Who the Real Culprits Are..?

 Once a teenager was taken to a doctor with complaints of behavioral disturbances due to poly -substance abuse. When his history was probed he told that “my father is a chronic alcoholic. He sends me to buy alcohol. He even uses cannabis for smoking. But I never scold him. Let him enjoy his freedom. I want to enjoy mine.’’ Then when the doctor spoke to the father he told that “sir I drink daily. But I go to work properly. Look at him. He is not studying or going to work. Then how can he drink?” The father politely came close to the doctor and questioned “sir I have used many substances but my son is using a new one a white substance to sniff what is that? Is it more euphoric? “What should the doctor tell the father? If the answer was yes the doctor would have turned the father too towards glue sniffing. The poor man never understood the real problem in the house. He was always blaming his son.

 A young couple bought their four year female child to a pediatrician with complaints of not obeying the parents. Their told the child was watching pogo channel continuously and refuses to change another channel or switch off the TV. The child was not doing the school homework regularly and often the class teacher complaints about that to them. They wanted to assess the IQ of the child. The child was assessed and IQ was found to be normal. During the course of interview the mother told that during infancy the child used to cry a lot and refuses to take food. So the mother switches on the TV, keeps a cartoon channel for the baby to see and feeds the child. She was doing that for nearly two years until the child went to playschool. Since both the parents are working they don’t have time to spend with child. Don’t have time to sit and talk and help the child in her homework.

From the two experiences which we had, the readers would have understood who the culprits were. Yes friends childhood period is one which is very important for every child. We should always be able to spend time with our children and sacrifice a few of our interests for the good nurturing of our child. Denying the proper support and then worrying for it makes no sense.So friends spend time with your children. The way you behave to them is the way they are going to behave back to you. 

LETS MAKE A DIFFERENCE.

Dr. Bevinsathya.

IT'S Crowded Here

                       A female once travelled with her family to a marriage function nearby. When she entered the van arranged for that and the door was closed, she felt distressed and breathless. She had palpitations , ringing in the ears, fainting attacks and excessive sweating and came out of the van. She felt relieved and she did not travel in the van on that day and never after that. She avoids travelling in bus and van but prefers her scooter to travel after that incident. Few days later she went to a shopping mall with her family. She took the lift to go to the upper floor. She suddenly felt giddiness, palpitations, nausea, upset stomach and sweating. She came out of the lift in the very next floor. She did not take the lift back down .She avoided to use lift from then on for past three years now due the fear of developing the same symptoms. Once the lady went to her neighbor’s house .when she was speaking to her neighbor the door closed automatically due to wind. When she noticed that she felt discomfort and became restless .she ran out of the house in fear.

                        The symptoms the female had were suggestive of a condition called AGORAPHOBIA. In Agoraphobia there is marked and consistently maintained fear and the person avoids crowds, public places, travelling alone and travelling to far away places. The persons suffering from this disorder feel escape might be difficult from these places or help may not be available. This condition can occur mostly in persons who are anxious and avoidant and also in persons in severe stress or depression. Women are found to have more prevalence than men.

Early intervention and treatment with medications, relaxation and breathing techniques are found to show excellent results. So friends if any person is found to have these symptoms please consult your psychiatrist as soon as possible for better results….

Few other phobias are 

ACROPHOBIA - Fear of heights
CLAUSTROPHOBIA – Fear of closed places
HYDROPHOBIA - Fear of water (in rabies infection)
XENOPHOBIA – Fear of strangers,
ZOOPHOBIA – Fear of animals.

Please know them and share with others. 

LET’S MAKE A DIFFERENCE .....

DrBevinsathya

Cocaine a lethal CNS Stimulant

                 Cocaine is an alkaloid which is derived from coca bush. It is commonly called by the street name “Crack”.  Cocaine is a central stimulant which can be inhaled, smoked, or injected. The highest concentration of cocaine is found in the inject able form. People abuse cocaine to attain euphoric effect. Though government has tried to eradicate cocaine abuse young people abusing cocaine are increasing day by day. Cocaine though a CNS stimulant can cause serious side effects to the abuser.

