patients start developing more symptoms. But it takes years for this to happen and it may not happen in all people. In some patients, parkinson's disease remains restricted to just a few symptoms.

    5. Ok doctor, thankfully I seem to be having just the hand shaking at this time. But other than the symptoms you just described, I am having other symptoms. I am always constipated, I cannot sleep well, and my saliva keeps dribbling from my mouth. Is it possible that these symptoms are also related to parkinson's disease?
    Yes. It is not just possible but very likely that all these symptoms are due to parkinson's disease. Parkinson's disease is recognized by all doctors as a disease affecting movement. But in addition to movement problems, patients can have many other problems.

    These are frequently not recognized, even by physicians, and therefore left untreated. If recognized and treated (and simple treatments are available for many of these symptoms), their resolution can significantly improve the patient's quality of life. It is important that your doctor should think about other diseases too. For example

    If you have back pain, it is important that the doctor should think about arthritis of the back, if you have impotence your doctor should think about diabetes etc. But in many cases, no other cause can be found - these problems are due to parkinson's disease. About 10-20 years ago, even doctors did not know about these complications of parkinson's disease. It is a matter of great pride for me that I had the opportunity to receive training from the world-famous indian professor who is at the forefront of research regarding these symptoms: Dr. Kallol ray chaudhuri at king's college hospital in london.

    6. How can you be sure that I have parkinson's disease?
    A better patient history and examination will help me to confirm my diagnosis. We need to rule out other problems which look like parkinson's disease. Certain drugs may produce symptoms that are very similar to parkinson's disease (see list). Make sure you are not taking these medications, and avoid these medications in the future.

    There are a few other diseases which have almost the same symptoms at parkinson's disease. Their names are complicated! these include diseases such as progressive supranuclear palsy (psp), multiple systems atrophy (msa) and cortico- basal degeneration (cbd)! th names are not very important the important thing is that there are other diseases that look just like parkinson's disease. Some of these diseases are identified by your doctor by looking for small clues on your exam: such as your blood pressure and the way your eyes move. Now let me tell you something very frankly even after a very detailed history and meticulous examination, the diagnosis may not be clear in some patients, even to the best of doctors in the best of institutions.

    7. So isn't there a test for parkinson's disease?
    Unfortunately, there is no test for parkinson's disease which can prove it with 100% accuracy. An mri (see information for everyone section) can be helpful to rule out some other diseases e. G. Multiple strokes, and 
    Therefore many doctors get an mri in patients with parkinson's disease. There is one test that can be helpful. It

    Is called the dat scan. The dat scan is abnormal in parkinson's disease, but it is also abnormal in some other diseases that look like parkinson's disease! therefore it is helpful only in certain cases. There are a few other tests like a cardiac scan (mibg scan), but these are only available at a few research centers, and again, do not help to completely rule out other diseases.

    8. But. That is very concerning. What you are saying is that in some patients the diagnosis remains unclear?
    You are correct. In most cases, the diagnosis of parkinson's disease can be made with certainty. But about 10% of patients have an uncommon mixture of symptoms so that no doctor, no blood test, no investigation can confidently determine if the patient has parkinson's disease or if he/she has another, similar disease. In such cases, most doctors explain the situation to the patients, and give them anti- parkinson's medications such as levodopa. Usually, a dramatic improvement is seen if the patient has parkinson's disease. If a patient takes an adequate quantity of Levodopa for 4-6 weeks and there is no clinical improvement, it is very unlikely that he has parkinson's disease.

    These medications cause clinical improvement in about 1/3rd of all patients with the other diseases such as msa, psp etc. However, this improvement is not as dramatic as the improvement seen in parkinson's disease and frequently does not last as long. As the years go by, other symptoms develop (such as urinary problems, eye movement problems and falling) and a more definite diagnosis can be made on the basis of repeat examination.

    9. Hmm. Doctor, there must be several medicines for parkinson's. If the parkinson's is caused by a lack of dopamine, shouldn't consuming dopamine help to reduce the symptoms of the parkinson's?
    Yes, there are many medications and yes you are correct providing extra dopamine to the brain is one of the best ways to make the symptoms better. I have provided a list of these medications, but it is worth highlighting two of them: levodopa is the oral form of dopamine. It is converted into dopamine when it goes inside the brain. Th is is usually the fi rst medication that is started. It is available in standard, dispersible and extended-release

    Preparations. Young patients with very mild symptoms of parkinson's disease are given a diff erent kind of medication initially. These medications are called dopamine agonists. Th ere are 3 dopamine agonist medications: pramipexole, ropirinole, and rotigotine. Th ey are available in standard and extended release preparations.

    10. So, what you are saying is that the dose of parkinson's medications does not stay constant throughout life?
    You are correct. Parkinson's disease often progresses as patients grow older. Some symptoms change and become less prominent but on the whole the symptoms become more severe. Th is progression is probably caused by gradual death of more and more cells producing dopamine. Very few people have side eff ects due to these based on the symptoms that develop, the medications. Often, parkinson's disease dose of parkinson's medication may need progresses as patients grow older and new to be changed, or new medications may be given. For example, if you have trouble sleeping at night, then the doctor can ask you to take an extra levodopa pill at night or an extended release ropnirole pill. If the benefi cial effect of levodopa is not lasting for as long as it used to, the doctor may ask you to take entacapone with the levodopa. If you have constipation the doctor will prescribe a laxative and so on. Sometimes it may take a few trials of different medications over 1-2 weeks to find the right combination that works for you. Parkinson's is not a deadly disease. Th ere are many medications for parkinson's. Th e doctor needs to have precise information about the patient's symptoms in order to prescribe the right medications. In parkinson's disease, the doctor needs help from his/her patient. It is essential to record your symptoms accurately and visit your doctor regularly, every 3 to 6 months.

