Are You Right or Left Brain ---Thinker!

Greetings . I  Would now  be Alternating  the blogs  between   Core Psychiatry  topics and  some Light Science Fun .These videos are  not made by me and   I hope  you take them in the right spirit and  not as an Actual Scientific norm. Thank You ... Stay  Happy..!

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The video just gives you an idea of impairment of judgement and effects on brain read through the blog and go through  the effects of Alcohol  Dependency...

Health Issues and Alcoholism

A recent study in the United Kingdom examined 20 drugs and found that overall alcohol was the most harmful drug, followed by heroin, and then crack. The findings considered both individual and societal harm. When a person abuses alcohol or drugs, the ramifications are felt within his or her entire sphere of influence: family, friends, work, school, and community. The cost to society of one single alcoholic can be staggering.

According to the National Council on Alcoholism:

• ¼ of all emergency room admissions, 1/3 of all suicides, and more than ½ of all homicides are alcohol related
• Alcoholic drinking contributes to heart disease, cancer and stroke
• ½ of all traffic fatalities are alcohol related
• 48-64% of people who die in fires have blood levels indicating intoxication
• Fetal alcoholism is the leading cause of mental retardation

Impact of Alcohol on the Body

Alcohol dependence and addiction have a profound impact on the whole body.

• Physical Implications of Alcohol Abuse
• Alcohol and the Brain
• Brain Damage and Alcohol Abuse
• Mental Health and Alcoholism
• Liver Damage and Alcohol Addiction
• Complications of alcohol-related liver disease
• Gastro-Intestinal Complications and Alcohol Abuse
• Acute Pancreatitis and Alcoholism
• Cardiovascular Disease and Alcohol Abuse
• Neuropathy (neuromuscular) and Alcohol Addiction
• Other Conditions

The physical results of drinking are dependent upon several factors:

• How much and how often a person drinks
• The age at which the person begins drinking, and the duration of time drinking
• Age, level of education, gender, genetic background, and family history of alcoholism
• General health

Areas of the body affected by alcohol consumption:

(source: http://pathwayscourses.samhsa.gov/aaap/aaap_3_pg7.htm) 

Physical Implications of Alcohol Abuse

Alcohol is rapidly absorbed by the body through the stomach, intestine, and directly through blood into the brain. A small amount of alcohol can alter brain function. Large amounts of alcohol ingested regularly damages the brain, the central nervous system, major organs, circulatory system, skeletal system, immune system, and psychological responses to the environment.

Alcohol and the Brain

When we think about a drunk person, we think about someone who staggers about, someone who stammers and slurs his or her words, or someone whose responsiveness is somewhat compromised.

Alcohol enters the brain and immediately alters the messages the neurotransmitters send to the rest of the body. The faster alcohol is consumed, the higher the blood alcohol level. Because alcohol is soluble in water solutions, it easily crosses the blood brain barrier. Within several minutes, normal neuron responses are diminished allowing the alcohol to manipulate the receptors.  Because the receptors are associated with “pleasure” centers in the brain, the body easily adapts to the manipulation. Yet the desire for pleasure will quickly require more alcohol intake to achieve the initial experience. Soon that pleasurable sensation is gone, though the body continues to seek the stimulus.

Unfortunately, the brain’s ability to process even a very small amount of alcohol will result in alterations of the brain. The more a person drinks, the worse the impact is upon the brain structure and the brain function. Scientists are still exploring the long-term effects of alcohol on brain function. 

Consuming large quantities of alcohol leads to a deficiency of vitamin B1 (thiamine). This vitamin is an essential nutrient for all body tissues. Thiamine deficiency causes some alcoholics to develop Wernicke-Korsakoff, a severe, two-phased syndrome.

Wernicke’s encephalopathy, phase one, includes “mental confusion, paralysis of the nerves that move the eyes, and difficulty with muscle coordination. Such a condition can leave a person confused about finding his or her way out of a room. Even if a person does not suffer from all the characteristics, they may have the syndrome.” (source: NIAAA, Oct. 04, #63)

80% of the people who develop Wenicke’s encephalopathy will eventually develop Korsakoff’s syndrome, phase two. This syndrome is chronic and irreversible. It affects a person’s ability to both learn new information and to recall old information. Furthermore, people suffering from Korsakoff’s syndrome experience forgetfulness and are frustrated easily. (source: NIAAA, Oct.04, #63)

Brain Damage and Alcohol Abuse

The amount of alcohol a person can ingest safely varies from person to person and depends upon genetic, biological, physical, psychological, psychosocial and environmental factors.

