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The most colourful of all personalities is the one known in medical parlance as Borderline Personality. Is it a boon or a bane? Let us find out.

These people walk the thin line between normalcy and psychosis. They can be quite happy one moment, and screaming with anger or crying their heart out the next. It is the unpredictability of their temper that makes them so interesting, and difficult to deal with.

If you ask them, these individuals do not know how to deal with these overwhelming emotions. It is the source of their greatest suffering, as also their creativity. Art comes naturally to them. They feel intensely and connect to others immediately. But after a time, maintaining interpersonal relations poses a great challenge.

This is because of the tendency to become emotionally dependent on others. Their near ones have to be emotionally available for them at all hours. Failing to do so is considered rejection and such individuals are overtly sensitive to rejection and criticism. If you are not there for them in times of emotional crisis (which are pretty common phenomenon for them), you are blacklisted. This brings us to the next facet of this personality.

They see the world in absolute black and white. No grey zone for them! This means that they can idolize you one moment and hate you with all their heart the next, when they feel you are rejecting them. And that can lead to vicious arguments, melodramatic accusations and attempts to harm themselves. After a point, it becomes too much to bear for their partners, friends or relatives. So, we usually see a lifetime of intense but short-lasting friendships and a collage of tumultuous relationships.

Their self-esteem is not over the top. There is a lot of problem with the mental image they have of themselves. As a result, they are constantly seeking validation from others. Failing to get it damages this self-image further, and anger and hatred get self-directed pretty often. Hence, there is a recurring tendency to harm themselves, including multiple suicide attempts.

Impulsivity is commonplace here. Looking before taking the leap is not a saying they take seriously! They pretty much always act on a whim and live to regret those decisions later. Shopping sprees, abuse of recreational drugs, promiscuity are a few examples of this impulsive behavior pattern.

In summary, individuals with such a personality are loving, caring, fun to be around and supremely creative. However, when it comes to handling emotions or keeping a check on their impulsivity, they are at a loss. The constant feeling of emptiness that plagues them is a curse they have to bear for a lifetime.

How do we help these individuals? The first step is to identify the features and understand that they need support, not criticism. Regular therapy sessions with or without medications under the supervision of a competent psychiatrist goes a long way in letting them live a productive life. Remember that it is a personality pattern, embedded deep in their psyche. Therapy takes time, but it pays to be patient!

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Worried parents turning up at psychiatrist’s clinics with their kids who are apparently behaving ‘abnormally’ is a common sight nowadays. Add to that prep schools and other educational institutions that insist on getting the child ‘evaluated’ for various apparent abnormalities, the parents are at their wits end. Though the trend is good in the sense that awareness about mental health is increasing, we need to understand that ‘normalcy’ in psychiatry is a complex concept, more so when it comes to kids. This article is a glimpse into the mindof today’s kids.

At the outset it is essential to remember that the world has changed rapidly in the past decade or two. There is hence a huge difference between the environment in which we are rearing our children and the one we grew up in. Let us explore them one at a time.

Family structure has changed from joint families to nuclear families. On top of that, in most households both parents have a full time job that they are trying to balance with their domestic responsibilities. Child rearing is reliant heavily on domestic helps and daycare facilities. The bonding that children share with their family is not well formed as a result. This is a major obstacle that hinders easy parenting later in life.

Most kids are sent to prep schools quite early to groom them for admission into reputed schools at the right time. It is necessary to understand that at this age the children show a wide variation in their rate of development. Meaning that though they may be of the same age, all of them do not have the same maturity level. There is nothing wrong with that. The ones who are lagging behind usually catch up in a few years. The same can be said about distractive and disruptive behavior. Some children have a difficult temperament, while others have an easy one. Obviously the latter will be easier to ‘manage’ at prep schools and daycare facilities. But that does not mean the former group is ‘mentally disturbed’.

