Author Archives: PsychManila

Consistent with that routine that I wrote about, I have been viewing online educational material that are important in my field. One of them is Dementia. The World Health Organization defines Dementia, as “a syndrome in which there is deterioration in memory, thinking, behavior and the ability to perform everyday activities”.  Aside from Alzheimer’s Dementia, there are 3 other kinds of this condition that are not as well known:

1. Vascular Dementia – This condition results from damage to the brain due to   poor or blocked blood flow (e.g. stroke, ischemia). Unlike Alzheimer’s Dementia in which symptoms progress gradually, symptoms of vascular dementia occur abruptly and appear right after the stroke.

2. Dementia with Lewy Bodies (DLB) – This is a slow onset condition in which deposits in the brain, called Lewy Bodies, cause changes in the brain. These changes result in problems in the person’s ability tothink (fluctuations in concentration, attention, alertness, disorganized thinking) and move (parkinson’s symptoms) as well as changes in behavior and mood (e.g. depression, apathy, anxiety, delusions).
   
   

These changes result in problems in the person’s ability to think (fluctuations in concentration, attention, alertness, disorganized thinking) and move.

In my work assessing adults for Dementia, I have encountered about 3 whose differential diagnosis included DLB. The most distinguishing symptoms for me are the clients’ problems with movement. Such symptoms include muscle rigidity, slowed movement, shuffling walk, tremors (mostly at rest) and balance problems. One client I had reported having hallucinations, another symptom of this condition. Dementia with Lewy Bodies recently caught the attention of many people because Robin Williams, a popular actor/comedian (of the Mork & Mindy, Mrs. Doubtfire fame), suffered from it before he committed suicide.

Surviving prolonged lockdown or the current restrictions of this pandemic has been a challenge. Anxiety and depression have become more of challenges for many of my clients in my counseling practice.

1. The first thing we need to do is to understand that an unusual situation, the pandemic, is happening right how for which we have limited control.
2. We need to accept the situation, be kind to ourselves and adapt to the situation. 
3. This means observing the guidelines set & disseminated by many sources regarding frequent hand washing, mask wearing, social distancing and limiting ones exposure (no unnecessary trips).
4. One way to manage or minimize these feelings is to keep a routine so that one continues to feel grounded and on top of things. This involves:

1. Waking up and sleeping more or less the same time every day,
   
   

2. If working at home, do it at about the same time each day, e.g. in the mornings say 9am to 12nn. Or maybe 2hours in the morning and 2 hours in the afternoon (depending on the nature of your work)
   
   

3. Aside from work, one can also go online and choose YouTube videos that are educational and will enhance your current skills. Perhaps 2-3 hours most days of the week could be set aside for this.
   
   

4. Spending more time with family by having more lunch/dinner/before bedtime conversations, playing games with your children, organizing home projects such as cleaning your storerooms, garage and so on.
   
   

5. Exercising regularly is very important. Walking and cycling are great   exercises for your heart and doing weights and yoga exercises are great for toning, strengthening and balance. Again this can be done 20-30 minutes most days of the week.
   
   

If you have not already done so, go ahead and make and follow that routine! I guarantee you that you will feel better and less vulnerable to negative thoughts and feelings that do not help you anyway!

Working from home also gave me the chance to take yoga classes from my sister most days of the week.

On the days we had no yoga practice, I would spend 30 minutes of brisk walking around my home – so I have been able to exercise regularly and keep my heart and circulation active and my mind oxygenated and alert! If you are not already doing so, I suggest 30-60 minutes of cardio-vascular exercise (e.g. Zumba, walking or cycling) and another 30-60 minutes of stretching and toning (e.g. weights, pushups, yoga) perhaps on alternating days.

I also gave myself a daily routine that included an online learning activity, physical exercise and time with family (my mom). I encourage these in my counseling clients as well. A daily routine is good because it gives structure and the feeling of continuity and reassuring regularity in our lives (important in this time of uncertainty). Giving yourself a goal or a project to focus on each day is another way to keep your mind active and engaged. Some people bake, some read/draw/write, while some have surprised themselves with harvesting vegetables from their garden!

I trust readers that you have also been making good use of your time – no use letting our fearful thoughts interfere with our life, challenging enough as it! Prevention is the best and keeping a healthy diet (lots of fish, vegetables & fruits), exercising regularly and keeping our minds active and continuously learning is the best way to do it!

How has the lockdown been for you? Were you able to catch up on work pending at the office or at home? Staying at home was certainly the time to do the things we previously did not have time for! (Including time with family!)

Indeed, the pandemic and subsequent lockdown in the NCR region has affected our lives in many ways. In our case, a consequence of the lockdown was the disruption of work for all of us professionals (medical doctors and psychologists) at the clinic. This was quite frustrating firstly because our work momentum was ground to a stop and secondly the learning from work with my clients was disrupted!

On the other hand, what the lockdown did was it gave people like me the opportunity to slow down and review as well as update my knowledge and skills important in my work.

For instance, I had felt the need to learn more about psychiatric conditions and psychopharmacology but have not had the chance to, what with the busy testing schedule at the clinic. These topics are accessible online and I have learned a lot! Hopefully, with the lifting of ECQ, or with the MECQ, we will be back at the clinic soon. I have already been putting some of these learnings to good use as I continue my work with clients online!

Continuing therapy sessions with my clients online have also made it imperative for me to familiarize myself with electronic devices and platforms. It’s a good thing I had been using Viber to chat with my son (who is based in Guangzhou China) so I was familiar with at least one online platform! Zoom is another platform I have become familiar with.

By the way, I will be continuing to provide psychotherapy (or teletherapy) sessions online. Just click the appointment button on my PsychManila website and go on from there! It is important to note that the service is open to clients based in the Philippines only.

With the coming lifting of the lockdown in many areas in our country, the opening of schools is still under debate. This is understandable what with the risk it poses to our children. As our children are confined to the home, there are things mothers and fathers can do to facilitate continued learning:

For children in the preschool age, give them an area in the house where they can play using their legs, hands, eyes and learn about their environment while having fun at the same time. Such activities may include movement exercises (e.g. doing the duck walk & arm raises to the tune of popular music), coloring and drawing activities and singing action songs all with the encouragement and participation of mom and dad!

For school age children, encouraging them to do tasks they enjoy such as drawing or writing as well as doing school related exercises will help occupy their time constructively. Time on the internet is best monitored and kept to 2-4 hours a day. Giving them assignments to help out with chores at home is also a great way to develop their sense of responsibility and problem solving skills as well as increase self-esteem and self-efficacy.

For adolescents, giving them a routine and structure will do them a lot of good. Such chores as participating in the preparation of meals, doing the laundry, planting vegetables and assisting mom/dad in a home based business are good opportunities to
a) develop their sense of responsibility and participation in the home,
b) increase sense of self-efficacy and self-esteem as they learn skills that make them more capable and proactive and
c) reduce the time they spend on social media (and prevent internet addiction!).

The lockdown also affords time for parents to spend time with their children (& vice versa!). Although work in the office may have slowed down, a lot can be accomplished at home!