What We Treat

Depression is the most prevalent psychiatric disorder. Lifetime prevalence is about 12 %  .Depression can begin  anytime during life even during  childhood.

Depression is more than just feeling the blues, having a down day or being sad in a reaction to bad news, depression matters because it can affect all aspects of persons life

Symptoms of depression include : Having little interest and pleasure in doing things ,feeling down and hopeless, trouble falling and staying asleep, or sleeping too much, feeling tired or having little energy, poor appetite or overeating, frustration even over small matters, irritability and angry outbursts, slowed thinking, indecisiveness, distractibility and decreased concentration, impaired memory,  moving and speaking so slowly or being so fidgety or restless, crying spells for no apparent reason, reduced sex drive, feeling bad about yourself , having low self-esteem, feelings of worthlessness and guilt, death wishes, suicidal ideation,  and unexplained physical problems

The etiology of depression has yet to be fully understood, however it is likely to be a complex interaction between genetic predisposition to the illness and  environmental factors like stressful life events.

Depression is a complex syndrome with many contributing biological factors and this include imbalance in the monoamines neuro-transmitters (serotonin, norepinephrine , and dopamine), decrease growth factors (like Brain derived neurotrophic factor ) which are important for the support and  survival of neurons, glutamate and its receptors, and  inflammation.

Evidence for negative impact of depression is well recognized . WHO reported that Depression is the leading cause of ill health and  disability worldwide. Depression leads to impairment in quality of life

Depression in parents can have adverse impacts on the health, development and education of their children. Depression in childhood and youth, if not treated, can have profound longstanding social and economic consequences in adulthood .

Depression increases the risk for development of chronic medical diseases. Depression is associated with  60% increased risk of developing type 2 diabetes. depression increases risk of developing
coronary heart disease  and studies showed that depression increases the risk of dying among patients who have  had heart attack

Another issue in depression is the danger for self. Depression  is the leading cause of death due to suicide, Almost 1 million lives are lost yearly due to suicide, which translates to 3000 suicide deaths every day.

Treatment options for depression include: psychotherapy , pharmacotherapy, and

For patients not responding we may use Neurostimulation Therapy (Electroconvulsive therapy, Trans-cranial magnetic stimulation)

DEPRESSION

Social Anxiety is the most common anxiety disorder and the third largest mental health care problem in the world .lifetime prevalence rate is 7–13%
Social anxiety causes chronic anxiety and fear over social situations. It prevents people from leading the life they want, it stops them from taking the job they are good at doing, and it prevents them from having friends and relationships even though they want them. Social anxiety may destroys lives.
Patients with SAD experiencing significant distress and anxiety in situations that involve interaction with other people, like being the center of attention, being observed while doing something, having to say something in a formal situation, meeting people in authority , entering a room in which people are already seated ,making phone call in front of others , eating in public, etc.
During and before these situation, the patient feels insecure, anxious, can be embarrassed easily and may suffer from blushing, sweating, shaking, palpitation, upset stomach, nausea, shaky voice, muscle tension, diarrhea abdominal pain and cold hands. Patients usually try to avoid situations that may trigger such fear and anxiety
SAD can go unrecognized for many years, some patients think that it is a personality characteristic that cannot be changed so they don’t seek help
What distinguishes someone who simply is ‘shy’ from someone who would be considered to have a disorder?
When there is a significant distress or adverse impact on social, occupational, and other important areas of functioning, the diagnosis of SAD should be considered
The two types of treatment for social anxiety disorder are medications and psychotherapy. These two approaches may be used in combination.

SOCIAL ANXIETY DISORDER

Panic disorder is characterized by the spontaneous and unexpected occurrence of panic attacks.

Panic attack is a period of intense fear accompanied with some of the following symptoms : Palpitations, accelerated heart rate, sweating, trembling or shaking, sense of shortness of breath , feeling of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, fear of dying, numbness or tingling sensations, and chills or hot flashes.

symptoms develop abruptly and peak rapidly within minutes and usually resolve within 15-30 minutes .

The fear of recurrent attacks result in significant behavioral changes (eg, avoiding certain situations or locations, becoming dependent or withdrawn) and worry about the consequences of the attack (eg, losing control, going crazy, dying).

Before diagnosing panic disorder , a general medical evaluation is important to rule out medical causes of panic symptoms.

Patients with panic disorder are reluctant to believe their symptoms are not life-threatening and they seek medical checkup excessively .

The causes of panic disorder are likely biologic (chemical imbalance in the brain) and psychosocial (stress).

Pharmacotherapy, and psychotherapy (CBT) are used to manage panic disorder.

Other important points are doing exercise regularly, practicing  good sleep hygiene, avoiding  anxiogenic substances such as caffeine and energy drinks, and to remember that panic symptoms are not life-threatening.

PANIC DISORDER

Generalized anxiety disorder (GAD) is a common anxiety disorder that involves chronic worrying, nervousness, and tension. Patients with  anxiety suffer from some or all of the following symptoms: constant worrying about  many things in life , feeling nervous and anxious, not being able to sleep , trouble relaxing, being so restless that it is hard to sit still, becoming easily annoyed and irritable, feeling afraid as if something awful might happen, and also may complain of  fatigue, difficulty concentrating,  muscle tension and muscle aches, trembling, being easily startled, sweating, nausea, diarrhea, shortness of breath, and palpitation.

It’s natural to be anxious, worries and fears are a normal part of life, the difference between “normal” worrying and generalized anxiety disorder is that the worrying involved in GAD is debilitating, excessive, intrusive, and persistent .

GENERALIZED ANXIETY DISORDER

Obsessive-compulsive disorder (OCD) is characterized by unreasonable thoughts  (obsessions) and / or repetitive behaviors (compulsions).

Obsessions are repeated, persistent and unwanted thoughts, urges or images that cause distress or anxiety. For example, fear of being contaminated by shaking hands or by touching objects others have touched, doubts that you’ve locked the door or turned off the stove, etc.

Compulsions are repetitive behaviors that you feel driven to perform. For example hand-washing until your skin becomes raw, checking doors repeatedly to make sure they’re locked, checking the stove repeatedly to make sure it’s off.

Treatment include medications and psychotherapy.

OBSESSIVE COMPULSIVE DISORDER

ATTENTION DEFICIT HYPERACTIVITY DISORDER

BIPOLAR DISORDER

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