    11. Doctor, you are saying that frequently the dose of levodopa needs to be increased. But what happens if too much levodopa gets into the person's brain?
    Yes, this can happen but it is not life-threatening. When there is excessive dopamine in the brain, the body starts moving too much. Often there are small jerks in the neck, shoulders and sometimes in the leg. If you are a fan of michael jackson, you have seen break-dancing. Th ese excessive movements look like break-dancing. Th e medical term

    For these excessive movements is dys-kinesias. It is very important for you to be aware of them and remember the word: dys-kinesias. Often, dys-kinesias are at their maximum 1-2 hours after you take levodopa. If you have trouble recognizing these movements, you should take a video of any suspicious movements on your smartphone and show it to your doctor. In the early stages of parkinson's disease, dys-kinesias are only seen when the

    Levodopa dose is very high. But in more advanced stages, they may be seen at lower doses and giving the patient an adequate dose of levodopa without producing dyskinesias may become diffi cult. At this stage, some dyskinesias may need to be tolerated. If you are suff ering from dyskinesias, you can reduce the dose of levodopa that you are

    Taking. But this may result in some of the symptoms of parkinson's disease (slowness, rigidity, freezing etc) to reappear. Another way in which dyskinesias may be reduced is by giving you amantadine.

    12. I am getting it now, doctor. This is like a weighing scale isn't it? too little levodopa causes the parkinson's disease symptoms to come back, and too much levodopa action causes dyskinesias.
    Yes! th at is absolutely right. In the initial stages, balancing this weighing scale is very easy. But after 10, 15 or in some cases 20 years, balancing this scale becomes diffi cult. After taking levodopa, many patients improve but also get dyskinesias. It becomes impossible to fi nd a levodopa dose that causes improvement without producing dyskinesias. Th erefore, at this stage, some dyskinesias may need to be tolerated as long as you are able to function satisfactorily.

    13. So doctor, you told me what happens when there is too much dopamine action in the brain. What if the there is too little dopamine action in the brain? What if levodopa just stops working?
    Levodopa never stops working. But it may become less effective, and its effect may become short-lived. Th ere could be many reasons for levodopa to become less eff ective. These are listed separately the most important reason is that the patient may not be taking the levodopa on an empty stomach. As parkinson's disease advances, the eff ect of levodopa lasts for a shorter duration of time. Here is a somewhat typical story from such a patient. Remember, this happens only in few cases:
    Taking the tablet helps me only for a short time. When I wake up in the morning, my feet contract, twist and become painful.

    14. I understand. It must be difficult at that stage to find the right combination of medications. What if the situation worsens further?
    Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to find the right combination; sometimes even 3-4 trials of diff erent combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health.

    Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's

    Patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. Th en I take my morning dose of levodopa

    And feel good. Sometimes I get some dyskinesias, but I don't complain about them because I am feeling good. But only an hour or 1.5 hours later, the symptoms of parkinson's disease start coming back. I become slower and slower, and then freeze. I get better again when I take levodopa, but I can't keep taking levodopa every hour!

    I understand. It must be difficult at that stage to fi nd the right combination of medications. What if the situation worsens further?

    Yes. And I think it is vital for patients to understand this. Frequently, with the right combination of medications the patient can get better. But it can take some time to fi nd the right combination; sometimes

    Even 3-4 trials of different combinations may be required. If a patient gives up hope and gives up in the middle of these trials, the only possible outcome is progressive deterioration of the patient's health. Sometimes, inspite of repeated adjustments, a good combination of medications cannot be found. But remember this situation arises 10-20 years after the parkinson's symptoms have been detected. Many parkinson's patients do not have to face this situation. If the right combination of medicines could not be found even after many trials, then still there is one solution. Brain surgery. A proper mixture of medications may help this situation as well. I had given you an
    Example of this earlier: entacapone can prolong the eff ect of levodopa.

    15. Doctor. Brain surgery? are you kidding me? this is a big deal. By the way, what is this surgery called?
    I know brain surgery is a big deal. This surgery is called deep brain stimulation, or this is a brain surgery, but a relatively dbs

    If your symptoms are well controlled with medications, no doctor in their right mind would recommend you to have surgery. But in a few patients, medications no longer produce adequate improvement. Either the improvement lasts for a very short time, or the medication produces such dramatic dyskinesias that giving an adequate dose is impossible.

    Approximately, 70% of such patients benefit from this surgery. The improvement is very significant, but dbs does not make all symptoms of parkinson's disease magically disappear. It is very important to have realistic expectations from the surgery. The improvement seen after surgery is batteries last for about 5 years, and can be Replaced when required.

    16. Well. How is this surgery done?
    This is a brain surgery, but a relatively minor one. A metal frame is usually attached to the patient's head. A very small hole (approximately 1 cm in diameter) is made in the head, and a thin (1 to 1.5 mm thick) wire is inserted through it. The wire is pushed into a very particular part of the brain called the sub-thalamic nucleus. Th e same process is repeated on the other side and another small wire is inserted. These wires are then connected to a small battery (a square of approx. 3 inch) that is kept in the skin below the chest. No part of this device can be seen from the outside, and any scars on the head are usually covered by hair in a few weeks. Th e device is usually turned on 4 weeks after the surgery. On an average, most.

