I am Dr. Ashish Sakpal, Psychiatrist, Mumbai. Today I am going to speak about ADHD. This disease begins at childhood but can persist in adulthood. It is very common as per the current statistic in India. There are more than 10 million cases which are diagnosed in India. ADHD can be understood by getting a child to a psychologist or a psychiatrist who can evaluate the child as per the issue he is facing. Let's understand what are the signs and symptoms of ADHD. It can be divided into 3 parts.
1. Behavioral problem
2. Cognitive problem
3. Mood problem
What is the behavioral problem with which child represents? A most common problem is hyperactivity. The child cannot sit calm or he is just running around, disturbing the class, hurting himself, restlessness. These are the usual problem which can be reported by the teacher. Sometimes, the child explores the new things in the house like touching objects in the house or disturbing the activity. Another symptom is impulsivity. He doesn't wait for his turn. Whenever the question is asked in the class, he raises his hand whether he knows or doesn't know the answer. But he will try to answer it first. He will not wait to follow the rules.
The cognitive symptoms which are reported by the teachers and the parents are mainly decreased attention span. He cannot remember the instructions given by the teacher. He often forgets a thing in the school. He is not able to have a major attention span. Constantly changing the channels on the TV. It becomes very difficult for the parent to look after the child. Most common symptoms are reported is forgetfulness, losing the concentration. The symptom is a mood disorder. The child is very irritable, constantly crying, anger issue, getting bored frequently. He disturbs like he will not let anyone speak. Sometimes he will feel fearful of speaking in the class. Learning difficulties, difficulties in writing, reading. So, these are the signs and the symptoms.
How do we manage ADHD? What is the treatment option available?
The treatment is as per the age of the child. There are different modalities of the treatment. The first is behavioral therapy. Making the family member understand the disorder because it is a neurobehavioral logical issue. 2nd thing is support groups. There are certain support groups or forums available online where parents can speak to the other parents, interact with them. The 3rd thing is occupational therapy where we can channelize the energy of the child to a more fruitful thing. The next thing available is the anger management issue where he cannot express his anger and we can train him to do that. Next is family therapy. In this parents need to be taught how to handle the child also involved in the school like the teachers can be given instruction like how to support the child or to look after him In adults we can try cognitive behavioral therapies. Their thought process can be understood.
Accordingly, he can relate his emotions and his behavior. So, other than this starting a child on the medications. There are certain medications which have shown good results. Medicines can be given to the child before he goes to school. And he can give a better performance in the school. Few syrups can also be given to the child where the child can focus better. In adults, the medicines modalities are different. If adults are facing any mood swings or any depressive symptoms. ADHD if not treated in a particular age group usually it has seen too many sequels in adult life. Like going towards addiction, work-related issues, relationships problem. So, it is important to diagnose this ADHD as early as possible. We also have different therapist coming to us like an occupational therapist, remedial educator, the psychologist who can help these children.
I am Dr. Ashish Sakpal, Psychiatrist, Mumbai. I am also working as a de-addiction specialist at various centres in Mumbai. Today I am going to speak about addiction. Where do we get the addiction word from? Addiction word is driven from the Latin language which actually means to devote, reward or to get. So, the addiction is where people get entangled into. There are different types of addiction. Mainly, addiction can be divided into 2 parts i.e. substance use or behavioral addictions. Substance addiction is like alcohol, cannabis, like usage of some tablets like sleeping pills or over the counter drugs or nail polish remover. These are mainly substances. The other part is behavioral addictions. Like internet addiction, cell phone addiction, shopping addiction, gambling addiction, pornography, video games and also addiction related to eating habits. So, these are different types of addiction which are fairly seen in society. Behavioral addiction is becoming more prominent now because no proper system is looking after them. Now let's understand how addiction affects our brain. Basically, humare brain mein alag alag zones hain
. There is a reward pathway. Jaise hum kabhi kuch achieve karte hain ya fir hum race mein first aaye hain toh humein ek feeling milti hai. Simple terms mein agar hum kahein, ek bulb jal jaata hai. Yahi chiz jab hum koi nasha karte hain. Isliya jitni baar aap nasha karenge utni baar ye bulb jalta hai. Aise aap nashe mein fus jaate hain. Reward pathway is the main thing causes addiction. What are the signs and symptoms of any kind of addiction. The most common symptom when somebody gets more time to the addiction. Jabki humein pata hai ki itna time spend karna humare liya thik nahi hoga. Next thing is craving. Desire hona ek hi chiz mein baar baar jaane ki. Tisri chiz hai social obligation bhulna. Jaise ki school mein jana ya fir ghar ki jimedariyan bhul jana. Next hum withdrawn ho jaate hain. Hum ghar valon se jyada baat nahi karte hain. Social meetings avoid karte hain. Sirf particullarly nashe vale doston se milte hain. Next thing is relationship problems. Whenever somebody is into any kind of addiction or substance, us vajaha se misunderstanding ho jaati hai. Relationship problems hoti hain.
