Articles on treatment of bipolar disorder

Bipolar Disorder- What Is It? (Symptoms)

Dr. Milan Balakrishnan, Psychiatrist
What Is Bipolar Disorder?Bipolar disorder, also commonly known as manic depression, is a brain disorder that causes shifts in a person’s mood, energy, and ability to function. The symptoms of bipolar disorder can result in damaged relationships, difficulty in working or going to school, and even suicide. There are generally periods of normal mood as well, but left untreated, people with bipolar disorder continue to experience these shifts in mood. The good news is that bipolar disorder can be treated, and people with this illness can lead full and productive lives.What Are the Symptoms of Bipolar Disorder?Bipolar disorder can cause dramatic mood swings—from high and feeling on top of the world, or uncomfortably irritable and excited, to sad and hopeless, often with periods of normal moods in between. The periods of highs and lows are called episodes of mania and depression.MANIC PHASE• Feeling on top of the world. A sensation of sheer and utter happiness that nothing—not even bad news or a horrifying event or tragedy can change.• Sudden or extreme irritability or rage. While mania is often portrayed as a pleasurable experience, that is not thecase for many people with bipolar disorder.• Grandiose delusions. Individuals believe that they have special connections with God, celebrities, or political leaders.• Invincibility or unrealistic beliefs in one’s abilities. The person feels that nothing can prevent him or her from accomplishing any task.• Hyperactivity. Scheduling more events in a day than can be accomplished; inability to relax or sit still.• Excessively risky behavior. Reckless driving, outlandish spending sprees, foolish business investments, or out-of character sexual behavior.• Uncontrollable racing thoughts/rapid speech. Ideas that abruptly change from topic to topic expressed in loud, rapid speech that becomes increasingly incoherent.• Less need for sleep.DEPRESSED PHASE• Intense sadness or despair. The person feels helpless, hopeless, and worthless.• No interest in activities they once enjoyed.• Loss of energy, fatigue.• Sleep difficulties. Either sleeping too much or not at all.• Changes in appetite. Either a noticeable increase in appetite or a substantial weight loss unrelated to dieting.• Difficulty concentrating, remembering, making decisions.• Thoughts of death or suicide.PS. 30th of March is World Bipolar Day. Birthday of Vincent Van Gogh who committed suicide due to the disorder. Follow #WBD2016 #Mumbai on Twitter.

World Bipolar Day !

Dr. Satish S.Nagargoje, Psychiatrist
Mozart, Winston Churchill, Agatha Christie, TS Eliot, F S Fitzgerald, Robert Downey Jr, Francis Ford Coppola, Buzz Aldrin, Ben Stiller, Van Damme, Vincent Von Gough – all great names!But what’s common in all? All have achieved unmatchable, great heights in their respective fields! Their names speak for themselves! What else? Do you find them odd, inconsistent, risk taking, impulsive, irresponsible, despite their all greatness. Have you found yourself wondering, how can a person of such great abilities can behave in so irrational manner?Yeah, they did act so, they lived life of highs and lows, full of inconsistencies, thanks to a psychological condition they had in common, Bipolar Disorder!Have you heard about it? Do you know someone with this condition? What is this?Lets discuss this on occasion of World Bipolar Day ! Its celebrated on 30 th March every year, the birthday of legendary painter, Vincent Von Gough, who was posthumously diagnosed as probably having Bipolar Disorder. This day is celebrated to psycho-educate people and spread awareness about this condition and destigmatise the illness.Bipolar disorder is a chronic, persistent, psychological condition, in which a person’s mood dwells between two poles – mania and depression (hence bipolar!), in phases , for some significant duration of time, affecting their personal, professional and social life. When in manic phase, person experiences excess talkativeness, overfriendliness, flight of ideas, over energetic, decreased need for sleep, over confident, increased risk taking behavior, increased libido, over spending, excess use of addictive substances etc. They sometimes experience hypomanic phase, in which they experience similar symptoms of less intensity.When in depressive phase, they experience low mood, low confidence, indecisiveness, low energy, poor concentration, lack of interest in life and day to day activities, decreased or increased sleep and apatite, suicidal thoughts etc. Their life is an emotional roller coaster ride, where they have less control on life events, and are driven by emotions most of the time. They suffer through their personal, professional, social life due to same. Addiction and suicidal attempts are more common in people suffering from Bipolar disorder. There is no cure for Bipolar Disorder, but with regular use of medication and counselling, frequency- intensity- duration of symptoms of the illness can be controlled, helping them to develop insight into their illness. And they can also lead a healthy, happy, respectful life, with some help from family and society! “As Martin Luther King once said, I have a dream that one day our nations will rise up and create all men equal. And I have a dream that my son, who has lived most of his life with bipolar disorder, will one day live in a nation where he will not be judged by his illness, but rather by the content of his character. I believe that World Bipolar Day will help bring my dream to fruition.” Knowledge is power ! Learn about Bipolar Disorder ! Ask your doctor for more information !Keep smiling ! Keep shining !

