Dr. Atul Aswani
This is Dr. Atul Aswani again and in the previous video, you saw me talking about the stress of urban life and also about depression and anxiety. So, I am also concerned about the bigger problems of psychiatry and one of the biggest problems that we have in psychiatry is the problem of schizophrenia. Now there are some people who are doing well in their professional lives and probably nothing wrong can be figured out when you look at them externally but their family members might tell you that they have a very suspicious nature. So they might be suspecting their spouse that their spouse is having an affair with someone and sometimes paranoid people will say that my neighbor is talking about me, my neighbor is planning to harm me so these are all delusions. Sometimes, these thoughts become so intense that these thoughts become like voices in the mind. Now, this is a condition called paranoid schizophrenia.
There is treatment available for schizophrenia but the difficulty is people who have this problem do not recognize that they have this problem and therefore it is the responsibility of the relatives to take care of a situation like this. The good news is we have a number of medications available to treat schizophrenia and also there is counseling. For example, we can make people think what is the evidence that your spouse may be cheating on you or what is the evidence that your neighbor is spending so much time thinking about you. So, when people do that, then they find that they can gradually distance themselves from the thoughts which are bothering them but as I said before schizophrenia is one big problem in psychiatry and sometimes this can be what we call as the disease of childbearing years where there is a lot of disturbance in someone's social life and occupational life. So the biggest cost of this disease is the loss of income earning years. So I would request you that if you know someone like that, you should not hesitate to take treatment. Now, there the other thing that I would like to talk about is addiction disorders.
So we know that many people like to have some alcohol in a party and sometimes alcohol can be a social drink but then alcohol can become an addiction also and people give you all kinds of reason to justify their addiction and something which is even bigger than alcohol is the addiction to tobacco. The problem with tobacco is that unlike alcohol, it is much more easily available and it is more addictive. What I mean to say here is that you cannot have alcohol and go to your office but you can smoke just outside your office, on the balcony of your office. So, tobacco is actually a bigger problem than alcohol. Again, the good news is that there is medication to treat the addiction to alcohol and to tobacco and there is a lot of development in psychological therapy which might help us to overcome these habits. So if something is a habit and it has been learned then it logically implies that it can even be unlearned and we can back step from this addiction.
Finally, I would like to talk about dementia. Dementia is generally a disorder of the senior years of life and this is a disorder which can look like depression, it can look like anxiety but the basic thing here is that the brain is losing its capacity and its power and this shows up in the loss of memory. So people begin to forget what they had for lunch today, they begin to forget where they kept their keys and sometimes they may become suspicious my maid has taken away the key to the cupboard whereas they may have themselves put the key somewhere else. There is medication for dementia also but the point to be kept in mind is that the faster you start treatment for dementia, the lesser the damage. So, there are many other conditions but in my practice, I deal with adult psychiatry most of the time and these are the conditions which I cover.
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This is Dr. Atul Aswani again. So, I would like to introduce you to the most common things which I am seeing in my practice these days. Now, since we are living in urban cities, all of us are working very hard and we have long hours, there is stress at work, there is stress at home and then we are not getting sleep at night because all of us are busy on social media and we are doing a lot of videos watching online maybe even including this video. So, what I am seeing in my practice is a lot of stress; that is one condition, but I also see is people who are feeling low, so that in technical terms is called depression. So, when somebody is feeling low for at least two weeks or a little more than 2 weeks we call it a major depressive disorder. This is something we should keep in mind. Besides depressive disorder, there are sometimes people who are feeling excessively happy.
Now, what is wrong with being happy? Nothing actually. So it is a good idea to be happy but when people are excessively happy like as in mania they get no sleep at all, they make risky decisions, they become impulsive and mania needs to be managed. Sometimes mania and depression may alternate and it is called a bipolar mood disorder. So these are the disorders of mood and then in addition to that there are disorders of anxiety. So like someone may feel restless all the time, they may be fidgety all the time, they may not be able to sit properly in one place that is general anxiety. In contrast, there are other situations in which suddenly so much anxiety happens that it becomes like panic and it is called a panic attack.
