Over and over I asked myself – Now what? Now what? What happens after a severance such as this? How long do one’s bones bleed? Do the tears ever finish? What does ‘recovery’ look like? Is it even possible? How does one keep placing one foot in front of the other? Where is the road? Where does it come from? Where does it go? How long and meandering is it? When does the screaming in my head stop? How long can I keep up the facade? Pretend to be sane? Is this what a new diagnosis of a terminal illness feels like? Is forgiveness possible? Self-forgiveness? Acceptance? Surrender? All these big words! Surrender what? To whom? Who am I now? What do I do?
No answers. Silence. The tilted earth keeps spinning around its imaginary axis. It keeps cradling me. The sun stays at the center of its orbit. My son stays at the center of my being. My breath keeps coming and going. I grow new eyes. My bones carry my weight even though they bleed. The road appears under my feet. It reveals itself one step at a time. Rumi and Khalil Gibran come and hold my hand. The screaming softens. The wall of bricks that was my body, loosens. I come to know the terror and the joy of being insane, catch glimpses of being free. Respect for those who went before and sadly others, who follow. I stop fighting with the big words and keep it simple. Watch. Observe. See. Open. Let the gash in my heart, allow the light in.
Vikram Patel is a psychiatrist and a Professor of Global Health who works tirelessly to improve the mental health of people living in low and middle income countries like India and Ethiopia.
His recent research has found that all countries are ‘developing’ countries when you look at the low proportion of the health-budget they spend on mental health. Some wealthy countries may have better systems of care for maternal and child health but overall, mental health remains universally, at the end of the queue.
At present, COVID has overtaken all other agendas. However, now more than ever before, there is a recognition of the two-way relationship between poverty and mental ill-health. This may be a historic opportunity to get this right.
The relationship between poverty and mental ill-health is a complex one. How can we distinguish a normal response to poverty from a disease process? Poverty can increase the risk of poor mental health via multiple pathways, for example, poor physical health, high levels of noise pollution, violent neighbourhoods, insecurity and humiliation.
Can an increase in income improve mental health? Yes. It can but it needs to be sustained.
The fact that having a mental illness may induce poverty is less well recognised. It may affect one’s education and hence, employment opportunities. In low and medium income countries, health care is paid for by people. Due to the length of time it takes to find an effective treatment, much effort and money is wasted in doctor-shopping. Depression is inequitably distributed in society but not recognised as such because wealthy individuals also get it. We accept that long term expensive therapies cannot be delivered to the poor, so what’s the point in studying them?
After nearly a year of job-losses, the number of people below the bread-line all over the world will increase by tens of millions. In India alone, the gains made in economic growth over the last decade are predicted to be wiped out this year. The historically disadvantaged will fare worse, suffer more.
We can expect a surge in mental health problems like we did after the 2008 global financial crisis, mainly led by suicide and drug misuse. Sir Angus S Deaton, a Nobel prize winning economist wrote extensively about these deaths of despair. Economists and global health experts warn that this one will possibly be far worse.
In India, while the state is spending all its energies on the pandemic, livelihood-based organisations are finding very poor mental health in their members. Taking a broad, multidisciplinary approach to depression and anxiety rather than viewing it through the lens of a medical specialty is the need of the hour. Policies all over the world need to de-medicalise the emphasis on specialists and empower front-line providers and communities to enable them to foresee, identify and address this problem.
The bi-directional relationship between mental health and finances means that appropriate mental health interventions can improve finances. Can we persuade policy-makers world-wide to listen to global health experts and economists, look at this fast-approaching avalanche and steer policies to protect those who are being and will be hit by it?
This video was made after a spate of suicides by senior NFL players in the USA as they were starting to feel the effects of Chronic Traumatic Encephalopathy (CTE). Michael Irvin spoke from the heart without a script and his truth is visible.
If your isolation is getting the better of you, know that you are not alone. You are loved, silently. Reach out your hand and they will be there.
An anthropologist, Margaret Mead was asked by a student “What do you consider the first sign of civilization to be?” He expected her to mention things like clay pots, fish-hooks and grinding stones but she replied, “A femur that had been broken and then healed. In the animal kingdom, if you break your leg, you die. You can’t run from danger, get a drink from the river or hunt for food. You are meat for prowling beasts. No animal survives a broken leg for long enough for the bone to heal. A bone that has healed indicates that someone took the time to stay with the one who fell, bound up the wound, carried the person to safety and tended the person through to recovery. Helping someone else through difficulty is where civilization starts.”
She also said that we should never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.
Over the last weeks and months, there have been thousands of job-losses, much sadness caused by separation and bereavement and much suffering due to limited social contacts and falling away of normal support systems. Perhaps explaining this tweet by London Ambulance Service.
May be this is the time for us all to step up and be there for those who are affected. Sharpen our radars and pick up the subtlest signs of despair around us. However small, there is something we can all do – start a conversation, smile, share a hot coffee, offer a few coins or share information on useful resources. There will always be a reason to not do it but you are a member of a small group of thoughtful, committed, citizens who are going to change the world. Slowly. Slowly.
Last Thursday night I had to think about what to wear as I was going out. Proper going out – to a gig at a small venue in Tower Bridge. Hugo, one of Saagar’s closest friends from school had released a single in his memory and was performing live and raising funds for Papyrus. I would be seeing our friends, have a drink and possibly dinner at a restaurant. Wow! About time. It’s been ages.
Took a train to London Bridge and as I was walking out of the station, 2 announcements came on in quick succession –
“The 1831 to Peterborough has been cancelled due to a person being hit be a train.”
“The 1830 to Horsham has been cancelled due to a person being hit by a train.”
That Thursday was back again. It was Day 0 again. At this very station, an announcement was made to say my train home had been cancelled. I found an alternative route without thinking once why my train was cancelled.
It is spreading. Despite everything we do. It keeps happening. This morning I woke up to talk of another lock-down and my heart sank. I have an income and a home and someone to share my life with. How many don’t? I have hope and optimism. How many don’t? How many other hearts sank this morning?
The prospect of going on living in a world without a warm touch or hugs or smiles is nothing less than a punishment. The morning is greyer and colder than it has been in a long time. The days are shrinking. I am reminded of 6 years ago, at this time of the year, as autumn was fast approaching and Saagar was ill, I was optimistic. I didn’t have the slightest doubt. I knew he would get better.
Now, I doubt my optimism.
PS: Please listen to this song and share it on: “Lay down” by Hugo Hartley on Spotify
kidsaregifts 