Psychiatric Drugs: Myths and Facts

Dr. Aditya Gupta, Psychiatrist
There are several myths regarding psychotropic medications in our society. Through this article I will try to break few of them, to aware the public and remove stigma. Each myth will be followed by the associated fact.Medications will change my personality/ make my brain weak - Medications work to correct what is wrong. It doesn’t change who you are nor make you weak.Medications are addictive – with the exception of few, psychotropics cause little if any physical dependency. If taken under medical supervision safely tapering off them is possible.Medications are for weak people, who can’t deal with everyday problems. – psychotropics are not stress reducers, they correct genuine disorders. Far from being a sign of weakness, it takes considerable strength to admit that you have an illness.Psychiatrists give drugs to everyone who comes to them, I only need counseling.–Psychiatrists are the only health professionals who are trained to evaluate all biological, psychological and social factors involved with an illness. They are trained in psychotherapy as well as medication treatment and know which method to apply and when. Have faith in your doctor.Why do I need to see a psychiatrist, can’t my physician/neurologist prescribe for me? –Psychiatrist is the only specialist in mental illness and in medications used to treat it. You wouldn’t expect your orthopaedician to operate your eyes, nor should your physician be expected to know everything about prescribing and monitoring psychotropic medications.Psychotropics are effective but not some magic bullets. Recovery from severe mental illnesses often takes weeks or months, but the results are worth the wait.

I Am bipolar..how Do I Help Myself?

Dr. Milan Balakrishnan, Psychiatrist
Is there anything I can do to help my treatment?Absolutely, yes. First, you should become an expert on your illness. Since bipolar disorder is a lifetime condition, it is essential that you and your family or others close to you learn all about it and its treatment. Read our related blogs on depression and bipolar disorder.You can often help reduce the minor mood swings and stresses that sometimes lead to more severe episodes by paying attention to the following:Maintain a stable sleep pattern:Go to bed around the same time each night and get up about the same time each morning. Disrupted sleep patterns appear to cause chemical changes in your body that can trigger mood episodes.Maintain a regular pattern of activity: Don't push yourself too hardDo not use alcohol or illicit drugs:Drugs and alcohol can trigger mood episodes and interfere with the effectiveness of medications. You may sometimes find it tempting to use alcohol or illicit drugs to “treat” your own mood or sleep problems—but this almost always makes matters worse.Enlist the support of family and friends: However, remember that it is not always easy to live with someone who has mood swings. If all of you learn as much as possible about bipolar disorder, you will be better able to help reduce the inevitable stress on relationships that the disorder can cause. Even the “calmest” family will sometimes need outside help dealing with the stress of a loved one who has continued symptoms.It is okay to seek professional help. Family therapy or joining a support group can also be very helpful.Try to reduce stress at work: Of course, you want to do your very best at work. However, keep in mind that avoiding relapses is more important and will, in the long run, increase your overall productivity. Try to keep predictable hours that allow you to get to sleep at a reasonable timeLearn to recognize the “early warning signs” of a new mood episode:Early signs of a mood episode differ from person to person and are different for mood elevations and depressions.The better you are at spotting your own early warning signs, the faster you can get help. Slight changes in mood, sleep, energy,self-esteem, sexual interest, concentration, willingness to take on new projects, thoughts of death (or sudden optimism), and even changes in dress and grooming may be early warnings of an impending high or low. Pay special attention to a change in your sleep pattern, because this is a common clue that trouble is brewing. Since loss of insight may be an early sign of an impending mood episode, don’t hesitate to ask your family to watch for early warnings that you may be missing.All this will help you tackle bipolar and reduce relapses so bring it on BIPOLAR!!