After decades of scientific research, the ramifications of chronic alcohol abuse are:

• Severe alterations in cognitive functioning. Frequent, chronic abuse of alcohol can lead to Wernickes-Korsakoff’s syndrome.
• Diminished decision making. Alcoholics are unable to appropriately respond to the negative consequences of continued drinking. Also, alcoholics are also described as being “impulsive, inconsiderate, uninhibited, inflexible or ill mannered…As a group, alcoholics share this constellation of behaviors characteristic of frontal lobe dysfunction…”, (source: Alcohol Research & Health, Wntr-Spring, 2010, “Alcohol’s effects on brain and behavior”, Edith V. Sullivan  et al online)
• Severe alterations in brain matter. Grey matter and white matter, both brain material used for learning and for cognitive functioning are reduced or destroyed by chronic use of alcohol.  Intellectual deficiencies and dementia are the results of long term alcohol abuse.

Alcohol also has the ability to block the formation of “new autobiographical memories…In addition to impairing balance, motor coordination, decision making, and a litany of other functions, alcohol produces detectable memory impairments beginning after just one or two drinks. As the dose increases, so does the magnitude of the memory impairments. Under certain circumstances, alcohol can disrupt or completely block the ability to form memories for events that transpire while a person is intoxicated, a type of impairment known as a blackout.” (source: What Happened? Alcohol, Memory Blackouts, and the Brain” Aaron M. White, Ph.D.,http://pubs.niaaa.nih.gov/publications/arh27-2/186-196.htm)

The impairment can be cumulative, resulting in a loss of memory over time, or it can be immediate, as in the experience of a blackout. Blackouts are the result of acute intoxication: drinking too much, too quickly, and on an empty stomach.

(soruce: http://pubs.niaaa.nih.gov/publications/arh27-2/186-196.htm)

The section of the brain involved in forming memories is located in the hippocampus. As the illustration shows, the medial septum has a direct link to the hippocampus and the frontal lobe, which is involved in the retrieval of memories, decision making, and planning. Thus, the disruption to  neurons in any area of this section of the brain impacts all the sections. Alcohol prevents the formation of new memories. (http://pubs.niaaa.nih.gov/publications/arh27-2/186-196.htm)

Mental Health and Alcoholism

Society accepts drinking as a normal part of everyday living. However, people who have a predisposition to alcoholism, or people who have mental health issues such as depression, bipolar disorder, anxiety disorder, panic disorder, and personality disorders are more likely to have an alcohol problem. Mental health disorders that exist alongside an alcohol addiction are called a dual diagnosis disorders. Plainly stated, drinking worsens mental health disorders. However, substance related disorders sometimes can manifest acting like mental health disorders

Approximately 37% of alcohol abusers have at least one co-occurring mental disorder (see dual diagnosis). What does this mean to a person who has not yet been diagnosed with a mental health disorder? Unfortunately, when alcohol is combined with any of the mental health disorders, a person’s life will take a downward turn. The use of alcohol does not help resolve the mental health disorder; indeed, it can worsen the mental health disorder. There is a greater chance of a dually diagnosed individual experiencing violent behavior, substance abuse, and problems with work, family and friends.

Other physical complications of alcohol addiction

Liver Damage and Alcohol Addiction

The liver is a vital organ in the body’s ability to absorb, process nutrients and remove a variety of toxins. It also controls the blood’s ability to clot, helps fight off disease, and reduce internal inflammations. Chronic alcohol abuse has a direct and deleterious impact on healthy, normal liver functioning. “Long-term, heavy alcohol use is the leading cause of illness and death from liver disease in the United States. The number of persons with alcoholic liver disease (ALD)…is conservatively estimated at more than 2 million.” (source: Alcohol Research & Health, Winter 2000, “Medical Consequences of Alcohol Abuse” n.a., onlinehttp://findarticles.com/p/articles/mi_m0CXH/is_1_24/ai_72884222/)

Liver disease develops in stages and while most people have heard of cirrhosis of the liver, the process does not begin there. ALD occurs in three stages:

