Question 1

Workplace stress

Accepted Answer

In small doses, stress can be a motivator, helping you perform better and teaching you ways to overcome obstacles. However, when the pressure builds with too many responsibilities, unrealistic expectations and personality conflicts,  it can lead to work-related stress. Stress may also be induced as a result of workplace bullying, harassment and discrimination.

Work-related stress is known to adversely affect employee engagement, morale and productivity. All of these could potentially harm the business goals.

What are the signs of work-related stress?
 • Lack of confidence
 • Lack of productivity
 • Negative thoughts and feelings
 • Irritability
 • Mood swings
 • Reduced appetite
 • Avoiding social situations

What are the benefits of stress therapy?
Psychotherapy provides employees an opportunity to let out negative thoughts and feelings, thereby reducing stress. Some of the benefits of therapy include:
 • Learn to identify triggers or thoughts that increase anxiety
 • Understand oneself better, which leads to increased confidence levels.
 • Learn to relax and stay calm
 • Increased engagement with co-workers
 • Reduced absence and turnover

Question 2

Anxiety

Accepted Answer

Anxiety is the feeling of fear or nervousness that we all feel when faced with a problem or making an important decision. It is a normal emotion. However, when a person feels extremely anxious and the feeling lasts for long periods of time, he or she is said to be suffering from an anxiety disorder.

Anxiety disorder is a maladaptive response to stress. It is the constant worry & fear that keeps a person from carrying on with life normally.

How do you know if you have an anxiety disorder?
Anxiety can feel different for each person. While for some it is  butterflies in the stomach, for others it is palpitations. Some may even feel a disconnect between body and mind. Some of the common signs & symptoms are:
 • Panic, fear & uneasiness
 • Sleep disorders
 • Unable to stay still or calm
 • Cold feet
 • Palpitations
 • Dry mouth
 • Nauseas
 • Tense muscles
 • Shortness of breath

Why see a psychiatrist for anxiety disorder?
Interestingly, every individual’s reaction to stress and ability to cope with it depends on his/ her socio- cultural background and genetic proneness.

This means that symptom presentation, explanation of the illness and coping abilities of every individual is different. Only a qualified and experienced psychotherapist can understand the meaning and importance assigned by an individual to these symptoms and the socio-cultural factors driving it.

Besides trying to self manage anxiety disorder (eg: reading up on Google without seeking professional help) further accentuates anxiety.

Is anxiety disorder curable?
Developments in epidemiology and psychobiology have significantly advanced our understanding of the anxiety disorders in recent years. Advances in pharmacotherapy and psychotherapy of these disorders have brought realistic hope for relief of symptoms and improvement in functioning to many people.

What are the common symptoms of anxiety?
 • Inability to concentrate
 • Restlessness
 • Thinking of the negative most outcome in most scenarios
 • Exaggerated phobias (fear of heights, darkness etc.)
 • Sudden shivering, dryness of mouth, giddiness, palpitations etc
 • Many times anxiety presents with depression

What are some useful tips to cope up with anxiety?
 • Cut down on caffeine, as it is a mood altering drug & tends to make symptoms of anxiety worse.
 • Eat well balanced meals & make exercise a priority.
 • Sleep disorders & anxiety tend to go hand in hand. Make sleep hygiene a priority.
 • Maintain a positive attitude and accept that you cannot control everything.
 • Understand your triggers.

Question 3

Depression

Accepted Answer

We all experience sadness at times. But depression is more than just feeling blue. It is a feeling of despair & extreme sadness that tends to last for more than just few days. It interferes with a person’s daily activities & may require a long term treatment.
Depression is one of the most common mental disorders with over 250 million people are affected globally(WHO).

How do you know you are depressed?
Here are some common signs of depression:
 • Agitation & irritable mood
 • Persistent feelings of sadness or hopelessness
 • Difficulty making even simple decisions
 • Social Isolation
 • Fatigue
 • Sleep disturbances
 • Significant weight loss or weight gain
 • Recurrent suicidal thoughts

What are the causes of depression?
Certain life events such as a death of a family member, breaking up with a loved one can lead to depression. Financial problems and stressful environment at work can also play a role
Personality: Certain personality traits increase risk of depression. People with low self esteem & those who tend to be severely self critical are more susceptible.
Illness: Chronic or life threatening illnesses tend to trigger depression in some individuals.
Drug or alcohol abuse: Excessive consumption of alcohol or use of drugs can increase a person’s risk of depression

