Bipolarindia, the nation’s first online community set up by a Bipolar for Bipolar Disorder and Depression. The Resource providers who interact on one common platform towards one goal: Lightening the burden of Bipolar and Depression.
There she sat in my class of software testing with a blank expression. It was not that she was unable to understand what I was teaching, rather she was unable to understand why she was there at all when all she wanted was to sleep. She was confused why she was unable to enjoy life as much as the rest of giggling girls around her, why people looked at her as if she were weird…
Enquiring about her behavior I found the answers ranging from “Ma’am, she is like that only” to “Ma’am, there is some problem in her family..”, “ she does not speak…” etc.
Her existence in my class was always a distraction for me, not only in the flow of my teaching but it was always dragging me into my own past.
Allahabad University. B.Tech (Electronics and Telecommunication).Class of Microwave and Radar…renowned Dr. Malviya teaching us, the budding electronics engineers, and me sitting in the corner staring at him blankly. Not unlike a zombie under influence of heavy drugs. Desperately wishing to find one corner in the world where I would not be asked to study, to compete, or do anything. Yes, do nothing at all. A girl diagnosed of Bipolar Affective Disorder at 18 and continuing with the pain since then. That was me.
Now, it was like looking at my mirror image.
In the Staff room every time teachers discussed her as a hopeless case my heart ached. So I decided to talk. Not to her but to the entire class. Ignoring the advice of my family:
“You should not tell anybody about your illness in your college. It could cost you your job.”
I had a choice to make. I thought if I did not speak, it could cost a LIFE.
I therefore made up my mind to speak.
It was a late afternoon lecture and students were in no mood to study. So I just asked them would they like to hear a story rather than overloading their brain with software engineering. The answer was a resounding yes.
I began telling them about my personal story and my struggle, something they had never ever imagined. I started with my brilliant track record in studies, my extracurricular achievements and selection in various India level exams. Until life started slipping out of my hands. The entry of rally of psychiatrists, the heavy drugs… And my deadly suicide attempts… the way each member of my family suffered because of me ,yet stood by me. The extremely helping friends ,who used to cycle miles to reach my home to teach me so that I could pass the exam. How I got tenth position and best design award, that was altogether a different triumph for my friends. Apart from my family who were my strength: selfless, loving and caring. Finally it was time to tell them that I had gone through ECT. There was pin drop silence. My eyes were moist. Tears were flowing down the cheeks of the girls. Boys trying to hold back the same. A one hour class had stretched to more than two hours without our realizing it. Leaving them in that state, I came back to my staff room. Few minutes later Sneha was there in my cabin, sobbing, along with the “newfound” support group Ranjeeta, Rajeev, and few more students.
She told me about her broken family, her treatment in one of the hospitals in Shahdara and how helpless she felt. I simply asked her if she would like to get treated by the doctor who was treating me .She agreed meekly. I had to talk to her mother first, which I did .She was so vulnerable herself with her husband leaving her and living with some other woman. Finally she showed faith in me and said yes.
The very next day we were in my doctor’s clinic. She was diagnosed with clinical depression. Her treatment started. Initially I accompanied her to the clinic.
Next few weeks passed with Sneha not showing up at college. Finally she started coming to the classes. Sneha used to sleep in class, with her head down .I asked students not to mind it. In free periods I asked Ranjeeta and Rajiv to make her sit in my staff room and teach her even if she was sleepy. So whatever she could hear in the class was repeated. We made her write the lectures with her shaking hands reemphasizing whatever we could.
Sitting there we would often laugh with her at her increasing weight and her over oiled hair. It was always nice to see her learn how to laugh at herself. Something I had taught myself to fight the ridicule a mental patient has to face. Sometimes I used to take Maggie for her just as a bribe to study with concentration.
Sneha started going to the clinic alone. It was a clear indication that she had understood her disease, and was ready to fight it without fear of stigma.
The next problem was to make other teachers understand her plight which was not an easy task for me. At times I had to beg for her attendance and sometimes for marks so that she could pass the internal exams at least. I made them keep the rule books aside and save a life. By God’s Grace she cleared her internal exams.
Final exams came and she appeared with preparation. When results were declared I had kept my fingers crossed .She had passed with good percentage.
From college placement cell, which I was heading as placement advisor, she could not get a job due to her back papers. Few months later she took up a job of software developer in a very small company.
One year later I saw her message in my message box that she wanted to meet me personally. She came with a box of sweets to tell that she has joined Nagarro, a very reputed Multi National company as quality Engineer. She hugged me and said “it is all because of you”. I had to remind her about the doctor who treated her she said yes ma’am I have not forgotten him “but it is you who took me to the Doctor’s”.
The actual care giver is still awaiting for his share of sweets…although I know that for him every patient successfully treated and integrated back in society is the sweetest gift.
the author of this post, is Reader and Placement Advisor at Delhi Institute of Advanced Studies. She dedicates this inspiring true story to all the compassionate doctors who have a heart like Dr. Philippe Pinel’s, the Psychiatrist who advocated the humane treatment of mentally ill.
All indications were that this time it would be big. Big, informative and inspiring this meet surely was!! It was Sunday, the 1st of April, 2018 and we were celebrating WORLD BIPOLAR DAY with a National Conference.
So we had delegates from Kerala, Pune, Surat, Thane and of course Mumbai joining us for this full day meet. Participants drawn from our Peer Support Group (care givers and those afflicted with Bipolar Disorder), Psychologists, Doctors and of course the panel of speakers.
The day began at 9 am with registration and later interaction over breakfast at the venue.The Conference began as scheduled, at 10 am sharp. After initial welcome address and run through of the day’s agenda, the first speaker took over.
