Bipolar disorder ( Swing of mood ) In present in all but symptoms are not of much visible or very much negligible under present circumstances of covid sign and symptoms are more prominent and needs councelling and treatment generally DEPRESSION is prominent on and needs reassurance and periodical and regular monitoring and evaluation.
Bipolar disorders are seen in routine practice and not difficult to diagnose if pt is familiar to practionar Early diagnosis is key to control Most pt comes in depressive state but careful personal interview leads to know the swing of mood and how aggression or hyper the mood swings With limitations treatment is to be given and prescribed by psychiatrists only as misuse of drugs can lead to calamities
Bipolar disorders.. Definition.. nice illustration.. Diagnosis of Bipolar Disorders.. System of patient nice illustration. Treatment.. Management.. Nice presentation thanks doctor Useful information.
Bipolar Disorder is a mental health condition that causes extreme mood swings like Mania & Depression. Management of Bipolar Mood Disorder are with medication , meditation & Yogic excercises , Balanced diet also play crucial role for management of Bipolar Mood Disorder. Nicely explained.
? MANIC DEPRESSION .. DISORDER ASSOCIATED WITH .. MOOD SWINGS .. USEFUL .. INFORMATIVE .. POST ..
NICE ILLUSTRATION SCHIXOPHERNIA IS A KIND OF MAJOR MENTAL ILLNESS WITH BI-POLAR DEPRESSION IT HAS A GENETIC PREDESPOSITIIN MOST OF TGE TIMES THEIR IFAMIKY HISTORY OF DEPRESDION THIS DISORDER OFTEN IS TRIGERED BY LOSS IF JOB FAILURE IN EXAMINATION DEATH OF CLOSE RELATIVE BROKEN MARTIAGE MAJOR MENTAL ILLNESS NEEDS REGULAR PERIODIC PSYCHIATRIC CONSUKTATION REHULAR INTAKEBIF DRUGS THEY HAVE DENIAL MOOD SWINGS EITHER DO NOTBTSLK OR 3XCESDIVE TALKING MANIA SUSPICIOUS BEHAVIUR LOSS OF INTERST IN WORK FATIGUE LOSS OF SECUAL DESIRE INSOMNIA ESRLY ARIUSAL FROM SLEEP LACK.OF INTERETNIN WORK LOW CONFENDENCE
Nice presentation:Bipolar Disorders (MDP) is one of two major psychosis and prevalence is 7% ,not a lesser numbers in India. What is the effect of covid pandemic on such people has to be investigated and properly managed to nullify the effects .
Very informative and useful presentation on Bipolar Disorders. Thanks for sharing useful presentation Sir
Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Very much useful I have encountered with various patients, in Current situation, this will help various medicis to distinguish between manic and depressive disorders
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Bi - Polar Disorder A person with bipolar disorder probably doesn’t fit the stereotype you have in mind. You might be surprised to learn that bipolar disorder isn’t just classified by out-of-control highs or suicidal lows. While these ups and downs certainly happen, there are also periods of normalcy mixed in on a regular basis. Another common misconception about people diagnosed with bipolar disorder is that they spend more time experiencing depression as opposed to mania. This is because people suffering from bipolar disorder are more likely to seek help when they are having a depressive episode than when having a manic episode. In fact, many people suffering from bipolar disorder keep their illness private for fear of judgment or punishment, especially in the workplace. What is bipolar disorder? Bipolar disorder, or “manic-depressive illness,” is a chronic mental illness. People with bipolar disorder often experience uncontrollable high and low moods known as mania and depression, respectively. A person’s medical history is important to accurately diagnose bipolar disorder because it is not a one-size-fits-all disease. People with depression only, also called “unipolar depression,” do not experience the highs and lows of mania. However, some people with depression may also experience some manic symptoms, this is known as “major depressive disorder.” The symptoms of bipolar disorder can also mimic those of other ailments, and people with bipolar disorder typically have another disorder or disease such as anxiety disorder, thyroid disease, migraines and headaches, so it can be hard for a doctor to make an accurate diagnosis. The condition can be controlled with self-management, a good treatment plan, and a high level of support. Four basic types of bipolar disorder Bipolar 1 Disorder Manic episodes lasting at least 7 days; or by symptoms so severe that the person needs immediate medical attention. Depressive episodes usually occur as well. Likely to experience depression along with the manic and depressive episodes. Bipolar II Disorder A distinct pattern of depressive and hypomaniac episodes, but not as severe as manic episodes experienced with Biopolar I. Cyclothymic Disorder Numerous periods of hypomaniac symptoms along with numerous periods of depressive symptoms lasting for at least 2 years in adults and 1 year in children and adolescents; however, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode. Other Specified and Unspecified Bipolar