Categories
Mental Health Wellness

Three health benefits of Yoga

Yoga has been India’s gift to the area of preventive health for centuries. Though the practice of Yoga has seen its ups and downs, in popularity, there is no denying the benefits that it brings to us. So on this International Day for Yoga, let me look at three key areas that Yoga helps us.

Strengthening the back

One of the biggest challenges of this lockdown in the quarantine due to Covid19 is a sedentary lifestyle. This has impacted our backs, especially lower backs. As the back and spine carry the entire load of the body it becomes important to keep the back straight and strong. Yoga practices can help. The one asana or practice that I can recommend from practice is the Bhujang Asana or commonly known as Cobra Pose. Highly recommended for those in sedentary jobs and that practically the whole country these days. This is a useful link, that one can use to learn more about the practice.

Strengthening the lungs

One of the biggest impacts of Covid 19 is on the upper respiratory system. As there is no cure for the virus, and no vaccine in sight, the best defense is strengthening the immune system. One of the ways to strengthen the lungs is by the practice of Anulom Vilom Pranayam. The practice as it helps the lungs to grow the size of the lungs and strengthen the upper respiratory system. This is a very important practice and this link is a good example of how to practice Anulom Vilom effectively.

Calming the mind

The other big casualty during Covid 19 is our mental health. Before the lockdown, it was estimated that by 2020 almost 20% of Indian citizens would require mental counseling. My estimate is that number would be close to 50% today. Financial uncertainty and almost no social contact has led to a situation in which many people are feeling the anxiety and slippi9ng into depression. The recent suicide by actor Sushant Singh Rajput has again brought the spotlight on how we as Indians are exposed to mental illnesses. The yoga practice of meditation really helps in fighting depression and strengthening our mental health. A practice daily of 5-10 minutes has had a huge impact on the mind and productivity. Here is a link that can help you get started on this practice.

I hope these links and practices are useful to you. I have been practicing Yoga for the last 4 years and this has really helped me make most out of my day and time. Here is wishing a very International Day for Yoga.

Categories
Mental Health Wellness

Let’s Talk: Managing your mental health during Covid 19

Man is a social animal and given this day and age, we have been used to getting around across geographies and interacting regularly with other people. But with the current lockdown this is an area that is directly impacted.

While people in lockdown in India have done the right thing to protect them from Covid 19 but their mental health is definitely suffering. Anxiety, depression, Insomnia among others have become common. In this situation, Mental Health Helplines are the best way out.

Lets Talk, a Mental Health Support Helpline is a free volunteer supported project initiated by a group of collaborators to help people cope with emotional impact of Covid-19 pandemic.  

It aims to help those facing dramatic psychological conditions such as panic attacks, anxiety / stress and those suffering mentally and emotionally due to quarantine / isolation /lockdown.

Lets Talk helpline number is 844 844 9428 and has a team of 120+ volunteers who are supporting this initiative, including Psychologists from across the country.

The project has been powered by different International and National Partners in the space of Mental Health, Helpline Support, Social Organizations and Outreach Support. Partners already on boarded include Global Dignity, Arogya World India Trust, Life Surfers, Suicide Prevention India Foundation, Oust Labs, Hope Network, Global Shapers Community, Ria and Manah wellness.

The team behind Lets Talk commented on this initiative

“We are grateful to the volunteers who have come forward to help and support the community at this critical juncture. We believe that mental health impact of this pandemic is going to be significant and will have long lasting impact.

At Lets Talk, we are continuously looking at multiple outreach channels, who could collaborate with us in our initiative to help all those who are worried about the uncertainty of events, a deep sense of meaningless at the moment, missing our loved ones and some of us, our freedom.

At this difficult time, we can’t help you to be in a different place, but we can help you be in a different mind space. So, Lets Talk.”

Categories
Healthcare Delivery

Introduction to Psychiatric Conditions

By Dr Kiran Manduva

Mental health is an often ignored aspect of overall health. It is a truism that there is no health without mental health. In fact, mental health is so crucial to one’s overall well being that a physically disabled or otherwise afflicted person can still be a happy and productive member of society if his mental health is taken care of. There are many examples of such people who ‘ve beaten tremendous odds in life to come up and make their mark on society. That is simply not possible without a robust psychological state of being. Thus, despite health being a holistic entity, if I had to choose, I will place psychological health a notch above physical health.

Instead of going into technical details and statistics, I will try to present a bird’s eye view of the problem at hand. At the risk of sounding simplistic, I will divide the psychological disorders into six groups, for the purposes of the present article. These are

  1. Major psychiatric disorders including schizophrenia, bipolar disorder, severe depression etc.
  2.  Minor psychological conditions including anxiety, minor depressions, stress-related conditions,
  3. Personality disorders, marital discord.
  4. Substance abuse including tobacco chewing and smoking, alcohol addiction, cannabis abuse etc.
  5. Neuro-developmental disorders like Mental retardation, autism, ADHD, SLD
  6. Dementias especially Alzheimer’s disease.

