Author Archives: Admin

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Psychotherapy Session

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Psychotherapy relies on conversation between the therapist and the client. It helps people through understanding and expressing feelings, motivations, beliefs, fears and desires. The client talks about what is on their mind and the therapist looks for patterns in situations in which the patient might feel stress or anxiety.


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Neuro-Psychiatric aspects of AIDS

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Many AIDS patients suffer from depression and die due to it.

Many AIDS patients suffer from depression and die due to it.

AIDS (Acquired Immunodeficiency Syndrome) is a disease that compromises the body’s immune system, causing it to break down and rendering it unable to fight off infection. The HIV virus weakens the immune system, leaving the body vulnerable to infections and other illnesses, ranging from pneumonia to cancer. The consequences of HIV infection are not only physical; the diagnosis comes with the prospect of dealing with the stigma and social discrimination in the face of certain death. Its almost like being a death row victim, lonely and sad.

The high prevalence of neuropsychiatric disorders in individuals infected with the human immunodeficiency virus (HIV) is related to a wide variety of factors including: direct effects of the virus, preexisting psychiatric conditions, personality vulnerabilities, affective disorders, addictions, and personal responses to the social isolation and disenfranchisement associated with the diagnosis of HIV. Studies have shown that patients with neuropsychiatric conditions have poorer outcomes and less benefit from antiretroviral therapy; however, psychiatric treatment improves HIV-related outcomes.

Psycho-social aspects of HIV infection

The most common psychological problems associated with AIDS/HIV infection are feelings of acute emotional distress, depression, and anxiety, which can often accompany adverse life-events. Receiving an HIV diagnosis can produce strong emotional reactions. Initial feelings of shock and denial can turn to fear, guilt, anger, sadness, and a sense of hopelessness. Some people even have suicidal thoughts. It is understandable that one might feel helpless and fear illness, disability, and even death.  Depression is twice as common in people with HIV as in the general population. Anxiety disorders too are common and may occur along with depression or as an isolated clinical entity. Substance abuse disorders are also widely seen as a result of underlying vulnerabilities or as a means to deal with anxiety and/or distress.

Neuropsychiatric aspects of HIV infection

CNS involvement in AIDS results from a variety of etiologies, including (a) the direct or primary effects of HIV-1 on nervous tissue, (b) the consequences of secondary viral and non viral opportunistic infections, tumors, and cerebrovascular disease, and (c) the complications of systemic therapies for AIDS and associated disorders. The manifestations range from cognitive (memory disturbance, attention deficits, dementia complex and delirium) to behavioral (psychosis, mood disorders etc.) symptoms.

Association of neuropsychiatric and psychosocial issues has consequences on management of the HIV infection. It impacts treatment compliance, may trigger off irresponsible behavior as a result of anger or frustration and may contribute to the growth of the epidemic. Thus identifying and treating these components of HIV infection is highly relevant in the treatment as well as prevention of the AIDS epidemic.

Dr. Jyoti Kapoor, DPM, DNB

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Chronic Headaches and Migraines

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Could a headache be a symptom of an underlying psychological problem?

Headache is one of the most common complaints in general population. Causes of headache range from muscle spasm to vascular contractions and so do myths surrounding this issue. Globally, it has been estimated that prevalence among adults of current headache disorder (symptomatic at least once within the last year) is 47%. Headache on 15 or more days every month affects 1.7–4% of the world’s adult population. Clinicians observe that while headache is common and many a times functionally disabling, its most often not associated with significant organic disease. Most work ups for common headaches have negative findings. Many people are susceptible to headaches at times of emotional stress and psychological stress usually exacerbates headaches, whether their primary cause is physical or psychological.

Tension type headaches are most common type of headache presenting in general population and its mechanism may be stress related or associated with musculoskeletal problems in neck. Chronic headaches are commonly found together with depression, anxiety, panic disorder and other chronic stress related conditions. The holistic management of headache thus lies in identifying psychological factors associated with it. Stress management thus becomes an important aspect of headache management. Following measures are useful in dealing with chronic headaches:

  1. Keep a headache diary, include precipitating factors, duration and intensity of attack and relieving factors.
  2. Identify modifiable factors like certain foods or situations that trigger headache attacks.
  3. Develop positive stress coping and stress relieving mechanisms.
  4. If headaches are chronic and debilitating, seek medical advice.