How does your Psychotherapist diagnose depression?
There is no one test that helps diagnose depression. The diagnosis is made based on your symptoms and a psychological assessment. In most cases, your psychotherapist would you a series of questions about your moods, sleep patterns, activity level, appetite etc to evaluate your psychological state.
How is it treated?
There are various approaches to treating depression. Some of the treatment modalities include:
 • Pharmacotherapy
 • Integrative psychotherapy
 • Cognitive behavioral therapy
 • Psychodynamic therapy
 • Light Therapy
 • Alternative therapies such as meditation or acupuncture

Question 4

Panic Attack

Accepted Answer

A panic attack is when a person gets terrified or is overwhelmed with fear without any apparent danger. These episodes can be frightening and the person having it generally thinks that he or she is having a heart attack or losing control or even dying. Panic attacks can occur anytime, even during sleep.
If a person has recurrent episodes and spends significant time in constant fear of another attack, he or she may have a panic disorder.

How do you know it’s a panic attack?
Panic attack is a sudden and strong feeling of fear. Here are some of the signs that indicate a panic attack:
 • Fast heartbeat
 • Sweating
 • Shaking
 • Shortness of breath
 • Chest Pain
 • Nausea
 • Dizziness
 • Tingling sensation
 • Hot flashes or chills
These episodes are usually brief and last no more than 10 minutes. People who have had a panic attack once are at a higher risk of having another one compared to those who never had a panic attack.

What causes a panic attack?
Although the exact cause remains unknown, there are certain factors which put you at risk. These include:
 • Genetic factors
 • Severe stress
 • Sensitivity to fear or stress
 • Traumatic experiences
 • Excessive use of alcohol or drugs

How is it diagnosed?
The diagnostic process involves understanding the patient’s symptoms, thoughts, feelings & behaviour patterns along with a series of psychological tests. Certain lab and/or imaging might be required to rule out any other physical problems that may cause such symptoms.

How can it be treated?
Panic attacks can be effectively treated with the help of one of more of the following methods:
 • Medications
 • Talk therapy
 • Cognitive behavioural therapy
 • Lifestyle changes

Question 5

Anger Management

Accepted Answer

Anger is an emotion that we all experience from time to time. It is totally normal, even healthy to express anger. However, rage, uncontrolled anger or anger that doesn’t subside for long periods of time can take over your life leading to violence, depression and even suicide.
Anger management is all about learning and recognizing the triggers and taking measures to deal with the situation without hurting oneself or others.

What are the causes of anger?
Anger may be a result of internal or external factors. Internal factors include perceived failures or injustices. External factors are outside the control of the individual such as humiliation or loss of privilege or property.

Who needs anger management therapy?
	Anger management therapy is recommended for people who experience the following:
 • Persistent negative thinking
 • Engaging in physical violence
 • Persistent feelings of irritation or hostility
 • Constantly feeling the need to suppress your anger
 • Abnormal behaviour such as breaking objects when angry
 • Avoid people or situations due to anxiety about outbursts

What is anger therapy?
Anger therapy is a psychotherapeutic program that can help you effectively deal with anger issues. There are many strategies available, but cognitive behavioural therapy is the most effective anger management therapy.
During your anger management therapy sessions, the therapist would teach you to:
 • Practice Mindfulness
 • Regulate emotions
 • Identify situations that make you angry
 • Develop skills to translate anger into assertiveness
 • Calm yourself down
 • Redirect your energy towards resolving the situation
 • Communicate effectively
Here are some tips that can help you cope with anger:
 • Keep a journal
 • Exercise more often
 • Practice mindfulness meditation
 • Find a constructive hobby

Question 6

Insomnia

Accepted Answer

Insomnia is a common sleep disorder that makes it hard for a person to fall asleep, stay asleep or causes them to wake up too early. Insomnia can be short term, lasting from a night to a few weeks or long term, with no sleep for 3 nights a week for a few months or more.
There are two types of insomnia. In the first type, known as primary insomnia, there is no underlying health condition for the patient’s sleep problems.  This is caused by environmental factors such as noise, light or temperature, certain stress inducing life events such as death of a family member, loss of job divorce etc.
On the other hand, secondary insomnia means that the person has difficulty sleeping due to certain health conditions such as asthma, depression, cancer, arthritis etc. Some of the causes of secondary insomnia include:
 • Depression or anxiety
 • Pain resulting from cancer or arthritis
 • Certain medications used for high blood pressure, asthma, allergies
 • Excessive use of caffeine, tobacco or alcohol
 • Endocrine disorders such as hypothyroidism
 • Sleep disorders such as restless leg syndrome or sleep apnea