and Related Disorders Bipolar symptoms that do not match the criteria of Bipolar I, Bipolar II, or Cyclothymic Disorder. Mania is buying 3 new televisions on impulse; thinking you can buy your favorite restaurant; or deciding to run a 5K with no training–and insisting you will come in first. Hypomania is mania with a tether, and while it may lessen some of the financial and personal disasters sparked by unchecked mania, it can still feel like going the wrong way on a one-way road. What are the symptoms of bipolar disorder? Bipolar symptoms include extremely intense emotions/feelings, changes in activity level, disturbed sleep patterns, and other unusual behaviors. These tell-tale periods of symptoms are called “mood episodes.” To gauge the severity of a mood episode, one should compare the intensity of the attitudes and behaviors experienced during these unusual periods of time to what is typical and normal for that person. While jumping out of a moving car is not typical for most people, something like blabbering and talking fast may be normal for one person but not for another. Some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomania episode, a person may feel energized, productive, and euphoric — yet they may still feel in control. However, to others that know them well, the mood swings and fluctuations in attitudes and energy levels are very apparent and are a cause for concern. Without proper treatment, people with hypomania may develop severe mania and depression. A person with severe episodes may also experience psychotic symptoms which tend to match the extreme mood, e.g., hallucinations or delusions. A person having a manic episode may believe he is something he is not, e.g., rich or famous; while a person having a depressive episode may believe he is worthless or a failure. Sometimes a person with bipolar disorder who occasionally has psychotic symptoms may be misdiagnosed with schizophrenia. How is bipolar disorder diagnosed? No single cause has been identified for bipolar disorder. Scientists believe several factors may contribute to the illness, including genetics, stress, and the structure of the brain itself. It is important to talk to your healthcare professional(s). It is a good idea to get a complete physical and routine lab tests to rule out other conditions. If no obvious cause for the symptoms is found, a mental health professional, such as a psychiatrist who is experienced in diagnosing and treating bipolar disorder can perform a mental health evaluation. To be diagnosed with bipolar disorder, a person has to have had at least one episode of mania or hypomania. Bipolar disorder does not discriminate – it can affect anyone The average age of onset of bipolar disorder is 25. Every year, 2.9% of the U.S. population is diagnosed with bipolar disorder, with nearly 83% of cases being classified as severe. Bipolar disorder affects men and women equally. What is the treatment for bipolar disorder? Ironically, conventional drugs used to treat bipolar disorder are mostly psychotropic drugs that can induce more of the symptoms a sufferer is trying to beat, like anxiety, nervousness, impaired judgment, mania, hypomania, hallucinations, feelings of worthlessness, psychosis, and suicidal thoughts. Lithium is the best known medication for treating the disorder because it is a mood stabilizer and is effective in treating both mania and depression, as well as for preventing relapse. The bad news is that one-third of the patients who have taken lithium for over ten years have developed chronic renal failure from the drug, according to a study in the Journal of Psychopharmacology. Sometimes antidepressants are used to treat bipolar depression, but this can be controversial because of the possibility that an antidepressant can trigger a switch into mania. Behavioral or family focused therapies, as well as complementary health approaches such as meditation, faith and prayer, play a big part in developing self-management strategies for coping with bipolar disorder.Sushmita Haodijam4 Likes7 Answers
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Friends today I am discusing about depression, stress and fear . We at Kamla Clinic Railway Road Pathankot treat all chronic problems with holistic medicines without any side effect. Visit or book ur appoint ment by call or whatsapp @ 9463311100. Five to ten per cent of patients visiting their GP will be suffering from “clinical” or “major” depression. This means that as a GP, two to three of the patients I see in a normal working day will be experiencing debilitating and disabling symptoms of feeling down, depressed or hopeless and will have little interest or pleasure in doing things. Too many people still think that depression is “all in the mind” and there is a great deal of guilt felt by sufferers that they cannot just snap out of it. Having a “nervous breakdown” still carries a stigma, especially if symptoms are severe enough to need a hospital admission or referral to a psychiatrist. I spend a great