Case taking difficulties of adolescent girls
- Dr Sunitha Devi Vannemreddy, M.D(Hom), consult the doctor at drsunithavannemreddy@gmail.com
Adolescence is the transition period between children to young adults. This is the stage comes in between the age of 13 to 19 years. It is also called as teenage. In this stage in girls, there is not only physical changes occurs but also emotional and behavioral changes we can find out.
Girls will starts her menstrual cycle during this stage, development in physical changes, breast development and pubic hair development and starting the signs of menstruation, will call as attaining the puberty. In this stage, child become adolescent, not complete young girl not complete a child. This is the transition stage, which makes lot of confusion in them.
In Indian culture, once child starts attaining the puberty, lot of restrictions will start arising in the house. Now a days there is not much orthodox principles are there, but some restrictions will starts automatically, which that young lad could not understand well. Her attitude of thinking will starts changing, she starts looking at the world, she starts comparing the physical changes with her peers, she become friendlier with her friends and she makes friends of like minded people. She is become more secretive towards the family. She shares everything with her friends. She feels that she become young and she was in a stage to decisions on her own. She feels that she is not dependent on her parents any more. Her world become more fantasizing and she will attract to most of the things at the same time. She couldn't able to know the way she has to choose. She will try to resolve her doubts from her peers; who are also at the same confusion state. Her concentration on studies will distract to external factors.
Her concentration suddenly focuses at her looks, beauty and she starts comparing with her peers. She wants new type of dresses, accessories, which she doesn't want them earlier. She become choosy, she wants her own decisions. Because of hormonal spurs, she doesn't like to be dominated, scolded and principled. She wanted her life on her terms. She starts quarreling with her mother for unnecessary reasons; she doesn't like to listen to her anymore, who is earlier mama’s daughter, become younger. She wanted to be in her world. She may become quite, she don’t like to participate in family discussions. She is more attracted to opposite group and she think that what is wrong if she try new things in life. She wanted to be independent and show her own identity.
At the same time, parents treat their children as children only. They don’t like to be questioned. They feel their kids are still immature and they don’t know what to choose, what not to. They don’t like to accept they have their own choices. They try to dominate them. Parents become more protective towards their children, as they journeyed from the same stage. They could not able to understand what’s going in their kids mind. They don’t like to understand the identity crisis of her daughter. They start yelling on her children, argue with them and scold them on small reasons. They scold them saying that “they become young and they have to perform their own works on time” and at the same time they don’t allow them to do the things on her will and wish. This kind of crisis will start in the houses of adolescents.
In during the case taking, same kind of obstacles will come across to me. The adolescent menstrual cycles are usually irregular, because of hormonal imbalances. It will take some time to become regular. Meanwhile adolescent will be emotional roller coaster with changes in her body. E.g.: menses and acne confusion about her womanhood. But in most of the Indian families, mother doesn't like to discuss about her daughters puberty and at the same time daughter can’t ask her doubt to mother as she feel she might be scolded. She tries to clear her doubts with her peers.
I would like to present one case to you, how difficult to treat the menstrual irregularities of young girls. One day, with the known person, a father came to my clinic to talk about his daughter, saying that she has irregular menses and putting on weight. I told him to bring his daughter. She came to my clinic next day along with her mother. She is 17 yrs old, pursuing her intermediate and more focused on getting rank in EAMCET for engineering. I asked her what is her health problem, immediately her mother started talking about her daughter’s menstrual trouble, saying that she has irregular menses 2-3 months once, and she has lot of acne on her face, dandruff and hair loss. She started telling me her daughter’s complaints without any gap and she is not allowing her daughter to express her feelings. She said “you have to take care of my daughter, as she doesn't eat food properly, that’s why she has irregular periods.” I told that i will take care of her complaints and asked her to allow her daughter to talk. Then she immediately said she know very well about her daughter problem, she is telling on behalf of her daughter as she is shy in nature and don’t talk to strangers. Again she started complaining about her daughter that she is moody, she don’t interact with others properly, whole day she sits in front of her books, but she is on her own world. Some time she doesn't react to her words. She cries and quarrels with her in house before arrival of her menses.
