ഇന്ത്യ
6 days ago
Wednesday, August 13, 2008
Rocky beaches of Kannur
Why go to Goa when you have Kannur ?. As part of my official work as Nodal Officer of DMHP Kannur, I used to visit Kannur frequently. Our training programs are usually conducted at Governemt Guest House Kannur, which is by the sea side. Below are some views of the rocky beaches of Kannur captures during my visit. Beautiful Arabian sea lined by rocks!. I feel like yelling 'WHY GO TO GOA WHEN YOU HAVE KANNUR !!!'
District Mental Health Programs of Kerala
These programs are now running in 5 districts of Kerala. Names are given below with names of nodal cetres in brackets. Trivandrum (Govt Mental Health Centre Tvm), Idukki (Medical College Kottayam), Thrissur (GMHC Thrissur), Wayanad (Institute of Mental Health and Neursciences Calicut) and Kannur (Medical College Calicut). Under these programs a team comprising of a psychiatrist, psychologist, social worker and nurse visits selected peripheral institutions (Primary/Community health centre, Govt hospitals etc) and gives mental health care free of cost. Medications, psychological therapies, counseling etc are given free of cost to patients. We also undertake training of doctors, nurses and other community health workers. Awareness programs targeted at public for sensitizing about mental health issues are also conducted. This program is run with full financial support of the Government of India.
In the following posts I have uploaded photos of the inauguration of the DMHP Kannur which is conducted by the Department of Psychiatry of Medical College, Calicut.
In the following posts I have uploaded photos of the inauguration of the DMHP Kannur which is conducted by the Department of Psychiatry of Medical College, Calicut.
Monday, August 11, 2008
Psychosis
This term denotes a major disorder of the mind. A patient with this condition has poor insight into his condition and lives in a world of unreal experiences and beliefs.
I happened to see a 25 year old girl with M Sc, B Ed. She has worked as a teacher for some time. For past one and half years she has been on treatment. She started telling her mother that the local police has registered a case against her and they may arrest her. Sometimes also feared that her father might also be arrested. This idea originated after she happened to overhear conversations by people walking by the road in front of her house. She insists that she could hear these conversations frequently. Her mother and other family members have tried to cross check this, but they could never hear anything. Gradually her fear increased and she refused to go out of the house. She also became sleepless and agitated; following exacerbation they consulted a psychiatrist. Later I happened to see her. With treatment there was good improvement. 2 months ago she thought she is completely cured and discontinued the drugs. Her parents failed to convince her against this. During this time her father was hospitalized and things ended there. Recently they again came to me with relapse of the same old symptoms - hearing those voices and the same fears and suspicions.
How do people start hearing unreal voices, believe in senseless things etc ? Neither her parents nor her psychiatrists are able to convince her about the absurdity of her ideas. When I asked her questions like "If there is a case against you in the police station why are they not coming to arrest you even after one and a half years ? What are the charges against you ?Have you done anything to prevent your arrest ?" etc, she has no proper answer. She is unable to follow the normal logical sequence of thinking. She cannot develop any insight even after lengthy discussions and clarifications.
There is another angle to the story. Parents were trying to get her married off after she was 21. But an astrologer told them that this is not the right time for marriage. Now the parents are totally guilty about listening to this advice. They are now worried that her chance of marriage in future is very bleak,
This girl is suffering from Paranoid Schizophrenia, which is a type of psychotic disorder. Excess transmission of a neurotransmitter called dopamine is found in some areas of brain in this condition. Treatment is by drugs to reduce this. Anti psychotic drugs are the mainstay of drug treatment. Education of family, rehabilitation etc are also equally important.
I happened to see a 25 year old girl with M Sc, B Ed. She has worked as a teacher for some time. For past one and half years she has been on treatment. She started telling her mother that the local police has registered a case against her and they may arrest her. Sometimes also feared that her father might also be arrested. This idea originated after she happened to overhear conversations by people walking by the road in front of her house. She insists that she could hear these conversations frequently. Her mother and other family members have tried to cross check this, but they could never hear anything. Gradually her fear increased and she refused to go out of the house. She also became sleepless and agitated; following exacerbation they consulted a psychiatrist. Later I happened to see her. With treatment there was good improvement. 2 months ago she thought she is completely cured and discontinued the drugs. Her parents failed to convince her against this. During this time her father was hospitalized and things ended there. Recently they again came to me with relapse of the same old symptoms - hearing those voices and the same fears and suspicions.
