Psychiatrist is a licensed physician with specialisation in the field of psychiatry.

Psychiatrists obtain medical degree (MBBS) upon attending medical college for 5 years followed by a further year of rotating clinical internship in medical specialties. They then receive basic residency training and qualification in psychiatry for 3 years (M.D in Psychiatry).They are qualified in assessment, diagnosis, treatment, and prevention of mental illness and prescribe medicines only if necessary.

Psychologists receive training in clinical psychology/ counselling psychology. After graduation they pursue M.phil and Ph.D. Depending on their training and education, they specialize in different types of therapies for mental health issues.

Any past medical or psychiatric records, psychological assessments.
For tele-consultations please keep your ID with you.

Yes. All psychiatric consultations are confidential. Your records will never be shared with anyone at any time without your consent.

Except:

1. When there is an imminent danger to you or others.
2. Required by law.

It depends on the nature and degree of a depressive episode. Usually for the first episode, one would need to take an antidepressant for up to 5-6 months. If they have remained symptoms free for the duration mentioned above, then an attempt can be made to taper down the dose and stop where appropriate.

In case of multiple episodes, a long-term course of medicines is required.

Technology-based patient consultation e.g., telephone, video, devices connected over LAN, WAN, Internet, mobile or landline phones, Chat Platforms like WhatsApp, Facebook Messenger etc., or Mobile App or internet based digital platforms for telemedicine or data transmission systems like Skype/ email/ fax etc

Many people are (wrongly) apprehensive about meeting a psychiatrist! Perhaps this is due to misinformation and misperceptions about psychiatry, psychiatrist and the stigma of mental health problems.

A psychiatrist is a warm, caring and attentive clinician with a deep interest in human emotions and understanding suffering, which can be an inevitable part of our lives. A Psychiatrist treats all individuals with respect and compassion, irrespective of the nature of their problem. Therefore, you should expect a non-judgmental clinician who will listen deeply and guide you with personalized and tailored solutions.

The first consultation may last for 30 minutes to an hour, and you are likely to be asked about your current problems, their impact on your life and relationship and work, and other relevant personal backgrounds. Typically, consultation and subsequent review or therapy sessions considers the “whole” person rather than just presenting the problem. Sometimes close family members and friends are involved in the assessment, of course with individual’s consent.

Expect extensive education about the presenting problem, diagnosis, treatment and long-term outcome. Specialist outpatient-based one to one therapy or group treatment program and day hospital attendance is advised where appropriate. Most people can expect therapy on an outpatient basis. Where home treatment becomes unsuitable or deemed unsafe, then admission at a wellness facility will be discussed.

Unlike tranquilizers (Diazepam, Alprazolam, Lorazepam), alcohol and nicotine (cigarette and chewing tobacco), antidepressants are not addictive. Therefore, individuals taking antidepressant medication do not develop tolerance (needing to keep increasing the dose to get the same effect) or suffer physical withdrawal state after reducing the dose or stopping intake.

However, it’s worth clarifying that the withdrawal effects reported in 1/3 who abruptly stop taking antidepressants (like paroxetine, sertraline and citalopram and venlafaxine), are not addictive withdrawal state.  These withdrawal effects may include flu like symptoms – aches and pain, stomach upset, anxiety, dizziness, insomnia, vivid dreams, electric shock sensation in the body

In most people these withdrawal effects are mild, but for a small number of people they can be quite severe. Where indicated it is advisable to taper down the dose of an antidepressant slowly rather than stopping it abruptly.  Ideally this is done under professional supervision.

Some people have reported that, after taking an antidepressant for several months, they have had difficulty managing without it, so feel they are addicted to it.  Most doctors would say that it is more likely that the original condition has returned.

The Committee of Safety of Medicines in the UK reviewed the evidence in 2004 and concluded that “There is no clear evidence that the SSRIs and related antidepressants have a significant dependence liability or show development of a dependence syndrome according to internationally accepted criteria.’

Addiction is a complex problem, perhaps a disorder or even a disease that affects the structure and function of the brain and individual’s behaviour. It is characterised by intense and, at times, uncontrollable craving for the drug or activity, along with the compulsive behaviour of seeking and use that persist despite devastating consequences for health, functioning, work and social life including relationship.

Drug and alcohol addiction is treatable, often with medications (for some addictions) combined with behavioural and motivational therapies. Highly structured and empathic approach is required when dealing with individuals presenting with drug or behavioural dependency, as it is likely that they will be plagued with guilt and shame, and be suffering from ambivalence or scepticism about change.

