Conditions Treated
Psychiatry works best when the diagnosis is correct and the treatment plan is honest. At ManoMitra, every consultation begins with a thorough evaluation, not a quick prescription. Whether you are seeking help for the first time, trying to understand a diagnosis you have carried for years, or looking to safely reduce medications you have been on for too long, the process starts with getting the picture right.
Below is an overview of the conditions Dr. Anindo Mitra treats, and how he approaches each one.
What are anxiety disorders, and how are they treated?
Anxiety disorders are the most common psychiatric conditions seen globally, yet they are also among the most over-medicated. In India, a significant proportion of patients presenting with anxiety have been on benzodiazepines — sometimes for years — without any plan for how long that treatment will continue.
At ManoMitra, the starting point is not a prescription. It is a careful assessment of what kind of anxiety is present, what is driving it, and what has already been tried.
Anxiety disorders treated here include Generalised Anxiety Disorder (GAD), Social Anxiety Disorder, Panic Disorder, Health Anxiety, and Phobias. Each has a different presentation and a different treatment pathway. Grouping them together leads to sloppy treatment.
What does treatment look like?
- Structured psychotherapy, primarily CBT-based approaches
- Sleep correction — disordered sleep and anxiety are tightly linked, and one rarely improves without addressing the other
- Medication when genuinely indicated — chosen to avoid dependence and minimise side effects
- Supervised benzodiazepine tapering for patients already on long-term anxiolytics
- tDCS (transcranial Direct Current Stimulation) — available as a supervised at-home neuromodulation option for patients who want a non-pharmacological approach
The goal is not to make anxiety disappear. It is to help you understand it well enough that it stops running your decisions.
When should depression be treated with medication, and when shouldn't it?
Depression affects an estimated 56 million people in India. It is not the same as sadness, and it is not a character flaw. It affects sleep, concentration, motivation, appetite, and the ability to function in relationships and at work.
What it does not always require is an antidepressant.
This is worth saying clearly, because the reflex to prescribe is strong. Many antidepressants carry a real risk of sexual dysfunction, weight gain, emotional blunting, or withdrawal difficulties on stopping — side effects that are frequently not discussed at the time of prescribing, and that significantly affect quality of life. For mild to moderate depression, the evidence for lifestyle intervention, structured psychotherapy, and sleep normalisation is more robust than many patients are told.
At ManoMitra, the diagnostic evaluation comes first. Bipolar depression, thyroid dysfunction, and other medical contributors are ruled out before a treatment plan is formed. When medication is indicated, the choice is made based on your symptom profile, lifestyle, occupational demands, and personal preferences — not habit or convenience.
What does treatment look like?
- Thorough diagnostic evaluation before any prescription
- Sleep correction and lifestyle optimisation as first-line for mild to moderate presentations
- Structured psychotherapy
- tDCS — a non-invasive, home-based neuromodulation option with a growing evidence base for depression
- Antidepressants when indicated, chosen carefully, with side effects discussed honestly upfront
- Clear plan from day one for how long treatment will continue
For patients with treatment-resistant depression — defined as depression that has not responded to at least two adequate antidepressant trials — additional options including neuromodulation (rTMS, ECT) are discussed.
What is bipolar disorder, and why does getting the diagnosis right matter?
Bipolar Disorder is one of the most consequential psychiatric diagnoses to get wrong. Misdiagnosed as unipolar depression, it is often treated with antidepressants alone — which can trigger manic episodes and worsen the long-term course of the illness.
One of the core concepts guiding treatment at ManoMitra is kindling: the phenomenon by which each untreated or inadequately treated episode lowers the threshold for the next one. Episodes become more frequent, sometimes more severe, and harder to treat over time. This is why the choice of mood stabiliser — and the consistency with which it is taken — matters far more than most patients are initially told.
Dr. Mitra's MD research examined clinical predictors of lithium response in 189 patients with Bipolar I Disorder at JIPMER, Puducherry. This gives him particular depth in the pharmacological management of bipolar disorder, including the nuances of lithium monitoring, when to prefer it over alternatives, and when to switch.
What does treatment look like?
Mood stabiliser selection is based on:
- Predominant polarity (whether depressive or manic episodes dominate)
- Metabolic profile and weight considerations
- Gender and reproductive plans
- Age and current life stage
- Side effect tolerance and occupational demands
Options include Lithium, Valproate, Carbamazepine, and Lamotrigine — each with a distinct profile and a different place in treatment. The role of antipsychotics in acute mania, and the risks of antidepressants in bipolar depression, are explained clearly at every stage.
What does OCD actually look like, and how is it treated?
OCD is one of the most frequently misunderstood psychiatric conditions. Most people picture hand-washing or checking locks. Many patients with OCD have none of these. They present with intrusive thoughts — about harm, contamination, blasphemy, sexuality, or symmetry — that they find deeply distressing and that they manage through covert mental rituals. These are just as disabling as visible compulsions, and just as treatable.
