If 4 symptoms present out of9 it is depression insomnia or more sleepy Lethargy dryness of mouth Constipation Suicidal thoughts Burning Somatic complaint Be focus relax yoga limitations God has much more then expected Adaptability is main You can't satisfy every body
At the age of almost 80 years and more than 40 years of psychiatric practice I could not find the first symptom of any mental disorder. I found a thick layer of dust on my ICD or DSM books that shows I do not give much importance to these books. Presently two bizarre thoughts are hammering me. What is the first sign of mental disorder (allow me to use the word "mental problem") and whether these books are only of academy importance or have very very helping tools in diagnosis in day to day practice.
Yes. Depression is the tip of the ice berg of mental illness. Under present circumstances of COVID pandemic every body is suffering from either one kind or another kind of mental illness.
An intelligent doctor may suspect depression from history and body language . but it is extremely difficult to diagnose bi polar disorder amd mix psychotic disorder for a non psychiatric doctor .
Iceberg phenomenon is the most common when it comes to depression.
It's important for us as medical professionals to understand that depression is as much neurobiological as it is psychological... It's important to notice the signs, counsel and refer the patients appropriately... It's not a sign of weakness in the side of the patients, it's a genuine call for help and support
Ayurveda explains Health as " Samadosha, samagnishcha samadhatu mala kriyaha.. Prasanna atma indriya manaha swasta iti abhideeyate" (sushruta samhita).. Means.. One is in perfect health when the functions of tridosha, sapta dhatu, trimala is normal with complete pleasant state of mind,.. So even the treatment approach will be two dimensional i.e physical and psychological.. Illness whether chronic or acute.. It's always include mental health.. The one with strong positive thinking will survive the worst, at the same time weak mind will face difficulties to face even simple fever
We should talk.i have seen patients feeling low ,in all different age groups We should often talk to our patients . We should be able to spend more time than normal. Well ! In my expirence I have dealt with quite more Ano rectal cases.. patients often feel bad about them selves ,they feel low as if it is sin.. after every sitting of kshara sutra..I make time to talk to them Counsel them makr them understand that it's totally normal and okay. I try to talk to the attendingor family and ask them to take care of patient., Their moods,I ask them what they do, how they behave , what are their thought processes. How they are taking any situation in their life Make them feel good about themselves. Because ultimately we want to heal them not just cure them I can be taking more time than any other doctor, while ops or IPs but I always consider talking to my patients even though if it takes that extra time.
Being a Doctor it's a huge responsibility for us to uplift the patients spirit.. N boost their confidence.. Hence doctors are called as "vaidya narayano hari".. So as he has faith in God he has faith in doctors also.. It's our responsibility to live it up
USEFUL AND VERY. HELPFUL INFORMATIVE UPDATE
Cases that would interest you
- Login to View the image
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 Likes5 Answers
- Login to View the image
14 year old girl brought with complaints of absent interactions with peers and teachers in school .Sitting eyes apparently closed inside class room .Not making eye contact with anyone. Deterioration in academic functioning also noticed. Decline started since four years which is gradual and interest in extracurricular activities is also coming down and absent now. Inside family atmosphere she functions well and takes initiatives to do outside trip to play areas,parks, cinemas. Irritability and occasional destructive behaviour also present inside house ,no change in biological functioning reported. Whenever her school mates visited her house she was in distress and there was irritability.Recently she seems to wear a scarf over head when she goes to outside house where there is likely to meet her school mates.Some excessive concern about cleanliness also noticed. Family history of depression in mother delusional disorder in father and suicide and substance use disorder in second degree relatives.Interpersonal issues between parents present. MSE revealed Poor but possible rapport, Slightly reduced range of affect, slightly reduced reactivity, low mood , sibling rivalry,no egodystonic distress regarding her problems also noticed.No hallucinations or delusion .No depressive or suicidal ideation. Unable to self appreciate fully her dysfunctions and unable to elaborate on reasons. physical examination nil significant.No history of abuse reported. How you proceed with the case ?Dr. Saleem Pallisserikuzhiyil1 Like25 Answers