5 Common Myths About Psychiatry and Psychiatrists

Dr. Era S. Dutta, Psychiatrist
MYTH#1– Everyone who goes to a psychiatrist is MAD/INSANE/PAGAAL.FACT- Psychiatry is the branch of medicine focused on the diagnosis, treatment and prevention of mental, emotional and behavioral disorders. Psychiatrists are DOCTORS who specializes in mental health,including substance use disorders.MYTH#2- A psychiatrist only TALKS. How is that treatment?FACT- The great leaders of the world make big decisions by TALKing.Talking is one of the tools that psychiatrists use to treat. In fact as a specialty, a psychiatrist is likely to give you far more time to Talk your heart out and unburden your mind.MYTH#3- Psychiatrist will give me pills that will surely make me groggy and sleepy all the time.FACT– As doctors we take oath to do the best for our patient. We never prescribe sleeping pills to those who don’t require it. It is true that a lot of medications have the side effects of making you slightly groggy, but these can be circumvented with small tips from the doctor.MYTH#4- “Once on psychiatric medication, always on psychiatric medication.”FACT– Suppose if you had Tuberculosis (T.B) tomorrow, would the doctor keep you on medication forever? NO. There is a specific course of treatment.Similarly if you suffered from Diabetes or hypertension, there are more chances that you would be prescribed life long medications.Psychiatric medications need to be prescribed for a stipulated period of time. The duration varies from case-to-case, based on many factors. Few chronic conditions may need treatment life long (just like diabetes or high B.P), but not all.MYTH#5- “I stopped the medication and my problems came back. It’s the doctor’s fault as he/she has made me dependent on medicines.”FACT– Suddenly breaking the car can lead to accidents, hence we avoid doing it. Similarly, psychiatric medications are to be tapered or switched gradually which only a qualified psychiatrist can help you with. Managing your own medications and stopping them may cause this problem.

Talking About ‘Reasons’ For Suicide

Debasmita Phukan
Recently, many leading newspapers and channels reported that according to the National Crime Records Bureau (NCRB) report, in 2014, Kota witnessed a 61 per cent rise in suicide cases. They also stated that NCRB has classified 18 ‘reasons’ for the suicides. Corroborating common perception, the top reasons were cited as academic failures, disappointments in romantic relationships and spats with family members. While I have no reasonto doubt the accuracy of the mathematical computations in the report, I do have some serious misgivings about the conclusions drawn by the Bureau about the causes of individual suicide cases. Firstly, no serious finding can be validated without a clear statement as to how it was reached. Newsreports need to address this issue and readers need to ask this question. So how did NCRB ascertain that X committed suicide because of a, b or c reason? Did all the victims leave clear reasons for their drastic step in suicide notes? If not, was there a thorough investigation of each one of those 100 cases? What sources did the Bureau use? What questions did they ask the victims ’families and friends? Were the reports completely reliable? I ask these questions because rarely can anyone know the exact reason that causes a person to end his, or her, life. Suicide is an extreme step and the motivation that drives one to it is complex, to say the least. Most times, the victims themselves probably don’t understand their relentless desire to let go of life. Even if they do, it would be extremely difficult (if not impossible) to accurately describe the array of factors that go into that fatal decision in a suicide note. Unfortunately, much like the mystery of the taste of cyanide, the causal factors behind an individual suicide case is buried with the deceased.Mental health professionals and researchers have studied suicide for years. Based on detailed case histories put together from information provided by those who had attempted suicide, family members and friends left behind by suicide victims, mental health practitioners who the deceased may have been seeing, and suicide notes, they have been able to deduce a number of factors contributing to suicide. What needs to be emphasized here is that there are factors that make one vulnerable to suicidal thoughts and behaviour. These factors are not isolated events that occur right before suicide but may be rooted in an individual’s psychological make-up since years before the incident, or even from birth (genetics has a role in suicide too). They may range from childhood abuse and neglect to loneliness in adulthood. Mental illness is the most prominent factor in suicide. To summarize, it is clear from mental health research that no one decides to end their life because of one solitary event. A stressful event may push an already disturbed person “over the edge”, but in no way can it be called the ‘reason for suicide’. To say that it is, is not only misleading but wrong. The only information that that provides is the long suffering person’s ‘last straw’. To reduce his/her suffering to that one event in this way only serves to belittle the victim and push blame that is often unwarranted to the people left behind. We as lay people too need to be more sensitive about the way we inquire after suicide survivors and how we talk about the victims. Saying that a boy slit his wrist ‘because his girlfriend left him’, that a student jumped off the top-most floor ‘because she failed her exams’, or that a woman killed herself ‘because she was fed up of her husband’ causes other people to make sweeping judgments about the deceased and those close to them. Statements such as these are what contribute to the stigma behind suicide. It makes people who attempt suicide appear weak and petty. If we don’t change the way we talk about suicide, people struggling with thoughts of suicide will always hesitate to seek help. And the suicide rate will continue to escalate.

