moncet, Author at Oasis Health

Woman and Mental Health

moncet — Mon, 24 Dec 2018 06:52:57 +0000

A Woman’s mental health and overall health is a critical determinant of a family and society’s well-being. The patterns of psychological distress and psychiatric disorder among women can be different from those in the other gender. Women have a higher chance of internalizing disorders like self-blame, isolation, worthlessness etc. while men show a higher chance of externalizing disorders – anger outbursts, irritability, and such.

There are other types of depression that are unique to women. Some women may experience symptoms of mental disorders at times of hormone change – such as perinatal depression (around pregnancy and before birth of a child), premenstrual dysphoric disorder (around monthly/ menstrual periods), and perimenopause (at time of stopping of menstrual cycle) depression.

Some studies report that women with bipolar depression report frequent premenstrual mood disturbances and bipolar depression may worsen during the premenstrual phase.

Depression:

More women than men experience depression. Nearly 1 in 4 women suffer from depression that requires treatment. This is likely influenced by social factors, poverty, isolation and possibly hormonal factors.

In addition to being more common in women than men, thyroid dysfunction is more common in patients with mood disorders. Both mixed mania and rapid cycling have been associated with elevated rates of overt and sub-threshold thyroid abnormalities.

With women being primary caregivers for their older parents, high rates of depression are noted.

Woman over the age of 85 years are at high risk of depression.

Post-natal depression also, has high rates of about 8-15% of women that is, depression after child birth.

A woman’s willingness to talk about their feelings and their strong social networks can help protect their mental health.

A complete assessment of women with bipolar depression is an integral part of management that includes a psychiatric and medical history, family and social history.

Depression can follow trauma which about half of all women experience, during their lives as attempted or completed sexual assault, or being abused by a domestic partner. Trauma is a risk factor for not only depression but can also, lead to post traumatic stress disorder.

Pregnancy, Birth & Parenting

During pregnancy and even after child birth a mother have various physiological changes which likely cause 41% of women to suffer from some form of depression also, called postpartum depression.

Bipolar Depression is also, prevalent in women nearly same as in men, at rate of nearly 1% of general population. It is more likely to happen during pregnancy or after child birth though, can be unmasked with other stressors of life.

All forms of depression can be treated and with newer medicines, side effects are non-habit forming and do not affect day to day life. For complete assessment, please contact Dr. Vikrant Mittal MBBS, MD Psychiatry at Oasis Health. He is one of the best psychiatrists in New Delhi/ NCR, trained from top US Ivy league hospitals.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539870/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4539863/

https://www.mentalhealth.org.uk/a-to-z/w/women-and-mental-health

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Why to see a psychiatrist or Child and adolescent psychiatrist for Children

moncet — Sat, 01 Dec 2018 05:02:44 +0000

Mental disorders in children are quite common these days, occurring in about one-quarter of this age group in any given year per research.

The most common childhood mental disorders are Anxiety disorders, Depression, Autism and spectrum disorders and ADHD (Attention deficit hyperactivity disorders). Although less common, other mood disorders like Bipolar depression, developmental disorders (learning deficits, Cerebral palsy) and Psychotic disorders in children, can have a lifelong impact on the child and his or her family.

As in any age group, there tends to be no single cause of psychiatric/ mental illness in children or even in adult or geriatric population.

In addition to the specific symptoms of each mental disorder, children with behavioral issue can exhibit different or unusual signs that can be attributed, to their age and developmental status.

Establishing the diagnosis of a mental illness in children usually involves the combination of getting comprehensive medical history, developmental history, and mental health assessments.

There are varieties of treatments available for managing mental illness in children, including several effective medications, educational or occupational interventions, as well as different forms of psychotherapy.

Children with mental health or developmental problems can have lower educational achievement, need more social support and care.

Research on mental illness in children focuses on a number of issues – increasing the understanding of how often these illnesses occur, the risk factors, most effective treatments, and how to improve the access that children have to those treatments.

Common rates of mental health issues in most populations –

ADHD- 8%-10% of school-aged children;

Major Depression – about 2% during childhood and about 4%-7% during adolescence and up to about 20% of adolescents till they reach adulthood.

Drug addictions, eating issues/ disorders, Bipolar disorder and less often early onset schizophrenia may manifest more frequently in teenage years than in younger children.

