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Loss of Vision & Disability - How Can Psychological Rehabilitation Help?

Loss of Vision & Disability - How Can Psychological Rehabilitation Help?

Visual impairment is a decreased ability to see to a degree that causes disabilities or problems, not fixable by usual means, such as glasses. Loss of vision may be acquired and develop suddenly. It may affect one or both your eyes.

What Causes Loss of Vision/Disability?

Loss of vision and disability can result from the following –

  • Clouding of normally transparent eye structures

  • Abnormalities in the retina

  • Abnormalities in the nerves carrying visual signals to the brain from the eyes

Changes in vision may also occur due to conditions like glaucoma, macular degeneration and diabetic retinopathy

Can Psychological Rehabilitation Help Manage Visual Impairment?

Vision loss and disability often interfere with one’s functional ability in everyday tasks. Sometimes, the disability may be so devastating that it affects a person’s mental health and behaviour. Psychological Rehabilitation is designed to help such visually impaired people deal with disability or impairment. 

Psychological rehabilitation involves a wide range of methods that aims to restore functioning after loss of vision, just as physiotherapy restores functioning after an injury or stroke. The program allows patients to continue living independently and maintain their quality of life despite vision loss. 

Complete or partial loss of vision can jeopardize one’s career – you may not be able to continue with your job due to the disability.  Many people suffer psychological and physical challenges, which force them to escape the outside world. Psychological rehabilitation helps in the following ways –

  • Helps individual understand and accept the disability, and find ways to cope with it

  • Motivates them in to keep trying

  • Cope with the pain and depression

  • Overcome feelings of fear or despair

  • Prevents the person from sinking into a state of self-pity, which may hinder recovery

Rehabilitation Psychology adopts a holistic and expansive approach to treat visual impairment. 


Paranoid Personality Disorder - How To Track It?

Paranoid Personality Disorder - How To Track It?

The mind is a very intricate organ and controls the entire body functioning with great precision. Any small change in its wiring would mean changes in the way a person functions, including changes of emotions and feelings.

There is a group of personality disorders known as “cluster A” personality disorders. One of the most common forms in this is a paranoid personality disorder, also known as PPD. The onset of the problem is in early adulthood and men are more likely to have this condition as compared to females. People with paranoid personality disorder are very odd or have eccentric ways of thinking. The most common way of thinking is suspicion with no reason to do so.


  1. They are always on watch or guard and believe that others are out to harm or demean them.
  2. Their belief and distrust are often unfounded, and they find it very difficult to form close relationships, either at work or at home.
  3. There is always a doubt in terms of other people’s commitment and trust, and believe that others are out to use them and often end up deceiving them
  4. Find it very difficult to confide in people, and think the information they tell others may be used against them.
  5. They are always known to hold grudges from past experiences and find it very difficult to forgive others
  6. They are not open to criticism and are extremely sensitive to what others think of them or tell them
  7. Try to read between the lines and interpret more than the obvious
  8. They are very quick to retaliate and think others are constantly attacking what they say and/or do
  9. There is a constant thread of suspicion especially of their spouses or partners, which would be completely unfounded, and add unwanted strain on the relationships
  10. Refrain from forming close relationships and keep some distance even in close relationships. They are generally cold and can be jealous and controlling of their near and dear ones
  11. Firmly believe that their thoughts and words and actions are always right and do not believe in conflict resolution. They are usually argumentative, hostile, and stubborn
  12. They always present as tense and cannot relax very easily

Causes: There is usually a past history of emotional or physical abuse, which is unresolved, leading to these symptoms. Hypnosis, which is often used to diagnose the condition, is very helpful in identifying the cause.

Diagnosis: There are specific assessment tools and questionnaires which are useful in confirming the diagnosis.

Management: Psychotherapy where the person is taught to manage the above feelings and taught to communicate and cope with others. This is often combined with antidepressants, benzodiazepines, and antipsychotics.

