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Comics for Mental Health: Self Harm and Healing

November 24, 2017

Self Harm and Healing by Pig Studio

Self Harm and Healing: Art by Pig Studio for The Health Collective

Inspired by Your Stories: Self Harm and Healing

ALSO BY PIG STUDIO: DEPRESSION

Reporter's Diary: Workplaces and Mental Health

November 19, 2017

By Vandita Morarka

Our earlier piece on employee mental health rights in the workplace looked at what the law says about mental health support at the workplace in India and examined glaring gaps in the legislation. While we wait for legislation to catch up to urgent realities, we must look to companies to implement mental health management strategies and policies.

MENTAL HEALTH AND THE WORKPLACE: AN AREA OF CONCERN

A study conducted by 1to1Help.net, a professional counselling company, on ‘The Mental Health Status of Employees in Corporate India’, highlights just how prevalent mental health issues are amongst corporate employees -- one of every two persons in the corporate sector surveyed reported anxiety and depression. They also waited at least a year before seeking professional help, according to The Hindu. The study also highlighted the increasing work and personal life stress as triggers for mental health issues. 
And that’s not all -- an Assocham study released last year revealed that 42.5 percent of employees surveyed suffer from depression, YourStory reported.

ALSO READ: Workplace Stress and the Need for Me Time

With individuals spending more than 1/3rd of their adult lives at the workplace, it seems to be an obvious place of intervention. But what are some of the underlying issues, and can we really blame companies for not prioritising mental health-care management, given that there is no binding legislation?

Sourya Banerjee, a lawyer based in Hyderabad, tells The Health Collective, “The Indian legislative process has always reacted to change and has never really been very proactive. So currently workplaces are not essentially bound to be doing much and hence are not sanitised with respect to the kind of mental problems their employees may face and it's effects.”

Free Royalty-Free Image Courtesy Raw Pixel
Image Courtesy: Raw Pixel


Queasy though one may be with the argument, maybe it comes down to pointing out the impact of intervention on the bottom line.
“You may come across multiple workplaces which acknowledge physical health problems but not mental health,” he points out, “That is not to say that no workplace is not taking care of the mental health of their employees.  Some have realised that a mentally fit employee results in higher work output.”

WHAT SOME WORKPLACES ARE DOING TO TACKLE MENTAL HEALTH CONCERNS

Raja Natarajan, Deputy Managing Director of SAGE Publications shares a decision taken by his company last year, to tie up with ICAS India (Independent Counselling and Advisory Services). It was a proactive measure, Raja says, telling The Health Collective, “SAGE has covered its employees for physical ailments and hospitalisation through Mediclaim facility. All employees are also covered under a Term Life Policy which covers the risk of death and provides financial cover to the family.  While all these are for physical conditions and events, we felt the need to create a platform for supporting their Mental Health as well.”  

Through Sage’s Employee Wellness Programme, employees and their families can get mental well-being from the 24/7 ICAS counselling service free of charge.

“The entire cost is borne by SAGE,” he shares, calling this a “very user-friendly service” which can be accessed by phone or email. “Face to face counselling service is also available, which puts employees in touch with specialist consultants and counsellors to help them deal with a range of issues, in their private and working life,” he tells The Health Collective.

He emphasises that the service is totally confidential. “Management does not get any reports that divulges details of any of the issues or concerns that an employee might have chosen to discuss with an ICAS consultant.”

An HR professional with another company, Arunesh (who prefers not to share his full name), says that his company has an Energy and Resilience portfolio of training programs, which covers mental health. “Probably workplace and emotional stress management is the only aspect of mental health that we dwell (on),” he tells The Health Collective, “There are awareness campaigns and various sessions where people are informed on how to reduce stress -- ranging from physical exercises, yoga, meditation, nutrition (and) overall managing the four energy dimensions well.”

We didn’t get into more detail on the energy dimensions, but he did concede that there’s not much being done on mental health.

ALSO READ: Mental Health and the Case for Insurance in India

We asked Havovi Hyderabadwalla, a consulting Clinical and Forensic Psychologist based in Mumbai, to suggest what workplaces should be doing to tackle mental health concerns.

She shares some key insights with The Health Collective:

  • Having access to an in house therapist is crucial. A culture of de-stigmatisation should be created amongst the employees (and) should be cultivated by all
  • Open door policies should be created where if someone is having a hard time at work juggling stress, anxiety, depression or the likes they should be able to seek support from their superiors
  • Communication between different levels of employee should be accessible
  • In case your immediate boss cannot help you there should be someone else who can help you out
  • Time Out corners with old school games are always helpful in de-stressing, away from screen time -- board games, pool tables, air hockey are some examples
  • Access to gymnasium facilities and sleeping pods facilitate healthy time-outs

ALSO READ: What's Work-Life Balance Got to Do With Stress?

Raja Natarajan also gives similar advice to other companies. He says, “Don’t waste time thinking about it – go ahead and provide this facility. Happy employees make for a great company that can achieve extraordinary results. It’s an investment in people and there are intangible benefits which cannot be easily measured.”  

Of course, as he points out, partnering with the right service providers is important.