6 Important Thoughts About Life

Dr. Swapna Patker, Psychologist
Depression is becoming common these days. People have many reasons to feel sad depressed and suicidal. More the advancement, more the expectations from life and more the disappointments. Less marks in exams, love break up, death of loved ones, professional disturbances, joblessness, loneliness, insults and helplessness are a few highlighted reasons that lead to severe depressions and suicides. Younger generation is less tolerant and gives up on the intimidation of every thing that's not as per their thinking. Of course, the pressure on the generation now is too high, to perform well, to live well, to look good and to be accepted. In the bargain, the mental health goes for a toss. Suicide is not an option at all. Meeting a psychologist and taking help is more easy, ethical and intelligent than leaving this world for some reason that could be sorted. 6 Important Thoughts that you need to know about life are: 1. Depression is a choice. If you allow too much negativity to seep in your thought process, you are bound to feel low. Positive attitude of people keeps depression away from their minds. Practice positivity for a depression free life. 2. Don't depend your life on people's judgements about you. Believe and respect yourself. Don't fall for over appreciation or hurting comments and insults of people. Don't give up your mood or  life because someone said something wrong to you. Be aware of yourself and don't let anyone tell you your worth. Take control of your self image and self worth. 3. Be comfortable with yourself. The way you look, the way you are and the way life is treating you is your life. Accept it. There are sarcastic and condescending people in this world, learn to mute them in real life. Don't let that affect your peace. Your life is precious; it's not worth giving it up for people who do not accept you the way you are. Learn to accept facts about yourself and plan to make the most out of whatever you already possess. 4. Mental wellness is more important than physical beauty and worldly pleasures. Skin colour, disability or illnesses should not be issues of depression in life. Love yourself. Some people intend to corner you and make things difficult for you. Don't fall for their trap. Safeguard yourself from people who are not concerned about your well being. 5. Each one feels low or lonely at some point time in life. Some succumb to the pressures of emotional turbulences and some get swayed away into the limbo called hopelessness. Take charge of your feelings and elevate yourself every time such negative thoughts touch your mind. 6. Help is available. If you ever feel that your mental pressures are beyond your control, take help of a psychologist or a counselor. Don't hesitate. It's better to take help and sort things than spoil or give up a precious life . Life is beautiful, if you can see it that way. Life will treat you the way you see it. Practice positivity and love yourself.

In the Grasp of Anxiety - When Worrying Has Become a Disorder

Ms. Pallavi Tomar, Psychologist
Everyone is familiar with anxiety.It may pop up as a feeling of unexplained apprehension, or a flood of constant worrying thoughts, a sudden burst of panic, or even an intense dread or fear. These feelings are all to situations, things and people perceived as overwhelming, unsafe or threatening. In all its manifestations, it is unpleasant and it is quite natural to want to avoid or eliminate these feelings.But before we move on to discussing anxiety as a disorder, lets understand the evolutionary function of this seemingly out of control beast.The essential evolutionary function of an anxiety response is to prepare an individual to deal effectively with danger and threat. That is why it exists at all.Take a look at a few symptoms and the function they may serve:The feeling of restlessness and increased heart rate may keep us physically prepared for action.Our interpretation of ambiguous information as threatening may actually be aimed at reducing the probability of missing any threats around us.Our mind racing with multiple thoughts of all that which can happen may actually keep us prepared for all possibilities and scenarios.The lack of sleep will allow us to be constantly alert.It propels us, makes us strive, challenges us and pushes our limits. Toss away anxiety and you may lose out a great deal of your motivation, persistence, excitement and caution.So ideally if anxiety is experienced in the right manner, for the right reasons and for the right duration – it is only natural!But how do we recognize the transformation of this natural experience of anxiety into a disorder?There are a few things to consider. Anxiety reactions manifest in three basic forms:As an emotion: The fear, the apprehension, the worry, and the despair.As a thought: Of an impending doom, of things going wrong, of death, of injury.As a physical response: To avoid, to evade, to check, to run, to become immobile, increased heart rate, difficulty breathing etc.In an anxiety disorder, these three basic forms of anxiety may be experienced as difficulties in any of the four below mentioned domains.Intensity – Is the experience of anxiety exaggerated and far too intense than what may be warranted in a situation? Does the individual find it difficult to contain and manage the anxiety? Is the individual finding it difficult to cope with the intensity of the signs and symptoms?Frequency – Are the signs of anxiety experienced too frequently by the individual? Is the individual repeatedly reacting to the same stressor/threat without developing newer ways to cope or deal with it?Pervasiveness – Are the signs or symptoms of anxiety experienced at most times across all situations? Does it seem to be pervading across all aspects of an individual's life?Dysfunction – Is the experience of anxiety impacting the individual's functioning in their personal, professional or social life? Does the individual have to make too many changes to accommodate and cope with the experience of anxiety? Is it affecting others around the individual?If your answer is affirmative to any of these questions, your experience of anxiety may not be serving the evolutionary purpose it is essentially meant for. But before you go ahead and diagnose yourself, I encourage you to talk to a mental health professional about your concern.

