Ruby Hall Clinic

We are all aware that the incidence of heart disease is increasing in India. Generally, the average age of heart patients in India is a decade younger, that means there are younger patients suffering from heart disease in India.

Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) is the disorder that causes vertigo, which is the false sensation of head’s spinning. The patient with BPPV may feel minor to severe faintness. BPPV may be caused by the incorrect position of the patient’s head. It is most felt when the patient moves head in either direction, lays down, or gets up from the bed especially in the morning.

BPPV is the disorder of the inner ears in which the crystals of calcium carbonate (known as ear rocks or otoconia) are accumulated and turned into the gel. This gel is then migrated into the semi-circular canals, which are normally filled with fluid. This fluid is generally unaffected by the gravity because of its lightweight.

With the migration, the accumulated gel tends to move down with the effect of gravity and bounces up again with any physical movement of the head and other factors. This results in its interference with the normal fluid movement within the canals that are used for the sensation of head motion.

Because of this interference and fluid movement, the nerves at the canal of the patient’s inner ear are excited and send false signals to the brain related to head rotation. In normal cases, this fluid is rested stationary within the canals. These false signals generate information in the brain that does not match with those sent by the second ear and eyes.

This mismatch of the generated information from multiple sources confuses the brain, which may make you feel spinning. This spinning is medically termed as vertigo, which may last up to a minute from its occurrence. Note that some patients would have a normal feel between every two vertigo invocations.

However, some of them may have a constant feeling of light head spinning sensation between two major spins of vertigo. Note that the dizziness caused by BPPV would not impact the hearing ability of the patient. It would also not make the patient difficult to speak. In case you have any of such additional symptoms, you must discuss with your physician immediately.

The occurrence of BPPV is seen mainly in the adults and is very rare in the children. However, it may impact individuals of any age group. The most cases of this disease are reported in the elderly people. Most of the patients with BPPV may feel the surroundings spinning while getting up from the bed in the morning.

However, the same symptom may also be associated with other disorders such as a migraine, trauma, ear infection, diabetes, intubation caused by lying in bed for a long period, osteoporosis, reduced blood flow, and more. It may also be associated with the incorrect posture of sleep. So, you must consult your doctor immediately when such symptoms arise in your body.

Symptoms of BPPV
The various symptoms of BPPV may include:

-  Dizziness

-  Vertigo in which the patient may feel the surrounding moving or spinning, especially while getting up in the morning

-  Disbalancing while getting up from sitting

-  Continual nausea and vomiting for over several weeks

-  Nystagmus in which the eye movements of the patient appear abnormal

Note that these symptoms may appear or disappear in between. It may happen that the patient is relieved from the symptoms for several months. But those may recur with lesser to severe intensity. Along with the symptoms listed above, some patients may observe the following symptoms in the extreme conditions:

-  Severe and intolerable headache

-  Fever

-  Double vision

-  Vision loss

-  Loss of hearing

-  Difficulty in speaking

-  Weakness in the legs or arms

-  Unconsciousness

-  Difficulty in walking

-  Tingling sensations in the brain, ear or other parts of the body

-  Numbness

Causes of BPPV
Age is a crucial factor that increases your chances of getting BPPV. It is often seen that the individuals of age over 50 years are most likely to get BPPV since the muscles of their inner ear may become weaker at that age. There may also be other causes of BPPV. Some of those are mentioned below:

-  Keeping head in a fixed posture for a long duration either on a dentist chair, salon and more

-  Performing the exercises that require high-speed movements of the head

-  Bike riding on a rough track

-  Various types of disorders of inner ear like Meniere’s disease

-  Resting on the bed for long duration for any reason, like hospitalization, prolonged rest over the weekend, working on a laptop for long while lying on the bed

-  Due to migraine

Prevention from BPPV-
Since BPPV may be caused by multiple reasons including the old age, it is very hard to prevent it completely. However, there are the multiple ways through which you may prevent it from happening to a good extent. Some of those are mentioned below:

-  Avoid doing exercises that may involve frequent and severe head movements.

-  Prevent yourself from any possibility of head injury. Wear a helmet while riding a bicycle, bike, and other sports.

-  Avoid lying on the bed for long hours.

-  Avoid prolonged steady head placement when awake.

-  Meditate on a regular basis.

-  Maintain hygiene in your surroundings to avoid the chances of infection in your ears.

-  Have a balanced sleep.

-  Exercise every day.

-  Don’t tip your head back for long hours to watch TV or to talk to your correspondents.

-  Take care of your immune system and adopt the habits that would keep it strong.

-  Avoid frequent head movements in case you are already a patient of BPPV. This may worsen your symptoms.

How BPPV is diagnosed?
If you observe even the mild symptoms of BPPV (mentioned above) for over a week, visit your doctor immediately. The physician would ask the patient several questions related to the symptoms. For instance:

-  When is the dizziness felt most during a day?

-  From how long the symptoms are observed?

-  Do you have a continual temptation of vomiting?

-  How are you normally relieved from the symptoms?

-  For how long at a stretch are the symptoms observed?

-  Do you have any other disease or disorders related to the ears or the brain?

-  Are you a patient of a migraine?

The doctor would also assess the complete medical history of the patient of the past several years. The eye movement of the patient would also be checked for the occurrence of nystagmus. The patient would also be asked to lay down on a table with the head tilted back. This test would help the physician in understanding if the patient has irregular control in eye movement.

It may also be observed if the symptoms occur most with the movement of eyes or head in a particular direction. Post collection of all this information, the physician may also prescribe the patient to undergo an infrared goggle test.

In case the doctor finds it difficult to identify the actual reason for those symptoms, the patient may be prescribed to get one of the following investigations done:

-  Video Nystagmography (VNG) or Electro Nystagmography (ENG) in which the abnormal movement of eyes is detected if any. In the ENG test, electrodes are used and in VNG, small cameras are used to assess if the dizziness is because of some inner ear disease. This is calculated by the measurement of irregular eye movement by placing the patient’s head in multiple positions.

-  Magnetic Resonance Imaging (MRI), in which magnetic fields and radio waves capture multiple images of the patient’s head or other parts of the body from different directions. Such images could be assessed to diagnose the condition of the dizziness and the possible reasons associated with it.

Treatment of BPPV
There are some chances that the symptoms of BPPV may disappear on their own in few weeks to months. However, to get rid of the symptoms sooner, the doctor would provide the treatment for the repositioning of the head movements. This therapy is called as canalith repositioning.

In canalith repositioning, the mispositioned canaliths due to the gel developed from the crystals of calcium carbonate that move from the fluid-filled semi-circular canals of the inner ear, are repositioned. This prevents the nerves of the canal of the patient’s inner ear by sending false signals to the brain related to head rotation. Along with this process, the doctor may also recommend the patient to avoid some particular head position for several weeks to months, which may trigger the symptoms again.

For the first few sessions of canalith repositioning, you are required to visit the therapy centre. Post then, the doctor may teach you the canalith repositioning procedure, which you could practice on your own at home if required. Post such a session, you may be required to take rest for at least 10-15 minutes so that the crystals of calcium carbonate are resettled in the canals of the inner ear.

