Articles on adolescence

Depression in Children and Adolescents – Not a Myth but a Candid Reality

Dr. R.Manoj, Psychologist
Many parents who come with specific behavioural or academic problems in children are taken aback when they are told that their child is depressed. The usage of the term depression itself makes the parents so uncomfortable that either they try to argue within the professional say that these may be temporary blues which every one experiences on regular basis caused by transient events or just fail to turn up for the next session. Some even request the professional not to mention the term “depression” in the report whenever the same is demanded by the professional or the institution that referred the child for consultation.One of the least recognised and acknowledge fact is children having depression.These are primarily because most of the adults feel that, children have no problems, worries or responsibilities which would make them prone to depression. But what they fail to understand is that the children’s problems, worries and responsibilities are big enough for them to become stressed and if adequate support is not available it can very well lead to depression. Moreover they are dependent on parents in every way, and the parents expect their children to live a life as per the parents aspirations and manage the problems by the methods and directions provided by the parents Any independent move by the child to handle their problems on their own or in consultation with anybody else is only felt as an act defiance which only leads to further pressure from the parents to tow the expected lines. These factors only create a feeling of powerlessness, lack of control and helplessness in children which only escalates the status in the children who are already stresses or prone to depression.In case of adolescents, most of the behavioural, cognitive and emotional changes are viewed as a natural part of their developmental process and parents turn a blind eye to their deterioration even when its obvious. It’s a well known fact that adolescence is a period of stress and storm and they have to handle multiple pressures both internal and external which can easily make them prone to depression. But parents never even think about the possibility even though they know that their child is undergoing a lot of turmoil which can be difficult for them to manage by themselves.The other important reason why parents find it difficult to acknowledge this fact is because children are not so articulate as adults in expressing their emotions. Most of the time it is manifested through behavioural problems or deterioration in performance, on various functionalities for which parents have their own interpretations which actually clouds their rational mind from looking into the possibility of the child being depressed.One more factor, that make diagnosis of depression challenging even for professionals is that most of the behavior and cognitive symptoms when existing alone can be diagnosed for other disorders such as mood deregulation disorder, oppositional defiant disorder, intermittent explosive disorder, attention-deficit / hyperactivity disorder, conduct disorder, anxiety disorders and autism spectrum disorders specifically Asperger's syndrome. In case of adolescence, it can also be diagnosed for substance use disorders. Many a times even when the parent decide to take a professional help they only project a single behaviour or problem which they feel as most significant or the most disruptive ignoring many other changes which they feel insignificant or the after effect of the significant one. This can mislead the professional and unless and otherwise the professional is willing to spend time to collect all other relevant information they may misdiagnose it for some other specific disorder. The difference between these disorders and childhood depression in childhood depression there are multiple symptoms along with explicitly noticeable emotionality. The other important difference is that the changes in behaviour, thought process and emotions occur in a short period of time which is quite obvious to people who see these children regularlyWhat every parent needs to understand is that depression in children are a reality, a highly prevalent mental health issue and its life threatening. The increase in the number of suicides among children and early adolescents for flimsy reasons which is just a nano percentage of the depressed population is the proof for the same. The prevalence rate of depressive disorder is estimated to be 2% in children and 4-8% in adolescence and 70% of children with a single depressive episode will experience a recurrence within five years, with the Lifetime prevalence of depressive episode being 20% by the end of adolescence.Untreated depression in children, can lead to devastating consequences, including consistent problems in school, at home and with friends, the loss of critical developmental years, increased risk for antisocial behavior and in some cases even suicide. Just like every other health issues depression in children can also be cured with early diagnosis and appropriate intervention.Listed below are few signs and symptoms which you should look for in your child which would be early warnings for you, of your child being prone to depression. These signs and symptoms can be categorized under four major functional areas of everyone’s life.BehavioralØ  There may be sudden or gradual changes in activity levels. They may show lack of interest in the activities which were pleasurable to them or even their day today responsibilities which they had been doing without ant push.  The child may either show lethargy in his activities or involve excessively in activities which the parents had been denying him from doingØ  School,refusal and high resistance to academic related activities  are one of the  symptoms which is commonly seenØ  Frequent expression of being tired and being bored about everything failure to involve in any of  his  activities inspite of  consistent encouragement can also be witnessedØ  There may be noticeable increase of sluggishness in their actions, reactions and even play and entertainment related activitiesØ  The children may withdrawal tendencies. They may suddenly or gradually move into isolation or keep themselves occupied in activities which are done in isolation such as playing video games. Places of isolation become their preferred and favourite ones and you can find them escaping to such places at the first opportunity.