During the conversation, i am listening to her complaints; started observing the patient. She kept quiet and bending the head forward. She is not at all concentrating what her mother talking about her. She is sad and little bit arrogant looks, she is looking at her mother. A kind of negligence i have seen in her eyes about her mother. Once she stopped the complaints list about her daughter, i told her to go out and wait for a second, as i wanted to talk to patient separately. But she denied it and she said there is nothing is there to talk separately. She said there are no secrets for her daughter. She denied going out. Then i asked the patient about her menstrual cycle in front of her mother and told them to come with ultra sound pelvis and thyroid profile reports next time.
After 15 days, both mother and daughter came with reports. In reports there is indication of multiple cysts in right ovary. I said she has PCOS and she needs Homeopathic care, diet management and proper exercise. I explained them that once attempt to weight loss will reduce the cysts activity and menses become regular. I explained her father the importance of case taking and told him to bring his daughter alone next time. He accepted it and told me that he will explain to his wife. After 2 days she came alone. i started a casual conversation with her in the beginning as i felt she is hesitant to talk about her personality. Slowly she started talking nicely, she is straight forward in nature and she talks what comes in her mind. She wanted to complete her engineering and become a software engineer. She wanted to do a job. But she was dominated by her mother. As her mother feel that she is still a child and she can’t take decisions on her own. She said her mother is overprotective about her, as she is only child to her parents. She thinks her mother to be her best friend but at the same time, she feel that she was not able to independent because of her mother over protectiveness. Her mother keeps an eye on her each and every activity and she listen to her conversations with her friends which don’t like. She don’t like to express her anger mostly, but once she become irritant on something, then she start yelling and cries while fighting with her mother. Then mother try to blackmail her emotionally, by not talking to her and fasting. Then she apologies her and promises that she will listen to her. Then slowly she started losing interest on her education, not much interested in anything, she likes to be in her own world, imagining something which makes her happy.
After talking to her i gave her 1 dose of Saphysagria 1 M, told her come after 1 month. I mean while talked to her father and counselled her mother, to understand her daughter adolescent stage and told her to give support and try makes her understand about the world and ask her to take decision on her own, told her to protect her without dominating her.
Till 6-8 months, her complaints are changing from one to other and then slowly she settled down.
This roller coaster emotional crisis will lead her to make wrong decisions. So girl’s parents should understand their stage and has to give support morally, emotionally and mentally. So that they can able to make decisions properly, otherwise they lose their happy adolescence and lead to suppression, behavioral problems; it will haunt her entire life.
So be patient in getting the results while taking care of adolescent cases and along with that counselling is needed them to get faster results.
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Adolescence is the transition period between children to young adults. This is the stage comes in between the age of 13 to 19 years. It is also called as teenage. In this stage in girls, there is not only physical changes occurs but also emotional and behavioral changes we can find out.
Girls will starts her menstrual cycle during this stage, development in physical changes, breast development and pubic hair development and starting the signs of menstruation, will call as attaining the puberty. In this stage, child become adolescent, not complete young girl not complete a child. This is the transition stage, which makes lot of confusion in them.
Her concentration suddenly focuses at her looks, beauty and she starts comparing with her peers. She wants new type of dresses, accessories, which she doesn't want them earlier. She become choosy, she wants her own decisions. Because of hormonal spurs, she doesn't like to be dominated, scolded and principled. She wanted her life on her terms. She starts quarreling with her mother for unnecessary reasons; she doesn't like to listen to her anymore, who is earlier mama’s daughter, become younger. She wanted to be in her world. She may become quite, she don’t like to participate in family discussions. She is more attracted to opposite group and she think that what is wrong if she try new things in life. She wanted to be independent and show her own identity.
At the same time, parents treat their children as children only. They don’t like to be questioned. They feel their kids are still immature and they don’t know what to choose, what not to. They don’t like to accept they have their own choices. They try to dominate them. Parents become more protective towards their children, as they journeyed from the same stage. They could not able to understand what’s going in their kids mind. They don’t like to understand the identity crisis of her daughter. They start yelling on her children, argue with them and scold them on small reasons. They scold them saying that “they become young and they have to perform their own works on time” and at the same time they don’t allow them to do the things on her will and wish. This kind of crisis will start in the houses of adolescents.
