Today depression is a significant health problem in India. Depressive disorders are primarily characterized by loss of interest in activities which were pleasurable before and a sad mood to the extent that it interferes with daily socio-occupational functions. It has varied presentations in different age groups, for example, children with depression can present with irritability, tantrums and poor academic performance, adults with sad mood and elderly with agitation, irritability and somatic complaints. Factors that contribute to the cause of depression are heredity in some cases, changes in neurotransmitter levels, altered neuroendocrine function, and psychosocial factors. Recognizing depression at an early stage is critical because if not treated it can lead to suicide. Depression is more common among lst-degree relatives of depressed patients.

Anxiety is different from anxiety disorders. Normal anxiety is beneficial for our survival as it helps us to be attentive to impending dangers. When anxiety is out of proportion to the situation considering the age, its called anxiety disorders. The causes of anxiety disorders involve a combination of factors including genetic, environmental, psychological and
developmental.

Types of Anxiety Disorder

• Generalized Anxiety Disorder:-In GAD the person has persistence and excessive worry about everything in life. They may be worried about theirjobs, family, children, and minor activities like meetings, repairs, cleaning, etc. This ongoing worry and tension may be accompanied by physical symptoms.
• Panic Diorder :-The core symptom of panic disorder is recurrent panic attacks, an overwhelming combination of physical and psychological distress. Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness and may go to a hospital ER. Phobias,
• Specific Disorder :-A specific phobia is an excessive and persistent fear of a specific object, situation or activity that is generally not harmful. Patients know their fear is unreasonable, but they can’t overcome it. These fears cause such distress that some people go to extreme lengths to avoid what they fear. Examples are fear of flying or fear of spiders.
• Agoraphobia :-Agoraphobia is the fear of being in situations (open spaces, crowd, enclosed places,
  transportation) where escape may be dif?cult or embarrassing, or help might not be available in the event of panic symptoms.
• Social Anxiety Disorder (social phobia) :-A person with a social anxiety disorder has significant anxiety and discomfort about being embarrassed, humiliated, rejected or looked down on in social interactions.
• Separation Anxiety Disorder :-A person with separation anxiety disorder is excessively fearful or anxious about separation from those with whom he or she is attached.
• Obsessive-Compulsive and Related Disorder :-It is an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.
• Posttraumatic stress disorder (PTSD) :-PTSD is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.

Treatment

Anxiety disorders are treated with medications and therapies like CBT, Acceptance and commitment therapy, EMDR, psychodrama and mindfulness therapy. EMDR is particularly helpful in PTSD.

Treatment For Addiction:-

The activation of the brain’s reward system is central to problems arising from psychoactive drug use. Psychoactive drugs are chemical substances that change a person’s mental state by affecting the way the brain and nervous system work. The rewarding feeling that people experience as a result of taking drugs may be so profound that they neglect other normal activities in favor of taking the drug. While the pharmacological mechanisms for each class of drug are different, the activation of the reward system is similar across substances in producing feelings of pleasure or euphoria, which is often referred to as a
“high.”

How do we know a person is addicted:-

• Cravings and urges to use the substance.

Reward system
https://www.youtube.com/watch?v=YzC,YuKX6zp8
https://youtu.be/7VUlKP4LDyQ

According to the American Society of Addiction Medicine (ASAM), this is the point at which
the pursuit of rewards becomes pathological:

• Reward-seeking becomes compulsive or impulsive.
• The behavior ceases to be pleasurable.
• The behavior no longer provides relief.

EMDR or Eye Movement Desensitization and Reprocessing is a therapy developed by Dr. Francine
Shapiro, an American psychologist. World Health Organization have indicated that trauma-focused
Cognitive Behavioral Therapy and EMDR are the only psychotherapies recommended for children,
adolescents and adults with a history of past trauma like PTSD. This therapy is based on the idea that
negative thoughts, feelings, and behaviors are the results of unprocessed memories. EMDR aims to
reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. According to
Dr. Shapiro, the goal of EMDR is to achieve the most profound and comprehensive treatment effects
possible in the shortest period of time, while maintaining client stability within a balanced system.

“Mindfulness means paying attention in a particular way; on purpose, in the present moment, and non-judgmentally.”

