Adult Disorder

SUBSTANCE ABUSE

Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. As people age, their bodies become less capable of tolerating addictive substances and more susceptible to negative effects. Adults may turn to addictive substances when coping with the stresses of child-rearing, balancing a career with family and managing a household. New risks for addiction and substance abuse may emerge for individuals in middle age who face financial pressures, divorce, the empty nest, personal or family illness, the economic and emotional stresses of caring for ageing parents or the death of a parent or other loved one. These substances not only lead to addition but may also contribute to psychiatric problems like mood disorders, anxiety disorders, sleep disorders and psychosis. Every persons experience with substance use disorder is unique, so our therapist aims to plan treatment that is tailored to individual needs of the client to ensure maxmimum benefit.

Worried that you / your loved one may be suffering from Substance Use Disorder?

1. Have you ever experienced problems in your life from alcohol/drug use?
2. Have you ever used more alcohol or drugs than you intended?
3. Do you get upset when your supply of alcohol or drugs is cut off or used up?
4. Does it take more alcohol or drugs now to get you high than in the past?
5. Do you ever justify or rationalize your use of alcohol/drugs?
6. Do you wish you wouldn’t use alcohol or drugs or felt guilty about it, but do anyway?
7. Have you ever used alcohol/drugs to the point where someone has disapproved of it?
8. Do you get irritated when someone wants to discuss your alcohol/drug use?

Services, we provide that can help you:

• Behaviour Therapy
• Supportive therapy
• Motivational Enhancement Therapy
• Medication
• Counselling

Obsessive-Compulsive Disorder (OCD) a disorder characterized by recurrent intrusive or uncontrollable thoughts, causing stress (obsessions) that prompt the performance of rituals in a repetitive manner (compulsions). A person with OCD can have either obsessive thoughts and urges or compulsive, repetitive behaviours, or even both. Typical obsessions involve themes of contamination, dirt, or illness (fearing that one will contract or transmit a disease) and doubts about the performance of certain actions (e.g., a preoccupation that one has neglected to turn off a home appliance). Common compulsive behaviours include repetitive cleaning or washing, checking, ordering, repeating, and hoarding. Compulsions tend to relieve the anxiety, but only for a little while.

While such individuals realise that their seemingly uncontrollable behaviour is irrational, they are unable to stop. Their daily life is affected as simple tasks or chores take the form of insurmountable problems. Relationships with family and friends can often become strained or problematic.

Worried that you / your loved one might have OCD?

1. Do you ever experience repetitive thoughts that cause you anxiety?
2. Do you ever fear germs or engage in excessive cleaning?
3. Are you constantly worried that something bad will happen because you forgot something important, like locking the door or turning off appliances?
4. Are there things you feel you must do excessively or thoughts you must think repeatedly to feel comfortable or ease anxiety?
5. Do you experience the need to constantly check on something or arrange things?
6. Do you wash yourself or things around you excessively?
7. Do you keep many useless things because you feel that you can’t throw them away?
8. Do you struggle to control these thoughts or behaviours?
9. Do you spend at least one hour a day thinking obsessive thoughts or performing these ritual behaviours?

Services, we provide that can help you:

• Behaviour Therapy
• Relaxation Training
• Supportive Therapy
• Medication
• Cognitive Behaviour Therapy

RELATIONSHIP ISSUES

All relationships and families go through difficult times and experiencing occasional problems and conflict in personal relationships is normal. However, sometimes these problems can become overwhelming. and the failure of a relationship is often a source of great psychological anguish. While there are many different types of problems that can plague a relationship, there are some common issues that many modern couples deal with at one point or another in their relationship, especially if they have been together for a long time like infidelity, jealousy, sexual problems, communication gaps & inability to strike a balance between personal & professional life. Treatment helps the client understand, idntify & analyse the problems in the relationships & find solutions for a happier life.

Worried that your relationships might be at stake?

1. Have you lost the spark in your relationship like before?
2. In recent past have you been spending less time with each other ?
3. Does all your differences in opinion result in fights and arguments?
4. Have you stopped sharing the same bed with each other?
5. Do you both talk only when it is required?
6. You don’t seem to remember when was the last time you got intimate with each other?

Services, we provide that can help you:

• Couple Counselling
• Sex therapy
• Family therapy
• Psychometric Assessment
• Cognitive Behaviour Therapy
• Interpersonal Therapy

CLUSTER A PERSONALITY DISORDER

People with Cluster A disorders often seem odd or eccentric, with unusual behaviour ranging
from distrust and suspiciousness to social detachment.