Repetitive complaints from schools send the already distressed parents into a frenzy. Here is a word of advice for such troubled parents. Spend more time with the child, preferably with the aid of their grandparents. A mentally disturbed child will have a persistent and pervasive pattern of disruptive behavior, that is the ‘abnormal’ behavioral pattern will be displayed in all settings (at school, at play, at home etc.) at all times. This simple observation can eliminate half of your worries and many “ADHD” labels. Often, children who are ‘ill-behaved’ at school do surprisingly well when left with their grandparents! As they say, experience and patience counts.

Children who have very little interaction at home often have slow developing speech and are socially awkward. They are not all “autistic“. Majority will pick up speech when exposed to a more social environment. Social skills are a set of learned behavior. Left with their peers, most children will learn them voluntarily, without the aid of special educators. Same goes for nightly bedwetting. Proper toilet training eliminates many problems, without going for medications.

Giving a detailed description of all childhood disorders is beyond the purview of this article. For further clarifications and queries, feel free to seek professional advice.

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Mental wellness is a holistic term that goes far beyond the mere absence of mental illness. It is a state of optimum psychological well-being. If we come to think about it, a major part of our day is spent with our family. They form our pillars of support. We turn to them in times of crisis, be it material or emotional. The role of family in promoting and maintaining mental health is therefore, undeniable. In the article that follows we discuss what constitutes a healthy family that ensures the psychological well-being of all its members.

Communication is crucial
It is important to maintain healthy communication channels between the members. The communication needs to be open, clear and direct. Adults need to have a common ground when instructing children. If children receive conflicting instructions from different adults in the family, they tend to get confused and indisciplined. It is also necessary that every adult member has a say in major family decisions and get an equal opportunity in voicing their opinions. Remarks that are judgemental and derogatory need to be avoided which costs mental wellness badly.

Respecting personal boundaries is important

Family is essentially a unit constituted by members who are unique in their own respect. Care must be taken to preserve this uniqueness. Families that force individuals to conform to rules that are too rigid foster dissatisfaction among its members. There is often a thin boundary between being concerned and being intrusive. While it is natural for family members to show their concern, intruding among personal space(for example a couple’s private life) can be disastrous. This is of utmost importance when there are adolescents and young adults in the family. Elders often find it difficult to let go of their babysitting habits, in the process either provoking a rebellion or smothering the child’s personality growth.

Rules are mandatory
There is always a need for definite rules for a unit to function smoothly. It is desirable to have a few ground rules or code of conduct that each member abides by, with no exception. Again, children learn best by modelling. Adults therefore need to set the example by following the set rules under all circumstances. That being said, it is important that the rules are not so rigid that they come in the way of personal growth of its members.

Flexibility balances everything
The character strength that underlies our ability to cope and adapt to new surroundings and situations is flexibility. A family that models flexibility for its members not only ensures individual happiness, but creates individuals who are more adaptive and emotionally resilient.

In a nutshell, humans being social beings, the crucial role that families play in nurturing psychologically healthy individuals in undeniable. Families that are flexible, supportive, cohesive and establish clear communication channels go a long way in promoting mental health and happiness.

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Everyone experiences stress once in a while. It is part of living. But we are so hell bent on living ‘stress-free’ that we forget it is not always as bad as we make it out to be.

Imagine you have an upcoming examination. But you are not stressed at all. Where, then, would you get the motivation to prepare? The fact that we are stressed before an exam pushes us to invest time and energy into the preparation. If it were not there, we would hardly accomplish anything.

By definition, stress of this kind, which drives us to push our limits and enhances productivity is called eustress. It is the good kind of stress. Here, the person is stressed, but nevertheless, is confident in his/her ability to solve the problem or cope with the trying situation.

Conversely, if he/she is unable to cope and at their wits end, it is distress. In the example above, if a person is driven to despair and panic attacks before an upcoming exam, thus making him/her unable to prepare for it, we would say he/she is distressed.

We therefore understand that given the same situation, it is the person’s ability to cope that determines if they are going to experience eustress or distress.