    17. I see. Doctor, does DBS cure all symptoms of parkinson's disease?
    No. DBS surgery improves only those symptoms which improve after levodopa.

    - Dbs surgery prolongs the eff ect of levodopa, decreases dyskinesias, improves slowness of movement, hand shaking, muscle stiff ness and in general makes the patient much more functional. However, symptoms that do not get better after levodopa such as freezing and falling usually do not get better after dbs.

    - Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body. Other symptoms that we talked about e. G. Sleep problems may get better after dbs. I conducted an audit of sleep symptoms after dbs during my time in london at king's college hospital, and found that there is

    Significant, but non-dramatic, improvement in many patients.

    Two problems can become worse after DBS:
    (i) Severe psychiatric problems such as severe depression and hallucinations and
    (ii) Severe diffi culties of thinking and memory. If any of these problems are severe, dbs is usually not off ered to the patient. If a patient has severe psychiatric problems and is under treatment, dbs may be considered in the future if they completely resolve.

    18. Okay doctor, what are the risks of this surgery?
    Th ere is a small amount of risk involved in any surgery. Since dbs surgery is relatively minor, the risk is low but is not non- existent.
    - The risk of death is less than 1%
    - Approximately 5% of patients can have serious complications such as stroke, seizure and infection. But most of these problems are cured with medications. Only 1% of these patients have permanent problems from these complications, such as permanent weakness of one side of the body.
    - A few patients have minor problems such as problems in wire connections or a non-functioning battery. Th ese are easily corrected. In short, about almost 90-95% of patient do not have any complications during or after the surgery, and the risk of death or permanent problems is very small (lts 2%).

    19. Can the doctor guarantee a significant benefi t after DBS surgery?
    No. No doctor in the world can guarantee Improvement after dbs. Th at being said, improvement happens in most patients as long as they are carefully selected. Before off ering you option of surgery, the doctor will give you a large dose of levodopa and make sure that your symptoms improve significantly. He/she will tell you that this is the maximum benefit that you may get after dbs, and try to set realistic expectations so that you are not disappointed after the surgery. Often the surgery is followed by a period of temporary improvement, even before the battery is switched on. This improvement Goes away in a few weeks. Th is is expected and you should not be disappointed - this is a good sign. After the battery is switched on, it may take between 3-6 months to achieve the optimal balance between your dbs and medications. During this time, your symptoms will improve gradually. But you should be patient if your symptoms

    Have not improved within 1-2 months there is a good chance they will improve with further dbs adjustments. Most patients improve after dbs surgery, but a few people do not improve. Th e reason why these people do not benefit from dbs surgery is unknown, and this is being vigorously researched in the us, uk and other countries. Read more here

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  • DNB (Psychiatry), DPM, MBBS

    Your mother has often yelled at you for playing video games for long hours but obviously you haven’t paid heed to it. Such is the obsession with video games that they don’t let you rest unless you have championed all the levels in the virtual interface. Here is the source of all problems. Studies have revealed that video games have a direct relation to neurological disorders. As a result, many health experts across the world consider video game as a kind of health abuse.

    People who play action-oriented video games are at higher risks. The more you indulge in these kinds of games, the more they are going to affect the hippocampus section of your brain. It is that part of the brain which is considered to be the centre of your nervous system, memory, and emotion. This has a detrimental effect on your overall brain health.

    Let us see some of the signs which may indicate the onset of certain complications arising from an over indulgence in these games.
    1. You spend hours on the computer or related gaming devices and devote lesser hours for your family and friends.
    2. You get agitated when someone stops you midway through the game
    3. You become socially isolated and show signs of occasional mood swings
    4. You are unable to keep a track of time once you start playing
    5. You repeatedly neglect your studies, resulting in a dip in performance at school

    Why does this happen?
    All of the above signs indicate that sooner or later you might develop neurological problems. When you spend an excessive number of hours on playing and navigating through the games, the ‘hippocampus’ portion of your brain shows signs of decreased gray matter. As a result, the volume of the hippocampus shrinks, causing severe nerve related disorders such as schizophrenia, Alzheimer’s disease, dementia, depression, and overall general stress.

    One of the biggest reasons behind this is a lack of self-control. Most of the video games will encourage you to steal cars, run away after a theft and kill your enemies. Moreover, if you succeed, you are rewarded. This naturally unleashes a blatant urge for the gratification of all these awkward desires in your real life too. Hence, once you are encountered with the reality, you tend to show violent behavior.

  • PGD IN ULTRAASONOGRAPHY, Non invasive cardiology course, MD - Medicine, MBBS
    General Physician

    Smoking increases the risk of heart disease and lung cancer, but even before those potentially deadly diseases develop, regular smokers are more likely to begin losing their teeth. A new study from britain's university of birmingham and the german institute of human nutrition determined that men who smoke are 3.6 times more prone to lose their teeth than non-smokers, while among women smokers the risk is 2.5 times higher. The researchers based their conclusions on data gathered from 23, 376 participants in a long-term study in germany. Part of the problem is that smoking is a strong risk factor in promoting tooth decay and gum disease, both of which can lead to tooth loss. The investigators noted that smoking can mask bleeding gums, a key symptom of gum disease, so that a smoker's gums may look healthier than they actually are. The good news is that quitting smoking can reverse the increased risk of tooth loss, although the researchers wrote that it could take more than 10 years for the risk to equal that of someone who never smoked.