Views expressed are personal. Material on The Health Collective cannot substitute for expert advice from a trained professional. Feedback is welcome @healthcollectif

November News: Best of Health Collective

November 19, 2017

Firstly, a BIG thank you to you, our readers and community. We couldn't have asked for a warmer welcome this past year. We aspire to do much more, launch our news series, India's Voxes, Ask the Experts, and more... Do keep sharing your thoughts, comments, stories and feedback here / @healthcollectif.

Check out our November Newsletter right here & don't forget to sign up for your monthly dose of mental health news!

 

Health Collective Thank You

Suicide Prevention: Is India's Data Enough to Tackle the Complex Issue?

November 15, 2017

By Devanik Saha

'Farmers commit suicide due to debt and crop failure'.
'Housewives commit suicide due to domestic violence'.
'Young students commit suicide due to failure in exams'.

You will have seen these phrases, which commonly appear in media reports and social media discussions on suicide in India. More often than not, any debate or discussion tends to revolve around a single cause depending upon a specific demographic (as highlighted above).

This can probably be linked to the official data on suicides collated by the National Crime Records Bureau (NCRB), which classifies reasons of suicide into stand-alone categories of family problems, unemployment, debt, illness and others. However, there are critical issues with this data, which is a hindrance towards the standard process of using data to design policy interventions.

As I reported in IndiaSpend: "When it comes to data regarding suicides and the reasons for it, NCRB figures cannot be trusted at all,” says Vikram Patel, a psychiatrist and Professor at Harvard Medical School with extensive experience on suicide. “Given the complexity of suicides, just listing single reasons for suicide is too simplistic. Further, the police aren’t trained to handle suicide cases and investigations and reporting is done randomly.”

ALSO READ: Is India ready to tackle a mental health crisis?

So what does the NCRB data say?

In 2015, 27.6% of suicides in India were attributed to family problems, followed by illness (15.8%) and marriage (4.8%), as per NCRB data. About 12% of suicides are not listed under any causes.

 

Causes

Percentage of suicides

Family Problems

27.6%

Illness

15.8%

Marriage related issues

4.8%

Love affairs

3.3%

Bankruptcy

3.3%

Drug abuse/addiction

2.7%

Unemployment

2%

Exam failure

2%

Other causes

26.2%

Causes not known

12.1%

Source: National Crime Records Bureau

 

The NCRB has started publishing data separately for farm suicides since 2014.

Causes

Percentage of farm suicides in 2015

Bankruptcy or indebtedness

38.7%

Farming related issues

19.5%

Family problems

11.7%

Illness

10.5%

Drug abuse/alcoholic addition

4.1%

Marriage related issues

2%

Poverty

1.1%

Property dispute

1.1%

Source: National Crime Records Bureau


WHERE TO GET HELP: CONTACTS AND HELPLINES (INDIA)

CHALLENGES OF NCRB DATA

Experts contend that there are two major challenges with NCRB data.

1. Underestimating the number of suicides
2. Portraying a simplistic picture of suicides

"There is now a general consensus that the NCRB data on suicides is an underestimate. The million death study reported 30% more suicides than NCRB, while the WHO estimated nearly 100% more suicides than NCRB data,” Dr Soumitra Pathare, a psychiatrist and co-ordinator, Centre for Mental Health Law and Policy, tells The Health Collective."

Dr Rahul Shidaye, a clinical psychiatrist and research scientist at the Public Health Foundation of India (PHFI), agrees. He spoke to The Health Collective in detail on this issue.

"In several cases, if a person has had alcohol a few minutes or hours before committing suicide, then alcohol is attributed as a cause of death, which is misleading,” Dr Shidaye tells us. “The NCRB collects data at a higher level and attributes single causes for suicides. However, it must be remembered that suicide has multiple cause and in epidemiological research, it is difficult to prove causation.”
 

THE NEED FOR MORE RESEARCH

It must be noted that suicide is not a sporadic act or incident, rather, it's a complex process which is caused by the interaction of multiple factors.

Dr Pathare explains “Suicides are usually to due to multi-factorial reasons with many pre-disposing causes and single/many precipitating causes. Additionally, causes of suicides are different for different groups, in different regions and at different points in time. So, it is an ongoing challenge to characterise the causes.”

Dr Shidaye told The Health Collective HC that to establish causal pathways leading to suicides, there is a need for psychological autopsies must be conducted. This involves collecting all available information on the deceased via structured interviews of family members, relatives or friends, and attending healthcare personnel. In addition, information is collected from available health care and psychiatric records, other pertinent documents, and forensic examination.

For instance, a psychological autopsy conducted in Bangalore in 2004 found that the cumulative and repetitive interaction of several factors -- such as family, marriage, education, occupation, general health, mental health -- and absence of protective factors contribute significantly for suicides. This is at odds with the NCRB data which attributes only a single reason for suicide.
 

Suicide Prevention/ Health Collective
(The Health Collective)


ALSO READ: Ask the Experts: Do We Need a New Approach to Suicide Prevention

As I discussed in this earlier column for The Health Collective, a key debate in mental health is the over-emphasis on the bio-medical approach of treatment, which discards social determinants of mental health. For instance, this 2017 study found that childhood sexual abuse is a strong predictor of suicidal ideation among adults.