Dr. Jyoti Kapoor, DPM, DNB

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Stress – Its effects on our body and mind.

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Stress is defined in dictionary as a mental, emotional or physical strain, like a force it pulls at an individual and elicits response. It’s this response to stress or strain or tension that what defines an individual’s coping skills or personality.

In physiological terms, Hans Seyle defines stress as a nonspecific response of the body to any demand made upon it. Modern world presents such challenges on a regular basis at home, workplace, in school and social events. Individual responses depend upon how challenging or threatening the situation is perceived. I can elicit a neuro-hormonal response understood as Flight or Fright reaction kicking in physiological cascade of symptoms ranging from palpitations, tachycardia, breathlessness, increased bowel movement, increase frequency of urination, dizziness, muscle tension or pain, trembling, dizziness, blurring of vision to restlessness, confusion and fainting spells. Long term chronic stress leads to unexplained physical symptoms of body pains, fatigue, gastro intestinal symptoms etc, as well as long term effects on hormonal milieu, immunity and aging process. The psychological effects are observed as headaches, insomnia, irritability, depression, anxiety, panic attacks and myriad other conditions.

Dr. Jyoti Kapoor, DPM, DNB

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Hypertension – Insight into the silent killer!

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A journey through mind- body interface.

The consequences of psychological stress affect the whole body but the stigma associated with psychological disturbance makes it easier for people to accept the physical disorder as an entity on its own. Human mind is incorporated in human body and its functioning is as chemically mediated as that of any other part of the body. Owing to lack of understanding of brain physiology modulating human emotions and behavior, society developed models of strengthening mind by self control and distraction resulting in a perception that all emotional disturbances can be controlled by self control itself. Novel understanding of physiology and genetics of emotional responses has thrown light on the interaction between mind and body. Any illness, weather physical or psychological happens due to an interaction between biological, psychological and environmental factors. A holistic approach to management and cure of illnesses thus requires an understanding and intervention at all these levels.

This is an attempt to explore and understand the impact of day to day stress on our physical and mental wellbeing- A journey through mind- body interface!

Physical Consequences of Stress- Why am I told that my BP is psychological?

In India, many times people use statements like ‘my BP increased’ while talking of situations when they felt anger/anxiety or stress, and with obvious reason because stress or anxiety is commonly associated with increase in blood pressure. But the problem arises when instead of evaluating and treating the psychological aspect of increase in Blood Pressure, the focus falls on lowering the blood pressure alone.

Persistent high arterial blood pressure above 120/80 mm HG is termed as pre-hypertension or hypertension, but the point to be emphasized is that this rise in blood pressure is persistent. Hypertension affects almost one billion people world- wide and is a leading cause of morbidity and mortality. The patho-physiology of increase in blood pressure is associated with either an increase in cardiac output or an increase in peripheral resistance. The cause of this increase, in patients with hypertension is not clear in 80-95% of sufferers so it is termed as essential or primary hypertension. But it is well known that the chemical released during high states of stress and anxiety constrict blood vessels and increase heart rate thereby transiently causing a rise in pressure of blood in blood vessels. Research has not directly associated essential or secondary hypertension to stress, but reduction in psychological stress has shown to result in better control even in those who are diagnosed with primary hypertension.

One of the common examples of stress induced increase in blood pressure is white coat hypertension, a condition in which an individual records high blood pressure only in front of a doctor or in a clinical setting. Stress response involves a cascade of neuro physiological responses that lead to ‘flight or flight response. Research like cardia study has shown that frequent activation of this type of response may damage the circulatory system making it vulnerable to develop vascular and cardiac complications and hypertensive disorder.

Dr. Jyoti Kapoor, DPM, DNB

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Important Notification

Due to recent ban on use of Rs 500/- and Rs 1000/-denomination currency, we request you to pay by either of the following means- 1. Currency notes other than Rs 500/- and Rs 1000/- 2. Mobile wallets- PayTm- 9990818967 PayUMoney- 9990818967 MobiKwik-9990718967 3. NEFT transaction to following account- Dr Jyoti Kapoor A/c No. 09291140082855 HDFC, sector 45, gurgaon IFSC : HDFC0002645 We don't have debit/ credit card facility. Regards मन:स्थली Dr Jyoti's Psychiatry Clinic Gurgaon

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