• 17 Jul
    Dr. KV Anand

    Grief: The Venture towards Resilience and adjustment


    Grief is an emotional response to a loss. It involves different stages usually; include anger, denial, depression, bargaining, and acceptance (Kubler-Ross, 1969).

    Albeit numerous individuals experience these phases in a genuinely predictable order, there is extensive overlap among the stages.

    Working through the phases of misery can in the end lead to the positive results of recuperation, determination, and flexibility. Notwithstanding, these results resemble a far off shore when one is suffocating in those first effective rushes of pain.

     In comprehension the journey from deprivation and grief to determination and resilience, it might be useful to see a portion of the procedures included. Mourning alludes to the condition of being that outcome from a huge misfortune.

    It envelops an extensive variety of responses - cognitive, behavioral, physical, and spiritual. Grief alludes to the inward procedure of recapturing harmony.

    It requires revamping on both emotional and cognitive levels, and incorporates a re-assessment of spiritual concerns.  


    Anticipatory grief alludes to grief that happens to proceed the misfortune. While it doesn't set one up for the misfortune, anticipatory grief allows time for determination of a few issues.

    Consequently, the sudden death of a friend or family member is especially troublesome for the survivors since it doesn't give at whatever time to expectant distress.


    Mourning refers to the general society articulation of grief, including religious customs, which can change extensively by society.

    Though the experience of sorrow is interior, private, and individualistic in nature, the way toward grieving is more outer, open, and social in expression..

    Commemoration responses allude to encounters of the pain reaction at certain huge times, even after there has been determination of melancholy.

    Grief is not for the most part considered a turmoil, but instead is seen as an adjustment to a misfortune. In this regard, the way toward lamenting is like the way toward healing.

    It includes working through the phases of distress. The tasks of lamenting incorporate encountering the agony of despondency, tolerating the truth of the misfortune, changing in accordance with a domain in which the cherished one is missing and pulling back one's passionate vitality and reinvesting it in another relationship.

    Inability to finish these tasks can bring about affected sorrow, which is a drawn out kind of depression connected with despondency.

    Affected grief can block further development and growth. For instance, the nonattendance of family or social backing amid mourning can complicate the process of grieving.

    Some of the early cautioning indications of unresolved grief are as per the following: 

    - Dodging the funeral, not going by the grave site, or not taking part in different rituals.

    - Not having the capacity to discuss of the lost adored one without encountering exceptional pain.

    - Encountering an extraordinary despondency response activated by some moderately minor occasion.

    - Seeing that the subjects of misfortune appear to come up every now and again in easygoing discussions. 

    - A powerlessness or unwillingness to move material belonging to the adored one.

    - Feeling constrained to impersonate or tackle propensities or identity attributes of the cherished one.


    The resolution of grief requires tolerating the truth of the misfortune, intellectually and emotionally, and rearranging the features of life despite the misfortune.

    Be that as it may, determination is not a return to the "old self." One never truly comes back to his or her previous self. Rather, one joins the experience into what in the end turns into another self.  

    Achieving resolution requires working through grief, which requires some time. Although the time required for mending may shift from individual to individual, the way toward healing includes a few essential tasks.

    The tasks depicted beneath can happen in a pretty much methodical way, in spite of the fact that there are extensive overlaps among the tasks.


    Encountering the emotional pain of the death. The agony and enduring of grief are not overcome by maintaining a strategic distance from pain, but instead by encountering and working through the pain.

    Albeit one's first reaction to a heartbreaking misfortune may include numbness or feeling nothing by any stretch of the imagination, one's first task includes the simple however apparently unconquerable assignment of encountering the agony of the misfortune.


    Discussing the loved one and the misfortune. At some point or another, encountering the pain of misfortune includes discussing the cherished one who has been lost.

    It is often a story that must be told again and again. However, there is an excruciating oddity to grief. Some of the time the family and companions that one has relied on the most in life are not by any means accessible, yet colleagues and even outsiders that one doesn't rely on at all may appear to be the most prepared to tune in.

    In any occasion, having contact with the individuals who care, especially the individuals who likewise knew and thought about the adored one, encourages the way toward sharing. 