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GPSCON 2018 at NDMC auditorium New Delhi

moncet — Wed, 14 Nov 2018 07:24:18 +0000

Recently, Dr. Mittal chaired a session at GPSCON 2018 at NDMC auditorium New Delhi. The presentation was on mental health and technology for the general physicians and surgeons.

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What Questions Should You Ask

moncet — Sun, 14 Oct 2018 04:23:31 +0000

If you haven’t been feeling like yourself and think you might be depressed, speak with your family doctor or your psychiatrist.

We should be asking about what our symptoms mean, which can be – I am not feeling well, not sleeping properly or broken sleep, having memory issues – difficulty with remembering things, anger problems or mood fluctuations. One should be asking about, if they would need medicines or how long they would need to take medicines.

What questions your Psychiatrist – your Mental Health specialist would ask?

If you consult a psychiatrist – mental health specialist in New Delhi, there are some important questions which he would ask. He would ask how you feel and your symptoms, memory issues, medical condition, medical history, family history. What are the anxiety (nervousness), sleep issues or drug or alcohol problems or in case, of child or adolescent patient, if they have behavioral issues or school related issues? During the session, the more information is provided by you, the more it will help your physician.

By giving you a thorough checkup, your doctor can rule out any other potential causes of your depression symptoms.

Is my conversation with my psychiatrist confidential?

Professionals who deal with mental issues understand that completely and anything you talk about with your psychiatrist, is confidential. Your psychiatrist might suggest involving family members in your assessment, which is completely your choice.

You don’t need to worry about your friends, family or employer finding out about your mental illness.

Write Down All Your Symptoms

Initially, when you have a doubt that you have some problem, just write down all your symptoms you can think of –

Feelings of sadness or depression
Not enjoying things like you used to
Changes in appetite or weight
Insomnia or sleeping more than usual
Feeling restless
Feeling extremely tired
Feeling hopeless
Feeling worthless
Feeling helpless
Feeling guilty
Having problems thinking, concentrating or making decisions
Thinking frequently about death or suicide

It will help the psychiatrist doctor to suggest a treatment for you.

What Types of Treatments are Available?

There are mainly three options available that a mental illness specialist would possibly advise: Talk therapy (counseling/ psychotherapy), medicines, or both. You can decide which one you want to try first or not.

Will My Illness Seriously Affect Me?

Left untreated, mental health can lead to other physical problems like blood pressure, heart illness, stomach issues like acid reflux, diarrhea, irritable bowel syndrome, asthma, Parkinson’s, Dementia (memory loss). But if treated, person can lead happy, healthy life.

When Will I Become Normal?

After evaluation by psychiatrist or mental health doctor, he would assess severity of illness and help project, time frame for return to normal routine.

Which Illness am I suffering from

Your psychiatrist will evaluate after discussion with you and history, about what kind of illness, you are suffering from and what to do to get well soon.

What is the difference between a Psychiatrist and psychologist/ therapist/ counselor?

Psychiatrists have specialized training including Medical School (MBBS) and MD in Psychiatry. They have expertise where they treat people using medications along with utilizing psychotherapy for treating mental health problem. While psychologist/ therapist/ counselor, specialize in using talk therapy only, to help you with mental health problem. A combination of the two approaches is often the best way to treat.

Conclusion:

Always ask question/s, from your Psychiatrist or your mental healthcare or illness specialist, available in your NCR area or New Delhi, India.

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Largest Brain Study Of 62,454 Scans Identifies Drivers Of Brain Aging

moncet — Fri, 31 Aug 2018 10:50:17 +0000

Schizophrenia, cannabis use, and alcohol abuse are just several disorders that are related to accelerated brain aging

Date: August 21, 2018

Source: IOS Press

Summary: In the largest known brain imaging study, scientists evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging.

In the largest known brain imaging study, scientists from Amen Clinics (Costa Mesa, CA), Google, John’s Hopkins University, University of California, Los Angeles and the University of California, San Francisco evaluated 62,454 brain SPECT (single photon emission computed tomography) scans of more than 30,000 individuals from 9 months old to 105 years of age to investigate factors that accelerate brain aging. SPECT tomography) evaluates regional cerebral blood flow in the brain that is reduced in various disorders.