Androphobia - How Does It Affect Your Sex Life?

Androphobia - How Does It Affect Your Sex Life?

Androphobia can be described as the unfounded and often overstressed fear of men. This phobia can affect both the genders, though younger females are more known to suffer from this kind of phobia.

Causes and origin:
Many psychoanalysts are of the opinion that women who had been victims of sexual assault or any kind of male aggression are more prone to androphobia. An unsympathetic and rude father figure can trigger this phobia in both the sexes. Many young girls are taught by their parents or caregiver to stay away from the opposite sex this can also instil a sense of fear for men in the young mind.

Intense and irrational fear of men is one of the commonest manifestations of this phobia. In many cases, the individual might experience disturbing thoughts about being assailed by men. In spite of realizing that the fear is unfounded, they still avoid any kind of association with men. In some cases, the person is extremely panicky and alert in presence of men. Extreme cases of androphobia are characterized by panic accompanied with tremors, increased heartbeat, dizzinessnausea, stomach ache and chest ache.

Androphobia and sex life:
Androphobia can gravely affect the personal life of an individual particularly his/her sex life. Androphobic women intentionally keep away from male company which definitely has a negative impact on their sex life. Even mildly androphobic women are known to feel uncomfortable while talking to men. The androphobics are generally depressed individuals who prefer to keep to themselves. In spite of having feelings for a man or having the urge to have sex, an androphobic woman will hardly be able to convey her feeling because of her intense fear of manliness. The loneliness and alienation which is associated with this kind of phobia often prompts a woman to contemplate suicide.

As with most other phobias, androphobia is also a curable condition. Your psychiatrist can suggest various medications and psychotherapies to cure your condition. The exposure therapy in which the phobic is slowly exposed to the much feared subject is known to work well in many cases. The CBT or Cognitive Behavioural Therapy is another treatment for androphobia where counselling sessions are conducted so that the phobic can express and share her nature of phobia.

During the sessions, the counsellor suggests ways of dealing with the phobia and keeping it under control. The objective of the Cognitive Behavioural Therapy is to recognize the pessimistic images related to men and turn them into positive ones. When none of these therapies work, the psychiatrist usually suggests anti-anxiety and anti depressant medications which improve the temperament of the androphobic.

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Oppositional Defiant Disorder In Kids - Ways To Deal With It?

Oppositional Defiant Disorder In Kids - Ways To Deal With It?

A child’s tantrums, especially during teens, are quite common. However, there could be some children who could be exhibiting an extreme version of these symptoms. This is known as oppositional defiant disorder.
Children with this disorder become easily irritable, angry, argumentative, defiant and feel vindictive against most elders (parents, teachers, and others). While this is something very common and can be ignored to be a part of teenage tantrums, the issue is when these symptoms do not seem to end. If they persist for beyond 6 months, it is time to worry. These may then begin to interfere with their daily activities including schooling, where they may not be easy for the teacher to manage.

Diagnosis of ODD: With the changing behaviour of teenagers, it is often difficult to pinpoint and say there is ODD. However, some guidelines for diagnosis are listed below. Angry/irritable, argumentative, defiant and vindictive. If these symptoms are seen for more than 6 months with no inducing reason, happens with non-siblings, and is affecting learning and playing, it is highly likely the child has ODD.

These symptoms can occur at home, at school, or in other settings – seen respectively in one, two, or more settings. Some of the symptoms are listed below.

  1. Repeated temper tantrums
  2. Anger bursts, swearing, using obscene language
  3. Extremely argumentative, especially with people in authority (teachers, parents, etc.)
  4. Annoying others and getting annoyed easily
  5. Noncompliance to rules and regulations at school and institutions
  6. Defending one’s mistakes and blaming others for it
  7. These result in poor academic performance, antisocial behavior, substance abuse, and higher suicidal tendencies.