Shrikant Kshirsagar, Yoga Expert and Corporate Yoga Facilitator set the tone for the day with an informative session.
essentially focused on breathing techniques and yogic exercises to improve well being. Kapalbhati (in its correct, relaxing avatar) and Brahmari were demonstrated. Practising these on a regular basis has a calming effect on mind and body and are particularly beneficial for Bipolar Disorder patients. The use of the Spirometer was also tried out to demonstrate to us how shallow our breathing is.
Quick Bites ~
‘We emphasise mainly on inhalation but do not realise that exhalation is equally important. It release toxins from our system.’
‘Eight breaths a minute is the ideal rate of breathing.’
‘As we slow down our breathing rate, we slow down our metabolism.’
Zeenat Jahan, Psychotherapist, NLP Practitioner, Life Coach & Corporate Trainer was next up.
She mesmerised with her heart felt talk on ‘Mind Power’. She shared the stories of people from various walks of life whom she has mentored and helped grow as confident individuals. The transformation in them was evident from the slides she showed us. Zeenat is a shining example of being a champion who walks the talk, no matter what challenges life throws in her path.
Quick Bites ~
‘Any illness is as big or small as we choose to make it.’
‘Does the brain control the mind or does the mind control the brain?’
‘If we consider the suffering of others, such as cancer survivors, it puts our suffering in perspective.’
Then we had our story sharing sessions, where Bipolar afflicted and caregivers shared their experiences. Tushar Khurana, a Bipolar Disorder champion had traveled from Pune to be with us. Tushar is currently doing his Business Management studies and has also authored a book, which will be published shortly.
He spoke about how lonely he felt until he chanced upon BipolarIndia and realised he was not alone.Our Peer Support Group is stronger because of people like him.
Rose (name changed) then shared her moving story of how she had discovered a family outside her own family~ her own parents disregarded her illness and are living in denial. This brave young lady has fought it on her own all the while. The amazing part was that she had just fought back from a manic attack last week yet had the resolve to join us for this day. She asserted that Bipolar is not a curse, it had shown her a new perspective of life. She is now studying Psychology so that she can be of help to the community.
Jahnabee Bohra represented the caregivers side of story sharing. She has lived with mental illness in her family. She pointed out how caregivers also need therapy as much as the patients.
She shared how she had chanced upon BipolarIndia while doing a random search on the internet and that had led her to attend the World Bipolar Day conference and Let’s Talk Depression meets in 2017. Attending these had been great learning experiences for her.
And then we took a well earned lunch break which was another great opportunity for interaction.
Well known Psychotherapist and Trauma TherapistH’vovi Bhagwagar demystified the role of Psychotherapy in the recovery from Bipolar Disorder. Her’s was a thorough, step by step walk through on how to select a Psychotherapist, what to expect from her and how Psychotherapy helps in managing the condition. A good Psychotherapist helps in ensuring adherence to medication and in spotting the onset of mood swings. She explained how addiction though commonly found among Bipolar Disorder patients, needed to be treated separately. Her detailed guidelines for caregivers and patients at times of acute depression and mania were immensely helpful.
‘Addiction is manageable but generally not curable.’
‘Activity is as important in managing Depression as medication.’
‘Bipolar Disorder is a Bio-Chemical condition which needs to be primarily treated with medication.’
Dr. Milan Balakrishnan, Psychiatrist and Psychotherapist took up the next session on ‘Managing Bipolar Disorder’. He spoke about the causes of the disease and the various drugs used to manage the illness. Also touched upon was the welcome change which has now come in with the Mental Healthcare Act in the form of the Advance Directive. With this, a patient can give advance consent about the kind of treatment he wants to opt for in case of future episodes. Doctor Milan expressed concern that substances like cannabis were being liberally touted as a ‘miracle cure’. He had seen many cases where use of cannabis tripped the patients into mania. The Q & A with the Doctor yielded hidden gems of information. For instance, there are injectible drugs in the market which release sustained doses of the medicine over a full month. Although these can be used in select cases, they are of great use when a patient is non-compliant.
Quick Bites ~
‘An average Depressive episode lasts for 6 to 8 months in Bipolar Disorder.’
‘Any Bipolar affected who is managing his condition well can opt for marriage.’
‘Between 1 to 5% of the general population suffers from Bipolar Disorder’
************************************************************************************************************** I took up the last session of the day. Why this topic? It had been chosen by members of our Peer Support Group and I had gladly accepted it because it pertained to my erstwhile career. While it is true that everyone needs to know the basics of financial planning, it is imperative that people drawn from my Peer community get their facts about this subject right and implement the knowledge. Even after my talk, i have received a few queries pertaining to it~ to do justice to the people unable to join us at the event, a separate post on my talk is coming up.
Quick Bites ~
‘One of the biggest fears we face is outliving our savings.’
‘Begin early, save aggressively, be disciplined.’
‘During mania, all this planning might be of little help. Have a Plan B.’
Our most challenging periods of turmoil teach us the most valuable life lessons. It has been sixteen years since I have been living with Bipolar Disorder. From the terrifying initial stages to the much calmer me today, it has been a cataclysmic journey. Along the way, I have grown immensely as an individual on multiple levels.
And have learnt some invaluable life lessons~ as they say, there is no better teacher than life.
1) I am not my illness
In the first year or so after diagnosis, my illness overwhelmed me. My entire thinking revolved around the monster that had me in its grip. Somehow, this became all consuming. I surrendered my identity to Bipolar Disorder. Experience taught me how to distance myself from the condition. Eventually, I did free myself from that mental prison. I was no more my illness, I had an identity independent of it.
2) There’s always someone whose suffering is much greater than mine
One bugbear of many a mental illness patient is self pity. While self compassion empowers, self pity weakens one’s resolve. It puts one in the victim frame of mind. Fortunately for me, my perspective was broader. I used to say to my Doctor that a Cancer patient’s suffering is far greater than mine. Even among my own community, I found that many were all at sea: in terms of coping, or financially or in managing relationships. Their hardships made me realise how blessed I was. At least, I was quite stable on these fronts. This taught me to be grateful for every moment of calmness I experienced. One has to just look around to realise how fortunate we are.