Ø  There may be a sudden or gradual loss of interest in family affairs or involvement with their favourite family member or even friends.Ø  In some children there may a dynamic opposite behaviour. They make show an increased level of dependency and express an exaggerated sense of insecurity in the form of fear of doing even very simple things such a short absence of parents.Ø  Sometimes the children may show  excessive interest in praying, repeating a few acts etc to ward off their fearØ  In some cases they may involve in self-injurious behaviour  hitting or biting themselves and in other times they may involve in reckless or aggressive behaviour for which they are sure to be punished physically. Sometimes it may even go the extend of attempting suicideØ  Sometimes they may become over-demanding and throw temper tantrums whenever their demands are not metØ  In case of adolescents there are possibilities of the child involving in substance abuse which includes, tobacco,  alcohol and other dangerous psychotropic drugsEmotionalØ  The child may look sad cry frequently for even simple issues or provocations which can be explicitly look as unreasonable. Some times the crying spells may for long spells even without any provocationØ  The child may show highly sensitive reactions such as being upset, disturbed, offended or disappointed even for simple criticisms or negative experienceØ  There may be a significant increase in expressed anger, and even aggressive reactions even without any reason. Sometimes they may pick up fights with their friends parents or siblings without any provocationØ  The child may become anxious, tensed and even panicky for no apparent reasons. They may show startled reactions even regular happens that happens abruptly such as noise of the horn etc.Ø  Expression of fear about even simple things, known people and situations , environments they have been already exposed to. They even show excessive avoidance  to everything they fear aboutØ  They may be seen worried, brooding a lot, getting irritated and frustrated even for very simple happenings frequently. They may also have difficulty in making choices regarding simple thingsPhysicalØ  There may be a significant change in appetite which may range from starving to overeating. This may even lead to significant weight loss or weight gain in a short period of time. Sometimes these children are found to be skipping regular meals and spending time munching junk foods excessively.Ø  They may also have sleeping problems which range from lack of sleep  to excessive sleep. In some cases the sleep is disturbed, the sleep cycle is disrupted and they may also have nightmares because of which they feel drowsy most of the time.Ø  The children who are depressed may also fake illness. In some other cases, they may complain of  pain in various parts of the body or even show symptoms of some specific illness which cannot be diagnosed by physical examinations.Ø  Enuresis (bed wetting) and encorpasis (inability to control their bowel movements) which develops after the control is already established also point towards depressionCognitive signsØ  There may be deterioration in attention and concentration which reflects in most of their activities. They may also been seen drifting into their fantasy world irrespective of the task they are engaged in. They also have difficulty with their short term memory because of the same.Ø  They may have feelings or worthlessness and self-depreciating thoughts which are expressed by self-criticisms  and good for nothing mindset even for simple failures.Ø  Poor self-esteem and low self-confidence which is expressed consistently through their inability to complete even simple tasks is one more important indicator.Ø  They may show pessimistic attitude towards everything, every event and even everybody they come acrossØ  They have significant feelings of guilt and express the need to be punished even over their perceived faults. They blame themselves even for mistakes in which either they have a limited role or no role at all.Ø  These children may express the belief that they are destined to suffer nad have to live their life the way it is which is an indication of strong feelings of hopelessnessØ  They have strong feelings of helplessness and they have strong feelings that nobody can help them and hence they  have difficulty in seeking help. They feel they are all alone in this world because they believe that there is nobody around whom they can trust, who would understand and help themØ  Suicidal thoughts which are expressed as death wishes are the clear signs of depression and if these thoughts are witnessed, then have no doubts, the child is suffering from depression.Depression should be addressed just like any other physical illness. Children cannot articulate their emotions or even identify that they are depressed. So it’s the responsibility of the adults specifically the parents and teachers to recognize it by observing the changes that happen in their behaviour, emotions, physical health and habits and their cognitive process and take appropriate measures. Its not necessary that the child should have all the symptoms mentioned above for the child to be diagnosed. If the child has even half of the symptoms mentioned above  you need to become cautious because you child may be in depression or prone to depression. If your child is experiencing even half of the above said symptoms, it is a good to get an evaluation by a professional clinical psychologist with experience in handling childhood disorders. If their child is either found to be depressed or prone to depression then effective intervention measures and appropriate support can be provided to prevent the condition from escalating and also safe guard them from  social isolation, losing their self confidence, developing negative self-esteem and safety risks that result from persistent depression