Lead author, psychiatrist Daniel G. Amen, MD, founder of Amen Clinics, commented, “Based on one of the largest brain imaging studies ever done, we can now track common disorders and behaviors that prematurely age the brain. Better treatment of these disorders can slow or even halt the process of brain aging. The cannabis abuse finding was especially important, as our culture is starting to see marijuana as an innocuous substance. This study should give us pause about it.”

The current study used brain SPECT imaging to determine aging trajectories in the brain and which common brain disorders predict abnormally accelerated aging. It examined these functional neuroimaging scans from a large multi-site psychiatric clinic from patients who had many different psychiatric disorders, including bipolar disorder, schizophrenia and attention deficit hyperactivity disorder (ADHD).

Researchers studied 128 brain regions to predict the chronological age of the patient. Older age predicted from the scan compared to the actual chronological age was interpreted as accelerated aging. The study found that a number of brain disorders and behaviors predicted accelerated aging, especially schizophrenia, which showed an average of 4 years of premature aging, cannabis abuse (2.8 years of accelerated aging), bipolar disorder (1.6 years accelerated aging), ADHD (1.4 years accelerated aging) and alcohol abuse (0.6 years accelerated aging). Interestingly, the researchers did not observe accelerated aging in depression and aging, which they hypothesize may be due to different types of brain patterns for these disorders.

Commenting on the study, George Perry, PhD, Chief Scientist at the Brain Health Consortium from the University of Texas at San Antonio, said, “This is one of the first population-based imaging studies, and these large studies are essential to answer how to maintain brain structure and function during aging. The effect of modifiable and non-modifiable factors of brain aging will further guide advice to maintain cognitive function.”

Co-investigator Sachit Egan, Google Inc. (Mountain View, CA), said, “This paper represents an important step forward in our understanding of how the brain operates throughout the lifespan. The results indicate that we can predict an individual’s age based on patterns of cerebral blood flow. Additionally, groundwork has been laid to further explore how common psychiatric disorders can influence healthy patterns of cerebral blood flow.”

Story Source:

Materials provided by IOS Press. Note: Content may be edited for style and length.

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Stress During Pregnancy Increases Risk Of Mood Disorders For Female Offspring

moncet — Fri, 31 Aug 2018 09:28:58 +0000

Study examines the effects of maternal cortisol levels on brain connectivity and behavior in offspring

Date: August 16, 2018

Source: Elsevier

Summary: High maternal levels of the stress hormone cortisol during pregnancy increase anxious and depressive-like behaviors in female offspring at the age of 2, reports a new study. The effect of elevated maternal cortisol on the negative offspring behavior appeared to result from patterns of stronger communication between brain regions important for sensory and emotion processing. The findings emphasize the importance of prenatal conditions for susceptibility of later mental health problems in offspring.

High maternal levels of the stress hormone cortisol during pregnancy increase anxious and depressive-like behaviors in female offspring at the age of 2, reports a new study in Biological Psychiatry. The effect of elevated maternal cortisol on the negative offspring behavior appeared to result from patterns of stronger communication between brain regions important for sensory and emotion processing. The findings emphasize the importance of prenatal conditions for susceptibility of later mental health problems in offspring.

Interestingly, male offspring of mothers with high cortisol during pregnancy did not demonstrate the stronger brain connectivity, or an association between maternal cortisol and mood symptoms.

“Many mood and anxiety disorders are approximately twice as common in females as in males. This paper highlights one unexpected sex-specific risk factor for mood and anxiety disorders in females,” said John Krystal, MD, Editor of Biological Psychiatry. “High maternal levels of cortisol during pregnancy appear to contribute to risk in females, but not males.”

“This study measured maternal cortisol during pregnancy in a more comprehensive manner than prior research,” said first author Alice Graham, PhD, of Oregon Health & Science University. To estimate the overall cortisol level during pregnancy, senior author Claudia Buss, PhD, of Charité University Medicine Berlin and University of California, Irvine and colleagues measured cortisol levels over multiple days in early-, mid-, and late-pregnancy. Measurements taken from the 70 mothers included in the study reflected typical variation in maternal cortisol levels. The researchers then used brain imaging to examine connectivity in the newborns soon after birth, before the external environment had begun shaping brain development, and measured infant anxious and depressive-like behaviors at 2 years of age.

