Heart TO Heart

Q: I have a major problem. Since the last one year, I've suffered from anxiety and it's ruining my relationship with my family and my boyfriend! I get mad over little things and sometimes, I take it out on them! Is there any way to deal with this situation? If so, please help. Samiya, Karachi
A: Sigmund Freud, along with many of today's less famous mental health practitioners and researchers, believe that anxiety and fear are same. Usually, the fear is from something not easily identified by the anxious person. Many types of mental health counseling try to help people link their fear to a particular source or sources. The idea is that greater awareness of our fears will help us change the way we think and/or act when they're around in order to make them less problematic. Feeling anxious on a regular basis can fuel things like insomnia and yes, anxiety can certainly affect our relationships. Being stressed in general from "everyday" sources, i.e. work, school, the weather etc. can push us toward the same symptoms as our more specific fears. The stress resulting from the more general sources can be reduced by time management efforts, exercise, meditation, and many other techniques, while more entrenched fears tend to be reduced, or even eliminated, more effectively with an examination of their causes. All that said, can you identify the causes of your angst, stress, and irritability? Think back to a year ago when your anxiety first became a problem. What, if anything, has changed? If you are in school, did it become more stressful? Did someone close to you become ill or pass away? Did you move? Are you unhappy with your job, or are you in a new position? Did you take on new responsibilities? Are you worried about something that may happen in the future? Maybe you'll discover that. Your next step is to figure out what changes you can make to your schedule so that your workload and stress level are manageable again. Taking time out to relax can be therapeutic, too. For some, a break from the day's activities to do something enjoyable has a wonderful effect on their emotional health. Don't forget about talking with your boyfriend and family about what has been going on and asking for support in dealing with your anxiety. Maybe talking to them about your feelings will help diffuse present and future strain. They might even be able to help you reach your goal of lower angst by providing you with wise suggestions or altering their own actions to help increase your calm.

Q: I'm desperate! I've forgotten the reason and purpose of my life. My life seems so senseless, eating, sleeping, going to work, hobbies, of course, while all around me, the world is tumbling down. How do I put some meaning in my life? Sehar, Lahore
A: Everyone gets the blues sometimes – they are a normal, but not terribly fun, part of life. However, when the feelings you're describing linger for weeks, or months, when it keeps you from getting to sleep at night, or getting out of bed in the morning, you may be what is considered, clinically depressed. Depression is an affective, or mood, disorder. It's estimated that depression affect's over ten million people in South Asia. There is chronic, low grade depression, in which a feeling of sadness may last for weeks and recur every few months, but you can still function; and, major depression, where you are unable to function in at least one daily activity; are plagued by feelings of loneliness, despair, and helplessness; have changes in both eating and sleeping patterns; and/or, may have thoughts of suicide. Feeling unfulfilled in life can really be a bummer. It may take some work on your part to determine your own morals and values, and then to find the group that will meet your needs. Sometimes, working with people less fortunate can give a type of gratification that isn't available from daily tasks. Good luck in your quest to find fulfillment. Remember, life is a journey and, often, it only gets better.
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Dermatologist
Dr Shah Hussain

Q: I have a 14-month-old baby who every 6-8 weeks suffers a bout of vomiting. This normally lasts for just one day and the vomiting normally subsides when she vomits green/yellow substance, which I presume is bile. My mother said these sound like bilious attacks and are fairly normal. My brother suffered from the same when he was a baby. Do you have any additional information as I haven't? Anon
A: The green/yellow material does sound like bile and this simply indicates that the baby has emptied its stomach and is bringing up some bile from its small intestine. Given the context you have described this is not of any great significance and simply indicates that the vomiting was quite forceful. The lay term of "bilious attack" is not a bad description for what we would normally describe as gastritis, which is not to be confused with gastroenteritis. Gastritis is a very common complaint and simply means that the stomach is inflamed. This can happen as a result of mild viral infection or sometimes it can be dietary in origin. Since these episodes are very sporadic I don't think you really need to change your routines in any special way. If the attacks increased in severity and frequency or if there was any evidence of failure to thrive then it obviously would need to be checked out further.
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General Physician
Dr Sadqa Gul
Q: I am 48 years old. I have started feeling that my facial skin is getting loose near both sides of the nose. Should I use an anti-wrinkle cream? Rukaiyya, Karachi
A: You could use a cream containing retinol and peptides every day. However, the best way to treat deep laugh lines or skin folds is to take filler injections.

Q: After the birth of my first child, I developed slight blemishes/pigmentation on my cheeks. These darkened further and have become very prominent and visible after I had my second child. Please suggest some natural remedies and other treatments available to get rid of this pigmentation. Huma Komail, Islamabad
A: You are probably suffering from melasma, a condition which occurs due to hormonal changes during pregnancy. You must strictly avoid the sun, use a sunscreen with an SPF of 50 and take vitamin C supplements. You could use a combination of tretinoin 0.025% cream with 2% hydoquinone cream and mometasone cream at bedtime.

Q: How should I treat the skin of my eyelids because winters are making it dry? I find some white thing being formed on the collarettes of the top lid. What can be done for this? Suggest some simple ways. Jaweria, Karachi
A: Flaky eyelids are common in winter due to a condition known as seborrhoeic dermatitis. Apply ketoconazole cream on the eyelid skin once a day. Apply a drop of coconut oil twice a day and avoid harsh soaps and face washes. This will help in reducing the dryness on the lids.

Q: I have small dark patches on my back and neck, I think it is a fungal infection. What should I use to get rid of these patches? Parveen, Faisalabad
A: Use an antifungal powder twice a day. Keep your skin dry and use clotrimazole cream at night on all the affected parts. If it doesn't go, please consult a dermatologist since it could even be an allergy or a pigmentation problem.

Q: I have pigmentation on my face. I have taken the treatment of crystal slipping and that has helped a lot. What kind of treatment should I take now to erase the remaining pigmentation? Do you suggest any face pack? I am using a cream with idebenone and little hydrogen peroxide. Sehrish, Karachi
A: You should go for skin lightening peels once in 3 weeks for about 6-8 sessions. You must avoid direct sun exposure as this will only increase the pigmentation. You may use a pack containing papaya or orange.