My Teenager Gives Me Heartache - Is That Your Thought Too?

Dr. Savita Chaudhary, Pediatrician
Adolescence is a transition phase when a child metamorphoses into an adult. The physical and mental changes occurring during these years are complex and confusing both for teenagers and their parents. The age group between 12 to 19 years is considered Adolescence. The variability of growth amongst teens and perplexity of mental changes poses great challenges to teens and their parents. Lets look at some of the common issues raised by parents.   1. My child is weakest/shortest among his/her peer group: During adolescence a teenager gains a lot of weight and height attaining almost 90% of his/her adult weight and height. These changes do not follow a regular pattern for all. Teenagers grow at different pace at different stages and hence cannot be compared. While boys keep gaining height till 18 (may be 20), girls usually do not gain height after 16 (may be 18). Various factors affect growth of a teen like heredity, constitution, parental, height, nutrition and physical activity. So do not compare your teens and guide them about balanced diet and physical activity..2. My teen is badly influenced by his/her peers: Teenagers find a common ground with their peers. The problems, doubts ,issues are the same and hence the connection. A teen is highly influenced by his peers .He wants to wear the similar type of clothes, hairdo, walk and behave. The so called cool quotient is established giving a sense of belonging to a teen. We as parents usually are wary of certain things and sound preachy. For example, You do not allow your 14 year old girl to wear short skirt at a mixed school party but fail to explain to her why not.So teens take it as a negative response and turn rebel. This creates a sense of distance and disconnect with parents. We have to empathize with our teens to understand the psyche and problems they face.Be watchful of your teen,s company but do not be judgemental. Explain the future consequences of unwanted actions taken under peer influence. Teach them skills to counter wrong peer pressure in a positive and affirmative manner. Learn effective communication skills to reach out to your teens.3. Why my teen is so argumentative and sarcastic: As a teen mind is developing, certain areas of brain are growing faster then others. The area controlling emotions and relationships grows really fast making teenagers highly emotional, hyperreactive and impulsive. This makes them short tempered and moody. The brain area related to perception and risk calculation is still underdeveloped so teens do not think before making a comment or taking an action. Teens therefore become argumentative , moody and even sarcastic. As a parent, I would advise not to take all this personally  and refrain from immediate reaction. Be quite and composed. 9 out of 10 such teens will realise their mistake and apologize provided you remain calm and do not counter react.4. My teen is not interested in studies: Most parents complain that their teens spend a lot of time on social media , television, computer and do not study.As parents, we have to ensure overall development of our children. Academics is a part of it as is sports and extracurricular activities. Talk to your teens , discuss the schedule and try to include physical activity also in the daily curriculum along with academics and screen time. Follow the dictum "We Decided" and make the time table in corroboration with your teens. Be role models to your teens. Ditch your cell phone while talking to them or spending family time. Choose a physical activity for yourselves as well and stick to it. Set achievable academic targets for your teens with his/her equal involvement and focus on the means to achieve them. Provide them opportunities to nurture the talents that they possess apart from academics and most importantly, give unconditional love and support.5. How do I sensitise my teen to sex and relationship issues: In a conservative society like ours, its difficult to talk about sex and sexual offences for parents. But its the need of the hour. We need to acquire communication skills to connect with our teens and give them the basic scientific knowledge lest they get it from some cheap and unreliable sources. We educate our girls about good touch bad touch and at the same time educate our boys to be sensitive and respectful to female sex. Gender sensitivity is the need today. Educate and empower your teens to understand their rights and stand up to any unwanted sexual advances. Encourage them to share their issues with you and promise them complete support from your side.

