Dr.Aneesh Baweja

Depression is more than just feeling low or down. It is a serious illness that is caused by various changes in the brain chemistry. There are a lot of factors that cause depression, which range from genetics to change in hormone level, stress, grief, medical conditions and other life circumstances. All these can lead to depression and that is something which does not go away on its own. However, there are a few efficient ways through which patients can deal with depression. These are as follows:

Exercise: Taking a brisk walk for fifteen to twenty minutes every day can be very healthy, not only for your body, but also for your mental health as well. Dancing, jogging, cycling and yoga are alternatives as well. Although, people who are depressed might not feel like doing any of those things, but one should try to do them anyway. Once a person gets into the exercising routine, they will start noticing the change in their mood. Deep breathing, yoga exercises and meditation can also help people feel better and less depressed.
Anti-depressants: Three brain chemicals that are responsible for handling your mood are norepinephrine, serotonin and dopamine. During depression, the brain circuits that make use of these chemicals stop working properly. In this case, antidepressants can be very useful. These tweak the chemicals that run through the brain and help improve your overall mood.
Psychotherapy: It is a method through which therapists find out a person s everyday stressors. This therapy is a powerful treatment for depression. Combining psychotherapy with medications can be even better and more effective. This also makes the symptoms easier to take. When a person talks about his feelings and problems with a stranger, it can help him or her release certain amount of stress.
Social support: Talking to a friend or attending group therapies has proven to be beneficial. However, it is important that the person you talk to is someone who you will feel comfortable around. Therefore, it could be someone you know or someone who empathises with you. This is possible either with your close ones or group therapies where the people you talk with, have been going through the same problem you have.
Meditation: Calmness and meditation can help you channelize your positive energy and thoughts over the negative ones. It can help a person see new perspective, develop forgiveness and compassion. Much like exercise, meditating briefly can help you gain immediate effects. It helps a person get over depression. This happens over time. One might not be successful in releasing their stress at once. It is a process that takes time.
The treatment that you get for your depression will depend on the kind of depression that you have. Some might get psychotherapy while others might get antidepressants or for some, exercise could be enough.

Social anxiety disorder or social anxiety phobia is characterised by an extreme and often, unrealistic fear of social situations and scenarios. A patient suffering from this condition will usually be ridden with self-confidence and a sense of intense nervousness, as if he or she is being constantly watched and scrutinised. It may be caused by biological, psychological or environmental factors. Let us find out ten ways of getting over the same.

CBT: CBT or cognitive behavioural therapy is a form of talk therapy that allows a patient to speak with a psychologist or psychiatrist, so as to find out the root cause of the condition. This form of theory helps in arriving at ways of overcoming the feelings of nervousness in social situations.
Practice going out with smaller groups: It is said that sticking to small and intimate groups can help in overcoming the hesitation and self-esteem issues that many of these patients feel. Once they are comfortable, they can take on larger groups.
Medication: Antidepressants and beta blockers are sometimes prescribed along with other kinds of medication, for patients who are unable to control their intense anxiety in social situations.
Face the fear: A little introspection will help you arrive at the reason or root cause of your anxiety. This can help in facing the fears and tackling them. You can talk about these fears with someone.
Unhelpful thinking: Tackle unhelpful thinking where you imagine people are looking at you in a certain way because they must be judging you. Tell yourself over and over until you believe that it is not true.
Focus on yourself: The key is to focus on yourself instead of getting hooked on to what others may be thinking about you. This will help in banishing negative thoughts.
Be in the present: Practice deep breathing or meditation to bring yourself back to the present every time you begin to think about what people may be thinking about you when you are in a social scenario.
Lifestyle changes: Drinking less and not smoking at all can also help in the better production of hormones that will help in balanced thinking, especially in anxiety-ridden situations.
Group therapy: Much like CBT, group therapy gives you space and platform to voice your fears and anxiety. The advantage of this kind of therapy is that you can also hear the stories and fears of other people, which will give you some point of reference when it comes to overcoming your own fears.
Communication skills: You can go to a counsellor or get soft skills training for better communication skills, which will help you improve your social interactions. This, in turn, will give you much confidence to deal with the world outside.

Bipolar disorder is also known as maniac depression. This usually sets in low and high moods in a person along with change 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 hallucination 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, high se drive, 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.

Treatment:

Medicines which involve mood stabilizers such as lamotrigine, valproate, lithium, carbamazepine and antipsychotics such as olanzapine, quetiapine should be taken. Psychotherapy is also recommended.