deal of my professional life reassuring people that they are not going mad and their symptoms do have a rational explanation. As well as clinical depression, where symptoms are severe enough to affect day to day living, 15 to 30 per cent of my patients will have depressive symptoms but still manage to continue with work or home life without serious problems. This situation is referred to as “subthreshold” or “mild” depression, depending on the severity and number of symptoms. This is probably the largest group of patients with a psychological problem that I see in my surgery every day. People come with a variety of complaints, including a feeling of persistent fatigue, lack of appetite or excess appetite resulting in comfort eating, not being able to look forward to enjoyable events such as holidays or family celebrations, poor sleep, feelings of anxiety and low selfesteem, guilt for “not really being ill”, feelings of not coping, lack of interest in activities or relationships, loss of sex drive and generally feeling cut off from the world. Whilst most of us can experience all of these feelings at some time to a greater or lesser extent, it is when they last for weeks on end that we start to feel unwell and out of balance. It is in these circumstances that the body starts to need a little help to recover. The good mood hormone What causes depression? Most people know that our brain produces a “good mood” hormone called serotonin. If we do not produce enough of it or it gets broken down too quickly, then a low mood results. Quite what triggers off this chemical imbalance is the subject of hot debate by scientists, but its results are only too clear to sufferers of this common condition. There may be an inherited element to depression, possibly a genetic factor but scientists are unsure whether depression is due to nature or nurture. I suspect it is a mixture of both. Certainly I come across some people whose brains permanently seem to produce low levels of good mood hormone, meaning they always feel somewhat under par mentally. Treatment In the past, people with symptoms of depression or anxiety were often treated with tranquillizers, or benzodiazepines like diazepam (Valium). This is because depression is really a mixture of feeling low combined with symptoms of anxiety. The latter can range from waking up with a sinking feeling or butterflies in the stomach or panic attacks to full blown physical symptoms of acid indigestion, problems with swallowing, diarrhoea, a feeling of tightness in the throat, difficulty breathing, weight loss, and a sureness that “something serious is wrong with me”. Although tranquillizers may still be used by the medical profession if symptoms of anxiety are very severe, they are now generally recommended only for short term use (up to two weeks at a time). The most common medications for depression these days are antidepressants which help to rebalance the mood hormones, commonly selective serotonin reuptake inhibitors (SSRIs) and less often, the tricyclic antidepressants (TCAs). Talking therapies NICE suggests that GPs use either counselling or cognitive behavioural therapy (CBT) to treat mild depression. This has been shown to be more effective in the first instance than medication for most sufferers with less troublesome symptoms. I find the socalled talking therapies extremely useful to help people change their sometimes negative way of thinking and such treatments can be life changing, helping people regain normal function without a reliance on tablets. I have worked as a GP in both Dorset and Hampshire and have always been able to refer patients on the NHS, but waiting times for nonurgent cases have become longer and longer over recent years, as more and more people are referred. So although my patients and I can access this invaluable treatment free of charge, there can be a three to four month wait to see a therapist and sessions may be limited to a certain number rather than what the individual really needs. This can be very frustrating for both client and therapist! Homeopathy’s place It is whilst waiting to see a therapist that I find homeopathy has a place for my patients. It can also be used as a sole treatment if patients do not feel that they want to see, or need to see a counsellor or therapist but nevertheless want some help to recover from their illness. I would emphasise that I am not suggesting that homeopathy should be used as the only treatment in serious depressive illness where there are feelings of wanting to die or a risk of suicide, or in mental health problems such as bipolar disorder (manic depression), schizophrenia or severe postnatal depression. These are complex and potentially life threatening illnesses and need advice from a psychiatrist alongside the GP and other healthcare professionals. Homeopathy may have a part to play as an additional or complementary treatment but NOT as a stand alone therapy in these situations. There are so many homeopathic medicines that can be used to treat the