In some rare situations where the symptoms are extreme and could not be relieved by the canalith repositioning procedure, the patient may be recommended a surgery with which the inner ear’s bone is plugged to prevent the movement of calcium carbonate crystals within the fluid-filled semi-circular canals. This effectively stops the symptoms of dizziness. Such type of surgery is effective with the success rate of around 90%. But in some rare cases, there is the risk of loss of hearing for the patient.

Other than these treatments, there are certain precautions that the patients of BPPV should take. Those are mentioned below:

-  Keep memorising your symptoms and be extra careful about balancing while getting up from your bed. The patients with BPPV are more prone to lose their balance, which may result in them to face injuries.

-  Try to be seated whenever you have a feeling of dizziness. In case you are standing and could not see some nearby seat, just take the support of some wall or any stable object.

-  Keep some lights turned on in your bedroom in the night, so that you would not face many difficulties in getting up in between if required.

-  Keep visiting your doctor periodically unless your symptoms are subsided.

-  Do not lay with the head tilted back, if you are already suffering from the symptoms of BPPV.

-  Avoid laying or sleeping towards the affected side of the head where symptoms are felt the most. Use two pillows while sleeping to ensure this.

-  Even when the symptoms are disappeared, those may recur. Prepare your mindset for that.

-  While waking up in the morning, lift the head very slowly and sit on the bed for a few minutes before standing up.

-  Avoid bending down for picking up something.

Complications
Although BPPV is not a fatal disease by its own, its symptoms may cause you to face complicated problems if not taken care of or treated on time. It often happens that the patients with BPPV collapse on the floor due to dizziness, which may cause them severe fatal injuries. It is very important for them to bring the practice to their habit of sitting down or holding some stationary object whenever they observe dizziness. Else than that, BPPV may cause the patient to have an uncomfortable feeling. If it lasts for long, the patient may suffer from depression.

Another related complication is associated with the surgery in which the inner ear’s bone is plugged to prevent the movement of calcium carbonate crystals within the fluid-filled semi-circular canals. This surgery is carried out with an attempt to eliminate the symptoms of dizziness caused by BPPV. However, in some rare cases, this surgery may cause loss of hearing.

Myths
Myth #1: Children may not suffer from BPPV

It has been seen that elderly individuals are more likely to be affected by BPPV. However, individuals of any age (including children) may suffer from this disorder. Some children may not be able to express the problems that they would be facing. So, in case your kids collapse by their own on a frequent basis, it is must for you to take them to a paediatrician.

Myth #2: BPPV is caused only by a migraine

A migraine is one of the causes because of which BPPV may occur. However, there are multiple other factors associated with this disorder.

Myth #3: BPPV is always healed by its own

It is not necessary that BPPV is healed by its own every time. If the symptoms are severe, you must get a proper treatment before facing any injury due to the associated dizziness.

Spending excessive time on computer or mobile phone often leads to neck pain which has grown to be a common problem among masses over the past few years.

Back Pain Symptoms
Back plays a very important role in a human body. It is composed of a complex structure of muscles and ligaments that supports the body and enables us to stand, move around, and indulge in almost every physical activity. The inconveniences with any of these bodily structures can lead to back pain which might range from severe to moderate. This is very common among people from all age groups due to their sitting and standing position.

Do you think why you have a back pain every time? Well, the cause of back pain is still unknown. The back pain varies from one person to another. Some of its symptoms suggest that back pain has a more serious cause that includes fever, weight loss, and numbness.

Symptoms of Back Pain
In most cases, back pain gets cured and one does not go to a doctor. Back pain is accompanied by many symptoms; some of those are included below. If a person experiences any of these symptoms, it might be a sign of a back pain; the doctor should be informed about it.

-  Fibromyalgia – Fibromyalgia causes pain in the entire body. A person has painful tender joints that hurt a lot even after taking medicine. In this condition, the affected person should not indulge in any kind of exercise. The symptoms of fibromyalgia differ from one person to another, but symptoms such as stiffness, fatigue, and issues while sleeping are common. Apart from back pain, patients also experience stiffness in the shoulders and neck. Patients complain of feeling extremely tired, especially waking up and feeling pain in specific areas called tender points. Many patients complain about stiffness, which is worse in the morning and increases as the day passes. Any physical exertion increases the pain.

It can be improved by adopting lifestyle changes that include a change in diet and exercising daily.

-  Degenerative arthritis –This condition occurs due to an internal damage caused to the facet joints. The surfaces of the joints are lined with smooth cartilage that allows movement. Both sides of the joint rub against each other, thus allowing a free movement. In case of injury or internal damage, apart from back pain, patients may also experience stiffness and pain in bending over. The joints are smaller when compared to the body weight they bear. The stress and strain may cause damage to the cartilage. Injuries and other internal and external damages over a lifetime may cause the joints to degenerate. 

The spinal facet pain in the lower back pain may, later on, lead to osteoarthritis.

-  Inflammatory arthritis– It is a group of disease caused due to inflammation of joints and other tissues. In this condition, there is pain in the lower back, together with morning stiffness in the hips or both; in some cases. There is also pain, feeling of tiredness and stiffness in the neck or the chest. Other symptoms of this disease include psoriasis, eye pain, and fever; depending on the specific disorder that is causing the back pain.

-  Osteoporosis – This condition is different from rheumatoid arthritis and other forms of arthritis as it only affects joints without affecting organs or soft tissue areas of the body. It is often characterized by thinning and weakening of bones that fracture easily. It is most common in postmenopausal women. When vertebrae are compressed because of a fracture, along with a slight to moderate slouch, it may result in back pain. This condition does not cause any pain unless a bone fractures.

-  Cancer in the Spinal Column: If cancer spreads to spinal nerves that control the bladder and bowel, there may be bowel incontinence. Its symptoms depend on various factors, including the tumor type, size, age and health. Some of the common symptoms include back pain, numbness, weakness and difficulty while urinating. These symptoms even get worse with time.

Sometimes the symptoms may occur quickly and sometimes slowly and it may take hours and days. Metastatic spinal tumors, which spread to the spine from a different location in the body, progress quickly.

-  Protruding disk: A spine intervertebral disc when sustains an injury to the spine, it is commonly referred to as Protruding disk. This injury can not only occur in the lower, upper, and middle back, but also at the cervical spine. People with significant disk disease go through severe pain in the lower back. If a disk compresses a nerve, the pain may spread down to one leg. In this condition, one should avoid bending or twisting. It is mostly caused due to poor posture while sitting and standing. To lower the effect of poor posture on the spine it is necessary to continuously maintain a good posture or regularly change the posture.

-  Back sprain: A series of ligaments and muscles hold the bones of the spinal column together. A person may strain these muscles by stretching them too much. This can even tear the tissue.

The muscles get weak due to which it cannot be held at one place. Because of this, the spine gets a little unstable and causes back pain.

Back pain usually occurs after heavy exertion in which muscles in the back, buttocks and thighs get stiff.

One can avoid back pain by improving one’s physical condition by adopting certain changes in lifestyle.

-  Exercise: One should start their day with light aerobic activities that do not strain the back. This can increase the strength of the back by allowing the muscles to function better. Walking and swimming are the most recommended form of exercise. Alternatively, people can talk to a doctor about which activities they should indulge in.

-  Build muscular strength: One should practice abdominal crunches and back muscle exercises that strengthen muscles so that they can work together. Communicating with the therapist to know the right exercises is important.

