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The interesting thing about the human mind is that it is able to handle multitudes of thoughts, visions and information, simultaneously and flawlessly. Yet, in the midst of so much diversity, it is able to preserve its integrity. Always. Well, almost always.

The exception is people living with Schizophrenia. I deliberately used the term ‘living with’, for it is often possible to lead a meaningful life, even for those with this mental condition. True, they are on perpetual treatment, but that is a small price to pay for preserving one’s sanity.

So, what exactly happens in Schizophrenia? If we were to delve into the minds of such unfortunate individuals, we would see that they are unable to differentiate the real from the imaginary. They are simultaneously living in two worlds, one real, the other imaginary. It is as if the mind is split into two halves, one real and the other unreal. Hence the name.

Say, for instance, while this person is speaking with you, there are imaginary voices speaking to him/her at the same time. Naturally, the chain of conversation breaks intermittently and his/her sentences are often lost midway. This is most distressing, to say the least but what if such voices were saying nasty things or commanding the person to act against his/her will? And that too, every moment of the day. That is exactly what happens to the person suffering from this disease. For them, those imaginary voices are as real as yours. This person naturally reacts, often with fear, at other times with anger. You might therefore see them talking emphatically to unseen people, hurling obscenities in thin air or recoiling in fear. As observers, their behavior seems utterly weird. But once you begin to understand why they are acting weird, it would be easier to understand their dilemma.
A note of caution here. Often, such imaginary commanding voices are so powerful that the person is compelled to comply with the commands. That means they might gravely harm themselves or others without any apparent provocation, if the voices that command wish so.

With time, the line between the real and the imagined blurs. The person begins to believe everything the voices say. That, in the real world translates to suspecting others, disrobing in public, collecting garbage strewn on the roads or simply wandering off at unholy hours. Such trivial issues like bathing, washing or self-care no longer matter to him/her and they spend days and nights talking to those voices, often foregoing food and sleep.
How, then do we bring them back to reality?

So far as treatment goes, the earlier we start, the better the results. It is always easier to douse a flame than a raging fire. As soon as you notice such symptoms in a near one, visit a psychiatrist and strictly adhere to the treatment regime. The treatment could last a lifetime, but in many cases, we are able to keep those unfortunate individuals happy, healthy and functioning while on regular medications. For more information, feel free to post a query to our site.

Bipolar Affective Disorder or Bipolar Disorder, as it is known commonly called is an interesting phenomenon.
Let us consider the two ‘poles’ of Bipolar Disorder. If Depression is the South Pole, then consider Mania as the North Pole. Affect, simply put, is the current emotional state of the mind. For a person living with this condition, this mental state swings from one pole to another, rapidly and totally.

Depression, the South Pole is all cold and dreary. Nothing seems pleasurable to the individual. There is no joy in living, working or socializing. The body feels fatigued, devoid of sleep, appetite or libido. There is no motivation for going on anymore. The person feels worthless and helpless. The future looks dark and hopeless. The person often turns to alcohol or other drugs for solace, but they offer little support. At this point, suicide seems like a logical way out.

The North Pole, or Mania is all bright and sunny. The individual feels charged up, full of bright ideas and lots of energy. Nothing seems impossible here, be it an unrealistic business endeavor or freeing the country from the grip of poverty. The person is overtly talkative, very jovial and goes about socializing with every Tom, Dick and Harry they meet. Such individuals feel they have little need for rest or sleep, often going on for days with only 2-3 hours of sleep a night. They overestimate their powers and often meet nasty accidents while driving at reckless speed or getting beaten up in a street- brawl. Yes, they are provoked very easily. Anyone who dares oppose their unrealistic ideas faces their wrath, often getting beaten up or abused. Money is spent liberally, be it on alcohol, recreational drugs, gambling or feeding the poor and needy. With such individuals, you never know.

So how long does the individual stay at each pole? That is unpredictable but a switch to the other pole is always imminent. There might even be a period where he/she touches middle ground and comes back to reality. This point is again dangerous. As the individual comes to terms with the damage that occurred to their career and relationships during the manic or depressive phase, it might drive them to sheer frustration or suicide.

Over my years as a psychiatrist, I have seen many brilliant minds and promising careers lost to an illness that could have been treated, had the patient and caregivers complied. So, for all those reading this blog, my sincere request would be that do consult a psychiatrist immediately if you or a near one is suffering from this condition and complete the treatment as advised. The way to cure may seem long and difficult, but it is always worth saving a life.
drdebasmitapsychiatrist

With the rising awareness among the citizens regarding the importance of mental health, people are exploring various options for mental health treatment in Kolkata. In today’s article, we will explore the various options available and how to go about it.

You can either approach a psychologist or a psychiatrist. Let me explain the basic difference between these two professions. A clinical psychologist is certified to conduct counseling/ psychotherapy sessions and do various psychological assessments like IQ testing, personality testing and so on. A psychiatrist is a doctor, who after MBBS, gets a post – graduation degree (MD) or diploma (DPM) in Psychiatry. Their training involves both the science of psychopharmacology (psychiatric medications) and the art of psychotherapy.