The intoxication of this substance is associated with tachycardia, hypertension, sweating sleep disturbances and increased psychomotor activity. The abusers lose their personal and social judgment and have psychotic symptoms. On chronic use of heavy doses the person can have seizures, respiratory depression, arrhythmias and heart attacks. The use of these substances can also be an illness behavior due to depression and other mood disorders. Cocaine is a lethal substance which produces dependence and is very difficult to stop once a person starts abusing it. Any person abusing cocaine must consult a psychiatrist as soon as possible to undergo dead diction treatment, supportive psychotherapy and behavior therapy to prevent further complications….

LET'S MAKE A  DIFFERENCE ......                                                                                                                 DR.Bevinsathya                                    

My Childhood Memories

I can scan my remote memory way back to the day when I crawled to my mother to get rice mixed with milk. She used to tell me stories to make me eat. I still remember the day I sat with my grandmother at the age of 2yrs in the balcony noticing a crow struggling to get away from a tree. Days later my grandmother fell ill and was taken to hospital and I ran behind the wheel chair in the ramp not knowing what was happening to her. I remember the day when I sat in my father’s arm and looking at grandma’s body and asked “when will grandma wake up?’’ not knowing she has passed away. The first day I went to school my mother made me sit in the classroom and waited outside. I was so afraid and I cried and ran back to her. I remember few of my first friends in LKG.

 I remember many a thing about me and my brother fighting with each other. Once at the age of 5yrs I tried to take a honey bottle which slipped and fell down. When noticed by my father I blamed my brother and he was beaten up. Once we both went late to house after playing in school and were gifted effectively. After every annual leave I remember the exam writing pad becoming a cricket bat and ice-cream ball becoming cricket ball for me and my brother. When I go with my brother walking to school whenever we notice a new bike or car we used to say “when we become rich we will buy all those cars and bikes”. Once my father gave two rupees for us to buy chocolate. I remember asking the shop keeper to give me a five star chocolate. He told me it cost five rupees. I went back and waited for few months to get another three rupees from father. I ran to the shop as fast I could and bought a five star and I and my brother shared it.Every Sunday father gives thirty rupees to buy chicken. I and my brother were made to wait hours because the shopkeeper was busy packing bigger parcels and welcoming people coming in bikes and cars. Whenever I am free I become a driver to a cycle tyre.

 The best of all my childhood memories was when my father and mother take us outside to take dress for New Year or birthday. We used to walk together for about five kilometres to textile shop. My father sacrifices his new dress because of us taking costly dresses. We thought then our father was not interested in buying new dress for him. Then we go to hotel to have a nice non-veg dinner. Our mother convinces our father to buy us ice cream for a final finishing touch. Then we walk back home happily talking about our new dresses when my father silently does come calculations by making gestures in air. We never knew what he was doing. Well he was calculating the expenses and the savings he has to make for future expenses.

Now after so much years has passed after seeing so many people having a poor childhood period going on to develop dependence to substances, drugs and other behavioural problems I realize the importance of my childhood. A famous psychologist has once told “tell me a child’s first two years I will predict his future”. Such is the importance of our childhood. When we ask a few patients what they like in childhood they used to say “I don’t like to remember that”. I learned love and affection from my mother, discipline from my father, sharing with others from my brother and patience a very important component in life from the shopkeeper who used to make us wait for hours for a few grams of chicken….thanks to all of them…

We knew we were not rich we were not wealthy but our parents never let us suffer and we were very happy. Well I know I can’t get these childhood times back again but if god gives me a chance to choose something I will say to him to give me the first ten years of my childhood back to go back and thank my parents, my brother ,my grandma and all those involved for making me what I am today. Friends it is never too late than never to thank your parents, brothers and sisters who have made you what you are today. Let it be today….

“DAYS MAY PASS BUT MY MEMORIES WILL STAY”.

                                                                                  LET’S MAKE A DIFFERENCE – Dr.Bevinsathya.

I Learned from my Patient..

Today I happened to see a person a known case of severe depression on drugs. He came for a regular review. I started talking to him. He elaborated his complaints to me. I explained to him his problems and the solution to his problems. He complained about his interpersonal conflict and other issues. 

I explained to him all his issues.The interview lasted for about an hour. He seemed to be relaxed and I advised him to come for regular follow up. He said ok but was standing there waiting for me to do something. I asked him “what is your doubt?” He hesitantly came close to me and asked “sir you have not examined me? I told you I have problem I my mind. But you have not auscultated my chest. Then how will you know my problems? “ Yes his concept of mind was related to chest. I politely took my stethoscope and auscultated the chest and told him he was ok. He felt so relieved and thanked me and left the op. 

