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Dr. Amit Malik

Founder CEO

Amit has trained and practised as a Psychiatrist for over 14 years. He strongly believes that combining great professionals and the latest technology will help address the stigma attached to psychological challenges and poor access to high quality psychological healthcare. In addition to being an extensively published author, Amit has held numerous leadership roles including Clinical Director. He has been a member of the Council of the Royal College of Psychiatrists, the Editorial board of International Psychiatry and the standing committees of the European Psychiatric Association. Alongside his MBBS and his postgraduate and super specialist qualifications in psychiatry from the UK, Amit also has an MBA from London Business School.

Dr. Shefali Batra

Co-founder and Chief Experience Officer

Shefali uses a preventive and psychological focus in her Psychiatric practice of 14 years. She founded MINDFRAMES, a wellness organisation, a decade ago to make mind support more widely accessible both in person and online. Through media excerpts and participation in press conferences on social issues, Shefali aims to prompt people towards their own wellness. She has worked with corporates in employee wellness and human factors to guide people towards holistic living. She completed her MBBS and postgraduate training in Psychiatry in Mumbai and holds a Leadership Certificate in Healthcare Management from University of California, Los Angeles.

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Definition

are a group of powerful and highly addictive substances that dramatically affect the central nervous system. They induce a feeling of well-being and improve alertness, attention, and performance on various cognitive and motor tasks. Closely related are the socalled "designer amphetamines," the most well known of which is the "club drug" MDMA, best known as "ecstasy." Finally, some over-the-counter drugs used as also have amphetamine-like action. Amphetamine-related disorders refer to the effects of abuse, dependence, and acute intoxication stemming from inappropriate amphetamine and amphetamine-related drug usage.

Description

Several amphetamines are currently available in the United States. These include Carolbar Womens Fashion Sweet Beaded Mid Heel Ankle Strap Court Shoes Pink 97NmcAF8eW
(Dexedrine), methamphetamine (Desoxyn), and (Ritalin). These Schedule II stimulants, known to be highly addictive, require a triplicate prescription that cannot be refilled. Amphetamines are also known as sympathomimetics, stimulants, and psychostimulants. Methamphetamine, the most common illegally produced amphetamine, goes by the street name of "speed," "meth," and "chalk." When it is smoked, it is called "ice," "crystal," "crank," and "glass." Methamphetamine is a white, odorless, bitter-tasting crystalline powder that dissolves in water or alcohol.

The leaves of the East African bush can be chewed for their stimulant effects. This drug, cathinone or Khat, has an effect on most of the central nervous system, in addition providing the other properties of amphetamines. Illegal laboratories have begun making methcathinone, which has effects similar to cathinone. Methcathinone, also known as "crank," is easily synthesized from ephedrine or pseudoephedrine.

Amphetamines were initially produced for medical use, and were first used in COOLCEPT Women Mid Heel Court Shoes White CR9RNB7
and bronchial inhalers. Early in the 1900s, they were also used to treat several medical and psychiatric conditions, including (a rare condition in which an individuals falls asleep at dangerous and inappropriate moments and cannot maintain normal alertness), attention-deficit disorders, , and depression. They are still used to treat these disorders today.

Amphetamine-like substances called ephedrine and propranolamine are available over the counter in the United States and are used as nasal decongestants. Phenylpropanolamine is also used as an appetite suppressant, and is available over the counter as well. These are less potent than the classic amphetamines, but are still subject to abuse, partly because of their ready availability and low price.

In the 1970s, governmental agencies initiated restrictions increasing the difficulty of obtaining amphetamines legally through prescription. During this same time period, a drug chemically related to the amphetamines began to be produced. This so-called designer drug, best known as "ecstasy," but also as MDMA, XTC, and Adam, has behavioral effects that combine amphetamine-like and hallucinogen-like properties.

The structure of amphetamines differs significantly from that of cocaine, even though both are stimulants with similar behavioral and physiological effects. Like cocaine, amphetamine results in an accumulation of the neurotransmitter dopamine . It is this excessive dopamine concentration that appears to produce the stimulation and feelings of euphoria experienced by the user. Cocaine is much more quickly metabolized and removed from the body, whereas amphetamines have a much longer duration of action. A large percentage of the drug remains unchanged in the body, leading to prolonged stimulant effects.

The handbook that mental health professionals use to diagnose mental disorders is the , also known as the . The 2000 edition of this manual (the Fourth Edition Text Revision, also known as ) describes four separate amphetamine-related disorders. These are:

Causes and symptoms

All amphetamines are rapidly absorbed when taken orally, and even more rapidly absorbed when smoked, snorted, or injected. Tolerance develops with both standard and designer amphetamines, leading to the need for increasing doses by the user.

