Nighat Ara, Psychiatrist
My mother has a very critical problem. She thinks that she has another
person talking inside her mind, which is very evil. We have taken her
to many doctors but it has been like 15 years, no change has occurred.
It all started after her marriage. My parents had a great marital problem.
They could not understand each-others demands. My mother felt deprived
all the time. My father was out to his work daily and my mother had
to do all the house-holds along with her job. After the birth of my
younger sister the pressure was extreme on her. She also became so rude
to me and my elder brother. Then suddenly the problem I stated above
started. A whole new chaotic situation grew. Recently she has been transferred
to a college outside Dhaka. Although we all have grown up but the memory
shock us. She has grown weak and in disappointment sometimes she stops
eating and taking her medicine there. She also refuses to go to the
doctor saying it's useless. Physically she has grown more feeble. I
really am very worried. Is it called MPD(Multiple personality Disorder)
and does the mental shock causes people to forget the past? In fact
she cannot remember anything. Plz tell me what to do. -Tormented.
You have described quite an alarming situation that needs immediate
& appropriate attention. Your mother is suffering from a chronic
psychiatric condition and had been to so many doctors without much help.
However, you didn't mention anything about the diagnosis or medications
she has received so far which could have been a valuable clue to understand
her present situation. You have also hinted at the communication gap
between your parents as well as serious marital problems that had precipitated
this mental condition of your mom. In fact, a stressful environment
can interact with the genetic vulnerability of an individual to a particular
mental illness, and accelerates the process of bringing the dormant
condition to a full-blown disease. Your mother thinks she has another
person talking inside her mind. This is a very important symptom that
needs to be explored further in detail to understand its origin and
nature. MPD (multiple personality Disorder) and few other major psychiatric
illnesses like Schizophrenia, Schizoaffective Disorder etc. are associated
with this symptom too. Sometimes Depressive Disorder can also present
with very similar picture. However, Clinical expertise, adequate observation,
complete history and trial with medicines are often helpful ways to
clear this confusion. Duration of symptoms (15years- pretty long time!),
severity of symptoms (self-negligence to the level of not eating well
or taking even important medications) and the consequences in other
aspects of life (can she do her job well? Has she alienating herself
from everyone else and is now socially isolated? ), all these are important
assessment tools in mental illnesses. As a working mother without any
support from her spouse, it seems that she was probably stretching herself
beyond her capacity. Her childhood history is also quite relevant here.
People have different tolerance levels and when the stress or trauma
crosses the individual threshold level, the brain can shut down and
psychological defences come into play to protect the traumatised person.
Multiple personality disorder (MPD) is now known as Dissociative Identity
Disorder (DID) according to DSMIV. It is very difficult to come up with
a diagnosis from this little information you have provided here, though
personally, I believe other major psychiatric illnesses need to be ruled
out first. Undoubtedly she needs proper attention and care. It is very
difficult to come up with a diagnosis (it is not fair to try even!)
from the little information you have provided here though, I personally
believe other major psychiatric illnesses need to be considered too.
"She cannot remember anything"- this generalized loss of memory
is again pointing to more serious mental conditions (some organic brain
diseases also produce this symptom). In DID (or in Dissociative amnesia)
people can suffer from loss of memory (usually around more selective
issues though), and mental shock definitely can cause a person to forget
the past, which again depends on the person's individual vulnerability
and personality trait. DID is often associated with anxiety or depression
which also requires treatment on their own right.
Mahfujul Haq Khan BDS, DDS, FSDCE (USA), PhD (Japan), Post
Doc. (Japan) Specialised: Crown and Bridge work, and Periodontal plastic
surgery (USA) Senior Medical Officer, Department of Dentistry, BIRDEM
I am 46 years and doing business in Chittagong. I always enjoy your
article as I have lot of dental problems. I have dental cavity but no
pain at all. Should I visit a Dentist?