Well he taught me a lesson today. Whatever may be the case auscultation of the chest is important for the patient when he comes to a doctor irrespective of his complaint. I thank my patient to reminding me time and again its importance. I learned from him today a lesson. Let me not forget its importance.

Dr.Bevinsathya.

Hippocrates the Social Reformer

Hippocrates is said to be a great Greek scholar and physician of 400 BC. He is called as the father of western medicine. But his contribution to psychiatry is more important. He was the first person to say that mental illness is due to bodily changes and not due to demonic possessions and black magic.

Doctors and Medical students take the Hippocrates oath during their medical journey.

Though Hippocrates was not able to point the changes in the nervous system or neurotransmitters he told that mental illness is due to an imbalance in the bodily fluids. He explained that human emotions can be divided into four humors.

A) SANGUINE (Blood) - A warm, outgoing personality. Rarely loses temper and is compassionate and loving by nature.

B) PHLEGMATIC (Phlegm) - A lazy, laid-back personality. Is rarely bothered by carrying out jobs or work, and does not express many emotions. Never is emotionally intense.

C) CHOLERIC (Yellow Bile) - An angry, aggressive personality. Is often loyal, but at the same time, has a very short fuse and is impulsive by nature.

D) MELANCHOLIC (Black Bile) - A sad, despondent personality. Tends to display more reactions of negativity towards stimuli, and is often selfish and self-absorbed.

But even in 2013 people believe mental illness could be a part of black magic or demonic possessions.

The more sad part is the amount of financial loss and stress they undergo before consulting a doctor. People consult a lot of magic religious persons and lose their hope before coming to a psychiatrist. They are so drained and tried that they are not able to accept the explanation of the psychiatrist. The latter they consult the poorer is the prognosis. This is very important in case of any mental illness. So friends please don’t hesitate to come out and solve your problems as soon as possible. BE OPEN AND BE FRANK

“LETS MAKE A DIFFERENCE”

Dr.Bevinsathya.

Am i FAT.....?

Feeding and eating is the main mode of energy intake of our body. Each person has his/her own pattern of taking diet. Some are concerned about their health, some about their body shape and some about flavors and taste and so on. There are few persons who self-starve themselves to maintain their body image. It is especially very common in adolescents girls. The overall incidence is more in women than men. 

There are two important medical conditions related to eating. 1) Anorexia Nervosa  2) Bulimia Nervosa(Binge eating). 

In Anorexia Nervosa persons self starve themselves to maintain their body image. Many famous personalities like actresses and singers especially below the age of 30 have lost their lives due to anorexia nervosa. 

In Bulimia Nervosa persons go on a eating spree followed by self induced vomiting and purging to over compensate their body fat content. Beware friends it is a bad habit to have. This eating pattern can disturb your body's nutritional balance.It can lead to malnutrition, menstrual abnormalities,decreased immunity, cardiac problems,cognitive disturbances,behavioural disturbances, infertility and in severe condition lead to liver , kidney malfunction and death too. It is very important to maintain a balanced diet all through the day 24/7. 

You can calculate your BMI which is an indicator of body fat content by using a simple formula(wt/ht2). If you have doubts in your diet pattern please consult your dietician or doctor to clarify them. It is very important to stay healthy and active than a so called body image. 

"Eat healthy Stay healthy". 

LET'S MAKE A DIFFERENCE.

Dr.Bevinsathya.

SIR PLEASE IN AM AFRAID...

Few days back on a fine evening two policeman brought a wandering person to the hospital with a magistrate order under the request of his mother. The main complaint was he was very aggressive and uncontrollable by others . On examination he was irritable and not so cooperative. He was advised admission. I asked the policemen to take him to ward but the person denied to go to ward.He refused and stood ground there for around 5 hours. In the meantime i noticed the two police personnel getting very restless and trying to tell something.