The classic amphetamines, dextroamphetamine, methamphetamine, and methylphenidate, produce their primary effects by causing the release of catecholamines, especially dopamine, in the . These effects are particularly strong in areas of the brain associated with pleasure, specifically, the cerebral cortex and the limbic system, known as the "reward pathway." The effect on this pathway is probably responsible for the addicting quality of the amphetamines. Catecholamines are any of several compounds found naturally in the body and act as hormones or in the sympathetic nervous system. Dopamine, an intermediate substance that emerges from the biosynthesis of ephinephrine and norepinephrine, is one of those compounds.

Designer amphetamines, most notably MDMA, causes the release of catecholamines, dopamine and norepinephrine; and in addition, releases serotonin . Serotonin, also a neurotransmitter, produces hallucinogenic effects. The clinical effects of designer amphetamines blend the effects of classic amphetamines with those of hallucinogenic drugs, such as LSD.

According to the , symptoms of heavy, chronic, or episodic use of amphetamine, known as amphetamine dependence, can be very serious. Amphetamine dependence is characterized by compulsive drug-seeking and drug use leading to functional and molecular changes in the brain. Aggressive or violent behavior may occur, especially when high doses are ingested. The individual may develop anxiety or paranoid ideas, also with the possibility of experiencing terrifying New Balance Mens 627 Industrial Shoes UK 85 UK Width 4E Brown WHXZOjja
that resemble , with visual or auditory , such as the sensation of insects creeping on the skin, known as "formication." hyperactivity, hypersexuality, confusion, and incoherence. Amphetamine-induced differs from true psychosis in that despite other symptoms, the disorganized thinking that is a hallmark of schizophrenia tends to be absent. Amphetamine dependence consistently affects relationships at home, school and/or work.

Amphetamine abuse is less serious than dependence, but can cause milder versions of the symptoms described above, as well as problems with family, school, and work. Legal problems may stem from aggressive behavior while using, or from obtaining drugs illegally. Individuals may continue to use despite the awareness that usage negatively impacts all areas of their lives.

Acute amphetamine intoxication begins with a "high" feeling which may be followed by feelings of euphoria. The user experiences enhanced energy, becoming more outgoing and talkative, and more alert. Other symptoms include anxiety, tension, grandiosity, repetitive behavior, anger, fighting, and impaired judgment.

In both acute and chronic intoxication, the individual may experience dulled feelings, along with fatigue or sadness, and social withdrawal. These behavioral and psychological changes are accompanied by other signs and symptoms including increased or irregular heartbeat, dilation of the pupils, elevated or lowered blood pressure, heavy perspiring or chills, nausea and/or vomiting, motor agitation or retardation, muscle weakness, respiratory depression, chest pain, and eventually confusion, , coma, or a variety of cardiovascular problems, including . With amphetamine overdoses, death can result if treatment is not received immediately. Long-term abuse can lead to memory loss as well, and contributes to increased transmission of hepatitis and HIV/AIDs. Impaired social and work functioning is another hallmark of both acute and chronic intoxication.

Following amphetamine intoxication, a "crash" occurs with symptoms of anxiety, shakiness, depressed mood, lethargy, fatigue, nightmares, headache, perspiring, muscle cramps, stomach cramps, and increased appetite. Withdrawal symptoms usually peak in two to four days and are gone within one week. The most serious withdrawal symptom is depression, possibly very severe and leading to suicidal thoughts.

Use of so-called designer amphetamines, the best-known of which is MDMA, leads to symptoms of classic amphetamine use. Users report a sense of feeling unusual closeness with other people and enhanced personal comfort. They describe seeing an increased luminescence of objects in the environment, although these hallucinogenic effects are less than those caused by other hallucinogens, such as LSD. Some psychotherapists have suggested further research into the possible use of designer amphetamines in conjunction with . This idea is highly controversial, however.

Like classic amphetamines, use of MDMA produces cardiovascular effects of increased blood pressure, heart rate, and heart oxygen consumption. People with preexisting heart disease are at increased risk of cardiovascular catastrophe resulting from MDMA use. MDMA is not processed and removed from the body quickly, and remains active for a long period of time. As a result, toxicity may rise dramatically when users take multiple doses over brief time periods, leading to harmful reactions such as dehydration, Sandals Female Summer Fashion Outer Wear Seaside Slope High Heels Clip Toe Slippers Thick Heel Shoes Green kWMHyQdyf
, and seizures.