numerous symptoms of depression and anxiety that it can be difficult to know where to start. It is important to make sure that your symptoms are not due to another illness such as an underactive thyroid or a stomach ulcer, so please talk to your GP first to make sure of the diagnosis before starting homeopathic treatment. Arsenicum album One of the first medicines that I think of when I see someone with all the symptoms of anxiety with depression, particularly when there are gastric symptoms of indigestion and diarrhoea, combined with panic attacks, is Arsenicum album. This medicine is based on white arsenic which causes severe gastroenteritis if taken in a toxic dose, which is why it can help similar symptoms when taken in a homeopathic potency. Somebody doing well with Arsenicum will probably be neat, tidy but restless. They may look anxious and drawn and tend to have a fastidious way about them, being able to give a lot of detail to their symptoms. Often I find that such a patient has to tell me all their troubles in a very methodical but sometimes time consuming way. Arsenicum patients can be convinced that they have a physical illness which is being missed because they feel so ill and may in fact end up having a number of investigations such as endoscopy and colonoscopy before finally accepting what is wrong with them. They can feel that they will never be well again. Fear is a prominent symptom, causing apprehension and dread, with an overwhelming feeling that everything will go wrong, and they despair of their recovery. These can be patients that I have to try very hard to reassure and I will often use a 30c dose, three to four times a day, with Aconite 30c taken as needed if they are having additional panic attacks. Ignatia Where depression follows from bereavement, loss, or a shock, such as witnessing a fatal road accident, Ignatia can be useful. The symptom picture is typified by emotional ups and downs with mood swings and is often quoted in homeopathic reference books as “laughter alternating with tears”. Having suffered the loss of my own parents, I know myself the separation feeling that one undergoes when someone close to you dies and I remember being able to talk quite calmly one minute, and then being overcome with tears soon afterwards before becoming calm again a few minutes later. Often the sufferer can prove difficult for friends and loved ones to deal with as they are SO up and down, being resistant to sympathy and oversensitive to well meaning advice, which may be wrongly taken as criticism. Ignatia patients tend to “bottle things up” and cry and give deep sighs during the course of their consultation. It may be hard for them to talk if they are overcome with their miserable situation and friends can find it well nigh impossible to cheer up such patients. Poor sleep is common and so is the feeling of a ball or something stuck in the throat, known conventionally as globus syndrome. I often give a few Ignatia 30c tablets to recently bereaved patients to take when needed, especially around the time of the funeral, and will use a 200c on a weekly or monthly basis for persistent depressive symptoms. Natrum muriaticum Another remedy that can bottle things up, but reacts quite differently to the Ignatia patient is Natrum muriaticum. This is one of my most frequently used homeopathic treatments for symptoms of stress, such as those typified by mild depression. I find it very useful when a patient has never been well since a shock or loss and feel as if they have a glass wall between them and the rest of the world. Often they have been unable to cry since bereavement and feel that they have not grieved properly for their loss. They feel worse for sympathy yet are very empathetic people. They sometimes build up a barrier emotionally and can appear somewhat cold and distant. They can worry about upsetting people unintentionally by saying the wrong thing and also can take things the wrong way. I tend to view these people as the “salt of the earth” type, having a strong sense of duty, but can find themselves being overwhelmed by the responsibility of their work, especially if they are caring for an elderly or sick relative. Such patients can feel that they should be doing more, not less, and feel they must “just get on with it”, and yet feel more and more tired and low in spirit as time goes on. Grudges can build up, with resentment. There may be an increased sensitivity to noise; certain passages of music may move them to those long awaited tears, but without relief from their low mood. I have discovered to my cost that using too high a dose of Natrum mur can cause emotional upset without improving the symptoms of depression so I tend to use a one off dose of 200c when there is a clear history of a definite cause to the illness and a daily 30c dose if the trigger is less clear. Sepia When all energy is drained, and my patient feels that they are unworthy of anybody’s love or attention, I turn to Sepia, a remedy which I have written about in the