• Paranoid. These people are suspicious and quick to take offense. They often have few confidants and may read hidden meaning into innocent remarks.
• Schizoid. These patients care little for social relationships, have a restricted emotional range, and seem indifferent to criticism or praise. Tending to be solitary, they avoid close (including sexual) relationships.
• Schizotypal. Interpersonal relationships are so difficult for these people that they appear peculiar or strange to others. They lack close friends and are uncomfortable in social situations. They may show suspiciousness, unusual perceptions or thinking, eccentric speech, and inappropriate emotion.

Worried if you / your loved one have/has a Personality Disorder?

1. Does the way you think, feel and behave cause you or others significant problems in daily life?
2. Does the way you think, feel and behave causes significant problems across more than one aspect of your life?
3. Have you been experiencing these problems for a long time?

If you have said yes to most of the above, we might be able to help you.

Services we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Medication (if required)
• Cognitive Behaviour Therapy
• Behaviour Therapy
• Acceptance and Commitment Therapy
• Dialectical Behaviour Therapy
• Family Therapy
• Interpersonal Therapy

CLUSTER B PERSONALITY DISORDER

People with Cluster B disorders share a tendency to be dramatic, emotional, erratic and attention-seeking. Their moods are labile and often shallow. They often have intense interpersonal conflicts.

• Antisocial. The irresponsible, often criminal behaviour of these people begins in childhood or early adolescence with truancy, running away, cruelty, fighting, destructiveness, lying, and theft. In addition to criminal behaviour, as adults they may default on debts or otherwise behave irresponsibly; act recklessly or impulsively; and show no remorse for their behaviour.
• Borderline. These impulsive people engage in behaviour harmful to themselves (sexual adventures, unwise spending, excessive use of substances or food). Affectively unstable, they often show intense, inappropriate anger. They feel empty or bored, and they frantically try to avoid abandonment. They are uncertain about who they are, and they lack the ability to maintain stable interpersonal relationships.
• Histrionic. Overly emotional, vague, and desperate for attention, these people need constant reassurance about their attractiveness. They may be self-centred and sexually seductive.
• Narcissistic. These people are self-important and often preoccupied with envy, fantasies of success, or ruminations about the uniqueness of their own problems. Their sense of entitlement and lack of compassion may cause them to take advantage of others. They vigorously reject criticism and need constant attention and admiration.

Worried if you / your loved one have/has a Personality Disorder?

1. Does the way you think, feel and behave cause you or others significant problems in daily life?
2. Does the way you think, feel and behave causes significant problems across more than one aspect of your life?
3. Have you been experiencing these problems for a long time?

If you have said yes to most of the above, we might be able to help you.

Services we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Medication (if required)
• Cognitive Behaviour Therapy
• Behaviour Therapy
• Acceptance and Commitment Therapy
• Dialectical Behaviour Therapy
• Family Therapy
• Interpersonal Therapy

CLUSTER C PERSONALITY DISORDER

People with Cluster C disorders often show anxiety and fearfulness along with a tendency to over control.

• Avoidant. These timid people are so easily wounded by criticism that they hesitate to become involved with others. They may fear the embarrassment of showing emotion or of saying things that seem foolish. They may have no close friends, and they exaggerate the risks of undertaking pursuits outside their usual routines.
• Dependent. These people so much need the approval of others that they have trouble making independent decisions or starting projects; they may even agree with others whom they know to be wrong. They fear abandonment, feel helpless when they are alone, and are miserable when relationships end. They are easily hurt by criticism and will even volunteer for unpleasant tasks to gain the favour of others.
• Obsessive–Compulsive. Perfectionism and rigidity characterize these people. They are often workaholics, and they tend to be indecisive, excessively scrupulous, and preoccupied with detail. They insist that others do things their way. They have trouble expressing affection, tend to lack generosity, and may even resist throwing away worthless objects they no longer need.

Worried if you / your loved one have/has a Personality Disorder?

1. Does the way you think, feel and behave cause you or others significant problems in daily life?
2. Does the way you think, feel and behave causes significant problems across more than one aspect of your life?
3. Have you been experiencing these problems for a long time?

If you have said yes to most of the above, we might be able to help you.