How does distress manifest? Physical symptoms like headache, loss of appetite, neck and shoulder pain, lump in the throat, back pain, heaviness in chest, tight muscles, stomach upset, skin rashes are common. On a psychological plane, they are unable to focus, lose temper easily, get fidgety, cannot sleep, have mood swings, and experience frequent bouts of guilt feeling.

How to avoid distress?

The idea is to hone our coping skills. Though a detailed discussion on coping skills training is beyond the scope of this article, here are some basics. Whenever under a stressful situation, practice engaging. That is the technical term for being acutely aware of your thoughts, feelings, sensations and your surroundings. When you do that, you interrupt the cycle of anxiety-provoking thoughts that send you on an emotional roller-coaster, leaving you utterly drained and panicked. Stay grounded. Keep a thought journal with you. Whenever there is a distressing thought, write it down, along with the associated feeling. For example, I am not prepared for the examination, I will fail and embarrass myself. The associated feeling is usually fear. It is this overpowering emotion resulting from faulty reasoning that drives you into panic mode. In the next column, write down a more reasonable alternative. Say, I have a week left before the exams, and a lot of ground to cover. I must work harder than usual and come up with a new study routine. The moment you write it down, it is easier to act on it. You have a concrete plan of action, and the overpowering emotions are reigned in. This comes with practice. If you practice these skills on a daily basis, they will come to you naturally in times of crisis.

If you want to learn how to convert distress to eustress, your best bet is to visit a good psychiatrist and get professional advice. Here’s to your ‘eustressed’ future!

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It is not often that we consider taking someone to therapy for being suspicious. But sometimes, we do not have a choice. Considering that the patient is unwilling to undergo treatment in most cases, what is the best treatment for suspiciousness?

The question we first ask is when does one need treatment for harboring suspicions? A simple answer is whenever their normal functioning is disrupted or impaired as a result of this. For example, a person who strongly believes that his/her spouse is unfaithful and therefore goes into depression, has intense anger outbursts or neglect their job to keep an eye on the spouse would fit the criteria. Their mental well-being, social relations and occupational functioning is hampered, just because of a singe baseless belief.

Another example would be a man who strongly believes the terrorists are out to get him. He is sure that they have put up cameras around his house and are having him followed. He therefore refrains from leaving his room, ignoring his work and societal commitments and repeatedly asks authorities for help. No amount of reasoning can persuade him to believe otherwise.

Yet others are fully convinced that they have a lethal disease. They visit various doctors, undergo extensive investigations and medical procedures, all in vain. They however stick to the belief that it is just a matter of time before their disease in detected. Till then, they continue their quest for finding the perfect doctor.
The family members of these individuals are as distressed as the patient. By the time they seek help from a psychiatrist, they have usually exhausted all possible methods to make the patient see reason. Not only have they failed miserably, their relationship with the patient has been strained in the process.

What does the psychiatrist do in such cases? The doctor’s job is to gain the patient’s confidence. Thereafter, the patient is slowly but surely persuaded to undergo treatment. With time, on treatment, the patient’s conviction regarding the misbeliefs begins to dwindle, the mood and functioning improve gradually. However, a word of caution here. This process is sometimes quite slow and is a test of patience for the doctor and family members. However, giving up should never be an option. Another mistake that the family commonly makes is to change doctors midway because the progress is slow. This is not a good idea. The next psychiatrist has to start from scratch and re-evaluate the patient before starting therapy. This delays the progress even more.

The treatment method is often a mix of medicines and counselling. The medications are usually resisted but are indispensable for proper treatment. It is in the patient’s best interest that the family members supervise the medications and accompany the patient regularly for therapy sessions.

To sum up, the best treatment for suspiciousness is one that has the right balance of medicines and therapy, including family counselling for the caregivers, and has a patient approach to healing, both on part of the treating doctor and the patient’s relatives.
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Living with epilepsy is a curse. The patient never knows when he will have the next attack. If he happens to be near fire, water or working at a height at the moment he starts to throw seizures it might cost him his life. Left untreated, it causes extensive brain damage. Today’s blog is a general overview of this dangerous disease and its treatment.

