Dr Dhananjay Chavan, Psychiatrist

I see only adult (>18 years) and geriatric patients.

My Practice

After completing my MBBS and MD in Psychiatry in 1991 from BJ Medical College, Pune, I spent two decades as a volunteer in a meditation organization. This afforded me time to study related ancient literature as well as biological sciences related to psychiatry. In 2012, I joined a full-time one-year fellowship in geriatric mental health. in 2013, I started consulting in Pune with various hospitals including Deenanath Mangeshkar Hospital, Aditya Birla Hospital, Healthspring and Jehangir Hospital as well as Dignity Home Foundation, a charity. When covid struck I moved to Nashik to be with my parents. Now, most of my consultations are online/telephonic. Thus, I am available to people irrespective of where they live. My focus is on evidence-based and common-sense solutions to mental health issues.

Mental health and Psychiatrist

Amid the noise about mental health on social media, misunderstandings remain rampant. Unproven bombastic claims distract from simple and effective proven strategies. Psychiatric disorders form a subset of those issues that come under the purview of medical science. Psychiatrists identify these conditions and treat them.

For the elderly, it is even more important for the psychiatrist to review social and other medical issues.

(Pic: Storm clouds were gathering on this hot summer afternoon and everything was getting dark, at least dark by Indian summer afternoon standards, when a beam of light burst through the clouds and lit up a patch of trees.)

Depression and Anxiety

Depression and anxiety are among the commonest conditions that affect our well-being and productivity. Early and proper diagnosis not only gives relief from immediate suffering but also improves long-term outlook. Psycho-education, medication, overall health awareness and psychotherapy are all important. Therapies referred to as Cognitive Behavioral Therapy (CBT) have the highest evidence for efficacy.

(The picture: this tree was burnt down in a forest fire but I was told that in the aftermath even the tree trunk gets new leaves. Nature has indeed endowed us with immense powers of healing and rejuvenation.)

Depression in Older Adults

Depression in older adults is often overlooked because

1. Ageist attitude (the wrong assumption that it is natural and expected to be depressed in old age)

2. Older adults often don't report feeling sad or low.

Depression in this population often manifests as a lack of interest, inability to enjoy pleasures, tiredness, multiple complaints including aches and repeated visits to GPs.

This condition should be diagnosed early as timely intervention is effective.

Depression can also indicate a prodrome of other medical conditions.

For the Family of Dementia / Alzheimer's Patients

Caring for dementia patients (Alzheimer's and others) is one of the most challenging tasks in the world. A geriatric psychiatrist (coordinating with your family physician) can improve the patient's quality of life and make the caregiver's task more manageable.

My books for family members of dementia are available in Hindi and Marathi on Amazon.

अल्जायमर्स एवं अन्य डिमेन्शिया के मरीज, उनका परिवार एवं सहायकों के लिए किताब

https://www.amazon.in/Dementia-Dhananjay-Chavan/dp/9388247167/

डिमेन्शियाचे रूग्ण आणि त्यांच्या कुटुंबियांसाठी माहिती पुस्तिका

https://www.amazon.in/Dementia-Dhananjay-Chavan/dp/9386450852/

Senior Citizens' Handbook

While these are golden years of life, older adults are also vulnerable to so many diverse physical, psychological and social stresses. So many facets of health acquire an immediacy at this stage in life. Just as older adults must be familiar with the basics of physical and mental health, the middle-aged too need to be well-informed. The preparation for optimum mental health in old age must start during middle age itself. Senior Citizens' Handbook is a collection of simple tips that is useful for the elderly and their family members.https://www.amazon.in/Senior-Citizens-Handbook-Dhanajay-Chavan/dp/9386450992/

Meditation and Mental Health

People with psychiatric conditions often benefit from meditation. Indeed, all spiritual traditions attract people with psychiatric conditions disproportionately. However, sometimes, meditators struggle to make sense of their experiences. Not having clarity about the range of normality can lead to meditators harming their health by ignoring the symptoms of medical disorders. It is a delicate task to discern among their meditative experiences indicators of a psychiatric condition.

These travellers on a spiritual path benefit from a private and confidential consultation where they are not worried about being judged and can discuss their issues with someone who is a practitioner for many years.

Sleep. The Problem and the Solution.

Sleep is perhaps the greatest tool for positive health. It is also a usual victim of the modern age. The invention of electricity and artificial light, the burgeoning use of screens (TV, laptops and mobile), jobs that require one to stay awake at night and working for overseas clients are some of the things that cause sleep disturbances with terrible consequences for health. From depression, hypertension, impaired memory and judgment to decreased immunity, lack of sleep takes a great toll on people. Many people do not understand the importance of sleep as there is undue focus on 'productivity' and false claims about requiring little sleep. In addition, we all have different sleep patterns. Some are early birds and some are night owls.