Values of Healthy Sexuality

Dr. Ramesh Maheshwari, Sexologist
VALUES  IN SEXUALITYAbstract: Adolescence is an age group which undergoes a lot of changes mentally, emotionally, and physically. Here comes an important aspect of their lives - sexuality. This article is to acquaint young adults and parents with values of sexuality.Sexuality is a natural & healthy part of living.All persons are sexual.Sexuality includes physical, ethical, spiritual, psychological, and emotional dimensions.Every person has dignity and self worth.Young people should view themselves as unique and worthwhile individuals within the context of their cultural heritage.Individuals express their sexuality in varied ways.Parents should be the primary educators of their children.In pluralistic society people should respect and accept the diversity of values and beliefs about sexuality that exist in the community.Sexual relationships should never be coercive or exploitative.All children should be loved and cared for.All sexual decisions have effects and consequences.All persons have right and obligation to make responsible sexual choices.Individuals,families and the society benefit when children are able to discuss sexuality with their parents and/or other trusted adults.Young people develop their values about sexuality as part of becoming adults.Young people explore their sexuality as a natural process of achieving sexual maturity.Premature involvement in sexual behaviours poses risks.Abstaining from sexual intercourse is the most effective method of preventing pregnancy and STD/HIV.Young people who are involved in sexual relationship need access to information about health care services.

How to Tackle Sexual Queries of Your Children?