Previously known as multiple personality disorder or simply, split personality disorder, dissociative identity disorder is a very serious and unpleasant form of dissociation. It is based on a lack of connection, or rather a discontinuity in thought, action, feeling, memory or even a misplaced sense of identity. It is usually considered to be a result of severe traumatic experiences in early childhood, varying from extremely physical to repeated emotional or sexual abuse. It is thought to be a self-defence mechanism where the person dissociates himself from any such experience or situation that would deem to be harmful to his or her conscious self. It is, however, not to be confused with schizophrenia

Symptoms

There are innumerable indicators that point towards dissociative identity disorder. Some of them include:

- Severe depression
- Sleeping problems such as insomnia or sleep apnea
- Alcohol or drug abuse
- Anxiety attacks and phobias
- Suicidal tendencies
- Abnormal rituals and compulsions
- Visual or auditory hallucinations
- Self-persecution and self-sabotage tendencies
- Time-loss and amnesia
- Mood swings
- Headaches and migraines
- Inability to remember important personal information
- 'Switching' of identities

Causes

The main causes of split personality disorder are unfortunately still unclear and vague although 99% of persons who suffer from this disorder have a severe traumatic history or background. The causes need not necessarily be physical or sexual abuse. It could also stem from emotional abuse like insistent neglect. Studies have also shown that children may become dissociative if their parents are either too strict or unpredictable.

Business world has evolved in the past few decades in such a manner where small businesses grow to become corporate. The world is increasingly being dominated by corporations and a significant number of people also work in these places.

Stress and The Corporate World:

One of the things that come along with the corporate environment is stress as it brings with it an entirely new lifestyle. Irregular food habits, odd shift durations, insufficient sleeping hours and extremely tough work situations are all part and parcel of this corporate world. Although highly rewarding in the path of materialistic pursuits, it squeezes out your life-force and pushes you to stress and other diseases such as:

Depression

Diabetes

Blood Pressure

Asthma

Migraines and

Acidity and other gastrointestinal problems just to mention a few.

Methods to Deal with Stress in the Corporate World:

In the corporate world, the level of stress proliferates quickly and very few workplaces actually harbor a healthy atmosphere to look after their employees. Thus you have to take steps to reduce stress by yourself. Here are some of the ways by which you can save yourself from the parasite of stress.

You may often feel everything around you going haywire in your workplace. The next time you have this notion, try gathering your focus on everything that is going right instead. Let optimism fill your day and keep your cool knowing that losing it will only cause you harm.

At work, when hours fall short for achieving your target, keep a To-Do list to manage your priorities in an efficient and organized way.

For most people work seems to engulf their entire life. Do not allow this to happen at any cost. Maintain a healthy balance between your office and your personal commitments. Make time for the people you love.

Take short breaks in between your work to rejuvenate your energy level.

Try out methods of relaxation, for instance a long walk, a hot bath, yoga or meditation.

Assess your work at the end of the day as well as set a schedule plan for the tasks to be completed on the following day.

Engage in hobbies like drawing, painting, dancing and gardening or music to disconnect from the pressures of the corporate world.

Pay a visit to a psychologist or a stress management workshop to de-stress yourself.

Nowadays, drug abuse is a universally condemned action such that selling certain drugs are illegal. Children are not allowed to take drugs until they reach a certain age such as 21 for most states in India. Lots of problems start occurring when you are addicted to a certain drug. It is also nearly impossible to stop since the nerve cells change the way they function due to drugs. These nerve cells overstimulate the 'reward circuit' of the brain. This means that your brain constantly needs to be 'rewarded' and this reward comes in the form of drugs. There are many reasons why people become addicts and here are some of them.

1. People want to get high
This is perhaps the most common reason why people become drug addicts. The moment they take in one drug, they love the feeling they get so much that they keep wanting to go back to it.
2. People want to fit in
This is also a very common reason. When all your friends and perhaps even your bosses and other superiors are taking drugs, you do not want to feel left out or ostracized by your friend group. This is why many people start taking drugs.
3. Unintentionally taking drugs due to injuries or medical conditions
Sometimes a doctor prescribes a medicine for a certain time period but it does not work or works too well and so you keep taking the drug so that you will feel better. This happens more often than you think.
4. People take drugs to relieve stress
This is another very common reason why people take drugs. You may easily rationalize with them thinking that taking drugs is a good way to relax from work and family pressures. However, the long term effects of taking drugs are much worse than the stress.
5. Boredom from daily life
In young teens and adolescents especially, life can be so boring that they want to try something new and thus resort to drug abuse.