How do people start hearing unreal voices, believe in senseless things etc ? Neither her parents nor her psychiatrists are able to convince her about the absurdity of her ideas. When I asked her questions like "If there is a case against you in the police station why are they not coming to arrest you even after one and a half years ? What are the charges against you ?Have you done anything to prevent your arrest ?" etc, she has no proper answer. She is unable to follow the normal logical sequence of thinking. She cannot develop any insight even after lengthy discussions and clarifications.
There is another angle to the story. Parents were trying to get her married off after she was 21. But an astrologer told them that this is not the right time for marriage. Now the parents are totally guilty about listening to this advice. They are now worried that her chance of marriage in future is very bleak,
This girl is suffering from Paranoid Schizophrenia, which is a type of psychotic disorder. Excess transmission of a neurotransmitter called dopamine is found in some areas of brain in this condition. Treatment is by drugs to reduce this. Anti psychotic drugs are the mainstay of drug treatment. Education of family, rehabilitation etc are also equally important.
Sunday, August 10, 2008
In the name of God....
Each religion has its own way of invoking God's blessings at the start of any venture. For Hindus it is 'Om Vigneshwaraya...'. For Muslims it is 'Bismillahi....'. Christians start with 'Our father who art in heaven...'. Religion has a major role to play in the social life of India. Often its customs and value systems create tension for individuals. Let me narrate a story in the name of God.
3 weeks ago a colleague of mine happened to see a 11 year old girl from a middle class, Muslim, rural background. She came with loss of voice of a few days duration. No major neurological or medical problems were found on evaluation. Hence she was referred to my colleague. She was a good student and stood first in singing and dance competitions at school. Her teachers persuaded her to participate in the sub district level competitions. She was interested, but reluctant as her religious teacher (ustad of the madrassa) used to prohibit students from such activities. Finally she mustered some courage and participated. She won the first prize. But on coming back to the religious school (she used to attend madrassa in addition to the regular school), the ustad scolded her. he also declared that he and other students will pray to God that she should be punished for this and she will lose her voice. He recited a prayer to this effect. She lost her voice two days after this. Her voice reappeared after s few sessions of psychological interventions.
My aim in narrating this event is two raise a few doubts.
1) Is such rigid restrictions beneficial in the long run.
I think this will only alienate people from religion. I can give another example. Professionals working in the field of de addiction know that majority of persons dependent on street heroin (brown sugar) in Calicut and Kochi are Muslims. This could be because of the strong opposition to alcohol. Muslim youth cannot walk in their locality smelling of alcohol. Hence they resort to drugs which has no smell. Initially they use ganja and later graduate to hard drugs like brown sugar.
2) If I had reported this incident to the media will they publish it ?
Again my answer is No. Because they may fear that this will antagonize Muslims. But I think such a fear is baseless. True friends of religion should publicize such incidents and campaign for educating religious teachers on how to handle children. Every teacher - of religious subjects or otherwise should have basic understanding of how to behave to children.
I have no intention of hurting the sentiments of anybody. Every religion has its own kind of problems. Rev. Pope has just finished his round of apologizing to Australians and Americans. This was for the misdeeds of his priests who molested little boys. He also had to foot the huge bill for out of court settlement of pending cases. Several stories of torture and sexual assault by Hindu clergy in the name of exorcising evil spirits have been reported,
Ultimately God is merciful and all forgiving. Then why should his intermediaries and representatives be so cruel ?
3 weeks ago a colleague of mine happened to see a 11 year old girl from a middle class, Muslim, rural background. She came with loss of voice of a few days duration. No major neurological or medical problems were found on evaluation. Hence she was referred to my colleague. She was a good student and stood first in singing and dance competitions at school. Her teachers persuaded her to participate in the sub district level competitions. She was interested, but reluctant as her religious teacher (ustad of the madrassa) used to prohibit students from such activities. Finally she mustered some courage and participated. She won the first prize. But on coming back to the religious school (she used to attend madrassa in addition to the regular school), the ustad scolded her. he also declared that he and other students will pray to God that she should be punished for this and she will lose her voice. He recited a prayer to this effect. She lost her voice two days after this. Her voice reappeared after s few sessions of psychological interventions.
My aim in narrating this event is two raise a few doubts.
1) Is such rigid restrictions beneficial in the long run.
I think this will only alienate people from religion. I can give another example. Professionals working in the field of de addiction know that majority of persons dependent on street heroin (brown sugar) in Calicut and Kochi are Muslims. This could be because of the strong opposition to alcohol. Muslim youth cannot walk in their locality smelling of alcohol. Hence they resort to drugs which has no smell. Initially they use ganja and later graduate to hard drugs like brown sugar.
2) If I had reported this incident to the media will they publish it ?
