Psychiatry | OMNI Hospitals

Attention Deficit Hyperactivity Disorder – Preventive Steps to Treat Children with ADHD

Wed, 08 Jan 2020 10:02:50 +0000

Attention deficit hyperactivity disorder is commonly referred to as a mental health disorder in children. In short, it is called ADHD. Mostly, ADHD affects children and teenagers. Sometimes, this disorder might continue even in adulthood. Children with ADHD are often hyperactive and cannot control their impulsive behaviors. Such kids have extreme trouble focusing on a specific task. Moreover, they may not sit in a place for a long time. Kids with ADHD can make friends easily and they can even break their friendships in no time. Children with ADHD require some special focus, especially in a classroom, gatherings and other places. Here is an excerpt from a video interview with Dr. K. Radha Krishna, Paediatrician, Managing Director, Omni RK Super Speciality Hospital, Ramnagar, Visakhapatnam on Attention deficit hyperactivity disorder [ADHD], its symptoms and steps that can be taken to treat kids with ADHD.

Q. What is ADHD and how it affects a child’s growth?

A. ADHD is an acronym for Attention Deficit Hyperactivity Disorder. It is a critical neurodevelopmental disorder that affects the growth of kids, especially at school. The kids with ADHD suffer with few symptoms like impulsivity, hyperactivity and inattentiveness. The child with ADHD doesn’t have the ability to control his/her impulses. This sort of problem affects the brain development of the child.

Q. How to diagnose whether a child has ADHD?

A. One of the major ways to diagnose whether a kid has ADHD is through their behavior at home, school and other places. Children with ADHD are extremely naughty, hyperactive and mischievous. The parents and teachers might get upset with the child’s behavior.

Q. What are the core features of ADHD?

A. The core symptoms of Attention deficit hyperactivity disorder (ADHD) include:

Inattentiveness: Inability to put focus to a class
Hyperactivity: Unnecessary activities that usually lands them in problematic conditions
Impulsiveness: Doing things without knowing its long-term or short-term consequences

Q. What are the causes of ADHD?

A. To be precise, the fundamental cause of ADHD remains unclear. Researchers still continue their studies to find out the causes of ADHD in children. According to some studies, genetics, and heredity play a vital role in the cause of ADHD in children. Some research activities on brain imaging show numerous physiological differences. One of the factors behind the cause of ADHD is the reduction in dopamine. Dopamine is a chemical present in the brain that assists transfer signals between the nerves. This chemical plays a crucial role in causing emotional responses and movements in people. Some other researchers say that people with ADHD have less gray matter. The gray matter helps with controlling muscles, self-control, speech abilities and decision-making.

Q. Is there any therapy to treat ADHD in Kids? Is it helpful in reducing the ADHD level?

A. The way parents or teachers handling this type of kids must be rather different from normal kids. They shouldn't be locked up in rooms, beaten up or hurt them physically if they do something wrong. For children with ADHD, the major treatment is behavioral therapy. There are various behavioral therapies to treat kids with ADHD. Some of them include: Psychotherapy or Talk Therapy: With this therapy, kids can learn to monitor and control their behavior. Spending time with the child and giving verbal inputs will help. A piece of appreciation for what they have done good will make them happy and help them come out of their problem.

Q. Are there any medications to treat ADHD?

A. Besides behavioral therapy, there are medications to treat ADHD in children. These medications are prepared in such a way that they affect brain chemicals helping the kids to control their impulsive behavior and actions in a better manner. The medications improve the dopamine levels and reduce hyperactivity in them. One of the most used drugs is Methylphenidate (Ritalin). It restrains the hyperactivity and impulsivity in kids with ADHD. In just a few months, the kid will goes back to being normal after using this drug. Only children above the age of 6 are prescribed with this drug. If a kid has this problem at the age of 2-3 years, the only thing one can do is to cure through behavioral therapy. It’s the most commonly used drug for treating kids with ADHD. Dosage: The dosage of Methylphenidate medication starts with 0.3 milligrams for kids above 6 years. This medication should be given in the morning and at times when the child is active. The impact of this medication will remain 3 to 4 hours in the kid. There is no necessity to give this medication before sleep. Another popular medication is 'Atomoxetine' which is available everywhere. The major problem with methylphenidate is that it may not be available in all medical stores. The same age limit applies to Atomoxetine as well. In comparison with Methylphenidate, Atomoxetine might be less effective on the kids. However, it is available in the form of a capsule and available everywhere.

Q. At which stage of ADHD kids need medication?

A. When parents notice hyperactive and inattentive behavior in the child, they can take them to a general physician. It is not suggestible to start the medication immediately. The child must be followed for about 5 to 6 months to perfectly diagnose the condition. Only after confirming that the child is suffering from ADHD, then they can take medication under the supervision of a physician or paediatrician.