Now that we have covered the basics, we need to understand whom to approach in what situation. Say you are looking for an IQ assessment for your child. That is the domain of a clinical psychologist. But if the child has associated behavioral problems/epilepsy you will need the help of a psychiatrist as well.

The question that troubles most people in Kolkata seeking mental health treatment is the safety and efficacy of psychiatric medications. Understand that any medication working on your body will have multiple effects, some desirable and some undesirable. For example, there are a variety of antidepressants we use. Some have sedative properties, meaning they can make you sleepy. Others have activating properties, meaning they perk you up. Now a patient suffering from insomnia due to depression will obviously benefit from the first category, provided the drug is taken at bedtime and not in the morning. Then it will naturally hamper with your work output. Another depressed person who is lacking in energy and motivation will benefit from the activating category of antidepressant. So, it is always a question of the right medicine in the right dose at the right time. And medications are often indispensable if you are looking for a holistic mental health treatment in Kolkata, or anywhere for that matter. Very rarely can we pull a suicidal patient out of severe depression based solely on talk therapy. The same goes for patients suffering from panic attacks or OCD. The medications keep them alive, healthy and functioning. Even medications for controlling high blood pressure or Diabetes have plenty of adverse effects. Does not mean we will live skip the medicines and live with the disease. The same goes for mental health treatment. Check with your psychiatrist for possible side effects and get your doubts cleared.

Here the question arises, does psychotherapy/ counselling have any role at all? Yes, it does. For an autistic or intellectually challenged child, this is the mainstay of treatment. For other disorders, evidence says two is most often better than one. Meaning, a balanced combination of medications along with psychotherapy is the key to the best mental health treatment. And it is best to let your psychiatrist decide when and how to combine these modalities.

I personally prefer a course of minimal medications at the lowest effective dose along with brief, precise counseling sessions scheduled at strategic intervals. Of course, the strategy differs from patient to patient. If you are considering options for mental health treatment in Kolkata, feel free to post your query on my website and I will be happy to help.
DrDebasmitaPsychiatrist

OCD – the name, for many is associated with the image of a woman cleaning and washing on repeat mode, as if her life depended on it. True. But today I will walk you through the varied presentation and treatment for OCD, short for Obsessive Compulsive Disorder.

Obsession is a thought that keeps on bugging you. You know it is futile. But you simply cannot get it out of your head. You cannot focus on the task at hand. In short, you do not get any fruitful work done throughout the day. For a person living with that, it can be a nightmare.

So what kind of thoughts are these? I will share a few I came across in my clinical practice. A school teacher kept thinking the world would collide with other planets and life as we know would come to end one fine morning. Another was convinced that if she drank from a red water bottle the water would turn to blood. Yet another young lady could not stop herself from counting to 101 before she set about any task. And if she was interrupted during this task, she would start all over again. That reminds me of a very interesting case of an elderly lady who after her husband’s death completely confined herself to her home. The reason she did that was bewildering. Every time she met someone, she had these mental images of that person walking all over her body, albeit as a lilliputian version of himself/herself. Note that these were intelligent people who understood he folly of such thoughts, but the irony is they could not stop thinking.

Oh, did I mention that OCD is not just about thoughts? You also have a healthy dose of imagery involved, as in the case above. A young man refused to go to family gatherings and never ever looked a woman in the eye, no matter how old she was. Though initially family members took him to be extremely shy, the real story was far more interesting. He had these sexually charged images involving any woman he met. He simply could not stop. As long as the woman was there, he kept on seeing the images before his eyes. It was embarrassing and distressing, to say the least. Not that he was a pervert. In fact he was a brilliant student and a sweet decent boy. Imagine his guilt!
I could go on and on. Over years of clinical practice, I have come across a variety of such distressed souls. What I have realized is that when a person seeks treatment for OCD, the first thing they are looking for is a compassionate listener. If the doctor cannot lend a patient ear to the patient, no matter how accomplished he/she is, the patient is never reassured. And when someone is in pain and on the verge of giving up, they need their faith.

If you are suffering from this disorder and reading my blog, know that treatment for OCD exists. OCD is caused by chemical imbalances in the brain that can be put right by medications. We also recommend intense therapy as an add-on. Remember that treatment options are many, but what makes the difference at the end of the day is whether you trust your doctor and are willing to participate in the treatment whole-heartedly. As my former patients tell me, it is their belief in treatment that pulled them through. I am sure we can do the same for you.
Till next time, if you have any queries feel free to post them on my website. Stay happy and stress-free!

