Cogniverse

  • Cognition is the mental process of understanding through thought, experience and senses.
  • The process of cognition is one of the foundations on which Psychiatry is built.
  • Cogniverse is symbolic of how vast, mysterious and full of possibilities the human mind is (much like the universe we live in).
  • Unfortunately, just like the human body, the mind is also affected by disease and dysfunction.
  • Most mental illnesses involve a disturbance of cognition, affecting our thoughts, beliefs and emotions and therefore, our behaviour.
  • Psychiatric and Psychological treatment is aimed at treating these disturbances.
  • The goal is to help restore a person to their best possible self, prevent further issues or relapses and improve their functioning, so they can lead a satisfying and fulfilling life.

Psychiatry vs Psychology

  • A common source of confusion in the general public is the difference between a psychiatrist and a psychologist, with most people using the terms interchangeably.
  • Though both fields broadly deal with the science of the human mind and behaviour, there are some important differences. Knowing this can help you avoid confusion and choose the right professional.
  • Psychiatry is the science of the human brain, the biological processes in the brain that influence a person's thoughts, emotions, behaviour, mental capabilities and the medical diseases that affect the brain. A deep understanding of the neurobiology of the brain is also required.
  • A psychiatrist is a medical doctor with an MBBS degree and a postgraduate degree of M.D., DNB or Diploma in psychiatry.
  • Psychiatrists are trained to diagnose and treat mental illness with medication as well as supportive therapy.
  • A psychologist's area of study is the science of human behaviour and thought. Psychologists commonly have a bachelor's degree, an MSc or in some cases a PhD.
  • They are experts at evaluating mental illness from a psychological perspective,providing psychological and supportive therapy and counseling. They also perform tests such as IQ, Personality, etc.
  • However, as they are not trained as medical practitioners, they will not be able to prescribe medication, or independently treat severe illnesses like Schizophrenia and Dementia.

Other mental health professionals with special training in mental health :

  • Psychiatric Social Worker
  • Psychiatric Nurse

Whom do I choose?

  • Persons who suffer from day to day distress, stress, relationship issues, identity crises, difficulty coping with daily life may benefit from choosing a psychologist who is specialised in that specific issue, and can provide a structured, long term treatment.
  • Severe mental illnesses and those with neurological components require a Psychiatrist’s intervention. Cases of Substance abuse, depression, anxiety, schizophrenia and bipolar disorder require medication and thus, a psychiatrist will be a better option.
  • In many cases psychiatry and psychology are complimentary, and each professional may refer you to the other one.

Common signs and symptoms of mental illness


Signs

  • Changes in mood and emotions, expression of suicidal ideas, self-harm
  • Change in behaviour such as being socially withdrawn, aggressive, argumentative, irritable, reduced talking, excessive talking, socially inappropriate behaviour
  • Change in eating and sleeping habits, self care, work and personal interests
  • Severe symptoms like suspecting others of trying to kill them or talking about them, talking to self, laughing or muttering to self, staring look, complete loss of sleep, lack of judgement
  • Memory issues, personality change, inability to perform daily activities

Symptoms

  • Lack of interest in daily activities and hobbies, no joy from life, suicidal thoughts, crying spells

  • Feeling on the edge, unable to relax, panic in normal day to day situations

  • Frequent body pains, weakness

  • Excess use of alcohol, smoking, drugs and being unable to control the use in spite of wanting to stop

  • Neglect of work and social activities

  • Sleep and appetite disturbance, weight gain or loss

  • Sexual complaints

  • Hearing voices, seeing things which aren't visible to others, feeling scared and paranoid, being unable to trust even close friends and family members

  • Repeated thoughts or compulsion to do activities even though they are not reasonable, EG : repeated checking, counting, washing hands, taking bath for very long, preoccupation with cleanliness


How mental illness affects the family

Mental illness has an enduring effect not only on the patient, but on loved ones too. The ripple effect of the burden of illness can extend to the whole family.
But most often, the silent sufferers are the patient's care givers, the ones who helplessly watch someone they love go through pain, distress and inability to have a normal life.