Treatment depends on the presenting symptoms, the age of the child, and supportive care available. The child should be able to actively take part in psychotherapy to reap good benefits. It would otherwise be a task with no results.

  1. Psychotherapy will help the child improve its cope and express and control anger. This also improves problem-solving skills.
  2. Cognitive-behavioural therapy tries to mould the behaviour.
  3. If required, the parents also would be involved to improve family’s involvement in the treatment. Caretakers are given special training if required so that they can support in long-term medical care.
  4. The child also needs to be trained for appropriate behaviour under different circumstances.
  5. Rewards for positive behaviour and punishments for negative behaviour are useful ways.

Prevention: Early identification can help in minimizing distress to the family and help in the early arrest of the disease. The family is also taught basic and simple steps which can help in supporting therapy. Early rejection at school and loss of learning, can happen which can be managed with early intervention. A nurturing and supportive family can help manage the child very well.

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Somatic Symptom Disorder - How To Handle It?

Somatic Symptom Disorder - How To Handle It?

Somatic symptom disorder is when you put so much focus on symptoms such as pain or fatigue that you have trouble functioning or experience severe emotional distress. You will be visiting the doctor a lot, completely unnecessarily and will waste a lot of money when you have no major health concerns. However, there are treatments which can help you cope with this problem. Read further to find out what they are:


1. Worrying excessively about an illness which has not yet occurred
2. Frequent health care visits
3. Fear of physical activity damaging your body
4. Fearing that the evaluation of doctors is not adequate

There are many more symptoms which may indicate that you are suffering from somatic symptom disorder. However, the most important way of telling whether someone is suffering from somatic symptom disorder or not is to see whether the patient is overly worried about a physical problem which has not yet occurred. One of the first steps in making sure that this does not happen is finding out what causes the problem and preventing it. Here are the causes of somatic symptom disorder.


As with other psychological disorders, the exact cause of somatic symptom disorder is not yet known. However, there are a number of factors which may increase the risk of it. Here they are.

1. Genetic and biological factors
These, as well as increased sensitivity to pain, are some of the factors which you have no control over. 

2. Environment you grew up in
Just like the genes you have, the environment you grew up in and your family influence will have a major impact on whether you develop the condition as well.

3. Problems processing emotions
When people have problems processing emotions, their physical symptoms seem like a bigger problem than they actually are.


Luckily, there are treatments for this disorder as well. They include.

1. Psychotherapy
Psychotherapy is the most common treatment used to help people with somatic symptom disorder.

2. Medications
Since depression and pain often occur when a person is suffering from somatic symptom disorder, antidepressants can be given as well. 

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Avoidant Personality Disorder - What Should You Know?

Avoidant Personality Disorder - What Should You Know?

Don’t like social gatherings? Have you always been the one who avoids family get together? If your answer is affirmative, then you are probably suffering from Avoidant personality disorder (APD).  Avoidant personality disorder is a psychological condition wherein, one feels extremely shy. Becoming overly sensitive to rejection and developing feelings of inadequacy are common signs of this disorder. This disorder can lead to problems in your work life and relationships. 


With APD, the commonly surfacing symptoms would include disapproval and disregard of situations and people, rejection and embarrassment. It generally gets very difficult for the one to get acquainted with new people and form intimate relationships. One generally ends up misinterpreting people’s comments and criticism thus, feeling angry and frustrated all the more. 


The exact cause of APD has not been established yet. It is believed that environmental and genetic factors play a role in this disorder. People who are inherently shy and reserved are usually prone to developing this psychological anomaly.

How do you treat APD?

In order to treat APD, you can opt for the following modes of treatment:

  1. PsychotherapyCognitive behavioral therapy is a treatment option for APD wherein, the doctor counsels on how to change one’s thinking patterns and thought process, thus, influencing his/her actions.
  2. Psychodynamic psychotherapy: Psychodynamic therapy involves you becoming aware of the unconscious thoughts. It helps you figure out how your past experiences frame your behavior. Your past emotional pains can be resolved with this technique so that you can move ahead with your life. 
  3. Medications: Anti-depressant medications used to treat depression and anxiety can be used to treat APD.
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Bipolar Disorder - What Should You Know?