3) I have braved the worst of storms, the future holds no terrors for me.
The only constant about Bipolar Disorder is that there is no constant. We are at the mercy of mood swings of varying degrees of severity. Whenever I was doing well in my career and felt motivated and driven, a nagging thought bothered me no end. How long will this phase last until I slip back into depression? Yes, that had been my story: very short lasting Hypomanic episodes followed by years of Depression. And in depression, all my enthusiasm and fizz evaporated into thin air. With time, I learnt to be stoic about this. Haven’t I dealt with the worst horrors of psychosis and mania? Have I not survived severe depression before? I won’t let worries of the future ruin my present. With the changed attitude, I don’t feel anxious about what’s in store for me anymore.
4) Have faith in the journey~ we are incredibly resourceful. Whenever I felt I was out of my depth and totally lost, I realised that I could draw out another power from my well of resources. Be it creativity, resilience, a philosophical approach, courage or some specific skill sets. Learning became my new thrust. I devoured many a self help book, attended training courses and sought mentoring from Gurus. The deeper the crisis, the greater the need to dig out a resource and more invaluable was the learning.
5) If Bipolar Disorder was a huge setback, it also blessed me in many ways!
I was quite a successful entrepreneur when the demon struck. However, until then I had not written anything of great artistic merit. Overnight, as it were, I discovered that I was a writer. My gift for writing creative and inspirational articles took the form of a Blog and later led to this, the first online Peer Support site for Bipolar Disorder in India. Then came my Book about my journey which was published globally. Writing is a mirror to my soul~ I began to understand myself better. I also picked up the art of photography, my connect with nature grew dramatically. I became more sensitive to the environment and my abstract thinking ability expanded. What God took with one hand, He gifted me many times over with another.
6) We are not alone
The overpowering feeling one has when the illness strikes is that of loneliness. I had withdrawn into a shell and felt I had to fend for myself on my own. This is a myopic view that the turmoil imposes on us. It is over time that we acknowledge how much others are contributing to our growth. From caregivers, family, our Doctors, mentors, colleagues and friends~ there are so many who rally around us during our crises, inspire and guide us.
7) My spiritual growth got fueled by this journey My existential crisis made me look inward. There were so many unanswered questions… as if it were destined, I chanced upon a copy of The Bhagavad Gita. That was a life changing moment. Anybody who has read it would know what I mean. For a troubled soul, such a resource could not have come at a better time. Questions which pestered me got answered. I realised that I was a spiritual being and the suffering of the body was my Karma playing out. That the immortal spirit was the true seat of bliss gave new meaning to my life.
8) My outreach to my tribe made me an observer
The more vulnerable I felt, the more compassionate I became. Arrogance melted away. I had a distinct edge when communicating with those from my community.. I had the ringside view, had been there and had walked in their shoes. This made me more accessible and credible in their eyes. Along the way, the afflicted himself became the ‘caregiver’ for many.
9) Love is a Super Power
It is in a full blown crisis that one’s relationships are fully tested. What got rocked was my marriage. Over time, however, both of us came to terms with it. In fact, the initial storms may well have helped in strengthening our relationship. I love my wife and my daughter deeply. They add meaning and purpose to my life. Marriage is also about adjustment and sacrifice. From being self obsessed because of my inner turmoil, I learnt to give to the relationship. Love for my family anchors me now. I wonder if I would have understood what true commitment is if I had not been thus tested by Bipolar Disorder.
10) Whatever happens to us happens for a reason
Life’s ways are not mundane, I firmly believe. No occurrence is a coincidence~ it is all as intricately planned as a detailed script for a drama. ‘Through our suffering, we find meaning’ Viktor E Frankl
Was my suffering wasted? Not at all! I might sound immodest but I strongly felt at one time that ‘I was the Chosen One.’ That my suffering had a deeper purpose~ to test me and to empower me. In a way, it set me free.
The shades that spread on the canvas
As the ear gets slashed
Aren’t your colors Vincent.
Aren’t you making a flagellant of yourself
When you scribble your name
In the corners of the aberrations that were
Borne as the consciousness of the brush turned sour?
May the seven Pharisees mock
The swaying wheat fields and the churches.
May they pass on with their scornful stares
Wearing a plastic smile.
To those who’re taken aback and pull back
What can the Cyprus trees do
Except waving goodbyes?
Stars sparkle in your sky.
Sunflowers bloom in your garden.
It’s your kid that waves at you,
And steps with a smile that brightens the air.
It’s your nature to write like a reflex.
Ain’t it going out of order knowingly, brother
To suppress your nature, fearing disorder?
This poem has been submitted by Saravana Raja
Saravana Raja lives in Chennai.
Loves to indulge himself in films, fiction, mountains and paintings.
Proud dad. Infinitely Ursus Maritimus.
Birds best exemplify the rhythm of life and like all other birds, this pretty bird too welcomed the dawn with its peppy chirp. It set off for the day to search for food as it did day in day out. As it soared high above the ground, it admired the scenic landscape below it and the pleasant breeze swirling around. Its fellow birds flew with it in a loose formation. As the sun went down and painted the skies in glorious hues of orange and pink, they would all fly back to their nests.
Of late, its fellow birds had noticed some peculiar changes in our bird’s behaviour. It stood out from the rest due to its unpredictable and strange antics. It would wake up and begin chirping in the middle of the night and restlessly take off into the skies before its teammates could even wake up. Even when the rest of the birds resorted to the shade of trees when the sun was scorching hot, it would energetically fly around, aimlessly. Even when flying back in the evening it would break formation and fly off in another direction. The flock of birds once and for all decided to ostracise it from the otherwise closely knit flock.