It’s hard to see them suffer and you may offer help or advice, and get frustrated that nothing you do can make it better.

In case of severe illness, the patient may be in a situation where they are unable to take care of themselves, and a parent or spouse or even a child becomes responsible for their daily survival.

It takes immense mental strength to go through a situation like this, and there will always be moments of despair.

If you are going through negative emotions as a result of having a family member suffering from a mental illness, or feel like you're unable to cope with the added demands of taking care of one, we are here to help.


Anxiety and Panic Attacks

Do u feel constantly worried, on the edge, like you just cannot relax?
Do you always suspect or expect the worst and play scenarios in your head?
Do you question your decisions or worry about the future?
Do you experience chest discomfort, frequent gastric issues, fast heart rate, dizziness or shaking of hands?

These are all signs of an anxiety disorder. Possibly one of the most underrated of all mental disorders, anxiety can actually cause a lot of dysfunction in daily life. Because of the constant worry that comes with anxiety, a person might resist trying new experiences, underperform at work, and have an unfulfilling social life.

A simple explanation for anxiety is over activation of the Sympathetic nervous system. The sympathetic nervous system is designed to help us deal with threat, stress and physical demands. For example, when you exercise, your heart starts pumping faster, your brain becomes more alert and your muscles start burning energy in order to move.
But, in anxiety, the sympathetic nervous system is overly active, even when it’s not needed. This means, even when you don’t need extra energy, your heart is pumping, your thoughts are racing, and your body is constantly preparing for a threat that doesn’t even exist!!! Undoubtedly, this takes a heavy toll on the mind and body.

Understanding the cause of anxiety needs expert intervention. With the right medication and Cognitive Behavioral Therapy, you can overcome anxiety, learn to regulate it and feel better equipped to cope with the uncertainty of life.
Further, supportive treatments like Relaxation and stress management techniques will help the mind and body calm down and relieve muscle tension, indirectly reducing anxiety.


Schizophrenia

Schizophrenia is a complex mental disorder which is caused due to a disturbance in the neurobiology of the brain leading to changes in personality, thoughts, behaviour and emotions. Patients with schizophrenia are unfortunately unable to understand or explain the nature of their illness, many times completely denying anything being wrong with them. This makes it difficult to convince them to seek help.

Common signs and Symptoms of Schizophrenia

  • Being Suspicious of people

  • Altered or abnormal Behaviour

  • Talking or muttering to self

  • Laughing to self

  • Aggression

  • Feelings of being controlled

  • Emotional disturbance

  • Disturbed Daily activities and Self Care

  • Change in manner of speech

  • Social withdrawal

  • Overall change in personality

  • Hearing voices

  • Seeing, Feeling things which aren’t sensed by other people


Is schizophrenia treatable?

When recognised early, with the right medication and psychological support, patients with Schizophrenia can be restored to normal functioning.

How long does treatment last?

Due to the chronic nature of the illness and the tendency to relapse, long term medication is required in schizophrenia. Treatment can last upto 5 years and in some severe cases, extend for longer. Discontinuation of medicine without expert supervision and advice is not recommended.

Is Schizophrenia genetic?

If a close family member is suffering from the illness, there are around 5-15% chances of inheriting the illness.



Depression

Depression is a major illness characterised by a persistent low mood, lack of enjoyment and lack of energy and motivation.
There can even be physical symptoms such as fatigue, vague pains, headaches, weight loss or gain, and sleep disturbance.
At it's worst, the sense of hopelessness that depression causes can lead to a lack of desire to live and result in suicide.

How do I know if I am/a loved one is depressed?

There are some common signs of depression. Keep in mind that when comparing these signs, do NOT compare a person with someone else who is considered "normal".

Always compare them to a person's past behaviour, and what changes you notice now.


