Midas Clinic

Hello everyone!

My name is Dr. Omkar Mate and I am a consultant neuropsychiatrist. Today we will be talking about ADHD that is attention deficit hyperactivity disorder. This is a disorder which commonly affects children and in result childhood developmental disorder. Around 11% that means 1 out of 10 children suffers from ADHD. So, what are the causes of it? It is commonly seen in boys than girls and the causes are usually genetic or hereditary that means if a relative is suffering from ADHD then the child suffering from ADHD is more likely to suffer from ADHD. Attention deficit hyperactivity disorder also happens because of maternal illnesses during pregnancy, the child when is born can suffer from it. The causes are different or what happens in the brain that means what happens inside the brain during ADHD. So, in those children, there is a deficiency of a horm chemical called as dopamine in the frontal circuits of the brain and there are some problems in the neural circuits of the brain because of which the child is inattentive or impulsive.

So, this is what happens inside the brain of a child which ADHD. What is it that happens outside that means what do we see in children with ADHD? Children with ADHD suffer from 3 things: 1 is inattention, second is hyperactivity, third is impulsivity. Not all three symptoms are seen in all children with ADHD. Now let us look at the part of inattention. In inattention, the child has problems in concentration, it has they have difficulty in concentrating on things or tasks so there are children who can't focus during school on the board, they are unable to write properly or fast, many times they cannot complete the work that they have started. During board games they are not able to concentrate like say they are playing ludo or chess, they are not able to concentrate for long and that creates problems in play also. So, they end up fighting with other children because they become impatient. Now what happens with because of this in school is their studies gradually are affected. Now the second kind of ADHD is impulsivity. By impulsivity, we mean that a child is not able to control the urges or impulses.

So, these are usually considered to be talkative children, they disturb others in the class, they are not able to sit in one place and they constantly fidget out. They also take part in risk-taking as they will jump from heights; they will not care about injuring themselves. So, these are children who may injure themselves multiple times and seem to be they can't avoid accidents. The third part is hyperactivity. So, a child with ADHD seems to be constantly restless, the child paces about is constantly running here and there. It looks as if the motor inside him is turned on all the time entirely. Usually, parents feel that their children do not get enough sleep at night, they are awake all the times and it is very difficult to keep control over them. They are constantly running around and pacing around. So that seems like a huge amount of energy in these children. Now, what happens if these symptoms are not treated? They lead to complications and the complications of ADHD are first and foremost scholastic problems that mean problems in studies and school. Their grades gradually keep falling, usually, they are very intelligent children but their grades start falling because of the lack of attention or the lack of concentration.

They also leave incomplete work which later leads to lying from parents or holding back report cards from parents. There are children who get punished, sometimes initially they are favorites of their teachers but later on, they are called as problem children or problem kids in school. Now if it is not treated, if ADHD is not treated it may lead to something which we call as adult ADHD that means a child grows up, his hyperactivity with may reduce with age so he doesn't keep on moving about or the motor seems to die off but his inattention or lack of concentration persists and because of this he is not able to focus on tasks and relationships, because of the impulsivity part of ADHD, these are adolescence or teenagers who take risk-taking behavior, they get into addictions, they get into promiscuous relationships and they also get into accidents and injuries multiple times. So, these are the complications of attention deficit hyperactivity disorder if it is not treated on time. So how is it to be treated? ADHD can be treated by different modalities and for that you should seek the help of a psychologist and/or a psychiatrist.

They will assess the severity of ADHD and suggest treatment. Treatment in children with ADHD includes behaviour modification or behaviour therapy which includes counselling with the child and parents, giving strategies like timeout to teachers which means that when they have many energetic and they are constantly fidgeting they can be told some other work for a minute or so, so that their attention can again be refocused on the task at hand. Along with that occupational therapy also helps but in some moderate to severe cases medication is necessary. This is not a medication which is addictive or so as it is thought. These are medicines which increase dopamine in the frontal part of the brain and help them to focus the attention and become these children become little calmer and more focused and the meditation helps in behavior therapy also. So, if you have any queries contact me on lybrate.

Thank you.

Hello, everyone, my name is Dr. Omkar Mate and I am a consultant neuropsychiatrist practicing at Madras clinic Nerul and Panvel. Today we will speak about a topic which is close to my heart because I am having a special interest in child and adolescent psychiatry. Today we will speak about childhood depression.

Yes, when we talk about depression, you always think that it is something which will be away from children because we remember childhood days as stress-free and hassle-free. But depression also affects children. Though, it is hard to imagine depression occurring in children. Children about 3 to 10 children amongst 100 suffer from depression. You will open any newspaper any day and you will find out news about children committing suicide or doing something bad to themselves. So, children also suffer from depression.