However, a critical concern arises that is conducting autopsies feasible in a large country like India. In relation to this, Dr Shidaye said “Even if not all districts or regions, it must be conducted in regions prone to high suicides. For instance, psychological autopsies may help find if the suicides are probably copycat suicides due to reporting.”

ALSO READ: Media watch: Portrayal of Mental Illness and Suicide

The lack of sufficient data and simplistic causes of suicides can lead to flawed policies.

"This simplistic attribution of causes in the case of farm suicides, leads to reactionary policies rather than pre-emptive ones, writes Dr. Shamika Ravi, a senior Brookings India Fellow and member of the Prime Minister’s Economic Advisory Council. “Suicides are characterised by a prior history of difficulties and, in most cases, mental illness that renders the person vulnerable to suicidal behaviour, for which we need to have a deeper understanding of factors that trigger and contribute to suicides among different demographic categories”.

Dr. Ravi’s arguments are substantiated by a study conducted in Vidarbha, Maharashtra, a region infamous for suicides. A 18-month suicide prevention programme in Vidarbha reduced the prevalence of depression and suicidal tendencies by providing psychological first aid to mentally ill persons through community health workers, as reported by Scroll earlier this year.
The study, published in The Lancet Psychiatry, found that the prevalence of depression fell by 22% in the one year and prevalence of suicidal thoughts fell by 51% due to the program.

THE WAY FORWARD

Going forward, there is a clear need for psychological autopsies in regions with higher incidence of suicides. The research needs to be complemented with innovative mental health interventions as in the case of Vidarbha, Maharashtra.

In March 2017, India decriminalised suicide, with the passage of the Mental Healthcare Bill. This was hailed as a huge step forward for mental health in India... however, the lack of sufficient data needs to be addressed if mental illnesses are to be appropriately tackled through policy interventions.


Disclaimer: Views expressed are personal. Material on the Health Collective cannot substitute for expert advice from a trained professional. If you or anyone you know has ever expressed a wish to end it all, or feels suicidal, please reach out for help immediately to a trained counsellor or therapist. Contacts and helplines.

Ask the Experts: Understanding Therapy

November 12, 2017

By Sukanya Sharma

As part of our special series, Understanding Therapy, The Health Collective features Dr Bhavana Gautam. Dr Gautam is a wellness consultant and certified Rational Emotive Behavioural Therapy (REBT) counsellor practising in Mumbai, Maharashtra. She speaks to The Health Collective about therapy and the importance of trust and communication between patients and therapists.

It’s important to keep in mind: There’s no one universal approach. Most therapists use different approaches as a roadmap to understand their client’s issues, and to work out the best practical solution.

Different Types of Therapy

  • Psychoanalysis – founded by Sigmund Freud this therapy believes in connecting with unconscious thoughts and feelings, to gain more insight of the current behaviour and feelings. It works on releasing repressed emotions and experiences. This type of therapy relies heavily on the interpretation of the therapist

  • Behaviour therapy – this type of therapy works on the role of learning in the development of normal and abnormal behaviours. A range of techniques are used to work on abnormal or unhealthy behaviours. most common and popular in this category is Cognitive behavioural therapy (CBT) which focuses on the current problem and how to solve it

  • Cognitive therapy – this type of therapy works on the irrational or dysfunctional thoughts that are the cause of the current irrational behaviour. Rational emotive behaviour therapy (REBT) belongs to this category. CBT could also be categorised here, considering it works on thoughts and behaviours too.
    In cognitive therapy, the patient is an active participant and is encouraged to work on identifying the problem, discovering the solution and enforcing it by self-motivation to ensure a much better compliance and impact

  • Humanistic therapy – in this case the emphasis is on the capacity of an individual to make rational choices and the therapist is not the authority and the individual is shown respect and concern to make changes for his own interest. In both cognitive therapy and humanistic therapy, the role of the therapist is to work together with the client and support them in discovering and implementing rational living.

  • Holistic therapy – most therapists do not have any one single approach and use a blend of the above therapies to reach the desired goal.

ALSO READ: MORE STORIES IN OUR UNDERSTANDING THERAPY SERIES

Why is it important to think about all of these options?
These are exactly the kind of details that need to be readily available to many. Understanding how therapy works opens doors for individuals who are considering stepping into a counselling session.

It's hard to take that first step to get help, sometimes -- it's a leap of faith. We understand that. And while taking that initial step doesn’t make for an easy conversation, educating oneself definitely helps with doubts and concerns.

Understanding Therapy/ The Health Collective
(The Health Collective)

 

Choosing to continue therapy could also prove to be a difficult choice for some.

To quote Dr Gautam:

"Individuals believe that the root of their current dysfunctional feeling is beyond them (a situation or a person). While this is true for a small number of cases, in most instances the problem is within the individual (his irrational beliefs, thoughts, feelings etc) and this can be a very uncomfortable truth to accept."

The hard truth is that this acceptance cannot be enforced by a therapist and must come from within. Loved ones can also play a huge role here. Dr. Gautam believes, “The socio-cultural environment as well as general awareness levels has a significant impact on the acceptance of therapy.”

ALSO READ: YOUR STORIES ON THE HEALTH COLLECTIVE

An individual’s ability to function at her highest potential depends on her mental and emotional health, an understanding that is still absent in Indian society.

What are some reasons for this?