Dr. Sanjay Tambe, Homeopath
14 year old Aditi had a problem, “Changes are occurring in my body and I am experiencing strange attraction towards youngsters of my age; is curious, at the same time a matter of concern also. I need to know about the changes occurring to my physical body, but the family members, specially my mother avoids answering. Increasing dominance of western culture and the vulgarity being shown in the TV, are mind – boggling. I quite understand the meaning of “I am young but not an idiot” but I want to know much more in this matter.Aditi is not the only child to have such questions about sexuality; the girls of her age do possess such inquisitive feelings. Only few get satisfactory replies to their question on this matter. However, in today’s scientific age, where open discussion on this subject is considered to be inferiority and reading books, magazines, periodicals on sexuality is termed as immoral where shall these girls tend answers to their questions? Isn't our narrow minded approach responsible for this?Sexual behaviour is a natural instinct in human beings. This instinct develops slowly in girls & boys right from their birth. Social environment, religious culture and the parental affection received by the child up to the age of 8 to 10 reflects in sexual emotions rising during adolescence.The internal and bodily changes occurring during the adolescence, goes to develop emotional upsurge in the child. Their upcoming personality also reflects in this period. In the present TV infested age this development normally commences at the age of 10 and is completed by 16th year. It is natural at this age to give vent to ideas on sexual or any subject as also to think about the strange changes occurring in the body. Normally, children expect a satisfactory explanation to their problems from the parents, however it proves to be a difficult task for the parents to give appropriate and satisfactory answer to their siblings. This is apparently due to the fact that the modern day changes are quite different from the changes that occurred in them during that age.How are the babies born ? Where do they come from? From which place my brother/ sister came ? What is menses? How and why does it come? Why boys do not have menstruation? Why marriage is essential? How do women conceive? What is abortion ? Can child birth happen before marriage? These and thousands of other such questions haunt the adolescent young minds, expecting satisfactory replies. Not satisfying inquisitive minds, giving evasive replies, efforts to avoid such subjects, scolding to quieten them or telling that they would know by themselves when time comes - all these are improper ways for dealing with the inquisitive mind of the child. Youngsters tend to get a shock when they actually realize that their parents lied to them and mislead them. Such a situation leads them to determine, not to open themselves to their parents. In fact an open discussion on such subjects is essential to develop friendly relation between parents and child.Kids passing through the tender adolescence period are ignorant about the changes occurring in their body. In this period, they are burdened to formulate their educational career. In such a state when their enquiries fail to get proper answers, they tend seek other sources, which eventually devours the child. These range from vulgar magazines, internet, depend on blue films or talk to their friends on these subjects. However, these avenues instead of increasing their knowledge, drive them to unwanted paths, and prove responsible for the disaster. Hence, it is essential that the parents prepare themselves to discuss openly with their kids on these subjects. Unless parents understand that such questions arise naturally in the minds of their children and raising such issues is not improper, they would not be able to guide their child properly.How to guide children:In order to provide proper guidance to children, a close watch on their behavior is essential including timely communication, so that children develop self-confidence.If conversation on sexual matters proves difficult then arrangement for providing books on this subject should be made by father for son and by mother for daughter. However, the books must be gone through before providing the same to children, to confirm suitability.Parents should fully understand and take this for granted that information and sexual matters are equally important compared to knowledge of other worldly matters of life.Due to changes in the inspiration fluids in the body it is natural to develop curiosity about them. Cropping up of innumerable queries in the mind and developing attraction towards opposite sex is just and ordinary matter at this age.Performing sexual activity in tender age can lead to several disorders (eg- venereal diseases, AIDS etc.). Similarly conceiving at small age can give rise to several problems is the future life. Parents must impart awareness in the kids in the regard.Putting multifarious restrictions on the girl when she become adolescent does not indicate that we have concern for her. “See now you are grown up so take care, don't talk to boys, they are bad, don’t go alone anywhere avoid going to neighbor when men are alone in the house, never believe a married man” – these and so many other wrong advises, produce hatred towards opposite sex in the mind of girl. Such teaching may prove harmful in their married life. Contrarily the girls should be given more freedom after proper guidance.Sexual information – when and how?There can be no limitation of age and time for providing sexual knowledge. This can be done even to a child of 5 years.Children of tender age are often subjected to sexual information above their level of understanding, lured by relatives or physically abused. These victimized children remain helpless due to ignorance of the adults around them. If they are pre – informed about such things then they can protect themselves and inform their parents about such incidents.Instead of scolding or beating children for any acts performed due to sexual attraction, they should be treated in a friendly manner. Information published in the newspapers/periodicals should be explained to them properly. Efforts should be made to give precise and satisfactory replies to their multifarious queries.However, while imparting sexual knowledge, care should be taken to ensure that children do not desist from their educational career. They should be made to understand that sexual pleasure can be obtained in its fullest at the proper time. Instead of coercing them for studies they should be allowed to enjoy from play and entertainment. This may distract their attention from sexual – thought and may help in deciding their goal in life.Important instructions for Parents and Teachers:Parents and teachers are the ones who reply and explain the curiosity and questions raised by children in their tender age. On receiving proper guidance these children develop in to responsible citizens and parents. To remove the apposition of the parent –teacher management in regard to sexual education, they should be first be taught about lessons in sexual – education.System of Sexual – EducationSexual – education should start from home, Once parents are awakened and the schools / colleges also start taking active part the child will automatically get awakened.Instead of criticizing and coercing element of hard- work and labour should be infused in their mind.Child needs solitude similar to elders. Constant hackling can distance the kid from parents.Sexual matter should discussed in plain and simple manner, instead of circumventing them hiding facts of giving tactical replies create more curiosity in the mind of children. This may result in less of attention towards studies and may further bad to wrongful deeds.Instead of waiting for a question from the child sexual information should be given voluntarily depending on age.While imparting sexual information special care should be taken to ensure that the child does not desist from his normal – studies and does not fall in bad ways.A close watch should be kept and day – to – day information should be obtained about the friends and the company which he keeps.Proper and satisfactory replies to the questions arising during the adolescence period can go a long way in helping the youngsters in achieving happy and joyful married – life. Children can also protect themselves from sexual abuse and various other social atrocities.

