Psychiatry

Simple steps to take care of children’s from gadget use

12 years old child seen with grandmother in OPD with the complaints of excessive use of gadget, i.e., mobile phone which she is finding very difficult to restrain him from using.

Another parent brought the child complaining that he sees inappropriate content in online by which he is misbehaving in school and they hear complaints from the school as well.

And many parents say that it’s difficult to control the behavior of getting upset easily, throwing tantrums when they can’t get the gadget to play or not able to being in online. Parents could easily notice these behaviors disappears when they get online they become calmer.

A three-year-old child has brought to Opd with delayed speech and language but she was excellent in using mobile phone says, father.

A teenage boy is more comfortable in his online world, and he would feel anxious, irritated when being in a social group. When an encountering with the social situation he would fidget and leaves the situation, and he feels better when online. He mentioned that online relationships give him more comfort than face to face.

We see not only in the OPD we hear in day to day life many parents saying and it’s hard for them to restrain from using gadgets.

Here are the simple tips for parents to follow:

Set proper time:

Setting adequate time allows parents to keep a track and restrict the amount of time spending on gadgets and don’t let them use after their time is finished.

With that parents can improve the habit of routine which prevents the child from spending more time on screen.

Active supervision:

Children spend most of their time being online and don’t pay much attention to their posture, screen brightness, and screen distance from their eye. Active supervision not only helps the child to maintain proper position at the same time it’s an excellent opportunity to co-engage with your children when they are using screen- it encourages social interactions, bonding, and learning. Sometimes a child can use the internet for seeing adult content, or they click on pop-ups. This practice leads to a lousy impact on a child’s character. This is a most significant problem in the growing world of technology. Don’t just monitor them online – interact with them, so you can understand what they are doing and help them to overcome.

Encourage play time:

Encouraging physical, unstructured and offline play stimulates the brain. These include activities that use physical movements to allow children’s to use their energy and it gives children the chance to develop gross and fine motor skills, learn new things and socialize. It also benefits a child's health. Make offline play a much priority, especially for very young children.

Avoid technology as an emotional pacifier:

Most of the parents use gadgets to distract children for example while feeding, dressing up and traveling. As we all know media can be beneficial in keeping kids calm and entirely, but it should not be the only way they learn to calm down and distract them.

Parents have to help the child how to identify and handle strong emotions, come up with activities to manage boredom, open communication to solve the problem, finding other ways to distract children’s and strategies for challenging feelings.

Educate the children importance of privacy:

Adolescence needs to know that once the content is shared with others, will be able to delete completely. Avoid texting of inappropriate pictures sharing personal details to unknown. The child has to be warned that sex offenders often use social networking, online gaming to contact and exploit children’s. 

Encourage face to face communication:

Research has shown that two-way communication with children’s improves language development much more so than passive listening or one-way interaction with a screen.

Encouraging child to talk back in case of language delayed kids. It helps to stimulate the brain by reducing nonverbal communication.

Parents have to set proper time for face to face communication or if necessary by video chat with far-away parent and grandparents.

Be an exemplary:

Children’s are great observers, and they mimic the habits of parents. Limit your use. Find more time to spend with your children by interacting, hugging, playing with them rather than just staying at a screen.

Now a day’s media and digital devices are an integral part of the world today. It will be healthier if we use them moderately and appropriately.

Research has shown that face to face time with family, children, and friends has a significant impact on children’s learning and healthy development. So let’s not get lost in a stream of media and technology.

Dr. Naveen Jayaram
Attending Consultant - Psychiatry

Book Appointment With Dr. Naveen Jayaram,Psychiatrist

Dr. Jamuna Kakarla
Visiting Consultant - Psychiatry

“I am just having many bad days or could this be depression?”

Mr. R, 30 year old man came to see the psychiatrist after his wife got fed up trying to tell him to get off the bed and go to work. "Doctor, I am tired, tired, tired. I didn’t want to come here today but I know I am not what I used to be 4 months ago. I feel sad all the time, I have no motivation to go to work, I have no interest in eating and I am having trouble sleeping well at night. My wife is very worried; she thinks I am blaming myself for everything in our lives. I really think I am responsible for my whole family's stress. Things are hopeless Doc!"