What puts you at risk of insomnia?
Almost everyone has an occasional sleepless or restless night. But, the risk of insomnia is higher due to certain factors such as :
 • Severe stress
 • Hormonal shifts during menstrual cycle & pregnancy
 • Mental health issues
 • Frequently changing shifts at work

Can insomnia be prevented?
Maintaining a good sleep hygiene can help prevent insomnia. Here are some tips:
 • Have a sleep routine. Get to bed at the same time each night.
 • Try to avoid naps during the day
 • Avoid using phone prior to bed
 • Avoid alcohol
 • Exercise everyday
 • Make your bedroom dark & quiet

How is insomnia treated?
Simple lifestyle changes such as changing sleep habits & managing stress can help restore sleep for most people. However, if these do not work, your psychotherapist may recommend one or more of the following treatment methods:
 • Cognitive behavioural therapy
1. Stimulus control therapy
2. Relaxation techniques
3. Light therapy
 • Pharmacotherapy: Use of certain medications to help a person fall asleep or stay asleep or both
 • Alternative therapies such as yoga or meditation

Question 7

Psychosis and Abnormal Behavior

Accepted Answer

Psychosis is a condition that adversely impacts how a person’s brain processes information. The affected patient loses touch with reality and sees, hears or believes things that are unreal. This can be scary for the person experiencing it. Sometimes, he or she may also hurt themselves or others.
Psychosis does not start all of a sudden. The progress is gradual and there are signs and symptoms one can notice as the disease progresses.

What are the warning signs of psychosis?
 • Trouble concentrating
 • Lack of self hygiene
 • Spending more time alone
 • Being overly emotional
 • No emotions at all

What are the signs of early psychosis?
 • Inability to pay attention or think clearly
 • Keep away from friends and family
 • Have unusual beliefs or thoughts
 • Hear, see or taste things that others don’t

What are the symptoms of a psychotic episode?
 • Hallucinations: Hearing voices when nobody is around, seeing things that are not there, experiencing weird sensations and feelings.
 • Delusions: Firmly holding on to false beliefs which are contradicted by reality.

What causes psychosis?
The exact cause of psychosis is not always clear, but some of likely causes include:
 • Genetics
 • Trauma such as death of a family member or sexual assault
 • Use of Drugs
 • Illnesses such as
1. Brain Tumors
2. Strokes
3. Parkinson’s disease
4. Alzheimer’s disease
5. Dementia
6. HIV or other infections that attack the brain

Question 8

Personality Disorder

Accepted Answer

Personality is the way one views life, relates to the outside world and  understands oneself. It is the unique combination of thoughts, emotions and behaviours that makes one’s personality.
Personality disorder is a condition in which the person thinks, feels and behaves in a way that deviates from the norm, causes distress and trouble perceiving and relating to people and situations.
Personality disorder affects the following areas:
 • How a person thinks about self and others
 • How a person relates to other people and situations
 • Emotional responses
 • Controlling behaviour

What are the factors that increase your risk of personality disorders?
 • Family history of personality disorders
 • Abusive childhood

What are the types of personality disorders?
Personality disorders tend to begin during teenage and can last for a long time. There are many types of personality disorders:
 • Antisocial personality disorder is a disorder in which the person has complete disregard for the needs and feelings of others. It involves consistently irresponsible and impulsive behaviour, and repeated violation of other’s rights.
 • Avoidant personality disorder is a condition in which the patient feels extremely shy, super sensitive to criticism and has feelings of inadequacy.
 • Borderline personality disorder is characterised by impulsive and reckless behaviour, intense emotions and unstable relationships. A person with this condition is likely to have strong feeling of emptiness with meaningless spurts of anger and even repeated attempts of suicide.
 • Dependent personality disorder features submissiveness and a need to be taken care of. People with this disorder fail to make even the simplest of decisions without assurance from others.
 • Histrionic personality disorder is characterised by excessive attention seeking behaviour and quickly shifty moods and emotions.
 • Narcissistic personality disorder involves obsessive need for admiration with an absurd sense of self importance and a complete lack of empathy.
 • Obsessive compulsive personality disorder involves being overly focused on the details with obsession for orderliness, perfection and control.
 • Paranoid personality disorder is characterised by suspicion and complete lack of trust in others.
 • Schizoid personality disorder involves social detachment and lack of emotional expression.
 • Schizotypal personality disorder is a condition wherein the patient displays eccentric behaviour and distorted thinking. He or she may have social anxiety and be very uncomfortable in close relationships.