Services we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Medication (if required)
• Cognitive Behaviour Therapy
• Behaviour Therapy
• Acceptance and Commitment Therapy
• Dialectical Behaviour Therapy
• Family Therapy
• Interpersonal Therapy

MOOD DISORDERS

Bipolar Disorder- Experience both the lows of depression and the highs of mania. Many describe their life as an emotional roller coaster, as they shift back and forth between extreme moods. The two key moods involved are mania, often characterized by intense and unrealistic feelings of excitement and euphoria, and depression, which usually involves feelings of extraordinary sadness and dejection.

People with Bipolar Disorders experience manic episodes at certain time points and depressive episodes at other time points. A person who experiences a manic episode has a markedly elevated, euphoric and expansive mood, often interrupted by occasional outbursts of intense irritability or even violence – particularly when others refuse to go along with the manic person’s scheme and wishes. Manic and depressive mood states are often conceived to be at opposite ends of a mood continuum, with normal mood in the middle. However, sometimes the person may have symptoms of mania and depression during the same time period.

Am I / my loved one suffering from Bipolar disorder?

1. Have you experienced a continually abnormal, inflated, unrestrained, or irritable mood as well as continually heightened energy or activity, for most of every day, for 7 days or more?
2. Do you experience a reduced need for sleep?
3. Do you feel an increased desire to continue talking?
4. Do you experience a rapid shift in ideas or the sense that your thoughts are moving very fast?
5. Do you feel highly distracted and/or extremely restless?
6. Have you engaged in risky and potentially problematic activities, like casual sexual encounters, overspending, gambling, multiple times over the past few weeks?
7. Do these symptoms cause significant distress or impairment in day – to – day functioning?

If you have said yes to most of the above, we might be able to help you.

Services, we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Pharmacotherapy (medication), if required
• Cognitive Behaviour Therapy
• Interpersonal Therapy
• Family Therapy

DEPRESSIVE DISORDERS-Whenever we feel particularly unhappy, we are likely to describe ourselves as “depressed.” In all likelihood, we are merely responding to sad events, fatigue, or unhappy thoughts. However, normal dejection is seldom severe enough to influence daily functioning significantly or persist very long. Depressive disorders, on the other hand, have no redeeming characteristics. They bring severe and long-lasting psychological pain that may intensify as time goes by. Those who suffer from such disorders may lose their will to carry out the
simplest of life’s activities; some even lose their will to live. These cause significant impairment in their day – to – day functioning at work, home and/or interpersonal relationships.

Am I / my loved one suffering from a Depressive disorder?

1. Do you experience little interest or pleasure in doing things that you liked doing earlier?
2. Are you feeling down, depressed, or hopeless?
3. Are you having trouble falling or staying asleep, or are sleeping too much?
4. Are you feeling tired or as having little energy?
5. Are you experiencing reduced appetite, overeating, or considerable weight changes?
6. Do you tend to feel bad about yourself – that you are a failure or experience feelings of guilt?
7. Are you having difficulty concentrating on things or making decisions?
8. Have you had thoughts like you would be better off dead, or of hurting yourself in some way?

If you have said yes to most of the above, we might be able to help you.

Services, we provide that can help you:

• Psychoeducation
• Psychometric Assessment
• Medication (if required)
• Crisis Intervention
• Cognitive Behaviour Therapy
• Rational Emotive Behaviour Therapy
• Family Therapy
• Interpersonal Therapy

ANXIETY RELATED DISORDERS

Post-traumatic stress disorder (PTSD) is a debilitating condition that follows an event that the person finds terrifying, either physically or emotionally, causing the person who experienced the event to have persistent, frightening thoughts and memories, or flashbacks, of the ordeal. Sometimes after effects from the traumatic events can be delayed for 6 months or longer, but when PTSD occurs soon after an event, the condition generally improves after 3 months. Some people with PTSD have long-term effects and often feel chronically, emotionally numb. PTSD in children usually becomes a chronic disorder.

Worried that you or your loved one might be suffering from post traumatic stress disorder?

1. Do you or your loved one have sleep disturbances?
2. Are you or your loved one feel jittery or “on guard”, losing touch with reality?
3. Do you or your loved one have a loss of interest in things they used to enjoy; appears detached, has general lack of responsiveness, feeling numb?
4. Do you or your loved one have trouble feeling affectionate and avoids certain places or situations that bring back memories?
5. Are you or your loved one often irritable, more aggressive than before, or even violent?
6. Do you or your loved one have flashbacks or intrusive images (flashbacks can come in the form of images, sounds, smells, or feelings; a person usually believes that the traumatic event is happening all over again)?
7. Do you or your loved one often worry about dying at an early age?
8. Do you or your loved one have regressive behaviours; acting younger than their age (such as thumb-sucking or bedwetting)?