  • M.S. Counselling and Psychotherapy

    What is stress?

    There are situations in life when a person is required to perform beyond his/her normal capacity, or situations when some expectations are not met. This creates anxiety, fear and anger. This is a situation where a person feels inadequate, under-confident and experiences loss of control. This affects a person's physical and mental wellbeing. This feeling of fear, anxiety, restlessness is commonly known as "tension or stress".

    Symptoms of Stress :

    1. Anger and Aggression: While under stress a person starts doubting his/her own capacity and efficiency because he/she feels inadequate or incapable of performing certain tasks. This creates a lot of anger or frustration and sometime, may result into aggressive behaviour. 
    2. Irritability: Under stress people get irritated for no reason. There is loss of patience, loss of sense of humour.
    3. Sleep Disorders: A person under stress may not be able to sleep at all or in some cases sleep excessively.
    4. Eating Disorders: A person under stress may lose appetite or in some cases, tend to overeat resulting in harmful effects on body.
    5. Anxiety: Stress may cause a lot of anxiety and restlessness. The person under stress may not to able to concentrate and unable to focus on any activity, making things more complicated.
    6. Depression: In a few cases a person under a lot of stress may go into depression.
    7. High BP: Body and mind are closely connected. Hence stress in mind creates stress in the body and under stress, blood pressure may rise.
    8. High Sugar Level: Stress may increase the blood sugar levels.
    9. Headache or Unexplained Body Pains: Stress may cause headache or body aches in different parts of the body, without any physical reason for it. 

    Sometimes, there may not be any symptoms for stress but the trauma manifests in the form to heart attack, Stroke etc.

    What causes stress ?

    1. Relationship Issues - Conflicts in relationships is a major cause of stress.
    2. Life style - Working for long hours, sedentary life style, unhealthy food habits, along with insatiable urge for money causes a lot of stress.
    3. High expectations from oneself and from others - The peer pressure, the pressure of constant deadlines builds up a huge stress. When a person has very high expectations from himself/herself without corresponding efforts, there is a fear of failure which causes lot of tension. At the same time, having unrealistic expectations from others also is a definite reason for disappointments, resulting in stress.
    4. Physical and Emotional Abuse - When a person is physically or emotionally abused and unable to defend himself/herself for various reasons, it causes frustration. This results in anger and stress.
    5. Competition - Unhealthy competitions with others create a feeling of inadequency and result in lower self esteem and sadness, thereby causing stress.
    6. Health Issues - Chronic and serious health issues cause lot of tension.
    7. Suppressed Emotions - Lack of freedom to express own emotions and feelings, amounts to stress.
    8. Lack of Assertiveness - Inability to say "No", when wanting to say so, inability to fight for one's own rights, causes tension and anger.
    9. Boredom - Lack of creative/interesting occupation may cause stress especially in old people or people with physical disabilities.
    10. Low self esteem, feeling hopeless and helpless - If a person has low self esteem and does not value oneself, it causes lots of negativity and stress.

    Why stress management is important?
    Body and mind affect each other's functioning. When the mind is stressed out, it gets reflected in the body in the form of high blood pressure, high sugar levels, indigestion, acidity, heartburn, ulcers, skin rashes, headache, nausea, cancer, eating disorders, psychosomatic pains etc. It may trigger asthma, migraine etc.

    Because of these harmful effects of stress, the body's capacity to function reduces. At times, it may cause serious threat to one's life. Hence, it is very important to learn to relieve and also to manage stress, in order to have a long and healthy life.

    There are a number of ways to relieve stress:

    1. Sleep, take rest, relax.
    2. Take a break from daily routine, do something different, take a short vacation.
    3. Go for a walk/jog/run/cycling. Practice Yoga, meditation, deep muscle relaxation, etc.
    4. Spend time with friends and family.
    5. Play with children.
    6. Spend time with pets.
    7. Pursue a hobby like reading, gardening, painting, music, dance, singing, cooking, etc.
    8. Recreation - Watch a movie, play, picnic, go for a drive or shopping.
    9. Pamper yourself with beauty treatments, massage, or your favourite food/drinks. 

    How to manage Stress?
    Stress is inevitable part of life now. Right from a kid going to Pre-Nursery school to senior citizens staying alone at homes and having severe health problems; all are under lot of stress. No one can avoid stress. But there are certain ways to manage your stress-

    1. Self-awareness. Learn more about your own self. Understand what induces stress in you, what tasks are difficult for you, what situations are difficult for you and then try to figure out the reasons why it is so. Try to resolve or modify your thoughts and attitude.
    2. Identify stressors and explore options. Once you identify what is causing your stress, try to find more options to resolve your issues.
    3. Reasonable Expectations and Feasible Goals. Have reasonable expectations from yourself and from others. Have goals which are possible for you to achieve.
    4. Learn assertive techniques. Learn to express your feelings, learn to fight for your own rights, understand and respect other's rights.

    Try to minimise stress in life and lead a happy healthy life.

    1742 Thanks
  • M.D Psychiatry , DPM, MBBS

    Therapy is an ideal way of freeing your mind over a talk session with a therapist. Here are 10 reasons you should try therapy for a better health of mind.

