Monday October 23, 2017

Mind over matter: Nivida Chandra on mental health

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By Swarnima Bhattacharya

It might be a slightly misleading exercise to undertake a qualitative analysis of the state of mental and psychological healthcare in the country, seeing as it is practically non-existent. Despite India’s first ever national mental health policy having been launched in 2014, there seems to be absolutely no concrete, organically evolving discourse on the ground to further the good intentions of the policy.

Adding to the existing stigma and silences around mental issues, are the very problematic, and often insensitive, myths propagated by popular culture about such afflictions. Remember watching Parineeti Chopra as “mental Meeta” in the film Hasee toh Phasee, and the highly romanticised, and ridiculous, portrayal of acute depression and suicidal tendencies in Priyanka Chopra-starrer Anjana Anjani? Well, these are to name just a handful.

Nivida Chandra
Nivida Chandra

Battling such unhealthy perceptions about mental illness —which is NOT synonymous with “madness”— is a novel initiative, The Shrinking Couch. Co-founded by Nivida Chandra and Krutika Bopanna, this is an online platform that enables discussions and disseminates information on mental health, care-giving and treatment. As part of our discussions during the World Mental Health Week, NewsGram caught up with Nivida Chandra, for a conversation on all things “mental”.

Excerpts from the conversation-

What prompted you to kick start an initiative like The Shrinking Couch? What lacunae did you find in the mental health care sector that you sought to fill in with this online platform?

–The Shrinking Couch tries to deal with several challenges facing the mental health care sector but does it at an individual level. Krutika and I often discussed the state of affairs, and saw trouble everywhere. For one, the ratio of caregivers to the number of people who needed help is very skewed. Further we had no way to recognise a good and certified therapist from someone who wasn’t one. So between the quantity and quality of help available, the stigma surrounding mental illness and a healthy awareness and acceptance of these issues- we found TSC to be the ideal solution.

We started TSC as a forum where people could both share their stories, and a platform from where those reading could feel connected and learn something – whether for themselves, or for someone they loved. For instance, if someone has been feeling depressed, but doesn’t have help close at hand or the option of getting help or the knowledge that help is available, s/he can read the innumerable experiences shared by many of our contributors, and see that s/he isn’t alone. Experiences of others also often give us insights for dealing with our personal issues, especially when we find our own stories mirrored in those of others. In this way, we see a symbolic “shrinking” of the proverbial “Freudian Couch”. Hence the name, The Shrinking Couch, which seeks to be an additive layer upon the traditional methods of therapy and care-giving especially since it takes into account the quality of care, anonymity of expression and knowledge about the conditions.

 

About the quality of care, we have noticed how one-on-one therapy is almost invariably too heavy on the pocket. And “taking therapy”, as an idea, is extremely urban. Do you feel that seeking help for mental afflictions has become a luxury for the rich?

–Yes, to some extent, I can’t deny that. Again, however, the ratio is very skewed. There are way too many people who need help, and an even greater number of people who don’t even know yet that they could do with some help. Very few people are certified practitioners giving therapy.

I find the rural – urban divide too redundant. There are two barriers to entry: money and mindset.

Those with money who want help, may still find NGOs giving the service free of charge, and those with the right mindset might save up a paltry sum to seek out whatever they can afford. There is a lot of good work going on in rural India to try and deliver evidence-based therapies to those who need them, and research is showing that it is being well received. There is actually no such well-intentioned outreach in our so-called urban spaces. So I find the rural-urban split unhelpful when thinking of therapy.

In the West, for instance, corporate places and institutes encourage employees to take up therapy; some often even bear costs for this. There is no such culture in India, though I’m not sure if this is how I would want us to move towards a culture of acceptance either. You don’t get help because someone is giving it to you for free. You have to learn to recognize when you need help for your mind and go get it proactively.

Moreover, concepts such as group therapy, which are much more practical, are almost alien ideas, known by only a few. I recently received a long phone call from a girl in “urban” Rajasthan, educated and financially well-off, but up against extremely regressive parents. She went ahead and sought help for depression and found that her therapist was playing ‘tetris’, hiding her phone under her table. Frankly I don’t care if that person was delivering this for free (they weren’t); this is unacceptable. It speaks volumes about the lack of ethics, the sensitivity and the importance that is placed on mental health.

 

Can you talk a little more about the stigma that is ruthlessly attached to mental issues? Why this social, cultural, communal fear in confronting these issues as they are?

–This is actually really easy to understand. The most important reason for this is that a mental issue, say depression or alcoholism, doesn’t really exist in a vacuum. It is not an individual affliction.

In the case of mental and psychological afflictions, the familial and psychical environment, and the social context of the individual play a major role.