-  Watch your weight: Being overweight strains the muscles of the back. Overweight people should cut down on their weight in order to avoid back pain.

-  Quit smoking: Smoking is definitely injurious to health. It is difficult to quit it at once; therefore, one should talk to their doctor about ways to quit it.

People suffering from back pain should bring about some changes in their normal routine and temporarily avoid lifting heavy items and sitting for long hours. If a patient is recovering from back pain, they can ask the doctors to follow up regularly to know whether the symptoms have been cured or not. Once the symptoms have relieved and the patient feels decrease in the intensity of the back pain, they should go back to their normal routine.

Nasal polyps
Nasal polyps are soft and painless benign growths on the lining of the sinuses and nasal passages. Nasal polyps hang down as grapes or teardrops. Polyps can occur in one or both nostrils at a time. They can occur due to allergies, chronic infection, drug sensitivity, some immune disorders, or chronic inflammation because of asthma. You may not experience symptoms if you have small nasal polyps. People with many nasal polyps or larger growths may experience blockage in the nasal passages, breathing problems, frequent infections and loss of sense of smell. Nasal polyps are more prone to adults and males but they can affect any person. Your doctor may prescribe you certain medicines in order to eliminate or shrink nasal polyps. In some cases, surgery is required in order to remove nasal polyps. There is a possibility that nasal polyps can return even after proper treatment.

Symptoms
It is not necessary that you will experience symptoms if you have nasal polyps. Due to polyps, there can be a blockage in the nasal passages leading to chronic congestion. Check out various signs or symptoms of nasal polyps:

-  People with nasal polyps may have a sensation that their nose is blocked.

-  Due to nasal polyps, people may not sense the smell properly.

-  People with nasal polyps may feel a pressure in the face or forehead.

-  Nasal polyps can make you breathe through the mouth.

-  Running nose, nasal stuffiness, and nasal congestion are all the possible signs of nasal polyps.

-  You may suffer from sleep apnea due to nasal polyps. Postnasal drip is a situation in which excess mucus collects in the back of the nose or throat.

-  Snoring can be a symptom of nasal polyps.

-  If you also have a sinus infection with the nasal polyps then you may also suffer from headaches or pain.

Causes-
The causes of polyps are still not known. There is no clarification on the part that why people get chronic inflammation or why inflammation leads to the formation of nasal polyps in some people and not in other people. The chronic inflammation happens in the mucous membrane of the sinuses and nose. As per some evidence, it is clear that people who get nasal polyps have different chemical makers in the fluid-producing lining and a different response of immune system than people who do not get nasal polyps. Nasal polyps can occur to any person at any age. But it has been noticed that they are more prone to middle-aged and young adults. There is a possibility that people can get nasal polyps with no nasal problems in the past. As per scientists, there can be some possible triggers including:

-  Churg-Strauss syndrome

-  Asthma

-  Cystic fibrosis

-  Allergic rhinitis or hay fever

-  Recurring or chronic sinus infections

-  Non-steroidal anti-inflammatory drug sensitivity including aspirin or ibuprofen

How is it diagnosed?
As soon as you discover that you have nasal polyps, you should see a doctor as polyps can lead to various complications. Your doctor conducts a general physical examination and also an exam of your nose. Your doctor will check the polyps with the help of a lighted instrument. Your doctor will do a diagnosis depending on your various answers to queries about the symptoms that you are experiencing. Your doctor may ask you to get various diagnostic tests done in order to confirm the diagnosis:

-  Nasal endoscopy: Your doctor conducts a detailed examination of the sinuses and nose with the help of a narrow tube with an illuminated magnifying lens or small camera, known as a nasal endoscope. The doctor inserts the nasal endoscope into your nostril and then guides it into your nasal passage or nasal cavity.

-  Imaging studies: Your doctor obtains the images with the help of computerized tomography which helps your doctor to point to the location and size of polyps in deeper regions of the sinuses. It also helps the doctor to find out the range of the inflammation. Other obstructions in the nasal cavity including abnormalities in the structure or different type of noncancerous or cancerous growth can be found out by the doctors with the help of these studies.

-  Allergy tests: Your doctor may ask you to get the epidermis test done in order to find out if allergies are developing due to chronic inflammation. A skin prick test can be conducted in which a few drops of allergens, substances that might be causing an allergy are pricked into the epidermis of your upper back or forearm. The drops of allergens are left on your epidermis for some minutes. Then your doctor observes your epidermis to check the signs or symptoms of allergic reactions. If it not possible to conduct a skin test then your doctor may ask you to get a blood test done that find out specific antibodies to allergens.

-  Test for cystic fibrosis: If it is diagnosed that your child has nasal polyps then your doctor may order you to get the tests done for cystic fibrosis. Cystic fibrosis is an inherited disorder in which the lungs and digestive system damage and it can threaten the life of the affected person. The diagnostic test for cystic fibrosis is a sweat test which is noninvasive that determines if the perspiration of your child is saltier as compared to the sweat of most people.

Prevention
Check out various ways that will help you to get prevention from nasal polyps:

-  If you feel the dry air in your home then you should use a humidifier.

-  You should wash your hands frequently especially after coming from outside or before starting a meal. This helps to reduce the chances of catching a viral or bacterial infection which can lead to a case of inflammation of the nasal passages and sinuses.

-  You should avoid those substances that can create an irritation including chemicals, airborne pollutants, and some allergens. This may help you to reduce the chances of developing nasal polyps.

-  You should manage your allergies and asthma properly. It is important to follow whatever is recommended by your doctor related to allergy and asthma treatment as it will reduce the risk of developing polyps.

-  You should rinse the nasal passages with a saline spray or nasal lavage as it will help you to remove allergens and irritants and make better the flow of mucus.

Treatment
It is a challenge to clear polyps completely. Your doctor will suggest you the best treatment option as per your condition in order to manage your symptoms and treat the factors that can lead to chronic inflammation. The treatment is given so that the size of polyps can be reduced or polyps can be eliminated. Initially, medicines are given to treat the affected person. In certain situations, the doctor may prescribe to go for a surgery. There is a possibility that polyps can recur that is why surgery is not a permanent treatment option.

Medications:
In the treatment of nasal polyps, the doctor generally prescribes medicines in the starting. The medicines help to shrink and remove the polyps even the larger ones. Check out various medicines for the treatment of polyps:

-  Nasal corticosteroids: Your doctor may prescribe nasal corticosteroid spray that will help you to minimize inflammation. By this treatment, polyps can eliminate or shrink. Budesonide (Rhinocort), fluticasone (Veramyst, Flonase), mometasone (Nasonex), flunisolide, ciclesonide (Omnaris), beclomethasone (Beconase AQ), and triamcinolone (Nasacort Allergy 24HR) are some of the nasal corticosteroids.

-  Oral and injectable corticosteroids: Your doctor may recommend you an oral corticosteroid including prednisone if a nasal corticosteroid does not work for you. You can take it alone or in combination with a spray related to the nose. There are some side effects of oral corticosteroids that is why they are taken for a short period. If you have severe nasal polyps then your doctor may recommend injectable corticosteroids.