Sometimes, the only thing a patient requires is proper sleep. The so-called sleeping pills are often not the solution and can be a problem.

Sleep disturbance can be the earliest symptom of a mental disorder.

Workplace Stress & Working from Home

Sometimes, just identifying the issues involved and developing strategies to cope with them is enough.

It is important to remember that stress at the workplace can be both a trigger and a symptom of psychiatric disorders.

The digital revolution has made working from home easy and apparently convenient but it can throw up mental health challenges if one is not mindful.

Chronic Pain and Headache

Low mood decreases the pain threshold and chronic pain is a risk factor for depression. Migraine headache is a risk factor for depression and vice versa. Migraine causes debilitating headaches often associated with nausea and sensitivity to light & sound. It is especially common among working women. Understanding the nature of headache is key to treatment.

Lectures and Workshops

Lectures for Mental Health Awareness

Awareness about Alzheimer's and other dementias

I believe that efforts for awareness about mental health are as important as my clinical practice. My talks help in creating awareness and removing the stigma around psychiatric conditions. Education about the basics of mental health allows early and effective intervention.

I like to target middle-aged people as they don't realize that th

I like to target middle-aged people as they don't realize that they have several decades of life ahead of them still and must prepare for it. I also conduct interactive sessions for caregivers of dementia patients.

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Awareness about Alzheimer's and other dementias

In India, majority of the patients with dementia never see a psychiatrist. Therefore, I conduct workshops for senior citizen groups in the community. I educate seniors about this condition, help them understand risk factors and also do basic screening for cognitive impairment.

Online lectures and workshops

Awareness about Alzheimer's and other dementias

Online lectures and workshops

It is often easier to reach people through online lectures arranged by corporate houses, organizations and professional associations.

General mental health awareness, basic information about psychiatric conditions, and stress at workplace are some of the themes for these.

I also conduct workshops for employees who are going to retire soon.

Frequently Asked Questions

Psychiatry is a science and an art. Its practice is a nuanced undertaking. The following answers can't elaborate on all aspects of the issue. I advise you to talk to your psychiatrist for a detailed answer and further clarification.

What is the difference between Psychiatry and Psychology?

Though both psychologists and psychiatrists are trained to identify mental issues and mental disorders, there are important differences.

People often confuse psychiatrists (who are medical doctors) with psychologists (who come from the background of humanities or what is called arts in India).

Psychiatry is a branch of medicine focused on diagnosing and treating

mental health disorders. A psychiatrist is a doctor who specializes in illnesses that have almost exclusively mental, emotional and behavioural symptoms. Behavioural here doesn’t just mean actions but also includes subjective distress or reported feelings and dysfunction. With ever-increasing evidence for a biological basis of mental disorders as well as better evidence-based treatments,

Psychiatry has become an exciting branch of medicine now attracting more and more young doctors.

Psychology is a branch of science that has ever so slowly moved away from philosophy. It is the study of mind, emotions and behaviour; the study of the human mind and its functions, especially those affecting behaviour in a given context. Thus, we have fields such as sports psychology, industrial psychology etc.

(In daily language, psychology is often used to mean the mental characteristics or attitude of a person or group. मुझे उस की सायकॉलॉजी समझ में नहीं आती। "I don't understand my husband's psychology!")

Many young people express a desire to study psychology but have no clue as to what this study involves. All they have is a vague fascination with the subject. Very few understand that it is a rigorous discipline that involves studying the basics of neurosciences. Various theories popular in yesteryears are still taught but they take up very little space in a typical academic course of psychology.

Anybody with a degree in psychology can be called a psychologist. A clinical psychologist is not a medical doctor but has expertise in dealing with mental health issues; often in specific areas such as learning disability, PDD (autism) etc.

There are many counsellors and therapists with questionable qualifications and even more questionable practices. This is because at least in India, this field is poorly regulated.

Does Psychiatrist know everything about mind?

Psychiatrist is not an all knowing expert of psyche or mind. He/she is a specialist doctor who diagnoses and treats medical conditions that manifest as psychological/behavioral symptoms.

What is the scope of psychaitry?

In the past century, the more psychiatrists restricted themselves to mental disorders, the

more they distinguished themselves in their competence in this specific area. This limitation of the scope of psychiatry towards biological science and somewhat away from philosophy doesn’t mean that philosophy or deeper questions about life in general are not important. Search for meaning and purpose of life is not just a noble pursuit but also perhaps the highest one. Though psychiatrists encounter human suffering in a way that other medical specialists don’t and thus are often forced to dwell on psychosocial and philosophical issues, psychiatry as a discipline to be effective (and ultimately helpful to humanity) can’t afford to stray from diagnosis and treatment of specific medical disorders that manifest as mental conditions.

How does a psychiatric consultation work?