In during the case taking, same kind of obstacles will come across to me. The adolescent menstrual cycles are usually irregular, because of hormonal imbalances. It will take some time to become regular. Meanwhile adolescent will be emotional roller coaster with changes in her body. E.g.: menses and acne confusion about her womanhood. But in most of the Indian families, mother doesn't like to discuss about her daughters puberty and at the same time daughter can’t ask her doubt to mother as she feel she might be scolded. She tries to clear her doubts with her peers.
I would like to present one case to you, how difficult to treat the menstrual irregularities of young girls. One day, with the known person, a father came to my clinic to talk about his daughter, saying that she has irregular menses and putting on weight. I told him to bring his daughter. She came to my clinic next day along with her mother. She is 17 yrs old, pursuing her intermediate and more focused on getting rank in EAMCET for engineering. I asked her what is her health problem, immediately her mother started talking about her daughter’s menstrual trouble, saying that she has irregular menses 2-3 months once, and she has lot of acne on her face, dandruff and hair loss. She started telling me her daughter’s complaints without any gap and she is not allowing her daughter to express her feelings. She said “you have to take care of my daughter, as she doesn't eat food properly, that’s why she has irregular periods.” I told that i will take care of her complaints and asked her to allow her daughter to talk. Then she immediately said she know very well about her daughter problem, she is telling on behalf of her daughter as she is shy in nature and don’t talk to strangers. Again she started complaining about her daughter that she is moody, she don’t interact with others properly, whole day she sits in front of her books, but she is on her own world. Some time she doesn't react to her words. She cries and quarrels with her in house before arrival of her menses.
During the conversation, i am listening to her complaints; started observing the patient. She kept quiet and bending the head forward. She is not at all concentrating what her mother talking about her. She is sad and little bit arrogant looks, she is looking at her mother. A kind of negligence i have seen in her eyes about her mother. Once she stopped the complaints list about her daughter, i told her to go out and wait for a second, as i wanted to talk to patient separately. But she denied it and she said there is nothing is there to talk separately. She said there are no secrets for her daughter. She denied going out. Then i asked the patient about her menstrual cycle in front of her mother and told them to come with ultra sound pelvis and thyroid profile reports next time.
After 15 days, both mother and daughter came with reports. In reports there is indication of multiple cysts in right ovary. I said she has PCOS and she needs Homeopathic care, diet management and proper exercise. I explained them that once attempt to weight loss will reduce the cysts activity and menses become regular. I explained her father the importance of case taking and told him to bring his daughter alone next time. He accepted it and told me that he will explain to his wife. After 2 days she came alone. i started a casual conversation with her in the beginning as i felt she is hesitant to talk about her personality. Slowly she started talking nicely, she is straight forward in nature and she talks what comes in her mind. She wanted to complete her engineering and become a software engineer. She wanted to do a job. But she was dominated by her mother. As her mother feel that she is still a child and she can’t take decisions on her own. She said her mother is overprotective about her, as she is only child to her parents. She thinks her mother to be her best friend but at the same time, she feel that she was not able to independent because of her mother over protectiveness. Her mother keeps an eye on her each and every activity and she listen to her conversations with her friends which don’t like. She don’t like to express her anger mostly, but once she become irritant on something, then she start yelling and cries while fighting with her mother. Then mother try to blackmail her emotionally, by not talking to her and fasting. Then she apologies her and promises that she will listen to her. Then slowly she started losing interest on her education, not much interested in anything, she likes to be in her own world, imagining something which makes her happy.
After talking to her i gave her 1 dose of Saphysagria 1 M, told her come after 1 month. I mean while talked to her father and counselled her mother, to understand her daughter adolescent stage and told her to give support and try makes her understand about the world and ask her to take decision on her own, told her to protect her without dominating her.
Till 6-8 months, her complaints are changing from one to other and then slowly she settled down.
This roller coaster emotional crisis will lead her to make wrong decisions. So girl’s parents should understand their stage and has to give support morally, emotionally and mentally. So that they can able to make decisions properly, otherwise they lose their happy adolescence and lead to suppression, behavioral problems; it will haunt her entire life.
So be patient in getting the results while taking care of adolescent cases and along with that counselling is needed them to get faster results.
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