Diseases & Treatment

Understanding Mental Disorders

Mental disorders can be manifested in various forms. The symptoms of mental illnesses can differ based on age, gender, the particular type of disorder. The signs and symptoms can also vary from time to time and person to person. However, certain symptoms may be considered as warning signs of mental health problems that warrant attention and intervention. These include:

  • Persistent worries or fearfulness
  • Pervasive feelings of low mood
  • Extremes of mood or frequent mood changes
  • Loss of initiative or desire to participate in any activity
  • Problems in thinking, learning, or memory
  • Odd, unusual behavior
  • Difficulty in sustaining attention and focus
  • Excessive irritability or anger
  • Social withdrawal
  • Disturbances in biological functions such as appetite, sleep, energy, or sexual activity
  • Disturbances in perception of reality
  • Misuse of substances such as cigarettes or alcohol
  • Death wises, suicidal thoughts
  • Somatic complaints such as palpitations, dry mouth, digestive problems
  •  Difficulty in day to day functioning

Mental disorders can affect individuals of any age, ethnicity, gender or socio-economic background. No one should be considered as immune to the ravages of mental illnesses. The Department of Mental Health and Behavioral Sciences, Fortis Hospital, Kolkata thus, practices lifetime psychiatry, providing appropriate interventions to individuals of all ages and is sensitive and affirmative towards all relevant background factors. It is best to get help and treat it as a psychiatry emergency.

 Common Mental Disorders

There are a vast number of psychiatric disorders that can affect individuals. However, some mental disorders are more common, and include:

  • Mood disorders: As the name suggests, this cluster of disorders is characterized by disturbances of mood and functioning. The two most common of the mood disorders include major depressive disorder and bipolar disorder.
  • The most prominent feature of depressive disorders is the inability to experience positive mood states. Other symptoms include loss of enjoyment, feelings of low energy, tearfulness, social withdrawal, irritability (specially in children), and increase or decrease in sleep and appetite. Feelings of guilt, worthlessness, reduced hope and optimism, low self-esteem and confidence, and reduced ability to concentrate are accompanying symptoms. In severe forms of depression, there can be death wishes, suicidal thoughts or attempts at self-harm.
  • Bipolar disorder is generally characterized by alternating episodes of depression and mania/hypomania which refers to symptoms of excessive elevations in mood, accompanied by increased talkativeness, excessive and racing thoughts, ideas of grandiosity and disorganized behavior.
  • Distinguishing mood changes between clinical condition and those that normally occur in case of almost all individuals can sometimes be tricky and diagnosis and treatment should always be done only by mental health professionals.
  • Anxiety Disorders: These are a range of clinical conditions including generalized anxiety disorder, phobias, separation anxiety disorder, social anxiety disorder and panic disorder. All of these clinical conditions have the common symptom of excessive or persistent fearfulness, worries and apprehension. Individuals with these conditions usually find it difficult to control their worries and apprehension, even though they may sometimes realize their irrationality. Other symptoms of anxiety disorders can range from physical ones such as dry mouth, palpitations, excessive sweatiness, pacing, digestive irregularities, nausea, muscle stiffness or pain to cognitive ones such as difficulty in concentration, negative thinking and reassurance seeking. Disturbances of sleep and appetite can occur in anxiety disorders too.
  • Obsessive Compulsive Disorder (OCD): OCD is characterized by the presence of obsessions, compulsions, or both. Obsessions refer to certain repetitive thoughts, images, or impulses that are perceived by the individual as unwanted and intrusive. These obsessions lead to significant distress and anxiety, which the individual often tries to counter with the help of compulsions. Compulsions refer to certain repetitive behaviors or mental acts that an individual feels driven to perform. Common obsessions include fear of dirt or contamination, fear of illnesses, sexual thoughts, aggressive impulses, need for symmetry or exactness. Common compulsions include repetitive hand washing, cleaning behaviors, repeated checking, and mental counting.
  • Dementia: Dementia is a collection of symptoms that result from damage to the brain caused by different diseases, such as Alzheimer's. These symptoms vary according to the part of the brain that is damaged. Symptoms of dementia, can thus vary widely. Some of the common early signs if dementia include forgetfulness, difficulty in focusing, confusion regarding time and place, difficulty in following a conversation, repeatedly asking the same questions, and mood changes.
  • Schizophrenia: Schizophrenia is a severe mental disorder which can have ramifications on a person’s thoughts, feelings, and behaviors. The reality perception of people with schizophrenia is often disrupted which can lead to significant difficulty in functioning. The symptoms of schizophrenia include signs of altered perceptions such as hallucinations, abnormal patterns of thought such as delusions, and disorganized speech. Loss of motivation, apathy, blunted emotions and social withdrawal also accompany schizophrenic disorders.
  • Attention Deficit Hyperactivity Disorder (ADHD): As the name indicates, ADHD is characterized by a difficulty in sustaining focus as well as overactivity and restlessness. This is primarily a disorder having its onset in childhood, but if untreated, symptoms, can persist into adulthood. The difficulty in sustaining focus is often reflected in the person making careless mistakes, not seeming to listen when being spoken to, and a tendency to get easily distracted. Restlessness and hyperactivity is evidenced in behaviors indicating impulsivity, inability to sit still for long, fidgeting, impatience, and excessive talkativeness. These problems often cause significant disruptions in academic, social, and occupational functioning.
  • Autism Spectrum Disorders (ASD): Autism Spectrum Disorders are a group of developmental conditions in which there are difficulties in communication and social interaction. These conditions usually begin at a very young age and last throughout a person’s life, though significant improvement can be achieved through treatment. The warning signs of ASD include problems in social interaction such as difficulty in maintaining eye contact, not responding when called, unusual emotional expression, difficulty in cooperative play, impaired communication as per age, difficulty in understanding and following social norms; repetitive behaviors, speech and fixed interests, rigid adherence to schedules, and delays in, or lack of, age-appropriate language and developmental skills.