What causes epilepsy
The human brain is a complex network of nerve circuits that fire at specific intervals. These circuits work in perfect synchrony to maintain normal brain functioning. However, sometimes they may go awry and fire in a frenzy. Such faulty brain circuits cause abnormal activation of various brain regions, resulting in seizures. A series of such recurrent seizures is called epilepsy.

How epilepsy presents
Our idea of epilepsy is a person thrashing his/her limbs about violently, frothing from the mouth, with up rolling eyeballs and clenched teeth. While that is not incorrect, it is important to understand that epilepsy has many faces. This classic manifestation of a seizure is not always present. Sometimes the patient may just lose consciousness and fall down. Children often have recurrent spells of apparent absent-mindedness when they simply ‘phase out’, not responding to being called. They cannot recall these episodes, which last a few seconds, later. Naturally they do not remember what happened during those spells, resulting in poor academic performance. At other times, the patient simply notices a loss of sensation or movement or an abnormal sensation in a specific body part.

Sequel of epilepsy
If an ongoing attack of epilepsy is not rapidly controlled, it might cost the patient his/her life. Left untreated, over long time, it causes extensive brain damage. The patient’s intelligence is compromised. He/she may develop mental disorders. Therefore, it is absolutely mandatory to treat epilepsy as early as possible.

Management of Epilepsy

Precautions

• The patient is not to be left alone near fire, sharp objects, waterbodies or at heights. An epileptic attack may occur anytime, causing death.
• Not a single dose of medication should be skipped. Even a single missed dose may precipitate an attack of epilepsy.
• If travelling alone, the patient should always carry an identity card with contact number of a family member

Investigations

• Tests like imaging of the brain, Electroencephalogram and several blood investigations are usually necessary for proper management. The time and type of investigation is based on the doctor’s clinical judgement.

Medicine

• Antiepileptic drugs are prescribed to control seizures. The dose is titrated upwards till the seizures are controlled or the patient experiences unacceptable adverse effects. Periodically, blood investigations are done to check the blood levels of the drug and also to check for adverse effects. It is important to note that antiepileptics are prescribed for quite a long time, sometimes lifelong. If discontinued without the doctor’s consent, there is risk of relapse of seizures.

If you found this blog informative, stay glued to our website. For queries, feel free to get in touch.
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In today’s fast-moving world, we are no strangers to anxiety and stress. It is really difficult to escape this constant cycle of misery. Or is it?
The secret to live a stress -free life is laughably simple. Today’s blog is about making healthy lifestyle choices to relax naturally.

Sleep Well

There is merit in the nursery rhyme – early to bed and early to rise. The advent of artificial light and digital media has reversed the day-night cycle for us humans. We are in the habit of going to bed with our laptops and mobile phones, getting drawn into the never-ending world of web series, social media and work mails till the wee hours of the morning. Then we get a few hours of fragmented sleep before it is time to rise and shine. The body and mind are chronically left fatigued and sleep deprived. To keep such a tired mind functioning, the body’s stress hormones come out to play. Day after day. No wonder we often run out of our energy reserve quite often and really feel the stress. The easiest way out of this mess would be to respect the body’s biological rhythm. We are wired to sleep at night and work during the day. Do not reverse the natural cycle. Go to bed at the same time every night and set your alarm to go off after at least six to seven hours of sound sleep. It is preferable that you wake up at the same time every day. Avoid taking long day time naps and switch off all your gadgets at least an hour before going to bed at night.

Eat on time

This is a no-brainer. But this golden piece of advice is often overlooked in favor of hurried snacks gobbled on the way to and from work at all odd hours. Your body has no idea when to anticipate a meal. As a result, the digestive juices go into a frenzy. Till a time comes when they revolt, leaving you with all sorts of problems like indigestion, bloating, irregular bowel movements, nausea and so on. The bottomline is to have three square meals a day at proper time. Your body will be thankful, and you do not need to stress about your indigestion woes on a daily basis.