Being isolated gradually broke the spirit of our little bird. It became morose and quiet. From being exuberant, it became sad. It wondered to itself, ‘Where has all my energy and enthusiasm gone? I don’t feel like even getting off my branch, let alone conquering the skies. I have no friends and nobody likes me.’
It came to a point that even ensuring that it fed itself well became an ask. Its mate had been perplexed about these sudden changes in its partner. Why had it become so lifeless? After a few weeks, the mate also lost patience and flew off. The desertion made our bird feel even more miserable. ‘I deserve this. Why would anyone love me?’. The beautiful surroundings had also lost their charm, nothing seemed appealing. It came to a point when it would just wait for when would the end come…
The above story is a metaphor.
Let’s replace our bird with a man afflicted by Bipolar Disorder.
Once orderly and hard working, the serious illness renders him virtually helpless. The excessive energy, aggression and odd behaviour are signs of mania. Society is at first perplexed by his extremely odd behaviour and then rejects him altogether. Stigma can be as deadly as the illness. Isolation suffocates the person suffering and makes him question his self worth. His condition affects his career too. From being the admired and dependable breadwinner of the family, he is now looked down upon. Sadness engulfs him, he loses all interest in daily activities and has suicidal thoughts. These are the signs of his depressive phase. The illness costs him his marriage too, for the spouse cannot take it any longer.
The bird found itself in a hopeless situation. Is there any hope for our man?
Yes, there is.
Firstly the man has no idea about what he himself is going through. If there had been more awareness in society about this and other mental illnesses, maybe someone, a friend, a colleague or relative could have spotted the red flags of a condition which can be life threatening if left undiagnosed and untreated. Is Bipolar Disorder curable? Science says it isn’t but it is treatable and the patient, under the care of a competent Psychiatrist, can lead a functional life. Disciplined approach in taking prescribed medication bolstered by Psychotherapy can help the afflicted turnaround from a point of hopelessness.
Of course, there are holistic remedies too which can support the mainline treatment, such as Yoga, Walking, Sleep hygiene, relaxation techniques, regular exercise. etc.
Family support is crucial in the recovery process. A person very close to the patient has to keep a constant watch out for change in symptoms and coordinate with the Doctor. Peer Support Groups which meet regularly can also help in building empathy and camaraderie within the Group. As for the stifling Stigma, society needs to be sensitised about all major Mental illnesses, so that people are treated more humanely.
Millions of Indians are affected by Mental Illnesses, some of them crippling ones.
It is about time that we urgently looked at this challenge with a different perspective and come out with innovative solutions involving all stakeholders.
(This post had been first published on Mental Hub, a site I strongly recommend to my readers)
This is about an inspiring story, in fact two stories. One is mine and the other had narrated to me. Let me begin with the latter.
In those days I was in the audio-visual presentations business which took me to varied venues and afforded the opportunity of meeting people from all walks of life. This day must have been drawn from some twenty years back but is etched in my memory. The power of story! At one such presentation, we had broken for lunch and I was accompanied an employee of a Multi National Corporation.
So I initiated a conversation with my lunch partner, Roger D’Souza. The conversation veered to drinking habits.
‘Many of my Christian friends drink, how about you Roger?’
‘Everyone in my family gave up drinking three years ago’ and then went silent.
‘What prompted that, if I may ask you?’
Then unfurled the dramatic story…
It was the birthday party of Francis, Roger’s elder brother. On a starlit winter night, the party was in full swing on the terrace of their suburban home, a bungalow. After the feasting and drinking was over, everyone streamed down and the guests parted ways. Except for the birthday boy, Francis who said he wanted to spend some more time on the terrace, enjoying the cool breeze. He did not come down for quite a while and the family fell asleep.
In the morning they realised that Francis’ bedroom was empty and they assumed that he must have slept on the terrace itself. When not found on the terrace too, they became alarmed. Francis’ limp body swathed in blood was later found in the compound.
As was his wont, he must have lied down on the terrace parapet and the many drinks he had downed must have knocked him senseless. Maybe he would not have fallen down in the first place if he had been alert. Maybe, if he were not so drunk, he could have called for help and not have bled to death…for it was later established that the fall had not killed him, he bled to his death.
That night of revelry which ended so tragically was the last time anybody from the family touched alcohol.
Roger’s grim face said it all.
Why does it take such a dramatic turn of events for us to see the light?
My story is less dramatic, yet I believe it can inspire others.
We grew up in a family where drinking was not taboo. So even during my teens or early adulthood, having a drink or two with family was commonplace, provided the occasion demanded it. Then college happened and indiscretions mounted, followed by early years of my career. The feeling of being financially independent bolstered the rebel spirit.
What happened was a weekend of casual drinking was now routinely binge drinking during any get-together. In fact I began craving my drink. The problem was I did not know when to stop and often got hopelessly drunk. And the frequency of such nights quite alarming.
It was a December wedding of a friend where I hit the bar with undue enthusiasm. With me was my younger cousin sister. We wound up well past midnight and as we headed towards the railway station I could barely stand straight, leave alone walk. In the train, I tried to keep awake and my drunkenness must have been obvious to all. It was particularly embarrassing for me that a school mate was seated just across me. What must he be thinking!!
Any case, I managed to reach home to a frosty reception from Mom. A massive hangover greeted me next morning, not unexpectedly. Mom had all this while warned me to tone down my drinking. This time she had had enough of it.
‘Do you know what shape you were in yesterday night? Forget protecting your sister, you were not fit enough to protect yourself! Listen, we’ve had enough of this. This day onwards, it’s either drinks or me.’
She was deadly serious and I respected and loved Mom far too much to not heed her advice. That was it. It has been over twenty seven years since I quit drinking. It happened overnight. Was it so easy? I remember that just a few days after me going teetotaler, it was my cousin’s birthday. A friend of his had gifted him a bottle of Scotch whisky. Believe me, I had to summon all my reserves of willpower not to succumb to temptation that evening. Temptation of maybe just one drink..
