Tuesday, 17 October 2017

When you DON'T choose to Sleep Alone: Insomnia

Are you one of those people who either have trouble falling asleep at night OR wake up throughout the night; often struggling to fall back to sleep? Most probably this will sound common to a lot of you, with the ‘busy’ lives that we are leading in today’s times. 

For some people, it could just be a matter of a few disturbances that occur throughout the week, resulting in acute insomnia; and this can last for just a month. Our lifestyles have become extremely hectic and our work patterns become far more demanding.

However, most people fall under the other category, which is chronic insomnia- that happens for over 1 month. Insomnia is not just about finding it difficult to fall asleep; it actually has a lot to do with the ‘quality’ and ‘quantity’ of our sleep. It is an inability for individuals to get restorative sleep, eventually causing daytime sleepiness, drowsiness and fatigue.

Of course this is accompanied by feelings of irritability, anxiety and even depression. The end result being that our personal and even our professional lives get adversely affected. It can even make day-to-day tasks difficult to execute such as driving, etc.


Although insomnia can occur without any underlying cause, most often it can aggravate other health problems such as psychiatric conditions, pulmonary disease and many other conditions that may cause physical pain.

 Some of the underlying conditions that cause insomnia are: diabetes, cancer, Parkinson’s disease, Alzheimer’s Disease, gastro esophageal reflux disease (GERD), hyperthyroidism, an overactive thyroid, heart failure, chronic pain, sleep apnea, restless leg syndrome, use of or withdrawal from alcohol and other sedatives such as anti-anxiety and sleep drugs like benzodiazepines, mental disorders such as bipolar disorder, clinical depression, generalised anxiety disorder, post-traumatic stress disorder (PTSD), schizophrenia, obsessive compulsive disorder, ADHD and dementia.

Medications: Now, this is the tricky part, because many people already suffer from some or the other health problem and the medicine they take for that health problem may create a side effect of insomnia. Medications such as epilepsy medications, antidepressants, hormone replacement therapy, medication for high blood pressure (hypertension), such as beta-blockers, non steroidal anti-inflammatory drugs (NSAIDS), certain medications that are used for treating asthma such as salmeterol, salbutamol and theophylline.

Psychiatric problems such as mood disorders, depression, bipolar disorder, anxiety disorders anti-anxiety sedatives, panic attacks, or even post-traumatic stress disorders; all cause insomnia. Even psychotic disorders such as schizophrenia can cause insomnia.   

Insomnia is also a side effect to many stimulants such as caffeine and alcohol, which can disrupt the sleep cycle. Sleep therapist and a hypnotist, Tanusha Banerjee says, "Remember how you survived on cups of coffees during the nights when you crammed for your exam? Caffeine is a stimulant, and it can make us alert by temporarily blocking certain sleep-inducing chemicals in the brain. It also increases adrenaline production. So, avoid having anything caffeine in the night time." That is also to mention tea, cola and other caffeinated drinks which can keep you up in the night and prevent you from sleeping. 

It could even run in the family. According to a 2008 study teens with parents who had insomnia have an increased risk of using prescribed sleeping pills and having mental problems.

It could also be a result of the daily stresses that are experienced at work or even relationships, or even environmental factors (such as having to work at night shifts, having a new born baby, etc.). There are also biological factors that play a role in causing insomnia as well too; these include heightened levels of cortisol, reduced levels of estrogen and progesterone (typically common during menopause). Its easy to try to ‘self-medicate’ one-self’ by consuming alcohol and taking benzodiazepines.         

So, what about the diagnosis of insomnia? As per medical information, it has been found that insomnia lasts for periods of time because of Symptoms or a history of depression, anxiety, or psychosis, Any new or ongoing health problem, painful injuries or health conditions, such as arthritis, coping with highly stressful life events, such as divorce or death and taking any medicines taken- either over-the-counter or prescription


Good Sleep Hygiene:

It’s very important to have good sleep hygiene; i.e. sleeping and waking up at the same time everyday, including weekends.

It also includes getting exercise on a daily basis, reducing alcohol intake, avoiding daytime naps (ONE OF THE MAIN REASONS FOR INSOMNIA), avoiding caffeine and smoking (and in general) in the evening and NOT going to sleep on an empty stomach (i.e. hungry). To ensure good sleep, it's important that you tire your body out," says sleep specialist Mohammad Hasin, "Exercising four hours before your sleep time is advisable.

Another method of treatment is Stimulus Control: This is a term used to describe situations in which a behavior is triggered by the presence or absence of some stimulus. Therefore we associate the bed only with sleeping and for no other activity. It should not be used as a place for watching TV or even reading or sending a text or talking on the phone. 