One of the policeman silently came to me and told "sir we can control any murderer or a smuggler but with this person we are very afraid.Sir he is very angry.He may hurt us sir. Give him some drugs and sent him off. Why are u admitting him?". Finally the mentally ill person obeyed to the words of the doctors and nursing staff and he came to ward. He was started on medical treatment.The next day when we went for rounds we tried to to talk to the person.Suddenly a policeman came running and told "sir dont talk to him he may hurt you". I told to the the policeman that this mentally ill person is not harmful than anyother so called normal person. Well i knew one thing for sure. These police men may have been trained to deal with criminals but when it comes to dealing with persons who are mentally ill they had zero knowledge.Well i think as a public personnel all police personnel should be given a outline about mental health and how to handle mentally ill persons. 

"LET'S MAKE A DIFFERENCE"

Dr.Bevinsathya..

Branding one as a Psychic...

I would like to share an experience of one of my friends who is a psychiatrist by profession. Around the year 2001 the psychiatrist was consulted by a businessman around 50years old complaining about his wife having sleep disturbances, lack of interest in day to day activities and suspiciousness about his behavior for a month. The psychiatrist advised him to bring his wife for consultation. The businessman was very reluctant but finally agreed to bring his wife. Few days later he came with his wife for consultation. The psychiatrist talked with the wife but she never replied back. She seemed to be very depressed. She was put on medications and advised review. The business couple was very regular in their consultations and treatment schedule. Years passed by but the wife never seemed to improve even after several psychotherapy sessions. The husband was very caring and supportive all through the treatment course. The psychiatrist even appreciated the husband for his continued support to his wife but the psychiatrist was never really able to understand the real psychopathology behind her behavior.

In the year 2006 the psychiatrist went to attend a medical conference to a nearby city. He was given accommodation in a star hotel. The last day of conference he was offered a party in the hotel by the organisers.In the party he noticed the hotel servants giving special attention to one specific person. The man seemed quite familiar to the psychiatrist. Yes the man was none other than the businessman who used to bring his wife for treatment. The businessman was accompanied by a young girl .The psychiatrist was very curious and enquired the hotel officials about the person. They told he was their prime customer and the girl was his personal assistant. The organizers told the person was a regular customer in their hotel. The psychiatrist was eager to speak to the person but left to his hometown without identifying himself. He had many unanswered questions in his mind.

Few months later the businessman brought his wife for treatment as usual. The psychiatrist asked the businessman to wait outside and started to talk to his wife. He shared his experience about her husband in the hotel with her. As he mentioned the incident for the very first time in five years the lady started to cry. The psychiatrist probed further. The wife started to narrate her problem. Few years back she has once incidentally noticed her husband sharing bed with another woman in their house. She argued about that to him. She called her relatives to help her. But the husband had a very good name with the relatives so none was prepared to listen to her. The businessman took it to his advantage. He started to consult a few psychiatrists before coming to him to brand her a mentally ill person. The psychiatrist asked” why didn’t you tell me the reason in your previous interviews?” She told her husband threatened to divorce her and even harm her if she reveals the truth. The psychiatrist consoled her and asked the businessman to come.

He told him “your wife is completely cured of her illness. She doesn’t want to take medications anymore.” The businessman’s face turned red. He tried to convince the psychiatrist saying she still had sleep disturbances and anger outbursts. The psychiatrist advised the businessman to come for follow up two weeks later. But he never returned. The psychiatrist now feels the husband would have gone to any other mental professional to brand the poor lady. He still regrets his decision to have sent the businessman away.He everyday thinks about the poor lady whom he could not help.

What could have he done to help the poor lady any suggestions?

LETS make the Difference.

Dr.Bevinsathya..

World Mental Health Day 10/10

Today ( 10/10 ) is world mental health day. The theme for this year is Mental Health and Older Adults. I personally feel we have not understood the meaning of this theme .Well if we had understood it there won’t be any old age homes popping up here and there every day. 

Few days back I had a chance to visit an old age home. It had inmate occupancy of fifty people. First I slowly walked around the home seeing most old people sitting lonely and a few talking to each other. In the kitchen few old women were cutting vegetables. Then I came to the main hall. I talked to a few persons over there. The first person was a retired clerk from railway who was brought here by his own son one year back. His son resides just a few kilometers away from the old age home. I asked the person" why did your son bring you here? He cleared his throat a bit and replied am a diabetic patient . I am not able to do my day to day work. So my daughter in law forced my son to bring me here". I spoke with him for a few more minutes before moving on to the next patient. 

