Category: Mental Health of Adults

Information and interesting news about topics in adult mental health. India focused.

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Big problem with modern doctors!

When you approach a doctor with some problem, you are vulnerable. You will readily accept most of their suggestions for “intervention/treatments”.

Sometimes your doctor will send you away without offering intervention/treatments. Because –
1. It is normal occurrence. No disease.

2. Your misconceptions need correction not your body.


3. It is a self limiting condition.


4. Intervention will make it worse. Better to wait and let it disappear.


5. Too early to identify precise problem. Not enough data. Better to wait for more data to emerge.

6. You get hassled by small issues, need to learn to live with some as long term health strategy.


And some more.

Such doctors are pure gold. Cherish them.

They are turning away a patient who is willing to investigate and get treatment because they are ethical.

Many patients feel that such doctors are rude, incompetent or don’t care therefore they are turning patients away.

I would pay more for a doctor who rightly tells me to ignore/wait/come back later/tolerate my issues than the one who jumps the gun readily

“emotional healing” is at the top of list of needs of many patients.

It is a legitimate human need. I agree.

Is it fair to expect it as top priority from a modern medical practitioner every time you meet them?

Are we getting more infantile as a society ?

Why do we constantly need hand holding and soothing ?

Is anxiety THE top problem in every healthcare interaction ?

Please don’t quote William Osler. He didn’t have medical negligence laws, internet, automobiles and insurance.

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Back to the roots for Psychiatry?

Psychiatry is presently not as ostracized as it once used to be, confined to asylums.

Now a days you may even find psychiatrists invited to public functions.

A welcome change but likely to be short lived.

Why?
Read on – #stigma has always been a huge problem for psychiatry.

We got mental health away from Shamans but managed to get stigma in the process.

Persons with mental illness were always feared and hated. Hence confined to asylum, away from sanitized life of people. Anything perceived as threatening (mentally ill, free thinking women, disenfranchised minorities, political opponents, sexual minorities) was labelled as “madness/character flaw/unsoundness” etc and sent to asylum to spend rest of their life. Psychiatrists worked in such places. Looking after those who were unwanted by the world. They made sense of this madness.

As medicine progressed, neurological basis were discovered and most importantly, prescriptions could be written to achieve “cure”. History of psychiatry shows that as soon as something is discovered to be –
1. Treatable by talk therapy (depression, anxiety, relationship issues, etc.)

2. “neurodevelopmental” to be treated with some medicines but largely support (autism, ADHD, intellectual retardation)

3. Effectively treatable with medicines (epilepsy, movement disorders)

It is moved to mainstream medicine and treated by psychologists, pediatricians and physicians/neurologists. Stigma continues to work strongly in society but MORE PROMINENTLY among medical doctors.
They are afraid of serious mental illnesses that involve losing “sanity”.

That means – Schizophrenia, Any psychosis, Bipolar disorder.


In India almost no non-psychiatrist doctor knows about “Phenomenology” and “mental status examination”. So they think psychiatrists just talk with people and give labels.

As we develop more effective medical and non-medical therapies for various ills of brain and mind,
psychiatry is headed back to asylum, its birthplace. A psychiatrist is trained in “bio-psycho-social” model to look after all aspects of mind-brain-body-self-others complex.

We are gradually handing over care of mentally ill to part-specialists because it is less stigmatizing (though not necessarily any cheaper or better). This leaves care of only seriously ill to psychiatrists and psychiatric nurses.

Sometimes in asylums, sometimes in community (not necessarily integrated with society).

“Mindless psychiatry” and “brainless psychology” is often rightly criticized. Now we have entered era of “narrative based mental health”

Where does it stand as science? How does it serve society? Is getting rid of multidimensional model specialists a really good idea?

Are we throwing away baby with bathwater?

I leave you to think and comment on this rapidly turning tide of twenty first century mental health.

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Managing your anxiety about Covid

If you are worried about catching Covid while at home, you can try these simple steps to reduce your worry –

1. Use small chunks of time (15-30 min) by allocating to specific activity

2. Do not re-work plans – e.g. if you are buying groceries once a week stay with it.

3. Stop looking for more info – avoiding crowd + closed spaces and wearing mask all the time is enough.

4. Washing hands ONCE after returning home is good enough.

5. Watch your emotions – distract yourself from worry, anger, sadness by involving in physical activity, art, music, etc.

6. Step away from Covid conversations in person and online.

7. Spend time with children doing chores at home, study etc.

8. Get exercise as possible.

9. Simple slowed breathing with long exhalations is helpful. Start with just 10-15 breaths multiple times in a day. Don’t stretch concentration to breaking point.

10. Call up elderly relatives for light chat and help them remember “good old days” avoid Covid discussions with them.

11. Get good sleep by switching off screens hour or two before bedtime and take light dinner.

12. Start writing – whatever you want. May be just a written record of your free running thoughts. It helps to calm mind. Usual caveat – this does not apply as treatment of mental health issues.
If distress continues beyond 2 weeks and affects your sleep, appetite, mood on daily basis, get help.

Take care.

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Preventing Suicides : What can you do?

10th Sept is World Suicide Prevention Day.

We all know that 800,000 people die every year due to suicide. 250,000 of those are Indian. So every third suicide happens in India.

Though Suicide is biggest cause of death for young Indians (15-30 age group), we do little about it.

Can you help someone stay away from suicide?

In this blog, I try to give simple tips to help you prevent suicide without feeling overwhelmed. Everyone can help.

1. All of us feel suicidal at times. Nobody is immune. If you haven’t felt it so far, give life a chance. In spite of my years of training and work in Psychiatry, I have felt suicidal at times and at least twice i was quite close to ending my life but my therapist saved my life with regular support in therapy.

2. As of now, we don’t know precisely what causes final act of suicide. People reach that point through various pathways.

3. One thing is sure, loneliness and hopelessness contribute a lot to final stage. Anger may be a big push for some who die by impulsive acts of self destruction.

4. So, whenever you realize that your friend, acquaintance, lover, student, neighbor, relative, is avoiding people , you should ask if they are okay.

5. If you are wondering about their suicidal thoughts, ask them a direct question about it. Asking is the best way to help. Dont be afraid that you may INDUCE suicidal thoughts in their mind by asking such questions. You will NOT be inducing suicide by asking.

6. Offer to talk, brew a cup of tea/coffee/hot meal. Don’t advice. Just hear them out. At the end, thank them for trusting you with all the information, thoughts and feelings.

7. Ask what you can do to help them feel better. It is a simple question but a powerful one at the end of patient and helpful listening.

8. Keep in touch. Don’t disappear from their life after this conversation.

9. If you feel overwhelmed, don’t be afraid of saying that (“it is so much to experience. Listening to your experience is overwhelming for me. I don’t know how you brave it all. Tell me how do you cope with this?”)

10. When you feel worried about their safety, call a helpline. All cities have suicide prevention helplines.

11. Lastly, remember, company and patient listening are most powerful tools to prevent suicide.


A supportive hand in hand and a patient ear goes a long long way.
Get professional help whenever it crosses your desire to help.

If you want to read Marathi translation of this article, my friend Prasad Shirgaonkar has posted it on his Facebook Page, https://www.facebook.com/prasad.shir/posts/10157411734091411 .