Optic Neuritis

Sudden inflammation of the optic nerve resulting in reduced vision in the affected eye is 'optic neuritis'. In particular, the myelin lining of the optic nerve which transmits visual stimuli to the brain is inflamed. As it is the optic nerve that carries visual information from the retina to the brain stem, vision is affected when the optic nerve is impaired. Optic Neuritis is also called Retro-bulbar neuritis.

Although the precise cause of Optic Neuritis is unknown, it is an autoimmune disorder. It usually occurs in children and young adults below 40 years of age. It can involve one or both optic nerves. It is more common in females. The annual incidence is approximately 6.4 / 100,000. Studies also reveal that about 1 in 5 patients who have had a first episode of optic neuritis are likely to develop nerve problems elsewhere in the body, or will develop multiple sclerosis.

Normally, the body's immune system fights infection by creating a reaction that can combat viruses, bacteria, fungi and others. But in autoimmune diseases, this reaction is directed against a normal part of the body instead of the inflamed part. In case of Optic Neurosis, there occurs inflammation and destruction of the protective myelin sheath that insulates the optic nerve by coating it and direct damage to the nerve axons leads to loss of vision.

In Optic Neurosis, the loss of vision can be sudden or develop gradually over a period of time. Vision loss may be partial or complete or may be only a certain part of the visual field. It is recommended that a person experiencing a first episode of Optic Neuritis undergo MRI of the brain. This can help identify for central nervous system lesions and the MRI can reveal an enlarged optic nerve. Other symptoms include loss of vision in one eye even for an hour, loss of color vision (achromatopsia), changes in pupil's reaction to bright light, and pain when the eye is moved.

Appropriate therapy is instituted depending upon the underlying cause of the infection in case of other autoimmune diseases. In some cases there can be no conclusive treatment as even oral and intravenous steroids, when used in treatment, do not have any long-term acuity and instead risks of side effects can be significant in some patients.

However, there are chances that normal vision returns within 2 to 3 weeks with no treatment. Corticosteroids given intravenously may speed up recovery whereas oral steroids may increase the chance of recurrence. Further evaluation can determine the cause of Neuritis and the underlying condition causing the problem can be treated.

Psychiatrist

Medical professionals who treat mental illness using a biomedical technique towards mental disorders and also make use of medications are called psychiatrists. A psychiatrist is a physician who deals in diagnosis, prevention and treatment of mental illness, emotional disorders and addictions. The condition includes anxiety, neurosis, developmental disabilities, depression and substance abuse. Psychiatry has various subspecialties like child psychiatry, adult psychiatry; behavioral medicine etc and psychiatrists have to undergo special training to undertake this task.

Psychiatrists are specialists in mental health and thus

• Study, prevent, make a diagnosis and treat psychological, emotional and behavioral disorders.
  
• They study the physical condition of the patient and adapt the necessary medical actions.
  
• They recommend diagnostic and laboratory tests for the patient depending on the severity of the case.
  
• Psychiatrists give treatments such as psychotherapy, psychoanalysis, cognitive behavior therapy depending on the patient requirement.
  
• Psychiatrists can also prescribe medicines for the patients.

Qualification to be a psychiatrist

• The person has to be a graduate from college and from a medical school.
  
• Should complete four years of residency in the field of psychiatry.
  
• To further specialize in fields such as child psychiatrist, there is additional training.
  
• After completion of this entire course, a psychiatrist will be addressed to as a mental health professional and physician. He/she will clearly differentiate between physical and psychological causes and relate both physical and mental distress.
  
• A board certification is a must to practice psychiatry.

Choosing the right psychiatrist speaks a lot in getting your treatment right. Given below is the guide to choose the right psychiatrist:

• Speak about your prevailing condition to your family physician and if he/she feels you need the help of a psychiatrist then ask for recommendation. Take a copy of your latest medical records if you have one, this will help your psychiatrist on deciding on the drugs for you.
  
• To cross check on any psychiatrist you can get in touch with the nearest psychiatric society or community medical health center. They can help you with information on the qualification of the psychiatrist you have chosen.
  
• A good psychiatrist should always discuss your problem in detail and discuss on why he has chosen any particular treatment for you. There are various therapies available for curing psychiatric problems and so the doctor should educate the patient on them and explain why he has chosen any particular treatment.
  
• Ensure that you provide complete true information about yourself and your condition to the psychiatrist as he/she is also a physician and can choose the right treatment for you depending on your medical background.
  
• Finally check if your insurance covers the entire cost of the treatment or make the necessary arrangements for your course of treatment.
  

Borderline Personality Disorder

Borderline personality disorder (BPD), is a serious mental illness, though less commonly known than schizophrenia or bipolar disorders. It is a form of pathology lying on the border between psychosis and neurosis. Persons with borderline personality disorder often exhibit intense bouts of anger, depression and anxiety. This may last for hours or sometimes a day. Impulsive aggression, self injury, abuse of drug and alcohol are some other symptoms.

BPD sufferers primarily see the world as extremes, either black or white. They either idealize or vilify everyone they meet. They veer between idealized love and distressing hatred and misery. They are known to develop sudden and stormy attachments toward family, friends and loved ones. Their emotions range from great love to intense hatred.

Usually, the diagnosis of BPD on these parameters is done on adults and not on children as signs and symptoms of BPD may go away with maturity. For diagnosis of BPD, five signs should be significantly present:

• Sense of intense fear and abandonment.
  
• Pattern of unstable relationships
  
• Unstable self image
  
• Impulsive and often self destructive behavior
  
• Erratic mood swings
  
• Chronic feelings of emptiness
  
• Inappropriate and undue anger
  
• Periods of paranoia and loss of contact with reality.