Exercise Daily

Exercise releases plenty of happy chemicals in the brain. These chemicals counter the stress that we are always under, leaving the mind and body relaxed and rejuvenated. Leave at least half an hour daily for your exercise routine. You need not necessarily join a gym or a yoga class. Even half an hour of brisk walking or climbing up and down the staircase is good enough. Mix and match all kinds of exercises like yoga, dance, jogging to keep the regime from getting boring and you will start to look forward to your exercise break.

Take time to Relax

Despite your busy schedule, keep half an hour just for yourself. Go completely digital detox during this time. Read a book, go for a nature walk, listen to music, indulge in a hobby. In short, do anything that makes you happy. This is your investment for a stress-free life. Ignore it at your own risk!
For more insights into mental health, stay glued to this blog page!
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Are you looking for counselling sessions for your mental health issues? Before you type top counsellor and mental health therapist in Kolkata into the search engine, be sure to go through this article.

For finding the top counsellor in Kolkata you need to have a clear idea about exactly what you are looking for. Counselling sessions are usually multiple. So, if you are looking for a one session wonder, chances are you will be disappointed. There is no magic mantra that the counsellor can recommend to solve all your problems, even if he/she is the top counsellor in Kolkata. You need show up for all sessions and follow the advice thoroughly.

What then, is the difference between counselling and therapy for mental health? Therapy, properly known as psychotherapy is more than just counselling. The therapist takes a detailed case history, comes up with a formulation based on which he/she chalks out a plan for psychotherapy that is most suitable for the client. The therapy is meant to retrain faulty brain circuits so that the root cause of illness is cured, once and for all. By now it must be obvious to the reader that even the top mental health therapist in Kolkata will not be able to do all that in one session. Also, therapy only works if the client does. Meaning, the therapist usually comes up with several home assignments for the client to practice between sessions. If the client neglects these assignments, there is no point in going for psychotherapy, even if you have the top counsellor and mental health therapist in Kolkata.

Before starting therapy, it is important to understand what you are signing up for. You need to show up for all sessions without fail. Therefore, if you have found yourself a therapist/counsellor whose clinic timings do not match your schedule, chances are you might put your follow up visits on hold indefinitely. That can be catastrophic. So, make sure the therapist/ counsellor is accessible. On that note, you may opt for online counselling or therapy sessions. They are as good as in-person sessions and save you the hassle of travelling all the way to the therapist’s office. You also have the independence of picking a time which is more convenient for you.

Another important point to keep in mind is comfort. You need to be comfortable pouring your heart out to the therapist. If you hold back on information, you stand to lose a lot. So it is a good idea to read up on your therapist beforehand and make sure you will be comfortable, considering the therapist’s age, gender, ethnicity etc.
One quality of a therapist most people look for is approachability. Feel free to ask as many questions as you want during the sessions. Understand the problem you are facing and work out the solution together with your therapist. The top counsellor and mental health therapist in Kolkata for you would be someone who listens carefully during all sessions, explains the illness and the rationale for therapy and includes you and your family/friends in the treatment planning.

Hope you find yourself the top counsellor and mental health therapist in Kolkata most suited for your cause. Happy recovery!

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Depression is, ironically, quite rampant in the city of joy. However, most people take a lot of time to accept that they actually need treatment for depression. If you are seeking consultation and counselling sessions for depression, this article is for you.

Let us understand what happens to the brain in depression. The “happy chemicals” in the brain networks are in short supply. The mind, as a function of the brain, therefore is unable to feel pleasure. Once that happens, the motivation or drive to work or perform our day- to -day activities is lost. And remember that the brain is the controlling center of the human body. So once there is a dysfunction in the control room, it is quite natural that the entire biological system will crash. That is to say, you lose your sleep, appetite and libido. The body is fatigued easily and the mind is unable to concentrate. Naturally, with no pleasure and no motivation to go on living, the person may turn suicidal.

The first consultation session for depression is usually dedicated to understanding the problem, both from the client and the caregiver’s perspective. Once that is done, the psychiatrist decides on the medications and counselling sessions for depression.