Q. How long does the ADHD child require medication?

A. Speaking about the time period in using this medication for a child with ADHD, it could be months, years or sometimes decades. In general, the doctor prescribes the drug for about 3 to 6 months. The drug will surely bring some improvement in the behavior of the child. After using the medication for a certain period of time and noticing dramatic changes in the kid’s behavior then, the doctor suggests them to stop the medication for a while, i.e., for about 15 days. Meanwhile, parents or teachers may notice whether there are still any ADHD symptoms. If the kid’s behavior has come to the normal stage then, there is no necessity of using the medication. But, most of the kids require using this medication for several years. The significant percentage of kids with ADHD need this medication lifelong. According to some studies, only 30 percent of the ADHD children will become normal beyond their adolescent age and the remaining kids require medication for decades.

Q. How to explain the kid's diagnosis to the child's friends and family?

A. There is a specific procedure to diagnose ADHD in kids. We can witness particular criteria for inattentiveness and hyperactivity impulsiveness in children i.e., 9. The Paediatrician will calculate the behavioural criteria in the kids and finds out whether they have ADHD or not. Any child who scores a 6 out of 9 points is known to have hyperactive impulsiveness or inattentiveness. Further, the Paediatrician will be able to understand the child's ADHD level and gives medication accordingly based on the criterion calculated. It’s not the mistake of the kid to behave in an improper way among friends and family. As a result of the chemical imbalances in their brains, the kids behave in a different way, unlike normal kids. However, with the help of medications, we can witness improvement in their behavior.

Q. Are there any side effects that are cause by using drugs for treating ADHD?

A. Yes, every drug has side effects. In the case of ADHD medications, Methylphenidate has side effects. Methylphenidate is a stimulant medication that might cause some potential side effects in the children. Some of them include:

Loss of Appetite
Mild Headache
Dullness
Pain in Abdomen
Weight Loss

If the symptoms are minor, then the child can continue using the medication. In case the symptoms are extreme and unbearable, then the only alternative is to stop using it.

Q. Do exercise, sleep, and diet make a difference in ADHD?

A. By making certain changes to the kid’s diet plan, doing exercise or additional sleep may not bring a drastic change in ADHD treatment. However, it must be noted that the kid should have routine adequate sleep of 8 to 9 hours. In case, if there is any reduction in their sleep timings, then the inattentiveness and hyper activeness might increase. A routine diet may not bring much change in the kid with ADHD. The intake of milk, fruits, veggies, and other foods has nothing to do with ADHD reduction. However, it is not advisable to feed the kid with too much sugar and artificial coloring food products.

Q. Can ADHD kids go to the same school as the rest of the kids?

A. Yes, they can. Mostly, children with ADHD appear as the biggest problem for the teachers in the classroom. In fact, there is no special school or class for ADHD children. They must go to regular schools like normal children. We can find at least one or two kids with ADHD in every class. In such a case, teachers must help the kids overcome their problems by taking extra care in the classroom. By concentrating on that child much more, there is no necessity for sending them to a special school. Some studies say, most of the ADHD children are adequately intelligent and sometimes over smart. But, the main problem with such kids is they couldn’t focus on one thing due to their inattentiveness and impulsivity.

Q. How to differentiate between an ADHD Kid and a Hyperactive Child?

A. There are two major things that we must remember about an ADHD child. The kids with ADHD might get affected socially and academically. A child with ADHD usually causes problems at school, home and with friends. The ADHD kids may not mingle with others for a long time or move socially well. They could be poor at studies and may not have a lot of friends. On the other hand, a routine hyperactive child is different from an ADHD kid in a way that they are socially well-behaved with others, friends and family members. Their academic and extra-curricular performance in school is good. In this way, we can differentiate between ADHD kid and Hyperactive kid.

Q. What is the major fact about ADHD?

A. The surprising fact is that the majority of children with ADHD are boys. Girls with ADHD are very rare and uncommon. The ratio of ADHD among girls and boys is 1:7.

Q. How can parents of ADHD children help them succeed in school and society?

A. ADHD is a very common problem in a few kids and it can be treated well through proper medications and behavioural therapies. With the help of these procedures, one can bring a drastic change in the ADHD kids’ behavior. All that the parents and teachers must do is to place some additional focus and attention on them while playing, in classrooms and while talking.

Dr Kandula Radha Krishna

Managing Director, Chief Consultant Paediatrician

Giggles by OMNI RK

Depression- How is it caused and how can it be treated?