Ghar valon ke sath madbhed ho jaate hain. Next thing is avoid the old hobbies. Kuch log kuch particular chizen avoid karna shuru kar dete hain. The most important is tolerance and withdrawal. Dheere dheere nasha ka time and frequency badhte jana. Jaise jo ek beer peeta tha ab vo 4 beer peeta hai. Vo koi aur type ka nasha karne lagta hai. Jo half an hour internet pe deta tha ab vo pura din internet pe deta hai. This is called as tolerance. Ab withdrawal mein patient ko agar koi particular chiz nahi mili toh patient ko problem hone lag jaati hai. Psychological problem like restless hona. Ghabrahat hona, neend nahi aana, chidchida hona, gussa karna. Physical symptoms jyadatar substance mein dikhte hain jaise haath paon kapna, chakkar aana , vomiting hona. So, what is the management? Ab is nashe ki adat ka kya ilaj ho sakta hai. Sabe pehle humein ye samjhna hai ki particular person is problem mein fassa hua hai. Bohut baari ekha gaya hai ki parents denial mein rehte hain. But jab actual mein pata chalta hai ki person is problem mein hai toh bohut time nikal jata hai. 2nd is hum apne family Dr se consult karen. Pata lagayein ki konsa nasha kar raha hai.
Kya test kar sakte hain. Is nashe ki vajaha se kya problem ho sakte hain health wise. 3rd thing is to consult a de-addiction specialist. They will guide you ki is chiz ka kaise ilaj kar sakte hain. Sabse important hai ki person ko accept karna hai. 2nd is family should not have any notion ki um ilaaj baad mein kara lenge, So, a person can go for detoxification. Is se withdrawal symptoms control honge. Craving control karne ke liya medicines and counseling use kar sakte hain. Aaj kal support therapies available hain. Support group me counseling mein bhi ja sakte hain. Motivational therapy mein bhi jaa sakte hain. Sso, my utmost urge is please understand the addiction and its complications as it is ruining our present and future. So, I am one of the persons who is treating all these addiction. If anyone wants to consult me, they can consult me through Lybrate. They can book an appointment online and come to me.
Thank You!read more
Today we are going to talk about sexual dysfunctions, as we know there are many misconceptions related to sex and its problems. So, today I would like to clear certain types of sexual problems which may exist. Sexual dysfunction can be classified into mainly 5 categories, first is disorders related to desire, jaise ki ichha mein problem hona, in desire related disorders there are mainly two categories like first is hypoactive sexual desire disorder and hyperactive sexual desire disorder. In hypoactive ichha kam ho jati hai sex ke baare mein and in hyperactive bahut tej ichha hoti hai sex ke baare mein. And the second category in sexual dysfunctions is a problem related to excitement in which there is condition called as erectile dysfunction, erectile dysfunction mein sexual activity ke dauran penis ka flaccidity ho jana, ya phir penis ka erection hone main difficulty hona yeh usually dekha gaya hai. Third category in sexual dysfunction is disorders related to orgasm in which the first is premature ejaculation and second is anorgasmia. In premature ejaculation during the sexual activity the person loses his erection early and thus resulting into problems related to reaching orgasm, jaise ki sexual dysfunction jo premature ejaculation hai usme jo penis hai uska dhilapan ho jata hai or during activity shurvat mein ek kadak pan rahta hai lekin aage chal ke dhilapan aa jata hai. Second is anorgasmia jisme jo patient hain unko kabhi orgasm hi achieve nahi hota hai. Fourth part in sexual dysfunction is problem related to pain, the category is mainly in vaginismus, vaginismus mein during sexual activity jo dono partners hai unko dard ho sakta hai jis wajah se sexual activity puri nahi ho pati. Fifth part is miscellaneous category in which there are problems related to general medical conditions and problem related to substance abuse.