    Incorporating the positive and the negative. To start with, the lost cherished one might be idealized so that the survivor recalls just the positive, while existence without the adored one might be vacant, forlorn, and depressing.

    At different times, one's memory of troublesome times in the past may bring an unforeseen grin. As one keeps on sharing the stories, and starts to encounter an alternate kind of life, the sharp complexities of highly contrasting will in the long run converge into more practical shades of gray.

    In the long run, the brilliant recollections of the past can get to be consoling indications of hope and joy. 


    Tolerating the reality of the misfortune. Despite the fact that there is no timetable, the shock of losing the adored one will in the end begin wearing off, and the truth of loneliness will start setting in.

    As one keeps on trudging along the way toward recuperation, stepping toward making another life once more, acknowledgment of another reality gradually starts to emerge. 


    Discovering significance in the experience. The grieving person will be able to find a meaning in his tormenting experience, a meaning which will propel him towards a meaningful further life.


    Gradual diminishing  of the emotional agony. At the beginning, the influxes of grief are powerful, regularly thumping one down in what may appear like a spirit pulverizing rout. After some time, the influxes get to be smaller and smaller, while the times of calm turn out to be longer and more.

    In the long run, there will come minutes when the waves are a delicate memory. 

    The excruciating experience of lamenting a misfortune can in the end lead to the positive results of recuperation, determination, and resilience.

    Recuperation includes the cognizant procedure of working through the phases of grief. Determination alludes to the possible result of tolerating the truth of the misfortune, psychologically and inwardly, and rearranging the aspects of life.

    Resilience refers to one's sure ability to adapt to future emergencies and even catastrophe. 

    While numerous individuals finish the undertakings of grieving all alone, the procedure of recuperation can regularly be encouraged by chatting with a psychologist who has prepared and involved in counseling.

    Despite the fact that there are no easy routes, there are some viable methods for working through the phases of grief and finding positive results that are not really conceivable when one is suffocating in those first powerful waves of grief.



    Frankl dies at age 92. (1997, November). Monitor on Psychology, 28(11), 46.

    Engel, G. (1961). Is grief a disease? Psychosomatic Medicine, 23, 18–22.

    Bonanno, G. A., & Kaltman, S. (1999). Toward an integrative perspective on bereavement. Psychological Bulletin, 125(6), 1004-1008.

    Kubler-Ross, E. (1969). Death and dying. New York: Macmillan.

    Lewis, C. S. (1961). A grief observed. San Francisco: Harper.

    Frankl, Viktor E. (1969). Man’s search for meaning: An introduction to logotherapy. New York: Washington Square Press.

    Kushner, H. (1981). When bad things happen to good people. New York: Avon Books.


  • 14 Jul
    Oyindrila Basu

    Anorexic often equate thinness with self-worth.


    Anorexia refers to an eating disorder which comes from starving; when people are obsessed with the idea of losing weight and becoming thin, they tend to shift towards an unhealthy diet plan, where they skip meals, eat extremely less and remain undernourished. As a result, they face tremendous weight loss and bear a skeletal structure.

    'Anorexia isn’t really about food. It’s an unhealthy way to try to cope with emotional problems.

    Usually physical symptoms are-

    • Extreme weight loss
    • Fatigue
    • Tiredness
    • Nausea
    • Low haemoglobin
    • Insomnia
    • Dehydration
    • Osteoporosis
    • Delayed menstruation
    • Constipation
    • Yellowing of skin.

    Women are more prone to this disorder, because physical appearance, weight etc. are matters of graver concern for them, due to social and traditional definition of beauty,  which promotes that a skinny figure is more appealing while the quotient of a beautiful body is concerned.

    Hence women are often obsessive-compulsive about abandoning fat from their foods and shedding calories.

    In that attempt, they never have enough even if they are hungry and this leads to a loss of appetite, which never builds up again, and this also disturbs the digestive system.

    Initially it was believed, that anorexia psychologically associates with the ‘fear of becoming fat’ but recently, studies have proved that it is more about the ‘pleasure of becoming thin’.

    It has been observed that women with anorexia love the concept of shedding some extra fat calories, and they are really excited to see thin people, who are underweight.

    The study was carried out by researchers from Paris-Descartes University and INSERM UMR in France, and the University of Ulm in Germany.