It could be the oppressive family, a hostile workplace, the adulterous/uncaring spouse, the unsupportive parents-in-law, the abusive teacher or the bullying classmate. It can be one, or all of these that come together to form an environment of ill-health. It is because the people around you are easily implicated, that a culture of silence is inculcated. This works in two ways: one, you don’t always feel confident about blaming those you love for your miseries, and two, most of the time, none of those around you want to take responsibility, or help you. So you end up feeling blamed and cornered, and ultimately alone, and likely mad.

 

It is rather paradoxical that your surrounding environment contributes to your mental affliction, but at the same time you are singled out for the blame. A common response to conditions such as depression and anxiety is that the person isn’t strong enough, or s/he should “calm down” or “move on”. What would you say about that?

–Yes, the culture of blame only worsens the already existing culture of silence. Most of the time, the sufferers also dismiss some very real issues as nothing more than “bouts of sadness” or a “rough patch”, because they themselves are resistant to the idea of being “mentally ill.” The general perception about mental healthcare facilities is far from encouraging. Psychiatric facilities are dingy colonial cob webbed buildings and boldly called paagal khanas – and I’m talking about ‘developed’ cities. In electroconvulsive therapy, medication and institutionalization can be forced upon you without any need to prove their requirement. So most people, very conveniently, are quick to associate mental and psychological afflictions with personal failing.

Internalising blame and victim-shaming are the major challenges facing mental healthcare in India.

When someone is told to move on, their feelings are not validated. They are made to feel false and silly, or perhaps dramatic and crying for attention. This actually pushes the person to either shut up, bottle it in, or break down and literally give in to being ‘mad’. Unfortunately, this fear of no one understanding them is what leads men to drink, women to cheat, and people to scream, hit and actually lose their human sense.

At TSC, we receive innumerable long, detailed letters and messages on Facebook by people asking if they can share their stories anonymously, or if they can even write at all. There is not only the fear of confronting the society but also yourself. Many women, for instance, just deal with their husbands “hitting” them. But once you get down to writing, the process of contemplation and transcription doesn’t allow you to view it as just “hitting”. Then, you realise you are in an abusive relationship. It is not easy to confront such revelations even at a very personal level, and obviously the social, cultural, legal and medical infrastructure does not make it easy.

 

The problems are truly wide-ranging. So, right from the resistance one faces internally and from the family, there are also challenges at the policy level. There has been sporadic talk about decriminalizing suicide, but none of that is actually in the offing. What would you say about that?

–A person who is brought to the brink of killing himself, and tries to do so, was legally viewed as a criminal until last year. Obviously it is all kinds of screwed up! I had written about suicide and the logic of preventing it a while ago. It took years of policy debate and much labor by the new mental health proposal to the government to convince them that a sad, struggling person is not a criminal, but needs help. A person who tries to commit suicide is NOT a weakling, and is not a hindrance to the precious right to live. So, yes, the policies are totally misplaced. There are still others on the right to vote, on holding property, and basic provision of care. A great proposal made was that of Advance Directive, in which a person has the right to decide his course of treatment should he or she have to be taken into a psychiatric facility and so on. It’s a beautiful detailed proposal that is yet to be passed. I’m sure there are other such proposals as well.

 

Is there anything else you would like to say to our readers about the work you do at The Shrinking Couch?

–I would welcome experiences and stories from as many people as would like to write. Everyone is welcome to share. For starters, you are welcome to read the stories that have very bravely been shared by many of our readers. This exercise of writing and reading is more therapeutic than most people realize. In the World Mental Health Week, I would encourage people to reflect, share, reach out and help, and also get help.

 

Next Story

Does Depression Increase risk of Early Death in Women? A new study answers

The findings showed that the risk of death associated with depression appeared strongest in the years following a depressive episode.

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Depression has significantly increased the risk of early death in women. Wikimedia

Toronto, October 23, 2017 : Due to the pressure caused by changing societal roles and multiple responsibilities, depression has significantly increased the risk of early death in women, a study has found.

The findings showed that the risk of death associated with depression appeared strongest in the years following a depressive episode.

“During the recent years in which women’s risk of death increased significantly, roles have changed dramatically both at home and in the workplace, and many women shoulder multiple responsibilities and expectations,” said Ian Colman from the University of Ottawa.

In the study, the lifespan for young adults with depression at age 25 was markedly shorter over the 60-year period — the lifespan shortened ranging from 10 to 12 fewer years of life, then four to seven years and later seven to 18 fewer years of life.

ALSO READ Recognizing Signs of Depression | Lets Talk About It

“At first the association was limited to men, but in later years it was seen for women as well,” said Stephen Gilman from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Maryland, US.