  • The stigma attached with accepting a mental health issue or illness

  • Lack of awareness that results in lack of acceptance of issues like depression, eating disorders, anxiety, stress etc as mental health problems that deserve treatment

  • Lack of access to therapists, and not having knowledge of who or how to approach

  • The desire to find quick pill-popping solutions to a mental health crisis rather than working with a therapist over a period to achieve a more holistic and sustainable solution

ALSO SEE: THE CONTACTS AND HELPLINES PAGE ON THE HEALTH COLLECTIVE

We do know that open dialogue plays a huge role in normalising conversations around Mental Health. Thanks to this sort of dialogue, young adults and adolescents tend to approach therapy with an open mind – a change that is slow and gradual, Dr Gautam feels. It is also significant that people understand that therapy depends on a relationship of mutual respect, concern and trust.

 

Disclaimer: Views expressed are personal. Material on The Health Collective cannot substitute for expert advice from a trained professional.

 

Mental Health in the News: Toxic Air and Mental Health

November 11, 2017

Mental Health/ Health Collective

 

THE HEADLINE: How Toxic Air Clouds Mental Health (Science Daily)

WHAT YOU NEED TO KNOW: Researchers at the University of Washington School of Public Health have found that air pollution not only affects the lungs, but also the brain. The study merged results of a study with 6,000 participants, with an air pollution database, with records corresponding to the neighbourhoods of each participant to look at the direct link between mental health and air pollution.

The study highlights that the risk of psychological distress increases alongside the amount of fine particulate matter in a given area.

For example, in areas where high pollution was recorded, the stress scores were 17% higher than those in areas of less pollution. This correlation is also shown to vary with race and gender in the US. While the study, which was published in Health & Place, establishes a correlation, it has not established the ‘why’ behind air pollution affecting mental health, which highlights the need for more research. To quote from the Science daily release, air pollution is also associated with changes in behaviour, eg spending less time outside or more time being inactive, which can relate to isolation and distress.

Source: University of Washington. (2017, November 2). How toxic air clouds mental health. ScienceDaily. Retrieved November 10, 2017 from www.sciencedaily.com/releases/2017/11/171102121128.htm


 

THE HEADLINE: 1 in 3 Indians Thinks Shrinks Are Mentally Ill, Says Survey (Times of India)

WHAT YOU NEED TO KNOW: A survey of 900 people in India -- across Chennai, Kolkata, Hyderabad, Lucknow and Mumbai -- found that one in three people though that psychiatrists themselves have some sort of mental illness. Disturbingly, but perhaps not surprisingly, mental health experts like qualified psychiatrists are practically the last port of call for most of those who need help -- after faith healers, GPs, even astrologers.

The study, published in the Indian Journal of Psychiatry, found that less than 10% of people would reach out for help first to psychiatrists. Levels of education didn’t seem to be a factor in these attitudes, the Times of India reports.

Health Collective Note: This is a relatively small sample, to be sure, but quite telling.  

Source: Times of India (2017, November 11). 1 in 3 Indians Thinks Shrinks are Mentally Ill, Says Survey


 

THE HEADLINE: Increased Social Media Use May Not Harm Mental Health (Deccan Chronicle)

WHAT YOU NEED TO KNOW: Researchers in Florida surveyed 467 young adults about social media and their personal and emotional lives. The study was looking at usage of social media, including the amount of time spent daily, and its importance overall in life. Questionnaires were also used to assess the state of mental health, relationships with parents, and levels of social anxiety, as well as to consider loneliness and suicidal ideation.

FROM THE HEALTH COLLECTIVE: Spread the Word on Dangers of Blue Whale, says Supreme Court

While the researchers say they found no evidence that the amount of time spent on social media has an impact on the mental health of young people, there was a trend called “vague-booking.” This refers to writing posts on social that have little clear information, but are worded in a way that would elicit concern. Researchers said that young people who did this tend to be lonelier and could have suicidal thoughts.  

Quoting from the Deccan Chronicle article which features this quote by the lead author of the study, published in the journal Psychiatric Quarterly:

"Vaguebooking was slightly predictive of suicidal ideation, suggesting this particular behaviour could be a warning sign for serious issues," said Chloe Berryman (lead author of the study). "It is therefore possible that some forms of social media use may function as a 'cry for help' among individuals with pre-existing mental health problems."

Source: Deccan Chronicle (2017, November 4). Increased social media use may not harm mental health, says study


 

THE HEADLINE: India is Staring at a Mental Health Epidemic, says President Ram Nath Kovind (Scroll)

WHAT YOU NEED TO KNOW: President Ram Nath Kovind says India is staring at a mental health epidemic. While speaking at the 21st World Congress of Mental Health in New Delhi, the President highlighted how 14% of the population needs mental health intervention. The biggest obstacle, the President said is stigma and denial, calling for the need to address this, along with the shortage of trained personnel.

To quote from Scroll’s article:

"We need to talk about mental health issues and treat ailments such as depression and stress as diseases that can be cured – not as guilty secrets that must be pushed under the carpet,” he said."

Source: Scroll.in (2017, November 2). India is Staring at a Mental Health Epidemic says President Ram Nath Kovind



ALSO READ: Is India Ready to Tackle a Mental Health Crisis

 

The Health Collective is delighted to feature a regular, curated news feed on Mental Health, but cannot independently verify third party content. Feedback is welcome – tweet @healthcollectif with your comments and stories you think we should include.