• Fatty liver (steatosis). This condition occurs with both alcoholic and non-alcoholic drinkers. It is easily defined by its name. Fat droplets develop within the liver leading to the organ’s enlargement. This condition has been found to be reversible once a person abstains consistently from alcohol.
• Alcoholic hepatitis. This second stage is far more severe than fatty liver disease. According to the American College of Gastroenterology, people suffering from alcoholic hepatitis have an enlarged liver and experience:
  • Weakness
  • Fever
  • Loss of appetite
  • Nausea
  • Vomiting
  • Pain in the area of the liver

When the inflammation subsides, scarring in the liver occurs leaving fibroid tissue called fibrosis. There is no reversing the fibrosis condition of the liver.

• Alcohol Cirrhosis. This is the final stage of liver disease. The fibrosis, or scarring, within the liver leads to “obstruction of blood flow through the liver. This prevents the liver from performing its critical functions of purifying the blood and nutrients absorbed from the intestines.” (source:http://www.acg.gi.org/patients/cgp/cgpvol2.asp#Alcoholic%20Liver)

Thus, liver failure follows.

During the progression of liver disease, the body’s natural defenses produce an increase in cytokines that help fight inflammations. Chronic alcohol abuse induces the steady increase in cytokines. This abnormal production creates other chemical responses within the body which then leads to a scarring and a weakening of the permeability of the intestinal cell wall. The weakened permeability of the intestinal cell wall enables toxins to move freely from the intestine into the liver and back. Alcohol disrupts the filtering mechanism that protects the purity of the blood stream, the digestion of food, and the absorption of protein.

Both men and women alcoholics suffer from cirrhosis and other alcohol-related liver disorders. However, the mortality rate for cirrhosis of the liver is two times higher for men than women. But, women are more susceptible to cirrhosis than men. (Gender and Alcoholism)

(source: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis_ez/)

Complications of Alcohol-Related Liver Disease

Alcohol-related liver disease usually occurs after years of heavy drinking and the complications can be serious. The lack of normal liver function and its inability to clean the blood supply for the body leaves people with cirrhosis also susceptible to:
Symptoms of Alcohol-Related Liver Disease

• Bleeding
• Bloating
• Waste build-up in blood causing confusion
• Portal hypertension
• Enlarged veins in the esophagus and stomach
• Yellowing of the skin, eyes

(source: National Digestive Diseases Information Clearinghouse, NDDIC)

• Build up of fluid in the abdomen
• Bleeding from veins in the esophagus or stomach
• Enlarged spleen
• High blood pressure in the liver
• Brain disorders and coma
• Kidney failure

(source: http://www.liverfoundation.org/abouttheliver/info/alcohol/)

Those suffering from cirrhosis can develop “hepatic encephalopathy” which causes altered:

• Sleep patterns
• Mood changes
• Personality changes
• Shortened attention span
• Coordination problems
• Flapping hands
• Coma

(source: National Digestive Diseases Information Clearinghouse, NDDIC)

The following are the less severe early symptoms of cirrhosis:

• Feeling tired or weak
• Loss of appetite
• Loss of weight

Gastro-Intestinal Complications

Just a small amount of alcohol consumption may negatively impact the entire digestive system. The digestive system includes the mouth (the tongue, the teeth), the parotid gland, the pharynx, the salivary glands, the esophagus, the stomach, the duodenum, small intestine, large intestine, the rectum, and the anal canal.

The digestive system, or the GI system, breaks down food, allows the absorption of nutrients into the bloodstream, and rids the body of waste products. Use of alcohol can lead to:

Symptoms of Gastro-Intestinal Complications from Alcohol

• Damage to salivary gland
• Swollen tongue
• Rotting teeth
• Gum disease
• Weakening the lower esophagus sphincter muscle (between the esophagus and the stomach)
• Vomiting
• Intestinal bleeding and gastric lesions
• Diarrhea from impaired small and large intestine muscle movement
• Malnutrition
• Heartburn
• Increase risk of esophageal cancer
• Absorption of toxins into the blood from the intestine that contributes to liver disease
• Development of Barrett’s disease (precursor to esophageal cancer)

(source:Alcohol Health & Research World, “Alcohol’s Role in Gastrointestinal Tract Disorders, Christiane Bode, Ph.D., http://pubs.niaa.nih.gov/publications/arh21-1/76.pdf)

Acute Pancreatitis

The pancreas is a gland involved in the proper functioning of the digestive system. It is also responsible for the creation of insulin and enzymes that metabolize carbohydrates, proteins, and fats. When the balance between the cells in the pancreas are disrupted and disorganized, serious side effects can occur. Alcohol use, medication, and gallstones are the three main reasons for pancreatitis. In general, more men suffer from acute pancreatitis due to alcohol abuse than women.