MDMA tablets often contain other drugs, such as ephedrine, a stimulant, and dextromethorphan, a cough suppressant with PCP-like effects at high doses. These additives increase the harmful effects of MDMA. It appears also to have toxic effects on the brain's serotonin system. In tests of learning and memory, MDMA users perform more poorly than nonusers. Research with primates show that MDMA can cause long-lasting brain damage. Exposure to MDMA during the period of pregnancy in which the fetal brain is developing is associated with learning deficits that last into adulthood.

Demographics

Amphetamine dependence and abuse occur at all levels of society, most commonly among 18- to 30-year-olds. Intravenous use is more common among individuals from lower socioeconomic groups, and has a male-to-female ratio of three or four to one. Among non-intravenous users, males and females are relatively equally divided.

The most common approach is to offset every other column or row. Columns are named col ( q ). Rows are named row ( r ). You can either offset the odd or the even column/rows, so the horizontal and vertical hexagons each have two variants.

Another way to look at hexagonal grids is to see that there are primary axes, unlike the we have for square grids. There’s an elegant symmetry with these.

Let’s take a cube grid and slice out a diagonal plane at . This is a idea but it helps us make hex grid algorithms simpler. In particular, we can reuse standard operations from cartesian coordinates: adding coordinates, subtracting coordinates, multiplying or dividing by a scalar, and distances.

Notice the three six hex grid directions are halfway between two of the cube axes. We’ll see this in the neighbors section, where moving along one of the six hex grid directions involves changing of the coordinates.

Because we already have algorithms for square and cube grids, using cube coordinates allows us to adapt those algorithms to hex grids. I will be using this system for most of the algorithms on the page. To use the algorithms with another coordinate system, I’ll convert to cube coordinates , run the algorithm, and convert back.

Study how the cube coordinates work on the hex grid. Selecting the hexes will highlight the cube coordinates corresponding to the three axes.

The cube coordinates are a reasonable choice for a hex grid coordinate system. The constraint is that x + y + z = 0 so the algorithms must preserve that. The constraint also ensures that there’s a canonical coordinate for each hex.

There are many different valid cube hex coordinate systems. Some of them have constraints other than x + y + z = 0 . I’ve shown only one of the many systems. You can also construct cube coordinates with x-y, y-z, z-x , and that has its own set of interesting properties, which I don’t explore here.

“But Amit!” you say, “I don’t want to store 3 numbers for coordinates. I don’t know how to store a map that way.”

Axial coordinates #

The axial coordinate system, sometimes called “trapezoidal” or “oblique” or “skewed”, is built by taking two of the three coordinates from a cube coordinate system. Since we have a constraint , there’s some redundancy, and we don’t need to store all three coordinates. This diagram is the same as the previous one, except I don’t show :

There are many choices of cube coordinate system, and many choices of axial coordinate system. I’m not going to show all of the combinations in this guide. I’ve chosen for “column” = and as “row” = . This choice is arbitary, as you can rotate and flip the diagrams to make many different assignments of ±x,±y,±z to q,r.

The advantage of this system over offset grids is that the algorithms are cleaner when you can use add, subtract, multiply, and divide on hex coordinates. The disadvantage of this system is that storing a rectangular map is a little weird; see the map storage section for ways to handle that. In my projects, I name the axes , , so that I have the constraint , and then I can calculate when I need the third coordinate for algorithms that work better with cube coordinates.

Although I recommend axial/cube coordinates, if you are sticking to offset coordinates, consider the doubled variant. It makes many of the algorithms easier to implement. Instead of alternation, the doubled coordinates double either the horizontal or vertical step size. It has a constraint ( col + row ) % 2 == 0 . In the horizontal (pointy top hex) layout it increases the column by 2 each hex; in the vertical (flat top hex) layout it increases the row by 2 each hex. This allows the in-between values for the hexes that are halfway in between:

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Mental illness, like physical illnesses, is on a continuum of severity ranging from mild to moderate to severe. More than 60 million Americans have a mental illness in any given year. Mental illness affects one in four adults and one in five children. Very few people, however actually seek treatment for mental illness. The associated with mental illness is still the biggest barrier that prevents people from getting treatment or retaining their treatment.

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A mental illness is a disease of the brain that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines. There are more than 200 classified forms of mental illness. Some of the more common disorders are: clinical depression, bipolar disorder, dementia, schizophrenia and anxiety disorders. Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.

Mental health problems may be related to excessive stress due to a particular situation or series of events. As with cancer, diabetes and heart disease, mental illnesses are often physical as well as emotional and psychological. Mental illnesses may be caused by a reaction to environmental stresses, genetic factors, biochemical imbalances, or a combination of these. With proper care and treatment many individuals learn to cope or recover from a mental illness or emotional disorder.