OCD is also underdiagnosed. The shame and secrecy patients carry around their intrusive thoughts means they often wait years before disclosing them. By the time they reach a psychiatrist, significant damage has been done to functioning and relationships.
Because OCD is disabling and responds well to a combined approach, treatment at ManoMitra does not follow a stepwise model of trying one thing before adding another. Medication and structured psychological treatment are usually recommended together from the start.
What does treatment look like?
- SRI medication at adequate doses for adequate duration — a point that matters, because under-dosing is common
- Exposure and Response Prevention (ERP) — the most evidence-based psychological treatment for OCD
- Dr. Mitra designs the ERP framework and coordinates directly with experienced clinical psychologists who conduct the therapy sessions
- Psychoeducation about the OCD cycle — because understanding why rituals make things worse is itself therapeutic
The aim is not just symptom reduction. It is helping you understand the OCD cycle well enough to manage it independently over time.
Can ADHD be diagnosed in adulthood, and how is it distinguished from anxiety or burnout?
Adult ADHD is real. It is also the diagnosis most at risk of being handed out too quickly in a consultation that takes 20 minutes and uses a self-report checklist.
Many conditions produce symptoms that look like ADHD — anxiety, depression, sleep disorders, thyroid dysfunction, burnout, and the cognitive effects of chronic stress. Prescribing stimulants without ruling these out is not good psychiatry.
The patients most likely to be missed are those who compensated through intelligence and structured environments — high-achieving professionals who managed in school but are now struggling to function without that scaffolding. Their ADHD is real, but it is also genuinely harder to diagnose, and harder to disentangle from everything else that is going on.
What does the assessment look like?
1. Comprehensive diagnostic evaluation — ruling out anxiety, depression, sleep disorders, and burnout before any ADHD diagnosis is confirmed
2. Psychoeducation about attention and executive function — what ADHD actually is, and what lifestyle approaches help
3. Behavioural and environmental interventions — often more effective than most patients expect
4. Non-stimulant medication options when appropriate
5. Neuromodulation (tDCS) as an adjunct where evidence supports it
6. Stimulant medications — considered only when clearly indicated after thorough evaluation, not as a default
The goal is not to avoid stimulants. It is to use them when they are genuinely needed.
Is addiction a psychiatric condition, and can it be treated without judgment?
Yes, and yes.
Substance use disorders are treated at ManoMitra with the same structured, unhurried approach as any other psychiatric condition. The substances most commonly seen include alcohol, opioids, nicotine, cannabis, and prescription medications — particularly benzodiazepines and opioid analgesics prescribed for pain.
Addiction is not a moral failing. It is a condition with a neurobiological basis, a predictable clinical course, and evidence-based treatments that work. Patients who feel judged in clinical settings either don't disclose fully or don't come back. Neither outcome is useful.
What does treatment look like?
- Medically supervised detoxification where needed, with access to a 40-bed inpatient facility at Athena Behavioural Health
- Pharmacotherapy for relapse prevention — specific to the substance and the patient's profile
- Motivational Interviewing — Dr. Mitra completed formal MI training under Dr. William Miller, one of the psychologists who developed the approach
- Psychoeducation for patients and families — because families are often the most important variable in long-term recovery
- Long-term recovery planning with clear, realistic goals
Can psychiatric medications be safely reduced or stopped after long-term use?
For many patients, yes. This is one of the most requested aspects of the ManoMitra practice — and one that most psychiatrists do not offer as a structured service.
Many patients arrive having been on psychiatric medications for 5, 10, or 20-plus years. Some are on combinations prescribed by multiple doctors over time, without a clear endpoint ever discussed. Others feel ready to try reducing medication but have found no one willing to help them do it safely, or have attempted it on their own and had a difficult experience.
Deprescribing is not the same as stopping. It is a gradual, supervised, planned reduction — carried out at a pace determined by clinical response, not by calendar. Every step is agreed upon in advance. There is no pressure to continue faster than is comfortable.
Who is this appropriate for?
- Patients who have been stable on psychiatric medications for an extended period and want to explore whether they still need them
- Patients on multiple medications who want to simplify their treatment
- Patients started on benzodiazepines, antidepressants, or antipsychotics without a clear endpoint
- Patients who want an independent second opinion on whether continued medication is still necessary
One principle Dr. Mitra applies from the first appointment: every patient should know, from the start, under what conditions their treatment might be reduced or stopped. Treatment without a defined endpoint is not a plan — it is an indefinite commitment that was never properly consented to.
Is it safe to take psychiatric medication during pregnancy or while breastfeeding?