Today, I am grateful to mom for being so firm with me at the right time. Many years down that day, I was diagnosed with Bipolar Disorder. Doctors will tell you that drinks and Bipolar Disorder just don’t mix. Alcohol impacts the effectiveness of BD meds and increases probability of indiscre behaviour manifold in Bipolar afflicted.
If you need more reason to quit, here are some~
‘Alcohol also affects the areas of the brain that are responsible for coordination, memory, and emotional regulation (anxiety, depression, aggression), as well as the ability to problem solve and learn. Additionally, the byproducts of breaking down alcohol in the liver are toxins, including ammonia and acetylaldehide, which find their way to the brain. These chemicals have been associated with killing brain cells and increasing the risk of certain cancers.’ (Read the full article here: Reasons to quit alcohol)
A sullen, withdrawn child to begin with, my personality lent itself well to depression. From what I can remember, or more correctly, can now identify as depression. Genetics had charted out plans for me: my father had been afflicted by a serious mental illness which was never diagnosed back then. Environment played an able ally to my predisposed DNA faultlines. I was doing fairly okay at High School in a then tiny town called Vasai, near Mumbai. It took vicious and persistent bullying to upset the fragile applecart.
I was cowardly by nature and generally kept things to myself and thus nobody at home got any wiser about the impending storm. The bullying got to me one day and I just stopped going to School, that too in my critical tenth Board Exams year. I missed around a month of Schooling, which should have been a red flag for something seriously amiss.
I had deviously disguised my problem as my persistent asthma that prevented me from attending school. At that time I was also at the vulnerable age of fourteen, facing a flux of hormonal changes difficult to handle on its own. Now the added burden of an unidentified monster seemed to have taken a grip over my life.
The problem only grew when I entered College.
Being socially awkward made me stick out like a sore thumb. This tormenting episode lasted for around a year, a year of sheer hell at a tender age. I recall certain psychotic tinges to my depression, so severe was it. I could not concentrate in my studies nor could I enjoy life. I used to loll around in bed most of the day, staring at the ceiling, my mind blank or full of morose thoughts. Meanwhile, I had built a reputation of being a first class hypochondriac in my family. Naturally, empathy to my suffering was not forthcoming, nor did anybody give it a second thought.
Almost exactly after a gap of one year (which was fortunately smooth sailing), depression struck again when I was sixteen. Once again, the symptoms were similar but there wasn’t any identifiable trigger this time around. If it was possible, maybe this episode was even more intense and disturbing. As I was approaching manhood, this was a blow to my self esteem and sense of identity: instead of being the man in the house, my elder sister Tejal seemed to be more assured and in charge of things.
Back then, there weren’t any Psychiatrists or Psychologists in Vasai who we could have approached to resolve my problem. That is, if we could have identified any! I remember a physician based in Mumbai passing my depression off as Vitamin B12 deficiency and prescribing me a series of shots for the same. Just wonder, just maybe, if only the monster had been nipped in the bud right then?
The last episode of depression in my younger years happened when I was twenty four.
This time it turned out to be extremely debilitating for different reasons. I was now assisting my uncle in our largish family business. My work responsibilities suddenly became a huge mountain to me…I felt so inept, my self esteem and confidence dived to a point of no return. Now things were no longer under wraps….there was something decidedly ‘weird’ about me. I could sense people smirking at my ineptness. Or was it my mind playing games? Thankfully, there was a lull after this. Fifteen years of a fairly smooth passage made me forget all about my illness.
The calm before the storm?
My word, it was the mother of all storms. I didn’t realise when my behaviour showed signs of being ‘abnormal’, to put it mildly. Irritable, emotional, highly charged up, intense feelings, intolerance to anyone not agreeing with me, irrational and absurd ideas, excessive energy, bursts of crying…a long list of red flags which warned my ever alert Sis that there was a problem, big time. To give you an idea, I would be jubilant in the day and wake up sad in the wee hours of the morning. My Sis once found me sobbing one such night, as I was penning down a dark poem in jagged writing, a result of my trembling hand.
Tejal somehow managed to convince me and we met a Psychologist at Jaslok Hospital.
In a few minutes she cut me abruptly to say that it was not her case, we needed to see a Psychiatrist. Even as I blabbered continuously, Doctor told me that I suffered from a serious Mental Illness by the name of Manic Depression (as it was called then). A week in Hospital gave me a close look at hell, yes, that was how horrific it was at that time. Having been diagnosed during a severe manic episode, the return to ground zero was shattering as I dwelt on my indiscretions and silliness.
Since then it has been years (fourteen of them) of depression: mild, low or threatening. The only time I have had respite from it is when I briefly trended towards Hypomania twice during that period. Being a Bipolar Type 2 entails more intense and longer periods of debilitating depression.
You might find it curious that I call myself a happy and fulfilled man.
One’s challenges don’t define the person, how one deals with them does. I have touched equilibrium…a mix of acceptance, philosophical approach, pragmatism and tons of patience.Exercise keeps my spirits high and a nutritious diet with adequate supplements is my fuel. Earlier it was hathayoga, now strength training at a Gym keeps me going. I still practice Pranayam and meditation which help calm me.
And definitely, from those agonisingly painful days, I have walked a long way.
And I didn’t walk alone either. Gratitude to my family, friends, Doctors and mentors for making it possible. And someone up there who is partial to me.
Therein lies my message of hope and inspiration for someone who is at the bottom of the seemingly bottomless pit.
“Suppression of depression is not good. Expression is always good. If depressed, share your feelings with others, it will make you feel better,” was PM Modi’s address to the nation prior to World Health Day.
The passing of the Mental healthcare Bill along with the PM’s declaration are positive steps towards reducing taboo around mental health.