Would you mind if I ask you: "Dental practice is not service oriented,
but rather, a business". When we go to a Dentist with a certain
problem, some dentists try to find out other problems simply to make
some extra money. Am I right? However, I do not mean you as I know you
Thank you for reading and enjoying my article and this will encourage
me to go forward.
You have mentioned that you have a lot of cavity without pain. Yes you
must visit a Dentist right away. Dental Caries (Cavity) very often appears
as a white chalky area on the enamel, which becomes brownish and then
black. As long as the caries remains within the enamel, no pain should
be experienced. It later softens, after which the tooth structure breaks
down. If not treated in the initial stages, it progresses towards the
pulp and will then require extensive treatment to save the tooth. Tooth
decay usually does not pose a serious health risk if treated early;
however, if the decay is allowed to progress, the tooth will likely
die, and the spreading infection may result in general blood poisoning,
fever, swelling in the face and neck, and a general feeling of being
unwell. So, please visit your dentist right now and save your money
and avoid further health hazard.
I will not mind any kinds of questions that might arise from my respected
readers. Your next comment is "Dental practice is not service oriented
rather business". Yes you are 100% right; we are doing business,
but it is a SERVICE ORIENTED BUSINESS. It is our moral professional
duty to inform the patient about any silent disease. At the initial
stage, most of the dental diseases are symptom free and if those can
be treated initially, then it will be helpful for the patient both financially
Dear Dr. Khan,
Hello, How are you doing? A few months back, I read an article mentioning
some tips "How to quit smoking". I have lost that article.
Would you please tell me the tips again? By the way, are you a smoker?
Keys for Quitting Smoking!
Studies have shown that these five steps will help you quit and quit
for good. You have the best chances of quitting if you use them together.
1. Get ready.
2. Get support.
3. Learn new skills and behaviors.
4. Be prepared for relapse or difficult situations.
1. Get Ready
Set a quit date.
Change your environment.
1.Get rid of ALL cigarettes and ashtrays in your home, car, and place
2.Don't let people smoke in your home.
Review your past attempts to quit. Think about what worked and what
Once you quit, don't smokeNOT EVEN A PUFF!
2. Get Support and Encouragement
Studies have shown that you have a better chance of being successful
if you have help. You can get support in many ways:
Tell your family, friends, and co-workers that you are going to quit
and want their support. Ask them not to smoke around you or leave cigarettes
Talk to your health care provider (for example, doctor, dentist, nurse,
pharmacist, psychologist, or smoking counselor).
Get individual, group, or telephone counseling. The more counseling
you have, the better your chances are of quitting. Programs are given
at local hospitals and health centres. Call your local health department
for information about programs in your area.
3. Learn New Skills and Behaviours
Try to distract yourself from urges to smoke. Talk to someone, go for
a walk, or get busy with a task.
When you first try to quit, change your routine. Use a different route
to work. Drink tea instead of coffee. Eat breakfast in a different place.
Do something to reduce your stress. Take a hot bath, exercise, or read
Plan something enjoyable to do every day.
Drink a lot of water and other fluids.
4. Be Prepared for Relapse or Difficult Situations
Most relapses occur within the first 3 months after quitting. Don't
be discouraged if you start smoking again. Remember, most people try
several times before they finally quit. Here are some difficult situations
to watch for:
Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.
Other Smokers. Being around those who smoke can make you want to smoke.
Weight Gain. Many smokers will gain weight when they quit, usually less
than 10 pounds. Eat a healthy diet and stay active. Don't let weight
gain distract you from your main goal quitting smoking. Some quit-smoking
medications may help delay weight gain.
Bad Mood or Depression. There are a lot of ways to improve your mood
other than smoking.
If you are having problems with any of these situations, talk to your
doctor other health care provider.
Quitting smoking is one of the most important things you will ever do.
You will live longer and live better.
Quitting will lower your chance of having a heart attack, stroke, or
If you are pregnant, quitting smoking will improve your chances of having
a healthy baby.
The people you live with, especially your children, will be healthier.