Bipolar Disorder - What Should You Know?

Bipolar disorder is also known as manic depression. This usually sets in low and high moods in a person along with changes in energy and sleep.

People with bipolar disorder tend to have periodical changes; sometimes they are over happy and other times they might feel sad, depressed and hopeless. Between these changes they are normal. The highs and lows are considered as extreme poles of moods, thus the name bipolar disorder.

Manic term is used when a person with bipolar disorder is highly excited and feels confident. Also, feelings of irritability and recklessness along with irrationality might occur. Some people with mania might have a hallucinations that is they see and hear things that are not there, along with delusions.

The term hypomania is used to describe mild symptoms of mania, in which a person does not have hallucinations and delusions and the symptoms do not interfere with their daily life. Similarly, the term depressive is used to describe a person's time when they feel depressed or sad.

Symptoms of Bipolar Disorder:

  • The highs and lows in a bipolar disorder do not follow any set pattern. One might feel manic or depressed for hours or days or weeks, months and even years together, before they actually switch to a happy mood. The severity depends from person to person and also changes with time by becoming less or more severe.
  • Symptoms of mania or the high are extreme excitement, change from being happy to angry and irritable along with restlessness, speech is rapid with low concentration, less sleep and increased energy, grand plans, alcohol and drug abuse and impulsiveness.
  • Symptoms of low or depressive phase are lethargy, worthlessness, feeling of sadness and hopelessness, lowered concentration, irritability, loss of sleep or excessive sleeping, loss of appetite and suicidal tendencies.

Diagnosis of Bipolar Disorder:

  • In case someone exhibits symptoms of bipolar disorder, then talking to a psychiatrist or a doctor helps. Doctors ask questions related to the mental illness and the associated concerns. Diagnosis is basically recognizing the symptoms of the person, whether they are due to some underlying cause or mood swings because of excessive alcohol. The symptoms have to be noted and the duration, for which they last along with the severity should all be noted. The most obvious symptoms are that of lows and highs in mood and changes in behavior, energy, sleep and thoughts.
  • Consulting a doctor or talking to family and friends helps to differentiate the symptoms of bipolar disorder from unipolar disorder.


Dissociative Amnesia - What Should You Know About It?

Dissociative Amnesia - What Should You Know About It?

In many cases, the body responds to a stressful or traumatic situation by disassociating with it. This can result in the development of a dissociative disorder. A dissociative disorder or dissociative amnesia is a mental illness that involves the breaking down of memory, consciousness, identity and perception. It can interfere with a person's general functioning, social life and relationships. People suffering from dissociative amnesia can have long gaps in their memory of the accident and the time before and after it. 

Women are at a higher risk of suffering from this condition as compared to men. It has also been found to have a genetic link as people suffering from this condition often have other members of their family who experience something similar. Manmade and natural disasters such as wars, floods, earthquakes etc that cause overwhelming stress is said to trigger this disease. 

The inability to recall past events is a primary symptom of this disease. Other symptoms include:

Treatment for this disease is a two step process. The first step involves relieving symptoms and controlling any behavioral changes. The second step aims at helping the person to recall and process their memories. Developing coping skills and rebuilding relationships is also focused on. Depending on the individual and the severity of symptoms showcased a doctor may choose to treat the patient using any of the following forms of treatment.

  1. Psychotherapy: This form of treatment is designed to encourage communication and give the person insight into their problems. It uses a number of psychological techniques. 
  2. Cognitive therapy: Changing dysfunctional thinking patterns and their resulting emotions and behavior patterns is the focus of this form of treatment.  
  3. Medication: Dissociative amnesia patients who also suffer from depression or anxiety can benefit from medication such as anti depressants and anti anxiety drugs. However, this medication does not treat the dissociative amnesia itself. 
  4. Family therapy: In some cases, along with the patient it is also necessary to counsel the family. Family therapy involves educating the family members about the disorder and symptoms of recurrence. 