Acute pancreatitis interferes with the absorption of foods with the following symptoms:

• Abdominal pain
• Fever
• Jaundice
• Listless

Cardiovascular Disease and Alcoholism

The regular consumption of alcohol can lead to a variety of cardiovascular problems. Alcohol, which is quickly absorbed undiluted into the blood stream, increases the level of triglycerides. Increases in the triglycerides can then lead to high blood pressure, heart failure, or stroke. Furthermore, the heart muscles can be adversely affected by the consumption of large amounts of alcohol, causing shortness of breath.

Binge drinking produces atrial fibrillation/flutter, or the heart beating at irregular rhythms, moving from rapid to slow. The disruption in the regular heartbeat deprives the body of the necessary blood and oxygen supply to function properly resulting in the destruction of healthy organs.

Neuropathy (neuromuscular) and Alcoholism

The ability to maintain muscular sensation, muscle strength, tendon reflexes, and the sensation of pain are a direct result of the health and proper functioning of the peripheral nerves. Peripheral neuropathy is a disruption in one or more of the peripheral nerves (part of the spinal nervous system).

Chronic alcohol intake causes neuropathies. Thiamine (part of the B1 complex) is an essential vitamin needed to maintain healthy bodily functions. Alcohol use causes a depletion of thiamine. This deficiency adversely affects the health of the nerves around the spinal cord. Thus, the combination of the thiamine deficiency and the absorption of toxins that build up within an alcoholic’s cells and nerves contribute to alcoholic neuropathy. It is estimated that 25-66% of chronic alcoholics suffer from the development of alcohol neuropathy.

Symptoms of Alcoholic Neuropathy

• Weakness or atrophy in muscles
• Numbness in lower extremities and feet
• Loss of sensation
• Tingling and burning
• Organ dysfunction

Other Conditions

Other less known conditions linked to alcohol abuse are:

• Eight different types of cancer
• Diabetes
• Alcohol psychoses
• Respiratory diseases
• Hypertension
• Cardiomyopathy
• Cerebrovascular disease

The discussions above do not include health conditions that are the direct result of alcohol intoxication, like traffic accidents, accidental death, fetal alcohol syndrome, violence against others, or suicide. 
The effects of alcohol are insidious and thorough. Society continually paints a picture of the benign and playful effects of alcohol. Nothing could be further from the truth, as millions of lives are decimated by alcohol yearly. There is nothing benign about violence, sexual assault, child abuse, or suicide as a result of alcohol abuse.

Drugs and there HIGHS...in a funny way

This is the easy way of explaining what really happens  when  you  get high .....
   Do see the lighter side of it ........ but  Drugs are no joke and  will post ... details of each  in coming  blogs...Tc ..do have a Laugh...

Divorce – The New Marriage Mantra?

“They are going through a divorce”, she said nonchalantly. Her friend mouthed an “Oh!”, equally nonchalantly. One would not ask, the other would not say! 

I was surprised to be witness to this passive exchange - no tch tching, no sympathy, not even gossip.

Had we learnt to mask our reactions or had we simply learnt to take in the 7 letter word – DIVORCE, as easily as some 4 letter words thrown around these days?!

So what’s the big deal really, you might ask. Divorce has become as common a word as ‘marriage’. 

Earlier in India, divorce was taboo (well almost), but not so anymore.  Divorce rates are rising steadily in India with a speed that would put some other nations with higher divorce rates to shame. The divorce rate in the IT industry, they say is climbing. But why single out the IT industry? Divorce rates are increasing everywhere – caste, creed, religion, culture, community, age no bar. 

So what’s going wrong in marriages these days?

