Learning Disabilities

Learning Disability (LD)


Learning Disability is an individual’s academic under achievement in reading, writing and mathematics despite the presence of average to above average intelligence, appropriate instruction, regular school attendance and favorable environment. Approximately 10% – 12% children are estimated to have specific learning problems out of which 4.6% of school aged children are identified severely disabled. LD is more in boys than girls with a ratio of 4:1.


Characteristics of a child with Learning Disabilities (LD)

  • He/she is intelligent but fails at school.
  • Writes ‘on’ for ‘no’, ‘was’ for ‘saw’, ‘14’ as ‘41’.
  • Hears the barking of a dog at distance but does not hear what the teachers say.
  • Remembers the sequence of TV serials or cartoons but does not remember mathematical tables.
  • Confusions about yesterday, today and tomorrow.
  • Mood swings.
  • Disorganized ad lazy.
  • Poor time management.
  • Enthusiastic about finishing particular task in academics but it comes out all wrong.
  • Omits, add or skip words while reading.
  • Do mathematical calculations in his/her mind but cannot put down on paper.
  • Unable to sustain attention on a given task for a specific duration of time.
  • Calls himself stupid or idiot.

Causes of LD

    • Prenatal factors- malnutrition, brain injuries, prolonged labour, accidents, anoxia, bleeding, toxemia, pre maturity and low birth weight.
    • Postnatal factors- neurological damage, seizures, chronic ear infections and encephalitis or meningitis.
    • Genetic factors
    • Biochemical factors- hypoglycemia, hypothyroidism, serotonin/dopamine variations.
    • Psychological factors- mental illness
    • Nutritional deficiencies

Types of LD

  • Dyslexia (Reading Disability)

Dyslexia is a Greek word, ‘Dys’ means difficulty and ‘lexia’ means words i.e. difficulty with words or language. Children with reading disability have difficulties in reading skills that are unexpected in relation to age, cognitive ability, quantity and quality of instruction and intervention.

Signs of dyslexia:

  • Reversal of letters; words and sometimes entire sentence.
  • Sounds are confused [empty- entry].
  • Concepts are reversed [floor for ceiling; cake for bread]
  • Reading rate is low
  • Omission of letters, syllables, words or word endings.
  • Addition of sounds or words in sentences (ischool / school).
  • Substitution of words / letter (home / house, ise cream / ice cream.
  • Mispronouncing words / letter (joo / zoo).
  • Transposing of order of words in a sentence.


  • Dysgraphia (Writing Disability)

Dysgraphia is a learning disability that causes individuals to experience difficulty when expressing their thoughts in writing and graphing. Students with dysgraphia have strong verbal skills but poor writing skills, random punctuations and spelling errors, illegible writing, unfinished words or letters, cramped or unusual grip, labored copying or writing or inconsistencies within the writing (print/cursive, upper/lower case).  

Signs of Dysgraphia:

  • Odd wrist, body and paper position.
  • Poor organization on the page
  • Mixture of print and cursive, upper and lower case or irregular size, shape or slant of letters.
  • Inconsistent space between words and letters.
  • Excessive erasures.
  • Decreased speed of writing / copying / inattentiveness about details when writing.
  • Holding the writing instrument very close to the paper.
  • Cramped or unusual grip and writing from the wrist.


  • Dyscalculia (Math Disability)

Dyscalculia is specific learning disability involving innate difficulty in learning or comprehending simple arithmetic. It includes how to manipulate numbers, difficulty in understanding numbers, learning math’s facts and a number of other related symptoms.

Signs of Dyscalculia:

  • Difficulties in relating the number of objects to its symbol, written or verbal.
  • Difficulty in pointing to small /big, more / less, tall / short when asked.
  • Difficulty to show that parts put together make a whole.
  • Difficulty in arranging / grouping objects by size / shape / color.
  • Reversal of numbers (45 for 54, 503 for 305)
  • Difficulty in copying numbers.
  • Difficulty in understanding concepts of units/tens/hundred in numbers
  • Difficulty in making judgment and reasoning.

Identification of LD

Children with signs of learning disabilities need to consult a trained Psychologist / Clinical psychologist for the assessment of specific learning disabilities. They used standardized psychometric tests to confirm  LD. Intelligence tests and learning disability assessment tools are used to find whether the child is learning disabled or not.


A multi-disciplinary team including Psychologist, Special educator, Occupational therapist, Speech therapist, Child Psychiatrist, Teachers and parents works in coordination make significant contribution in dealing with problems of children with LD.