1. Persistent Low mood, sadness, feeling hopeless, helpless or worthless

2. Lack of pleasure from activities that you normally enjoy.

3. Getting fatigued easily, Lack of energy, lethargy

4. Pessimistic thoughts, Negative view of the future/world/self, Guilt

5. No hopes for the future, death wishes, suicidal thoughts, self-harm

6. Lack of self confidence

7. Sleep disturbance, increased or decreased sleep, waking up too early in the morning

8. Loss of appetite and weight loss, Increased appetite and weight gain

9. Loss of sexual interest and sexual activity

How do I know if what i am feeling is depression or just sadness and that it will pass??

Many stressful or difficult life events and transitions can lead to a short lasting episode of feeling low. This is a normal human reaction, and in most people, with social support, coping skills and the mere passing of time, the negative feelings reduce.

However, if the symptoms persist for too long, and are causing difficulties living life normally, such as affecting your close relationships and social life, your work and your body, then it is likely that you might need professional help.

It is always sensible to consult an expert who can evaluate, analyse and explain what you are going through.

Never hesitate to seek help.


Living with a Depressed loved one :


It can be heartbreaking and mentally exhausting to watch someone you love suffer, and feel like nothing you do to help them matters.
But do understand, the depressed brain is not able to feel normal joy and happiness the way others do. And due to their negative thoughts, they may even feel like they are being a burden, or that their friends and family will be better off without them.
Always try to convince your loved one to seek professional help, because in many cases just the support offered by a close friend may not be enough.

Simple acts to support a loved one

  • Listen. Listen. Listen.

  • Refrain from judgement, Don’t blame them for their illness

  • Let them know you’re there for them

  • Try not to offer generic advice like "just go out it'll get better" "snap out of it"

  • Validate their feelings

  • Offer help with daily chores, mundane activities

  • Gently encourage them to seek professional help


Bipolar disorder

In simple terms, the polar opposite of depression is called MANIA. It involves symptoms like excessive happiness, irritable mood, excess talking, grand and elaborate plans, believing oneself to be powerful, belief of having special abilities, loss of sleep and appetite, increased energy.

Usually, Mania occurs in episodes along with episodes of depression in between. This is called Bipolar disorder.

What essentially happens is a person shifts between feeling extremely happy and extremely sad over a period of months or years. Each episode can last for months.

Being a chronic and serious illness which can significantly disable the patient, it requires medication.

Mood stabiliser therapy combined with anti-depressant or anti-manic drugs can help control the symptoms and in many cases lead to long term remission.


Obsessive Compulsive Disorder

OCD is caused by a disturbance in brain circuits which are responsible for controlling impulses and judgement.

This leads to a patient suffering from recurring thoughts, feelings, emotions and acts which he has very little control over. Attempts to control the thoughts or behaviour leads to anxiety and distress which does not resolve unless the patient gives in to the Obsessions or compulsions.

Soon, a patient ends up spending a significant part of the day yielding to the illness, leading to difficulties at work, with family and close relationships. A great amount of distress is felt due to the lack of control and helplessness. It can even lead to depression, anxiety and suicide.


Examples of Obsessions :

  • Need for symmetry and organisation
  • Fears of dirt, contamination
  • Fears of disease
  • Fear of killing someone or killing self
  • Violent or horrific images coming into the mind
  • Disgust with with bodily fluids, secretions, waste
  • Forbidden sexual thoughts,

Examples of compulsions :

  • Repeated hand washing
  • Checking locked doors, gas stove
  • Organising things in a rigid manner
  • Acts like touching, spitting, gestures
  • Hoarding things without any value and being unable to discard them
  • Mental rituals like repeating a number, sequence or phrase

Treating OCD

  • OCD is best treated by a combination of medication and a specialised psychotherapy called Exposure and Response Prevention.
  • Early recognition and treatment improves the chances of recovery.

Dementia

With improved medical care, the average lifespan of a person has increased. With the rising senior population, it is important to be aware of diseases of old age.