-  Other medications: To treat the conditions which may contribute to inflammation (chronic) in the sinuses and nasal passages, a doctor may prescribe medication to curb the same. In order to treat allergies, antihistamines are used and to treat a recurring chronic infection, antibiotics are used. Patients with aspirin sensitivity and nasal polyps may get benefit from the treatment of aspirin desensitization.

Surgery:
If medications are not effective in eliminating or shrinking polyps then the doctor may ask you to go for endoscopic surgery. This will help in solving the problems related to sinuses and removing nasal polyps. In the surgery, the surgeon inserts a tiny tube with a camera or magnifying lens into the nostrils and guides the tube into the sinus cavities. Some instruments are used to eliminate nasal polyps and other obstacles that block the fluids from the sinuses. The affected person can be discharged on the same day of the surgery. Your doctor may recommend the patient to use the nasal spray after the surgery in order to prevent polyps from recurring. Saltwater (saline) rinse may also be prescribed by the doctor to catalyze the process of healing after the surgery.

Complications:
Complications occur due to nasal polyps because it restricts the normal airflow, fluid drainage and also because of the degenerative inflammation that underlies their development. The major complications of nasal polyps generally include the following:

-  Obstructive sleep apnea: In this chronic condition you usually stop and begin to breathe frequently during the time you sleep.

-  Asthma flare-ups: The serious and chronic rhinosinusitis can cause and even worsen the condition of asthma.

-  Sinus infections: It has been observed that you are more likely to get sinus infections if you suffer from the disease nasal polyps. These sinus infections occur very frequently and sometimes, they can also become serious or chronic.

-  Disfigured structure of the face: Nasal polyps can alter the shape or structure of the face which consequently causes the condition of double vision. Often if the patient has cystic fibrosis, he or she can have eyes which are set wider apart than they are normally.

-  Complications due to surgery: When nasal polyps are treated, especially by surgery, they can cause severe nosebleeds. Along with that, surgery in case of nasal polyps can also cause infections. If the treatment with nasal steroids sprays or oral corticosteroids is continued, it can reduce your ability to fight off and counteract sinus infections.

Conclusion:
Noncancerous, soft, painless growths which may form on one’s sinuses or nasal passages are known as nasal polyps. They may look like teardrops or hanging grapes. Due to allergies, asthma, drug sensitivity, recurring infection or some immune disorders may result from chronic inflammation.

People generally do not experience symptoms when they have small nasal polyps. Nasal polyps may lead to breathing problems, frequent infections blockage in the nasal passages, and loss of sense of smell. Men are more prone to nasal polyps than women. Polyps can happen to a person of any age.

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Asthma
The word "asthma" originates from the Greek word, ásthma that means, "panting.” Asthma is a medical condition in which the airways swells and produces extra mucus that can make breathing difficult. Because of the inflammation and the extra mucus, it can trigger shortness of breath and wheeze or coughing.

Documented as early as Ancient Egypt, Asthma can be either a minor nuisance or life-threatening. In asthma, the inside walls of the airways get inflamed so that lesser air can pass through them from and to the lungs making breathing a difficult exercise. This swelling can also make the airways really sensitive and increase a person’s susceptibility to allergic reactions.

Asthma has been on the rise significantly since the 1960s and now according to WHO estimate, around 300 million people suffer from asthma worldwide. In fact Asthma is one of the most common chronic childhood illness.

Symptoms of Asthma-
The symptoms of asthma vary. But what most people with asthma have in common is the extreme airway sensitivity because of triggered airway inflammation. Some people have frequent asthma attacks, some people experience asthma only during certain times, some people have it all the time and some people only experience it infrequently.

Common asthma signs and symptoms include:
-  Wheezing or coughing

-  Shallow breathing

-  Breathlessness

-  Chest pain

-  Throat infection

-  Faster heart rate

-  Trouble in sleeping

-  Difficulty in speaking

Types of Asthma-
Normally people suffering from an asthma attack tend to have a whistling or wheezing sound when exhaling. There are different types of asthma. Some of the most common types of asthma are: 

1. Exercise-induced asthma 
Also called exercise-induced bronchoconstriction, this type of asthma is induced by strenuous exercises and can cause symptoms like coughing, wheezing, shortness or breath and other symptoms. These symptoms may worsen when the air is dry and cold and usually get triggered during or after an exercise.

2. Occupational asthma 
As the name suggests, occupational asthma is triggered by breathing in certain chemical fumes, dust, gases, or other kinds of exposure to allergens at the workplace.

3. Allergy-induced asthma 
Allergy-induced asthma is the most common type of asthma, which is triggered by common airborne allergens like pollen, mold spores, dust mites, or particles of skin.

What Are Causes of Asthma?
Although the causes are not particularly clear and anyone can get asthma at any age, it is more common childhood ailment. The studies are still underway to prove a clear asthma cause but according to the researches this disease is believed to be caused by a blend of genetic and environmental factors. Genomics, which is the study of how a person’s genes interrelate with environmental factors, may be the key to understanding why certain people are more prone to asthma than others.

Asthma Triggers-
Asthma triggers can differ from person to person and the key is to know what irritants trigger your asthma to ensure minimized exposure to it. Some generic asthma signs and symptoms can include:

-  Cold air

-  Exercise and other physical activities

-  Common cold and other respiratory infections

-  Stress

-  Airborne substances like pollen, mold spores, pet dander, cockroach waste, dust mites, etc.

-  Airborne substances, such as pollen, dust mites, mold spores, pet dander

-  Certain chemicals and air pollutants (smoke)

-  Certain preservatives (added to food and beverages)

-  Gastroesophageal reflux disease (GERD)

-  Certain medicines like aspirin, ibuprofen, etc.

Risk factors-
There are several risk factors that can increase your chances of developing asthma including:

-  Genetics. Having a family especially a blood relative suffering from asthma

-  Having other allergic condition (hay fever)

-  Smoking

-  Exposure to secondary smoking

-  Obesity (people who are overweight are at a greater risk of developing asthma)

-  Exposure to increasing amount of smoke or other pollutants

-  Occupational triggers

-  Stress and anxiety

Diagnosis of Asthma-
Even though it is a common childhood disease, it doesn’t mean, as an adult one cannot develop it. If a person is feeling any of the symptoms whether a child or an adult, it is always a good idea to get checked to know for sure if you have asthma. Asthma symptoms can come and go since it is a ‘variable’ disease.

It is also important to not do self-diagnosis, as some symptoms, which may look like asthma triggers, may not be actually asthma-like persistent cough caused by other diseases like certain heart diseases and chronic obstructive pulmonary disease (COPD).

Effective diagnosis of Asthma depends upon its classification. There are four different classifications of Asthma:

Classification of Asthma
-  Mild intermittent – It is a mild case of asthma if the symptoms last only for up to two days a week, symptoms flaring up mainly at night and asthma lasting not more than two nights in a month.

-  Mild persistent – Mild persistent asthma is when the symptoms can occur twice in a week but not more than one episode per day.

-  Moderate persistent – This happens when a person experiences symptoms once a day and in excess of one night a week.

-  Severe persistent - Symptoms can last throughout the day and frequently at night on most days.

Diagnosis of Asthma
1. Physical test
The doctor would want to rule out other possible condition through a physical exam to get to know the signs and symptoms.

Some lung function tests can help in determining how the lung in functioning in a person.