    71 women with and without anorexia were shown images of people with different body weights. Subjects who were normal weight and slightly overweight did not react much; however, subjects with anorexia were joyful and over excited on seeing images of thin skinny people, who were underweight and never reacted as much to those of healthy people’s images.

    The idea of becoming thin gave them pleasure.

    There can be genetic reasons for anorexia. Some people might be prim and proper and a lover of perfection hereditarily. Perfectionism about their looks, especially figure lead them to quit food and this can have drastic effects.

    Besides psychological factors cannot be neglected. A person who loves everything to be just right, cannot compromise with his/her weight. They resort to impractical and unrealistic weight loss plans which only lead to anorexia.

    A patient never realise when the fear of getting fat actually changes to pleasure in losing weight. When a person with anorexia observes him/herself getting thin, they enjoy the moment, and hence continue the practice.

    Motivation towards losing weight is good, but increased motivation results in unrealistic weight management goals which can be hazardous to health.

    Professor Gorwood and his team conclude that future research should be geared towards reward systems rather than phobic avoidance.

    A psychological cure is significantly required to get rid of the disorder.

    Beware of anorexia when you observe these things-

    • Obsessive concern with weight
    • Avoiding food in public
    • Making excuses for not eating
    • Obsession with calorie count
    • Visiting sites which talk about food and calorie relation
    • Checking weight on machines regularly
    • Posting images with weigh loss mention on social networking sites etc.

    Counselling can always help. We have discussed on this earlier in Obsession with weight can lead to anorexia in teenagers.

    Psychologically, you have to be confident of yourself and appreciate the way you are, then you can avoid changing your shape and size; you need to be healthy and happy above everything else.


  • 12 Jul
    eWellness Expert

    Spontaneous Self-Affirmation adds to your Mental Wellness.


    Self-affirmation refers to a recognition and acceptance of the self or existence itself in a positive way.

    A person develops values and principles that are relevant to him or her and identifies him/herself with it; when those values are confronted with alternate views that seems to threaten their belief of self, they react defensively; such people who learn to agree with themselves strongly tend to be happier individuals.

    Self-affirmation theory is a psychological theory that focuses on how individuals adapt to information or experiences that are threatening to their self-concept. Claude Steele originally popularized self-affirmation theory in the late 1980s, and it remains a well-studied theory in social psychological research, though it was preached by French psychologist Emile Coué back in 1920s.

    Knowing yourself is important, valuing your capability is very significant for personal development.

    When you say ‘I can’, you actually cross many hurdles, towards your goal.

    Many such positive statements spoken to self can help a person progress in different fields, from growing business, education, weight loss to social communication.

    When you are content with yourself and satisfied with your abilities, you tend to be stress free.

    "An emerging set of published studies suggest that a brief self-affirmation activity at the beginning of a school term can boost academic grade-point averages in underperforming kids at the end of the semester. This new work suggests a mechanism for these studies, showing self-affirmation effects on actual problem-solving performance under pressure," said J. David Creswell, assistant professor of psychology in CMU's Dietrich College of Humanities and Social Sciences.

    A recent survey performed by the Health Information National Trends Survey 2013, on US adults proved that optimism is directly related to good mental health.

    Even cancer survivors were evaluated as control group to gain a deeper understanding of spontaneous self-affirmation.

    Results showed that participants higher in optimism reported better health on nearly all indices examined, even when controlling for SSA. Participants higher in SSA reported lower likelihood of cognitive impairment, greater happiness and hopefulness, and greater likelihood of cancer information seeking. SSA remained significantly associated with greater hopefulness.

    We have already discussed in our article You are worthy, love yourself that loving yourself is very important to stay happy.

    Spontaneous self-affirmation gives high self-esteem, which helps in developing immense confidence within a person.


    How will you develop a spontaneous self-affirmation?

    The more you bother about others’ opinion, the more you are likely to get nervous, anxious and upset. This not only affects your mental wellness but also your cognitive abilities to task in situations.

    However, to believe in yourself, you need to be honest and positive.

    Develop good humour; that will help you to fight with all kinds of odd situations with a brave face.