Relapse is common and can happen even after long periods of abstinence, underscoring the need for long-term support and care. It is important to recognise that motivation fluctuates, and to err is human! Remember, relapse is an opportunity to gain awareness and prompt further effort with treatment engagement rather than individual or treatment failure.

There is no simple answer to this. Historically those with addiction were thought to be morally flawed and lacking in willpower. Those views shaped society’s responses to alcoholism and drug abuse, treating it as a moral failing rather than a health problem. This led to an emphasis on punitive rather than preventative and therapeutic actions. Scientific advances and discoveries about the functioning of the brain altered views toward addiction and enabled us to respond effectively to the problem.

Addiction is a complex issue, perhaps a disorder or even a disease that affects the structure and function of the brain and individual’s behaviour. Scientific research has argued that addiction is a brain disease. While the path to addiction begins with the act of taking drugs or indulging in the activity, but over time a person’s ability to choose not to do so, is compromised, and seeking and consuming the drug /activity becomes compulsive. This behaviour results largely from the effects of prolonged exposure (to drug or activity) on brain functioning. Initial pleasure and enjoyment from the said activity may become compulsive with habitual involvement, even required to feel normal, or reduce unpleasant feelings or emotions. 

Addiction affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behaviour.  Simple biological or genetic basis cannot explain the heritability of addiction or addictive behaviour. It is well established that the vulnerability is multi-factorial with an interplay of genetic makeup, age of exposure to drugs (and activity), environmental influences (including stress from work, relationship and social milieu), and psychological status. Associated medical and psychiatric illnesses are common, and there has been an argument whether they are the cause or effect of particular addiction.

It’s a very broad concept but will try and simplify it.  Addiction can be categorised under chemical (or drug addiction) and behavioural addiction. This divide somewhat explains that behavioural element is essential for turning an infrequent habitual behaviour into compulsive/dependent one, and that particular chemical property is required for physiological withdrawal state. In behavioural addiction there can be withdrawal state but with prominent psychological component.

Common forms of drug addiction (especially in India) include alcohol and tobacco (cigarettes and gutka). Addiction to opium, stimulant drugs (like cocaine and amphetamines), glue and gum sniffing is less common but on the rise. Abuse of cannabis (weed, ganja, hash) is commoner than thought. Perhaps there is underestimation of the misuse of prescribed, and illegally available anti-anxiety and hypnotic medication (such as Anxit, Valium, Librium – containing Alprazolam, Diazepam, and Chlordiazepoxide, and sleeping pills – Zolpidem, Zopiclone).

Behavioural addiction is a growing epidemic. So far, diagnostic manuals (DSM-IV and ICD 10) have only recognised sexual disorders under the category of impulse control disorders and disorder of adult personality and behaviour such a pathological gambling and betting. This section includes a behavioural pattern of clinical significance, which tends to be persistent and appear to be the expression of the individual’s particular lifestyle and mode of relating to himself or herself and others.

With increasing recognition of other behavioural disorders, categorised by compulsions or repetitive, compulsive behaviour that are not substance (or drug)-related, subtypes such as Internet addiction is likely to be included in an upcoming version of DSM-V (Diagnostic and Statistical Manual, Version 5). This category includes addiction to chat rooms, online multiplayer gaming and gambling, compulsive surfing and online shopping and cyber sex and cyber pornography and social networking sites. Other types include sexual addiction, and addiction to video games, food, sex, work and television.

Both drug and alcohol addiction can be effectively treated with behavioral therapies. For addiction to some drugs such as heroin, nicotine, or alcohol, medication will be required to reduce suffering and physical withdrawal complication. Treatment will vary for each person depending on the type of drug(s) being used. Multiple courses of treatment may be needed to achieve success. Relapse is common and does not signify individual or treatment failure, but rather should be seen as an opportunity to learn and prompt treatment re-engagement or modification.

Detoxification is the process of allowing the body to rid itself of a drug while managing the withdrawal effects with or without medication. Detoxification from alcohol and tranquilizer is usually done with short-term or long-term reducing dose of medication, as there is risk of high level of anxiety, confusional state and convulsion (fits). ‘Detox’ is often the first step in a drug treatment program and should be followed by treatment with a behavioral-based therapy and/or a medication, if available. Detox alone with no follow-up is not an effective treatment.