Sometimes it is necessaary to make use of eye covers and plug ears in case there is bright lights and noise in the surrounding area. It is VERY, VERY important to NOT FORCE sleep. If you just cant sleep after twenty minutes of time, it is better to leave the bed, do something and come back when ready.

Another technique of treatment is known as behaviour therapy, which includes relaxation techniques and cognitive behviour techniques. This therapy helps a person to manage the problems and life stressors in their lives in a better manner.

However, despite all of these techniques there are medication which can help such as melatonin agonists, non-benzodiazpine sedatives and occassionally benzodiazepines. However, with every medication there is always a side-effect and these too have side effects.         
Tips for a Good Night of Sleep:

1) Create a Routine & Stick to it: Ensure that you wake up at a fixed time (suppose 8 AM) and sleep at a fixed time (10 PM). As far as possible avoid the afternoon snoozes.
Make sure your room is noise-free: Sleep in a room that is dark, with a comfortable temperature and does not have any surrounding noise.
2) Create a relaxing bedtime ritual: Have a relaxing, warm bath 30 minutes before bedtime: This will refresh you and create a mood to sleep. You can also listen to soft music or even use this time to read a book.
Have a glass of warm water/milk – whatever you prefer.
3) Avoid having heavy meals at dinner time.

In addition to all of this, some of the other cognitive and behavioural treatments include:

1) Sleep-restriction therapy: This is a therapy that is used to restrict the amount of time that is actually spent in bed versus   the actual amount of time spent asleep. The sleep time is gradually increased as and when the sleep improves.
2) Relaxation training: This method is also known as relation technique and is a method/process/activity/procedure to help a person basically relax. In order to do this, he/she has to attain a state of increased calmness or reduced levels of anxiety, pain, anger and stress. It helps to reduce the number of intrusive thoughts that may be interfering with the quality of sleep.
3) Bio-feedback: It is a method by which a person learns to control their body’s functions, such as say their heart rate. In this method, the person gets connected to electrical sensors, which help to receive information (feedback) about your body (bio).

Risk Factors: Who Should be on the lookout?

Although, everyone should pay attention to their health the risk of insomnia is higher for certain people. These people include:

A woman: Hormonal shifts that take place during the menstrual cycle and even in menopause. During menopause, hot flashes and night sweats are common and disrupt the sleep. In fact, insomnia is particularly common during pregnancy as well.

You’ve crossed the Age of 60: With changes in health and sleep patterns, so does the chance of getting insomnia increase.

No Fixed Schedule to Follow: A schedule brings about a sense of discipline in our lives. Without one, it could just bring about a lot of chaos and disruptions to our sleep-wake cycle.

A Mental health disorder or physical health condition:  Are you one of those suffering from anxiety or depression or physical health problems such as obesity, gastrointestinal problems, asthma, diabetes or heart disease?

In addition to psychological and physical health problems there is the constant nagging of your number one enemy, that being stress! "Stress doesn't only make us feel awful emotionally," says Jay Winner, MD, author of Take the Stress Out of Your Life and director of the stress management  Program for Sansum Clinic in Santa Barbara, Calif.
"It can also exacerbate just about any health condition you can think of." Its important to remember that stress is not JUST a feeling or JUST IN YOUR HEAD! According to Jay Winner, MD, author of Take the Stress Out of Your Life,  It's a built-in physiologic response to a threat. When you're stressed, your body responds.
Your blood vessels constrict. Your blood pressure and pulse rise. You breathe faster. Your bloodstream is flooded with hormones such as cortisol and adrenaline. "When you're chronically stressed, those physiologic changes, over time, can lead to health problems," 

Its high time you STOP the sleepless nights, take control of your life and daily habits and push INSOMNIA out the back door!


Sunday, 15 October 2017

Hope Versus Depression

Is hope false, but depression considered being normal?

Hope and depression: – two polarising extremes we can say, right?

 To go on further we can even also talk about emotions such as  hope and hopelessness or even despair, which are so drastically  different from one another. 

Why talk about these two opposite emotions: it’s because they have a strong connection to one another; i.e. hope is like an antidote to hopelessness of despair and helps us move forward.

Hope is the emotion that fuels our human spirit forward and encourages us to achieve our goals and overcome our obstacles. It also encourages risk-taking and imagination, which can even lead to a lot of positive changes. However, when we talk about hope it is important to distinguish between REAL hope and FALSE hope and not get confused between the two:

False Hope: In order to understand what false hope really is, think about all the con games such as sweepstakes, gambling, risky investments, get rich quick schemes, quack cures, hoaxes, urban legends, mysticism, faith exploitations, promised miracles and similar other scams.  

Whats the common thread for all of these activities? They all are manipulations which exploit distortions in our own thinking processes and even other vulnerabilities.

Hope is tested only when it meets what it requires. An accurate assessment, constructive criticism, sound judgment and personal responsibility are the real differences between REAL hope and FALSE hope.