In which basically jo sex ki problems hona due to koi medical condition jaise ki diabetes hona, blood pressure hona, ya phir koi drugs, ya phir koi madak dravyoin ke sevan ki wajah se sexual problems hona. These are broadly the five categories under which sexual dysfunction exist. Now we will talk about the causes of the sexual dysfunction ya phir karan yeh sexual dysfunction hone ke. The most common cause is local genital pathology, jaise ki genital organs hai unmein koi pathology ki wajah se sex mein problem aana, second cause is endocrine dysfunction ya phir hormonal changes hona body mein jiss vajah se sexual problem hona. Third cause is neurological dysfunction jaise brain ki bimariyon ki wajah se sexual dysfunction hona. Fourth cause is due to drugs jaise ki koi dawaiyoo ke lene ki vajah se, jaise ki blood pressure ki dawaiyan, psychiatric dawaiyan and the last is due to substance jaise ki koi nashe ki cheeze, jaise ki tambaku ka sevan, alcohol, ya phir koi bhi nashile padhartho ka sevan ke vajah se sex main problem aana.
So how to diagnose these kind of sexual dysfunction, inn saare sex related bimariyon ko hum pehchane kaise. The first most common thing what we do, is take general history of the patient and physical examination, second is we send the patient for some blood investigation related to his problems described in the examination and thus there are certain special tests which can be done for these sexual problems like phenyl plethysmography or doppler or a duplex ultrasonography or maybe we can do is nocturnal penile monitoring, tumescence manassin monitoring and lastly what we do is cavernosography. Now how to treat this sexual dysfunction, the first and foremost is to identify the cause causing the sexual dysfunction and treat it as per your diagnosis, second is counselling it can be individual counseling or group counselling. In counselling what we exactly do is we understand the education about sexuality and sex related problems the patient has, any particular problems related to the couple or any communicated issue with the couple which can be there during the sexual intercourse or otherwise. After counselling what we can start is behavioural therapy for the patient in which first is relaxation therapy to calm the patient the excitement related to the sexual act. Second is ascertain skill in which we explain how to communicate to each other for couples, third is biofeedback and forth is systematic desensitization. What else is there is master in johnson therapy, in which these are specialised skills which can be taught during the sexual intercourse to the patients like squeeze technique, start stop start technique and later what we can try after behavioural therapy is medication or medicines which can be given to enhance the performance of the patient during the sexual intercourse. It is a temporary phase for the medication, gradually we have to work upon the counselling and the behavioural therapy and after which the medications can be stopped.
This was the brief description of sexual dysfunctions for more information you can contact me through Lybrate or book appointment through Lybrate portal and do not hesitate to come and talk about sex and its problems related to your life. Thank you.read more
I am Dr. Ashish Satpal, I am consultant psychiatrist working at Oshiwara, Kandivali, Mira Road and Bhayandar.
Today we are going to talk about Obsessive Compulsive Disorder. It is very common in India and other countries. If we see the probability of having obsessive compulsive disorder its 1 in 100 - sau logon mein se ek aadmi ko obsessive compulsive disorder ho sakta hai.
Males or females purusho aur striyon mein samantar hai, koi alag bhed- bhav nahi hai isme. Obsessive compulsive disorder mein mainly start hota hai obsession se, jahan pe the patient gets recurrent intrusive thoughts , jaise ki baar baar ek ki vichar aana , koi particular soch ke baare mein, koi particular image ya phir koi intrusive impulse ke baare mein. Agar wo patient control nahi kar paya woh thought , to us wajah se anxiety yaani ki ghabrahat ho sakti hai.