Creative, caring, vulnerable, passionate. These are the words that come to your mind when you fondly think of these individuals. But you cannot help calling them unpredictable, impulsive, moody or even unreliable. You would associate them with a colorful life. Parties, art, romance, fashion, recreational drugs – there seems to be an abundance of pleasures in their life. They come across as carefree, confident people who know how to carry themselves well. But beneath the tailored dress and bold tattoo are numerous scars, each from a time when they cut themselves in a fit of rage. Often, after a bitter fight with a loved one. Their lives seem to be an endless collage of short but intense relationship, ending in failed suicide attempts.

So what makes a borderline personality? Family genes, disturbed home atmosphere or abuse as a child are some of the common culprits. They grow up with a deep rooted sense of insecurity. Within each moment of joy is embedded an underlying fear of losing it all. Quite often they feel rejected by the one they love, for no rational reason. And yes, the intensity of all their emotions is way above average. The anger on display every time they feel overlooked is as intense as the admiration of first love. No wonder their relationships are tumultuous and short-lasting. They are caught in an endless pursuit of pleasures to fill up the emptiness within, but in vain, leaving them frustrated and depressed. It manifests as intense mood swings, overdose of recreational drugs or botched suicide attempts.

It is easy to give up on them saying we cannot change a man’s nature, but with patience and willingness, it is not an impossible task. If you identify with this character, or know somebody who does, feel free to ask for expert advice.

A perfectly boring afternoon. The lockdown and the seething heat. As I stared out of the window at the isolated street below, all signs of life seemed to have evaporated. The news played in the background. Mounting death rates. Oxygens shortage. Life simply was not worth living, it seemed. I must have dozed off for a while. I opened my eyes to a breathtaking view. The twilight sky was lit up. Dazzling shades of vermillion and molten gold. A fiery red ball at the horizon. A flight of birds flew by. The coconut trees swayed in the distance, casting a black shadow across the golden tapestry behind. Suddenly, it hit me. I had lived another day to witness nature’s miracles. Tomorrow would bring new struggles. But today, at this moment, I was happy. I lingered for long, taking in the sheer glory, the beauty filling my soul with joy. As they say, my cup runneth over.

A life without purpose is like a ship without a radar. Your purpose is what gives your life a direction. When you get up each morning, you know you have a task at hand. Each day, you move a little closer to your destination. It gives you a sense of fulfilment.

You will be tempted time and again to give up on your dreams and live an easy life. But no matter how luxurious your life is, it will still be a lost cause. You will tell yourself you have achieved so many things, but your mind will never be at ease. Deep down, it will keep reminding you how far you have strayed from your path. That is when boredom sets in. And an unknown fear creeps over you. You cannot quite put your finger on it. But you are mostly anxious and unhappy.

And there is no escape from this. Except to go back and pick up from where you left off. It may not be an easy path. It may not even lead to a glamorous destination. But it is yours and only yours. You cannot say that about most things in life.

So take some time out to reflect on your purpose. Trust me, your life will never be the same again.

The adolescent sitting before me is in a foul mood. Her mother is in tears. She simply cannot get her daughter to make amends with her husband.

It is illogical of her mom to ask that of her, retorts the daughter. Her father is always overtly critical of everything she does. Nobody else has a say in the family except him. It is always his way or the highway. Every time she tries to get him to change his ways, they get into an argument. Pretty soon, it is a shouting match.

The mother is tired of playing referee. She wants her daughter to calm down and concentrate on her career.

The girl wants that too. But apparently, living in the same house with dad is not helping.

She reminds me of a wild stream thrashing against a rock that hinders its journey. She wants to wither it down, and forge her way. But there is a simpler way, I tell her. Simply take a detour. Bypass the rock. It has sedimented over so many years. It is not easy to wear down. Why waste your energy?

Often, in our lives we are so hell bent on challenging old ways that we forget our true purpose. Change is necessary, but you do not need a head on collision each time. You can simply take a detour and let your success prove your point.

The man sitting before the psychiatrist is deeply troubled. It has been 14 years. He has gone from one doctor to another. He hardly sleeps. Faints often. Has frequent headaches. There are chest pains and aching muscles. He lies in bed all day, too weak to get up. He worries a lot, he says. But strangely he never shares his thoughts with anyone. Not even his wife of twenty years. Whenever he is angry or hurt, he keeps it to himself. He never could find a way to express, he says.
This is the first time he is opening up. He speaks of his life. The failure, the guilt, the frustration. The youngest of seven siblings, he was the least educated. His business ventures did not reap the rewards he expected. His conjugal life was haywire. He attributed his bedroom troubles to a youthful misadventure. He still lives with the guilt of that incident. He beat himself up every time he thought he had offended someone.

You could try speaking to the voice recorder on your phone, the doctor suggests.

Slowly, over the next few sessions, as the recorder plays, it all tumbles out. Pent up anger. Countless guilts. Unspoken words.

The aches lessen. The fainting becomes infrequent. The spirit lifts up.

A lifetime of unheard regrets that had found their way out as bodily symptoms finally find closure.

# DrDebasmitaPsychiatrist