    Increase your knowledge; read more to know more, when you have the backing of knowledge and wisdom with you, you will be more confident in any kind of discussion or conversation; you can easily say to yourself, “I know better than anyone else”.

    Exercising has always proved to be a positive booster. It helps you remain fit, and when you are physically fit, you automatically feel confident.

    Look towards the brighter side of things. Appreciate the good qualities in you. There is nothing wrong in saying “I am good”, that gives you happiness; for why should your estimation depend on someone else!

    Defend yourself in a positive way, enjoy every moment of your life, being your best friend.

    References 1 2 3 4


  • 09 Jul

    The comprehensive guide of Depression treatment options


                Depression, for those who have suffered from it, would seem to have had its origins in sin and past life guilt and, for those who have been treated and have gotten better, would seem like any other illness worth taking a chance with the doctor and having benefited from it. 

    psychological problem are so hard to have someone be convinced for treatment primarily because these problems are so subjective and therefore difficult to detect, except for the experienced psychiatrist or psychologist, and also there are no numbers to give these illnesses some amount of objectivity. 

    Treatment of depression is therefore challenging to say the least and to say that they are not insurmountable would be an understatement, especially with the plethora of remedies we currently have for treating depression.


                Before we start off on a journey of knowing what to do when a person is depressed, we need to know what depression is. 

    Depression is a clinical syndrome of a cluster of symptoms including but not limited to sadness of mood, loss in interest in things or activities that were previously cherished, feelings of guilt that are not necessarily real, loss of energy or lethargy, difficulties in concentration, difficulties in appetite and sleep, and suicidal ideations.


    Are there Natural remedies?


                There are many natural remedies for depression that are described in medical textbooks as well. 

    We all know about the importance of exercise for physical health; however, we seldom consider it as important for mental health as it should be. 

    A daily routine of exercises, mild to moderate, or at regular intervals if the exercise is strenuous for example ever 2-3 days a week. 

    There is no set regimen, which means that you are at your own will to choose what is comfortable for you.  The bottom-line being that, you need to do it without fail. 

    An example of an exercise routine for someone going to the gym would be 40 minutes of exercise involving initial stretching and 20 minutes each of isometric and isotonic exercise. 

    This would involve both weights and cardio training. 

    The science behind exercising is that it releases hormones in the brain called endorphins. 

    Endorphins are opiate receptor binding hormones that cause pain relief as well as happiness.


                Food has been related to health in general and again people would mostly think about food for physical health. 

    Although food is helpful when a diet is maintained for physical health it is also very beneficial with regards to mental health. 

    As such foods that are rich in multivitamins and multi-mineral micronutrients are helpful for depression. 

    Food rich in omega-3 fatty acids are recommended.  Evidence also suggests that foods that contain these substances for example certain kinds of fish are good to include in the diet plan of depressed people since it alleviates depressive symptoms. 

    Antioxidant rich foods (i.e. foods rich in Vitamin E, Vitamin C and beta carotene) are helpful in depression and other psychological problem . 

    Complex carbohydrate rich food is also recommended in depression.  The Mediterranean diet is a balanced, healthy eating pattern that includes plenty of fruits, nuts, vegetables, cereals, legumes, and fish. 

    Calcium and Vitamin D is also linked to better mental health especially in those who do not have enough sunlight exposure either because of sunlight being deficient or for those who cover themselves while outside due to cultural or seasonal necessities. 

    Selenium rich foods such as nuts in limited amounts are also known to treat depression.


                Making lifestyle changes may also help in symptom relief for depressed persons. 

    If one is in the habit of a regular substance use such as alcohol or other drugs, this in itself may contribute to depression. 

    It is highly recommended that you go off of alcohol or substances if that is the case. 

    Sometimes combination of these addictive substances along with medications for depression given by a psychiatrist may render the antidepressants useless.  Certain other foods like caffeine when taken in excess and closer to bedtime may interfere with sleep and precipitate depressive features as well as anxiety. 

    In such cases cutting down on caffeinated beverages especially the one closer to the bedtime or decreasing the total amount of caffeine consumed per day may be beneficial.


    Are there medications to help depressed patients?


    There are many medications in the armamentarium of a psychiatrist that can help alleviate the depressive symptoms. 