Specific intervention strategies are used to help the students to achieve success in the areas of reading, writing, and math.

Screening Checklist for Learning Disabilities

Read the items listed carefully and put  for yes or X for No‟ against each item:


Oral expression

  • Has difficulty in orally expressing concepts that the child seems to understand
  • Has difficulty in pronouncing letters and words
  • Shows omission of words, phrases or both in reading

Written expression

  • Has difficulty with planning a topic and organizing the ideas
  • Has difficulty in answering various kind of questions in a question paper
  • Has difficulty with copying or completing work on a printed page

Hand writing

  • Has poorly formed letters (doesn’t complete the curves, loops of letters e.g. a, o etc)
  • Has inconsistent space between letters and words
  • Has difficulty in following lines on paper


  • Shows frequent spelling errors (e.g. omission or additions of letters in words)
  • Spells a word in several different ways(e.g. School as Skool, Shoocl, Skchool)
  • Reverses letters in spelling

Basic reading skills

  • Slow reading rate/ has difficulty modifying reading rate according to material being read
  • Substitution of words which look almost same in meaning
  • Reread words or phrases

Reading comprehension

  • Shows uneven comprehension and retention of material read
  • Has difficulty in recognizing words and its meaning
  • Unable to sort out important information from un important details

Mathematical calculations and Problem solving

  • Confuses operational symbols especially + and x
  • Has difficulty with the abstract concepts of time and direction
  • Poor long term memory in math functions

Organizational and study skills

  • Slow to start and complete tasks
  • Has difficulty in organizing and completing written tasks
  • Poor in time management

Attention and concentration

  • Has trouble focusing and sustaining attention on academic tasks
  • Has difficulty concentrate in reading and writing
  • Has problems in taking notes  or copying mathematics problems accurately

Fine and gross motor skills

  • Has trouble playing with block/beads, using spoon/ fork, coloring or copying shapes/ objects
  • Too much pressure on the paper while writing
  • Has difficulty in coloring, copying and drawing

Visual, auditory and tactile perception

  • Has trouble differentiating between similar letter and shapes (e.g. b and d, w and m, was and saw)
  • Moves head or points to words with finger while reading silently
  • Doesn’t hear fine differences in words

Social skills

  • Is unable to detect the difference between sincere and sarcastic comments
  • Has difficulty in maintaining good relationship between teachers and peer group
  • Unable to control emotions



Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is one of the most common childhood disorders and can continue through adolescence and adulthood. It is currently recognized as a disorder with behavioural, emotional, educational and cognitive aspects that impact on the life of a child with ADHD every day of the year. ADHD children face two major problems at school are poor scholastic performance and poor peer relations. Even bright and gifted children with ADHD may get poor grades because of their inability to concentrate and complete the tasks. ADHD also impairs memory. Many children with the disorder repeat a class or drop out of school.

ADHD symptoms can appear between the ages of 3 and 6 and can continue through adolescence and adulthood. It is more common in males than females. Females with ADHD are more likely to have problems primarily with inattention. Other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, and substance abuse, are common in people with ADHD.

Signs and Symptoms

Inattention and hyperactivity-impulsivity are the key behaviours of ADHD. Some children with ADHD only have problems with one of the behaviours, while others have both inattention and hyperactivity-impulsivity. Most children have the combined type of ADHD. In preschool the most common ADHD symptom is hyperactivity.

Inattention: –

Children with inattention may often:

  • Fails to pay attention to tasks or play, including conversations, lectures, or lengthy reading.
  • Difficulty in sustaining attention on tasks or play activities.
  • Not seem to listen what is being said to him/her.
  • Not follow through our instructions and fails to do schoolwork, chores and duties.
  • Difficulty in organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines.
  • Avoid or dislike tasks that require sustained mental effort, such as schoolwork or homework, preparing reports, completing forms or reviewing lengthy papers.
  • Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones.
  • Easily distracted by unrelated thoughts or stimuli.


Children with hyperactivity-impulsivity may often:

  • Fidget and squirm in their seats.
  • Leaves seat in classroom or in either situation when he is expected to be seated.
  • Run or climb excessively in situations where it is inappropriate.  
  • Be unable to play or engage in hobbies quietly.
  • Be constantly in motion or “on the go,” or act as if “driven by a motor”.
  • Talk nonstop.
  • Blurt out an answer before a question has been completed.
  • Have difficulty in waiting in queues.
  • Interrupt or intrude on others, for example in conversations, games, or activities.