Why Is Bruxism on the Rise in Teenagers and Adolescents?

Dr. Shweta Dixit Chaudhary, Dentist
The pediatric population of this generation often faces a lot of stressful situations related to peer pressure and exposure and access to a vast amount of information through the mass and social media which is beyond their comprehension as well as their coping skills. Such unwarranted stressful situations may lead to psychological problems causing a condition called 'Bruxism' or night grinding of teeth. Apart from peer pressure, certain other causes of Bruxism include misaligned or overcrowded teeth, nutritional deficiencies, dehydration, allergies, endocrine disorders, sleep disorders, and even intestinal parasites. Estimates of the incidence of bruxism range from 38% in patients below 17 years old to 74% of 15-18 years and 77% in 7-14 year olds. Few symptoms of night-time grinding include:• Tenderness in the jaw and the muscles nearby • Ear-ache• Headache• Increased tooth sensitivity due to their wearing offTreatment modality of this condition ranges from psychological evaluation of the child and treatment of the underlying cause e.g.: correction of occlusion, dental restorations and medicines to treat intestinal parasites. One of the time -tested modalities for protection of the teeth and perioral muscles in bruxers is the use of mouthguards or nightguards. A mouthguard (UK: gum-shield) is a protective device for the mouth that covers the teeth and gums to prevent and reduce injury to the teeth, arches, lips and gums. A mouthguard is most often used to prevent injury in contact sports, as a treatment for bruxism or temporo mandibular disorders, or as part of certain dental procedures, such as tooth bleaching. Depending on application, it may also be called a mouth protector, mouth piece, gumshield, gumguard, nightguard, occlusal splint, bite splint, or bite plane.Types of Mouth GuardsThere are three types of mouth guards:Stock and boil-and-bite mouth guards are usually found in most sporting goods stores. Athletic mouth guards can vary in comfort and cost. A custom-made mouth guard fabricated by a dentist or orthodontist is considered by many to be the most protective option. The most effective mouth guard is resilient, tear-resistant and comfortable. It should fit properly, be durable, be easy to clean and should not restrict speech or breathing. Generally, a mouth guard covers only the upper teeth. Occlusal splints (also called bite splints, bite planes, or night guards) are a type of removable mouth guards carefully molded to fit the upper or lower arches of teeth.They are used to protect tooth and restoration surfaces, manage mandibular (jaw) dysfunction, bruxism and stabilize the jaw joints during occlusion or create space prior to restoration procedures. Maintenance Of Your Mouth Guard: It is essential to maintain proper hygiene of a mouth guard to increase its longevity. Also, it should also be replaced once it becomes worn out because it will no longer offer optimal protection.Methods for proper maintenance of mouthguard:• Gently scrub it after each use with a toothbrush and soap solution. Do not use any abrasive as it will lead to wear and tear of the appliance• Store it in its protective case• To prevent it from melting or becoming deformed, keep it out of hot water or the sun• Avoid chewing on it • Replace it if it doesn't fit properly as well as when it wears off 