Yeh ghabraahat kam karne ke liye usually patient compulsion karta hai jise kriya kehte hain . Baar baar haath dhona ya phir baar baar koi cheez check karna toh is kriya ki wajah se usse temporary relief milta hai , jis wajah se jo obsession , jo thought tha woh exacerbate ho jata hai.Yeh ek positive cycle ki tarah har baar jitni baar yeh obsession, anxiety, compulsion and temporary relief hoga uthna hai ye circuit from hota jata hai.
In obsessive compulsion disorder, usually jo humne dekha gaya hai ki ek soch jo atuck jati hai is wajah se baar baar ye kriya hoti rehti hai. For example , kisi ko soch aati hai ki mere haath gande hain ya phir cheeze aas paas gandi hai toh uska compulsion hoga ki woh baar baar hath dhoyega.
Kisi ko baar baar khyaal aayega ki maine light band kiya hai ke nahi, switch band kiya hai ki nahi, gas knob band kiya hai ki nahi uska compulsion hoga ki baar baar woh check karega. Is wajah se zyaadatar patient apna time waste kar lete hain, jaise ki ek ghanta ya dedh ghanta sirf nahaane mein ya hath dhone mein guzar dena, ya phir baar baar ek hi khayal aana ki meine woh cheez check ki hai ki nahi. Koi koi patient ko rituals rehte hain jaise ki itni baar bhagwan ka naam lena taki mujhe achha lage ya phir mera din kharab ho jayega , baar baar koi impulse jo aati hai unko ki mujhe baar baar mobile check karna hai, mujhe baar baar ye dekhna hai ki maine barabar sahi jagah pe hoon ke nahi, is wajah se zyadatar woh apna jo kaam rehta hai wo bhul jate hain.
Yeh day to day life mein bahut impact karta hai kuch kuch hudd tak kitna hota hai ki 24 ghante mein se 16 se 18 ghante patient ye kriyaon mein time waste karte hai.
OCD ya Obsessive Compulsive Disorder ke themes alag alag hote hain, ek theme hai contamination jaise ki gandagi ke baare mein khayal aana aur usse related compulsion hai, cleaning, saaf safai karna. Doosra theme hai symmetry ki cheeze barabar hai ke nahi uske baare mein check karte rehna, uska compulsion hai ki hum baar baar cheeze arrange karne lag jate hain. Teesra theme hai anger, gussa aana baar baar gusse ke baare mein khayal aana, uska jo compulsion jo kiya hai ke hum apne aap ko baar baar check karte rehte hain. Aur ek theme hai ki anchahi impulse baar baar aana, jaise ki sexual thought jo baar baar intersuve hai jo humko theek nahi lagta aur uska jo compulsion part hai usme hum rituals karte hain ki hum bhagwan ka naam le lenge, ya phir hum koi jagah avoid karenge jaana, toh isme jyadatar log fas jaate hain aur uss wajah se day to day life mein yeh impact karta hai.
Obsessive compulsive disorder childhood ya early adolescence jaise ki early age mein teenagers mein usually start hota hai lekin agar yeh late detect hua jaise ki middle age toh iska aage chalke prognosis achha rehta hai. If it is early age like childhood me detect hua hai toh prognosis thoda guarded hoga, jo karan hai obsessive-compulsive disorder hone ke wo ab tak bahut clear nahi hai, the exact cause is unknown.
Jo karan bataye gaye hain literature main usme ek cause hai ki genetic, jaise ki anuvanshik karan ho sakta hai jaise ki aapki family mein kisi ko OCD hai to aap ko hone ki probability around 30 to 40% hogi. Dusra karan hai environmental factor, jaise ki aap ke aas paas ki jo cheeze hai jaise ki stressful life substance use nasha karna ya phir koi bhi cheez ka samvedansheel hona yeh sare karan ki wajah se OCD bad sakta hai.