2. Spirometry
One of the most common pulmonary function tests, spirometry measures lung function by checking the amount of air a person can inhale and exhale after deep breaths.

3. Peak flow
The peak expiratory flow is a pulmonary device that can measure the maximum speed one can breathe out. If the readings are low, it may be a sign that the person’s lungs are not working properly and could be a potential sign of asthma.

These tests can be done with a medicine called as bronchodilator (albuterol) to check if the lung functions better with the medication. If the test gets better after the use of bronchodilator, then it is highly likely for a person to suffer from asthma

Additional tests and Diagnosis For Asthma
Other tests that may be required to diagnose asthma include:

1. Methacholine challenge-
Methacholine is considered an asthma trigger and so when it is inhaled it can cause mild constriction of the airways. Most people who have asthma are likely to react to methacholine. Doctor could use this test to determine whether you have asthma.

2. Imaging tests-
Certain imaging tests like x-rays and CT scan can help in identifying certain abnormalities that might be causing breathing issues.

3. Allergy testing-
Most allergy tests can help in identifying allergy to triggers like pollen, dust, etc.

4. Sputum eosinophils-
This test can help in identifying the while blood cells in the mucus to see if asthma is present or not.

5. Nitric oxide test-
For people whose airways are inflamed, they may have higher nitric oxide level than normal which may be able to help in identifying whether the person is suffering from asthma or not.

7. Provocative testing for exercise and cold-induced asthma-
As the name suggests, in this a person is made to perform vigorous physical activities in a controlled environment to check for the triggers.

Treatment of Asthma-
Although there is no known cure available for asthma and it is generally a life-long condition, treatment can control asthma symptoms so a person can lead a normal life. Also when it comes to asthma, there is no one-size fit all treatment methodology. The idea is to understand the triggers that worsen your symptoms, taking steps to avoid them and taking the medication on time to keep asthma in check.

1. Inhalers 
Inhalers are medical devices, which are used for supplying medication into the body through the lungs. There are three types of inhalers. These are:

-  Reliever Inhalers: These inhalers are used for the purpose of relieving symptoms at the time of asthma attack. Normally reliever inhalers don’t have many side effects, in some people they may increase heart beat and induce shaking. 

-  Preventive Inhalers: True to their name, this types of inhalers are used to stop the symptoms from developing.

-  Combination Inhalers: If either of these kinds of inhalers doesn’t work for a person, they would need an inhaler that would both relieve the attack and prevent it from happening again.

2. Tablets -
If inhalers don’t work to control the symptoms, one may also use tablets.

Leukotriene receptor antagonists (LTRAs) 
LTRAs are the oral tablets prescribed for asthma and are also available in syrup and powder forms. It can be taken every day without many side effects. However, some people may experience some side effects including headaches and stomach pain.

• Theophylline

If LTRAs tablets cannot be prescribed for some reasons or is not working, doctors may also prescribe Theophylline. It should be taken every day.

• Steroid tablets-

Steroid tablets are given to give relief from an asthma attack. Long-term usage of steroid tablets for is not recommended unless a person is suffering from severe asthma and if inhalers aren’t handy controlling the symptoms. Some possible side effects of using steroid tablets for long-term are mood swings, fragile bones, high blood pressure, etc.

Other treatments for Asthma
Other treatments like surgery or injections may be required in case other treatments don’t work for a person.

Injections 
For certain people with severe asthma, some injections like omalizumab, mepolizumab, or reslizumab may be able control the symptoms. For some severe asthma patients, injections are prescribed every few weeks in order to control the symptoms. However, these injections should be taken only under the prescription from an asthma specialist, as these injections may are not advisable for every asthma patient.

Surgery 
For some people for whom treatments like inhalers, tablets, and injections don’t work or in certain cases cannot be administered, a surgical procedure called bronchial thermoplasty can be used. In this treatment, a flexible thin tube is passed down the throat into the lungs and heat is used to warm up muscles surrounding the air controlling nerves to stop causing asthma-like symptoms.

However, this process is fairly new and so much research has not been done on its long-term relief.

Complementary therapies 
There are many complementary therapies that can help ease the symptoms, prevent asthma from happening, and help strengthen the lungs and the airway muscles. However, before incorporating any of these therapies in your lifestyle, it is always best to check with your asthma specialist first. These therapies include

Certain breathing exercises including yoga
-  Alternative medicines like homeopathy, chiropractic, and Ayurveda

-  Dietary supplements

-  Acupuncture

-  Certain traditional Chinese medicine

-  Ionizers

Common Myths About Asthma
Myth #1: Asthma is a psychological disease

One of the biggest beliefs that many people have is that asthma is psychological and thus they don’t believe in getting medical help. Since asthma affects the airways it is to be noted that is not psychological as it causes the immune system and the lungs to behave erratically when it comes to certain triggers.

Myth #2: Asthma medications lose their effectiveness over time

Asthma meds don’t lose their effectiveness over time and can be used for long-term if the right doses are taken as directed.

Myth #3: People with asthma should avoid physical activity

Although strenuous exercises can sometimes induce asthma, simple exercises can keep a person fit and healthy and help them lead a normal life.

Myth #4: You can outgrow asthma

Some asthma symptoms may improve over time. People also learn how to deal with asthma better as they age since they know what triggers it and what doesn’t. However, there is no outgrowing asthma because it is a lifelong condition.

Myth #5: Asthma Is Easy to Control

Asthma can be easy or difficult to control depends on the kind of asthma a person is suffering from and the triggers. Although even in mild form of asthma, the treatment is required to give the necessary relief to a person to reduce flares and maintain proper lung functions.

Depression
Depression is a medical condition that leads to unrelenting sadness or interest deprivation. It is also referred to as mood disorder, depressive disorder to clinical depression. The disease affects the feeling, thinking pattern or behavioural pattern of the patient leading a several emotional or physical issues.

A lot of people relate depression with weakness and do not pay heed to the treatment of the disease, which results in several complications. Often, depression requires long-term treatment. Most depression patients can lead a healthy lifestyle with the help of proper medication or psychotherapy, and in some case the blend of both.

Types of Depression:
There are several types of depression. Some of the many types of depression are:
-  Anxious Distress (Restlessness)

-  Mixed Features (Concurrent depression and mania)

-  Melancholic Features (Depression involving feelings of agitation or guilt)

-  Atypical Features (Depression accompanied by hunger, or sleep disorder)

-  Psychotic Features (Depression accompanied by hallucinations or delusions)

-  Catatonia (Depression with persistent or uncontrollable movement)

-  Peripartum/Postpartum Onset (Depression during or after pregnancy)

-  Seasonal Pattern (Depression during change of seasons)

While these are the common types and variations, depression is not limited to these and it may occur in manifold ways and at manifold times in one’s life. It is imperative to stay vigilant, not only for the patient but for those who are around them, since unlike other diseases, often depression cannot be noticed by the person who is experiencing it, and those around them have to initiate inquiry.

Disorders that Lead to Depression:
In addition to the different types of depression disorders, some other disorders may also lead to depression. Some of these disorders are: 
-  Bipolar I and II Disorders (Extreme high or low mood)

-  Cyclothymic Disorder

-  Disruptive Mood Dysregulation Disorder (frequent extreme temper outbursts)

-  Persistent Depressive Disorder

-  Premenstrual Dysphoric Disorder

-  Other Depression Disorders

While it is common to have disorders or other reasons that lead to depression, it is important to remember that sometimes the reasons or situations may not be clear. Processing emotions become incredibly difficult when one is depressed, which only makes it worse.