    1. Therapy is for everybody: Therapy is not for crazy people with mental illness. It is good for anybody and everybody who wants to gain peace of mind.
    2. It is easier to talk to a stranger about some matters, than a friend: Only a stranger has the ability to recognize an irregularity in you, which your friends cannot. Therapists can dig into matters deeply and arrive at different conclusions.
    3. You get to learn more about yourself: During therapy, you talk about stuff and come to different realizations about things, which you never thought or cared about before, which allows you to discover a new side of yourself.
    4. You can get out of your comfort zone: Before going for therapy, you may feel awkward or strange to sit with a stranger and discuss personal matters. However, therapists are professionals and once you open up to them, you will be able to discuss everything with them comfortably.
    5. You feel supported: There are many issues in life, which seriously affect you, but no one pays heed to them. Your therapist listens and discusses everything you have in mind. Finally, you are heard.
    6. You develop better self-awareness: Therapy gives you a chance to stop for a moment and contemplate about certain areas of life, which you usually never cared about. What you never thought about might finally affect you, and you will try to improve on it.
    7. You feel better: You may have serious issues and might be feeling troubled. The therapist gives you suggestions and when you leave the clinic, you are bound to feel much lighter and calmer.
    8. You can focus on yourself: In the daily hustle bustle of life, you may be so occupied that you never get a chance to think about or focus on yourself. Weekly therapy gives you an hour, which is dedicated only to you to explore your feelings, thoughts and concerns about life.
    9. You may be pushing down yourself: Ignorance of serious issues causes a negative effect on your life and health, as well in the lives of your dear ones. Therapy allows you to bring all these ignored issues to light and after recognizing them properly, you can improve upon them.
    10. Smart, successful people believe in therapy: Therapy is for strong people who have the courage to approach a stranger with their personal issues. Majority of smart and successful people recognize the benefit of therapy and undergo the same for their own benefit.

    Therapy is  very effective and allows you to express yourself honestly and benefits you in many ways.

    474 Thanks
  • MBBS, MD - Psychiatry

    There are a number of mental disorders and conditions that may affect the psyche of a person, due to various reasons including hormonal changes, environmental factors and even genetic conditions. Paranoid Personality Disorder is one such condition that gives rise to eccentric behavioral patterns. This may make the patient seem odd or even strange to others. Here are the signs, causes and various forms of treatment available for this condition.

    Symptoms and Signs

    Most of the patients suffering from this disorder are completely convinced that there is nothing wrong with their behavior and everyone around them are conniving against them with ulterior motives of bringing them down. This will make them highly suspicious individuals with intense trust issues. They also become angry and violent very soon and usually do not have a justified reason for such temper tantrums. These patients will also be detached and isolated socially, with hardly any friends and relationships. They will also have trouble seeing their own problems and flaws, which can keep them from having meaningful relationships.


    The cause of this disorder is not known as yet. There is much ongoing research in this field. It is widely believed that this disorder is born due to a combination of biological factors and other environmental factors that may have conditioned the brain in a negative manner. Chemical and hormonal imbalances are known to be at the core of many such disorders. Also, it may be seen in people who come from a family of Schizophrenic patients. Trauma experienced during one's childhood can also lead to the onset of this disorder.


    One of the most effective forms of treatment for this disorder includes therapy. Talk therapy or CBT which is also known as Cognitive Behavioral Therapy is a form of discussion based therapy that can help the patient in talking about his or her feelings. These are then analysed in a clinical setting with the intervention of a trained psychiatrist or psychologist who will help the patient in pointing out abnormal behavior. This kind of therapy also helps in reaching the root cause of the issue that may have caused this condition in the first place. By doing so, there is a better chance of treating this cause and thus changing the attitude of the patient. This will help in steering the patient towards more normal behavior in the long run. This kind of therapy will have to take place over a long period of time before the results begin to show up in the day to day living and functioning of the patient. Anti-depressants and anti psychotics may also be prescribed.

    2516 Thanks
  • MBBS, MD - Psychiatry

    In order to determine whether a person is having a drug problem, there are several signs, which can be interpreted to know about the exact drug abuse state of a person. Drug abuse requires immediate attention before it becomes more problematic. There are several patterns and stages of drug use that have been listed below:

    1. Hard drug use: Heroin, cocaine and methamphetamine fall under the category of hard drugs and are the most dangerous drugs. There are severe effects on the health and behavior of a user of hard drugs. Some people use these kinds of drugs for recreational purposes, but some can get addicted just after using them once. Such people usually isolate themselves from society and possess a high-risk behavior.
    2. Frequent drug use: Frequency alone cannot determine whether a person is addicted to a certain drug. Some people may take drugs only once and twice a week, but still suffer from acute addiction. Frequency of drug use may indicate tolerance and a person may require more with each day. Frequent drug users usually keep on continuing the habit and it is hard for them to quit.
    3. Early drug use: Some people start taking drugs at an early age during adolescence, and they are likely to develop severe drug problems later in life. People who take drugs before the age of fifteen turn out to be addicts as they grow up. The earlier a person uses drugs, the earlier he becomes addicted. Early drug use is a common phenomenon in today's world.
    4. Solitary drug use: Using drugs and addictive substances while a person is alone may result in fatal addiction and various problems in life. Teenagers using alcohol, marijuana and cigarettes are prone to serious drug problems during adulthood. Solitary drug users are usually poor in studies and have a violent or abusive behavior.
    5. Escapist drug use: Many people use drugs for dealing with stress, several problems in life or for building self esteem. These are used as a substitute for escapism, which allows a person to escape from reality to a place where nothing bothers them and they can be at peace. Such people are likely to develop drug problems. Some people may experiment with drugs just for the sake of trying, but slowly they may like it and get addicted. This causes several problems in life, and a drug problem arises. Such drug problems may affect the health in many severe ways.