OCD ki treatment agar hum dekhe jaye toh usually doh part me hoti hai, ek hoti hai psychotherapy jisme hum log cognitive behavioral therapy use karte hain jiska part hai exposure and response prevention. Jaise ki psychotherapy mein hum log usually patient ko uss darr se expose karte hain aur jo uske eventually compulsion activity rehte hain unko prevent karna sikhate hain.
ERP ya Exposure Response Prevention has shown good result in early cases, jo cases bahut jayada hote hain usme hum log medicines use kar sakte hain, medicines jaise ki serotonin wale medicine SSRIs. Serotonin aisa ek jayadatar dekha gaya hai ki OCD me serotonin ka level kafi kam hota hai, toh jaise hi hum dawaiya shuru karte hain jaise ki SSRIs Selective Serotonin Reuptake Inhibitor, jisme brain mein serotonin ki matra bad jati hai aur yeh jo circuit hai yeh thoda slow ho jata hai.
Medicines or therapy ke saath mein OCD ko hum kafi acchi tarah control kar sakte hain. OCD ye ek aisi bimari hai jo day to day life mein humko her ek cheez mein hum ko latka sakti hai. OCD ka sahi ilaj pehla step yeh hai ki hum OCD ko samjho OCD ko samajhne ke baad hum aage usko apnaye aur therapy ki aur bade. OCD ye ek aisi bimari hai jo hume har samay humko fight karna padega ke aise nahi hai ki char din goli khayi aur aap theek ho gaye, maybe treatment can go up to maybe one year or maybe 3 years also. But then you have to be persistent aapke jo prayatna rehte hain wo regular hone chahiye tabhi aapko isme asar dekhega.
For more information regarding OCD or any other psychiatric disorders you can contact me through lybrate portal, aap mujhse sampark kar sakte hain lybrate online services se ya phir aap mujhe personally aake bhi consult kar sakte hain.read more
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Treatment Of Male Sexual Problems
Treatment Of Female Sexual Problems
Anger Management Therapy
Treatment of Behaviour & Thought Problems
Quit Smoking Techniques
Cognitive Behavioral Therapy
Memory Improvement Techniques
Obsessive Compulsive Disorder Treatment
Treatment of Abnormal Behaviour
Psychological Diagnosis (Adult And Child)
Electroconvulsive Therapy (Ect) Treatment
Management of Emergency Conditions
Manual Therapy Treatment
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I was having therdepression. Ashish Sakpal has so much knowledge that for everything my family takes herreference. Even though I was fit and fine, it was shocked when I got to know that I have depression. Both Ashish Sakpal and staff were very helpful. The waiting area in the dr Kiran's Mind Center is very comfortable for elderly patients. The complete process of depression treatment was so painless and quick, and i am so relieved that I chose to consult him. Over the period of time I noticed a number of changes in myself. With the help of hertreatment for depression I am feeling so great.
I had got addicted to smoking due to which I started facing several issues. One of my colleague referred Dr Ashish. In the very 1st seating he told me the problem and how the treatment procedure will be carried out. My problem was such that it required a number of sessions, and I must say after all the sessions, I am feeling much better now. I must say that he is really a patient doctor and helped me in full recovery.
There is no one I trust more with my Problems than dr Ashish Sakpal, he is far and away the best doctor I have ever met and nothing I can say really does justice to the man who has had a very special approach with my problem solving of alcohol addiction , he is extremely knowledgeable, compassionate, caring person and a truly outstanding doctor,. His clinic is at dr Kiran's Mind Center in Mumbai
From quite some time i was suffering from it, but never gave much importance. I was having issues with premature ejaculation. He is very professional and is a really patient listener. I was quite concerned, as my health was degrading day by day, but due to Dr Ashish Sakpal and the premature ejaculation treatment I didn't lose hope.
dr Ashish Sakpal made me comfortable and induced enough confidence in me to share my problem with him regarding anxiety issues in sufficient manner and in detail. He did not hurry me and answered my doubts and questions in calm and composed manner. I am very thankful to him. He can be consulted at dr Kiran's Mind Center in Mumbai.