It is insensitive and downright uninformed to seek clear reasons and outlines from a depressed person as to why they feel the way they feel, as is to ask them to go out more or just focus on other things.

It is only when the basic activities like sports, music, hobbies, etc stop entertaining a person that they get depressed, so asking them to do those things reflects immaturity and lack of any knowledge about the subject.

Symptoms of Depression:
Often signs and symptoms of depression often go unnoticed. Some people ignore depression symptoms like weakness or temporary mood swings. But it is important to understand the symptoms of depression and get adequate treatment for the same. 

Typically, symptoms of depression include:
-  Extreme emotions of hopelessness or sadness

-  Extreme angst, irritation or frustration

-  Loss of interest/pleasure

-  Sleep disorder (too much sleep or insomnia)

-  Exhaustion

-  Appetite loss

-  Weight gain

-  Restlessness or anxiety

-  Slow reflexes

-  Emotions of guilt

-  Problems in concentrating, thinking, or remembering things

-  Suicidal tendencies

-  Back pains

-  Headaches

Depression Symptoms in Children
Symptoms of depression in children are almost same as that of adults. However, there are some differences. In children of younger age, depression symptoms may involve body aches and pains and/or emotions of sadness, clinginess or irritability. In some cases, depression may cause loss of weight in younger children.

In teenagers, depression symptoms may include emotions of sadness, agitation, negativity or worthlessness. Teenagers suffering from depression are extremely sensitive and avoid social interactions. In some cases, such teenagers may also start using recreational drugs or alcohols. In some extreme cases, teenagers suffering from depression also form suicidal tendencies.

Depression Symptoms in Adults
Depression takes several years to be treated completely. In adults, the symptoms of depression may include:

-  Memory loss

-  Personality changes

-  Body aches or pains

-  Exhaustion

-  Appetite loss

-  Sleep disorder

-  Loss of interest

-  Loss of interest in socializing

-  Suicidal tendencies

-  Exhaustion, severe tiredness

-  Suicidal thoughts

-  Changes in appetite

-  Sleep disturbances

-  Panic attacks

-  Headaches, aches and pains, bloating, digestive issues,  cramps, breast tenderness, etc.

-  Inability to concentrate

-  Loss of interest

there can be many other symptoms of depression, and a person of any age group may experience the disease without even exhibiting all or any of these symptoms. To identify depression and its occurrence, sensitization and awareness are key.

What Causes Depression?
Medical fraternity has not yet been able to find out the exact cause of depression. 

However, some of the most common factors of depression may involve:
-  Neurological Disorders

-  Brain Chemistry

-  Hormonal Disorders

-  Family History

-  Social Causes

-  Biological Causes

-  Psychological causes
 

Depression Risk factors:
Often depression is found in the age group of 20 to 30 years. However, this disease can strike anyone at any age.

 Listed below are just some of the many risk factors associated with depression, due to which a person may be susceptible to the disease:
-  Personality traits (low self-esteem, self-critical or pessimism)

-  Traumatic events (physical abuse, sexual abuse, death of loved one, difficult relationship, or financial problems)

-  Family history (blood relatives with depression, bipolar disorder, alcoholism or suicidal tendencies)

-  Mental health disorder history (anxiety disorder, eating disorders or post-traumatic stress disorder)

-  Alcohol abuse

-  Recreational drug abuse

-  Chronic illness (Cancer, stroke, chronic pain or heart disease)

-  Side effects of some medicines (some high blood pressure medicines, or sleeping pills)

Complications:
Depression is a serious medical condition that may lead to several complications if untreated. Some of the most common complications of untreated depression include:
-  Obesity

-  Body ache or pain

-  Cramps

-  Tendency to consume alcohol

-  Tendency to drug misuse

-  Extreme anxiety

-  Panic disorders

-  Social phobia

-  Personality disorders

-  Social isolation

-  Suicidal tendencies

-  Self-mutilation

-  Premature death

Other than these as well, there are several complications that may be case specific. as the complications of the disease are physiological and psychological at the same time, it is very important to handle a case effectively and be extremely careful with a patient of depression.

Prevention from Depression:
There are no scientifically proven ways to prevent depression. However, there are few things that may help prevent depression:

-  Controlling stress

-  Taking help from family and friends

-  Starting treatment early

-  Ensuring long-term treatment and help

Diagnosis of Depression:
In order to diagnose depression, following tests may be conducted:

-  Physical Examination

-  Lab Tests

-  Psychiatric Evaluation

Treatment of Depression:
Often psychotherapy and medications remain the preferred ways to treat patients suffering from depression. Treatment of depression involves several drugs and medicines in addition to psychiatric or psychological evaluation.

Those suffering from severe depression may also need to stay in hospital for treatment till their symptoms subside.

Medications
Patients suffering from depression may be prescribed several types of antidepressants. Be advised to consume antidepressants only after consulting a certified medical professional. Some of the most common antidepressants prescribed to depression patients include:

-  Selective Serotonin Reuptake Inhibitors (SSRIs) – [fluoxetine (Prozac), paroxetine (Paxil, Pexeva), citalopram (Celexa), escitalopram (Lexapro), vilazodone (Viibryd) and sertraline (Zoloft)]
-  Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – [levomilnacipran (Fetzima), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and duloxetine (Cymbalta)] 
-  Atypical Antidepressants – [mirtazapine (Remeron), vortioxetine (Trintellix), nefazodone, trazodone and bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL)] 
-  Tricyclic Antidepressants – [amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor) and protriptyline (Vivactil)]

Note: Tricyclic Antidepressant drugs have severe side effects.  
-  Monoamine Oxidase Inhibitors (MAOIs) – [phenelzine (Nardil), tranylcypromine (Parnate) and isocarboxazid (Marplan)]
 

Other medications
Doctors may add other medications along with antidepressants to fasten the effects of the drugs.
For some patients, the regular dosage of antidepressants may not be very effective, and doctors may not prescribe them straight away due to the associated complications and risks of extreme side effects.

Often the following alternative therapies are used to treat depression. they are not always successful and sometimes can be pointless in specific cases; but patients have been seen to benefit from them otherwise, especially when used alongside prescription medications.

-  Yoga

-  Herbal remedies

-  Reflexology

-  Acupuncture

-  Meditation

-  Massage

-  Exercise

-  Guided imagery and relaxation

Risk of Stopping/Missing Out Antidepressants Dose
It is recommended not to stop consuming antidepressants without confirming with your doctor. Antidepressants usually are not of addictive nature but may lead to some physical dependencies. Abruptly stopping antidepressants or missing out a dose may lead to withdrawal symptoms. It is important to consult doctor and gradually decrease the dose. 

Consumption of Antidepressants in Pregnancy
Antidepressant consumption is not advised to pregnant women as it may pose a risk to the unborn child. Likewise, breast-feeding women are also not advised to take antidepressants as it may adversely affect the newly born. It is important to consult a doctor before starting antidepressants in the state of pregnancy.