Stronger Children Might Have Lower Risk of Diabetes and Heart Disease

Ms. Swati Kapoor, Dietitian/Nutritionist
It is a well known fact now that high levels of physical fitness lower the risk of many health problems. But recently, the first ever study to find the link between strength capacity in adolescents and reduced risk for diabetes, heart disease or stroke has been published in the journal Pediatrics.Staying fit is an essential habit that should be inculcated in youngsters. It will positively affect their long and short term health. For example, a recent study found that exercising during younger years helps bones become stronger and increases their longevity, even conferring benefits during aging.The researchers of this latest study, led by Mark D. Peterson, research assistant professor at the University of Michigan Medical School, note that previous studies have found low muscular strength in teen boys linked to several major causes of death in young adulthood, including suicide and cardiovascular diseases. Later it was seen that adolescents with stronger muscles have a lower risk of heart disease and diabetes, according to a new study that examined the influence of muscle strength in sixth grade boys and girls.It was found that physical activity or ay recreational activity done by adolescents helps them to have stronger muscle, which ultimately makes them strong as well as keeps them away from health problems like diabetes and heart disease. Stronger kids also have lower body mass index (weight to height ratio), lower body fat, smaller waist circumferences, and higher fitness levels, according to the study that suggests that muscle-strengthening activities may be important to kids' heart health.Muscle strength is equally important to children's cardiometabolic healthPeterson, one of the researchers from University of Michigan concluded that- “ It's a widely held belief that BMI [body mass index], sedentary behaviors and low cardiovascular fitness levels are linked to diabetes, heart disease and stroke, but our findings suggest muscle strength possibly may play an equally important role in cardiometabolic health in children."He also said the stronger the youngsters are and higher their muscle mass, the healthier they will be. “Exercise, sports and even recreational activity that supports early muscular strength acquisition, should complement traditional weight loss interventions among children and teens in order to reduce risks of serious diseases throughout adolescence," he adds.It is very important for children to adopt any moderate to intense physical activity on a daily basis to have higher muscle mass and strength, to improve their chances of being stronger and healthier throughout their lives.

The Secret of Ageing

Ms. Raisa Luther, Psychotherapist
Ageing. The process starts from the moment we are born. You can’t stop the clock. The only way to stop the process is to die!Youth is worry-freeDuring the first 25 – 30 years, ageing is a rapid and overt process of change. Puberty, adolescence and youth are stages of immense shifts both physically and mentally. It is the age of transition from childhood to adulthood. Except for the vulnerable age of adolescence when there may be some identity issues, the individual normally feels confident and upbeat about life during this period. Death and disease are far from his mind. Hope, aspirations, drive to compete and achieve are at an all-time high.Growing upAround 30, the person begins to experience the responsibilities that go with a job, spouse, and maybe even children. He now has to comply with societal rules and obligations. He now has to think about the future in a more practical way than he did when he was younger. He begins to plan for coming days and years.Fear creeps inAs he or she gets older, the body begins to show signs of ageing – health issues begin to crop up. After 40, he begins to think more about preserving and prolonging his physical condition. Mentally, he may be in optimum condition to think and analyse. He now has the benefit of experience. At this stage, a new element enters his life – Fear.Fear of old age and death. Fear that there is little time to achieve goals. Fears that one would lose loved ones – especially parents. Fears that the children may not ‘settle’ down. Fears regarding grandchildren. Unknown fears.Fear vs. FaithThe antidote to fear is faith. That is why age-old religious texts stressed on prayer and service during this stage in life.Modern world has, however, extended life expectancy exponentially. Since 1900 the global average life expectancy has more than doubled. Today, the global life expectancy is 71.4 years. Medical science now helps people live healthy and productive up to 70s and beyond. This poses its own challenges. Retirement is not an option any more for many. Elderly persons now have to channelize their energy for fulfillment and to avoid a sense of uselessness. The accumulated experience and consequent wisdom can now be leveraged for families, businesses and service organisations.Acceptance is the keyWhile life expectancy has increased dramatically, there are some who do not wish to go beyond youth. They are not comfortable with their senior status. Anti-ageing formulations and fashions are big business. This industry feeds on the fears of people.The secret to continual and consistent well-being is Acceptance. Accept your age and live accordingly. While identifying and leveraging your personal assets, accept your shortcomings. Act your age - it’s okay to look your age, too. Stay positive, healthy and feel happy and fulfilled!