Blame it on poor relationship management and certain other external factors like work, stress, environment, family and expectations that lead to a divorce. Although each divorce case and its reasons are different there are a few common causes that lead to it:

1)      Changing work environment: Rising ambitions and increasing work pressures exert an inhuman demand on both partners, whether both are working or not. This results in none being able to give each other enough time for the relationship to work, leave alone prosper. The additional demands of children and family make things worse; if both partners are working, the situation is like a sitting bomb ready to explode at short notice.

2)      Gender roles are blurred: When both partners are on an equal footing in their careers, it becomes difficult to establish clear roles for each one at home. The blurred roles add to intolerance, frustrations and may lead to separation.

3)      Incompatibility: Sometimes the marriage is wrong in the first place with at least one partner being against the marriage or forced into it. In such cases, sooner or later the gaps start raising their ugly heads.

4)      Other reasons such as in-law trouble, domestic abuse, alcoholism, etc.: These reasons always existed; only now it is easier for the abused to end the marriage. Society also looks at such instances more benevolently than it used to, earlier.

5)      Extra marital relationships: With both men and women spending more time working outside and succumbing to attractions outside the marriage. These ultimately may result in divorce. 

Is it possible to prevent a divorce? Save a marriage?

Divorce can be prevented in some cases, but not all and not always. Where the relationship is sliding, steps can be taken to arrest the downslide. It is possible through counseling to pinpoint the underlying causes and take concrete steps to eliminate those causes over time, then working on the relationship to revive it. Relationship management has helped hundreds of couples who have been fighting for a divorce on relatively flimsy reasons. Through emotions management and relationship management, many divorces have been avoided with the couple enjoying a fulfilling relationship for years. 

So what exactly is this relationship management?

I am not talking of an MBA degree here, I am talking about some simple principles we all need to follow in all relationships – romantic or not.  

Key Principles that can make a good relationship better or save a deteriorating one      

1. Forget selfishness. Be ready to give more. 

Both partners should be willing to give more. Not resorting to calculating who has done what, or who should do how much; both should give love, time and effort to the relationship. 

2. Do not expect anyone to be perfect. Avoid playing the blame game.

Accept that like your partner, you have your problem areas which he/she cannot take, and be willing to change. If things go wrong, do not blame your partner, see how you could together improve the situation. .

3. Say ‘Sorry’

Everyone makes mistakes, but in a good relationship, both willingly accept theirs. Saying sorry can do a world of good to your relationship. Keep your ego aside, say sorry and move on. 

4. Listen more. Talk less.

First make sure you know that your relationship is not a win-lose game. If anything, it is a win-win game. If you listen more, you will understand your partner better, his/her fears, concerns, insecurities and goodness. That way you will be able to give more. When your partner does the same, you have a Win-Win relationship on your hands

5. Trust and support one other.

If you follow the principle of ‘Trust by default’ and ‘Support without a cause’, you will have a long lasting and happy relationship. Support your partner in all times and see how things improve

6. Talk and Communicate. Be open.

Misunderstandings can ruin a relationship within no time. Instead of sulking, talk it out with one another; you will be surprised how easy it is to resolve the issue. Never be critical of one another, but do make it a point to suggest an improvement. A healthy dialogue is the foundation of a healthy relationship.

7. Respect one another

Respect all human beings and more so your partner. Respect can change your perspective about your relationship and help you realize its value in time. 

There is no perfect relationship. Only, perfectly good relationships. 

When anxiety is killing you from inside…

“It was dark and I was watching the murder in horror. I was cold and sweaty, both at the same time but seemed to be frozen and welded to my seat. The darkness was killing and though I was sipping my coke I could not ignore my heart beating wildly against my chest. I was drenched n a cold sweat and was shaking. It was so dark everywhere. I wanted to run”. 

It happened to her every time they went to watch a movie or a play; the darkness, the sea of faces and the enclosed spaces seemed to scare the daylight out of her; so much so that she stopped thinking rationally. When her husband asked her “What are you scared of?”, she could not think of an answer. But scared she was, to the point of passing out in sheer terror. She had GAD (General Anxiety Disorder).

So what is GAD?

There are different types of anxiety disorders people suffer from. In GAD, people typically complain about a heart- attack-like feeling or report an attack.

We end up taking anxiety lightly, at least the rest of the family or friends do and the sufferer ends up suffering in silence not able to voice her thoughts, just like the lady above. Most people do not understand what anxiety is, they do not accept that is a form of a mental illness and that the sufferer needs help.