Unplug and Learn to Reconnect

November 5, 2017

By Sukanya Sharma
 


“If you're born in a cubicle and grow up in a corridor, and work in a cell, and vacation in a crowded sun-room, then coming up into the open with nothing but sky over you might just give you a nervous breakdown.” ― Isaac Asimov, Foundation (Courtesy Goodreads)
 


Hi! I'm 24 years old, I have an umbilical cord attached to my phone, my laptop is my best friend (because of course my work and personal life pretty much reside in it) and while I like to meet people, I'm also that person, who ditches calls or flakes on plans because I want to stay in bed and make out with technology. You know what I mean.

 

But I'm increasingly starting to think that his Netflix and chill tradition has totally ruined human relationships. No offence, Netflix. I mean, see above re the umbilical cord. When did this need to avoid people become a "thing'? It's like living through your teenage years again and trying to avoid human contact... except this time your feelings are not limited to just your parents!

Black Mirror, a Netflix original show that seems chillingly close to the reality of the coming years is something that scares me. In an article on newstatesman.com, Ed Jefferson writes about the real possibilities of the occurrence of each episode in real life, and you'd be surprised to know how close the results were. Creepy!

As a kid, what did you think the future would look like? I'm guessing flying cars, taller glass buildings, and more silver and gray. Every thought we have of the future is related to technology… let’s not forget the development of better smart phones, smart TVs, social media...and I could go on. Okay, fine, enough with the technology bashing... I'm just wondering how do we negate some of these effects and re-assert control? Go enjoy a sunrise somewhere, take a break from the digital leashes we've signed up for?

By Mmacbeth (Own work) [Public domain], via Wikimedia Commons
Sunrise over the bay, Little Gasparilla
(By Mmacbeth (Own work) [Public domain], via Wikimedia Commons)


More immediately, here’s what inspired this post: I was going through my social media feed and stumbled upon a heartfelt message dedicated by a friend to someone who had recently committed suicide. The girl was just in her 20s, and she had taken her life. The comments on the post revolved around how there was lack of "real" conversation in her life, that a "hello" on Facebook was not enough, and that the digital age ironically had bridged a gap in friendships.

ALSO SEE: HELPLINES AND COUNSELLORS A PHONE CALL AWAY

It's true. The human touch has a profound effect on our lives, and technology is robbing us off from this beautiful experience. Social Psychologist Jean Twenge writes about how being surrounded by people is good for mental health and how newer lifestyles  -- nuclear families, late marriages, living alone -- are making us more and more unhappy. She also says, "there’s also clear evidence that people who focus on money, fame, and image are more likely to be depressed and anxious.” (Source: http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html )

I know that sounds like a generalisation, but … it hits home. Are we prioritising the wrong things?

You know those memes we see on social media regarding hugs, and cuddles, how they gives us the warm and fuzzies, for the most part? How we tag our loved ones in it? How we crave to be with our partners? The human touch is a huge element in combating feelings of isolation, or depression. It's essential to our development. And starts early on. Did you know breastfeeding, that early-stage body-to-body contact activity, has been shown to affect the baby's development? And no, I don't just mean the "oh, it's good for the baby's health" development, but "the baby will probably grow up to be a decent and empathetic human being" development.

I don’t think we can ever truly “live” through technology. I think we need a reminder every now and then that our anti-social behaviour can take a toll. Dr. Bhavana Gautam talks about the importance of “talking to people”, and it’s not just her -- many therapists press upon the need to talk and share.

 

 

ALSO READ: We Need to Talk About Mental Health and Therapy


Apart from that, friends and family too need to create a safe environment for conversations. While an individual takes a step towards opening up, as a friend we too need to extend our hand to hold them steady.

Coming soon: My next piece on the issues of physical and mental health. But I have to leave you with this: I’m not old enough (editor’s note!) to remember Blackberry thumb, but did you know there's such a thing as text neck?

Spine-health.com describes it as a modern spine ailment: "Text neck is the term used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, or other wireless devices too frequently and for too long."

Phew. Time to take a deep breath, unplug and take control! If you need more inspiration, here’s some in a nutshell.

“There are billions of stars to visit, diseases to cure, people to help, happy feelings to be experienced, and video games to be finished, there is so much to do,” to quote from this cool video, Optimistic Nihilism.

 

 

Also Read: Health And Wellness on The Health Collective

Mental Health and You: Words that Stick

November 4, 2017

Kishore Mohan for The Health Collective

Art by Kishore Mohan/ Health Collective

 

Check out more original Comics by Kishore Mohan on The Health Collective

 

Spread the Word on Dangers of Blue Whale: Supreme Court to DD and TV Channels

October 28, 2017

By Team Health Collective

On October 27, 2017, the Supreme Court (SC) took cognisance of the ‘Blue Whale Challenge’ and termed it a national problem. While asking the government for a time-bound plan to ban the game, it has also directed the state-run channel Doordarshan and private television channels to help create awareness about the deadly game, by telecasting the dangers during prime time programming.
As NDTV reports, the ‘game’ has been linked to at least six suicides by children in India, though India Today reports this morning that the court was informed that investigations are on into 28 cases of deaths linked to the game.