You will have extra money to spend on things other than cigarettes.
Yes I was smoker!
Visit Dr. Khan’s website “www.aikodental.com” for more information on
oral and dental health.
BY THE WAY
for child trafficking
trafficking is one of the major crimes against children. In Bangladesh
the phenomenon is severe. Every month, around two hundred children are
trafficked to India, Pakistan and the Middle East. There are serious
punishments for trafficking but the problem still continues to exist
along with all forms of other abuse against children. For your information
according to the section 6 of 'naari o shishu nirjaton domon aain 2000',
punishment for child trafficking is death or life sentence, sometimes
with a fine depending on the degree of the crime.
UNDER A DIFFERENT SKY
The time was between corduroy and linen, end
of summer with a touch of fall. The weather was indefinitely indecisive
and I felt the direct ambiguity in every vein of my body. Every Fall,
my eyes struggle a bit more to shine, smile the usual smiles as my
ears hear the drop of every leaf.
The soon to be naked trees burning with orange and red leaves celebrate
with me the last few days of warmth without the mechanical help of
heaters. I miss the summer that I never fully take advantage of, I
miss the heat which I never gladly welcome without squinting a bit.
Outside, people in their winter clothes, back to full sleeves and
turtle necks, walk by up-to-date with fall fashion. The sweater that
I bought at an off-season sale with an unbeatable price finally gets
to hug my body, I walk out to be one of them, trying to overcome the
depression of the coming winter with stylish winter clothes, the clothes
which we feel so enthusiastic to wear during the first few semi-cooler
As the winter gets graver, the corner of our eyes frequently touch
the bright summer clothes and open-toed sandals peaking out from the
back of the closet to give us some hope; optimism from sunflower prints
and magenta hues.
Some people suffer from symptoms of depression during the winter months,
with symptoms subsiding during the spring and summer months. Of course
the smart psychologists have identified this as a sign of Seasonal
Affective Disorder (SAD). SAD is a mood disorder associated with depression
episodes and related to seasonal variations of light.
I wonder sometimes if I have SAD, and how sad it would be if I was
diagnosed with this particular disorder. Sure, it would provide me
with an excuse to remain cranky and grumpy during the winter months,
but the attachment of a disorder while defining my personality really
would hurt my Bengali mind. Because like most Bengalis I find words
like disorder, counseling, psychologists terribly offensive, and I
would rather be diagnosed with a major case of denial than a definite
But the matter is not so light; winter in North America for me poses
all kinds of definite threats. Not just me, think of all those September
babies who were born, nine months from the cold December, how many
of them were conceived out of the joy of Christmas and new year's
eve and how many of them were conceived from mere frosty boredom and
I guess those are the kinds of data that will never be collected and
documented, it will only circle around my twisted world of random
thoughts. But just to set the records straight I have nothing against
September babies, I get along great with Libras and Virgos amuse me…
But seriously have you thought about it? Why are all the major holidays
during the winter months in America, Thanksgiving, Hanukkah, Christmas
and New Years? Why is it that the colder world has to act extra hard
during the winter months to make a show of joviality?
We have to be showered with Christmas presents and consume lethargic
food like huge turkeys to keep us sedated. We are even given bonuses
at work during winter months, the only time employers give away free
money (how unnatural is that?), Christmas bonus, Christmas parties,
even an after-Christmas 70% markdown in stores…why do we deserve so
much during the winter months, to keep us from which sudden SADness?
I remember as a child I would draw a very frequent picture out of
imagination and glimpses from animation shown on television, the sketch
was of a snow man and two little kids proudly standing next to him.
There were unnaturally huge balls of snow falling from the sky…every
time I finished drawing the picture I sighed regretting living in
I guess it's the affect of my age, or SAD or my terrible snowman drawings
which never got appreciated much, that have lead me to dread the winters
in America. And now, living in between summer and winter, this Fall
I am falling again in the arms of short days and long nights and a
bitter Bengali mood.