Today, I am going to try to dispel the clouds of misunderstanding that ‘Anxiety’ is shrouded in. I am going to try to answer some questions that people ask me about ‘Anxiety’. Here you go:

FAQs

Q # 1: What is anxiety? I feel anxious even before a presentation. Is something wrong with me? 

Anxiety before presentation or a performance is perfectly normal. Anxiety becomes a disorder when it starts occurring regularly.

Anxiety has three characteristics:

a)      It has to be intrinsic (within you)

b)      It is vague – does not have a shape – you really cannot pinpoint its reason

c)      It is conflict producing – it puts you in a dilemma

Anxiety is not fear and there is a difference between the two. Fear is external, has a definite shape (you know what is it that is making you fearful) and fear never produces conflict. Example: There is a snake under your chair and you are terrified of it – that is fear.

But anxiety is – you are scared ‘something untoward’ is going to happen and you don’t know what that ‘something’ is, why it could happen or when it could happen. 

You become a patient of anxiety when it starts becoming a frequent phenomenon.

Q # 2: How do I know that I /my near and dear one may be suffering from anxiety? What are its signs?

Questions to ask yourself :

1)      Are you constantly worried?

2)      Are you gripped by fears that you know are irrational, but can’t shake off?

3)      Do you believe that something bad will happen, always?

4)      Do you avoid everyday situations or activities because they cause you anxiety?

5)      Do you experience sudden, unexpected attacks of heart-pounding panic?

6)      Do you feel that there is danger lurking around every corner?

7)      Is your normal life disrupted due to excessive worrying? 

Q # 3 Is anxiety of one type, people worry about so many different things…?

There are different types of anxiety disorders people suffer from, as is given below. In all these, people typically complain about a heart- attack-like feeling or report an attack.

1)   Generalized Anxiety Disorder:  Symptoms will be among those mentioned above.

2)   Panic Disorder: The person has a heart-attack-like feeling, palpitation (heart beating wildly), profuse sweating and a feeling of ‘I am going to die’.

3)    Obsessive Compulsive Disorder (OCD): Obsession about something to the extent that the person feels that it will be the end of the world if he/she does not perform a particular task. Example: A person may have an obsession about cleanliness so much that he/she may even try to keep toilets outside his home clean, unknowingly).

4)    Post-Traumatic Stress Disorder: This anxiety is the result of some trauma the person has or is suffering from like bereavement, death of a near one, shock due to accident, close shave with fate, etc.

5)     Specific Phobias: A phobia is an intense, irrational fear about a particular thing such as Hydrophobia (Fear of water/ocean/swimming), fear of closed spaces like Claustrophobia (a person may be terrified about getting stuck in a lift) or Vertigo - fear of heights.

Q # 4 How does anxiety affect my body?

1)      Anxiety may cause disturbances in your Blood Pressure

2)      May affect normal functioning of your thyroid and cholesterol

3)      Anxiety has a direct correlation with many illnesses – diabetes, BP

4)      Anxiety before a pre-surgery blood test or MRI is even known to affect the prognosis (readings).

Q # 5 Can Anxiety be cured? How?

There are various ways to address ‘Anxiety’. Anxiety disorders respond very well to treatment and more often than not in a relatively short period of time. So stop worrying! The specific treatment approach depends on the type and severity of the anxiety and the individual.  Most anxieties are treated with behavioral therapy, medication, or some combination of the two.

Behavioral therapy for anxiety disorders: Cognitive-behavioral therapy and exposure therapy are types of behavioral therapy, meaning they focus on behavior rather than on underlying psychological conflicts or issues from the past. Behavioral therapy for anxiety usually takes between 5 and 20 weekly sessions.

Medication for anxiety disorders: This is most effective when combined with behavioral therapy and anxiety self-help methods. 

 

Q # 6 Do I have to take medicines for life? Will I get addicted to these medicines?

The duration for which you may need to take medicines depends on the type of illness. In an acute illness, it is good for you to begin with medicines and later switch to therapy. 

Q # 7 Will medicines make me drowsy or stop me from work?

These days medication has no sedation, which means you will have no difficulty in concentrating on tasks and day-to-day functioning will be normal.

So just relax. Anxiety can be cured.