I AM ALWAYS TENSE, ANXIOUS AND WORRIED; IS THERE A SOLUTION TO THIS?

We all have a friend, relative or a colleague who is always tense and anxious! Ever wondered why is he/ she so anxious all the time? Or, is it that you are the one who is anxious and made fun of?   So what is this condition and how can we ‘solve’ it? Is this normal? This is the focus of discussion today.

            Being anxious sometimes is a good thing and helps us correct mistakes and prepare well for the future. However, when anxiety is present all the time, it is not such a good thing. Why? Because, being anxious all the time makes you feel bad and prevents you from enjoying life. It also impacts your physical health and can be detrimental to organs such as the heart. Additionally, being tense and worried all the time impairs your ability to concentrate, plan and solve the problem at hand, thereby defeating the whole purpose for which the nature probably designed anxiety for! And more the problems persist, more the anxiety – a vicious cycle that many find difficult to come out of!

            So what causes some people to be more anxious than others? Is it that their lives are more difficult than others? Well sometimes yes, but not always! So if there are no more problems, why this excessive worry? Let’s find out!

Broadly, we can view the problem to be related to two kinds of issues – one, personality style and two, psychological disorder.

Certain persons have a personality style that is prone to worry. It is not that they are suffering from a mental disorder that is making them anxious. It is just the way they have always been, since their childhood days! And why have they been that way since childhood? Genetics, family and cultural background, events in early childhood, chemical changes in the brain and so on. Personality styles characterized as anxious-avoidant, anankastic and paranoid are often prone to this kind of anxiety.

The second group of psychological disorders includes a wide range of anxiety and depressive disorders. Unlike personality styles, they often have a definite onset and sometimes a definite end point. In other words, there have been periods when the person is not so worried and periods when he/ she is markedly worried. Generalized Anxiety Disorder (GAD) is a well known disorder in this category. As the name suggests, the persons suffering from this disorder have worries related to multiple areas of life even though they sometimes recognize or have been told by others, that this anxiety is unwarranted.

SO WHAT IS THE SOLUTION?

Let us consider the second group of psychological disorders first. This group is often treatable with medicines. A disorder implies a specific abnormality and hence the ability to correct the abnormality with medicines. Psychotherapy is also useful but tends to be used in those with milder symptoms.

The first group, i.e., problems associated with a personality style, is generally corrected, with psychotherapy. Medicines are generally not useful, except in very severe cases or in the presence of additional psychiatric complications. Can personality styles be changed or corrected? Yes, contrary to popular belief, it can be changed to a significant extent!

So that was it for this week friends! Hope you found it useful!

Please let me know if you want me to discuss any specific issue by typing in the comments section below.

Write in at stayhappy.prakash@gmail.com

So until next time, STAY HAPPY!

Dr. Sathya Prakash, MD, Dip. CBT

Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert

lybrate.com/dr.sathyaprakash

DEPRESSION: ONE DISORDER, MANY DISGUISES

Hello friends!
                       We all have heard of depression being increasingly common given the modern day stressed lifestyle.

                   But how exactly do we recognize depression? Does feeling sad and being depressed mean one  and the same thing? Are feeling burnt out or stressed out the same as being depressed? Let me clarify some of these things here.

          I will not be talking about technical details, medical jargon or DSM criteria here; I will only explain in simple terms how depression can manifest in many different ways and often in a disguised manner.

Classical presentation:
              Pooja, 22 years old is a college student. She lost her mother to cancer 3 months ago. Pooja was very close to her mother and could not seem to overcome this loss. She was frequently reminded of her mother. She remained sad all throughout the day. She gave up her hobbies of swimming and playing badminton. Otherwise a bright student, she started missing classes and fared poorly in a periodic test at the college. She lost confidence in herself and would often feel that there was nothing left for her to live for in this world. Eventually she was brought to the emergency department of a hospital, having consumed 50 tablets of sedatives, in a bid to end her life.

          This is the typical version of depression that many of us are familiar with, but very often, we still hesitate to take treatment!

Non-classical or disguised versions of depression:

•            Ram Singh, a 70 year old gentleman, has had a healthy and satisfactory life. He was in good physical health and had retired from a prestigious position few years ago. His children were all well settled and his own financial position was excellent. About an year ago, Mr. Singh started complaining of abdominal pain and headache. He was seen by a physician, a gastro-enterologist and a neurologist and extensively investigated. All lab tests and scans were normal and not indicative of any medical illness. He did NOT report of any sadness of mood. He complained of excessive fatigue and gradually began withdrawing from various activities that he was otherwise busy with. He also complained that he could not remember things as well as he used to earlier. Mr. Singh was eventually diagnosed with old age depression, treated appropriately and now doing well.
• Rahul, a 17 year old outgoing boy, has been seen to be very irritable lately. He started smoking cigarettes with friends which he would not do earlier. He started having quarrels with friends, back answering teachers and parents and stayed away from home until late in the night. He did NOT report of any sadness of mood. Rahul was eventually diagnosed with  adolescent depression, treated properly and now doing great.
• Ankur, a 10 year old boy was outstanding at studies. He was always very keen to go to school and study. His teachers praised him and saw a great future for him. Off late however, Ankur does not want to go to school. He frequently complains of abdominal pain and is often forced to be brought back home from school. He occasionally began to pass urine in bed at night, something which was very unusual. Ankur too, did not report any sadness of mood. Ankur was eventually diagnosed with childhood depression. Appropriate treatment resulted in dramatic improvement in his condition, and now, he is back to his genius best.

The bottom line:

            Depression is not the same as being sad. Depressed persons need not express sadness or even appear sad, in fact they may have a smiling face to show to the world. Depending upon the age and cultural background, depression may present itself in many different ways. It is important to identify depression early and institute appropriate treatment as full recovery is possible!

Hope that was a useful discussion, friends!

Please let me know if there is any specific issue that you want me to address. Write in at stayhappy.prakash@gmail.com

So until next time, STAY HAPPY!

Dr. Sathya Prakash, MD, Dip. CBT

Consultant Psychiatrist, Psychotherapist and Behavioural Sciences Expert

lybrate.com/dr.sathyaprakash

icliniq.com/drsathya