To illustrate this, recollect the Keynote Address at the 2004 democratic national convention; which was an inspiring speech that was delivered by Barack Obama on “The Audacity of Hope”. 

In his speech, he sited many examples where there was undaunted strength of people that overcame all of the obstacles in order to achieve great things. 

In addition to this, Obama went on to write a book entitled The Audacity of Hope: Thoughts on Reclaiming The American Dream.

Real Hope: On the other hand, real hope combines a firm grip of reality with a hopeful outlook of the situation at hand. The outlook ranges from a very positive one to a hopeful spirit to even a very negative or hopeless stance. So a person can express emotions ranging from hopeful, high hopes, optimistic, open, positive and even favourable; to skeptical, pessimistic, hopeless and doubtful.

As the person gets more and more involved with the challenge at hand they also learn more about the real problems that they are facing. Their entire grasp of reality actually begins to change where the individual is fully informed about the difficulties they will face. People here are usually tenacious, courageous, inspiring and persistent to achieve results.  
However, at times when hope CAN be FALSE, what about the other emotions that seep into your life like depression? Why even bring up such a negative emotion such as depression? – Well, its because FALSE hope is actually like your holding onto something that may never ever actually happen; i.e. you are HOPING (FALSELY) it is really unlikely and eventually impossible to achieve. Does this make any sense to you?

For instance, if you were to have "false hope", that basically means that you have an unshakeable faith that everything will turn out to work in your favour, no matter how unfavourable the situation is.

 It is similar to wishful thinking. 

The outlook is definitely hopeful, but is it even possible?

 The reality is very unknown, denied, dismissed and distorted. Our thinking is a result of our own judgment, perception, bias and experience.   

In 2017 Claudia Bloese wrote that “…almost all major philosophers acknowledge that hope plays an important role in regard to human motivation, politics and religious beliefs.

Depression is considered to be the exact opposite of hope and according to Greek mythology, (which is taken from the ancient myth of Pandora’s creation in Hesiod’s Works and Days), the box was a jar given to Pandora that contained all of the evils of the world. Pandora opened this box and all the evils flew out, but only hope stayed inside. 

In today’s time and age this phrase, “to open Pandora’s box” means to perform an action that may seem innocent and small but actually turns out to be ac act that has severe detrimental and far-reaching negative consequences.

However, while there is always hope around us depression blinds us to this fact. It is first very important to know the difference between sadness and depression; because they are NOT AT ALL the same. Everyone feels sad at some time or the other; its impossible to always be happy, right?

However, clinical depression is far more severe; it is a lot more than JUST the occasional bouts of sadness. Sadness is not always linked with depression; in fact other emotions such as an empty feeling, or being numb, or even no awareness of feeling anything at all can be associated with depression.

There are different levels of depression, ranging from short in duration and mild to long term and very severe forms of depression, which can even, be life threatening. So what’s it like to suffer from depression?

What are the symptoms?

Some of the major symptoms include feelings of guilt, feelings of helplessness, self-harm, loss or even gain of weight, self-hatred, loss of energy and even motivation, becoming very vulnerable and ‘oversensitive’, getting delusions and/or hallucinations, suicidal thoughts, physical aches and pains, an inability to concentrate and loss of sex drive.

Depression is an extremely debilitating condition to suffer from and the most painful to fight against, because at the end the REMOTE CONTROL to changes in our life remains in our hands. It is no doubt a sense of intense grief and deep sadness        

Saturday, 14 October 2017

Understanding Traumatic Brain Injury (TBI)

Our brain is an incredible and magnificent organ that controls not only the things that people do and think, but also who they are. It was once believed by philosophers that the heart was the seat of our soul but over time we now know that it is actually our brain which is the real organ of thoughts and feelings; our source of reactions to the world and interpretations of it. Now, what happens if one day you lose complete control over your nervous system and your life is torn apart? In short, what would happen to you or anyone that you know if found in such incidents such as a car accident, falls or even firearms?

All of these causes lead to traumatic brain injury (TBI) and it is usually the younger adults and elderly who are at the highest risk for TBI. Also known as intracranial injury a traumatic brain injury (TBI) occurs when an external force injures the brain.

A head injury is a broader term that involves damage to other parts of the scalp and skull. As a result of TBI the person affected will suffer from physical, cognitive, emotional and behavioural problems. This outcome can range from complete recovery to a permanent disability or death. Along with TBI, there are additional injuries such as spinal-cord injuries.

The method (mechanism of injury - MOI) of injury to the muscle, skin, bones and organs include Open head injury, closed head injury, Hypoxia, Tumors, Deceleration Injuries, Stroke and Infections.
Is it mild? OR Is it Severe?
Many people are quite unaware of the scope of how overwhelming dealing with TBI can be. It is first important to distinguish between the type of injury: Only after answering this question should you seek appropriate treatment.