The next person was the senior most person of the old age home. He was an eight nine year old healthy man
whose son works as a general manager in postal department. I asked him "when did u come here?".He smiled at me. He asked me "Who are you?"I introduced myself. Then he started to speak."I am a retired teacher. My only son is in a very big post in postal dept.He is very busy so he was not able to take care of me. So he sent me here two years back with 200 rupees in my hand. I am not a pensioner. But my son sends me Rs500 every month as pocket money for my expense. I am happy here". He was very active and happy all through the interview. Then we organized a meeting for all the inmates in a hall. 

I noticed one old woman sitting lonely not involved in the meeting. I went her and started to speak to her. She stopped me and asked "wait tell me when will my son come to see me?” I asked her when he last came to see her. She cried immediately and replied back “on the day of admission 15years back. He went to Sudan with his family. He is a doctor ".I had no words to console her. I started to talk to the gathering. I asked them “are you happy here?” They all told together that they were happy. After an interactive session finally at the end I asked them a sensitive question."Okay I know you are all happy here. But if one day your son or daughter realize their mistake and come to take you back what will you do?. There was a period of silence for about five minutes. After that one old woman from the front corner stood up and told" who does not like their children? I love them above all. After my husband's death I stood alone to save my family of three female children. Now each one of them are married and well settled. But now no one wants me. I like to live and die here itself." There was an eruption of claps from all the inmates.

 Friends I noticed one common thing in all the inmates. Their children were all well settled and financially sound but they have left their parents in these old age homes which run by charity.”Are we doing justice to our self by doing so and neglecting our parents who have carried us, cried for us, prayed for us and finally sacrificed their needs for us? I was so unlucky to lose my grandparents at a very early age. I remember my parents who have sacrificed a lot for me and my brother in shaping our careers. How can I forget them? How Can I kick the ladder which helped me to go to higher heights? The day we feel the importance to care our elderly ones will be the day we become human beings. We extract all their energy when we need it but when they are tried and crumbled and need our energy we turn our backs. I think it is the duty of every one of us to repay our elderly parents with care and affection in their second childhood rather than blaming them for their shortfalls. By doing so and giving them moral support is very much necessary for them to have a normal mental life. Treat them and love them as you do with your children. Well friends think for yourself “have I ignored my parents?”And act immediately on this day because you maybe the next in line. Yes your children are watching you closely. It is never too late. Thank you.

LET’S MAKE A DIFFERENCE.

Dr. Bevinsathya.

Mama i dont need Breakfast..

In our day to day life we are so busy that we tend to skip our breakfast. Breakfast is defined as breaking the previous night fast. Breakfast is a necessary component of every individual's daily routine schedule. People particularly children run away to school skipping breakfast, but beware children skipping breakfast in a regular basis tend to have impaired concentration, attention and poor memory and even behavioural abnormalities more than the children who take breakfast.

A famous quote "eat like a king in morning,eat like a prince in noon and eat like peasant in night" is done in the reverse order by many people.Some people even think they can reduce weight by skipping breakfast. But studies say people skipping breakfast are more prone for risk of diabetes,obesity ,insomnia,acid peptic disease and other related problems in near future.So friends spare some time and take your breakfast regularly to avoid any unneccessary complications....

Dr. Bevinsathya.

Drug abuse - A slow Poison.

I chose to write about this topic following a request from one of my friends who is a pharmacist working in govt sector. Well, I understand the interest and care he has for a common man as he knows better than many others, regarding drugs and its misuse. I would like to share two of my experiences, a positive one and other a negative one regarding drug abuse.

First, the negative experience. We had a man, a painter who was dependent on a painkiller which had opioid drug component in it. He had initially started to take the drug occasionally for his headache. The man was a chronic alcoholic too. But in due course of time he shifted his attention from alcohol to these drugs. He was consuming nearly twenty tablets per day, around five each session for around eight years. Unfortunately for him the government banned the particular drug few months back. He became nervous and restless and started travelling to neighboring places and eventually has travelled hundreds of kilometers in search of these drugs, but in vain. He developed myalgia, tiredness, sleep disturbances and consulted few local physicians before he finally came to the Psychiatry dept. The sad part is that, he came in search of an alternate drug and was unaware about his dependence. The worse part being that his wife, not realizing the grip the drug had on him, was asking us to provide him painkillers. He was admitted in ward and was on treatment and psychotherapy. One evening when I was on duty, the deaddiction nursing staff rang me to inform that he was missing in ward. Yes! He absconded from the ward because he was not provided painkillers! I realized that we had failed in motivating him towards deaddiction.