How is a personality disorder diagnosed?
The psychiatrist may conduct the following evaluations to diagnose a personality disorder:

Make an in depth enquiry about your health by asking the patient a series of questions.
Lab and screening tests to rule out other medical reasons, alcohol or drugs.
Psychiatric evaluation through discussion about the patient’s thoughts, emotions and behaviour.

What are the treatment options?
The type of treatment depends on the kind of personality disorder the patient has, the severity of the disorder and his or her present life situation. As personality disorders are long standing, they require treatment for several months or even years.

Some of the treatment options include the following:
 • Psychotherapy
Psychotherapy can help the patient understand his or her behaviour and identify the thought patterns or feelings that act as triggers. A good psychotherapist can help the patient learn to effectively cope with symptoms. Some of the most effective types of psychotherapy include:
 • Cognitive behavioural therapy
 • Psychodynamic therapy
 • Dialectical behaviour therapy

• Pharmacotherapy
There are many types of medications that can help relieve symptoms of personality disorders. Some of these include:
 • Antidepressants to help with anger, sadness or impulsive behaviour.
 • Mood stabilisers to reduce irritability and aggression and even out mood swings.
 • Antipsychotic medications in case the patient experiences psychosis.
 • Anti-anxiety medications to help the patient with sleeplessness or severe anxiety.

Question 9

Alzheimer's

Accepted Answer

Alzheimer’s is a neurodegenerative disease causing cognitive decline and memory loss. It is the most common form of dementia.

The decline of mental capabilities in an Alzheimer’s patient is both chronic and progressive. However, the associated psychological problems tend to fluctuate depending on the patient’s mental & emotional state. As such, doctors emphasise on psychotherapy as key part of the treatment plan.

What are the symptoms?
	An Alzheimer’s patient may experience the following:
 • Reduced ability to remember new information.
 • Inability to recognise faces or common objects
 • Impaired reasoning or difficulty exercising judgement
 • Difficulty remembering common words
 • Changes in personality or behaviour

What are the risk factors ?
 • Age: Alzheimer’s commonly occurs in patients above 65 years old.
 • Family history: A person is more likely to get it if he or she has a close family member with the condition.
 • Genes: Certain genes have been linked to this disease.

How can psychotherapy help?
Psychotherapy can help the patient deal with anxiety and depression caused by the disease. It may also help with behavioural disorders such as delusions associated with it. A therapist can help the patient come to terms with their diagnosis and improve their overall outlook towards the situation at hand.

Question 10

Dementia

Accepted Answer

Dementia is a collective term used to describe progressive deterioration of mental capabilities such as memory, thinking, orientation, language or decision making.  Although dementia most commonly affects older adults, it is not a normal part of the ageing process. Alzheimer’s is the most common form of dementia.
This disease has a physical, mental, social & economic impact on the patient as well as his or her caregivers.

What are the common signs & symptoms of dementia?
 • Loss of memory
 • Difficulty remembering words
 • Inability to reason or solve basic problems
 • Difficulty with coordination & motor functions
 • Confusion & disorientation
 • Difficulty with visual & spatial abilities
 • Personality changes
 • Lack of emotional control
 • Hallucinations
 • Depression & anxiety
 • Paranoia

What are the risk factors?
 • Age of 65 or above
 • Family History
 • Unhealthy diet & lack of exercise
 • High blood pressure & Cholesterol
 • Obesity & Diabetes
 • Smoking & Alcohol
 • Vitamin & Nutrition deficiencies

How can it be treated?
Treatment for dementia begins with identifying and treating the underlying cause such as nutritional deficiencies, hormonal changes, tutors or drug related dementia. In some cases, where the cure is not available as in case of Alzheimer’s, treatment can be aimed at effectively managing the cognitive & behavioural symptoms.

A combination of medications, psychotherapy and environmental modifications can be effective in treatment of dementia. Certain psychosocial interventions such as behaviour oriented therapy, emotion oriented therapy, cognition oriented therapy and stimulation oriented therapy may also be beneficial for the patient.

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