The first question when you greet somebody is 'how are you' and this often refers to our state of well-being. While most answers would be great, awesome or good, we usually think of how we are doing physically. While some of us may talk about physical conditions (say things like feverish, have a cold, etc.), not many would think of talking about mental health conditions. However, mental health is very important for overall well-being.

Can you think of someone who is severely depressed or anxious all the time and have a good physical health? Chances are very bleak, and if you consider the overall health as a mix of mental and physical balance, this is not possible. Read on to understand how important mental health is and why you should start paying more attention to it.

Improved physical health: If someone is in a stressed state, it is obvious that they would not be able to do the activities they enjoy. Being affected mentally also leads to reduced immunity and sleep disturbances, making the person prone to infections and other disorders. Stress is one of the main risk factors for chronic medical conditions like heart disease and diabetes.
Improved prognosis: Most often, doctors focus on treating the physical aspects of a person s health. However, with recent emphasis on mental health, more and more doctors are looking at wholesome measures to improve a person s health. Results show that when a person s mental health is also addressed, the physical ailments respond very well.
Improved productivity: People with unattended mental health disorders often resort to absence from work and/or school, can have financial instability, be homeless and can fall repeatedly. Being mentally healthy provides overall changed perspective of life and therefore improves productivity.
Improved personal relationships: Children of people affected with mental illness are prone to neglect, abuse, rejection, and behavioural issues. There is also social isolation, which may lead into adulthood, and these children may also have emotional health problems. Others in the close circle including spouses, siblings, parents, close friends and colleagues would be clearly affected by a person who is mentally unhealthy.
Social effects: These people are highly prone to social crimes like rape, murder, theft, violence, etc. They may not be able to afford their treatment and/or resort to these crimes to assert themselves.
Improved quality of life: Life expectancy is higher in people who are mentally healthy. Even with mild symptoms of anxiety and depression, this is reduced, and the chances of a happier, healthier life are reduced.
Whatever the effect, mental health needs to be addressed as equally as we do physical problems, using medications, counselling, or lifestyle changes.

Kleptomania is a form of psychiatric disorder. It is a difficult disorder, and an affected person experiences a lot of shame, remorse, stress or feels guilt, which are associated with stealing. It is categorized as an impulse control disorder which affects the behavior of a patient. Kleptomania may be associated with obsessive-compulsive disorder. The patient develops an impulse to steal and cannot control this impulse and later feels guilty.

Here are several tips which you can use in order to deal with kleptomania.

Understanding the situation: It must be clearly understood that a kleptomaniac person does not steal with the intention of becoming rich. It is done only for mental satisfaction and to pacify the urge of stealing that comes from within to an affected person. The patient usually does not care about the object he steals, but he only cares about the act of stealing. Usually, kleptomaniac patients steal insignificant things. When an affected patient becomes extremely nervous or fearful, they tend to steal an object. After the act, they feel much better and relieved. Later, a feeling of guilt arises in the person about his stealing act.
Treat the affected person gently: A kleptomaniac person requires love, care and great understanding from his/her loved ones or family members in order to recover. The problem and the situation must be recognized and perceived carefully. A person close to the patient should deal with him gently and try to make him understand. In many situations, a kleptomaniac may be aware of his actions but does not confess to avoid harassment.
The situation is different from stealing: It must be kept in mind that the actions of a kleptomaniac cannot be exactly termed as stealing. Stealing is an organized activity done by conscious individuals in order to gain something material or money related. Kleptomania is an act of impulse which a patient conducts for psychological satisfaction. The patients are fully aware that stealing is not the right thing, but yet they cannot control their impulse to steal.
Treatment procedures: Once a kleptomaniac person accepts that they are suffering from a disorder, professional help must be taken. Cognitive Behavior Therapy is the primary treatment for kleptomania. This includes aversion therapy where a distraction is created when a person develops the impulse to steal an object. Systematic desensitization is another process where a patient is made to imagine a scenario to get over the urge of stealing. Covert desensitization makes a patient imagine negative impacts of the stealing act such as arrest or harassment.
The social life of a kleptomaniac becomes very difficult and both the patient, and his family are subjected to a lot of trouble and harassment. Necessary measures must be taken for kleptomania.

