• Just like Depression, Bipolar Mood Disorder (BMD) is a mood disorder in which there are episodes of mood fluctuations.
• Episodes can be of depression or mania/ hypomania
• Mania/ hypomania is indicated by persistent cheerful/ irritable/ elated mood with grandiose thoughts, racing thoughts, decreased need for sleep, increased energy, loss of inhibitions, reckless decision making, excessive involvement in pleasurable activities, increased substance use/ smoking/ drinking etc.
• The frequency of the episodes can vary from multiple episodes a year to one episode every few years.
• There can be mood variations, with seasonal changes.
• This is an episodic illness, with no symptoms in the inter-episodic period.

There are many subtypes of anxiety disorders, the symptoms of which vary accordingly.
In all of the anxiety spectrum disorders, the commonly seen signs of anxiety can be:

• Excessive, inappropriate, unexplained anxiety/ restlessness/ unexplainable fear over prolonged periods
• Palpitations, racing negative thoughts, butterflies in abdomen, nausea, increased sweating, difficulty in breathing, choking sensations, increased urination/ stool frequency etc.

Some people have severe attacks of anxiety/ panic which last for a few minutes to a few hours. They have extreme anxiety causing fear that one might go mad/ something bad is going to happen/ they might be having a heart attack and might die. These people also rush to the emergency department suspecting a heart attack.
Some people present with unexplained bodily pains, which are non-specific, variable with time, associated with signs of anxiety.
Some also suffer from anxiety in specific situations like social anxiety/ performance anxiety.
Some also have episodes of loss of awareness, seizure like symptoms, jerky bodily movements, excessive crying, lasting for a few minutes to hours. This may be stress induced and can be hysteria
Some might present with fear of having some major illness, despite all normal investigations and multiple doctors’ consultations. This is an anxiety spectrum disorder, known as hypochondriasis.
In Body Dysmorphic Disorder, there is severe anxiety related to the one’s physical appearance. There is a perceived idea of some body part/ appearance being inappropriate/ disfigured. It is a false belief or exaggerated than the reality.
Having anxiety is a normal phenomenon for most, but if it is too frequent/ out of proportion and affects the performance/ functioning then it is a disorder and needs to be treated.

OCD is manifested by:

• Obsessions: which can be in the form of repetitive thoughts/ images/ impulses, causing interference with daily activities. One does understand and identify these thoughts as being irrational/ illogical/ inappropriate/ out of proportion, but can't control them by will.
• Compulsions: One performs certain acts/ tasks (for eg. checking, washing, praying, chanting, counting, ritualistic behaviors etc.), which are time consuming and cause functional impairment. If these acts are not completed, it causes severe anxiety.
• Impulsivity may be present in a few cases, in which due to inability to control the impulses, one may suffer from harmful consequences.

Schizophrenia presents with different set of symptoms in different patients. Though there are variations in the symptoms, the common symptoms/ signs in schizophrenia may be: 

• Irrelevant talking, muttering
• Inappropriate social behavior: aggression, disrobing, shouting obscenities, poor selfcare (not bathing/ brushing/ grooming)
• Laughing/ smiling without any apparent reason, gesturing
• False, unshakeable beliefs that some people are conspiring against or talking about or making fun of him/ her, someone is trying to harm him/ doing Black magic

Rarely patients also present with complete mutism, severe restriction of movements, inactivity lasting for days, lying in abnormal painful postures for hours, urinary/ stool retention

Schizophrenics have severe functional impairment. But there is a proportion of them that have only a few perceptual/ thought disturbances but may be perfectly functional in other aspects

• SLEEP DISORDERS

Sleep disorders can present with either altered in sleep quality/ quantity.

There can be increased/ decreased quantity of sleep. Normal sleep can vary between 6 and 10 hours/ day for a normal person. If there is a change is the regular amount of sleep, it needs to be investigated.

Some people feel tired and not fresh even after having adequate hours of sleep

Some may suffer from intermittent waking up fin the night and not being able to fall asleep immediately. This sort of fragmented sleep is not refreshing and is disturbing

Some people are unable to have sound and adequate sleep during the night resulting in daytime drowsiness

Some may also have frequent dreams/ nightmares, affecting the quality of sleep with frequent waking up with a startle.

• EATING DISORDERS

There might be significant alteration in the appetite. It may be decreased/ increased appetite, with alteration in quantity/ frequency of meals. This can lead to significant changes in their weight too.

Some present with binges of eating, which might be impulsive or anxiety-mood related

Some present with purging/ induced vomiting with or without binging. They may also have excessive inadvertent use of laxatives/ bowel stimulants

Prolonged excessive and frequent consumption/ use of any of the substances like alcohol, tobacco chewing/ smoking, weed/ ganja/ bhaang/ marijuana/ hash, brown sugar/ afeem, sedatives/ sleeping pills, coke/cocaine/meth, sniffing on certain substances or use of other drugs can cause dependence on that substance

If one has either physical withdrawal symptoms if the substance is not used or has cravings in its absence, then he is likely to be dependent on that

Unavailability can lead to physical withdrawal symptoms, aggression, physical pains/ discomfort

It can also lead to social/ occupational disturbances. They keep on being mentally and physically occupied in activities related to substance use

There might be episodes of intoxication, leading to harmful consequences

• Substance use can also lead to other mental disorders.
• Substance dependence can also be genetic.

The most common mental health ailments in geriatric (elderly) group of patients are

• Dementia: it is a disorder in which one stops creating memories leading to forgetfulness, inability to recall recent events/ names of people/ routine activities as well as past events in very severe cases. Secondary to memory disturbance, behavioral disturbances also occur. They might become paranoid, anxious, restless, have difficulty in maintaining hygiene. This is a progressive condition which worsens with age but if treated at an early stage, progression can be controlled.
• Delirium: presents with altered orientation, behavioral disturbance, with alteration in consciousness as well
• Depression/ adjustment issues/ grief are also commonly seen disorders in the elderly people. Sleep disturbance, change is appetite, altered mood are some of the signs which should not be neglected in elderly patients.

Children at different ages present with different mental health disorders. Commonly seen disorders in children are:

• Attention Deficit- Hyperactivity Disorder (ADHD): This generally presents by 7 years of age. The child is restless, fidgety, unable to sit in a place for long, interrupts everyone, unable to focus on work/ play, academically poor despite having good/ fair intellect. 
• Bed wetting: Bladder control in children is generally achieved by 5 years of age, but if not then it needs to be treated. Bedwetting can restart in some at a later age even after bladder control is once achieved. This can be due to anxiety/ stressful conditions.
• Autism: It is seen at a very young age, when the child doesn’t maintain eye contact, has poor social skills, decreased interaction with people, uncomfortable in presence of strangers. Autistic children need special education and their caregivers too need psychoeducation. These children might have normal intellectual functioning as well.
• Social withdrawal/ anxiety in certain situations: Some children present with pains/ crying, fear in certain situations. They might become extremely anxious while getting separated from their mothers.
• Learning disabilities/ lower intellectual functioning: Some children have a normal IQ, but unable to learn specific subjects, like a language/ mathematics / unable to read/ write despite understanding it all. Dyslexia is a type of learning disorder.
• Oppositional behaviors/ aggression/ abusive behaviors