Self care

Is Meditation really all that?

Is Meditation all that? Well, I’m glad you asked. Meditation is the practice of using various techniques to train the mind to focus and be clear. The modern world is becoming more and more plugged-in, frenetic and multi-tasking. Meditation may well need to be the next step in our evolution. Eastern religions and philosophies have always extolled the benefits of meditation. In the West, we have been more sceptical of the benefits of sitting still and doing “nothing”. Over the last few decades, science has been applying tools like functional MRI’s and EEG’s and rigorous research techniques, like longitudinal studies,…

Inflammation: the brain on fire

A patient came in very upset. She was suffering from headaches and joint pains. She had been to various physicians and had several tests done. She was told that her pain was due to her mood disorder. She felt that she wasn’t being taken seriously, that her doctors wrote it off as “all in her head”. The reality is that mental illnesses can make you physically ill, and physical illnesses can trigger a psychiatric illness. The common pathway is inflammation Inflammation is your body’s response to insult and injury. It is normal and necessary. It’s when a part of your…

Taming the PMS beast

Most women are familiar with the emotional and physical symptoms a week before their period which define PMS (Premenstrual Syndrome). PMS is the source of many jokes, has been used as a defence in murder cases and has been discounted as hysterical nonsense. Over 150 symptoms are attributed to PMS and include common ones such as bloating, migraines, cramping and fatigue to weird ones like smelly farts and sore throats. Emotional symptoms can range from anxiety to homicidal rage. With such a broad symptom list and variable presentation even in the same woman from month to month, PMS has been hard to classify and…

Dementia. Darn, it’s on the tip of my tongue

I am taking a break over the holidays. For the next four weeks, I will be republishing a few of my favourite blogs. I’ve noticed an alarming thing lately, although I should not be surprised. My patients are growing older. Teenagers I was helping with their self-destructive behaviours two decades ago are now anxious mothers. Anxious mothers whom I met 20 years ago are now looking at retirement. It shouldn’t be surprising; I am getting older too. So is the rest of the world. Life expectancy has been steadily increasing worldwide over the last two decades. This is largely…

The holiday blues – tinsel and tears

Summer holidays are starting. I have learnt to close my practice doors in the middle of December. Partially because of increased family commitments, but also because everybody is so out of their routines that they miss their appointments or get the times wrong. During the December holidays, routine psychiatric work falls apart and emergency work picks up. We cannot compare holiday blues and stress to clinical depression and anxiety. It’s like comparing a cold to incapacitating flu. The emergency work I handle seems to be triggered by increased alcohol and substance abuse, less sleep than usual and financial stress. There is…

Exam time: the outer rim of hell

It’s the time of the year when I, as a psychiatrist, find myself writing letters motivating for extensions, deferments and more time. Nobody likes exams; it’s hard work and the feeling of being evaluated can be unpleasant. But for some people exam time becomes a psychic hell. A patient came to me having continuous panic attacks. She was incapable of sleeping or studying. She had been procrastinating with exam preparations; once she started, she was overwhelmed by the sheer volume. She started working non-stop, breaking only to refill her coffee or buy some cigarettes. Initially, she made good headway. The problem began when she was…

Why can’t I shake this recurrent depression?

By the time patients come to me for the treatment of their depression, they have often been sick for some time. When we go into the history of the illness, it becomes clear that most have been depressed before.  If you have had two episodes, more than likely, you will have a third one. If you have had three episodes, there’s a 90 percent chance you will have a 4th. It seems that a single episode of depression is more the exception than the rule. The greatest predictor of a relapse of depression is stopping antidepressant treatment. More and more evidence…

Boundaries. The guardians of joy.

Patients often ask me if my work sometimes gets too much. If hearing about the miseries of mankind becomes a tiresome task. Most of the time I can honestly say no, I love my job. A major reason why I can love my job is that of good training. From the moment you enter a psychiatric residency the teaching and learning of boundaries is a priority. So in the room, in your hour, I try to be 100% present with you. But I am very aware that it is your life and your journey. When I am with another…

Let’s talk about the value of ideal weight

Ideal weight is such a sensitive issue. In my practice, almost every woman and many of the men are unhappy with their weight. I often wonder what it would be like if every person in the world woke up one day, happy with how they looked. I think a lot of diet and beauty industries would go bankrupt! What is “ideal weight”? Surprisingly, this concept is not that easy to define. First off, there seems to be a paradox in patients’ awareness. Next, doctors can not seem to agree as to what it is and how best to measure it.…

Why am I so tired?

I am not talking about feeling weary. I am talking about bone crushing fatigue even after a good night’s sleep or a relaxed holiday. The body is a wonderful structure. If something is a bit off kilter, it will tell us, we must just listen. Fatigue is a terrific teacher. We have no choice but to slow down and review.  If we take heed and make corrections, then the body will restore itself. It wants to be well and function optimally. So, if you are feeling tired all the time, it’s worthwhile trying to figure out why. The bulk of the…

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