 

I. What is the Blue Whale Challenge?

The Blue Whale Challenge is a macabre online series of dares, believed to have originated in Russia where there have reportedly been more than 130 related deaths and two arrests, The Indian Express reports. The challenge has affected teenagers globally, with worrying reports coming in from Iran and Pakistan as well. The series of tasks assigned by a curator/curators culminates in a suicide bid. The game is shared via social media networks.

Pragya Lodha, Research Assistant at De Sousa Foundation tells The Health Collective:

“Blue Whale has affected only those teens who were already emotionally or psychologically vulnerable. Not every teen or youth was and would be affected in the same way. It is important that we create an environment at homes and schools to speak about emotions in a comfortable way.”

For further reading, here is a fairly detailed explainer from the NCPCR on what parents need to know. We are not reproducing/ re-printing all the dares reported, given concern about potential copycat effect.

Also Read: Samaritans’ Guidelines for Reporting on Suicide

Please do reach out to a trained professional if you or someone you care about is displaying disturbing behaviour or if you are concerned about suicidal or self-harm tendencies.

Also See: Suicide helpline numbers operational in India and where to Get Help 

To quote from one of our own contributors, Tanmoy Goswami writes in The Health Collective:

“BY ITSELF A GAME CANNOT KILL. But give it a lost mind and just enough motivation, and it can turn into a knife or a free fall from the terrace. In India, there seems to be no dearth of motivation for the morbidly-minded: 371 Indians kill themselves daily on average; 18-29-year olds are particularly at risk. Many more attempt to but fail."

 

II. ASK THE EXPERTS

In light of the potential consequences of the game, the new directive by the Supreme Court is bound to trigger a conversation as to whether an open broadcast will lead to heightened awareness about the deadly threat or potentially lead to copycat attempts by at-risk children or even those looking for an adrenaline rush.

The Health Collective spoke to a few experts for their insight.  

Francis Joseph, co-founder, School Leaders Network, stressed on the need to educate parents.

“The only way to defuse the Blue Whale challenge is to educate the parents; not only the children. Parents and teachers need to be more alert and observant about their children’s behaviour and this is the only way out to defuse this infectious challenge. It’s more of a parenting challenge. Showing video clips on TV prime time will just make the challenge more popular, which can be good in the case of parents; but risky when it comes to children.”

However, he was slightly cautious about the SC directive.

“I would like to state that the Blue Whale challenge, which is harming children worldwide, is not a game which can be played on a app. It’s more about a phenomenon similar to the Ice Bucket Challenge (though IBC was for a good social cause). The children are targeted via social media; maybe based on their browsing data. The tasks psychologically compel them to go on using high emotional and social pressure. Hence, I am curious on what game are we banning?

While respecting the Supreme Court’s decision, I personally feel that the more we publicise the Blue Whale Challenge, the more we are challenging our children to take it on. Peer pressure can drive our children to take up such challenges.”


Manohar Rangnekar, Assistant Director, Samaritans Mumbai, tells The Health Collective:

“The Supreme Court directives are one of many ways in which the reach of this game (to youth) can be controlled. We need to go deeper into the psyche of the players, particularly to unearth what gets them hooked to this game. Is it thrill?  Like one dancing on a running train? Is it a form of attention-seeking? Is it an antidote for a depressed mind? These and many more questions relating to the emotional state of the players need to be answered.”

He adds a very important point.

“Any public show to create awareness of the game has to focus not on the game, but giving emotional support to each and every member of the family. Society at large -- and more specifically parents of the adolescents -- will have to be impressed about getting trained in listening skills to give emotional support to each one.”


Also Read: Media Watch: Portrayal of Mental Illness and Suicide

Janki Mehta, a consulting psychotherapist and founder of Mind Mandala, expressed her support for the directive.

“I think the verdict for awareness is a good move. It will make a lot of people aware of the game and its repercussions. Though I do hope that the media house brings in a mental health experts to help them with this task, she tells The Health Collective.

“Doing a prime time TV show may help though I feel the audience -- which is young children and teenagers probably -- will need it beyond TV. Using the same medium they played blue whale on of cell phones, social media, to get this message across is a much better idea. I think parents also need help because many do not understand how this game works or how it can influence their children, teachers and schools as well…”

“Obviously there is a lack in communication amongst children and parents and their relationship somewhere which one needs to identify because something created a problem and these preventive methods won't last long unless we address the root,” she adds.  


-- Inputs by Vandita Morarka, Sukanya Sharma and Devanik Saha
Views expressed are personal. Do share your comments right here or @healthcollectif. (Post updated on November 12 to correct Designation of Pragya Lodha)

Your Stories: How to Travel Light

October 24, 2017

The Health Collective is delighted to feature an interview with Shreevatsa Nevatia, author of How To Travel Light: My Memories of Madness and Melancholia (Penguin RandomHouse India, 2017). We highly recommend the book, which releases October 25, 2017 in India. 
 

Nevatia speaks to Amrita Tripathi about his book, his journey, and some of the very personal and difficult moments along the way... as well as the solid backing and support he has had from loved ones.