- Login to View the image
The syndrome is associated with abdominal pain, nausea, vomiting, Obstruction and peritonitis, which depends on the size of this structure. Identify the structure and this extremely rare conditionSamarth Goyal4 Likes20 Answers
- Login to View the image
35 year old female presented with wrist Slash, telling some one told me to do so. she is married having two children.No significant stressors.History suggestive of psychotic illness for past four years which is episodic. Poor compliance with treatment.Premorbid personality well adjusted.No history of BPAD or MDD. when the patient reported she was on olanzepine 15 mg and sertraline 50 mg from a psychiatrist when she tried self harm now for first time.Mood depressed ,no depressive ideas ,percecutary and referential ideas present along with pseudohallucination commanding to commit suicide. Also complaints of palpitations,fear , running out behaviour in response to pseudohallucination. Olanzepine uptitrated to 25 mg, Sertraline changed to desvenlafaxine 50 mg along with bzd considering associated low mood which was persisting.Parient became euthymic suicidal ideation disappeared full improvement noticed in 20 days. Suddenly next day started pseudohallucination and running out behaviour,mood changes ,dsh ideation. Considering the primary diagnosis of Psychosis , possible worsening of psychotic features with SNRI desvenlafaxine stopped.Patient returned to premorbid level in one week and discharged on olanzepine 25 mg and bzd. Due to complaints of sedation bzd tapered down next visit and within two days patient attempted suicide telling commanding hallucination. How can be proceeded with the case . Please opine. @Dr. Shama Rathod @Dr. Sumi AswinDr. Saleem Pallisserikuzhiyil3 Likes17 Answers
- Login to View the image
Ayurveda and Mental Health BACK GROUND Psychiatric illnesses are fundamentally no different from medical illness. Historically, illnesses in which there was prominent disturbance of psychological function or behavior and no obvious pathology came to be regarded as psychiatric. However, modern world now knows that there is demonstrably altered brain function in many psychiatric disorders; also psychiatric illness is no less real or less deserving of care than are medical conditions. Ayurveda defines health as a state of equilibrium of tridosha, trimala, sapatadhatu and homoeostasis of mind as well as sense organs. Grahachikitsa is one among the eight major branches of Ayurveda that deals with prevention and management of mental problems. In spite of great advancement in the science of psychiatry, since decades the problems retained with the management of a certain mental problems like anxiety, stress, mental retardation etc. have not fully solved. In addition to this, adverse effect of anti-psychotic; anxiolytic medication is also creating considerable amount of discomfort to the patient. At this juncture, need is felt for he exposition and adaptation of such therapies that could effectively tackle these conditions without adverse events. EXPOSITION OF PSYCHE: AYURVEDIC VIEW: The mind or manas is considered three dimensional in terms of three gunas viz. sattva, rajas and tamas. The raja represents activity and dynamism while the tamas denotes inertia and darkness. Sattva is the state of pure mind with absolute balance when both the extreme qualities of mind viz. rajas and tamas cease or merge in each other. It is believed that all mental illness are because of the disorders of rajas and tamas. Sattva is never the cause of illness. This is why rajas and tamas are also called manas doshas. In consideration of the trigunas, Ayurvedic puts forward that there can be three broad categories of mental personalities or prakritis viz. sattvik prakriti, rajasik prakriti and tamasik prakritis. These three on the basis of finer consideration are further divided into 16 manas prakritis or mental traits. These 16 personality traits are characterized with unique features, which may also predispose specific mental diseases simulating 16 personality factors (16PF) of modern psychology. According to Ayurveda, Mind is a Sensory as well as a Motor organ, because the impulse of Action of a Sensory organ like the Human Eye and a Motor function like speech are due to Mind only. Mind is amalgamated to Touch Sense. Touch sense is present all over the Body (Area of Consciousness). The sense of Touch and also the corresponding faculty in Mind in which the duel cause- is yields pleasurable and painful sensations. This also links Mind with the Body Metabolism. Mind exerts a special effect on the Metabolism of the Body. Ayurveda regards three metabolic elements present in our body. These