Suicidal Tendency
Mostly antidepressants are safe to consume. However, consume of some antidepressants may increase suicidal tendency in kids, young adults and even senior citizens. The suicidal tendency starts showing in the very first week of consumption of antidepressants.

It is imperative to keep an eye on the patients who are on antidepressant dosage for unusual behaviour pattern. In case the patient experiences suicidal tendencies when consuming antidepressants, it makes sense to consult a certified medical professional immediately.
 

Common Myths About Depression:
Myth #1: Depression is not real disease

Reality: A lot of people believe that depression is not a serious medical condition, but just some random personality trait or weakness. This is wrong. Depression is a serious medical condition that can affect anyone. It is one medical condition that may lead to several life-threatening complications right from physical disabilities to neurological disorders and even suicidal tendencies. 

Myth #2: Depression is just an extreme form of sadness or grief.

Reality: This is yet another popular myth about depression. However, the fact is that depression is different from ordinary sadness or grief. Ordinary sadness or grief subsides with time; whereas in depression, sadness or grief doesn’t really subside. Successful treatment of depression takes months, in some cases years.

Myth #3: Depression patients are required to take medications lifelong

Reality: Depression requires longer treatment, but it doesn’t require lifelong treatment. Doctors decide the tenure of the treatment of depression. And once the treatment culminates, the patient doesn’t need to get the treatment again. The exact time period of depression treatment depends upon the severity of the disorder of the patient and widely varies from person to person. In fact, latest research and studies reveal that patients can successfully complete the treatment of depression with a combination of psychotherapy and medications in as little as 24 weeks. 

Myth #4: Those with family history of depression are sure to have it

Reality: While it is true that depression can be passed on from parents to their children, it is not likely that everyone with family history of depression will have it. Genetic predisposition of depression is rare.

Myth #5: Depression patients need treatment lifelong.

Reality: This is entirely untrue. Depression patients are required to take medications for as long as their treatment continues. In addition, the duration of consuming medication for depression depends upon the time period prescribed by a certified medical professional after a careful analysis of symptoms, intensity and severity of the disease. Once a patient has substantially improved and integrated into a healthy lifestyle, there is no need to continue treatment. However, it is only a doctor who should decide when a patient is ready to go off of therapy.

Myth #6: Antidepressants always cure depression

Reality: Antidepressants have huge side effects and terrible withdrawal symptoms, which is why doctors only prescribe them after careful consideration in case results are not noticeable otherwise. Antidepressants sometimes fail to work on individuals with specific cases. Antidepressants work by altering the brain chemistry of the patient and thereby helping improve the situation. But when the cause of the patient’s depression does not coincide with the effect of the antidepressants at all, results may be few. In such cases, doctors prescribe other forms of treatment which may be beneficial on their own, or alongside medications and antidepressants.

Myth #7: Depressions only happens because of a sad situation in someone’s life.

Reality: This is sometimes the case indeed, but often times is false since a sad situation is not always even present in the patient’s timeline of disease. sometimes a tragic situation is a trigger which brings out the underlying disease to the surface after denial or pretending, or sometimes by worsening it. Medical experts have been trying to identify causes of depression for a long time but this task is not easy. some identified causes are brain chemistry, hormones, social factors, but very often the precise cause of a patient’s depression is not possible to be pointed out.

Myth #8: Talking about depression makes it worse.

Reality: nothing could be far from true on the list of myths associated with depression. very often, depression is a consequent or bottling up emotions and not expressing oneself. This tendency, over a prolonged period of time, may cause depression, and may be caused due to feelings of hopelessness, feeling unimportant or invalid, etc. Then, not talking about it is a solid cause for depression to worsen. Talking about one’s feelings, questions, and expressing opinions requires a lot of work when one is suffering from depression, as the various causes of these must be targeted and solved first. But once a patient is able to express themselves, their condition is seen to improve in most cases.

Myth #9: Depression is a result of lack of willpower.

Reality: This is terribly misinformed statement, since depression is not the result of lack of willpower, it is instead the cause for it. People of high stature who have made great contributions to the development and changes in the world have been patients of depression, and it would be stupid to say that these people lacked willpower and commitment. A lazy attitude, low self esteem, lack of self conviction are not direct causes of depression, rather they create lifestyle problems which together, with other factors, contribute to depression or its worsening.

Myth #10: Depression is a woman’s disease. Real men do not get depressed.

Reality: Few things could be as sexist as labeling a disease that affects the mind and body as a disease of women on the pretext that men are strong, physically and emotionally, and do not malfunction in any way. Depression affects men and women alike and both genders experience the disease the same way. Through history, this sexist assumption has lead to misdiagnosis and mistreatment of patients of depression. Women have often been diagnosis with depression due to forced domestication but that is only part of the issue, and there are endless reasons one may be suffering from depression.

Myth #11: Antidepressants alter one’s personality.

Reality: a common misconception is that those taking antidepressants are unable to experience emotions in an attempt to not feel the sadness that comes associated with a disease. Some patients do experience a ‘flatness’ where they do not experience much feelings, but this is not the desired effect of antidepressants. If one experiences this, it should be reported to the doctor immediately because it is highly likely that the dose of antidepressants prescribed to the patient is higher than what is needed. A change in the dosage will ensure this does not happen and the unnecessary changes in one’s personality are reverted. One must always remember that the point of antidepressants is to provide better adjustment and not change one’s personality.

Myth #12: Depression is a sign of mental weakness.

Reality: This myth is shaped by the stigma that is associated with depression. Depression is observed in patients who are extremely intelligent, have performed high-pressure jobs very well, perform great under stress and duress, have high mental capacity as exhibited by past actions. This shows that mentally strong people are just as likely to be depressed as anyone else. Research has also shown that people who are smarter often experience more stress and pressure to perform well, have positions of responsibility assigned to them, along with a stronger ability to feel what they are going through. This together can make them more susceptible to depression.

Myth #13: Teenagers also develop depression have to live with its consequence forever.

Reality: Lifelong depression is a reality, however gruesome; but is mostly not the case. Teenagers are prone to many negative feelings due to a lot of reasons, internal and external. In such a situation where the pressure is high on them, they may experience depression. But this does not mean that this disease will plague them for the rest of their life. As they grow older and get better accommodate to their environment and adjust better, they are certainly going to be well-coped adults and be healthy.

Myth #14: All LGBTQ persons are depressed, being gay means being depressed.

Reality: Being gay, trans, bi, or queer means being a unique and colourful individual, and does not mean being gay at all. However, studies have indicated that people of the LGBTQ community are often plagued with the deadly disease of depression. This is not because of a link between the two- depression is a disease caused due to several reasons, free of gender identities. This, instead, is because how the society has failed its LGBTQ community and mistreated them, denying them the respect and freedom that they deserve. When any individual is mistreated like so, denied the freedom to express themselves, and forced to fit into monochromatic heteronormative roles, they are going to go through an emotional turmoil. This is the cause for the multifold mental health issues that the LGBTQ persons have to go through. But it is clear that depression is not a disease which selectively attacks a specific group, community, or gender.