Similar to any medical consultation: When one goes to a psychiatrist with complaint/s, he/she asks for details about your complaints along with other medical and personal history. Often input from the spouse or a close family member is sought. He/she then gives a tentative diagnosis and prescribes appropriate treatment. Sometimes, the psychiatrist asks for some tests (or another specialist's opinion) to reach a diagnosis. Afterwards, treatment options are discussed and decided. Sometimes, the psychiatrist may simply reassure one that the symptoms don't signify any disorder. This reassurance (along with tips for a healthy lifestyle) is all that is needed.

Do psychotropic medicines cause significant weight gain?

Some of them, particularly the class referred to as SGAs, indeed cause weight gain and other long-term metabolic side effects. DO ASK YOUR PSYCHIATRIST about the medicines you are prescribed.

Do only 'mad' people need a psychiatrist?

NO! Overwhelming majority of psychiatric patients are people who suffer from symptoms such as depression and anxiety but are otherwise productive members of society who live meaningful lives as professionals and family members . There is a tiny subsection of psychiatric patients, such as some but not all schizophrenic patients, who do lose touch with reality.

Do most Psychiatrists use Freudian theories?

Hardly any psychiatrist practices classical psychoanalysis today. The image of a psychiatrist sitting by the patient’s head-side reclining on a couch is outdated. Literature and other art forms are usually late in catching up with scientific advances and hence that image endures.

Freud was a major force in psychiatry in the middle of the last century. He taught people to talk about psychological issues. Also, arguably, the influence of Freud and psychoanalytical

theories, at that time undermined psychiatry’s standing in the medical world. Today, philosophers of science often put Freudian theories under pseudoscience. In his own lifetime, Freud himself had discarded some of his theories. Ever courageous in revising his theories, he would also do so today, given the mountain of evidence against many of his theories. That should neither decrease one’s respect for Dr Freud nor admiration for his captivating writing. (Freud was nominated for the Nobel Prize, not for medicine but for literature).

In short, Freud is less and less relevant if you wish to understand the state of psychiatry today.

Are psychiatric conditions hereditary?

In most psychiatric conditions, both genetic factors, as well as environmental/ psychosocial factors, play a role to various degrees. It is not nature versus nurture but both of these together.

Several psychiatric disorders are similar to other diseases such Type II Diabetes (T2DM), a metabolic disorder in which lifestyle factors play a significant role.
Different conditions have different genetic components.

Do elderly suffer from depression?

Yes, they do.

Overall, in society (excluding aged care home population) incidence of depression is lower among the elderly than among youth. Also overall, elders also have less fear of death than younger people. They often live a comfortable and productive life. Old age is not a helpless and painful state. Ageing is inevitable, pain and misery most certainly not!

Still, some elderly, do suffer from depressive disorder.

Multiple co-existing illnesses in the elderly also increase the chances of psychiatric disorders. Many conditions such as heart disease, severe arthritis, chronic infections, Parkinson’s and Alzheimer’s often have significant associated depression that requires treatment, often medication.

When should we suspect dementia or Alzheimer's in a family member?

It is best to seek a psychiatric consultation whenever you see any deterioration in any cognitive ability, mood or personality. It is especially important when a family member shows forgetfulness of recent events. It is useful to remember that in the early stages of Alzheimer's, remote or memories of the distant past are intact.

Sometimes, the fear is unfounded but if indeed dementia has set in, then an early diagnosis helps immensely.

If there is no cure for dementia/Alzheimer's, why seek consultation at all?

Early diagnosis is vital and helps in several ways:

1. The medicines available to slow the progression of the disease are more effective in the early stage.

2. The patients have time to prepare themselves in various ways. They can start putting things in order if they haven't already done so. They can tick off some of the remaining items on their bucket list. They can discuss with their family members about their preferences when in advanced stages they may not be in a position to make those decisions. They can even make a Will in the early stage.

3. It gives caregiver an insight into the patient's behaviour and thus saves much psychological distress. Often, when the condition is undiagnosed, the family members remain bewildered and frustrated.

4. It allows family members to plan their vacations or duties as there is much-advanced notice.

How many therapy sessions does one need?

You may or may not be advised psychotherapy. However, psycho-education, that is, the basic understanding of your condition is essential.

Psychotherapy doesn't simply mean chitchat. It is supposed to follow certain established psychotherapeutic approaches. Most are around 8-12 sessions. There is no robust evidence for efficacy for more sessions. That is why I am often amused when somebody comes to me and reports that they have been in therapy for dozens of weeks or months; often exceeding 25 sessions.

There has to be discussion about what approach the therapist is going to take and about the length of the treatment.

Do all phobias need treatment?

Not all phobias need treatment but they all need understanding!
One should seek consultation when phobias cause significant mental distress or start interfering with family/ social / work functioning.

Is meditation effective in treating psychiatric condition?