Services we can help you with:

• Psychoeducation
• Stress Management
• Relaxation Training
• Crisis Intervention
• Cognitive behaviour therapy
• Eye Movement Desensitization and Reprocessing Therapy (EMDR)

GENERALISED ANXIETY DISORDERS-It’s a common thing to feel tensed and fearful in situations that we find threatening. But you might be suffering from a serious anxiety problem if your anxiety has been too difficult to handle and you could not do what you wanted to do because the tension took over you.
A state of tension which is also accompanied by bodily changes such as sweating, palpitations, trembling, breathing difficulty or dizziness can be taken as a cause for concern. During such a state, one might also find it difficult to concentrate on the task at hand which leads to inefficiency and mistakes.

Take an Assessment

Are you experiencing a marked increase in the amount you are worrying?In the past few months, have I have been:

1. Getting agitated easily
   2. Feeling fidgety and restless
   3. Reacting excessively to situations
   4. Experiencing a marked increase in the amount I am worrying
   5. Finding it difficult to control the thoughts that are making me anxious
   6. Have recurring and excessive thoughts about a certain activity
   7. Having difficulty focusing on my work
   8. Feeling fearful towards a specific object or environment
   9. Getting nervous in social environments
   10. Have experienced a traumatic event and continued to think and dream about it
   11. Feeling fatigued easily
   12. Feeling symptoms like shortness of breath, tingling, trembling numbness, light-headedness, palpitations, etc. while stationary
   13. Experiencing issues falling asleep and/or staying asleep
   14. Eating lesser than usual
   15. Unable to or had problems when trying to relax at the end of the day

If you have scored between 0 and 5, you anxiety seems to be under control. If you have scored between 5 and 10, your anxiety is approximately average. If you have scored between10 and 15, you are highly inclined to being anxious. Learning techniques that lower your anxiety and help you cope with situations better are recommended.

PANIC-How many times have we told ourselves, ‘don’t panic’? Maybe several times. But, in reality, panic is a serious condition where one faces extremely high level of tension for no specific reason that occurs suddenly, peaks briefly and then subsides.
Have you facedsome or most of the following symptoms which took place suddenly during a brief time period and passed?

Did you experience the following…

1. Palpitations
2. Sweating
3. Trembling
4. Shortness of breath
5. Feelings of choking
6. Chest pain
7. Nausea
8. Feeling dizzy
9. Fear of losing control or “going crazy.”
10. Fear of dying

Since the state of panic is temporary and subsides after sometime, it might seem like it can be ignored when it is not happening. But in some cases, it hampers normal, daily living and makes you unable to function in important situations.

PHOBIA-Are you terrified of something that does not seem scary to others? Do you try to avoid something just so that your fears don’t bother you? Commonly, phobias can include irrational fear of animals, insects, heights, public speaking and being in closes spaces such as elevators.

There may be otherwise good adjustment to general life situations but one may experience physical symptoms such as sweating, nausea, trembling, palpitations, or dizziness when one has to face the situation that causes apparently paralysing fear.

Phobias are treatable and one can get relief from this problem.

EATING DISORDERS

Bulimia Nervosa is also a type of eating disorder, in which, a person tends to have an inconsistent pattern of eating. Sometimes the person over eats so much that it exceeds his/her normal amount (binge-eating) and at other times, the person tries to compensate his over-eating to prevent weight gain by engaging in behaviours such as self-induced vomiting, excessive exercise, fasting or using laxative and diuretics.

The nutritional deficiency caused by eating disorders can have a negative impact on vital organs or have life threatening consequences.

ANOREXIA NERVOSA-If you find yourself having a strong fear of becoming fat even though you are underweight or have a normal weight, this might signal a problem. Anorexia Nervosa isa type of eating disorder that involves disturbed eating patterns and negative thinking related to food. This problem is more common in females than males. It often begins in adolescence and occurs in adulthood. In Anorexia Nervosa, a person might be so preoccupied with being slim that she/he might starve herself/himself to achieve weight loss. This could have severe consequences and, in women, lead to disturbance in menstrual cycle. The person might have a low body weightbut be unable to see the seriousness of the problem.

