10 Dec 2009

Mind Mysteries: Part 2

Majority of my patients suffer from what I term it as “IT’s Stress”; 90% of people who go through stress are a part of corporate world. Both seem to walk hand in hand, IT and Stress. I usually counsel and suggest them taking off, & may be exploring the “No-man’s Land”.

Certain amount of my cases needs special attention and involves lot of investigation. Such instances go into my daily journal. One such subject today complained of “lack of pleasure” in his routine life. He said these days the chocolate poured on vanilla ice-cream never interests him which was his passion ages back. The page 3 parties do not welcome him anymore due to the isolation he did to himself when attending them. His 3yr old relationship went for a toss after he explained her that the love making part isn’t pleasurable anymore.

My initial diagnosis here was schizoaffective disorder; but this man confided that he did not experience any hallucinations as such. I could make out that he is from a Brahmin family. He wore the thread that refused to stay in, but peep. His lifestyle although was quite contrary; My Analysis said that he sometime back had ‘Wine’ and ‘Woman’ in plenty.

‘Do you do drugs?’ was my prime question. He had replied with a negative nod.
‘I used to do lot of hookah but never tried drugs’ his hands rested on his stomach, joined and facing upwards. A quick sign of increase in comfort zone it displayed.

‘I have lost like a bunch of weight doctor. 12kgs to be precise’.

I could make out with his dull eyes that he had been thinking too much. He looked pale; when you return after a long holiday, touch the plants to tell them how awesome your trip was, & realize that they haven't been watered at all by the maid although she claims that she did every alternate day. Yeah he looked the way plants would look; insipid & dull.

Final year of my studies involved peeking through reports of people who had made it big in the field of psychology. I doubted he showed signs of ‘Anhedonia’. Al though the major cause for it would be drug addicts following withdrawal, this case was completely different. He definitely needed attention. I prescribed him Natra-Bio, Stress Relief 60ct and asked him to come see me two days later.

Paul Keedwell MD of King's College few years back proposed a theory in which stated anhedonia may result from the breakdown in the brain's reward system, involving dopamine pathways. According to him certain sections of the brain in depressed subjects had to work harder to process happy thoughts. Just like how events in your life are responsible for the emotions you exhibit, Nucleus accumbens in the brain plays an important role in reward, laughter, pleasure, addiction, fear, and the placebo effect. Placebo effect is something where the patient is injected with inert medicines and informed them that such medicines will help them. Nucleus accumbens creates a therapeutic effect in such patients; the confidence instilled in them almost cures the diagnosed ailment. 

Anhedonia is is an inability to experience pleasure from normally pleasurable life events such as eating, exercise, social interaction or sexual activities. Sustained-release bupropion could possibly bring some changes; the journal recorded all the details.

Chilly winters, early mornings, fluffy bed, warm blanket wrapped, hot cup of coffee and that day’s newspaper makes the deadliest combination. ‘The Way Newspapers are read’ is one of the hot topics for the thirsty researchers in our field. Few spend like 2 hours to read the paper; such people give importance to the details. On how the accident happened, how many were killed, how many injured, the actual spot, the aftermath announcement of government aids they will know all. Folks who read the last page first usually are sports enthusiasts or the gossip goers, or have a tendency of objects reversal. These are the bunch of guys who would never buy a book if the back cover page has no thrills.

My time with the paper starts with solving the ‘Su-do-ku’ puzzle. It’s an old notion that if you begin your day with a puzzle you can crack anything as complicated as or more complicated than that. & that is the reason why ‘Sudoku loo rolls’ are rocking these days. But today it wasn’t the same; the headlines had taken my attention.

“Dr.Padmanabhan, Director of MIND asked to resign”

It was big news, shocking as well. You might wonder how on earth this can happen without me even having a clue about it. You see I am considered as ‘detached and emotionless’ at workplace. Losing parents few years back at a road accident might be the cause. Having no one to talk to other than gypsy my dog would also be another indication. But as long as I have no issues with me being secluded, I guess it should be fine.

“Bangalore Nov 1st, according to latest reports Dr.Padmanabhan of MIND, the mental asylum was asked to resign from the post of ‘Director’ by the higher authorities. He has been the director of the hospital for 3 years. He was not available for any questions. Other sources reveal that the ex-director was suffereing from “Neurasthenia”. Dr.Padmanabhan retired from MINHAMS, government hospital for mental illness 3 years back. He later went ahead to join MIND. He is preceded by Dr.Lohith who currently resides in United States of America” read the report.

So exit of the influential Dr.Padmanabhan and coming of Dr.Lohith as the new director of MIND. That’s lots of news to digest.

Should I call him? But what kind of conversation can I have in such situation. & what is this “Neurasthenia” thing the paper is talking about. All I knew was he was on a vacation with his family and hence out of town for a month.
‘You have a call’ uttered my blackberry.

It was the director calling.

A little skeptical but yet I picked the phone “Hello sir, Good Morning”

Will Be Continued