Dementia is a neurological disease, commonly of old age, which mainly affects memory, leading to difficulties in daily activities like organisation abilities, remembering tasks, judgement, forgetting previously learned information and in advanced cases, being unable to recognise family members, difficulty taking care of self and complete dependence on a caretaker. In some cases, psychiatric symptoms like irritability, suspicion, paranoia, sleep disturbance, personality change can predominate.

Many neurological disorders can cause dementia, but the most common cause is Alzheimer's disease, where there is damage to the nerve cells that are responsible for storage and retrieval of memories in the brain.

How do you know if an elder in my family may be suffering from dementia?

  • Dementia is different from old age related cognitive decline. Dementia causes a degree of functional impairment which is much more than what happens in normal ageing.
  • Therefore, early recognition can slow the progress of the illness and reduce disability.

Watch out for these signs


  • Problems with short term and recent memory : Forgetting what was eaten for a recent meal, Forgetting recently learned information, forgetting appointments
  • Problems keeping track of belongings like keys, wallet
  • Problems with daily activities like preparing meals, doing simple calculations, remembering the route to the house
  • Obvious change in emotion and behaviour, frequent mood changes, irritability, crying spells, anger outbursts

Diagnosis and treatment

  • Diagnosis is based on clinical assessment and memory testing by a trained professional.
  • Medication and Supportive treatments can help improve the functionality of the patient and also slow down the progression of the illness.


Addiction

Addiction, in simply terms, is a problem with controlling/stopping a behaviour in spite of the mental, physical and social harm caused because of it.

Often addiction is used in the context of repeated use of substances like alcohol, smoking and other drugs. “Behavioural addictions” also exist, where there is no drug use, but a problem with repeated indulgence in behaviour such Gambling and Gaming addiction.


Common signs and symptoms of addiction :

  • Excess time being spent on use of substances, trying to buy/procure them, more importance being given to substance use rather than other activities
  • Neglect of other activities like social engagement, occupation and recreation.
  • Social withdrawal, irritability, anger outbursts, lack of concentration, lack of motivation, Depressive symptoms
  • Strong craving for the substance
  • Increase in quantity and frequency of use, lack of control over use (Example : You decide to go out with friends and have only one drink, but end up drinking much more than you intended to. Deciding not to drink on a particular day, but not succeeding)
  • Physical symptoms of withdrawal : Shaking of hands, headaches, weakness, sleep disturbance, mood disturbances are some symptoms which suggest withdrawal. (Your body has become used to the substance and when it is not available, there is a disturbance in the nervous system causing physical and psychological symptoms)
  • Physical symptoms due to ill effects of the substance : weight loss, disturbed appetite, frequently falling sick, weakness, anemia, liver damage, kidney damage, gastric complaints

4 simple questions to ask yourself/loved one that suggest a problem with substance use:


A simple screening questionairre called CAGE is used by clinicians to recognise substance abuse. You can apply the same to recognise whether a substance is starting to take control of your life.


  1. Did you ever think that you need to cut down on your use?
  2. Do you get angry or annoyed when someone tries to tell you to reduce substance use?
  3. Have you ever felt guilty about it?
  4. Do you sometimes feel the need to take the substance first thing in the morning just to help you get out of bed or to start the day?

A YES to 2 of these can suggest that it may be time to seek professional advice.



Is the patient to be blamed for their addiction?


Even though starting consumption of substances involves a personal choice, as time progresses, there are changes in the brain, especially in the circuits that are responsible for controlling impulses and compulsive behaviour. Slowly, the substance use becomes a compulsion that the patient has little to no control over.
This is the reason addiction is considered a disease of the brain, and blaming the patient for their problems is only going to induce guilt and even increase their substance taking behaviour. A non judgemental and supportive approach is best when trying to help a person overcome their addiction.


Recognising that you need help and seeking it takes a tremendous amount of mental preparation and motivation.
Deciding to seek help and treatment itself is a positive step in the direction of recovery.
Treatment involves medication to restore the body to it’s previous state and psychological interventions to improve motivation for abstinence, handle craving, prevent or minimise relapse and improve treatment compliance.


Consult a Psychiatrist for a detailed evaluation and treatment.