Symptoms

Any change in the behaviour of the person ( sudden  or gradual over the period of time ) which can be noticed by the relatives. Symptoms of the schizophrenia can be one or two of the following in excess :-

• Decreased or stopped communication or talk / staying aloof / social withdrawl,
• Irrelevent talk, out of the context,
• Easy irritability over minor issues or excessively aggressive, abusive, assaultive behaviour,
• Disturbed sleep,
• Seen talking to self or laughing to self without reason,
• Being suspicious against relatives/ neighbours/ unknown/ others without any reason, ( and staying firm over it even after lots of clarifications and explianation ),
• Hearing the voices which are not heard by others,
• Some kind of odd thinking, speech or behaviour,
• Disorganized behaviour like collecting garbages, wandering without any reason etc.

Schizophrenia is treatable and can lead a near normal life.Complete and proper treatment is the key.

These are very common diseases. All anxiety disorders collectively accounts for approx.18 % of the general population. All these share features of excessive fear, anxiety and related behavioral disturbances.

These are many like OCD, Specific phobia, Social anxiety disorder, Panic disorder, Agoraphobia, Generalized anxiety disorder, Seperation anxiety disorder etc. Symptoms in short are :

• OCD ( obsessive compulsive disorder ) –

As name suggests it has two symptoms, obsession and compulsion. Any of the two or both are seen in a patient. Obsession is an excessive, recurrent, intrusive thought that comes to mind without our wish, very difficult to control and cause too much of anxiety and restlessness in patient.

• Specific phobia –

Excessive fear or anxiety about a specific object or situation (e.g.  flying, heights, animals, receiving an injection, seeing blood etc).

Out of anxiety patient actively avoids those situations or objects.

• Social anxiety disorder –

excessive fear/anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others.

Exa. social interactions (having a conversation, meeting unfamiliar people),being observed (eating or drinking), & performing in front of others ( giving a speech ) etc.

• Panic disorder –

Patient gets recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, & during which time few of the following symptoms occur like,

Palpitations, chocking sensation, tremulousness, sweating,

giddiness, fear as if it is a heart attack etc.

and persistent worry about additional panic attacks or their consequences(e.g. losing control, having a heart attack, ”goingcrazy”).

• Agoraphobia –

Marked fear or anxiety about 2 or more of the following situations like using public transportation, being in open spaces,  being in enclosed places, standing in line or being in crowd, being outside of the home alone.

And

Patient avoids those situations or requires companion.

• Generalized anxiety disorder –

Patient feels anxious about number of events or activities (such as work or school performances) where he finds it difficult to control the worry.

And It is associated with  restlessness / being easily fatigued / difficulty concentrating or mind going blank / irritability / muscle tension /  sleep disturbances.

These comprises of psychological factors and psychiatric diseases commonly influencing/affecting the General medical conditions/diseases like asthma, heart diseases, arthritis, irritable bowel syndrome etc. ( in terms of causative factor/ symptoms severity/outcome /delayed recovery/exacerbation etc.).

Example :

• depression delaying recovery from myocardial infarction / heart attack,
• anxiety exacerbating asthma,
• hostile and pressured behaviour contributing to cardiovascular disease ( related to heart ),
• Stress causing exacerbation of ulcer, hypertension, headache, fibromyalgia.

These are not addictions but the diseases, has biological causes and are very much treatable. Diseases includes dependence over these substances and others ( both psychiatric and medical ) caused by them.

Such substances includes alcohol, cigarettes, tobacco, cannabis ( charas/ganja/bhang ), opioids, sleeping pills etc.

Three things to know here are :

(a) Most important one is to distinguish between normal behaviour and psychiatric disease. Because some parents are overcautious about even a small variability/change in normal behaviour and some are ignorant about even the big change.

(b) eg. of some NORMAL / TEMPORARY variations in behaviour of children are :

• Increased hyperactivity/irritability is normal to some extent upto the age of 6 yrs, it decreases over time. Strange environment, hunger, lethargy can increases hyperactivity.
• Concentration increases with age, so lack of concentration in some conditions is normal in children. If someone doesn’t like or does not want to do something like homework, its normal to have decreased attention in same.
• Anger and jealousy towards younger sibling is normally seen in 2.5 to 6 yrs old child.
• Anxiety on separation from closed one like mother is normal in 10 to 18 months child.
• Thumb sucking, nail biting, hair pulling, urination in bed is considered to be normal till 4 yrs of age.
• During language development grammatical mistakes, repeating words and sentences is normal. etc etc…….

(c) common psychiatric diseases/ symptoms seen in children :

Children usually presents with cluster/ mixture of symptoms. Some common psychiatric problems seen in them are –

• Autism
• Special learning disorder
• Intellectual disability
• ADHD ( attention deficit and hyperactivity disorder )
• Others like conduct disorder, tic disorder, enuresis etc.

All these either presents with scholastic backwardness or negative behavioural problems noted by parents or teachers.

BY 2020,population of elder people above 65 yrs will be 10,000,000.(Greying population).

Forgetting things is not always aging, but it could be a part of disease called DEMENTIA.

All the diseases that affects younger people can affect them with some variations like depression in elderly presents with multiple physical symptoms ( like pains)without any known medical causes.

Some of the symptoms of dementia are :

• forgetting things like names, places, most recent activities though the past memories ( years back ) remains intact,
• behavioural changes( like irritability, personality changes, suspicion, confusion, depression, anxiety etc.),
• Sleep disturbances,
• difficulty carrying out daily activities like dressing, managing money etc.

All these symptoms usually gets exaggerated as the night approaches.

There are many others like :

• Related to sleep – insomnia ( decreased sleep ),

Hypersomnia ( increased sleep ) etc.

• Headaches – tension headache,

Migraine headaches etc.

• Related to eating – anorexia nervosa leading to cachexia,

Bulimia nervosa – excess eating etc.

• Related to sexual act and sexuality –
• Erectile dysfunction,
• Premature ejaculation,
• Decreased sexual desire etc
• Related to personality – e.g. borderline PD.
• Etc.etc.