Myths and Facts About Suicide

Dr. Riddhish K. Maru, Psychiatrist
MYTH 1: A person who talks about committing Suicide, won’t actually do it.FACT 1: About 80% of persons who commit suicide express their intentions to one and often more than one person.MYTH 2: Suicide usually occurs without warning. FACT 2:  A person planning suicide usually gives clues although in some cases, suicidal intent is carefully concealed.MYTH 3: A suicidal person fully intends to die. FACT 3: Most suicidal people feel ambivalent toward death and arrange an attempted suicide in the hope that someone will intervene.MYTH 4: If a person attempts suicide once, he or she remains at constant risk for suicide throughout life. FACT 4:  Suicidal intentions are often limited to a specific period of time, especially if help is sought and received. Person is at highest risk to repeat suicide in the 1st year following the act. Help can be effective. MYTH 5: If a person shows improvement after a suicidal crisis, the risk has passed. FACT 5:  Most suicides occur within three months or so after the onset of improvement, when the person has the energy to act on intentions.MYTH 6: Suicide occurs most often among the very rich and the very poor. FACT 6:  Suicide occurs in equal proportions among persons of all socioeconomic levels. MYTH 7:  Families can pass on a predisposition to suicidal behavior.FACT 7:  Suicide is not an inherited trait, but an individual characteristic resulting from a combination of variables. One of which is positive family history.MYTH 8: All suicidal persons are mentally ill, and only a psychotic person will commit suicide.FACT 8:  Studies indicate that 95% suicidal persons have mental illness.

Eating Disorder: Things You Should Know!

Ms. Swati Kapoor, Dietitian/Nutritionist
A harmless remark by an educated parent on the physical attribute of their growing teenage girls resulted in a shocking “anorexia pact” by the duo at the age of 11. Now at the age of 33 and being doctors they don’t lead a normal life. Eating disorders might start at a very early , if not identified and treated can stay with you for life.Anorexia nervosa is one of the most common eating disorder that is associated with abnormally low weight achieved by extreme dieting, fasting and followed by compulsive exercising.  Mostly young girls are afflicted from this disorder especially in the absence of early parental care and support to inculcate healthy eating habits. Eating disorders have been around forever but finally society is accepting the seriousness of this ailment  and encouraging parents, friends to come together and support the person suffering from it.  There is a higher success rate of controlling and reversing it through family and social support .Eating disorders mostly start from home and parents play an extremely critical role in stimulating and curbing them.  Children very closely watch and imitate their parents. If the parents fuss too much about their looks and being thin the kids will imitate them. Similarly if the parents eat a lot of unhealthy food the kids would be inclined towards junk food even when they grow up. Therefore it is mostly parent’s responsibility to inculcate healthy eating habits amongst children.Eating disorder can have serious repercussions on health like weakness, fatigue,  anaemia, heart & kidney problems, osteoporosis, infertility, disruption of sugar levels  and even death. Nature and nurture is equally responsible for this condition. Therefore it is imperative to apply a three pronged approach to dealing with it.First restore the healthy weight of an individual, second to treat the psychological factors that may have caused this situation and lastly ensure there is total support and care to prevent relapse.Healthy Food does not make you fat. Its unhealthy eating patterns like eating too much processed food that only has empty calories and not nutrition. Also controlling the portions even at an early stage is important. This does not mean dieting it means regulating a healthy meal pattern in children where importance is give to a balanced diet that includes fruits, vegetables, dairy and grains. If a healthy food routine is followed the kids will tend to eat less junk as they will be fuller for longer resulting in optimum growth, overall health and better immunity.Also teens suffering from eating disorders tend to be very sensitive and emotional. Its important as a parents need to be more tuned to their emotion needs, provide them that extra affection and care.