Causes of ADHD

No one knows what causes ADHD. Like many other illnesses, a number of factors can contribute to ADHD, such as:

  • Genes
  • Lack of discipline
  • Conflict between parents
  • Parental neglect
  • Sibling rivalry
  • Exposure to environmental toxins during pregnancy
  • Low birth weight
  • Brain injuries
  • Birth complications


The most effective way to treat ADHD is a combination of following approaches.


Special Education:

A student with ADHD may require the support of a special educator in order to fully access the curriculum. The special educator may work as either a resource room teacher or in-class support teacher.


Behaviour Therapy:

Along with the academic support children with ADHD requires strategies for modifying undesirable behaviours. Positive and negative reinforcement, extinction, Schedules of reinforcement, modelling, shaping, time-out, response cost, and token reinforcement are commonly used techniques to treat ADHD. It enhances self-esteem and increases motivation in children.



ADHD medication may help to improve the ability to concentrate, control impulses, plan ahead and follow through with tasks.


Tips for parents:

  • Seek professional evaluation and treatment early.
  • Have consistent and reasonable expectations of your child.
  • Give the child clear directions and break up assignments into some small simple tasks.
  • Set up an effective discipline system.
  • Create a fixed routine and structure the day for your child.
  • Identify your child’s strengths and build on them. Children with ADHD are often creative, very energetic and have a high IQ.
  • Try to provide a quiet distraction-free environment for your child to study or play in.
  • Channelize your child’s energies in constructive physical activities.
  • Be sure to praise your child for his or her efforts, not just the outcome.
  • Tell your child that you love and support him or her unconditionally.

Childhood Anxiety

Childhood Anxiety

Anxiety disorders are among the most common mental health disorders in youth, affecting more than 10 percent of children and adolescents at some point in their development. Children with learning and attention issues may be even more likely than their peers to worry about school, social activities and change. Without treatment, childhood anxiety is likely to persist, negatively affecting a child’s social and family functioning and overall quality of life. Anxiety disorders increase the risk of adult disorders, including future anxiety as well as depression, substance use disorders and suicide.

Signs of Anxiety

Physical: –

  • Frequently complains of headaches or stomachaches, even though there’s no medical reason for them.
  • Refuses to eat snacks or lunch at school.
  • Restless, fidgety, hyperactive or distracted.
  • Starts to shake or sweat in intimidating situations.
  • Constantly tenses his muscles.
  • Has trouble falling or staying asleep.

Emotional: –

  • Cries often.
  • Acts extremely sensitive.
  • Becomes angry without any reason.
  • Afraid of making minor mistakes.
  • Has extreme test anxiety.
  • Has panic attacks (or is afraid of having panic attacks).
  • Has phobias and exaggerated fears.
  • Fear of learning and attention problems.
  • Worries about future.
  • Frequent nightmares about losing a parent or loved one.
  • Gets distracted from playing by his worries and fears.
  • Obsessive thoughts or compulsive behaviors (finger tapping, hand washing, etc.).


Behavioural: –

  • Avoids participating during class activities.
  • Remains silent or preoccupied when he’s expected to work with others.
  • Refuses to go to school.
  • Stays inside, alone, at lunch or recess.
  • Avoids social situations with peers after school or on weekends (extracurricular activities, birthday parties, etc.).
  • Refuses to speak to peers or strangers in stores, restaurants, etc.
  • Becomes emotional or angry when separating from parents or loved ones.
  • Constantly seeks approval from parents, teachers and friends.
  • Says “I can’t do it!” without a real reason.

Types of Anxiety

Separation Anxiety Disorder

Separation anxiety disorder is a condition in which a child becomes fearful and nervous when away from home or separated from a loved one usually a parent or other caregiver to whom the child is attached. Some children also develop physical symptoms, such as headaches or stomach aches at the thought of being separated. The fear of separation causes great distress to the child and may interfere with the child’s normal activities such as going to school or playing with other children.