past for its use in the menopause and postnatal depression. I have used this almost exclusively for women who are sad, silent, solitary individuals, completely lacking in zest. Tears are never far away and a feeling of having to keep emotions under control otherwise one will have to scream is typical of the strain that such patients can feel. There is a wish to keep busy but with no incentive to do so and these patients can spend hours sitting motionless in sadness. Sepia women will often tell me that they love their husbands or partners but cannot manage the physical side of the relationship, which they feel is starting to cause difficulties for their other halves. Sepia usually suits women who tend to feel chilly and they can either feel incredibly hungry, being unable to ever feel full or have nausea at the mere smell of food. They often have a sinking, or “allgone” feeling in the pit of the stomach, especially when they wake, which is not relieved by eating. Older people One area of depression and anxiety I would like to mention is that of the older patient. I am really referring to the over 75s and those perhaps with physical frailty or other health problems and not all “pensioners”, as the media seems to refer to anybody over the age of 60 these days. Depression in this older age group can sometimes give rise to symptoms of forgetfulness and memory loss and lead to a mistaken diagnosis of dementia or Alzheimer’s disease. This is why antidepressant medication is often given by doctors if such symptoms appear. Unfortunately it can take up to three months for conventional treatment to have a full effect, and because memory problems may affect an older person’s health, and their ability to stay at home to a great extent, doctors tend to treat earlier than later. If you have a sympathetic GP, or, even better, one that it is homeopathically trained, it may be possible to try a remedy such as Alumina for a trial period first. This is a homeopathic potency of aluminium and is indicated where there is confusion about time (“time seems to pass too slowly”), difficulty making decisions, unease in the evening (“as if something were going to happen”), involuntary weeping without cause and a dazed feeling, making mistakes in writing and speaking. All such symptoms are worse in the morning and tend to improve as the day goes on. An alternative to try is Baryta carb, which I have found especially helpful if symptoms are worse with worry or come on after a stroke. Both Alumina and Baryta carb can be given at 30c strength daily. Finding a quiet place Depression is all too often seen as a problem of women, and although it is true that twice as many female patients are treated for anxiety and depression as men, both sexes can be affected. However, it does not have to be the “black dog” that the late Winston Churchill suffered from and does not always need to be treated with medication. Regular exercise can help, as this increases the endorphins produced by the brain, which are responsible for the highs that athletes can experience. Many GPs can refer patients to local “exercise on prescription” schemes which often offer a supervised course of gym sessions at a reduced fee. Finding a quiet place, through meditation, painting or walking the dog, can really help rebalance the mind and body; too many patients look blank when I ask them “and what do you do for yourself?” after listening to what they do for others. Look for your own quiet place if any of the above applies to you and please take further advice. It will be worth it, I promise.Dr. Rajesh Gupta5 Likes5 Answers
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A 30 year old female patient came with the complaints of - Hair fall since 3 years - Mood swing and Irritable since 3 year - Facial hairs since 16-17 of age - Weight gain even after strict diet - Irregular menses since 6-7 months After taking in depth history I found - She is under stress since puberty, first for studies in school and college as father is teacher and wants her to perform excellent in studies, but she wants to be a singer and that his father dont like - She is very introvert - Parents wants her to marry now, but she is confused about arranged marriage - Works in a MNC and having very hectic schedule Prakriti Kapha-Pittaja Weight 70kg. BP 110/90 Koshtha Madhyam Agni Samanya Mala-Mutra Pravratti Samanya Artava - Scanty, Kunap Gandhi sometimes , Irregular Manas - Anxiety, Irritable, Aggressive Nindra - Ratri Jagran many times, 5-6 hours Thyroid Profile - Within Normal limits RBS - 130mg/dl Please share your valuable opinion on this case And Suggest the perfect AYUSH line of treatment.....Dr. Hemant Adhikari10 Likes33 Answers