The above is an informal classification presented here for the sole purpose of simplifying the subject matter for the laypeople so that a better understanding of the issue can be achieved. This is not meant to an exhaustive list and some of the rarer conditions are not covered in the classification. These categories are not watertight and many conditions span the different groups based on their severity and other variables. Often, a person can suffer from multiple conditions from different groups because psychological disorders are not discrete entities, as categorised below. Rather, psychological disturbance can manifest itself in multiple ways and quite often in more than one form, simultaneously, in the same person.

Below, I shall dwell upon each of these groups of disorders in brief- how they arise, how they impact the person and how they can be treated.

The disorders in the first category, the major psychiatric disorders, like schizophrenia, bipolar disorder, severe depression etc can loosely be termed ’psychoses’, in which, the person develops delusions and hallucinations, which cause him to lose touch with reality. These disorders usually have a heavy genetic component and also depend on the maternal health (especially fevers etc) when the patient was ‘in utero’. These can normally be treated only with medication with adequate psychological, social and occupational support for reintegration into the society. In many cases, the patient may need to be on the medications for a fairly long period of time.

The second category, the minor psychological conditions like anxiety, depression and stress related conditions arise mainly due to two reasons. One – as a genetic accompaniment to major psychiatric disorders that someone else is suffering from in the larger family. Two – due to various interpersonal issues, family disharmony and social conditions like school and work related stresses, poverty, unemployment etc. Many of these patients need a variable period of treatment with psychological medicines that ameliorate the neurotic symptoms. These conditions can also be treated with better coping skills, self empowerment, breathing exercises, Yoga etc. Once the person is better, the medicines can be slowly tapered off and allow the natural defences of the person to deal with the issue.

The third category is that of personality disorders and its consequences. These are people who have a particular pattern of seeing themselves or relating to others, and many times, these might result in interpersonal disharmony and suffering to either the patient himself or to the others. A frequent cause of marital discord is the existence of some traits of any personality disorder in one or both the partners. Many violent crimes, including domestic violence, child sexual abuse and other criminal violence can also be due to personality disorders in the perpetrator. This often needs a comprehensive approach including medication, counselling and the intervention of other agencies like child care services and law enforcement services including the police

The fourth category is that of substance abuse. There is a steep hike in the number of people addicted to various substances like nicotine (smoking tobacco), alcohol and cannabis. The youth of the society are more prone to it due to their innate impulsive and rebellious nature of their behaviour. This can result in significant damage to ones long term health and productivity, apart from causing family disharmony. This needs treatment with medication, counselling and in many cases a relatively long period of treatment in a rehab centre.

The fifth category is that of neurodevelopmental disorders that afflict children right from their very early age. This is due to the altered brain structure and includes conditions like mental retardation, autism, attention deficit hyperactivity disorder, specific learning disability. These children have a different trajectory of development of milestones, behavioural and academic problems. They need lot of intensive psychological intervention.

The sixth category is that of dementias, the most common being Alzheimers dementia. This is a disorder of the elderly brain degenerating and is more prevalent in the community as the proportion of the elderly increases in the society. It is a problem that is only going to increase in the country and needs lot of family support, medication and institutional old age care.

It is imperative that any person suffering from any kind of emotional or behavioral problem approach a mental health professional without delay or stopping oneself due to the stigma normally attached to psychological conditions. With proper treatment, many are able to lead a near-normal and productive social and occupational life. The public health strategies for different conditions need to be tailored to the particular subgroup of disorders and is an uphill task for the country to ensure the availability and effective delivery of health care services to all the needy.

About the author

Dr Kiran Manduva did his MBBS in 2001 and studied Psychiatry from NIMHANS in 2005. He is interested in deaddiction, psychotherapy for victims of sexual abuse and neuroscience. He is especially interested in novel public health approaches to make psychiatric care accessible to all.

Categories
Wellness

The curious rise of mental illness in India

Rahul (name changed) was having a tough time at office. He had worked his way to the top of the finance industry in Mumbai India. He was now a Sr VP at a financial institution and looking forward to a great time steering the entry of a new financial institution in India. But somehow his work load was increasing. What started as a stretch project spanning a few weekends, had consumed him for months. Soon he started dreading the thought of going to office. Even at work his ability to cope with work was reducing, affecting his effectiveness. Soon he was in a cycle, where stress was eating away at his ability to get things done, which contributes to further delays and more stress. Soon panic attacks started hitting him in the office. He would sweat profusely and remain tense throughout the day.

Rahul was lucky that he recognised some of the symptoms and sought medical help. He reached out to a counsellor and started treatment immedicably. He also took a break from work and focused entirely on his wellbeing. Slowly over a period with counselling and medication, Rahul felt better as the incidents of panic attack and their severity started reducing. Before long he was back at a new job, this time with the knowledge that he would have to handle his work better and avoid triggers that might set off the attacks again.