However even if you cross that first barrier and accept that you have an emotional problem and are ready to take help you may still wonder…am I receiving the right treatment at all? Many people believe that visiting a counselor will solve their problems, but unless the person you are meeting is managing your illness effectively, you are unlikely to show much change. One needs to meet an accredited and trained psycho-therapist (not a “counsellor”), someone who will actively work to alleviate your symptoms.
Therapy is hard work. It is not just about “Talking and Listening”. You will need to work within and between sessions to change your activity level, daily schedule, mood, thinking and social relationships.That doesn’t mean you need to work on your own. Your therapist work with you through the negative thinking patterns that reduce your motivation to make these changes.
What’s the first step?
In the first session your therapist will usually administer a brief screening tool for depression such as the BDI(Beck’s Depression Inventory). Your therapist needs to assess if you meet the current diagnostic criteria for major depression (diagnosticcriteria are a set of indicators which classify if a person is suffering a particular illness). Major depressive disorder typically includes a set of symptoms a person needs to be feeling almost EVERYDAY for atleast 2 weeks.
Diminished interest or pleasure,
Significant weight loss or weight gain
decrease or increase in appetite
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive or inappropriate guilt.
Diminished ability to think or concentrate, or indecisiveness.
Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Simultaneously your therapist will also do some of this in the first session:
Discuss need for anti-depressant medication (if you are not already on these)
Sending you for blood investigations. Low levels of Thyroid, Vitamin D3, Vitamin B12 and Hemoglobinmay masquerade as depression. Supplements may reduce depressive symptoms within few weeks
Psycho-education on depression. Depression is a brain disorder…there is an imbalance incertain brain chemicals(such as serotonin, endorphins and norepinephrine) responsible for happiness, motivation and energy. Once you see evidence that depression is a chemical disorder, you are less likely to feel that you are somehow responsible for being depressed. Here is something your therapist may show you:
I think I could have managed all this through google search… So what’s next?
Your therapist will then check your activity and daily schedule. Most people with depression spend their day doing little or no productive activity. Some people with depression may be able to sustain regular routine, but may not be able to do things that give them a sense of accomplishment or pleasure. You will record activities in a similar chartduring a typical week and monitor your schedule along with your therapist. You will also rate on a scale of 0-10 (0=None, 10=Highest) level of Accomplishment or Pleasure you experienced when doing the activity.
In the next session (usually a week later) your therapist will evaluate this schedule and together you will draw certain conclusions. Eg:
Watching too much T.V.
No physical exercise
Few pleasurable activities
You will then discuss with your therapist to add activities that can give you a higher sense of pleasure and accomplishment.
Walking atleast 10 min a day in sunlight
Meeting friend on Saturday
Reading a novel by favourite author.
Completing blog article on business stress
Okay, this seemed easy. Now what happens next?
Maintaining the activity log, then discussing activities and finally completing those activities is easier said than done. Negative thinking is the biggest challenge that a person with depression needs to work with. Imagine a cardoing a 100 mile journey on ¼ filled fuel tank. It will reach reserve fuel in no time. A depressed mind is exactly like that.The person tries his or her best todo certain activities but negative thinking is that empty fuel tank, it usually doesn’t allow one to go too far.
So now your therapist will introduce to you the concept of monitoring your thoughts…a concept called Cognitive Restructuring based on the Cognitive model. The cognitive model suggests that how we perceive a situation influences our emotional, behavioral (and often physiological) reactions. Our perceptions are often distorted when we are distressed. In therapy, you will learn to identify and evaluate “automatic thoughts” (spontaneously occurring verbal or imaginal cognitions), and to correct your thinking so that it more closely resembles reality. Evaluating Automatic thoughts usually decreases emotional upsetness and increases the likelihood of behaving more functionally.
Once you start monitoring and evaluating your thoughts, slowly you will see your mood improve. At the start of each session your therapist will also do a Mood check by asking you “On a scale of 0-10 how would you rate your mood today?” If your mood has dipped significantly from the last session you will evaluate why and assess the situation and negative thoughts.
In a few weeks, you may see significant improvement in your mood. You may start feeling like you earlier self and return to many of the activities you had stopped doing.
You will also use the above thought record sheet and other tools to start modifying your more persistent and underlying core beliefs (the “root” of your depressed thinking). Eg: (“Ï am worthless, unlovable, failure). Your therapist may also ask you if you would like more comprehensive treatment which involves working on adverse childhood experiences using a form of therapy called EMDR (Eye Movement Desensitization and Reprocessing). EMDR addresses early traumatic experiences that may have led to the developmentof the current depressive symptoms.
Therapy will continue for about 12-15 sessions. You will continue to monitor daily activity, mood and distorted thinking patterns. You may meet your therapist for follow-up sessions once a month to reduce chances of a relapse. The good news is that you will have learnt skills by now that help you identify your triggers for depression and learnt skills and techniques to improve your mood.
Now that you what therapy is about….what’s stopping you?
H’vovi Bhagwagar is a Clinical Psychologist and trauma therapist, with over 17 years of experience as a psychotherapist, mental health trainer, motivational speaker and researcher.
Hvovi operates her clinic “MANASHNI” at Powai, Mumbai. She also consults with Dr. Reddy’s, Oberoi International school and is a panel expert with Bipolar India and RobinAge Newspapers.
Hvovi works with clients diagnosed with mood disorders, personality disorders, phobias, panic attacks and bipolar disorder.
Hvovi is the first Indian to publish a case study in an International Journal on anxiety disorders using trauma therapy. She is one of the few Indian psychologists who is trained in treating rare cases of complex trauma such as Dissociative identity Disorder.
World Health Day 2017 is around the corner (April 7) and this time the theme is ‘Depression~ Let’s Talk’
So yes, Let’s Talk Depression!!
I thought it would be apt to publish a post on a first account journey of Depression Warrior, Shubhrata Prakash~ her Book is named (with stark simplicity) ‘D Word’. With the kind permission of her Publishers, Pan Macmillan India, I am sharing a select excerpt from the Book~
“Alice laughed. ‘There’s no use trying,’ she said: ‘one can’t believe impossible things.’