Statistics

Depression is one of the most common mental Illnesses in the world and is in the top ten causes of years lost to disability according to the world health organization. According to several studies done in India, the prevalence of depression ranges from 7.9 to 8.9 per thousand population. In urban parts of India, the prevalence was nearly twice of that in rural areas. (Grover et al, IJP)

Is depression easy to identify?

If someone researched online to understand depression in India, plenty of articles come up and one can read about it. Newspapers try to do their part to let the public know that there is an illness called Depression. Yet, very few people seem to realize they are depressed or that a family member is not "lazy" but depressed. People try to “keep going" and this makes things worse. 

What is depression?

Depression is an illness which is manifested as:-
•    Feeling sad always (sometimes without any reason) or emptiness, irritability, feeling low (This is much deeper than feeling sad once in a while)
•    Loss of motivation or enjoyment in activities that were fun before
•    Feeling tired or fatigued, aches and pains
•    Difficulty in sleeping well ( finding it hard to go to sleep, sleeping too much, waking up multiple times, or waking up very early)
•    Loss of appetite , weight changes
•    Poor concentration (people might feel they have "memory problems")
•    Many people complain that they feel guilty all the time, some people talk of feeling hopeless and even worthless.
•    There are people who think about committing suicide and sometimes they do succeed.

Do I have to have all the listed symptoms?

No! One does not have to have all the listed symptoms to have clinical depression. People vary in how they experience depression. 

Everyone's body and mind is different. Some people might experience most or all of the symptoms, some people might have a few.

Why do people get depressed?

Depression is an illness, influenced by biological, social, psychological and environmental factors. Depression can run in families, it has a genetic component.

Can Depression be treated?

Depression can be treated. There are different types of treatments which include medications, therapy or a combination of the two. There are other forms of treatment which are based on the severity of illness.

Medications: there are many different medications that help one overcome depression. The medications commonly used for depression are not addicting and don’t necessarily have to be taken for a lifetime.

Talk Therapy or counselling is a form of treatment that helps persons with depression. One can talk to their treating psychiatrist on the best form of therapy.

What can I do to get better?

Other than seeing a psychiatrist, you should also

• Exercise, eat healthy, stay away from drugs of addiction. 
• Reach out to friends that you trust, do not isolate
• Read and educate yourself about depression
• Give yourself time to get better.

Dr. Naveen Jayaram
Attending Consultant - Psychiatry

Book Appointment With Dr. Naveen Jayaram,Psychiatrist

Dr. Jamuna Kakarla
Visiting Consultant - Psychiatry

Panic Disorder is common, treatable and does not have to be life long- Dr Sabina Rao

"I don't know Doc, everything is fine at home but I think something is wrong with me. Out of the blue, I have palpitations, I feel scared, I get dizzy, I can't breathe and I think I am going to die! It happens several times a day and I am exhausted. My whole life has changed, I think I will have to quit my job. I have seen all kinds of doctors but they haven't found anything!"

Seema came to see me and appeared very anxious in the room. She said she was 32 years old married and worked in one of the Multi National Companies. She said she was married and had a 6 year old daughter who was doing well.

Anxiety disorders is a broad term for a set of conditions where a person's main complaint is anxiety or tension or worry. These are common disorders and a significant chunk of population suffers from it. Illnesses or disorders such as generalized anxiety disorder, panic disorder, social anxiety disorder are some of the examples.

Typically, a person rushes to an emergency room thinking they are a having a heart attack or a stroke and tests reveal no physical or blood abnormalities. A person might visit several different doctors, in different specialties, "looking for an answer". He or she might spend significant amount of money on various blood tests, procedures. When tests reveal that "nothing is wrong", it might be immensely frustrating. It can feel worse when a doctor suggests, "you need to see a psychiatrist". Yet, that might just be the solution.

Having Panic Disorder does not mean one is "crazy". It is a diagnosable condition with well documented treatment. In India, the life time prevalence of what are called common mental disorders(CMDs) is 20-25%. Anxiety Disorders, including Panic disorder is one of them. The specific prevalence of Panic Disorder is not known in India but it is high enough that a significant percentage of our population suffers from it and very few seek any help from a psychiatrist. Usually women suffer from it more than men do. The illness occurs usually in younger adults but it can occur at any age. 

By definition, a person suffering from Panic Disorder experiences intense fear, palpitations, shortness of breath, tremors, giddiness and a variety of symptoms several times a day. These episodes last several minutes. Eventually these episodes can cripple one's life and create a fear of the next attack. 

