SUNDAY MAGAZINE

Mental disorders

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Name withheld:

For the last 14 years, I have been suffering from a mental disorder. First I was diagnosed as suffering from Obssessive Compulsive Neurosis. Two years later, the diagnosis was changed to schizophrenia. I have been taking the prescribed medicines regularly. The psychiatrist says my problem lies in a disturbed childhood. What can I do to lead a normal life?

Dr. Jitendra Nagpal, Senior Consultant Psychiatrist, VIMHANS, New Delhi

All kind of illnesses whether mental or physical require on part of the patient that he not only follows the advice and instruction of the doctor but is also regular with the treatment.

From the diagnoses that you have mentioned it is extremely important for you to take your medication as advised by your doctor and be regular with it. Do not neglect your follow up with your doctor and be open about any change in your symptoms.

Besides this it is equally essential for you to follow your daily life in a routine manner. You can take the help of your therapist in helping you chalk out a daily activity schedule. Practicing relaxation exercises like pranayam would also help.

Y.M. Hathiwala:

My 24-year-old son has been having problems from school. He was very poor in studies and no amount of scolding or advice made any difference to his attitude. In fact the Principal was constantly summoning me because of his attitude. He was poor in his studies and would do the opposite of what he was told to do. This continued throughout his growing years.

Recently I was told he could have been dyslexic. Is this possible? I have observed over the past five years that he is often deep in thought, smiles to himself. He displays sudden signs of anger and also gets into hopeless and very sad moods. What is his problem? How can we help him.

Dr. Jitendra Nagpal, Senior Consultant Psychiatrist, VIMHANS, New Delhi

From what you report your son definitely needs help. On the basis of the description it is difficult to comment on the diagnoses. It would be advisable for you to consult a mental health professional and take your son for an evaluation. This becomes extremely important keeping in mind your description of his current behaviour as well.

N. Sunderaraj:

I suffer from depression since 1981. Despite consulting psychiatrists and being on medication (lithium carbonate and others prescribed by doctors) for as long as two decades, the depression never vanishes. It comes suddenly and I suffer for days, weeks and even months. Then suddenly it disappears. The period of depression is uncertain. Doctors defined my illness as MDP and advised me to live with it.

Could you suggest any way to overcome these episodes? Also I am worried about having been on medication for 20 years and their possible side effects. Please shed some light on that as well.

Dr. Jitendra Nagpal, Senior Consultant Psychiatrist, VIMHANS, New Delhi

MDP or Bipolar Mood Disorder is a chronic illness, which has a relapsing and remitting course. It has two distinct phases, one is of depression in which the patient feels low, has reduced interest in the surroundings, disturbances in bio-rhythm and pessimistic thoughts about the future.

Alternating with these periods, there would be periods of feeling high and being hyperactive and energetic. These mood fluctuations can follow a seasonal rhythm.

Pharmacotherapy is the first line treatment for this illness. Medicines have to be continued for a prolonged time. Depending on the phase of the illness, mood-stabilisers and anti-depressants need to be prescribed. Lithium is a mood-stabiliser, which is efficacious in both the `high' and `low' phases.

Since, on lithium, you are still having depressive phases either you are not taking lithium in adequate dosages or you have become lithium resistant or you need ADD for short time.

On long-term usage, it can have adverse effects on the heart, kidneys and thyroid. It can also cause cognitive disturbances and deceased spontaneity.

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