Clinical hypnosis: This type of treatment uses intense relaxation and focused attention techniques to access the unconscious part of the mind and allow people to explore their thoughts, emotions and repressed memories.

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The BIG Question - Medications Or Counseling In Mental Health Management?

The BIG Question - Medications Or Counseling In Mental Health Management?

I have mulled over this topic for quite some time now, and  the question that comes to mind for a medical doctor who is trained in psychiatry is "Why do we even have to talk about this topic"?  However, I realize after being in the field of psychiatry for more than 12 years now, it is relevant to explain this in lay person's language because of the huge stigma that goes with the subject of mental health.

It is important to note the difference or similarities of Medications or Counseling in Mental health or as such General Health care.

Counseling is an art, whereas Medicine is as much of an art as it is about science. 

Both are ways of approach towards a patient that involves speaking with, building rapport and empathizing with the patient's condition. 

However, while counseling involves different approaches by way of talk therapy using the mind as the subject and the various processes of the mind such as behavior, intellect, memory, insight, understanding, etc, a psychiatrist would use medications in addition or in isolation depending on the time constraints that the patient load would impose.

While, we know that medications are effective in the treatment of mental health conditions, there is evidence in the scientific world that talk therapy or counseling is as effective for some mental health conditions as medications, if not better. 

Depression and anxiety are two such mental health conditions.  Medications while being helpful in the above conditions, counseling or psychotherapy is as effective and it has been proven that the combination of therapy and medication is more effective that either one of them alone. 

Some do however argue that psychotherapy is pseudoscience. 

Let us examine as to which ones are on the brink and which kinds of therapy are not useful at all.

Psychoanalysis, sometimes dreams analysis and narco analysis, childhood experience analysis are considered as having poor to no evidence in the literature, as being effective treatments for any mental health condition. 

The evidence for placebo or a sugar pill being more effective or as effective as the above kinds of therapies exists in the literature. 

However, these kinds of studies are very difficult to do as each of these therapies are different in their own regard and maybe even come across as different to different individuals.

One is allowed to form their own opinion based on their own experience with regards to these therapies.


Mental health is characterized by a sense of purpose or a sense of coherence in the widely chaotic world of medications or psychotherapies. 

We need to structure either therapy to make sense of this chaos - give some method to the madness. 

Flexibility and resiliency can be developed only with exposure.  Exposure to stress or difficult situations only teaches the human mind as to how to overcome these stresses or difficult situations. 

These are ingrained in our DNA and passed on to the next generation.  While we know that humans are because of our DNA we also know - now - that life experiences also contribute to the DNA. 

This novel method of thinking is known as "epigenetics". Therefore, hardiness, although largely genetic can also be developed by exposure to stress and passed on to the next generation.  This would give new meaning to the phrase - "survival of the fittest".

There is evidence in large randomized controlled trials (RCTs) in the scientific research world regarding the efficacy of many psychotropic medications i.e. the medications used in treating mental health conditions.  

I also believe that there is a lot of use of these medications in routine use, having used them with patients with mental health disorders for the many years that I have practiced psychiatry as well as being a resident trainee in post graduate training programs in the United States.  

However, there are cultural variables in the acceptance of these medications.  The cultural variables are explained by the fact that mental health was in general, i.e. all over the world, not a very well accepted pathology.  In a sense, mental health was not important till it was recognized most recently to be treatable.  

In the past mental health was treated as a curse or as a social malaise and people were institutionalized in penitentiaries or asylums and sometimes even put to the guillotine.  However, this fact has fast changed with the onset of scientific evidence for the existence of benefits with the use of psycho-therapeutic medications.