What can be the causes in children? The causes of depression in children mostly are in their surroundings. So, there can be fight amongst their parents, they may suffer from traumatic events like earthquakes or accidents happening around them. They may have some problems in the household, there may be sibling rivalry which means they may be jealous about their younger siblings or brothers or sisters. There may be problems like a death in the family, someone close near or dear to them may pass away. Other than that, there may also be physical or sexual abuse happening to the child. Along with that there may be academic problems that means learning problems a child may suffer from. These are some of the environmental problems which may lead a child to become depressed.

But if we are talking about changes in the brain, then what happens in the brain is some neurochemicals that are chemicals in the brain reduce in the brainchild because of which the child suffers from depression. Now, how does depression present in children that means what are the symptoms? See, an adult when is depressed is able to tell above or talk about his feelings. An adult will tell people around them may be friends, family members that he is feeling sad or low or that he is feeling angry. A child, however, is not able to recognise emotions. So, most of the times a child suffering from depression shows it through his behaviour. A child suffering from depression may become very angry. He may start doing behaviours which he never did previously like a child may start lying, he may start stealing, he may not complete his or her homework, he may even tear pages in his notebook. Sometimes children withhold information from their parents, they will not show report cards to the parents and such behaviour prom problems increase. Children may also become more demanding. They may ask for many things, material things, they may ask for new things just to see whether the adults in the family or their parents love them enough. So, they start seeking attention. This attention seeking behaviour is common in children suffering from depression.

Along with that, there is something which we call as acting out. Acting out means that a child shows behavioral problems like temper tantrums, anger outburst, throwing things, breaking things, sometimes harming self with a blade or a knife. So, these acting out behaviors are common in children suffering from depression. They may also talk about physical symptoms, by that I mean something like a headache or a tummy ache or some backache or some coughing which a doctor is not able to explain. That means the symptoms, these physical symptoms that a child show, they are not explained by any physical illness. So, they are usually taken to multiple doctors for treating their headaches, tummy aches or for things like coughing where the doctor is not able to find any problem and that time, we should suspect depression in the child.

What happens because of this? So, a child who is supposed to study is not able to do that like adults in depression are unable to focus or concentrate in things, a child with depression is not able to study. They are not able to play, they have lost the interest to play many times and even they are not able to concentrate at any task at hand. So, that is why their scholastic progress declines. So now, how can a child with depression be treated? Many a times we come across parents who are not able to understand their child suffering from depression. Many times, they are in denial that even a child can suffer from depression. But as I told you they really do and then the first step in treating the child is to seek professional help. Professional help for depression is provided by psychiatrists and clinical psychologists or counselling psychologists. These are people who are able to understand the diagnostic criteria of diagnosing a child with depression.

The treatment options in a child include counseling or therapy as well as medicines because a child does not have maturity in thinking to understand what is going wrong. So many times, something called as behaviour therapy or behaviour change or behaviour modification is done with children, that means they are counseled to increase their positive behaviour and they are counselled also to reduce their negative behaviour. This type of counselling takes up much time and is a done by professional psychologists. However, if the child is moderately or severely depressed, then we always suggest medicines because finally what is going wrong in the brain is that certain neurochemicals are down. So, medicines are nothing but those which are given to increase those chemicals. A child with depression can be cured in months’ time if the treatment is followed as advised by the treating doctor. For more help, you can contact me on Lybrate.

Hello!

I am Dr Omkar Mate consultant neuropsychiatrist practicing at Midas Clinic Neurl, Navi Mumbai.

Now let us talk about anxiety and anxiety disorders . Anxiety is that feeling of nervousness, sometimes associated with traveling, racing heart and shortness or difficulty of breathing. Anxiety is a normal response of human mind and body to certain stressful situations . It is not always bad like stress too is not always bad, being anxious before exams leads a person to study better, work better and get better marks. This stress is a positive stress which increases performance, it is called used stress. However, sometimes a person becomes so anxious that the anxiety hampers or reduces person's functioning of performance, this is distress.

The next level of distress is an anxiety disorder - there are different types of anxiety disorders like a panic disorder, obsessive compulsive disorder, social anxiety disorder, various types of phobias . Let us look briefly at each one of them.

A panic disorder is something which is made up of panic attacks . What is a panic attack ? Panic attack is that intense fear or anxiety with associated symptoms like racing heart, difficulty in breathing or shortness of breath where sometimes the person feels suffocated and he feels that I am going to die. This episode usually lasts for 15 minutes to an hour and goes away on its own, but sometimes these episodes recur and a person remains fearful that I will get this episode again. In such cases a panic disorder is diagnosed.