Through mindfulness training, we learn to be awake and be aware of each moment in our lives and to make a purposeful choice by being more open-minded and by observing ourselves and our environment with curiosity and non-judgmentally. It helps us to be more alive. It’s not that stressful moments stop existing in our daily lives but we learn to deal with such moments more effectively and purposefully. We move from an automatic mode to a conscious mode. We develop the capacity to choose our life path more consciously and purposefully.Research has shown that mindfulness training has helped not only people with mental illnesslike depression and anxiety disorders but also people with diabetes,

psoriasis, hypertension,asthma, coronary heart disease, bromyalgia, irritable bowel syndrome, headache. Accordingto William R. Marchand MD who is a psychiatrist and neuroscientist at the University of Utah,mindfulness is also helpful for bipolar disorder in addition to medications. Mindfulness canenhance performance at the workplace including sports. Mindfulness meditation can improve the immune system thereby boosting the ability to fight illness.

One of the most exciting studies in the last few years, carried out at Yale University, found that mindfulness practice decreases activity in the default mode network (DMN), the brain

network responsible for mind-wandering and self-referential thoughts – a.k.a., ”monkey mind.”
The DMN is “on” or active when we’re not thinking about anything in particular when our
minds are just wandering from thought to thought. Since mind-wandering is typically associated with being less happy, ruminating, and worrying about the past and future, it’s the goal for many people to dial it down. Several studies have shown that mindfulness, though its quieting effect on the DMN, appears to do just this.Mindfulness is for everyone young and old irrespective of social, economic, and cultural
background. As it is a mental state and a practice that has no religious connotations, people
across beliefs and faiths can experience mindfulness.

CBT was founded by Dr. Aron Beck. In depression and anxiety disorders, people experience a series of automatic negative thoughts relating to the self, to the world, and to the future. In CBT these negative thoughts are identified, challenged and re-evaluated. These led to a change in the pattern of the behavior in patients.

Psychodrama is an active form of group and individual therapy which as its means of expression makes use of speech and body language. There is no script, but scenes from a person’s life are enacted the way he or she experienced them. Psychodrama helps the patient, called a protagonist, to complete whatever he or she has been unable to do in reality. The person realizes the thoughts and emotions that inhibit him/her and also the new patterns of behavior that will help to express himself/herself freely.

Counseling is the process of assisting and guiding clients, especially by a trained person on a
professional basis, to resolve especially personal, social, or psychological problems and
difficulties. Counselors are less likely to be concerned with the past experiences of the client and instead focus on the problem at hand and how the client feel and think about it. The counselor helps the client to see the dif?cult issue in a way that makes them feel more positive.

In 1905 French psychologist Alfred Binet and his colleague, Simon developed the first test of Intelligence to screen students with learning problems. Over the years it was modi?ed, and new tests were designed. The term IQ or intelligence quotient was coined by a German Psychologist in 1912. In recent times it is being seen that the enthusiasm about intelligence tests was excessive. One’s intelligence attached to a number may predict performance in school subjects but definitely does not foretell success in later life. The intelligence test is more suited for children who go to school and more accustomed to paper-pencil tests featuring delineated answers. IQ tests are concerned about if one arrives at a correct answer without considering the process how one goes about solving a problem. The intelligence tests rely upon language, upon a person’s skill in de?ning words, mathematical calculations and reasoning.

What is a relationship? It just means the way two or more people think and feel about one another. We often think, especially with marriage, that the relationship is automatically developed after marriage. It’s not true. Marriages or any human connections do not work by itself. We have to make it work. The point most people miss is that the way we connect with others starts with the way we see ourselves. If we feel inferior or not worth or feel superior to others it will affect our behavior with others. Connecting with people also depends on several skills like listening to understand, communication, to let go, time management and many others. How we respond to criticism also determines how well we can get along with others. It has been seen that traumatic events of the past also negatively affect our relationship. So, relationship counseling is just not telling clients what to do and what not to do in a relationship. It’s about changing how one thinks about oneself, about others and developing some life skills.

Human children are the most helpless in the whole of the animal world and need a long period of care and support. Parenting in human beings is not only giving physical support to children but also supporting them emotionally and teaching them to be independent. Children need to be trained to develop the right values, take decisions and be responsible. They need to learn several life skills and find their passion. This is what will make them successful in life and not merely marks in exams. Parents need to learn how to support their children in these aspects. What do you do when your children throw a tantrum or refuse to go to school? What will you do when your children are bullied in school? How do you protect your children from sexual abuse? So, in parenting counseling what is taught is not only how to deal with the immediate crisis but how to support the children in becoming someone they can be proud of.