This is one of the most common — and most anxiety-provoking — questions in psychiatry. The answer is not a simple yes or no. It depends on the medication, the dose, the trimester, the psychiatric condition being treated, and the risk of leaving that condition untreated.
Untreated psychiatric illness during pregnancy is not a safe option. Depression, anxiety, and psychosis during pregnancy carry their own risks to the mother and the developing baby. The clinical question is not whether to treat, but how to treat in a way that minimises risk on both sides.
Dr. Mitra has specific training in perinatal psychiatry, having trained under a senior psychiatrist who contributed to national guidelines in this field.
Services include:
- Preconception counselling — reviewing psychiatric medications before you try to conceive, and discussing what changes may be needed
- Pregnancy planning — risk-benefit assessment of continuing, changing, or stopping medications during pregnancy
- Peripartum mental health — managing depression, anxiety, OCD, and psychosis during and after pregnancy
- Postpartum care — including postpartum depression, postpartum OCD, and postpartum psychosis
- Breastfeeding guidance — medication safety during lactation and dose adjustment where needed
At what age can a child be assessed by a psychiatrist, and what conditions are treated?
Psychiatric conditions in children and adolescents are common, frequently missed, and often present differently from how the same conditions appear in adults. Anxiety in a teenager may look like school refusal. Depression in a child may look like irritability or behavioural problems. ADHD is sometimes the diagnosis — and sometimes not.
Dr. Mitra completed dedicated child and adolescent psychiatry training during his MD at JIPMER, and is currently pursuing additional fellowship training through the Indian Association of Child and Adolescent Mental Health (IACAM). He also works with schools, conducting mental health awareness sessions and coordinating with school counsellors for referrals when psychiatric evaluation is needed.
Conditions treated in children and adolescents include:
- Anxiety disorders
- OCD
- ADHD — assessment and management
- Depressive disorders in adolescents
- School refusal and academic difficulties
- Behavioural difficulties and emotional dysregulation
Assessment is age-appropriate and involves parents as part of the process. Medication in children and adolescents is used cautiously, at the lowest effective dose, for the shortest necessary duration.
Can a psychiatrist help with relationship problems, or is that only for psychologists?
A psychiatrist who only prescribes is a limited psychiatrist. Relationships are one of the most consistent determinants of mental health outcomes — and ignoring them leads to incomplete treatment.
Dr. Mitra works with couples using structured therapeutic frameworks:
- Gottman Method Couples Therapy
- Emotion-Focused Therapy (EFT)
These sessions address communication difficulties, relationship distress, conflict patterns, intimacy concerns, and the impact of one partner's mental illness on the relationship dynamic.
Family work is a central part of psychiatric care at ManoMitra — particularly for patients who are receiving inpatient treatment or managing a serious psychiatric condition long-term. Regular family meetings focus on:
- Psychoeducation about the diagnosis — what it is, what it is not, and what to expect
- Addressing expressed emotion, which is one of the most robust predictors of relapse in schizophrenia and bipolar disorder
- Relapse prevention planning
- Building realistic, sustainable family support
How is psychiatric illness in older adults different from psychiatric illness in younger patients?
Psychiatric illness in older adults is frequently under-recognised, under-treated, and over-complicated by co-existing physical health conditions and polypharmacy. The risk of drug interactions is higher. Cognitive decline can mask or mimic depression. And the threshold for using certain medications — particularly antipsychotics — is different in older patients because of real risks that do not apply to the same degree in younger ones.
Working in Gurugram has given Dr. Mitra significant exposure to older adults and their families navigating these complexities.
Conditions treated include:
- Dementia — Alzheimer's, vascular, and mixed types
- Behavioural and Psychological Symptoms of Dementia (BPSD)
- Late-onset depression and anxiety
- Delirium — assessment, management, and family guidance
Management in older adults focuses on safe prescribing — minimising medication burden, identifying and addressing reversible contributors, and giving families practical guidance on what to do and what to expect.
When is inpatient psychiatric treatment needed?
Inpatient psychiatric care is appropriate when the level of risk or the complexity of the presentation exceeds what can safely be managed on an outpatient basis. This includes acute psychiatric episodes requiring stabilisation, complex medication changes that need close monitoring, and medically supervised detoxification.
Dr. Mitra is on the team at a 40-bed inpatient psychiatric facility at Athena Behavioural Health, Gurugram.
Inpatient care is available for:
- Acute psychiatric episodes requiring stabilisation
- Medication monitoring and adjustment in complex cases
- Medically supervised detoxification
- Intensive psychotherapy programmes
- Relapse prevention and rehabilitation planning
Not sure if what you're experiencing is on this list?
Most people are. Book a consultation and we will figure it out together.
Consultations are available in-person at Athena Behavioural Health, Sector 47, Gurugram — and online pan-India via Zoom or Google Meet.