There is even a feeling that I may be getting a heart attack or someone might feel that they are almost going to die, so these are panic attacks and then there are sometimes a lot of intrusive thoughts, negative thoughts which repeatedly come into people's mind; the classic thought is that my hands are not clean so this becomes an obsessive thought and this creates a compulsion. What is the compulsion? The compulsion is that I must wash my hands. So, in current day practice, I am counseling people for the day to day stresses of their life that is one. Then number 2, we are looking at disturbances of mood, people who are feeling low and sometimes people who are feeling happy and number 3 we are also looking at anxiety, the anxiety due to corporate stress, exam stress, the anxiety of interviews and the anxiety which is seen in panic attacks or the anxiety which is seen in OCD. In my next video, I will talk about some other disorders and for that time thank you for seeing this video.
I am Dr. Atul Aswani, so when you think of psychiatry or you think of psychiatrist, many times you feel that psychiatrist only give medicine and you do not want to take medicine. Now the reality is there are some conditions where medication is important but let me emphasize that medication is not everything. Let me give you an example if someone has pain in his teeth and he goes to a dentist, the dentist might fill the cavities in his teeth and the dentist might do a procedure but I am sure the dentist will say to that person that from now on you have to brush your teeth twice a day religiously, you have to floss, you may also need to do a mouthwash, avoid things which are sweet and sticky and so on. So, in the same way in my branch sometimes when stress is too much and people are finding it very difficult to have a normal day, a little dose of medication can reduce your anxiety and discomfort within 24 hours but then you cannot be on medication all your life to manage the anxiety or discomfort which you should be able to manage on your own.
So, this is where it becomes very useful to learn how to think better and that is your whole domain of psychological therapy or what we call as cognitive behavior therapy. So cognitive behavior therapy basically says that more than the events in my life it is how I interpret those events that make all the difference. For example, all of us know that a traffic jam is part and parcel of modern day urban life but two people stuck in a traffic jam will have two very different responses to the traffic jam. 1 person in a traffic jam might gradually become more and angrier and stressed and he may begin to say what is the government doing, where is my tax money going, why are there potholes on the road and he might say how did I get stuck up here; however, the other person might use the time in the traffic jam to make phone calls to friends, cousins and relatives whom he has not spoken to and he might even use that time to listen to music or read a book or if you have the ability and the space you might even go to sleep in the traffic jam.
Now both these people will spend the extra money and extra petrol in reaching their destination but let me assure you the second person will reach his destination more happier and less uncomfortable than the first one and this shows to us that medication is not the solution for all our psychological discomfort. We even need to learn how to think better, to be able to actively selected thoughts which are better than some other thoughts, so we call them are helpful thoughts and unhelpful thoughts. So just in a similar way if I were to tell you people who have high blood pressure may take medication to reduce their blood pressure but they should also exercise, they should also reduce salt in their diet, they should also have a good night sleep and the same thing applies to my branch. Medication may be required in some cases but good thinking, better thinking, positive thinking, helpful thinking applies in all cases.
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I am Dr. Atul Aswani. I am a psychiatrist and counsellor. So, this is like more than 15 years in this branch of psychiatry, I love my subject and this subject is very unique. You know whenever I go to a party or to a social function and people happen to ask me what do you do and I tell them that I am a psychiatrist, they say Oh! that means you can read my mind. I say "No! I cannot read your mind" and in some ways, psychiatry is very different from other branches. For example, if someone were to have a fall and go and see an orthopaedic surgeon, they would be really surprised if the orthopaedic surgeon give them some treatment or medication without doing an X-ray; in the same way if someone would have a chest pain and they would go to a cardiologist, the cardiologist will generally not do anything till he does an ECG and a blood pressure, pulse measurement at the most basic.
But in my branch, the uniqueness is there are very few investigations. Actually, we come to decide what we are handling just by interviewing people. So, it is in the pattern of thoughts that we recognize what people are suffering from or what treatment they would need. So, psychiatry is a unique branch but I would like to encourage all of the people who are undergoing stress is that they should not hesitate to take help. Sometimes, it's a very good idea to approach a counselor and if you feel that counseling is not proving to be enough then it is a good idea to see a psychiatrist also. Now that you are seeing this video, you can obviously see that psychiatrist is like anyone else, is like any other medical professional, we do not have two horns on our head or any such things. So, you are most welcome to consult a psychiatrist when you are feeling that the level of stress is way above what you can handle.
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