Symptoms: –
  • An unrealistic and lasting worry that something bad will happen to the parent or caregiver if the child leaves.
  • An unrealistic and lasting worry that something bad will happen to the child if he or she leaves the caregiver.
  • Refusal to go to school in order to stay with the caregiver
  • Refusal to go to sleep without the caregiver being nearby or to sleep away from home
  • Fear of being alone
  • Nightmares about being separated
  • Bed Wetting
  • Complaints of physical symptoms, such as headaches, stomachaches, nausea or vomiting on school days.
  • Excessive crying, tantrums and social withdrawal 
Treatment: –

Psychotherapy is the main treatment approach for separation anxiety disorder. The focus of therapy is to help the child tolerate being separated from the caregiver without the separation causing distress or interfering with function. A type of therapy called cognitive behaviour therapy works to reshape the child’s thinking (cognition) so that the child’s behaviour becomes more appropriate. Family therapy also may help teach the family about the disorder and help family member’s better support the child during periods of anxiety. Anti-anxiety medications may be used to treat severe cases of separation anxiety disorder.


Social Anxiety Disorder

Children with social anxiety disorder feel symptoms of anxiety or fear in certain or all social situations, such as meeting new people, participate in co-curricular activities, answering a question in class. Doing everyday things in front of people such as eating or drinking in front of others or using a public restroom also causes anxiety or fear. The person is afraid that he or she will be humiliated, judged, and rejected. Some children with the disorder do not have anxiety in social situations but have performance anxiety instead. They feel physical symptoms of anxiety in situations such as giving a speech, playing a sports game, or dancing or playing a musical instrument on stage.

Symptoms: –
  • Sweat, tremble, feel a rapid heart rate, or feel their “mind going blank”
  • Feel nauseous or sick to their stomach
  • Show a rigid body posture, make little eye contact, or speak with an overly soft voice
  • Find it scary and difficult to be with other people, especially those they don’t already know and have a hard time talking to them even though they wish they could
  • Be very self-conscious in front of other people and feel embarrassed and awkward
  • Be very afraid that other people will judge them
  • Stay away from places where there are other people
Treatment: –

The first step to effective treatment is to have a diagnosis made by a Psychologist, Clinical psychologist or Psychiatrist. Social anxiety disorder is generally treated with psychotherapy medication or both.

Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about a variety of events. It is often accompanied by physical symptoms such as headaches, muscular tension, restlessness, heart palpitations, and stomach upset. Children and adolescents with GAD may worry excessively about their performance and competence at school or in sporting events, about personal safety and the safety of family members, or about natural disasters and future events.

The difference between normal feelings of anxiety and the presence of generalized anxiety disorder is that children with GAD worry more often and more intensely than other children in the same circumstances. Children with GAD tend to worry about the same things as their non-anxious peers but they do so in excess. These worries and associated symptoms cause significant distress and impair daily functioning. Children with GAD are often overly self-critical and avoid activities in which they feel that may not be able to perform perfectly. They also tend to seek frequent reassurance from caregivers, teachers, and others about their performance, although this reassurance only provides relief from their worries.

Treatment: –

Early identification and effective management can help reduce the severity of symptoms. Psychotherapeutic approaches, including cognitive-behavioral therapy, are among the most researched and promising treatments for childhood anxiety. In certain instances, medication in combination with psychotherapy may also recommend for treatment of generalized anxiety disorder.

School Refusal

School Refusal

Children with school refusal may complain of physical symptoms shortly before it is time to leave for school. If the child is allowed to stay home, the symptoms quickly disappear, only to reappear the next morning. In some cases a child may refuse to leave the house. Children who suffer from school refusal tend to have average or above-average intelligence. But they may develop serious educational or social problems if their fears and anxiety keep them away from school and friends for a long time.

Signs of school refusal: –

  • Frequent complaints of illness before or during school, such as stomach aches, headaches, nausea, diarrhea.
  • Tearfulness before school or repeated pleas to stay at home
  • Tantrums, clinginess or running away before school
  • Difficulty attending school after weekends, holidays, school camps or sports days
  • Long, unexplained absences from school
  • Periodic absences or missed classes for which no explanation is given
  • Frequent lateness to school
  • Long periods spent in the sick room 

Causes of school refusal: –

There are lots of reasons why a child might refuse school, and pinpointing the cause can be difficult. Often there are a number of factors that contribute to a child’s non-attendance. It is important to understand and address underlying issues when supporting children to return to school or attend consistently. The following factors might be involved in school refusal

  • Anxiety about social situations or activities that involve a performance or evaluation, such as sports days, speaking in front of the class or tests.
  • Anxiety around being separated from parents.
  • Academic problems or learning difficulties. 
  • Peer issues, such as social isolation, bullying or conflict with friends.
  • Difficulty or conflict with teachers
  • Traumatic events, such as family illness, grief or parental separation/divorce.
  • Difficulties with transition, such as moving to a new school, returning to school after a long absence due to illness or entering/exiting primary school.
  • Rewards inherent to staying at home, such as spending time with a parent, watching TV or playing video games. 