‘I dare say you haven’t had much practice,’ said the Queen. ‘When I was your age, I always did it for half-an-hour a day. Why, sometimes I’ve believed as many as six impossible things
before breakfast.’ – Through the Looking-Glass
MDD distorts thought processes and alters one’s view of both one’s inner and outer worlds. It sets off a storm in the mind, the brain and indeed, one’s complete psyche – buffeting, pulling and pushing them about with mercurial winds of thought. The mind struggles to find that eye of the storm where it can rest till it all blows over.
Viewing everything through coloured glasses
In The Wizard of Oz, the American classic by L. Frank Baum, written and published in the early 1900s, Dorothy, the little girl, Toto, her dog, and her companions – the Scarecrow, the Tinman
and the Lion – reach the Emerald City. The Guardian of the Gates gives them glasses to wear, to shield themselves from the glitter of the city. Once they put on the glasses, everything in the city appears green. Only towards the end do they discover that the Emerald City is as fake as the Wizard. It is just a plain white city that looks emerald green because of the green glasses that Dorothy and her companions are tricked into wearing.
Now, just replace the ‘green’ with ‘black’, and there, you have the whole story of depression. The ‘fake’ Wizard called Depression tricks us into wearing dark, negative-tinted glasses, which change your thought processes and cause cognitive distortions. Biologically, it has been seen that there are alterations in the neural pathways responsible for thought processes and cognition in the brains of people with depression. These pathways occur in the prefrontal cortex of the brain. With an improvement in mood and changes in cognition from therapy and correctional behaviour, these pathways show changes again.
The negativity that you experience is not your fault.
It is because of the cognitive changes that everything seems so dark and bleak. And depression lies to you. It tricks you into believing that everything is black or white. It wipes away the greys from the natural colour palette of life. It causes anger, hurt and grief even when there is no real reason for any of it. It puts blinkers on your eyes and makes you refuse to see anything other than the negative things it wants you to see. It conjures up fearful images in your mind that make the useful humdrum of life appear like a horror movie. It magnifies your already present fears to chimerical proportions.
Erosion of self-worth The worst toll that MDD extracts is on your self-worth.
It makes you feel like a failure in life. All your achievements seem worthless. You tend to overlook big successes and focus on small failures that now appear really big. You tend to compare yourself with people around you and always tend to see yourself faring poorly against them. Depression turns your rational sense on its head; you compare your biggest failures with other people’s biggest successes. . . and, what do you expect will be the result? Naturally, a feeling of worthlessness. You see everyone around you as doing well in life, except for you, the loser. And it is not your fault, remember, it is depression that is making you this way.
Worse, when you have been formally diagnosed with MDD, you think the world at large views you as a ‘nutcase’. Also, the immediate world cannot help you, crippled as it is with the stigma attached to MDD. As the visits to the doctor and the psychotherapy sessions start, as you are able to contribute less and less to the household and to your workplace, and as you also see your near and dear ones getting upset over your illness, it has a multiplier effect on your feelings of worthlessness, pitching you deeper into depression.
Living a dual life
Being under the spell of MDD leads to the feeling of living a dual life – by which I do not mean bipolar disorder, schizophrenia or borderline personality disorder. By ‘dual life’, I mean a life
characterized by the dominant dark haze of depression with lucid interludes of normal cognition. During the periods of clear thought, you remember your life pre-depression. You remember your basic personality of being a fun-loving, normal thinking person. But you are so different now, full of negativity and moping all day.
This ‘split’ in one’s reality leads to further despair. A person with depression is not able to come to terms with the changed reality of their depression-ridden lives, having been a different person
earlier and someone else now. His lucid intervals make him aware he is losing out on life, reminding him of everything that his life is not, making him even more miserable.”
~ Shubrata Prakashis a writer, poet, blogger and civil servant. A graduate in Mathematics and post-graduate in Business Management, she has briefly worked in the world of advertising, before joining the Indian Revenue Service.
It was the 30th of March, 2017, World Bipolar Day.
Just like last year, BipolarIndia organised the only public function of its kind in India to mark the day with a grand Event. An Event designed to spread awareness, educate the audience and bring people from various parts of the country together. Gratifyingly, we achieved this and then some more.
After enjoying the tea/coffee and snacks, our evening kicked off! Yogacharya and Wellness Consultant Shammi Gupta began the proceedings with a presentation and demonstration of Hathayoga. Her talk emphasised on techniques to bring balance in an illness which is essentially about imbalance.
‘Practicing asanas which involve body balance, helps the practitioner become more aware of the body.’
She also cautioned on how breathing exercises need to be carefully chosen in BD~ hyper breathing exercises could agitate the mind while on the other hand deep meditative relaxation state could depress the mind. ‘Practising carefully chosen asanas could help bring equilibrium in an unbalanced and agitated mind.’
Sanjay Agarwal, who had joined us from Surat, then shared his experience in dealing with Bipolar Disorder. How he had not only learnt to cope with it but now went on a new path of compassion…of offering support to the mentally ill at a civic hospital on a daily basis. He splits his time between his business and his passion. ‘My family thought that I was incapable of coping with my illness and left me. I am glad they did for I think that I am better off on my own now.’ he shared with us emotionally.
At last year’s Event, I had already shared my own story of struggle with and recovery from Bipolar Disorder. My focus this time was on the larger picture, that is, how the Bipolar community was bonding through the Peer Support Meets and how we were planning to take it further. “Is Bipolar Disorder a blessing? It might be fashionable to say so, but I ask you a question. Is hunger due to a famine a blessing? Just because I am sated, I cannot overlook the suffering of hundreds of thousands. Bipolar Disorder is a famine of the soul.”
Time to make our Big Bang announcement!!