Rahul’s case is not an isolated case. I remember when I joined the technology world, my first job was with this healthcare network. A middle level manager who was my mentor at that time used to warn me about not taking projects with pressure. He said it was just not worth it. Coming from the medical world, we know all about pressure and its physiology that helps us a humans trigger the flight or fight reflex.

According to a report published by the World Economic Forum in 2014 on the impact of non-communicable diseases on Indian economy it is projected that the loss due to lack of mental health would run into trillions.

“The evidence is compelling. India stands to lose $4.58 trillion before 2030 due to NCDs and mental health conditions. Cardiovascular diseases, accounting for $2.17 trillion, and mental health conditions ($1.03 trillion), will lead the way in economic loss.”

So today we stand at the crossroads of healthcare highway, where mental well being is going to cost us more than Diabetes and Cancer put together by 2030. India it seems is one of the most depressed country in the world. We have close to 6.7 % of the population that is suffering from some mental illness. And just like Diabetes there is no specific urban/rural divide on this. So, the common feeling that people in the villages are not affecting by depression is not true. On the other hand, I feel they are worse off as there is limited awareness and facilities available in the rural areas. According to a WHO report done by National Care of Mental Health, suicide rates in India are around 10.7 per lakh of population and they are mostly below 44 years.

What should one do if you felt tings were not ok mentally?

Well for starters contact your physician immediately. Best not to self diagnose. I myself had consulted my physician after the death of my mother and visited a counsellor.

The secondly seek support from family and friends. I had taken my wife into confidence during that time. She had accompanied me to the session.

Finally, no matter how bad it may seem there is no justification for self-harm. If such thoughts to occur, best to take help from one of the many depression helplines. I have a list that I found at a website, not sure if this is current but still a good list to use.

In conclusion, mental health is a clear and present danger for us in India. Rising expectations and the collapse of work life balance has brought us to this situation. I still feel digital can help in specially providing immediate, anonymous counselling. Work is important but not at the cost of life. Do take care and keep smiling.

Categories
Healthcare Delivery

Dealing with depression in the digital world

A few days ago a young man committed suicide in India. The reason was a internet game called the “Blue Whale Challenge” that sends the players a set of 50 tasks as the end of which they are asked to commit suicide.

A very obnoxious way to structure a game, nut what struck me was that most of the players were young, loners and odd. They did not have social circles and very quiet. In other words they were displaying some form of sub-clinical or even clinical depression. It is not uncommon to read newspaper reports of students committing suicide during the exams. But while one can understand the affect, no one has really put light on the cause. Indians today are suffering from mental illness like never before.

According to WHO almost 90 million citizens in India suffer from either depression or anxiety disorders. That makes it almost 7.5% of the population. There is still a belief that conditions like depression and anxiety disorders are mostly western in origin. But that is not true. Ayurvedic doctors like Charaka have written in details on the signs and symptoms of mental illnesses and have also given the cure.

In most cases anxiety attacks can be managed with some common sense. Easiest way is to breathe deeply and might provide feelings that are better in no time. Sometimes just walking out of situations or walking out of the door is the key step ti manage the anxiety attack. One out of 3 people has experienced a feeling of loneliness and depression, and a few of them can’t even say what’s which makes them feel this way.

 

The other key factor in the management of mental illnesses is that we need to increase social interactions. There are many ways to chase melancholy and the loneliness away, What matters is removing impulses making them feel low or sad. Feeling lonely could be as simple as not having anyone about them to socialize with on a daily basis. One feel lonely and still can be about people, and so to not feel this way, attempt to learn why.

Depression can happen to anyone, and causes it to be varied from one individual to another. Being lonely might lead to becoming depressed, but they don’t always go hand at hand. Feeling anxious and despondent occurs whenever we can’t deal with things in life at that moment, and we feel that there’s no hope to getting past that. They could begin to find ways to create they feel, when someone has identified a number of reasons why he or she are feeling the way they do. Among the ways people can manage the situation is by taking medication under consult with a physician or Psychiatrist to determine if it’s right, prior to taking any medication.

Using remedies may be an acceptable replacement to using medication. Going to a health shop can offer many excellent choices for currently taking a natural approach to your depressed mind-set. The individuals who work there may be extremely helpful in finding the legal remedies which will work best. Another excellent way of getting rid of the blues is to create an appointment with a few mental wellness specialist in your area. Occasionally talking things out with someone completely distanced from one’s life, can give a chance to work out some of what’s bothering an individual.

So to conclude, it is unwise to deal with depression alone. Always consult a physician or doctor if you feel symptoms of depression. Social Interactions help us manage the condition better. Always avoid stress, look for pleasant interactions to avoid the anxiety attacks. Health is a state of physical and mental well being. Live long and prosper.

(Photo by Kyle Broad on Unsplash)