Abdullah Saleem — Fri, 15 Nov 2019 07:24:24 +0000

Depression is not just a feeling of unhappiness or being a bit fed up for a few days - which is common and totally normal. Those who are suffering from depression can suffer from an immense feeling of sadness that can last for weeks and maybe even months. Everyone is different and the condition can manifest itself in different ways but is often described as a total disconnect from all feelings of happiness. Here is an excerpt from a video interview of Dr Lokesh Kumar, Psychiatrist, Department of Psychiatry, Omni Hospitals, Kukatpally, Hyderabad, on Depression, its causes and symptoms.

Q. What is depression?

A. Depression is a serious medical illness; it's not something that you have made up in your head. It's more than just feeling "down in the dumps" or "blue" for a few days. It's feeling "down" and "low" and "hopeless" for weeks at a time. Depression also makes you lose your self-confidence, self-respect and interest in things that would once excite you. Suicidal thoughts and an idea of a worthless future are also very commonly seen symptoms of depression.

Q. What are the symptoms of depression?

A. The most common symptoms of depression are: - Irritability, agitation or restlessness - Lower sex drive - Inability to focus, concentrate or make decisions - Insomnia or sleeping too much - Change in appetite and/or weight, eating too much or too little - Tiredness and lack of energy - Unexplainable crying spells - Unexplainable physical symptoms such as headaches or body aches - Feeling hopeless or worthless - Withdrawal from social situations and normal activities - Thoughts of death or suicide

Q. What are the causes of depression?

A. The causes of depression are not fully understood, but scientists think that an imbalance in the brain's signalling chemicals may be responsible for the condition in many patients. Moreover, a variety of distressing life situations are also associated, including early childhood trauma, a job loss, the death of a loved one, financial troubles or a divorce. Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors, according to the NIMH.

Q. Does depression occur to only weak-minded people?

A. Depression is one of the most common forms of mental illness. For too long, depression has been viewed as trivial or as a sign of weakness but that couldn’t be further from the truth. Depression is a real health condition and one that can happen to anyone, regardless of gender, age, background or occupation. Most likely, depression is caused by a combination of genetic, biological, environmental, and psychological factors, according to the NIMH.

Q. How is depression different from grief?

A. Sadness is a standard human emotion. It looks different for different people and in different situations, but we all experience it regularly, maybe some of us more vividly than others. Being sad allows us to deal with painful experiences and loss. It can be cathartic and relieve tension. Grief is a normal reaction to a tremendous loss. If you lost something or someone important, it’s expected for you to be stricken with grief for a long time—much longer than the two-week criterion for depression. The key is whether or not that sadness is paired with other factors of depression—loss of energy, trouble concentrating or making decisions, difficulty sleeping, disruption in eating patterns, feelings of hopelessness, worthlessness or thoughts of self-harm. Depression is a pervasive lack of pleasure in things you’re doing.

Q. What are the stages of depression?

A. The initial onset of clinical depression is not easy to identify. Its early symptoms are subtle, gradual and tend to develop in succession, like dominoes tumbling one after the other. The stages by which you can tell the illness is escalating from mild and moderate depression to severe depression are: - Low motivation and a lack of energy - Loss of interest in hobbies and other favourite pastimes - Loss of emotional edge - Vague and undiagnosable aches, pains and physical ailments - Changes in sleep patterns or eating habits - Small problems suddenly seem insurmountable - Performing in school or at work becomes increasingly difficult - The world will begin to seem like a dark, scary and dangerous place

Q. How different is depression between males and females?

A. Females are more prone to depression when compared to males, due to hormonal changes and other stress factors.

Q. Do all people who commit suicide do it because they are depressed?

A. It is not true that all people who commit suicide do it because they are depressed. There might be a number of factors for a person to take such a step and depression can be one among those few factors. Although people who are suffering from severe depression are capable of committing suicide.

Q. What are the different types of depression?

Q. Can work stress turn into depression?

A. For any psychiatric disorder, there are three ways by which it progresses and hence the symptoms are also seen in these three areas. They are: - Biological symptoms - Psychological symptoms - Social symptoms When the biological and social factors are affected, work stress can turn into depression.

Q. What is a major depression?

A. Major depression is a mood disorder. It occurs when feelings of sadness, loss, anger, or frustration get in the way of your life over a long period of time. It also changes how your body works. It is also an alternate name to moderate depression.

Q. Can lack of sleep cause depression?

A. Lack of sleep is one of the causes of depression but not the only cause. Depression is caused by a combination of genetic, biological, environmental, and psychological factors, according to the NIMH.