Meditation is as useful as healthy food and exercise! However, meditation is not an alternative to psychiatric treatment. It also depends on both a person's aptitude and the nature of the psychiatric condition.

For any spiritual or religious practice, my opinion is that it is usually quite helpful, as long as there are practices involved are not detrimental to one's finances or health.

Everybody feels low sometimes. When is it Depression?

Depression is a mental state and it is also a term used for depressive disorder as in “He is suffering from Depression.” While depressed mood is a symptom of depressive disorder; being sad doesn’t mean one has depressive disorder. Everyone gets sad to lesser or greater extent throughout one’s life for various reasons and for various durations. Such is life.

Depression involves some or all of the following key symptoms that last for several days:

Persistent sadness or low mood,

loss of interest,

low energy,

disturbed sleep,

appetite disturbances,

suicidal thoughts,

agitation,

guilt or self-blame,

poor concentration,

low self-esteem.

If you are feeling low for most part of the day for several days, seek psychiatric consultation immediately.

What is the relation of personality and Depressive disorder?

While different personalities have different temperaments and different vulnerabilities, Depressive disorders are not limited to any particular personality. Suffering from depressive disorder doesn't mean one is weak-minded. Many otherwise wise and competent people can suffer from Depression just as they can suffer from other medical disorders.

Is what is referred to as LGBTQ+ a psychiatric disorder?

Most emphatically not. However, people from LGBTQ+ community are more likely to suffer from Depression and Anxiety. Social discrimination and stigma are an important reason behind this.

In India, homosexuality was decriminilized only in 2018. That shows both the prejudice and apathy of our society. There are several good resources on the web that give more information as well as support. I have also posted a short youtube video in Marathi on it https://www.youtube.com/watch?v=pzbnKx7V2XA

Are psychotropic medicines addictive?

Most of them are not addictive. Some, such as benzodiazepines, are habit-forming but can be useful for certain patients. Most antidepressants including SSRIs are among the safer medicines and are not addictive.Ask your psychiatrist about side effects of medicines you are prescribed.

Is a psychiatric consultation completely confidential?

It is. The patient's privacy is scrupulously maintained. No information about the consultation is disclosed to anyone without the specific consent of the patient.

How long does one need to continue medications for a psychiatric condition?

It differs from patient to patient and disorder to disorder. It is best to understand this from your psychiatrist. It is important to remember that discontinuing medicines may not result in immediate relapse of the condition and hence may lull the patient into false sense that he/she doesn't need the medicines any more. Always talk to your psychiatrist before you stop the medicines. Often there is no strict guideline about this and a psychiatrist makes a decision after discussion with the patient.

Is it a good idea to seek a second opinion from another doctor?

Certainly. It helps if you inform both doctors. Also, don't keep running from one doctor to another and the next. Address your queries to the doctor that you choose. It helps when a psychiatrist knows you over a long period of time.

Isn't it natural to be depressed after a major illness or when one has chronic pain? Why see a psychiatrist?

Indeed, all infections including viral and bacterial can cause depression and depression may make one more vulnerable to infections by reducing immunity. Same with chronic pain. If one is depressed, pain threshold goes down. Therefore, irrespective of the cause, if you are feeling low for most of the time of the day and for several days, you should seek a psychiatric consultation.

Will I be prescribed medicines simply because I have consulted a psychiatrist? Even if there is no good evidence that the medicine will help my condition?

This is where discussion with your doctor helps. It is important that you ask your doctor why you are being prescribed medicines, what the side effects are and what the plan going forward is.

A walk in nature is among the best therapies in the world.

I see only adult (>18 years) and geriatric patients.

My Practice

Mental health and Psychiatrist

Depression and Anxiety

Depression in Older Adults

For the Family of Dementia / Alzheimer's Patients

Senior Citizens' Handbook

Meditation and Mental Health

Sleep. The Problem and the Solution.

Workplace Stress & Working from Home

Chronic Pain and Headache

Lectures and Workshops

Lectures for Mental Health Awareness

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Online lectures and workshops

Awareness about Alzheimer's and other dementias

Online lectures and workshops

Updates

Frequently Asked Questions

A walk in nature is among the best therapies in the world.

I see only adult (>18 years) and geriatric patients.

My Practice

Mental health and Psychiatrist

Depression and Anxiety

Depression in Older Adults

For the Family of Dementia / Alzheimer's Patients

Senior Citizens' Handbook

Meditation and Mental Health

Sleep. The Problem and the Solution.

Workplace Stress & Working from Home

Chronic Pain and Headache

Lectures and Workshops

Lectures for Mental Health Awareness

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Awareness about Alzheimer's and other dementias

Online lectures and workshops

Awareness about Alzheimer's and other dementias

Online lectures and workshops

Updates

Frequently Asked Questions

Social

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