The good news is there is well documented and researched treatment for it. These treatments include medications and therapy. In counselling or therapy, some of the things an individual learns is to recognize a panic attack for what it is, and to use techniques to counter the panic attack. For example reminding oneself "I am not going to die, this is a panic attack" can work if one learns to use the technique and use it effectively. Medications are also a good option. Whether to go with therapy or medications or both can be discussed in a session. A psychiatrist advises treatment based on how debilitating the symptoms are, how long they have been present etc.

Dr. Naveen Jayaram
Attending Consultant - Psychiatry

Book Appointment With Dr. Naveen Jayaram,Psychiatrist

Dr. Jamuna Kakarla
Visiting Consultant - Psychiatry

Are you suffering from a mental illness? Dr Sabina Rao tells you why there is nothing to be ashamed

Mental illness is in the list of top ten disorders that cause disability across the world according to the World Health organization.

The WHO also says, globally 350 million people suffer from depression. In the Indian private sector over 42 % of people suffer from anxiety and depression as per a study done by the industry association Assocham.
 

Inspite of the suffering, very few people in India seek help for mental illnesses. Across the world,more so in countries like India, seeking help for a mental health condition is a “no­no”, is “stigmatizing”.
 

As more and more people migrate internally for a better life, as many families move out of the joint family system, traditional supports are becoming less easily accessible to people. The lack of support is felt not only by the migrating population, it is also felt by the families they leave behind.
 

Within Bangalore, as people move closer to the work place and move out of their family homes, loneliness, depression, anxiety can start to emerge in families, couples, parents and grandparents.
 

In big cosmopolitan, relatively expensive cities such as Bangalore, both partners need to work. This means they need to make arrangements at the home front, arrange for child care. If this does not happen effectively, often one partner has to quit work. This example of a catch 22 situation creates stress in the lives of people making these choices.
 

Many mental health conditions are treatable. Not all mental disorders require medications. Mental disorders such as depression and anxiety, are called “common mental disorders”. Mild to moderate depression, generalized anxiety disorder, illnesses such as panic disorder can be treated with therapy/counseling.
 

There are some rarer illnesses such as Schizophrenia, Delusional Disorder and Bipolar Disorder that get better with dications and therapy.
 

Schizophrenia is typically characterized by hearing voices, feeling as if people are plotting against one or feeling scared. It is a rare illness but most people with this illness can be treated successfully.
 

Bipolar Disorder, also called Manic Depression, is typically characterized by significant highs and lows in mood. The mood alternates between feeling excessively happy or elated to very severe depression.
 

Feeling low for most of the week, loss of appetite, loss of interest in activities, difficulties with concentration and loss of sleep are some of the common symptoms of depression. In more severe cases of depression, one can experience hopelessness, helplessness, worthlessness and even suicidal thoughts.
 

Symptoms of anxiety include feeling tense most of the time, feeling like one cannot relax. Palpitations, feeling giddy, breathless, sweaty palms, tunnel vision can all be signs of a panic attack. Sleep problems tend to accompany depression, anxiety and a variety of mental health conditions.
 

Substance use such as excessive use of alcohol, tobacco and other recreational drugs have emerged as very significant contributors to health problems in India. Use of alcohol and other drugs are sometimes used by people suffering from anxiety and depression too. Sometimes, those suffering from Social Phobia, which is the inability to be comfortable in groups of people due to the fear of being judged, tend to use alcohol, sometimes drugs as ”crutches” to overcome the fears.
 

Mental Health cannot be seen as a separate entity from physical health. Mental and physical health tend to go hand in hand. Just as a lot of physical conditions have treatments and cures, so do mental illnesses.
 

Mental illness can act as a barrier to stability of individuals, couples, families, one's profession, and communities as a whole.
 

Leading a healthy lifestyle, such as eating healthy and exercising help the mental health of individuals. In addition, treatments in the form of medications and a variety of evidence based therapies, such as cognitive behaviour therapy, dialectical behaviour therapy, etc, are good options.
 

It is important to seek help, seek help as soon as possible.

Dr. Naveen Jayaram
Attending Consultant - Psychiatry

Book Appointment With Dr. Naveen Jayaram,Psychiatrist

Dr. Jamuna Kakarla
Visiting Consultant - Psychiatry