Treatment: –

If your child begins refusing to go to school, arrange a meeting with the school counselor, or with a therapist. Most kids who refuse school will need to talk through their concerns with a psychologist. Family therapy can also help your family find ways to support your child.

Tips for parents: –

  • Act as a supportive partner and listener.
  • Talking to your child about their reasons for not wanting to go to school.
  • Talking about positive aspects of school, such as friends or a favorite subject.
  • Meeting with your child’s teacher to discuss the problem.
  • Helping your child build a support system.



Anger is a completely normal, usually healthy, human emotion. But when it gets out of control and turns destructive, it can lead to problems—problems at work, in your personal relationships, and in the overall quality of your life. Like other emotions, it is accompanied by physiological and biological changes; when you get angry, your heart rate and blood pressure go up, as do the levels of your energy hormones, adrenaline, and noradrenaline.

Anger can be caused by both external and internal events. You could be angry at a specific person (such as a coworker or supervisor) or event (a traffic jam, a cancelled flight), or your anger could be caused by worrying or brooding about your personal problems. Memories of traumatic or enraging events can also trigger angry feelings.

The instinctive, natural way to express anger is to respond aggressively. Anger is a natural, adaptive response to threats; it inspires powerful, often aggressive, feelings and behaviours, which allow us to fight and to defend ourselves when we are attacked. A certain amount of anger, therefore, is necessary to our survival.

Approaches of anger

The three main approaches are expressing, suppressing, and calming.

  1. Expressing your angry feelings in an assertive—not aggressive—manner is the healthiest way to express anger. To do this, you have to learn how to make clear what your needs are, and how to get them met, without hurting others. Being assertive doesn’t mean being pushy or demanding; it means being respectful of yourself and others.
  2. Anger can be suppressed, and then converted or redirected. This happens when you hold in your anger, stop thinking about it, and focus on something positive. The aim is to inhibit or suppress your anger and convert it into more constructive behaviour. The danger in this type of response is that if it isn’t allowed outward expression, your anger can turn inward—on yourself. Anger turned inward may cause hypertension, high blood pressure, or depression.
  3. you can calm down inside. This means not just controlling your outward behaviour, but also controlling your internal responses, taking steps to lower your heart rate, calm yourself down, and let the feelings subside.


The goal of anger management is to reduce both your emotional feelings and the physiological arousal that anger causes. Strategies that are used to control anger are relaxation, cognitive restructuring, problem-solving, better communication, using humour, change environment, timing, avoidance, finding alternatives etc…



Substance Abuse

Psychoactive drugs act on the nervous system to alter our state of consciousness, modify our perceptions and change our mood. Human beings are attracted to psychoactive substances because they help them adapt to an ever-changing environment. Smoking, drinking and taking drugs reduce tension and frustration, relieve boredom and fatigue and in some cases help us escape from the harsh realities of the world. The use of psychoactive drugs for such personal gratification and temporary adaptation, however, can carry a high price tag: drug dependence, personal and social disorganization and a predisposition to serious and sometimes fatal diseases.

Commonly abused psychoactive substances are: –



Alcohol is the most widely drug used in our society. Alcohol acts upon the body primarily as a depressant and slows down the brain’s activities. As people drink more, their inhibitions become even further reduced and their judgements become increasingly impaired. Activities such as driving become impaired as more alcohol is consumed. Eventually, the drinker becomes drowsy and falls asleep. With extreme intoxication, a person may even lapse into a coma and die.

Alcoholism is a disorder that involves long-term, repeated, uncontrolled, compulsive and excessive use of alcoholic beverages that impairs the drinker’s health and social relationships. Alcohol intoxication can cause irritability, violent behaviour, feelings of depression and in rare cases hallucinations and delusions. Long-term escalating levels of alcohol consumption can produce tolerance as well as such intense adaptation of the body that cessation of use can precipitate a withdrawal syndrome marked by insomnia, feelings of anxiety and evidence of hyperactivity of the autonomic nervous system.