The unique and disruptive collaboration with Thyrocare.
Almost all Bipolar afflicted who are under treatment are required to undergo blood tests to monitor drug levels in the bloodstream as well as any side effects on the thyroid or liver function, among others. The issue is that these tests are quite expensive and are called for anywhere between once to twice a year, depending on how the outcomes are.
To illustrate with an example, a fortnight ago, I went through a gamut of such tests which cost me INR 8,245/-. Imagine spending such amounts twice in a year~ certainly beyond the reach of a majority. The breakthrough is this customised Package of Tests that will now cost just Rs. 2,100/- (a potential saving of 6000 each time!).
This disruptive pricing has been made possible because of dual reasons. One, the CEO of Thyrocare sees the significant subsidy as a CSR initiative that would benefit many. Secondly, Thyrocare’s fully automated lab (the first and only of its kind in India) pushes down costs to make the offer sustainable. I personally think, it is a step towards more such collaborations in the coming time.
After all, beyond awareness and motivation, we must find ways of making help more meaningful at a level which makes a real difference.
“If I may be permitted, I would need a little more than ten minutes to speak, for I have so much to tell”, said Akhileshwar Sahay, and I readily nodded in approval.
And then followed a speech by him that held us in thrall. Firstly, the mind-boggling authority with which he shared information about the recently passed Mental Healthcare Bill, in which he had taken a lead role as one of the key policy makers.
Akhileshwar spoke about how draconian the previous laws were and how dramatic and beneficial the provisions of this new Bill are to its intended beneficiaries.
And then he narrated his gut wrenching emotional story of upheavals, trauma, struggles and ultimately the triumph of the human spirit against all odds. That he can still function with any degree of normalcy is a miracle, trust me!
“Anybody who says Bipolar Disorder is a blessing, has not truly experienced its ugly side fully. BD is an unmitigated disaster.”
One could see how that resonated with his own story of incredible challenges and then overcoming them with the stellar support of his wife.
Naturally, he was greeted with a standing ovation as the crowd rose as one to applaud this great man!!
Dramatic Storytelling of a chapter from my Book was next on the cards. Nilum, an accomplished storyteller took us into the world of the protagonist’ s family and how BD plays spoilsport. Does our heroine triumph or does she falter?
The purpose of this narrative rendition was to neatly bring to the fore how exactly a family is torn apart by BD and how family support is key in the recovery process. In the end, true love wins the day.
The story built a picture of how BD plays out in a person’s life and how the family must rally around the afflicted.
‘Demystifying Bipolar Disorder’ was the topic of Dr Milan Balakrishnan, Psychiatrist and Psychotherapist (who is also an Expert on the pan of BipolarIndia)
There was so much even for me to takeaway from this presentation~ thoroughly researched and compiled to bring immense knowledge in one compact capsule. ‘Although the chances of suicide go up in depression, in severe depression, conversion rates are often low because there is no energy to even convert the thought of suicide into action.’
I am sure even the lay person in the audience must have benefited from his talk. ‘Is it possible for a person to prepare how to handle mania? The fact is that at such times the affected person just does not have control over his faculties. Thus, appointing a person or two persons to take decisions on one’s behalf at such time is crucial.’
Our Guest of Honour, Mrs. India 2015 and Mrs. Earth 2016, Priyanka Khurana Goyal then addressed us.
Her understanding and compassion for the cause was obvious. ‘I think more than physical illnesses, it is mental illness that needs more urgent attention and empathy. While we can see and ‘feel’ the pain of physical illnesses such as cancer, the suffering of a mentally ill goes unnoticed. It is our collective duty to spread awareness. I pledge support to BipolarIndia and their cause and will promote it in my own way.’
A committed soul had flown in from New Delhi especially to interact with her tribe at this Event. Tripti Mishra, educator, mesmerised us with her emotional story~ a bipolar disorder afflicted herself, she shared the ups and downs in her life candidly. ‘I disagree with Vijay ji on one point. Bipolar Disorder has been a blessing for me!’
said the brave lady with great pluck and conviction, as she shared with us her dream…
‘Psychotherapy Treatment for Bipolar Disorder’ was Clinical Psychologist and CBT Therapist H’vovi Bhagwagar’s topic (she too happens to be on BipolarIndia’s Expert panel) ‘Bipolar Disorder is primarily an organic condition and thus has to be treated by a Psychiatrist. However, a trained Psychologist can in many ways help in the recovery process with counselling as a conjunctive therapy.’
Her presentation demonstrated how journal keeping helped her modify her clients’ thought patterns by making them analyse their thought processes. ‘A good Psychologist’s role is also to co-ordinate with the Psychiatrist and ensure that the patient does not skip medication.’
As a Bonus, here’s H’vovi’s Presentation!!
She also explained how EMDR could help mitigate past trauma or phobia, challenges so often present in BD afflicted.
Meanwhile, whetted and stimulated by all this information, the audience was eager to get its queries answered. The Panel discussion was an informal talk, mainly based on an open Q & A format so that the audience could actively engage themselves in the discussion.
Hvovi, Dr Milan, me were joined by Certified Nutritionist Mahakmitra Bhandari & Fitness Trainer Saurabh Chavan.
Hvovi happened to give credit to me for the wonderful Event, to which I responded~ ‘Last year I might have been a lone wolf, however now our Peer Support Group is a strongly bonded family and this is a collaborative initiative. We are now like a pack of wolves!’ BipolarIndia expresses gratitude to all the Speakers, Medical Experts, Mrs Earth Priyanka Goyal, Shammi Gupta, Mahakmitra & Saurabh for sparing time from their commitments to make the evening such a memorable one.
Thanks to our Peer Support Group~ Guys, your enthusiasm is the fuel to our thrust!
AV Power, the generous sponsors of the hi-tech AV equipment at the show.
Let’s Walk Together >>> the future bodes well for collaboration and compassion.