Again my answer is No. Because they may fear that this will antagonize Muslims. But I think such a fear is baseless. True friends of religion should publicize such incidents and campaign for educating religious teachers on how to handle children. Every teacher - of religious subjects or otherwise should have basic understanding of how to behave to children.
I have no intention of hurting the sentiments of anybody. Every religion has its own kind of problems. Rev. Pope has just finished his round of apologizing to Australians and Americans. This was for the misdeeds of his priests who molested little boys. He also had to foot the huge bill for out of court settlement of pending cases. Several stories of torture and sexual assault by Hindu clergy in the name of exorcising evil spirits have been reported,
Ultimately God is merciful and all forgiving. Then why should his intermediaries and representatives be so cruel ?
All the perfumes of Arabia..!.!.!.......
Repeated washing with all the perfumes of Arabia could not convince Lady Macbeth that her hands were clean. This is the plight of patients with Obsessive compulsive disorder.
Ms. R k was a 27 year old home maker, living with her family. For the past few years she has been bothered by inability to control some behaviors. It started as her concern that her hand and the household dishes were not clean. She will spend a lot of time washing them. Often her hands would wrinkle. Her fingers started to swell beneath the nails due to infection. Relatives could persuade her to stop only with great difficulty. When she closes the doors at night she will repeatedly check whether the doors are locked properly. Later she also had difficulty to go out. When she meets other males she fears that she has an urge to look at their genital areas. She is embarrassed whether others will notice her eye moving to their waist and below. Because of this she seldom goes out. Of late she has developed another problem. When she attempts to pray in her prayer room, she can't look at the images of male Gods displayed there. If she looks at them, she starts having sexual thoughts involving the God and her. She is terribly guilty and wept while narrating this latest trouble.
This lady is suffering from Obsessive Compulsive disorder (OCD). The repeated thoughts occurring against her will, which she cannot dismiss away or suppress are called obsessions. The repeated senseless actions - washing and checking again and again - are called compulsions. Attempts to control these obsessions and compulsions result in severe anxiety. Hence OCD is classified as an anxiety disorder.
Earlier this disorder was thought to be rare, but recent evidence shows that it is much more common. It has a genetic component like many other mental disorders. The exact cause is still unknown. It is shown that there is excess activity of a neurotransmitter called serotonin in some parts of the brain in this condition. Hence drug treatment is targeted at this. Drugs used for this condition are called Serotonin Specific Re uptake Inhibitors. These drugs are also having antidepressant action.
Psychological methods of treatment is also effective. Cognitive and behavioral techniques (for example - exposure and response prevention discussed in the post on anxiety disorders)are found to be useful.
But majority of patients need combination of both these methods. Drugs reduce the symptoms. Behavioral techniques help to reduce relapses after drugs are stopped.
Ms. R k was a 27 year old home maker, living with her family. For the past few years she has been bothered by inability to control some behaviors. It started as her concern that her hand and the household dishes were not clean. She will spend a lot of time washing them. Often her hands would wrinkle. Her fingers started to swell beneath the nails due to infection. Relatives could persuade her to stop only with great difficulty. When she closes the doors at night she will repeatedly check whether the doors are locked properly. Later she also had difficulty to go out. When she meets other males she fears that she has an urge to look at their genital areas. She is embarrassed whether others will notice her eye moving to their waist and below. Because of this she seldom goes out. Of late she has developed another problem. When she attempts to pray in her prayer room, she can't look at the images of male Gods displayed there. If she looks at them, she starts having sexual thoughts involving the God and her. She is terribly guilty and wept while narrating this latest trouble.
This lady is suffering from Obsessive Compulsive disorder (OCD). The repeated thoughts occurring against her will, which she cannot dismiss away or suppress are called obsessions. The repeated senseless actions - washing and checking again and again - are called compulsions. Attempts to control these obsessions and compulsions result in severe anxiety. Hence OCD is classified as an anxiety disorder.
Earlier this disorder was thought to be rare, but recent evidence shows that it is much more common. It has a genetic component like many other mental disorders. The exact cause is still unknown. It is shown that there is excess activity of a neurotransmitter called serotonin in some parts of the brain in this condition. Hence drug treatment is targeted at this. Drugs used for this condition are called Serotonin Specific Re uptake Inhibitors. These drugs are also having antidepressant action.
Psychological methods of treatment is also effective. Cognitive and behavioral techniques (for example - exposure and response prevention discussed in the post on anxiety disorders)are found to be useful.
But majority of patients need combination of both these methods. Drugs reduce the symptoms. Behavioral techniques help to reduce relapses after drugs are stopped.
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