Nicotine is both a stimulant and sedative. It gives an immediate kick due to the discharge of epinephrine from the adrenal cortex. Stimulation is followed by depression and fatigue. Type of smoking whether, from a cigarette, pipe or cigar, chewing tobacco has the same effect. In chronic smokers nicotine levels tend to persist overnight, thus they are exposed to the effects of smoking for 24 hours. Stress and anxiety reduce the effect of smoking due to increased secretion of cortisol. Withdrawal symptoms begin within 24 hours and consists of craving, irritability, anger, anxiety, poor concentration, increased appetite, impairment in psychomotor and cognitive functions.



Cannabis commonly called as Charas, Hashish, Ganja and Marijuana. It is usually taken by smoking with tobacco or by eating it by mixing in food or drink. The clinical effects seen depend on the underlying mood. It exaggerates the preexisting mood whether of anxiety or happiness. The patient also has increased enjoyment or visual sensations and a sensation of time passing slowly. Long-term use impairs memory and learning. However, it does not cause dependence.



Opioids such as morphine, pethidine are used to relieve pain. The drugs produce euphoria or a sense of joy. Following this, there is a sense of relaxation with the user being alternately drowsy or awake. Thinking becomes slow due to depression of the brain. In high doses, opioids may cause death by stopping respiration. The drug is taken by injection or by chasing it i.e. by burning over a silver foil and inhaling the fumes. The drugs are very addicting and once dependent the patients are difficult to cure. Addicts taking the drug by injection route often share needles and syringes which are not sterile. Thus they are prone to get infections such as HIV, septicemia and endocarditis.


Solvents & Gases

Solvents & Gases include

  1. Industrial solvents such as paint thinners, degreasing fluids, gasoline and glues.
  2. Art or office supply solvents such as correction fluids, marker pen fluids and electronic contact cleaners.
  3. Gases such as butane and propane lighters, aerosols, deodorant sprays and fabric protector sprays.
  4. Medical gases such as ether, chloroform, halothane and nitrous oxide.

These are inhaled from containers and produce short-lasting intoxication and loss of inhibition. Repeated inhalations can cause organ damage. Inhalation of high concentrations can be fatal.


Individual therapy, family therapy, group therapy, relapse prevention, pharmacotherapy and rehabilitation are used to reduce the usage of addictive substances.



Personality disorders are deeply ingrained maladaptive patterns of behaviour manifested by the time of adolescence or earlier, which continue throughout adult life. The personality is abnormal either in the balance of its components, their quality and expression or in its total aspect. Because of this, the individual suffers or others have to suffer and there is an adverse effect on the individual or society.

Types of Personality disorders

  • Paranoid personality disorder: persons with paranoid personality disorder are characterized by long-standing suspiciousness and mistrust of persons in general. They refuse responsibility for their own feelings and assign responsibility to others. They are often hostile, irritable and angry.
  • Schizoid personality disorder: a pattern of detachment from social relationships and a limited range of emotional expression. A person with schizoid personality disorder typically does not seek close relationships, chooses solitary activities and appears indifferent to praise or criticism from others. These persons are often seen by others as eccentric, isolated or lonely
  • Schizotypal personality disorder:  there is a pervasive pattern of acute discomfort in close relationships, distortions in thinking or perception, and eccentric behaviour. A person with a schizotypal personality disorder may have odd beliefs or magical thinking, odd or peculiar behaviour or speech, or may incorrectly attribute meanings to events.
  • Antisocial personality disorder: this disorder is more common in men. A pattern of disregarding or violating the rights of others. A person with an antisocial personality disorder may not conform to social norms, may repeatedly lie or deceive others, or may act impulsively.
  • Borderline personality disorder: a pattern of instability in personal borderline personality disorder may go to great lengths to avoid abandonment (real or perceived), have recurrent suicidal behaviour, display inappropriate intense anger or have chronic feelings of emptiness.
  • Histrionic personality disorder: a pattern of excessive emotion and attention seeking. A person with a histrionic personality disorder may be uncomfortable when he/she is not the centre of attention, consistently use physical appearance to draw attention or show rapidly shifting or exaggerated emotions.
  • Narcissistic personality disorder: a pattern of need for admiration and lack of empathy for others. A person with a narcissistic personality disorder may have a grandiose sense of self-importance, a sense of entitlement, take advantage of others or lack empathy.
  • Avoidant personality disorder: a pattern of social inhibition, feelings of inadequacy and extreme sensitivity to criticism. A person with an avoidant personality disorder may be unwilling to get involved with people unless he/she is certain of being liked, be preoccupied with being criticized or rejected, or may view himself/herself as being inferior or socially inept.
  • Dependent personality disorder: a pattern of needing to be taken care of and submissive and clingy behaviour. A person with a dependent personality disorder may have difficulty making daily decisions without reassurance from others or may feel uncomfortable or helpless when alone because of fear of inability to take care of himself or herself.
  • Obsessive-compulsive personality disorder: a pattern of preoccupation with orderliness, perfectionism and control. A person with an obsessive-compulsive personality disorder may be preoccupied with details or schedules, may work excessively to the exclusion of leisure or friendships, or maybe inflexible in morality and values.