“Higher maternal cortisol during pregnancy was linked to alterations in the newborns’ functional brain connectivity, affecting how different brain regions can communicate with each other,” said Dr. Buss. The altered connectivity involved a brain region important for emotion processing, the amygdala. This pattern of brain connectivity predicted anxious and depressive-like symptoms two years later.

The findings reveal a potential pathway through which the prenatal environment may predispose females to developing mood disorders. The study supports the idea that maternal stress may alter brain connectivity in the developing fetus, which would mean that vulnerability for developing a mood disorder is programmed from birth. This could be an early point at which the risk for common psychiatric disorders begins to differ in males and females.

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Materials provided by Elsevier. Note: Content may be edited for style and length.

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Anxiety, Depression, Other Mental Distress May Increase Heart Attack, Stroke Risk In Adults Over 45

moncet — Fri, 31 Aug 2018 09:15:26 +0000

Date: August 28, 2018

Source: American Heart Association

Summary: A new study links anxiety, depression and other mental distress to an increased risk of heart attack and stroke among adults ages 45 or older, even after factoring for lifestyle behaviors and disease history. The associations were slightly stronger for stroke among women than men.

Adults ages 45 or older who experience psychological distress such as depression and anxiety may have an increased risk of developing cardiovascular disease, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

In a study of 221,677 participants from Australia, researchers found that:

among women, high/very high psychological distress was associated with a 44 percent increased risk of stroke; and
in men ages 45 to 79, high/very high versus low psychological distress was associated with a 30 percent increased risk of heart attack, with weaker estimates in those 80 years old or older.

The association between psychological distress and increased cardiovascular disease risk was present even after accounting for lifestyle behaviors (smoking, alcohol intake, dietary habits, etc.) and disease history.

“While these factors might explain some of the observed increased risk, they do not appear to account for all of it, indicating that other mechanisms are likely to be important,” said Caroline Jackson, Ph.D., the study’s senior author and a Chancellor’s Fellow at the University of Edinburgh in Edinburgh, Scotland.

The research involved participants who had not experienced a heart attack or stroke at the start of the study and who were part of the New South Wales 45 and Up Study that recruited adults ages 45 or older between 2006 and 2009.

Researchers categorized psychological distress as low, medium and high/very high using a standard psychological distress scale which asks people to self-assess the level.

The 10-question survey asks questions such as: “How often do you feel tired out for no good reason?” How often do you feel so sad that nothing could cheer you up?” How often do you feel restless or fidgety?”

Of the participants — 102,039 men (average age 62) and 119,638 women (average age 60) — 16.2 percent reported having moderate psychological distress and 7.3 percent had high/very high psychological distress.

During follow-up of more than four years, 4,573 heart attacks and 2,421 strokes occurred. The absolute risk — overall risk of developing a disease in a certain time period — of heart attack and stroke rose with each level of psychological distress.

The findings add to the existing evidence that there may be an association between psychological distress and increased risk of heart attack and stroke, she said. But they also support the need for future studies focused on the underlying mechanisms connecting psychological distress and cardiovascular disease and stroke risk and look to replicate the differences between men and women.

Mental disorders and their symptoms are thought to be associated with increased risk of heart disease and stroke, but previous studies have produced inconsistent findings and the interplay between mental and physical health is poorly understood.

People with symptoms of psychological distress should be encouraged to seek medical help because, aside from the impact on their mental health, symptoms of psychological distress appear to also impact physical health, Jackson said. “We encourage more proactive screening for symptoms of psychological distress. Clinicians should actively screen for cardiovascular risk factors in people with these mental health symptoms.”

All factors analyzed in this research, apart from the outcomes of heart attack and stroke, were identified at the same point in time, which made it difficult for researchers to understand the relationship between psychological distress and variables such as unhealthy behaviors like smoking and poor diet. With that analysis approach, they may have underestimated the effect psychological distress has on the risk of heart attack and stroke.

Co-authors are Cathie Sudlow, D. Phil., and Gita Mishra, Ph.D. Author disclosures are on the manuscript.

The University of Queensland and the University of Edinburgh funded the study.

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Materials provided by American Heart Association

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