Dementia: Merging frontiers and emerging vistas.

内容摘要

Byline: T. Sathyanarayana Rao, M. Asha If the head and body are to be well, You need to begin by curing the soul. Plato, Dialogues All emotional illness is basically unfinished business and unexpressed truth. For, truth has the power to heal, protect, guide, and inspire. The cardinal principle of psychotherapy is to help the patient become (more) truthful about his/her feelings. A psychotherapist may be elegantly described as a choreographer of emotions. A healthy and wise approach to mental illness would be the one based on honesty and truthful living which has a tremendous therapeutic impact. This preventive and healing aspect of natural therapy has been unfortunately obscured and almost drowned in the drone of (sometimes) premature pharmacological interventions. When we are dealing with potentially irreversible disorders, prevention and delaying the onset gain enormous significance than combating after the onset. Natural therapy might be one of the best secrets of preventing emotional illness including dementia which is very often irreversible. It is the general lack of holistic approach in clinical practice that frustrates the patient and the caregivers as well, because mental illness is no longer viewed as an isolated case of neuropathological disarray. It has biological, psychological, emotional, social, economic, cultural, ethical, AND, spiritual dimensions, whose silent cries have been largely ignored thus far. Now, the paradigm is undergoing a welcome change (slowly but surely) with neuroscientists working in harmony with spiritualists evidenced by the emergence of Neurotheology. Manifesting as a set of symptoms representing a progressive decline in cognitive processes, dementia derives its name from the Latin root de meaning apart or away and mens (genitive- mentis ) meaning mind. A lonely sojourn of utter confusion and frustration for the patient, dementia has become a huge global problem. Paranoid orientations tend to develop in demented people who have premorbid sensitive and suspicious nature. Existing personality traits are intensified by degenerative brain biochemistry and also the stress accompanying old age. It has been observed that elderly people with Alzheimer's disease (AD) are usually unaware of their own cognitive deficits and hence do not attribute negative incidents to this cause.[sup] [1] The sense of rejection, abandonment, helplessness and the deepening urgency to grab the fragments of slipping self-identity and self-worth are nearly palpable in many dementia patients. Minds which had once been beautiful, active and vibrantly alive gradually become blank and disconnected struggling endlessly and painfully to make sense of disjointed images. The shell of the mind closes in on its empty self. Dementia results in three principal kinds of loss: i. the loss of love, ii. the loss of control - intertwined with fear of rejection and making the person more vulnerable to loss of love, and iii. the loss of self esteem - including being embarrassed and being exposed as flawed.[sup] [2] The magnitude of this disease is straining family and societal resources. The often associated problems of marked agitation, uncontrolled eating habits, inappropriate sexual behavior, senselessly repetitive behavior, unpredictable emotional outbursts, hoarding of useless objects, etc. in demented people can be enormously distressing to the caregivers, especially in the long run. AD patients with depression tend to develop extremely morbid preoccupations and delusions - hypochondriacal ideas about suffering from various dreadful diseases, for instance, often viewed as punishments for past sins. As a way of atonement, suicide is a possibility in such cases. Robertson (1982) aptly stated that meaningful life can be prolonged if brain degeneration could be held at bay. But in broad terms, reasonable cerebral function is the key to the quality of survival in the elderly. …