are called Vata, Pitta and Kapha. They are nothing but the Biological representatives of the five basic proto-elements, in the Body. These three are responsible for normal physiological functions or pathological Disorders. Their Balanced state results in normal Healthy Life while their physiological Imbalance is responsible for Body Metabolism. Similarly the disturbed Mental States also disturb the balance of these three Biological elements, which in turn cause Body Disorders. Hence Disorders emerges as results of visciation of both the body and the Mind. Thus interaction of Body and Mind is well thought of in Ayurveda. As stated beforehand, Mind is ultimately the Stronghold of the Body. Hence Ayurveda regards mind as the Keymaster in causing Body disorders through visciation of the three Biological Elements and vice-versa. THE MENTAL HEALTH AND ILL HEALTH: AN OVERVIEW: It can be concluded that consciousness, mind and body disorders are invariably interlinked with each other. Most of the body disorders can be well averted by achieving a higher state of consciousness and a healthy mental state. Ayurveda strongly advocates Mental Health Care for keeping sound Mental Hygiene. Human Mind is like the strongheld of the Horses Indriyani (organs) of the Chariot). Sharira (body) lead by buddhi (Intelect) for the Master Self (Soul). One become wise by properly holding his Mind under control. Mind thus controlled leads the Body in proper orderly manner. Otherwise an uncontrolled Mind goes astray and provokes temporary lasting, untruly, destructive activities. Hence Ayurveda preaches sound Mental Hygiene by adoring Truth and avoiding untruth in short. Rasayan (rejuvinisation) is the method by which old age and disorders are avoided by increasing natural body immunity. Besides intake of certain drugs, it can be achieved by following Mental Hygiene also. This is called as Achara Rasayana, According to Ayurvedic, mental health is a state of sensorial, mental, intellectual and spiritual well-being. The mental ill health is brought about essentially as a result of unwholesome interaction between the individual and his environment. This interaction operates through three fundamental factors viz. Kala (time rhythm) ie the deficient excessive or perverted aspects of seasons etc. Indriyartha (sensorial inputs) i.e. deficient, excessive or perverted use of senses. Buddhi (intellect) i.e. volitional transgression. When the intelligence, retaining and controlling powers and memory of an individual are distracted and in that state when he performs wrong actions, then it is called volitional transgression. It is the perverted use of mind and intelligence or faulty understanding (pragyaparadha). Ayurveda believes in the theory of punarjanma (reincarnation) and Karma (actions of past life). Accordingly, the principal causative factors involved in mental illness are (1) genetic factors, (2) personality make up and (3) environmental factors. The mental disease in general is characterized by altered behavior, which may present with a wide range. The clinical diagnosis is done on the basis of pattern of alteration of the behavior and certain associated symptoms and signs. An over all view of the total Ayurvedic literature available in the context of ancient psychiatry would reveal that Ayurveda describes in detail all possible clinical entities of psychiatric illness as comparable to the contemporary sciences. The common psychiatric diseases described in Ayurveda are different kinds of unmade (psychosis), apasmara (convulsive disorders), chittodvega (anxiety disorders), chittavasada (depressive illness), mada (alcoholism and drug abuse), murcchha, smanyasa(condition associated unconsciousness). PRINCIPLES OF MANAGEMENT: The treatment modalities described in Ayurvedic classics include-: Daiva Vyapashraya: Spiritual therapy that includes the use of mantra, japa, other religious activities and wearing of precious stones etc. Satvavajaya: Psycho-behavioral therapy incorporating the principles of assurance therapy (ashvasana), replacement of emotions and psycho-shock therapy. Yukti vyapashraya chikitsa: Biological therapy includes samshodhan (cleansing therapy/panchkarma), and shaman therapy (pacification) The patient is subjected to biocleansing therapy in order to cleanse the channels of the body followed by shaman therapy or palliative treatment with the help of drug, dietetics and life style. A number of single and compound medhya (promoters of intellectual faculties) formulations are used in Ayurveda for the treatment of mental diseases. These are believed to act as brain tonics and adaptogens. The medhya drugs are considered as specific molecular nutrients for the brain providing a better mental health leading in turn to alleviation of the behavioral alterations. Source : CCRASDr. Hemant Adhikari7 Likes13 Answers