    Drugs are used in several patterns. All people do not use drugs in the same pattern and frequency. The pattern of drug use by a person lets the doctor determine the level of drug abuse he is on, or if he is addicted.

    2280 Thanks
  • Partners in Health
    Multi Speciality

    Even after putting her best in her family, Radha's husband was shouting at her again, her children were again complaining about the food, her mother-in-law about her joint pains and even when she had a million issues on her mind, the one bothering her most was her board presentation scheduled tomorrow in office.

    Tired, exhausted and challenged she smiled remembering her mother's words-

    'They say it's difficult to be a woman! You need to think like a man, act like a lady, and look like a girl and work like a horse.'

    From an amoeba to higher species four aspects are common-Nutrition, Reproduction, Excretion and the fourth one is Stress. Working professional or a home maker, a woman's plate is always full with multiple projects and a huge list of things to do. Cooking, washing, cleaning, picking & dropping kids, homework, spouse attention, extended family, social obligations, and dependency on maids, over demanding workplace, sometimes obnoxious co-workers, and long commuting hours are facets that bother every woman today.

    All these activities and stressing situations are disturbing. The human mind is not conditioned to handle so much. The result is emotional disturbance- anxiety, energy drain and undue stress.

    We need to understand that we have the power to be happy, stress free, peaceful and only we can help ourselves. Hence it's important to take charge of situations causing stress. We should try to go easy on ourselves and accept the following:

    We are not Durga or an Octopus with multiple hands: We need to understand our limitations and should not stretch ourselves. We can always ask for help from others. Sometimes people around us are just unaware about our needs. We should ask our family, friends, co-workers for help bluntly, rather expecting them to read our mind.

    Don't try to control the uncontrollable:  We should not get tense unnecessarily when something happens unplanned and hampers your schedule. We need to accept facts -we can't change the weather, situations, how others behave. The best way is to relax and accept situations and re-plan your day.

    Don't be a perfectionist: Expecting perfection from others adds on to our stress.  Not everyone can be organised like you. Your maid might not be able keep your home spotless, your daughter's hand writing could be as poor as the girl you hated in your class, and your co-worker might not be good in MS Excel. A perfectionist cannot delegate work. Be easy on yourself and on others. Most importantly don't nag people about issues; it can make them feel suffocated.

    Self-compassion: Be compassionate with yourself too. Don't feel pressure to perform every time. Don't try to put extra efforts beyond your limit to please others. Give some room to others to make mistakes- after all people learn from them.

    Stay on schedule: An organised approach to handle tasks always gives a pleasure of accomplishment and it's very important to design a balanced routine and stick to it. A 'Me Time' is very important when you budget your day.

    Simplicity reduces stress:  Keeping less stuff helps us to manage and organise things better. Don't buy or store things you don't need.

    Take care of your health: Our mind, body and soul are inseparable. Taking care of your health, practicing yoga, and exercising, eating a healthy diet is important to fuel better emotional well-being.

    Tears are not sign of weakness! Don't feel guilty: Yeah! Shedding tears does not make you weak.  Don't feel miserable for being sensitive. Express yourself openly!

    Be assertive in communication style: We can always put across our points assertively without sounding irritated, frustrated or angry. It's important to put your thoughts and difference of opinion constructively.

    4627 Thanks
  • Diploma in Diabetology, P.G. Diploma in Health Science (Diabetology), Certificate Course in Evidence based Diabetes Management -, MBBS

    Addison’s disease is a disorder caused due to significant damage in the adrenal cortex (located alongside the adrenal gland’s perimeter that helps mediate stress reaction), which leads to a deficiency in the secretion of the hormones ‘aldosterone’ (that regulates the sodium and potassium level of the body), ‘androgen’ and ‘cortisol’ (which control the body’s reaction in situations of intense pressure) by the adrenal glands.

    There are generally two stages of Addison’s disease. The causes vary according to the stages:

    In the primary stage of the disorder, the body’s immune system attacks the adrenal cortex and significantly damages it.

    Other significant causes are as follows:

    • This might occur as a result of the development of tumors and cancerous cells in the body
    • Resulting from certain infections
    • Long-term usage of glucocorticoids (inflammation reducing steroids) might result in the primary adrenal insufficiency
    • This might also be caused due to tuberculosis or severe bleeding in the adrenal glands.

    Risk Factors

    If you’re suffering from any one of the following complications, your chances of contracting Addison’s disease increase significantly:

    • Cancer or if you have undergone any surgery to remove parts of the adrenal gland
    • Tuberculosis or diabetes.
    • Frequent usage of coagulants

    The treatment of Addison’s disease varies according to the cause of the disorder.
    The most common treatments for the disorder include:

    • A prescribed dosage of glucocorticoids might be recommended
    • Replacement of the hormones that the adrenal glands are unable to produce: Cortisone acetate or prednisone might be used in order to replace the ‘cortisol’ hormone.
    • Meditation or other relaxing techniques to ease excessive stress levels or manage any trauma that you have been through.
    2105 Thanks
  • DHMS (Diploma in Homeopathic Medicine and Surgery)

    Stress is the physical or emotional response of the body to an internal or external stimulus that upsets the equilibrium of the body. The stress hormones which are secreted in animals only during starvation, childbirth or torture are secreted in human beings all the time.