A note here. Most people would rather skip the medications and only go in for counselling. But counselling is not a one session wonder. You will be given regular home assignments during each session and for the therapy to work, you are supposed to turn up for the sessions on time with the assignments done properly. The catch here is, in depression, your brain simply lacks the motivation to do anything at all, let alone do mental exercises and mindfulness assignments on a regular basis. So, you will probably need a course of antidepressants to start with and they are quite safe when prescribed by a psychiatrist.

Cognitive Behavioral Therapy, the commonest approach to counselling in depression dictates that our thoughts, emotions and actions are inter-dependent. That is to say, if you think negatively (thought) in a given situation, you are bound to get sad or anxious (emotion) and as a result try to avoid the situation or give up in despair (action/behavior).

In counselling sessions, clients are taught how to identify thoughts that are negative and anxiety provoking. Once the person learns how to identify his/her negative automatic thoughts, the next step is to replace it with a more rational positive thought. For example, after a messy presentation at work, the person might think that he/she is completely worthless and incapable of coming up with a good presentation ever. That is a negative automatic thought. The person is asked to write it down along with his explanation for thinking that way. He is then asked to write down from memory a few good past performances at work. After this exercise, the person automatically begins to see the irrationality of considering himself/herself a total failure. The psychiatrist repeats the same process during the follow-up counselling sessions. As the pattern of thinking changes from negative to positive, the person begins to think more rationally. His/her confidence improves and the mood brightens.

If you are considering psychiatric consultation and counselling sessions for depression, make sure you are fully committed and willing to attend the sessions regularly. As I always say, therapy only works if you do. For further queries, feel free to contact us.
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Nicotine addiction is a global burden. India is no exception. Between smoking and chewing tobacco, the number of people dependent on nicotine is quite large. However, the good news is that many are coming forward today to get rid of this habit.

A lot has been said about the health hazards of regular tobacco use. It is responsible for causing cancerous growths in different parts of the body, like the lungs and mouth. Several chronic lung diseases are a direct result of regular smoking. It is the culprit behind stomach ulcers and heart problems. Despite knowing that, people find it difficult to quit.

It is not that the do not want to. But addiction is a powerful enemy. Long term tobacco (nicotine) use causes multiple changes in the brain circuits. That is to say, the brain is rewired such that as soon as the person tries to quit, the mind and body suffers immensely.

What happens when you want to quit? The brain, which was used to the stimulating effects of nicotine, feels energy deprived. So, the person becomes drowsy and irritable. Anxiety increases manifold. This is in addition to the constant craving for a smoke. The body experiences tremors, sleep patterns are disrupted and the person becomes dysphoric. It is at this point that the motivation to quit no longer holds, resulting in a relapse.

Is there a way out? The answer is yes. We initially start the patient on Nicotine Replacement Therapy. That is, we give him/her nicotine in the form of gums, lozenges or patch. That maintains a steady but controlled supply of nicotine to the brain, thus preventing withdrawal symptoms. Thankfully, we now have specific medicines that act as anti-craving agents to reduce the desire to smoke or chew tobacco. These medicines also ensure that the person is able to sleep well and does not become dysphoric. Together with this, we start the client on psychotherapy, the commonest being Motivation Enhancement Therapy or MET. The idea behind this is to boost the client’s motivation to quit and prevent a relapse. There are several sessions of MET that the client must attend before he/she masters the art of complete abstinence.

Do people relapse often? Unfortunately, the answer is yes. The reason is often non-adherence to the treatment regime. Quitting a long-term habit that has extensively rewired the brain takes time and motivation. The psychiatrist is there to guide the client, but the client must meet the doctor half way. Otherwise, the treatment never works.

We often encourage family and friends to attend the therapy sessions along with the client. This ensures an additional support system, a safety net for the client. Together, the psychiatrist, the client and his/her well-wishers build a team that functions effectively to achieve the deaddiction status.

If you are a habitual tobacco user, it is time to consider quitting for a healthier tomorrow. If you have further queries on the subject, feel free to post a query to our site and we will get back to you in no time.

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