Mental Health and Neurology

Attention Deficit Hyperactive Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder that has been linked to the brains'chemistry and anatomy.ADHD presents itself as a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

The manifestations of inattention include lack of persistence,wandering off task,having difficulty sustaining focus,and being disorganized not due to defiance or lack of comprehension.Hyperactivity refers to excessive motor activities when it is not appropriate,like fidgeting,tapping or talkative.Some patients might behave impulsively without proper forethought.ADHD begins in childhood where  signs of hyperactivity become less common during adolescent.In adulthood,impulsivity may remain problematic even when hyperactivity has diminished.

ADHD is associated with reduced school performance and academic attainment,social rejection,and in adults,poor occupational performance,or even unemployment as well as interpersonal conflict.Fortunately,ADHD is treatable.Research is continuing on many fronts and there are now many therapies that can help manage the condition and allow people with ADHD to live more fulfilling lives and reach their full potential.


American Psychiatric Association:Diagnostic and Statistical Manual of Mental Disorder,Fifth Edition.Arlington,VA,American Psychiatric Association,2013.



Bipolar Disorder

Bipolar disorder,also called manic-depressive disorder,is a neurological illness characterized by periods of abnormally elevated mood (mania) followed by a periods of extremely low mood (depression).

While we all experience changes in mood from time to time, the extreme mood swings seen in patients with bipolar disorder are very different. During the manic phase of the illness, people with bipolar disorder can experience feelings of euphoria, extreme optimism or exaggerated self-esteem, racing thoughts and irritability. They may have little need for sleep and act impulsively and even behave recklessly. During the depressive phase, the same person may then feel sad, worthless or hopeless, have little energy, show changes in sleep patterns, and show other signs of clinical depression.

The symptoms of bipolar disorder can cause significant distress and result in damaged relationships, poor job performance, and even suicide. However, there is reason for hope; while there is no cure for bipolar disorder the illness can be effectively managed and controlled.

Bipolar disorder is treated today with a combination of medication and psychotherapy; medication helps to stabilize moods, while therapy help individuals understand their moods and behaviors, detect patterns and triggers and develop strategies for managing their mood swings and related symptoms.

For more information on bipolar disorder, speak to your doctor.


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.





From time to time,we all experience feelings of depression or experience a period of grief after a loss.These feelings can be very intense over a very short time,but they pass.Clinical depression,on the other hand,is a serious medical condition characterized by long-lasting feelings of intense sadness and hopelessness coupled with additional mental and physical changes.

Depression is believed to be caused by an imbalance of chemicals, called neurotransmitters, which help send messages in the brain. These chemicals in the brain also help to regulate emotions, behaviours, and thinking. Several triggers may play a part in the onset of depression and can vary from one individual to another, including but not limited to:

  • Family history and genetics
  • Medical illnesses
  • Certain medications
  • Life events or environmental stresses
  • Biological factors
  • Psychological vulnerability

Fortunately, depression is very treatable. The two main treatment approaches are psychological counseling and/or pharmacotherapy (medication) with antidepressants. The goal of treatment is to restore a balance of emotions, relieve symptoms and return the individual to their pre-depression self in thoughts, functions, and general outlook on life.

For more information on depression and its treatment, speak to your doctor or a mental-health professional.

  1. Stephen M. Stahl,The Psychopharmacology of Painful Physical Symptoms in Depression,J Clin Psychiatry 63:5,May 2002
  2. U.S. Agency for Health Care Policy and Research. Depression in Primary Care: Vol. 2. Treatment of Major Depression. Rockville, MD: 1993


Diabetic Peripheral Neuropathic Pain (DPNP)

Nerves allow your body to feel temperature,pain,and other sensations.Over time,the effects of diabetes can harm the nerves in the legs,feet,arms,or hands.The damaged nerves can become overly sensitive,to the point where the slightest movement or light touch of the skin can trigger intense pain.This condition is known as diabetic peripheral neuropathic pain or DPNP.

Common symptoms of DPNP include burning or shooting pains, often in the feet and legs, and increased sensitivity to touch in those areas. Others symptoms include the loss of sensation, numbness or tingling in the extremities. DPNP frequently worsens at night. This can cause or exacerbate sleep disorders like insomnia. DPNP may seriously affect the patients’ mood, social activities, mobility, work, and their enjoyment of life2.

There are a number of medications available that can effectively manage the condition. A health care professional or can provide information on the options available.

  1. Galer BS, et al. Diabetes Res Clin Pract. 2000; 47: 123-128
  2. Gottlieb DJ, Punjabi NM, Newman AB, et al. Association of sleep time with diabetes mellitus and impaired glucose tolerance. Arch Intern Med. 2005;165:863-867.


Generalized Anxiety Disorder (GAD)

Worry and anxiety are a natural part of life,and in fact,anxious emotions can serve a purpose by helping us prepare to deal with difficult or stressful circumstances.But people with generalized anxiety disorder (GAD) stay worried,fear the worst will happen,and experience ongoing,debilitating anxiety even in the absence of a stressful or threatening situation.The worry may become so excessive and persistent that it can limit an individual’s daily activities.

People suffering from GAD are usually worry excessively about a number of events or activities. They find it difficult to control the worry and keep worrisome thoughts from interfering with attention to task at hand. Adults with GAD tend to worry about routine life circumstances, such as their job responsibilities, health and finances, misfortune to their children or minor matters. Children with GAD often worry about their competency or their performance in the school or sports events, although in fact they are not being evaluated by others.

Excessive worrying can seriously impact the individual’s capacity to do things quickly and efficiently. It could cause tiredness, difficulty concentrating and disturbed sleep.  While the specific cause of GAD is unknown, doctors have identified a variety of biological and psychological factors. Research shows that GAD tends to run in families, but anxiety and worry can also be learned.

The treatment for GAD can involve medication therapy as well as psychological counselling, or a combination of both. A mental health specialist can provide additional answers.


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.




Schizophrenia is a complex neurological disorder,believed to be caused by a biochemical imbalance in the brain.The symptoms include delusions,hallucinations,disturbances in thinking and communication,and withdrawal from social activity.The peak age of onset for first psychotic episode is in the early- to mid-20s for males and in the late-20s for females.The onset may be abrupt or insidious.

If left untreated, schizophrenia can take a huge financial and emotional toll on patients and their families, in addition to placing an economic and social burden on society as a whole. Sadly, because of the nature of the illness, schizophrenia can also lead to incarceration, homelessness, and even suicide for those who are ill.

Although there is still no cure for schizophrenia, the illness is treatable, and many people with schizophrenia go on to lead fulfilling lives in recovery. Psychiatrists agree that today, the best way to manage schizophrenia is through a combination of medication therapy and psychosocial interventions, a term which describes a range of treatments such as psychological counseling, patient education programs, and other support services.

There are a number of medications currently available in Malaysia that treat schizophrenia. Since each person’s illness is unique, their medication plan will also be unique, and the type of medication and dosage required will vary for each individual. Regardless of which medications are used, regular and ongoing monitoring is important to ensure that patients are taking their medication as prescribed, to gauge their response to the medication and to monitor potential side effects.

With early intervention and proper treatment, many individuals living with schizophrenia are able to manage their disease and live a full, productive life. For more information on schizophrenia, please speak to your doctor.


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.