    Medically, the mental or emotional aspects of stress are exceedingly important. Unhappiness, shock, illness, fear and much else can cause stress, which in turn can make people vulnerable to so many different illnesses both mental and physical. Stress and anxiety go hand in hand; every illness has a degree of anxiety. Even a predominantly physical illness like a sore throat can cause some stress. Certain illnesses have a very large stress component; particularly illnesses like depression, anxiety states and panic attacks.

    A person’s tolerance of stress varies enormously – some people thrive on it; high-powered businessmen, for instance, who constantly have to make important decisions. Others buckle under quite small stresses and this may lead to illness.

    For the past two centuries, Homeopaths have concentrated on the interconnection between psychology and physiology.

    To start with, the homeopathic enquiry is a very profound one and very often during a consultation various factors come to light, which may be creating some degree of anxiety or stress in the patient’s life. A discussion as to how they may be overcome, removed or mitigated, can often be very helpful. Discussion itself can be extremely therapeutic. In many cases, the patient is anxious or worried because nobody has taken time to talk to them. The homeopathic physician spends a lot of time with patients. It is however very important that the practitioner should have a sound knowledge of conventional medical diagnosis because during the discussion signs and symptoms of disease which need conventional (sometimes urgent) treatment may emerge and a qualified doctor with a knowledge of diagnosis knows when to refer a patient urgently to the appropriate specialist and is able to do so.

    Having carefully assessed the patient, taking into account not only his illness and how he is reacting to it, but his whole make-up, the homeopathic physician then tries to work out the patient’s constitutional remedy. If he succeeds in selecting the right remedy, the patient’s well­being, resistance, resilience, general health and ability to cope are enhanced and many stress symptoms can be helped.

    There are a number of polychrests (medicines of many uses) often prescribed constitutionally, which are particularly appropriate for different sorts of worry and stress. The following I have used to good effect on many occasions: Lycopodium for the patient who greatly underestimates their abilities and anticipates every ordeal however small with pessimism; Silica patients are terrified of failure and Calc carbs are just too weak and exhausted to attempt anything! These medicines are only effective, of course, if they “fit” the patient so far as his whole constitution and make up is concerned.

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  • MD - Psychiatry, MBBS

    Schizophrenia has been recognized as a mental disorder that combines symptoms like hallucinations with distorted thinking and others like fright and severe paranoia. This condition is one that gets progressively worse over time and leads to delusional thinking. Oversleeping and complaining of fatigue are usually the earliest signs of this condition's onset. Eventually, it becomes a debilitating factor in the life of the patient, who will not be able to function in a normal way due to the severe symptoms.

    Read on to know more about the types and causes of this condition:

    1. Genetic Causes: Schizophrenia may be caused due to genetic factors and it may be a learned or inherited disorder. It is known to affect patients who have a parent or a sibling who may have suffered from this condition. Yet, one must also remember that Schizophrenia can only be influenced by genetics, and not determined by the same.
    2. Environmental Causes: When there has been an exposure to a viral infection during the pre natal stage, the patient is susceptible to this condition. Also, it may affect children who have been subject to the loss of a parent or separation at an early age. Physical and emotional abuse in one's childhood may also bring on this condition. Low level of oxygen at the time of birth is one of the causes of this condition in many patients.
    3. Anomalies in Brain Structure: When the brain ventricles of the patient are enlarged, he or she may be prone to this condition. Also, anomalies in the temporal lobes and amygdala have links with the onset of this condition.
    4. Types: A wide variety of mental and medical conditions can manifest with psychotic symptoms that must be considered in the differential diagnosis of schizophreniform disorder. These include psychotic disorder due to another medical condition or its treatment; delirium or major neurocognitive disorder; substance/medication-induced psychotic disorder or delirium; depressive or bipolar disorder with psychotic features; schizoaffective disorder; other specified or unspecified bipolar and related disorder; depressive or bipolar disorder with catatonic features; schizophrenia; brief psychotic disorder; delusional disorder; other specified or unspecified schizophrenia spectrum and other psychotic disorder; schizotypal, schizoid, or paranoid personality disorders; autism spectrum disorder; disorders presenting in childhood with disorganized speech; attention-deficit/hyperactivity disorder; obsessive-compulsive disorder; posttraumatic stress disorder; and traumatic brain injury.

      Since the diagnostic criteria for schizophreniform disorder and schizophrenia differ primarily in duration of illness, the discussion of the differential diagnosis of schizophrenia also applies to schizophreniform disorder. 

    Brief psychotic disorder - Schizophrenia disorder differs in duration from brief psychotic disorder, which has a duration of less than 1 month to residual schizophrenia.

    Residual Schizophrenia is a condition where the patient does not experience the various debilitating symptoms of the condition, and is on the road to recovery. Yet, even in this type of Schizophrenia, the patient will not really show any interest in life and the activities around him or her. Finally, the last type of Schizophrenia is Schizoaffective Disorder which is characterised by the symptoms of Schizophrenia as well as the symptoms of major mood disorders. When combined, this condition can lead to major complications and complex behavior.

    A patient suffering from this condition will need to see a mental health specialist like a psychiatrist or a psychologist on an immediate basis. The treatment will be carried out on a long term basis for the results to start appearing.