Mild TBI is also known by other names as concussion, minor head trauma, minor TBI, minor brain injury and minor head injury. It is the most prevalent form of TBI and post injury symptoms are often known as post concussive syndrome.

Some of the common symptoms of Mild TBI include: fatigue, headaches, memory loss, visual disturbances, sleep disturbances  depression, seizures, poor concentration/attention and irritability-emotional disturbances.

There may also be other symptoms such as nausea, mood changes, slowness of thinking, sensitivity to lights and sounds, loss of smell and getting lost or confused.

It’s OK to be different and it’s all right to patient with yourself or whoever it is that is suffering from TBI. Here are some tips that may just help you out:
  • Take additional time on activities if you need to. Don't rush through things that may just stress you out.
  •  Manage your Stress by including some form of exercise or relaxation techniques everyday. 
  •  Break down bigger tasks into small, achievable ones that can be managed.
  •   Always make it a habit to repeat back what people tell you so as to ensure that YOU have got the information correct!
  •  Use your cell for keeping reminders for your medicines and to take dictated notes that have regular scheduled playback time. 
  •   Include exercise everyday! It will help you improve your sleep, relieve tension and also improve your attention.
  •   Engage in social activities from time to time. It is very important to stay socially connected.

Effects of TBI

The mild TBI injury is considered mild because the loss of consciousness and/or confusion lasts for approximately 30 minutes. Although the person faces certain cognitive problems such as memory problems, attention deficits, difficulty thinking, headaches, frustration and mood swings; the MRI and CAT scans are usually normal.
The problem is that most often the symptoms may not even be noticed at the time of injury or may even get overlooked. They may appear as subtle and this will lead to a delay in its diagnosis.

·       On the other hand, when the person loses consciousness for over 30 minutes and faces memory loss for over 24 hours it is known is as a severe TBI injury.

The effects of TBI: The effects of TBI can be extremely profound on the individual as well as on the family. There may be cases where certain individuals suffering from severe injuries are left in long-term unresponsive states. An overall change in the functionality of the brain occurs.

It will lead to a a severe impact on an individual's family life, their job and even their community interaction. TBI contributes to many deaths across the world each year and this goes on to lead to the development of secondary mental health problems; which most people ignore. Depression and anxiety, being the top two mental health problems that people silently suffer from across the world due to the neuro-chemical changes in the brain.

Life as a Survivor of a TBI: 

Have you ever-wondered how difficult just living life is for these’ people- these survivors’ of TBI?

Daily life becomes a hindrance and small tasks that are seemingly easy become terribly difficult for them. Of course, the amount of difficulty faced will depend on how badly injured the person is. However, there are certain common complaints that are shared. These include loss of memory (forgetfulness), difficulty-paying attention (ADHD), finding it easy to become lose energy and get overwhelmed, easily frustrated, anxiety and depression.

The Brain Injury Association of America (BIAA), which was founded in 1980 is a brain injury advocacy organisation. It works at representing individuals, families and professionals who are affected by traumatic brain injury (TBI) and BIAA provides information, education and support to assist the millions of Americans currently living with traumatic brain injury and their families. They have used the month of March to raise awareness of brain injury which is celebrated across the world.

Frontal lobe damage leads to an increase in irritability and limited disinhinition and self-control.
A person who suffers from a stroke will face diffivulties with their speech as well as comprehension. They may even face problems with motor functioning in certain areas of the body or hearing and vision; all depending on which part of the brain has been affected.

The brain is known to be a very malleable as well as mysterious organ which recovers in unusual manners. Emotional support cannot be under-estimated  for recovery and this type pf support is helpful both on a psychological level as well as for the patient’s motivation    

It is very important to understand your rehabilitation team, so that you can regain your abilities and independence and lead the best possible life you can.

Get to Know them: Who is Who?

          Physical Therapist: He/she will work with you so that you can improve your flexibility and muscle strength.
·       Occupational Therapist: He/she will assist you with your essential activities such as bathing, grooming, using the bathroom and dressing.
·       Speech-language pathologist: He/she will evaluate your abilities to understand others and express yourself. If necessary, the speech-pathologist will also address “swallowing/sensitive-issues”

       Finally, do not let TBI define you or anyone you know! 

It is a known disability across the world and is a leading cause of death. 

Besides being the number one cause of coma, expectations do need to be kept into account. The recovery from TBI is not an easy one and involves permanent, life-changing adjustments. A lot of grit and perseverance is required.   
 There is power inherent in committing yourself to the process of creating health in all levels of your life – Christiane Northrup M.D.

When you DON'T choose to Sleep Alone: Insomnia

Are you one of those people who either have trouble falling asleep at night OR wake up throughout the night; often struggling to f...