 


1. What are some of the thoughts going through your head now that the book is out for everyone to read? Relief? Worry about being judged? Anything you can share …

Working as a journalist, I had always been conscious of my audience. Writing a memoir, I realised very quickly, required a very different approach. Authors invariably sound disingenuous when they say they have written a book for themselves, but I can say this—I wouldn’t have been able to write How to Travel Light if I had periodically stopped to ask, “What would she or he think?”

This is the story of my life as I remember it. I have judiciously considered each of my memories, and for what it’s worth, I can now say, “I know this much to be true.” There is some relief in having said it all. The experience has been undoubtedly cathartic, and it is perhaps because the book inadvertently did me so much good that I don’t find myself very worried about people’s judgements

Besides, I believe that those who judge someone by their past do so in shorthand. I recognise the Shreevatsa I write about, but today, I am someone else. I hope readers of the book factor that in. There is, though, a kind of judgment that makes me anxious. I want people to think the book is well written, that it has literary value. I confess to vanity.  

 

2. Contributors on our site The Health Collective share stories about living with BPD, or schizophrenia, coping with depression and more... What would you like to tell them? What to your mind is the value of sharing our stories and normalising the conversation around mental health, especially in India given the stigma we still see?

Ten-and-a-half years after being diagnosed bipolar, I have found that nothing defeats stigma better than the act of speaking.

I have to compliment you and The Health Collective for providing such an enabling platform to those who are struggling with mental health afflictions. To clear doubt and misconception, you need confession and conversation. Though unique, there is great comfort in knowing that your condition and subjectivity isn’t without precedent. If one can only come to know oneself in relation to others, we need to first ensure that a wide cross-section of voices gets heard.

I have often used stories to map the tumult of my own mind, and I do think we need to invent a world where narratives of those living with mental health conditions are part of a more common discourse. Nothing would alleviate pain more.


To the contributors on your site, I could only say, “Please keep writing,” but for your readers, people who aren’t necessarily afflicted, I’d really like to add something very small—“Please, let’s talk.”

 

 

Shreevatsa Nevatia Interview (The Health Collective)
(The Health Collective)

 

3. How do you describe your phases of mania, for those who haven't yet read your book? How did it manifest (and sometimes let your friends know that you needed help)?

Mania is seductive. There are some tell-tale signs. It all starts with losing sleep. Feeling a boundless energy, I’d start to join dots that don’t necessarily belong on the same page. Freud, Kafka and Krishna, I would argue, have all said the same things and arrived at the same conclusions. I have felt Julie Andrew’s Maria in The Sound of Music is my perfect parallel. When manic, my appetite for all things amplify — books, films, music, life, love. This expansiveness is, however, short-lived. Very soon the world isn’t impressed by your plans. It is instead confounded.
 

Once I’d meet those familiar roadblocks of misunderstanding, I’d turn megalomaniacal. From being nimble and playful, my language would turn didactic. Pleasure and levity would become my entitlements. My demands would be extravagant, and I would feel no remorse when berating family and friends for what I thought was their limited supply. I would alienate my support system. I would never seek help. Thankfully, they never once gave up on me.    

Also Read: Your Stories on The Health Collective

 

4. You did experiment with tapering off from your medication, given the side-effects… Any advice on what's helped you in the long run, come to terms with your condition?

The side-effects of drugs like Lithium and Depakote can be very debilitating. Your hands tremble uncontrollably, and it becomes impossible to hold a plate or a cup of tea. You start gaining weight, you feel sluggish, and both your mind and body feel oppressively heavy. Nostalgia is always dangerous, and in my case, it was doubly so. It made me either taper my medication, and sometimes, it made me stop taking my pills altogether.

 

I would yearn for a former self that I felt looked and thought better. I realise I was chasing something and someone altogether impossible. I was only able to escape this cycle when I began describing the extent of the side-effects to my psychiatrist.
 

He would hear me out and tailor my prescription accordingly. It takes a lot of trial-and-error to find the right balance of drugs. I’m more functional today because I swallow my Lithium, and also because I was forced to rediscover patience.   

 

 

Also Read: Severe Side-Effects, One Woman's Journey Through Depression

 

5. You write very movingly also about the feelings that are evoked, when you talk about your family visiting you, say, or your ex-girlfriends... What are some of their thoughts on this book and your journey? 

 An anecdote will perhaps answer this question better. Having finished writing the book, suddenly aware that I had said all I could, I asked my mother to read my work. I didn’t want her to be blindsided by the memoir’s content or by the feedback it might receive.

I remember saying, “Ma, I worry that someone is going to ask you why I wrote all this.”

 

Her response was even. “I’ll say that you wrote it to become better.”

 

I pressed on. “But I didn’t have to publish it, did I?”

 

She replied, “You are publishing it so that other people can read it and feel better.”

 

My parents, doctors, friends, even my ex-girlfriends, have been nothing but encouraging. They have all seen me at my worst, and I think most of them were just relieved when they saw me do something I’ve always relished doing. They were all glad to see me write.      

6. What was the hardest part for you? (You write about guilt and shame... can you expand on these feelings and doing away with the negative feelings) And the hardest part of your journey for your parents?  