    Many of these medications have evidence with regards to their being better than nothing at all for treatment of depression. 

    Hence, if a person is suffering from depressive symptoms despite taking up non-medication measures to help with depression, medications are a sure way to seek help. 

    All medications should be taken under the supervision of a qualified psychiatrist. 

    Medications for depression, like the medications for any other illnesses, have side effects and these side effects differ for different people. 

    Therefore a good judge of the kind of medication one needs for their depression would be a psychiatrist. 

    Please consult a psychiatrist for a thorough evaluation and medication management for depression.


    A common question that patients in particular and people in general have about medications for depression, especially and for psychological problems broadly is that of efficacy and effectiveness. 

    Another question is about the possibility of “addiction” to these medications. 

    To allay any anxiety about antidepressant medications – these mood elevator medications are not addictive and they have proven efficacy and a lot of evidence for their effectiveness. 

    Different people need different medications for depression and these medications may need to be titrated over time to help optimize their dosages for good response. 

    The ideal goal of treatment is - remission, which is to say that the aim of treatment is to completely rid the patient of all symptoms of depression and have the patients come back to baseline in terms of their functionality.


    How about talk therapy?


                Yes, psychotherapy or counseling as it is otherwise called is one of the treatments of depression. 

    There are various kinds of psychotherapy for example Inter-Personal Therapy (IPT), Cognitive Therapy (CT), Behavioral therapy (BT), Cognitive Behavioral Therapy (CBT), Psychodynamic psychotherapy, etc. 

    Evidence exists in literature that a combination of psychotherapy and medication management for depression is better than either of these modalities on their own.           

  • 09 Jul

    Vaginismus and Depression in Women

    vaginismus and depression in women

    Apart from the cyclical changes in both physiological and psychological terms that women have to endure and become resilient, women also need to change to external circumstances.  

    They are probably designed to be flexible enough for change.  However, depression can get the better of even the so called toughest woman and it is something that can be treated to the fullest degree.  

    Among the various symptoms of depression that are easily modified with medications, the one symptoms that is rarely discussed is that of sexual problems or sexual disinterest due to physical causes resulting in depression.  

    A specific sexual disturbance that comes to the fore especially during the initiation of first sexual contact or encounter is that of dyspareunia.  Dyspareunia is the difficulty to perform sexual acts due to pain or discomfort either in the male or the female.  And the female version of dyspareunia is called vaginismus.  

    So vaginismus is the condition where pain and spasms occur as a result of physical contact or pressure during sexual intercourse. 

    There are various successful vaginismus treatments that do not require medications, surgical operations, psychotherapeutic measures, nor any other complex interventional procedures.


    Vaginismus is treatable and the success rates are quite high. 


    Among the most effective treatment approaches are a combination of pelvic floor control exercises very commonly known as kegel exercises, insertion or dilation training using objects that are specific to the sexual treatment procedures, pain elimination techniques using psychotherapeutic measures like exposure and response prevention, transition steps with incremental tolerance to pain and enjoyment of the act, and exercises designed to help women identify, express and resolve any contributing emotional components either from the past experiences or from ill-informed sexual learning experiences which are mostly hearsay.


    Treatment can often be done by the woman at the privilege of confidentiality at home, allowing a woman to work at her own pace in privacy, or in cooperation with her health care provider.

    The sexual pain, tightness and penetration difficulties that are due to vaginismus are completely treatable and can be fully overcome with no remaining pain or discomfort, over the course of time.


    Women experiencing pain or tightness during sexual activities, penile penetration problems including unconsummated relationships, can expect a very high degree of resolution of their vaginismus. This would allow for full pain free and adequate intercourse to the satisfaction of both partners.


    Vaginismus treatment exercises follow a manageable, step-by-step process


    Step 1 – Understanding Vaginismus

    It is a mostly educational part where the patient is provided education about vaginismus and the various causes of the condition.  It provides an overview of vaginismus and how sexual pain, tightness, burning sensations or penetration difficulties may result from it. This helps women to get started by being proactive about their sexual health as understanding vaginismus is fundamental to the process of overcoming it.