NOTE : Persons with mental illness usually exhibit a of symptoms – not just one or two symptoms – that are and interfere with . This listing of warning signs and symptoms of mental illness is to be used as an educational and information tool – not as a diagnostic instrument. A diagnostic evaluation by a licensed mental health and/or medical professional is needed to determine if someone has a mental illness. A diagnostic evaluation may include: (a) a complete physical checkup to rule out other illnesses; (b) information gathering on family health history; and (c) other diagnostic tests/evaluations as determined by a licensed professional.

Adults

Preadolescents

Younger Children

Contact the Mental Health Association in Forsyth County at (336) 768-3880 for more information and/or referrals to mental-health specialists.

Mental illness, like physical illnesses, is on a continuum of severity. More than 60 million Americans have a mental illness in any given year, although very few actually seek treatment. The statistic most often quoted is that one in four adults and one in five children will have a mental health disorder at some point in their lives. The associated with mental illness is still the biggest barrier that prevents people from getting treatment or retaining their treatment.

ANXIETY DISORDER

All of us encounter anxiety in many forms throughout the course of our routine activities. However, the mechanisms that regulate anxiety may break down in a wide variety of circumstances, leading to excessive or inappropriate expressions of anxiety. An anxiety disorder may exist if the anxiety experienced is disproportionate to the circumstance, is difficult for the individual to control, or interferes with normal functioning.

More than 19 million American adults are affected by an anxiety disorder. Children and adolescents also develop anxiety disorders. People with anxiety disorders also have other physical or mental disorders such as: depression, eating disorders, substance abuse, cancer or heart disease as examples.

Generalized Anxiety Disorder

People with Generalized Anxiety Disorder have chronic, exaggerated worry about everyday routine life events and activities, with symptoms lasting at least six months; almost always anticipating the worst even though there is little reason to expect it. People with General Anxiety Disorder have co-occurring physical symptoms, such as fatigue, trembling, muscle tension, headache, or nausea.

Phobias

People with phobias have extreme, disabling and irrational fear of something that really poses little or no actual danger; the fear leads to avoidance of objects or situations and can cause people to limit their lives.

Panic Disorder

People with panic disorder have experienced a panic attack. The disorder occurs when the person fears having another panic attack. Panic disorder is, therefore, characterized by panic attacks, which are sudden feelings of terror that strike repeatedly and without warning. Physical symptoms include: chest pain, heart palpitations, shortness of breath, dizziness, abdominal discomfort, feelings of unreality, and fear of dying.

Obsessive-Compulsive Disorder

People with Obsessive-Compulsive Disorder have anxious impulses to repeat words or phrases or engage in repetitive, ritualistic behavior, such as constant hand washing.

Post-Traumatic Stress Disorder

People with Post-Traumatic Stress Disorder have persistent symptoms that occur after experiencing a traumatic event such as war, rape, child abuse, natural disasters, or being taken hostage. Nightmares, flashbacks, numbing of emotions, depression, and feeling angry, irritable, and distracted and being easily startled are common symptoms of PTSD.

Support group for adults with anxiety disorders such as: panic disorder, obsessive-compulsive disorder, posttraumatic stress and generalized anxiety. Meetings are held the second and fourth Thursdays at 7:00pm at The Mental Health Association, 1509 S. Hawthorne Road, Winston-Salem.

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MOOD DISORDER

Most of us have an immediate and intuitive understanding of the notion of mood. We readily know what it means to be happy or sad. Mood disorders, however, are outside the bounds of normal fluctuations from sadness to elation. Mood disorders affect about 7% of Americans and rank among the top 10 causes of disability. In the workplace, major/clinical depression is a leading cause of absenteeism and diminished productivity. Depression-related visits to physicians account for a large portion of health care expenditures.

clinical or major depression, dysthymia and bipolar disorder, formerly known as “manic-depression”. Suicide is the most dreaded complication of major depressive disorders. About 10 to 15% of patients formerly hospitalized with depression commit suicide. Similar to anxiety disorders, mood disorders affect around 19-20 million American adults. Children and adolescents are also susceptible to mood disorders as well.

Clinical Depression

Depression causes people to lose pleasure from daily life, can complicate other medical conditions, and can even be serious enough to lead to suicide. Depression can occur to anyone, at any age, and to people of any race or ethnic group. Depression is never a “normal” part of life, no matter what your age, gender or health situation. Unfortunately, though treatment for depression is almost always successful, fewer than half of those suffering from this illness seek treatment. Too many people resist treatment because they believe depression is not serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.

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