What Indian Parents Should Know About Internet Addiction in Adolescents

Dr. Aditya Gupta, Psychiatrist
Internet use have been increased markedly not only in India but also worldwide in the last decade. In India, use of internet is enormous, especially in the young population.There have been growing concerns worldwide for what has been labeled as “internet addiction” which refers to pathological compulsive internet use.Symptoms of Internet Addiction/Warning SignsIncreasing preoccupation with, and investment of  resources (e.g., time,money, energy) on  Internet-related activitiesLoses track of time while online, Sacrifices needed hours of sleep to spend time onlineUnpleasant feelings (e.g., depression,anxiety, loneliness, emptiness) when not onlineNegative impact on work/school performance, Spends time online in place of homework or chores Problems develop in existing relationshipsDifficulty in forming new offline relationshipsPrefers to spend time online rather than with friends or familyBecomes agitated or angry when online time is interruptedBecomes irritable if not allowed access to the InternetLies about amount of time spent online or "sneaks" online when no one is aroundSeems preoccupied with getting back online when away from the computerLoses interest in activities that were enjoyable before he or she had online accessPsychological impactLike addiction to drugs and alcohol, the Internet offers children and adolescents a way to escape painful feelings or troubling situations. They sacrifice needed hours of sleep to spend time online and withdraw from family and friends to escape into a comfortable online world that they have created and shaped. Children who lack rewarding or nurturing relationships or who suffer from poor social and coping skills are at greater risk to developing inappropriate or excessive online habits. Because they feel alone, alienated, and have problems making new friends, they turn to invisible strangers in online chat rooms looking for the attention and companionship missing in their real lives. They may come from families with significant problems, and they cope with their problems by spending time online. The skill to develop face to face relationship is lost.Those addicted to Internet have high incidence of anxiety disorders and depression.What parents can doTechnology will continue to advance and is not going away, so we’d better learn to ride the wave. Parents should work with their child to establish clear boundaries for limited Internet usage.Allow perhaps an hour per night after homework, with a few extra weekend hours.Stick to your rules and remember that you’re not simply trying to control him/her - you are working to free them of a psychological dependence. It is important for every parent to learn the terms (both technical and popular) and be comfortable with the computer, at least enough to know what your child is doing online.They should also reassure their children that they are not criticizing him or hampering his privacy but are concerned with the consequences of pathological internet use.

Orthopaedic Problems and Relation With Obesity

Dr. G K Sudhakar Reddy, Orthopedist
Obesity or being overweight is now recognised as a serious cause of ill health. Obesity is associated with significant orthopaedic problems and losing weight was found to have positive effects on relief of symptoms from all these conditions.   1. Osteoarthritis  - in Knee, hip and hand joints 2. Osteoporosis   3. Low Back Pain   4. Tendonitis  5. Nerve compressions  6. Trochanteric Bursitis   7. Plantar Fasciitis   8. Gout  9. Fibromyalgia  Osteoarthritis   Osteoarthritis is a common disabling condition which affects normal daily life activities which is caused by obesity. Other lifestyle factors are also associated with osteoarthritis like level of joint activity, lack of exercise, muscle weakness, and joint injury. Of these muscle weakness is common in obesity. Obesity triggers osteoarthritis by transmitting excess weight on the weight bearing joints like the knee and the hip.   Knee Osteoarthritis  Knee Osteoarthritis is caused due to the excessive weight burden on the knees in an obese and overweight person. This is the most common arthritis especially, in the Indian subcontinent.    While walking an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.    In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint lining and cause inflammation of the joints giving rise to joint pathology.   Hip osteoarthritis  The force transmitted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.      Hand osteoarthritis   Obese people also have a higher risk in having hand osteoarthritis due to the metabolic effect produced by fat tissue.   Osteoporosis   Osteoporosis is a progressive bone condition that is characterised by a decrease in bone mass and density, reduced Bone Mineral Density (BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.    Low back pain   Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.   Other conditions   Obesity is a also a risk factor for:   * Upper extremity tendonitis (inflammation of tendons) causing pain in shoulder, elbow, wrist  * Nerve compressions in wrist and elbow causing painful hand symptoms and weakness.   * Plantar fasciitis which is a common cause for heel pain.  * Trochanteric bursitis, causes frequent lateral hip pain in elderly and middle-aged individuals.   * Gout which is characterised by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe. It is formed by the deposition of monosodium urate crystals and can also present as kidney stones, soft tissue lumps.  * Fibromyalgia is a complex disorder resulting in pain, disturbed sleep and altered mood.