For the study, published in CMAJ, the team looked at 60 years of mental health data on 3410 adults from a region in Atlantic Canada and linked the data to deaths in the Canadian Mortality Database.

Though depression has also been linked with poorer diet, lack of exercise, smoking and alcohol consumption — all factors that can result in chronic health conditions — did not explain the increased risk of death associated with depression in this study, the researchers noted.

Family physicians should monitor the patients for mood disturbances, especially recurrent episodes of depression, so that they may offer treatment and support, the researchers suggested. (IANS)

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Facebook Acquires the Anonymous Teenage Polling App ‘tbh’

An official statement from Facebook said: "tbh and Facebook share a common goal -- of building community and enabling people to share in ways that bring us closer together"

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Facebook brings the developers of 'tbh' app to share and expand a common goal of making stronger communities. Pixabay

San Francisco, October 17, 2017 : Facebook has acquired ‘tbh’, an anonymous polling app for teenagers which has over 5 million downloads and 2.5 million daily active users in the US.

The app lets teenagers anonymously answer kind-hearted, multiple-choice questions about friends, who then receive the poll results as compliments, TechCrunch reported on Tuesday.

“When we set out to build tbh, we wanted to create a community that made us feel happier and more confident about ourselves. We felt that people craved genuine and positive interactions in their online experiences,” ‘tbh’ said in a statement.

“Over the last few weeks, over 5 million people have downloaded tbh and sent over a billion messages. More importantly, we’ve been inspired by the countless stories where tbh helped people recover from depression and form better relationships with friends,” it read.

ALSO READ How Facebook is Helping Its Users Fight Identity Theft

Financial terms of the deal weren’t disclosed but according to TechCrunch, it is likely to be somewhere around less than $100 million and will not require regulatory approval.

“As part of the deal, tbh’s four co-creators — Bier, Erik Hazzard, Kyle Zaragoza and Nicolas Ducdodon — will join Facebook’s Menlo Park headquarters while continuing to grow their app,” the report added.

“When we met with Facebook, we realised that we shared many of the same core values about connecting people through positive interactions. Most of all, we were compelled by the ways they could help us realise tbh’s vision and bring it to more people,” ‘tbh’ said.

In a statement to TechCrunch, Facebook said: “tbh and Facebook share a common goal — of building community and enabling people to share in ways that bring us closer together”. (IANS)

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Healing Emotional Trauma for A Peaceful Mind, Body and Soul

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Healing emotional trauma
Healing emotional trauma is hard but not impossible. Pixabay
  • Emotional trauma is never ending; always finds its way back to you.
  • Dealing with it and facing reality is the way to heal yourself.
  • Accepting, forgiving and letting go are the first steps to healing emotional trauma.
  • Surround yourself with people who love for you are.

Emotional pain has a way around people; it always comes unannounced which we have no control over. But dealing with the emotional trauma is something we do have control over. Just like a bruise or a scar the emotional trauma also goes away but you can’t escape it as it’s a part of your life whether you like it or not. Augustus wasn’t wrong in saying that pain demands to be felt in the famous John Green novel “The fault in our stars”. Healing emotional trauma the right way is when you face it.

  1. Acceptance

The first step to healing emotional trauma is accepting it. If you keep something locked away it eventually goes bad and smells, just like that accepting the existence of the pain is necessary to get rid of it. Don’t throw fits and instead embrace the situation because everything does happen for a reason no matter how bad. The important thing to remember is to keep the faith.

Healing emotional trauma
Accept the situation and believe that you can overcome it. Pixabay

  1. Healing emotional trauma involves Forgiveness

Grudges can sometimes destroy your inner peace more than you could imagine it to be. When you hold on to a something for too long your arms start to pain and eventually give up on you. Similarly, holding on to grudges hurts you more than the person you’re holding it against. The smart choice for healing emotional trauma would be to let the baggage go unless it’s Gucci.

  1. Don’t think and ruin it for yourself

Overthinking a situation ruins your inner peace and also makes you intensify the graveness of the pain. What’s done is done, don’t ruminate on it for long. The best option would be to chuck it and move on with your life.

Healing emotional trauma
Forgiving and forgetting is the first step to healing emotional trauma. Pixabay

  1. Surround yourself with people who motivate and encourage you

    Acceptance
    Surround yourself with people who love you for who you are. Pixabay

Dealing with emotional pain can be nerve wrecking and facing reality alone can be scary. In times like those, you need people who will understand you and accept for who you are. Toxic people who put you down or fail to understand you as a person are not the right way to heal your emotional trauma.

-Prepared by Tanya Kathuria of Newsgram; Twitter: @TanyaKathuria97