Areas Of Care

Causes of Mental Disorders

A lot is still to be known regarding the genesis of mental disorders. The current understanding of mental illnesses is that a complex interplay of biological, psychological and social factors is involved in the development and maintenance of mental disorders. Biological factors include genetic contributions, disturbances in neurotransmitter functioning, brain pathology and hormonal fluctuations. Psychological factors involve a person’s personality composition, patterns of thinking, interpretation of life experiences and learned behaviours. Social factors can include poverty, traumatic events, and discrimination.

How are mental disorders diagnosed?

A mental disorder is diagnosed through multiple steps and procedures. The first step to a diagnosis is usually a detailed case history taking and examination of the individual’s current mental status, that is conducted by a trained mental health professional after building rapport with the person. A thorough physical examination is also conducted by the psychiatrist, and a few investigations may also be suggested, in order to rule out any physical conditions that may be involved. Core mental disorders, however, are usually not diagnosed through blood tests or lab investigations. Rather trained professionals analyze how the particular set of symptoms may or may not fit into certain diagnostic categories. For further diagnostic clarifications and treatment planning, psychometric assessments are also carried out by clinical psychologists. Through the process of interview, questionnaires, and other procedures, these assessments help to better arrive at diagnostic conclusions as well as judge the severity of the problem.

How are mental illnesses treated?

Since mental health problems are caused by a variety of factors, treatment for mental disorders also have multiple points of focus. The first and most important step to the treatment process is early identification. As in the case of any illness, the sooner the problem is detected, the better are the outcomes. Thus, any sign of unusual mental functioning must be brought to the attention of health care providers immediately for further investigation.

Two broad approaches to the treatment of mental disorders include pharmacological and psychotherapeutic.

Pharmacological approaches to treatment include medical intervention at the advice of a psychiatrist which helps to alleviate the symptoms of mental disorders. It is important to keep in mind that psychiatric medications must not be started or stopped suddenly without consulting a psychiatrist.

Psychotherapeutic interventions include treatment with the help of therapies of a wide range of modes and genres that focus on symptom alleviation through the help of communication, ventilation, analysis of problem and the use of relevant strategies and training aimed at empowering the individual to overcome the problems stemming from a mental disorder, handling of life stress and skill development for handling of crises. These interventions are carried out by clinical psychologists. 

About the Department

The Department of Mental Health and Behavioral Sciences, is a multidisciplinary team comprising of psychiatrists, clinical psychologists, counselling psychologists, special educators, and other experts, who together provide well-rounded, comprehensive and holistic mental health care aimed at both the prevention as well as treatment of mental health issues. Some of the services provided by the department include:

  • Diagnosis and treatment of all mental and behavioural disorders including depressive disorders, anxiety disorders, schizophrenia, substance misuse and addictions
  • Psychometric assessments including IQ assessment, Personality assessment, neuropsychological evaluations and disorder specific assessments.
  • Child psychiatric services including the diagnosis, assessment and treatment of developmental disorders such as Autism, ADHD, developmental delays, learning disability.
  • Geriatric mental health including comprehensive mental health services for elderly individuals for treatment of dementia, depression, and other psychological problems.
  • Interventions aimed at cessation of use of addictive substances such as alcohol, cigarettes, and other drugs.
  • Management of sleep disorders.
  • Behavioural medicine to address the psychological factors involved in physical health problems such as asthma, ulcers, IBS, diabetes for better management of these conditions.
  • Chronic pain management.
  • Training workshops and seminars for life-skills training and stress management aimed at the prevention of development of mental disorders.
  • Internship Programs for young students with the goal of sensitization and education of mental health issues and guidance with careers in the field of mental health.