Psychotherapy and behaviour therapy are the main modes of treatment. Drugs are given only to treat short-acting mental illnesses which occur in between.

Psycho Somatic

A psychosomatic disorder is an illness that connects the mind and body. This occurs in such a way that the physiological functioning of the body is affected by the psychological tensions that either causes a disease or worsen the pre-existing disease in a person.

It is also known as a Psycho-physiologic disorder. An improper stimulation of the autonomic nervous system, which regulates the functions of the internal organs, is responsible for the evolution of this disorder and leads to impairment of the functional organs. A broad range of physical diseases and conditions may be especially prone to be made worse by mental factors. These include skin conditions such as eczema and psoriasis; high blood pressure; heart problems and more. Psychosomatic disorders frequently affect the respiratory and gastrointestinal systems as well as the cardiovascular system.

Psychosomatic disorders can have mild to severe effects on one’s quality of life, from interfering with the normal ability to function to cause physical or mental disability.

Types of psychosomatic disorder

There are three general categories of psychosomatic illness. In the first one, a person has both mental and physical illness, whose symptoms and management complicate each other. The second category involves a person who experiences mental issues due to the medical condition and its treatment. For example, patients feeling depressed because they have cancer and are taking treatment for it. The third kind is called somatoform disorder. It is a condition in which a person with mental illness experiences one or more physical symptoms, even if he does not have any associated medical condition. Somatoform illness is further classified as follows:

  • Hypochondriasis: This is a condition in which the individual has a pervasive fear of illness and disease.  Persons with this disorder overreact to a missed heartbeat, shortness of breath and a slight chest pain. They often change doctors, moving from one to another searching for a diagnosis that matches their own.
  • Conversion disorder: When a person who does not have any medical illness experiences neurological symptoms such as seizures, which have an effect on movement and senses, it is a conversion disorder.
  • Somatization disorder: Here, an individual feels frequent headaches and has diarrhoea, which does not have any relation to a serious medical condition.
  • Body dysmorphic disorder: A person gets stressed about the appearance of their bodies such as wrinkles and obesity. Here the person severely gets affected by anorexia.
  • Pain disorder: Here, a person senses severe pain over any part of the body, which might last for six months to one year, without any physical cause. For example, migraines, tension headaches, back pain, etc.


Cognitive behaviour therapy  (CBT) is often the treatment of choice for a psychosomatic disorder. This therapy helps patients learn new ways to cope with and solve their problems as they gain a deeper understanding of their condition or circumstances. Patients will also learn to set realistic life goals and identify and change behaviours or thoughts that have negative effects on their lives.



Depression is a common mental disorder involving persistent sadness and  loss of interest or pleasure accompanied by several of the following symptoms:  a loss of energy, a change in appetite, sleeping more or less, anxiety, reduced concentration, indecisiveness, restlessness, feelings of worthlessness, guilt, or hopelessness, and thoughts of self-harm or suicide. A person with depression considerable difficulty with daily functioning at home, school and work.

Depression is the leading cause of ill health and disability worldwide. According to the latest estimates from WHO, more than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015. Lack of support for people with mental disorders, coupled with a fear of stigma, prevent many from accessing the treatment they need to live healthy, productive lives.


  • Depressed mood most of the day
  • Loss of  interest and pleasure
  • Decreased activity
  • Weight loss
  • Loss of confidence or self-esteem
  • Unreasonable guilt
  • Recurrent thoughts of death and suicide
  • Diminished ability to think or concentrate
  • Change in psychomotor activity
  • Fatigue or loss of energy
  • Feelings of worthlessness
  • Sleep disturbances (insomnia/hypersomnia)


Interpersonal therapy, cognitive behavioural therapy and problem-solving treatment should be considered as a psychological treatment of depressive episode. Relaxation training and physical activities are also used to treat depressive episode/ disorder. In moderate and severe depression, problem-solving treatment should be considered as an adjunct to antidepressants.