Q. What is bipolar disorder?

A. Bipolar disorder, formerly known as manic-depressive illness, is a serious medical condition. Someone with bipolar disorder has extreme episodes of mania, or being very “up” or energetic and active, and episodes of depression, or being very “down” and sad.

Q. What is postpartum depression?

A. Postpartum depression is a form of depression that a mother can experience within the first few weeks, months or even up to a year after having a baby. If left untreated, this depression can last for months or even years after the baby is born. The longer an episode of depression goes untreated, the longer the recovery and the higher the risk of suicide. It’s true that it’s normal for many new mothers to feel a bit down after childbirth, but if these “baby blues” last more than two weeks and affect your ability to take care of yourself and your baby, you may have postpartum depression.

Q. What is PMDD?

A. Premenstrual Dysphoric Disorder commonly known as PMDD, shares similarities with Premenstrual Syndrome (PMS). PMDD can cause severe irritability, depression, and anxiety the week or two before your period starts. This is due to the sudden drop in hormones after ovulation occurs.

Q. Is help needed during a depression?

A. Yes, help will definitely do good for a person suffering from depression. A common treatment for depression is Cognitive Behavioural Therapy (CBT). This is a talking therapy that teaches you to identify negative thoughts and feelings and offers coping strategies to help deal with them. For more severe forms of depression, antidepressants are prescribed which boost the activity of particular brain chemicals (such as noradrenaline and serotonin) that are thought to play a role in regulating mood. They can help to lift the mood, but they can also come with side effects. Other alternative therapies include music and art therapy, mindfulness, meditation, exercise programmes and work rehabilitation programmes.

Q. What is a seasonal affective disorder?

A. Seasonal affective disorder (SAD), is a kind of depression that tends to occur (and recur) as the hours of daylight grow shorter during the fall and winter months, but it may occur during the summer for some individuals. Light therapy, talk therapy, medication and changes in biorhythms (chronotherapy) are often used treatments for seasonal affective disorder. Lifestyle changes that can help decrease the symptoms of seasonal affective disorder include increasing time spent outdoors, more physical exercise, and maintaining healthy eating habits.

Q. What is the medication used to treat depression?

A. Antidepressants are prescribed which boost the activity of particular brain chemicals (such as noradrenaline and serotonin) that are thought to play a role in regulating mood. They can help to lift the mood, but they can also come with side effects. SSRIs target the brain's serotonin, a signalling chemical (neurotransmitter) that studies have found to be involved in depression. This class of medication includes fluoxetine (commonly known as Prozac), sertraline (Zoloft), paroxetine (Paxil), escitalopram (Lexapro) and citalopram (Celexa). Side effects, which are usually temporary, include changes in sexual desire, digestive problems, headaches, insomnia and nervousness. Other classes of antidepressants include serotonin and norepinephrine reuptake inhibitors (SNRIs), Norepinephrine and dopamine reuptake inhibitors (NDRIs), Tricyclic antidepressants, and Monoamine oxidase inhibitors (MAOIs). Medications take time — usually 2 to 4 weeks — to work, and often symptoms such as appetite, concentration problems and sleep improve before people may notice mood changes

Q. How can psychotherapy treat depression?

A. The most common form of psychotherapy used to treat depression is Cognitive Behavioural Therapy (CBT). This is a talking therapy that teaches you to identify negative thoughts and feelings and offers coping strategies to help deal with them.

Q. Is hospitalisation required during depression?

A. It depends on the severity of the depression. Most cases of depression are handled on an outpatient basis. If the patient exhibits suicidal behaviour, then hospitalisation is necessary.

Q. How can we prevent depression?

A. A healthy lifestyle, socially, physically and mentally will help prevent depression to a large extent. Dr Lokesh Kumar Psychiatraist OMNI Hospital, Kukatpally

Psychiatry

Fri, 31 Mar 2017 13:15:39 +0000

The Department of Psychiatry and Behavioural Health at OMNI is dedicated to providing comprehensive, high-quality services that enable individuals to improve their overall quality of life. At OMNI, we have the experience and expertise to treat all behavioural health concerns, whether they are psychiatric, substance abuse, or both. We believe every patient deserves to be treated with compassion and respect. We work across various demographics and our programs are tailored to suit the special needs of a variety of patients. Our specialized programs provide psychiatric with the care and attention they may not find in a general psychiatric program. We are dedicated to improving the mental health of every child and adolescent within our community while providing support for parents, caretakers, and other family members. We provide emergency care and support services for patients when they need it most, both on and off-site. We are committed to helping individuals recover from substance addictions in a safe, comfortable environment. We offer therapeutic care for a diverse clientele, and our clinicians specialize in a wide range of treatments.

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