One of the emerging psychiatric disorder that has significant medical and psychiatric consequences is compulsive sexual behaviour or hypersexuality, is an obsession with sexual thoughts in which people cannot manage their sexual behaviour. It may involve a commonly enjoyable sexual experience as self-stimulation which becomes an obsession. The person suffering from the condition may also get involved in sexual behaviours that are outside the bounds of commonly accepted conduct like paying for sex or having extramarital affairs.

Untreated compulsive sexual behaviour damages one s self-esteem, health, job, relationships and career. However, with treatment and self-help, one can manage compulsive sexual behaviour and learn to manage one s urge. Males are more likely to be unfaithful than females because they have stronger sexual impulses and weaker self-control. Compulsive sexual behaviour symptoms vary in type and severity. During intense sexual impulses, one feels as if they're beyond control. This is the first and the most common symptom as the patient uses compulsive sexual behaviour as an escape route for problems like loneliness, depression, anxiety and stress. One has trouble establishing and maintaining emotional closeness, even if one is married or in a committed relationship.

The treatment for compulsive sexual behaviour involves psychotherapy and medications. A primary goal of treatment is to help one manage urges and reduce excessive behaviours while maintaining healthy sexual activities. If one has compulsive sexual behaviour, one may need treatment for mental health condition. People with compulsive sexual behaviour often have alcohol or drug abuse problems or a mood disorder such as depression.

Counselling sessions can help one learn how to manage one s compulsive sexual behaviour. Intensive treatment programs for compulsive sexual behaviours focus on identification of core triggers and beliefs about sexual addiction. It assists in development of healthier choices and coping skills to minimize urges and deal with the preoccupation of sexual addiction. Psychodynamic psychotherapy can prove to be very useful as it focuses on increasing one s awareness of unconscious thoughts and behaviours, and developing new insights into their motivations. Resolving conflicts using this therapy is also recommended. The other kind of treatment program is cognitive behavioural therapy. This therapy helps one to identify unhealthy, negative beliefs and behaviours and replace them with healthy, positive ones. Family therapy and couples therapy may restore trust, minimize shame and guilt thus establishing a healthy sexual relationship between partners.

Medications include anti-depressants like selective serotonin reuptake inhibitors, mood stabilizers and anti-androgens have also been used to treat compulsive sexual behaviour. Anti-androgens are prescribed as it reduces the biological effects of sex hormones in men thus reducing sexual urges. Luteinizing hormone is also prescribed as it reduces obsessive sexual thoughts by reducing the production of testosterone. Anti-seizure medications, naltrexone, and medications which decrease male hormones have been found to decrease the compulsive urges and impulses associated with sexual addictions for some sufferers.

What are mood swings?
Mood swings are defined as sudden and abrupt changes in mood. These mood swings can sometimes help promote problem solving abilities, but a stronger form of these can be associated to a more complex disorder namely, bipolar disorder that is characterised by the cyclical shift from manic to depressive and vice versa.

What causes mood swings?
There are several things that can trigger mood swings starting from your brain chemistry to substance abuse. The most common cause of moods swings can be-

Abnormal levels of neurotransmitters (NTs) in the brain (ex. Serotonin is majorly responsible for change in moods, changes in emotional state and sleep)
Anabolic steroid abuse
Borderline personality Disorder
Autism or other pervasive developmental disorders
Epilepsy
Premenstrual Syndrome
Schizophrenia
Major depression
Post traumatic stress disorder
How to deal with mood swings?
Mood swings can make life difficult for yourself and those around you as well. It is advisable to keep your mood swings under control in order to get along with your life normally.

Try to remain positive: May be you have had a string of heartbreaks off late or failed interviews, but do not let that define a trend in your life. This can lead to depression and make you upset. Keep your mind open to other possibilities and never lose hope. Hope is something that keeps one going; it gives someone a purpose in life.
Balance your life: Learn to maintain a balance between work and leisure. Don t make your life all about work, take small breaks to do what you like (perhaps read a book, or play an instrument).
Accept the grey in your life: Life is like a box of chocolates . You will never know what comes your way. It is never just black and white. Learn to accept that life can go a little downhill sometimes, but don t be too alarmed by that. Enjoy the best and always keep yourself prepared for the worse.
Learn to laugh: Enjoy and appreciate the little things around you. It might surprise you, if you consciously look around with an open mind, you will see the miniscule things that may make you laugh. Maybe that neighbour you find annoying is actually a fun guy to be with or that aunty who is always badgering you with questions is actually concerned about you. And most of all learn how to laugh at yourself! People have made a career over doing that. There is absolutely nothing wrong with that. You are more fun than you expected to be.