The second incident was a successful one. This person was a teacher who lost her husband in an accident a few months ago. A General practitioner put her on sleeping pills which had a benzodiazepine drug component in it since she had sleep disturbances and anxiety. She gradually started developing dependence to the drug. She was consuming nearly five times the dose of the actual prescribed dose. She developed lack of interest in her work, loss of appetite and went in for severe depression (Sleeping pills are CNS depressants which on long run can only harm you). She attempted suicide, consuming around thirty sleeping pills. She was treated and referred to psychiatry dept for evaluation. At the dept, she was given counseling and motivated. She stopped her dependence once and for all and is doing well for past two months.

From the two experiences, I have understood that people who develop drug dependence had a premorbid stress or substance abuse to go with before they developed this behavior. It is a common misconception to consider only young people, when we talk about drug abuse and dependence. But the sad truth is that drug dependence is very common among all groups of people. The only thing is young people develop dependence faster compared to others. People are usually unaware they have become victims of substance abuse until they develop complications.

There are four types of drug abuse: a) CNS stimulants like amphetamines b) CNS depressants like barbiturates, benzodiazepines and opioids c)Hallucinogens like LSD d) Other common drugs like paracetamol, antacids etc. Initially people develop tolerance and craving following drug intake, later leading to dependence. People with dependence later develop sleep disturbances, tremors, giddiness, anger outbursts followed by recurrent infections, decreased memory, attention, concentration, suicidal ideations, cardiac arrhythmias, respiratory failure and death. Certain drugs also carry an increased risk of
cancer.

A man under the claws of drug abuse should consult a doctor, preferably a psychiatrist because drug abuse needs physical as well as psychological treatment; if not, relapse is very common. Hence we need to be aware about drug abuse and help other unaware people too….

Have given some of the drug users photos and the visual change in their looks, hope this make you understand things better..

”LETS MAKE A DIFFERENCE”

Dr. Bevinsathya.

Know your Child's Behaviour...

Few weeks back we had a 12 year old boy who was not going to school properly for past sixmonths and found stealing money frequently from house. He used to get dressed in school uniform and go out of house but he doesnt attend school. When questioned what he was doing without going to school he was angry towards his mother. His father was a chronic alcoholic who didnot care for his family.

So his mother decided to follow him to school . He as usual started to school but didnot go to school. He went to his friend's house. His mother caught him red handed inhaling glue from a plastic bag with few of his street boys in the house. She was not aware of the abuse pattern of these volatile/inhalant substances. She had beaten him up. The very next day the boy took 400 rupees from his house and ranaway from his house and went with few of his street boys to railway station.He was caught by the police wandering around .He had a  bag of glue sticks and plastic bags. The police has adviced his mother to consult a doctor.

His mother just then realized her son has some problem and took him for treatment.The magnitude of the abuse pattern of inhalants/volatile substances is more than one could imagine. The most common age group using the inhalants and volatile substances are young adolescents due to the easy availability cheap price and are legally available.The most common used substances are glue,gasoline,spray paints,thinners, varnishremover, stain removers and kerosene. The abusers sniff the vapour or fumes from the volatile

substances sprayed in plastic bags to maximise the effect.The children particularly growing in  low socioeconomic status are found to use the volatile substances more commonly due the cheap price. These substances contain toluene ,butane acetone and few other substances which cause tremors incoordination impaired judgement behavioural disturbances and in severe cases respiratory depression cardiac problems and even death.

The abusers are usually found to have anti social personality traits.They are usually self injurious and have conduct disorders.These persons usually later shift to dependence of alcohol cannabis and other illegal substance usage. It is very necessary to identify the behaviour in a very early stage because in later stages  it is usally difficult to treat. As for the boy was concerned he was inhaling glue for about an year and has even started smoking.The prognosis of this child is poor considering  the factor his father is a chronic alcoholic and  the duration  the  boy was inhaling the substances. The main reason is many parents are ignorant about these type of behaviours like the boy's mother.So please be aware and if you notice any such habits in your child's behaviour please consult your psychiatrist as soon as possible.

Lets make a difference.

Dr. Bevinsathya..