Emotional highs and lows are great as long as they don’t linger beyond the moment. For some, however, mood swings can persist over time, leading to radical changes in behaviour.
Friends and family should hit the panic button if the mood change persists for four to six weeks. “If the oddities in a person’s behaviour are too significant and too sustained and are affecting his day-to-day functioning, it’s time to get professional help,” says Dr Sameer Parikh, head of psychiatry department, Max Super Speciality Hospital.
Though genes play a role, what causes a person to tip over is still debatable. There are many triggers, though, among which stress — be it emotional or physical — is a common one. Psychiatrists are increasingly getting cases of severe mental disorders such as schizophrenia, delusional disorder, bipolar disorder being triggered by strain that is too hard to handle.
“Stresses take many forms. Be it relationship problems, work-related issues or the death of a loved one... it can disturb a person’s mind,” says Dr Rajesh Kumar, associate professor, psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS). “Most people grow out of life’s low phases on our own, but people with a psychological predisposition to anxiety may find it hard to cope, eventually leading to a breakdown when they succumb to it,” he adds. Usually, it is friends and family that first observe the shift in personality.
Standardisation of psychiatric diagnosis has resulted in almost 90% accuracy, as compared to the 40% a decade ago. “Diagnosis is no longer a single man’s job as a multi-disciplinary team, including a clinical psychologist and social worker, evaluates a person before making a final diagnosis,” says Dr Nimesh Desai, director, IBHAS.
Special projective tests designed for children are helping doctors diagnose disorders in children as young as two. “We ask them to draw, observe how they handle toys in playrooms and ask them to narrate stories to check their reaction,” says Dr Sameer Malhotra, head of psychiatry at Fortis Hospital, Vasant Kunj.
As children take longer to open up, reaching a diagnosis may take multiple sittings. Treatment involves counselling and drugs, with shock therapy being used extremely rarely under anaesthesia. On an average, medicines cost up to Rs 1,000 a month, and need to be taken for an indefinite period. “The age of the onset of illness, family history and frequency of attacks decide the duration of treatment, which lasts for at least five years,” says Dr Shailaja Pokhriyal, clinical psychologist, BL Kapur Memorial Hospital. The chances of a relapse are always there, so follow-ups are initially weekly and then monthly.
*Names of patients changed to protect their privacy.