SCHIZOPHRENIA SPECTRUM DISORDERS

Delusional disorder is characterized by firmly held false beliefs (delusions) that persist for at least 1 month, without other symptoms of psychosis. A delusion is a firm false belief that continues to exist despite evidence to the contrary. The belief can be regarding any usual aspect of the person’s life but is not believed by anyone else except him since it is not true. Examples may include, infidelity of spouse, that one is being harmed or one is being loved by someone. A person with a delusion will be convinced that his/her belief is true and misinterpret new information to confirm the delusion. However, other than the delusion, the person may be able to function adequately in other aspects of life. Thus, a delusion may exist for a long time before it causes a crisis or conflict.

Delusional disorder is distinguished from schizophrenia by the presence of delusions without any other symptoms of psychosis (eg, hallucinations, disorganized speech or behavior, negative symptoms). Delusional disorder may arise from a preexisting paranoid personality disorder. In such people, a pervasive distrust and suspiciousness of others and their motives begin in early adulthood and extend throughout life.

Early symptoms may include the feeling of being exploited, preoccupation with the loyalty or trustworthiness of friends, a tendency to read threatening meanings into benign remarks or events, persistent bearing of grudges, and a readiness to respond to perceived slights.

Worried that you / your loved one may be suffering from Delusional Disorder?

Since the past 1 month or more,

1. Do you tend to get angry or frustrated very easily?
2. Do you feel that your thoughts tend to get fixed in your mind and you can’t get your mind off them?
3. Do you feel that your thoughts have a definite impact on others as though you can control things or ‘do things’ with your thoughts?
4. Do you feel that your thoughts, feelings and actions are being controlled by someone else?
5. Do you believe that other people can read your mind, or you can read others’ minds?
6. Do you find it difficult to relate to other people and trust them?

If you have said yes to most of the above, we might be able to help you.

Services we can help you with:

• Medication
• Counselling
• Psychometric Assessment
• Cognitive Behaviour Therapy
• Rational Emotive Behaviour Therapy
• Family Therapy

Schizophrenia-is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Commonly, people suffering from this problem, have several other symptoms that are considered to be odd and out of touch with the real world. Thus they might be unable to carry on with their daily life, work, and relationships smoothly. They might even neglect their hygiene and withdraw themselves from the others. Symptoms of schizophrenia usually start between ages 16 and 30. The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.

Positive symptoms: “Positive” symptoms are psychotic behaviors not generally seen in healthy people. People with positive symptoms may “lose touch” with some aspects of reality. Symptoms include:

• Hallucinations
• Delusions
• Thought disorders (unusual or dysfunctional ways of thinking)
• Movement disorders (agitated body movements)

Negative symptoms: “Negative” symptoms are associated with disruptions to normal emotions and behaviors. Symptoms include:

• “Flat affect” (reduced expression of emotions via facial expression or voice tone)
• Reduced feelings of pleasure in everyday life
• Difficulty beginning and sustaining activities
• Reduced speaking

Cognitive symptoms: For some patients, the cognitive symptoms of schizophrenia are subtle, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. Symptoms include:

• Poor “executive functioning” (the ability to understand information and use it to make decisions)
• Trouble focusing or paying attention
• Problems with “working memory” (the ability to use information immediately after learning it)

Worried that you / your loved one may be suffering from Schizophrenia?

Since the past 1 month or more,

1. Do you feel that your thoughts often become jumbled, jump around or become blocked?
2. Do you feel that your thoughts tend to get fixed in your mind and you can’t get your mind off them?
3. Do you feel that your thoughts have a definite impact on others as though you can control things or ‘do things’ with your thoughts?
4. Do you feel that your thoughts, feelings and actions are being controlled by someone else?
5. Do you hear voices / see / smell / feel / taste things that other people don’t?
6. Do you believe that other people can read your mind, or you can read others’ minds?
7. Do you find it difficult to relate to other people and trust them?
8. Do you find it difficult to make decisions and get yourself moving to do anything?
9. Do you have difficulties controlling impulses (like shouting in public or suddenly becoming angry) or difficulties engaging in regular daily activities (like bathing or dressing)?
10. Do you experience severe difficulty in expressing your emotions?

If you have said yes to most of the above, we might be able to help you.

Services we can help you with:

• Medication
• Counselling
• Psychometric Assessment
• Cognitive Behaviour Therapy
• Rational Emotive Behaviour Therapy
• Family Therapy