Tips to manage depression

  • Talk to someone you trust about your feelings. Most people feel better after talking to someone who cares about them.
  • Seek professional help. Your local health-care worker or doctor is a good place to start.
  • Remember that with the right help, you can get better.
  • Keep up with activities that you used to enjoy when you were well.
  • Stay connected. Keep in contact with family and friends.
  • Exercise regularly, even if it’s just a short walk.
  • Stick to regular eating and sleeping habits.
  • Accept that you might have depression and adjust your expectations. You may not be able to accomplish as much as you do usually.
  • Avoid or restrict alcohol intake and refrain from using illicit drugs; they can worsen depression.
  • If you feel suicidal, contact someone for help immediately.


Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat.

Symptoms of Anxiety:

  • Sweating
  • Dizziness, light-headedness, or feeling faint
  • Trembling
  • Increased or irregular heartbeat
  • Back pain
  • Nausea or gastrointestinal problems
  • Restlessness and fatigue
  • Muscle tension
  • Being easily startled
  • Recurring and ongoing feelings of worry, with or without known stressors
  • Avoidance of certain situations that may cause worry, often affecting the quality of life


Major Anxiety Disorders

  • Generalized anxiety disorder (GAD): This is a chronic disorder involving excessive anxiety and worries about several events or activities for most days during at least a six month period. Symptoms of GAD are restlessness, easily fatigued, difficulty in concentrating, irritability, muscle tension, sleep disturbances and impairment in social, occupational and other daily functioning.
  • Panic disorder: Brief or sudden attacks of intense terror and apprehension characterize the panic disorder. These attacks can lead to shaking, confusion, dizziness, nausea, and breathing difficulties. Panic attacks tend to occur and escalate rapidly and peak after 10 minutes. However, they may last for hours. Symptoms of panic disorder are severe palpitations, pounding heart, sweating, trembling or shaking, extreme shortness of breath, feeling of choking, chest pain or discomfort, nausea or abdominal distress, feeling faint, derealization or depersonalization, fear of losing control, fear of dying, numbness etc…
  • Phobia: This is an irrational fear and avoidance of an object or situation. Phobias differ from other anxiety disorders, as they relate to a specific cause. The fear may be acknowledged as irrational or unnecessary, but the person is still unable to control the anxiety. Phobia comes in many forms. Some of the most common phobias are height, darkness, insects, animals blood, strangers etc…
  • Social anxiety disorder: This is a fear of being negatively judged by others in social situations or a fear of public embarrassment. This includes a range of feelings, such as stage fright, a fear of intimacy, and a fear of humiliation. This disorder can cause people to avoid public situations and human contact to the point that everyday living is rendered extremely difficult.
  • Obsessive-compulsive disorder (OCD): This is an anxiety disorder in which the individual has anxiety-provoking thoughts that will not go away (obsession) and urges to perform repetitive, ritualistic behaviours to prevent or produce some future situation  (compulsion). Individuals with OCD repeat and rehearse normal doubts and daily routines, sometimes hundreds of times a day.

The most common compulsions are excessive handwashing or taking bath, checking and counting.


  • Post-traumatic stress disorder (PTSD): This is anxiety that results from previous trauma such as military combat, sexual assault, natural disasters and accidents. Symptoms of PTSD are flashbacks, constricted ability to feel emotions, sleep disturbances, difficulties in memory and concentrations, feelings of apprehension and impulsive outbursts.



Treating a person with anxiety depends on the causes of the anxiety and individual preferences. Often, treatments will consist of a combination of psychotherapy, behavioural therapy, yoga therapy and medication.

There are several exercises and actions that are recommended to cope with this type of anxiety:

  • Stress management: Learning to manage stress can help limit potential triggers. Keep an eye on pressures and deadlines, compile lists to make daunting tasks more manageable, and commit to taking time off from study or work.
  • Relaxation techniques: Simple activities can be used to relax mental and physical signs of anxiety. These include meditation, deep breathing exercises, long baths and yoga asanas.
  • Exercises to replace negative thoughts with positive ones: Make a list of the negative thoughts you experience, and write down a list of positive, believable thoughts to replace them. Picturing yourself successfully facing and conquering a specific fear can also be beneficial if the anxiety symptoms are related to a specific cause.
  • Support network: Talk with a person who is supportive, such as a family member or friend.
  • Exercise: Physical exertion can improve self-image and release chemicals in the brain that trigger positive feelings.