Now that we have concluded that therapy, either talk therapy or medication therapy or a combination of both, is helpful in depression and anxiety we need to know a bit about the medications that are given by us psychiatrists to patients.  

If you are prescribed a medication, be sure that you:

  • Tell the doctor all medications - either from classical medicine or otherwise and vitamin supplements you are already on.

  • Remind your doctor about allergies and problems you have had with past use of medicines.

  • Understand how to take the medicine before you start using it and take your medicine as instructed.

  • Don't take medicines prescribed for another person or give yours to someone else.

  • Call your doctor right away if you have any problems with your medicine or if you are worried that it might be doing more harm than good. Your doctor may be able to adjust the dose or change your prescription to a different one that may work better for you.

Inform you Doctor about medications and therapy you have taken

Lastly, when visiting with your psychiatrist or psychotherapist, kindly let them know that you are using only medications or only therapy or both as the case may be.  It sometimes is the case that when one is on therapy for certain conditions the other kind of therapy may not be needed. 

I also believe that medications are used in many cases to tide over an acute crisis situation and may be needed only for a short term in contradiction to the popular notion that medications for mental health conditions are used for a lifetime and that they cause side effects and are "harmful" for the body.  This is NOT true. 

One should weigh the risks versus the benefits of the medications and only then mull over the decision to take them or leave them.  This is true with psychotherapy or talk therapy or counseling as well.  It may be best to consult your primary health caregiver for deciding what may be best for you.

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When In Crisis - What Steps Should You Take?

When In Crisis - What Steps Should You Take?

Anger and temperamental issues are a very common part of a person’s identity. It is there from birth and is thought to mirror the hereditary qualities. It can be permanently present or could be triggered in certain situations. Some people have a hot temperament than others. However, there are a few ways with which temperamental issues can be dealt with effectively. These are as follows:


  1. Individual or group therapy sessions can be useful. A commonly utilised sort of treatment, psychological behavioural treatment treats people or groups with discontinuous unstable issues.
  2. Distinguish which circumstances or practices may trigger a forceful reaction
  3. Figure out how to overcome anger and control wrong reactions utilising procedures, for example, relaxing preparing, re-thinking circumstances (psychological rebuilding) and learning adapting attitudes.

Distinctive types of medications may help in the treatment of temperamentally unstable issues. These medicines may incorporate certain antidepressants (particularly specific serotonin reuptake inhibitors or SSRIs), anticonvulsant mind-set stabilisers or different medications if necessary.

Controlling your outrage
Some portion of your treatment may include:

  1. Unlearning issue conduct.
  2. Adapting admirably to anger.
  3. Rehearsing the systems you learn in treatment to help you perceive what triggers your fits and outrage and how to react in ways that work for you rather than against you.
  4. Building up an arrangement. Work with your specialist to build up an arrangement of activity for when you feel yourself getting irate. For instance, in case that you think you may lose control; try to expel yourself from that circumstance. Go for a walk or call a trusted friend to attempt to quiet down.
  5. Dodging liquor and other substance use. These substances can build forcefulness and the danger of harmful temperamental outrages.

Consider taking these actions before a crisis emerges:

  1. Call someone at home or someone you trust for help and guidance.
  2. Keep all guns away or covered up. Try not to give the abuser the key or use the gun.
  3. Gather a crisis pack that includes things you will require when you leave, for example, additional garments, keys, individual papers, medicines and cash. Conceal it or leave the pack with a trusted friend or neighbour. Try to go away from the situation so hat you do not do something regrettable.
  4. Educate a trusted neighbour or friend regarding your condition so that he or she can call for help if needed.
  5. Know where you will go and how you will arrive back in case that you feel angry, regardless of the possibility that it implies you need to leave during the night. You might need to work on escaping your home securely.
  6. Decide on a code word or visual flag that implies you require the police and tell it to your friends, family or your children.
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