    Step 2 – Sexual History Review & Treatment Strategies

    A balanced approach is taken to help women review and analyze their sexual history. Exercises help identify and evaluate any events, emotions, or triggers contributing to vaginismus sexual pain or penetration problems. Checklists map out the woman’s sexual history.  Topics also include blocked or hidden memories and how to move forward when there have been traumatic events in a woman’s past.


    Step 3 – Sexual Pain Anatomy

    Psychoeducation about sexual anatomy and function can also help alleviate many misconceptions about the causes of vaginismus. The causes of pelvic pain and penile penetration problems, may become overt and an understand of the same is helpful in diagnosis of the condition and treatment. Confusion regarding problems with inner vaginal areas and vaginal muscles frequently lead to misdiagnosis and frustration. Topics include how to distinguish what kind of pain or discomfort is normal with first-time or ongoing sex and what physical changes take place during arousal to orgasm cycles in the context of sexual pain or penetration problems. Anatomy areas such as the hymen and inner vulva are explained.


    Step 4 – Vaginal Tightness & The Role of Pelvic Floor Muscles 

    Female sexual pain and penetration difficulties typically involve some degree of involuntary tightening of the pelvic floor. This step focuses on the role of pelvic floor muscles, especially the pubococcygeus (PC) muscle group, explaining in great detail how once they are triggered they continue to cause involuntary tightness with attempts at intercourse. Effective vaginismus treatment focuses on retraining the pelvic floor to eliminate involuntary muscle reactions that produce tightness or pain. Learning how to identify, selectively control, exercise and retrain the pelvic muscles to reduce pain and alleviate penetration tightness and difficulties is an important step in vaginismus treatment.


    Step 5 – Insertion Techniques

    For women with penetration difficulties or pain, techniques must be learned to allow initial entry without pain. In this step, women practice pubococcygeus (PC) muscle control techniques as they allow the entry of a small object (cotton swab, tampon, or finger) into their vagina, working completely under their control and pace. Any involuntary muscle contractions that had previously closed the entrance to the vagina and prevented penetration are overridden. Women begin to take full control over their pelvic floor and learn how to flex and relax the pelvic floor at will, eliminating unwanted tightness and allowing entry.


    Step 6 – Graduated Vaginal Insertions 

    When used properly, vaginal dilators are effective tools to further help eliminate pelvic tightness due to vaginismus. Dilators provide a substitute means to trigger pelvic muscle reactions. The effective dilator exercises in Step 6 teach women how to override involuntary contractions, relaxing the pelvic floor so it responds correctly to sexual penetration. Graduated vaginal insertion exercises allow women to comfortably transition to the stage where they are ready for intercourse without pain or discomfort.


    Step 7 – Sensate Focus & Techniques for Couples To Reduce Pelvic Floor Tension

    Helping with the transition to pain-free intercourse, this step explains sensate focus techniques for couples to use to reduce pelvic floor tension and increase intimacy. Couples begin to work together during this step as exercises teach how to successfully practice sensate focus (controlled sensual touch) and prepare for pain-free intercourse using techniques from earlier steps. The exercises are designed to build trust and understanding and assist in the process to adjust to controlled intercourse without pain.


    Step 8 – Pre-Intercourse Readiness Exercises

    Finalizing preparations for couples to transition to fully pain-free intercourse, this step completes pre-intercourse readiness. Couples review and practice techniques that eliminate pelvic floor tension and prepare to transition to full intercourse. Preparing ahead of time to be able to manage, control and eliminate pain or penetration difficulties, the exercises assist with the final transition to pain-free intercourse.


    Step 9 – Making The Transition to Intercourse

    Step 9 explains the techniques used to eliminate pain and penetration difficulties while transitioning to normal intercourse. Many troubleshooting topics are covered (with supporting diagrams) such as positions to use to maximize control and minimize pain, tips to ensure more comfortable intercourse, etc.


    Step 10 – Full Pain-Free Intercourse & Pleasure Restoration

    The final step toward overcoming vaginismus includes penis entry with movement and freedom from any pain or tightness. Step 10 exercises are designed to educate, build sexual trust and intimacy, and complete the transition to full sexual intercourse free of pain. Couples can begin to enjoy pleasure with intercourse, initiate family planning, and move forward to live life free from vaginismus.




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