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Ans. Noticeable changes in behavior, moods - suspicious of other; depressed; anxious; withdrawn; tense; irritable or angry. Mood swings, sleep disturbances and changes in appetite, restless, either hyper energetic or hyper exhaustion.
Ans. Yes; with medicines and therapy combined with supportive family and / or workplace environment, structured schedule for the patient etc
The length of the treatment varies from patient to patient. Lifelong medication may be required in some cases. However, many lead a fairly productive life with ongoing treatment.
The type of Mental Illness can undergo changes over a period of time. For example, psychotic if any may be controlled but anxiety or depression on OCD may step in. Hence family members must keep vigilant about new symptoms or behaviour changes and report immediately to the Psychiatrist. Never dismiss any new symptoms or changes in behaviour as irrelevant, "being an old case".
Ans.Side effects vary from medicine to medicine it is not possible to generalize. But it is better for the family members and the patient to ask the psychiatrist about side effects.
Ans. Usually if the patient is doing well on the present medication, new medicines are not introduced. However, in chronic cases that do not stabilize, the doctor may adopt a policy of trail and error with the medicines. But it must be done only after informed consent of the family members and the patient wherever possible. Patients and their families, have a right to seek clarifications on medication changes. They must be sure of the patients' cooperation as well for change of medication. Taking a joint decision with the patient must be attempted wherever and whenever possible.
Ans. There is no general rule. It varies from person to person but it does affect the quality of life to some extent. However, keeping symptoms under control is more important than any other aspect of life. The new generations of atypical anti-psychotics are believed to promote quality of life more than the older drugs. However, these are matters of debate that is best left to the Psychiatrist.
Ans. The world health organization (WHO) has identified 5 types of treatment methods or mental illness. These are medication therapy, patient’s therapy, family therapy, social therapy and occupational therapy.
Ans. Mental Illness is treatable and can be controlled. Many of us believe that medical alone can help in recovery. A combination of medical, psychological and social therapy models are required. Most importantly, a positive family attitude is a big asset.
Ans. Yes. Families have some apprehension about ECTs or popularly known as electric shocks. Thought not a permanent of miracle cure, it helps to control symptoms effectively in the short term. It must be administered always under anesthesia as per the Supreme Court Order. Consult your Psychiatrist for more information. Side effects are believed to be temporary such as loss of short term or what is known as autobiographical memory.
Ans. Unless there is something critical, the doctor may not find the need to spend more time. It is better that the care give or even the client patient does some homework by jotting down the points that you think needs special attention and showing it to the doctor. Once you communicate your doubts, clarification is bound to be provided.
Ans. Yes, it is a part of the illness and avoids making the patient guilty about it. Anytime your patient talks about it, share with your doctor immediately. See if the patient spells out concrete plans or strategies and methods etc. Besides constant vigil, keep reassuring the patient about how much he or she means to the family. Also, emphasize the fact that it is part of the illness and will gradually disappear with therapy and proper medication. Keep giving reassurances. It may be desirable for you to learn from a Counselor about ways and means of reacting to such situations.
Ans.Warning signals are restlessness, anger, agitation, eating problems, sleeping problems, depression, social withdrawal, decreased compliance with medication, anxiety, preoccupation with symptoms; break down in routine, stopping from College or office etc. Once the signals are clear, then the Psychiatrist has to be told. It is better to keep a set of Emergency medication, if advised by the doctor. Prompting an Emergency by admitting the patient on medical advice may also be tried. Family members must reduce their own level of anxiety and panic responses.
Ans. It is very important for the patient to have a schedule so that he / she can get back to functional levels very soon. Keeping the patient occupied and busy is an important responsibility but at times it is not possible to do this at home, for this professional help is required and it’s better to put the patient in rehab for some time.
Ans.Mental Illness is a devastating experience for the families; and of course nightmare to the patients. Under these circumstances, therapy helps the family-patient dynamics in a manner that it reduces emotional burden on both so as to carry out the rehab program with minimal disturbance in the routine.
Ans. Consult the Psychiatrist to alter the timing and dosage of medicine if required. Lethargy and apparent lack of interests pose major hurdles in motivating the patients. Be patient and does not express too much expectation. Things are likely to change gradually.
Ans. No. Nor is it a taboo. It depends on the patient’s ability and willingness to undertake the responsibilities in a marriage. It is better to seek medical opinion before finalizing anything. The policy of disclosure and not hiding anything from the prospective alliance is to be strictly followed. Unfortunately, failures are more common.
Ans.This question has no definite answer. It is matter of deep concern to families giving them sleepless nights. Many options suggested below are more of academic relevance for families. Hiring lifelong care is neither possible nor affordable. Just see if you can identify someone - a special someone who will keep a watch if in case the patient is orphaned. Other options given below can also be explored depending on specific situation in each family.
• Supportive relationships from peers / cousins or friends
• Self care and management skills to be imparted if possible
• Prepare the sibling with adequate training
• Set up a private Trust
• Ask the doctor about prospects of marriage.
• Identify long term homes.
• Start a self help group and make it a project in the group for which Govt. of India. Ministry of Social Justice and Empowerment provides grants.
• Fight for the rights of the destitute locally with your State Government.
Career and consumer support groups must ask the Government to provide simple and safe options that are affordable to the common Indian. The demands for long term homes are shunned by many mental health professionals and officials as reviving the asylum model of care. However, when confronted with the question of “Who after us?” none of them are able to offer a satisfactory solution.