Obsessive compulsive disorder is another anxiety disorder, here a person repeatedly checks things like door, gas stoves, light switches, sometimes a patient has a habit of washing hands repeatedly. Now all these things are usually repeated by a person to take care of anxiety and a reason for the anxiety in such patients are thoughts. There may be thoughts that somebody close to them maybe ill,  or thoughts that my hands are dirty and illness will spread in my family because of my dirty hands, it can be thoughts like the gas stove or door is not locked and robbers will rob my house or the gas stove being on can lead to an accident. Usually, the themes are related to fear and illness or death. Repeated thoughts make the person anxious which in turn causes such behaviour .

If such symptoms lead to hampering of his or her life or his functioning or his profession then it needs to be treated , if the symptoms are for more than half an hour to 1 hour. Another anxiety disorder is what we call a social anxiety disorder. Here a person is fearful or afraid of making public appearances or talking in public places or going to social gatherings with a constant fear of thought in their mind that what will others think about me, whether I will make a fool of myself . This leads people to avoid certain social situations.

If a person who is a management person is scared of making presentations , this will definitely affect his performance. So in such cases where a person's performance -occupationally or socially is dependent on his public speaking and he is not able to do so because of anxiety then we diagnose it as social anxiety disorder.

One of the commonest anxiety disorder seen is something which we call as phobias. All of us are aware of a phobia like many of us are scared of injections or needles, there are some of us who faint on seeing blood. Similarly, there are different phobias like fear of height, fear of closed spaces like claustrophobia and fear of crowded places which is agoraphobia. A person having phobia need not always be treated, for example if a person who has fear of heights is not required to go on tall places as it may not be treated.

However, if certain phobias are actually leading to problems like fear of flying in planes in a person who wants to travel abroad or who has to travel for work, it makes that person afraid and he tends to avoid such situations. So functional impairment in such cases need treatment for phobia, around 1 in 5 people suffer from one or other anxiety disorder, however, many times they are not detected. Anxiety disorders are the most treatable disorders and mostly curable also with the help of medicines and proper therapy techniques and counselling techniques.

Thank you for more enquiries about anxiety disorders you can contact me through lybrate.

Hello everyone!

I am Dr Omkar Mate consultant neuropsychiatrist practicing at Midas Clinic Nerul. I am going to talk today about depression and anxiety, which are common psychological disorders seen today.

Depression and anxiety are the most common disorders, let us talk first about depression, 8 out of 10 females and 4 out of 10 males suffer from an episode of depression in their lifetime. Indian studies till date show that around 4.5 crore people have suffered from an episode of depression till year 2015. There are some myths commonly seen with depression, let us see what they are. The first myth is people feel that low willpower causes depression, now the truth is depression is a multi-factorial illness. It may be due to stressful life situations like a break up or somebody passing away and it may be because of illnesses, like hypertension, diabetes, arthritis, tuberculosis or other chronic illnesses, but all these things are nothing but triggers. What happens actually in a person's brain is certain neurochemicals reduce that means serotonin and norepinephrine in the brain of a depressed person are low and that is why he gets stuck in thinking which we call as ideas of hopelessness, helplessness and worthlessness. Another myth seen in depression, about depression is that only adult suffer from depression, the truth is people from all age group suffer from depression. 1 out of 100 children and 1 out of 10 females suffer from depression after pregnancy, even older age group people suffer from depression. Another myth is you have to take depression medicines for life and also these medicines are addicted. The truth about this is that medicines for a depression increase the levels of Neurotransmitters like serotonin and norepinephrine in the brain this helps a depressed person to think positively. However, if you suddenly stop medicines for depression for some days you may have disturbed sleep and also the episode of depression can recur, this makes people believe that depression pills are addictive. But tell me even medicines for diabetes and hypertension, if a person suddenly quits them the blood sugar levels are the blood pressure of a person may rise does that means that these medicines are addictive, the answer is no. Similarly depression medicines are not addictive and if a person reaches a psychiatrist earlier, early then these medicines can be stopped after complete treatment. Depression is one of the few psychiatric disorders which can be cured completely. Now let's look at some symptoms of depression feeling low, forgetfulness, impaired concentration, having no interest or less interest in pleasurable activities, like watching movies, reading books, listening to music, being angry all the time or getting irritated at small things, decrease sexual drive, disturbed sleep, waking up at night, feeling that death is better than life, these are some of the symptoms of depression. If anybody suffers from 4 or 5 of these symptoms for a period of more than two weeks then that person should immediately seek help from a psychiatrist or a counsellor and get yourself checked for depression. Let us fight the stigma against depression, create awareness.

If you have any further queries about depression you can contact me through Lybrate. Thank you.