Frequently Asked Questions (FAQs) about Depression:
1) Who is at risk of developing depression?
Ans: Here is a list of those who are at a greater risk of developing depression:

-  Those with family history of depression

-  Those who have experienced traumatic or abusive experiences in childhood

-  Those with history of suicide/suicide attempt in the family

-  Those experiencing stress or tensions

-  Those who are often socially isolated

-  Pregnant women experiencing postpartum

-  Those with serious illness

-  Those who consume alcohol

-  Those who partake in drug abuse

-  Patients taking certain prescribed medications

2) Why is depression more common in women than men?
Ans: It is believed that depression is twice more common in women as compared to men. There are many potential reasons and causes why more women experience depression than men. Unique hormonal and psychosocial factors contribute to depression in women, alongside the heaving weight of social oppression, and gender roles and expectations.

3) What is Postpartum Depression (PPD)?
Ans: After pregnancy, women become particularly vulnerable to depression. This is because of physical and hormonal changes and the overwhelming responsibility of the newborn. A large number of new mothers experience ‘baby blues’, a brief period of mild mood changes. Postpartum Depression is serious medical condition that not only requires apt medical attention and treatment but also requires emotional support for new mothers.

4) What is treatment resistant Depression?
Ans: Treatment-resistant depression (TRD) is medical condition of major depressive disorder. This type of dispersion disorder doesn’t respond to standard treatment. This type of depression may range from mild to acute and may require a number of treatment methods.

5) Are there any exercises that can help in treatment of depression?
Ans: Aerobics is known to offer relief from mild depression. This is because it stimulates the neurotransmitter norepinephrine, which is related to mood. In addition, it also increases the endorphin level.

6) What is Brain Stimulation Therapy?
Ans: Brain Stimulation therapy is a therapy used to treat depression. In this therapy, transcranial magnetic stimulation repeatedly sends magnetic pulses to the brain. This therapy has been found to be effective in the treatment of some major depressive disorder.

7) What is Electroconvulsive therapy?
Ans: Electroconvulsive therapy is mostly used as treatment to cure acute depression and treatment resistant depression cases. This therapy is particularly helpful in treating psychotic depression.

8) Is there any remedy for prevention of depression?
Ans: Though there are no ways to prevent depression, it is easy to control the signs and symptoms of depression. One can easily make changes to their lifestyle and control their depression from getting complicated.

Here are just some of the many things that one may do:

-  Setting a routine lifestyle

-  Setting up personal and professional goals

-  Regular exercise and healthy diet

-  Taking sleep

-  Regular screening

9) What are some of the best anti-depression supplements?
Ans: Some of the best anti-depression supplements are:

-  Fish oil

-  B-Complex vitamin

-  Amino acid 5-hydroxytryptophan

-  GABA (gamma-aminobutyric acid)

-  Vitamin D

Though these supplements are readily available in the market, it is important to consult a certified medical professional before taking these.

10) What is manic depression? 
Ans: Bipolar disorder is also called manic depression. It is a serious medical condition. It is major mood disorder, where the patient experiences abnormal moods of highs (mania) and lows (depression). The state of high and low mood is referred to as manic and hypomanic disorder. Bipolar disorder or manic depression is a chronic recurring medical condition.

Tips for Living With Anxiety

• If you deal with anxiety on a regular basis, medication doesn't have to be your only treatment.
• To calm your mind and cut stress, try working these self-care tips into your daily routine:
• Move your body. Exercise is an important part of physical -- and mental -- health. It can ease your feelings of anxiety and boost your sense of well-being. Shoot for three to five 30-minute workout sessions a week. Be sure to choose exercises you enjoy so you look forward to them.
• Pay attention to sleep. Both quality and quantity are important for good sleep. Doctors recommend 8 hours of shut-eye a night. If anxiety is making it hard for you to fall asleep, create a routine to help you catch your ZZZs.

In our daily interactions, we often meet people who have mood swings and their state may vary from a few hours to a few days. The impact of these unhealthy mood swings damages their personal as well as professional life. The person suffering from these mood swings may have depression, bipolar or borderline personality disorder. There are more than 10 million individuals diagnosed with each of these psychological issues every year in India. In this article, we are going to talk about Borderline Personality Disorder (BPD) or emotional instability i.e. a pattern of abnormal behaviour characterized by unstable relationships with other people at a longer period of time.

Individuals with such instability have an unstable sense of self, may feel empty or afraid of being neglected. They might be unusually sensitive in a relationship, have trust issues with everyone, difficulty in regulating their emotions, and quite impulsive in nature. This impulsive nature mostly provides them immediate relief from their emotional pain and in extreme situations to lesser down this pain, they get involved into risk-taking, dangerous behaviours like rash driving, compulsive gambling, substance abuse, binge eating, unprotected sex, accumulating debt, the threat of suicide or self-mutilation tendencies.

They most likely have a history of breakups or a sequence of a futile love relationship. Even the possibility of multiple sexual partners, not just impulsively but intentionally too. It helps them to fight the feelings of emptiness. Whenever they feel empty, lonely, or even bored, sex may generate positive feelings. While, some individuals, on the other hand, can even have a negative attitude towards sex, thus avoidance of sex for fear of experiencing an exacerbation of their symptoms is also quite common amongst them.

Individuals with this psychological illness tend to believe in an all or none phenomenon, they might feel intense joy and gratitude at perceived expressions of kindness, and intense sadness or anger at perceived criticism or hurtfulness. A slight disappointment with others can cause a shift in their feeling from admiration or love to anger or dislike. These mood disturbances can undermine relationships with family, friends and even colleagues. We all might be ignorant about such mood swings, but we have to understand that at times they could be quite abnormal and require professional help.

There are various reasons for the very occurrence of this type of emotional instability or BPD, some of them are:

1. The most prominent cause is molestation, sexual or physical abuse experienced by an individual. Research points out that an incident of sexual or physical abuse can increase the chances of developing disorder manifold.

1. Traumas like being neglected, rejected, separated from their parents, at an early age can have a later impact too.

1. Brain Development also plays a major role many people with BPD have something wrong with the neurotransmitters in their brain, particularly serotonin. Altered levels of serotonin have been linked to depression, aggression and difficulty controlling destructive urges.

1. Family History where parents or sibling might be suffering from BPD can also lead to a higher risk of developing it. It can injure many areas of life.

1. Not just inheritance but also the environment in which an individual grows up influences his thought process and his behavioural patterns. People have a hard time dealing with it and their hypersensitivity often results in a very intense and variable response by a person. The individual learns to express his emotions in an extreme way or completely inhibits them. The root cause of the problem can be traced back to childhood.

1. Emotionally unstable individuals lack self-awareness and are not very certain about how they see themselves and their interests. In most of the cases, people suffering from it have low self-worth and self-image. Their behaviour is very intense and most of the time doesn’t fit the situation.

The psychological condition (mood swings) can last for years and may be quite long-lasting, so it would be highly recommendable to seek for professional help if you are facing such issues. Borderline Personality Disorder is usually treated with counselling (talk therapy). Although medication may reduce the symptoms, they do not cure as the therapies do. Therapy is beneficial for people at this stage as the counsellor has the appropriate training and patience to comprehend the emotional crises that the person experiences. The main intent of the counsellor is to help the person to identify the cause of these mood swings and to make the individual learn how to modify such behavioural patterns. The counsellor also further helps them to develop better communicative strategies and improve interpersonal relationships. Through counselling, the individuals learn how to cope positively in stressful situations, tolerate distress and how to start responding instead of reacting.