Frequently Asked Questions

Bipolar Disorder

 What do you need to know?

1% suffer from Bipolar disorder and 15% end their lives by suicide

 How do I know if I have Bipolar disorder?

If you have bipolar disorder, you may sometimes feel excessively happy, impulsive, irritable, or irrational (called mania) everyday for a minimum of a week.

you may sometimes feel excessively sad, hopeless, suicidal, decreased sleep everyday for a minimum of 2 weeks (called major depression).

Episodes of mania and depression are interspersed with periods of normalcy

 What causes bipolar disorder?

The problem may be related to an imbalance of chemicals in the brain causing disturbances in thinking, feeling and behavior

Bipolar disorder can make it hard to do a good job at work or school, have relationships with friends and family, and it even increases the risk of suicide during the episode, if it is not treated. However, a number of effective treatment options are available.

 Treatment for Bipolar disorder?

BD is treatable, episode is curable, recurrences can occur. Treatment includes curing the current episode and preventing the further episodes

With effective medications, a patient can get back to his normal routines like study/ job/ business/family/ social life after recovery

 How long should I take the medications?

Long term medication is essential. Patient’s insight and patient centric approach yields better results in preventing further episodes

 Risk of having Bipolar disorder

People with a family history of bipolar disorder are at increased risk of developing the condition. Most people develop the first symptoms of bipolar disorder between age 15 to 30 years.

 How does the doctor make a diagnosis?

There is no test that can diagnose Bipolar disorder. Instead, the diagnosis is based upon a medical and psychiatric history and a physical and mental status examination. Laboratory testing may be performed to rule out other diagnoses

For many reasons, it may take years to diagnose bipolar disorder. As an example, a person may have multiple episodes of depression which is treated with the diagnosis of Recurrent Depressive Disorder. Perfectly correct. Later, may be after many years, if the patient develops a manic episode the diagnosis gets revised as Bipolar Disorder.

Major Depressive Disorder (MDD)

 How do I Know that I am suffering from Major Depressive Disorder?

It is different from normal sadness that we all experience in our daily lives, which is temporary, mostly has a preceding stress associated

If you have Major Depressive Disorder, you might experience the following symptoms such as feelings of sadness, guilt, despair, experience loss of interest and motivation, easily fatigued and have recurring thoughts of negativism, hopelessness, helplessness, suicide – most of the time in a day, most of the days in a week, at least for two weeks….and often it is without any stress….

The usual age at onset is 15-35 years; one in 5 people may suffer from MDD in their life time

Suicide is a global phenomenon and occurs throughout the lifespan, and is the second leading cause of death in 15 - 30 years globally. 800000 people die out of suicide every year, and 1 in 40 seconds thorough the world end their lives by suicide. 16 persons per lakh population per year die by suicide in India (2019 WHO statistics)

Types of Depressive Disorder:

There are the several types of depressive illnesses

Melancholic depression: characterized by characteristic sleep disturbance (late insomnia) and diurnal variations of mood. Good response is noted with a combination of different treatment modalities

Post partum depression: depression starts within about 6 months after the child birth in a woman. There is a high risk of recurrence with every post partum period

Psychotic depression: depressive features are presented along with delusions and hallucinations. This variety of depression may take a longer time to respond with the treatment

Chronic depression: depressive disorder lasting for >1 year

Seasonal Affective disorder (SAD): depressive disorder recurring in a particular season, especially during the winter months.

Premenstrual dysphoric disorder (PMDD): women may experience depressive symptoms, irritability, low frustration tolerance in relation to their menstrual cycles

Bipolar depression: it occurs in Bipolar disorder, it is diagnosed when the patient experience both depressive and manic episodes. Most often, Bipolar disorder presents as recurrent depressive disorder initially and it may take a few years for the first manic episode to occur.

Disruptive mood dysregulation disorder (DMDD): it is a condition where child (10-18 years) is chronically irritable, experiences frequent temper outbursts that seem out of proportion to the situation at hand. In between the episodes they are irritable most of the times

Obsessive Compulsive Disorder (OCD)

 Identifying OCD

Imagine a teenage girl brushing her teeth for 20 minutes (taking long times to do a work), washing hands for 33 times (repeatedly does the same work in multiples), has to wear this color dress only on this day of the week etc. This can be an example of a person who is suffering from OCD

 Will the patient know they suffer from some illness?

The person is well aware of the illogicality and irrationality of the thought and action, but finds himself miserably failing to stop the thought or action.

 Why a patient cannot help himself/ herself??

He/she may feel the distress due to illness but may not express the distress to his/her loved ones. His/her mind is preoccupied with these thoughts and fear some harm might happen if not followed by those actions in a set pattern.

Relatives are at a loss to understand the patient’s struggle. Their remarks can lead to extreme anger outbursts and severe depressive withdrawals. Depressive reactions are very common in patients with OCD, with its attendant risk of suicide.

 How to support one with OCD

Generally there is a long delay between the onset of symptoms and treatment seeking. Most of the patients with OCD are secretive; obsessions and compulsion are restricted to their house; major socio occupational dysfunction may not be apparent, though the distress and suffering to patient is very high. Hence the delay in seeking treatment.

Treatment for OCD

There are treatments available for OCD, involving medications and counseling. Medicines constitute one important and essential component of treatment; mostly non sedative and have safer side effect profile, the patient can continue their daily routine, job, studies while on medications. Usual course of treatment may range from 1 year to many years depending on the disease profile. Some patients with OCD are known to require high doses for a meaningful relief.

Counseling, that includes teaching relaxation techniques and behavioral modification, is necessary to improve the insight of the patient and the family members for better understanding of OCD as a disorder. It is supportive, involves family members, deals with symptom management

General questions:

 What is mental illness?

To be simple, it is a sustained, disturbed and abnormal change in emotion, thinking and behavior which may result in maladaptive expressions, leading to significant and persistent disturbances in family/ work/ social settings. Brain is the seat of Mind, the conceptual originator of thoughts and emotions. Behavior is the visible, external expression of body, initiated, directed and guided by the internal processes of mind

 What to expect when I reach the hospital?

After registration at the reception counter (if you have not visited us in the past), You will be called in for an initial assessment by a doctor, with whom you might have to share your reason for visiting this hospital. The doctor will ask you related questions to arrive at a diagnosis and will discuss various management plans. Then you will be directed to consult Dr. M. S. Reddy.

 How long will the initial assessments be?

The initial assessments might take around an hour

 Are there waiting times?

As it is a psychiatric hospital, assessments might take a while as we are dealing with sensitive emotional content of patients and families. We appreciate if you cooperate with us and deal patiently as waiting times might be a little longer

 What treatment I will be getting?

Medications ± counseling± neuro modulative therapies may be suggested for your condition.

Medications prescribed are specific to your diagnosis and are not always sedatives. You will be called frequently to the hospital until you feel comfortable with the medications and/or until improvement in your condition is noticed, there after you will be seen at more longer intervals.

 Are medications addictive?

Medications are not addictive, you are not expected to drink alcohol/ take any drugs while on medications. Medications are to be taken daily as prescribed by your doctor.

 Do I have to take them for life?

The duration of the treatment depends on your condition. Generally, medications would be continued for a brief period of time, 8-12 weeks for relief and several months on maintenance. We aim at a complete recovery from each episoder in terms of getting back to your normal self

 Will lifestyle changes help me?

Yes of course! Maintaining proper sleep hygiene, avoiding recreative drugs and alcohol, exercising every day, yoga and meditation will definitely help, but cannot replace the need for medications. They support medications and may help you recover at a faster rate