    2541 Thanks
  • MPhil Clinical Psychology, Masters in Psychology

    Tragedies are a part of life and at some point of life, every person undergoes some large-scale tragedy. It may be in different forms like separation, crisis in relationships, financial stress, death of a loved one, some severe disease and many others.

    A large scale tragedy can cripple a person and devastate him. However, instead of breaking down, one should stand strong and face the situation. Here are 5 ways to cope with a large-scale tragedy:

    1. Talking to someone, honestly: You are not alone is this world and should not forget that there are many other people all around you. In case of a tragedy, you usually have a lot of pent-up feelings inside you. Instead of keeping them to yourself, you must share these feelings with your friends or any person whom you trust. Venting out will enable you to relax.
    2. Act on truth: Always keep in mind that whatever happens in life, there is a chance to start afresh. Always remember that you are not alone and there are people to help you out, no matter what kind of tragedy you have undergone. There is always some hope left.
    3. Be realistic: You have to differentiate between wishful thinking and hope and get it clear in your head. Wishful thinking might not get you anywhere and eventually you will be more disappointed. However, if you stick to reality and hope realistically, slowly you will be able to come out of your shell and face the world again. Face the reality that you have to struggle a lot for quite a long time and do not think about miracles.
    4. Second chances: In many situations, a tragedy comes with a blame. However, you should not confuse between condemnation and responsibility. Taking responsibility is wise, but self-condemnation takes you along the wrong track. You should give yourself another chance. You must let go of guilt and learn how to forgive and forget. By giving a new start, things will get back to normal. This is applicable in case of relationship-related tragedies.
    5. Have faith in God: When you are in a situation which is too tough to cope with, and you cannot foresee any hope, you have to believe in God. Keeping the faith is the best thing to do, and you should believe that hope is possible. If you have faith in a greater power, you will get through.

    Large scale tragedies are difficult to cope with and can make you feel that your life is over. However, instead of isolating oneself and burying the grief, proper measures should be taken to cope with the tragedy for better and peaceful living.

  • Partners in Health
    Multi Speciality

    We look around at our friends' marriage and often conclude that their marriage is better than ours. No wonder we turn to self-pity mode for not being to lucky to have a happier and exciting relationship. Who knew the love shall fade away! Where is the harmony and intimacy we always dreamt of ??

    Why does romance not last? When we need someone to love and more importantly to be loved. All success, a seven digit salary, and big cars, nothing. nothing lets us feel content unless we have someone to share it with. Probably you have been married for years and have lost the romantic spark you had. And you look back and start analysing, where, what, when and how things went wrong?

    And blame game starts; you curse circumstances and try to justify your actions

    Ritikaa and Mehul fell in love at first sight. Despite family resistance they married. After a few months, they were arguing for small things and wondering why did they have married. Dr Radhakrishnan is a scientist married to a pathologist; he is looking from separation from his wife after 26 years, though he is not seeing anyone else.

    Suchitra and Prakash married ten years ago, they divorced after two years of their marriage. They don't have kids. There were no obligations but they reunited four years back and divorced again, but still the relationship is not broken.

    Do happy couples exist??? Heartbroken Alok who is just 32 yrs old, asked me with teary eyes - I earn 4 crores a year, but I feel lonely, unloved and dejected!

    Every day I listen to stories of heartache! And my belief in the power of love and affection is growing many folds.

    Marriage is more than being a room partner! Not only marriage but any relationship is like a plant, we need to nurture it to blossom. Every marriage faces its own challenges at different time and for different reasons. We need to consciously work on it but with ease.

    No marriage is boring or perfect! It's about how do we respond to our marriage.

    Every couple has to face common issues related with adjusting with new families, career balance, baby plans (in some cases), spending, eating, hygiene (bathroom etiquettes) habits of spouse, interest and hobbies, gender specific responsibilities and of course money matters.

    Let it be anything . .Assertiveness is key to success.

    Watch your own actions:

    • Are you imposing thoughts and actions on your spouse: you have imagined a world, and are trying to move things as per our own wish?

    • Are you expecting without explaining to her/ him: you might be soul-mates, but don't forget that no two people can be the same. Explain your expectations but don't put conditions to get it accomplished. Allow your spouse to take her or his call.

    • Are you respecting differences in opinion- disagreement is not disrespect for your views and opinions. It's about perspectives (based on pre conceived notions)

    • Are you reading your spouse's mind and assuming? Stop assuming, ask but be assertive, use appropriate words, tone and pitch.

    • Are you giving some room for mistakes?  Give people some space to make mistakes, forgive them and self too. Communicate if something bothers you a lot.

    • Are you judging by actions not understanding intentions? Relax! Before you make opinions and decide you can't take it anymore. Sometimes your spouse is completely clueless and unaware about your mind.

    • Are you trying to bridge the gap between your spouse and your parents? Relationships are very one-to-one. Never try to bridge the gap between them, you shall end up being a sandwich and will spoil your relations too. Let them grow their own relationship.

    • Communicate clearly and explain your expectations about money matters - involve your spouse in your financial planning, it's a way to generate trust between you and spouse and it helps to work on budgets and spending habits.

    • Express clearly about sexual needs and desire. Physical intimacy plays a very important role in marriage. Seek professional help to sort things out before you think you are incompatible.

    • Make a choice not a sacrifice (otherwise you shall expect your spouse to repay it in the way you want).

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