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Bipolar disorder is a mood disorder which involves periods of excitability (mania)alternating with periods of depression. The "mood swings" between mania and depression can be very abrupt. Other names for bipolar disorder are 'bipolar affective disorder', 'manic depressive disorder', and 'manic depression'. Short Title Bipolar disorder Causes The exact cause of bipolar disorder is not known. It develops in late teens or early adulthood. Prevalence is similar in men and women. It usually appears between ages 15 - 25.It is an inherited disorder. Changes in neurotransmitter in the brain can cause the disease. Hormonal imbalance can also be considered responsible for bipolar disorder. Environmental factors like stress, abuse, major loss, and trauma are the predisposing factors for developing bipolar disorder. Clinical Presentation The disease can be of various types. Types of bipolar disorder are Bipolar disorder I, Bipolar disorder II, and Cyclothymia. In bipolar disorder I, there is at least one fully manic episode with periods of major depression. In the past, bipolar disorder I was called manic depression.Mania symptoms include agitation or irritation, elevated mood, inflated self-esteem (delusions of grandeur, false beliefs in special abilities), sleeplessness ,over-involvement in activities, poor temper control, tendency to be easily distracted,reckless behaviour such as binge eating, drinking, and/or drug use; unprotected sexual encounters. These symptoms of mania are seen with bipolar disorder I. In people with bipolar disorder II, hypomanic episodes involve similar symptoms that are less intense. In this, people seldom experience full-fledged mania. Instead they experience periods of hypomania. These hypomanic periods alternate with episodes of major depression.Depression symptoms such as feeling hopeless, sad, or empty, inability to experience pleasure, fatigue or loss of energy, physical and mental sluggishness, appetite or weight changes, sleep problems, difficulty concentrating, remembering, or making decisions, feelings of worthlessness or guilt. There may be withdrawal from activities that were once enjoyed, withdrawal from friends. Patient gets thoughts of death or suicide.Cyclothymia is amild form of bipolar disorder and involves periods of hypomania and mild depression, with less severe mood swings. Bipolar disorder not otherwise specified (BP-NOS)is the one in which the symptoms don't meet the diagnostic criteria of bipolar disorder I or II but the behaviour of the person is clearly an out of range behaviour. Rapid cycling bipolar disorder is a severe form of the disease in which patient has four or more episodes of major depression, mania, hypomania or mixed stated within period of one year. Investigations Medical history by the patient and Clinical examination by the psychiatrist helps in diagnosis. Positive family history helps to diagnose bipolar disorder. The diagnostic criterion is as follows - for bipolar disorder I there should have had at least one maniac or one mixed episode. For bipolar disorder II there shouldhave had at least one major depressive and one hypomaniac episode. For Cyclothymia, one has had several hypomaniac and periods of depression but never had major depression, full maniac or mixed episode. In this symptoms continue for two or more years. Treatment Psychotherapy is required for treating bipolar disorder.It involves cognitive behavioural therapy, which teaches anger management techniques, relaxation techniques. Getting enough sleep helps keep a stable mood in some patients. Medications like anti psychotics, anti-depressants, anti-anxiety drugs, mood stabilizers help in treatment of the disease.Electroconvulsive therapy (ECT)may be used to treat bipolar disorder. Individual and family and counselling will also help in managing bipolar disorder.Hospitalisation may be required in severe episodes of disease. Other Modes of Treatment The other modes of treatment can also be effective in treatingbipolar disorder.Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treatingbipolar disorder. Complications Untreated bipolar disorder can complicate into following serious problems: Drug and alcohol abuseSuicide or suicidal attemptsLegal and social issuesFinancial problemsRelationship problemsSocial isolation and lonelinessPoor performance at work or schoolFrequent absence from work/school Prevention Strategies that can help prevent minor symptoms aggravate into bipolar disorder include paying attention to initial warning episodes of depression or mania, avoiding alcohol or drug addiction, strictly following the prescribed medication schedule, informing the physician treating the patient before any kind of changes to medications or taking any additional medications as per condition. Facts and Figures The World Health Organization lists bipolar disorder as the sixth leading cause of disability in the world. About 4% of people in world suffer from bipolar disorder.Dr. Raj Pandey Mishra5 Likes10 Answers
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20 yr male known case of chronic pancreatitis....for past 3 yrs .. developed lesion as shown in the fig.over Lt forearm...no h/o trauma or suicidal attempts ... lesion was spontaneous and self limiting...Dr. Suriya Prakash Raja0 Like16 Answers