Waking up in hospitals and mental health institutions has undoubtedly been the hardest part of this journey. When your mind begins to condone excess, exhausting itself in the process, a break from society is beneficial. But internment does invariably begin to feel like punishment, and I think it is that decision to put their son away which has been the most difficult for my parents. Each time I have found myself confined, I have regretted my manic aggression and irresponsibility.

 

It isn’t always enough to say, “That was not me, that wasn’t me at all.” My delusions have always found an audience. My loved ones have witnessed my debilitation, so there are still times when I wish I could expunge all those memories.  
 

 

ALSO READ: D is for Depression: The Shubhrata Prakash Interview (Hindi)

 

7. If there were three or four things you would share with families or loved ones of those suffering from bipolar disorder, what would those be? 
 

  • Bipolarity doesn’t have a cure, but thankfully there is enough medication that helps manage the disorder. It seems too much of a stricture at first, but if one does persist with one’s pills, gets at least seven hours of sleep, and stays away from drugs, lucidity does finally become possible.
     

  • Therapy might not yield instant results, but it does slowly give you the ability to look at yourself from both, the inside and outside. There is much relief that such consideration can bring.
     

  • We bipolar patients demand a lot from our families and friends. Our loved ones often need a reservoir of love and patience in order to cope with our turbulence. The only thing that I can ask of them is probably this – please do not let that reservoir dry up, and sometimes, do play along.


8. How does one even begin to come to terms with the child sexual abuse you went through?

The trouble with child sexual abuse is that it seems too dastardly an act to be true. Growing up, I asked two questions – “Why me?” and “How could this have happened to me?” I only started coping when I changed my line of questioning, when I stopped looking at myself as a victim, and when I started looking at my own hardship as common.


The #MeToo Campaign, for instance, only proves that sexual assault is all too widespread, but like a friend pointed out, it again puts the onus of confession back on someone who might not want to make public her trauma. Writing about my abuse certainly helped me draw a line of sorts, but what helped me more was psychoanalysis. I found in Freud and my psychoanalyst an understanding not just of my victimhood, but also of acts we often think are too depraved to theorise.    


Also Find: Child Sexual Abuse Helplines and Other Resources

 

 

Note: Views expressed are personal. Material on The Health Collective cannot substitute for expert advice from a trained professional.

How To Travel Light will be available for sale from October 25, 2017; You will be able to read an excerpt right here on The Health Collective   

 

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What It's Like to Live With Anxiety and Depression

Do check out this incredible comic (created by Nick Seluk of The Awkward Yeti). I first saw it on Upworthy and was blown away by it -- like so many others have been. It is reproduced here with the kind permission of The Awkward Yeti.

 

 

This incredible comic was created by Nick Seluk, creator of The Awkward Yeti, based on a story told by Sarah Flanigan, and published on taptastic.com 

It is reproduced here with kind permission from The Awkward Yeti

 

Adolescents, Relationships and Stress

In India, year after year, we are almost inured to stories of students driven to extreme stress by board exams. At times, in the absence of learning coping mechanisms or other ways of releasing these incredibly high levels of stress, a significant number of them choose, tragically to cut short their young lives.


YOUNG SUICIDES

The National Crime Records Bureau report looking at Suicides in India (2004-2014) analyses the 'Percentage Distribution of Suicide Victims by Profession during 2014' to find that 6.1% of suicide victims in 2014 were students. (Another shocking statistic: 15.3% of suicide victims were found to be housewives; find an analysis of the data and concerns about under-reporting here on IndiaSpend)
 


There doesn't seem to be enough attention paid to causes of suicide -- often a web of causes, not just one simple cause.

Nonetheless, many counsellors I had spoken to over the years, including some manning exam helplines for Indian students, mentioned that frequently callers dial in to talk about relationship issues and relationship pressures. It's not just the stress of exams/ Board exam results and the massive pressure we've been socially conditioned to accept as normal, that is.
 

RELATIONSHIP PRESSURE AND ADOLESCENTS

Noted child and adolescent psychiatrist Dr Amit Sen had told me years ago, about how kids are in relationships at ever younger ages -- think tweens or pre-tweens -- and aren't always able to navigate the complications of this; often relationships of course are due to peer pressure.


FROM THE ARCHIVES:
 Dr Amit Sen's own words on the context in India: 

"For the longest time we have found correlations between exam stress and rising depression in adolescents. There is no doubt in my mind that study and exam pressure takes a heavy toll on the minds and well being of teenagers in India. It robs them of other experiences that are vital for adolescent development. Paradoxically, as they begin to slip under the pressure, the system exerts even more pressure.

More recently, we have become increasingly aware of the close relationship between romantic relationship and depression. And indeed, as the article suggests, it is not only to do with break ups but also ongoing/"serious" relationships that often become too complicated for the mid-teens to handle. The cause and effect relationship is,however, not always clear. Its also true that depressed teenagers make themselves more vulnerable and tend to get into messy relationships more easily. A lot depends on the readiness/maturity of the person and clarity about what the relationship means and where the boundaries lie. In India, and perhaps in all places, teenagers often get widely conflicting messages about romantic relationships. This is where life skills and sex education (that is sustained and ongoing) might be preventive/protective of the many ills that plague our children today."

-- This was in response to this article in The Huffington Postwhich, among other things, raised some key points from a startling survey of more than 8,000 American adolescents on issues of depression and romantic relationships.

  

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