Mental Illness

Day 589

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Ruth was 47. She lived with Bipolar Disorder for 20 years. For all those years her mother looked after Ruth and volunteered for a Mental Health charity. The week after Ruth’s death, her mother rang the Charity with the bad news of her suicide. She didn’t receive as much as an e-mail of sympathy from them.

Saagar was under the care of our GP (General Physician/Family doctor). I didn’t hear anything from him after Saagar’s death. At the Coroner’s inquest the GP said that he had been advised against calling me by the Medical Defense Union (MDU). They claim to be ‘on your side’ and give ‘expert guidance and support’. It goes to show that on hearing of Saagar’s death the first phone call the GP made was to the MDU. The advise he got given was medico-legal in nature and that is what he was looking for. Interesting! Isn’t it?

I had the honour of meeting Ruth’s mum today. We could see so many similarities in Saagar and Ruth. Both adorable, affectionate, creative  and kind. I was her mirror and she mine. The bond we felt was very special. She let me try on Ruth’s sun-glasses. She thought they looked great on me and I do too. She let me have them. In that moment, I felt exactly how she must have felt – deep pain tinged with a tiny drop of relief; deep loss with a sense of peace. RIP Ruth.

Here’s a poem I found on the Order of Service for Ruth’s funeral:

Afterglow

I’d like the memory of me to be a happy one.
I’d like to leave an afterglow of smiles
When life is done.
I’d like to leave an echo whispering softly down the ways
Of happy times, bright and sunny days.
I’d like the tears of those who grieve,
To dry before the sun.
Of happy memories that I leave when my life is done.

-By Helen Lowne Marshall

Day 588

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Thursday night in the City is chock-a-block. Standing room only in every pub. Sometimes not even that. For many, Friday is a write-off and so is Saturday if the workload at A&E departments all over the country is anything to go by. While on a visit to a Neuro-surgical Intensive Care Unit in Scotland, the recurring theme was ‘fell off a bar stool’, ‘fell off a bar stool’ and ‘fell off a bar stool’.

Today I anaesthetised for a hand surgeon and of the 6 patients on my list, 2 young men landed up there because they punched a wall, a mirror or a glass window in a state of extreme drunkenness.

There is widespread social approval of excessive alcohol consumption for nearly all social strata and all age groups in our society. Alcohol is a depressant. It is often used as an unhealthy coping mechanism by the young and old alike. The more one drinks, the more one needs to drink for the same effect – tolerance. When young people drink heavily, it has a serious negative effect on the development of their young adolescent brains. If everyone drank responsibly, the NHS would save billions of pounds.

Jung said that these behaviours – smoking, drinking, avoiding, not being able to achieve an intimacy with others, point to “a fatal resistance to life in this world”.

Here is a set of ideas penned down by an anonymous author:

We drank for joy and became miserable.
We drank to be sociable and became argumentative.
We drank to feel sophisticated and became obnoxious.
We drank for friendship but made enemies.
We drank to help us sleep but woke up exhausted.
We drank to feel strong and it made us weaker.
We drank for exhilaration but ended up depressed.
We drank to help us calm down and ended up with the shakes.
We drank to gain confidence and became afraid.
We drank to make conversation flow more easily and the words came out slurred.
We drank to lessen our problems and saw them multiply.
We drank to feel heavenly and felt like hell.

Day 586

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“In an interconnected world characterized by profound mobility of people and goods, few threats to health are local anymore.
Air pollution is a trans-boundary hazard that affects the global atmosphere and contributes to climate change.
Drug-resistant pathogens, including the growing number of “superbugs”, travel well internationally in people, animals, and food.
The marketing of unhealthy foods and beverages, especially to children, is now a global phenomenon.
Safeguarding the quality of pharmaceutical products has become much harder, with complex manufacturing procedures and supply chains spanning multiple companies and countries.
Ensuring the quality of the food supply is also much harder when a single meal can contain ingredients from all around the world, including some potentially contaminated with exotic pathogens.
The refugee crisis in Europe taught the world that armed conflicts in faraway places will not stay remote.
The Ebola outbreak in 3 small countries paralyzed the world with fear and travel constraints.
Last year, a business traveller returning home to the Republic of Korea, infected with the MERS coronavirus, disrupted the country’s economy as well as its health system.
The rapidly evolving outbreak of Zika warns us that an old disease that slumbered for 6 decades in Africa and Asia can suddenly wake up on a new continent to cause a global health emergency.
This year’s appearance of urban yellow fever in Africa, now confirmed in the capital cities of Angola and the Democratic Republic of Congo, is yet another serious event with potential for further international spread.”
– an except from the address to the 69th World assembly by Dr Margaret Chan, Director-General of the World Health Organization. Geneva, Switzerland. 23 May 2016.

While there was much to celebrate and worry about in her speech, it mainly focussed on physical illnesses. ‘Non-communicable disease’ and ‘drug problem’ were the possible indirect references to mental illnesses. 

In 2013, the Lancet published the largest study looking at Global Burden of Disability (GBD) caused by mental illness. It used DALY as the unit of measurement. DALY stands for Disability Adjusted Life Years.  One DALY equals 1 year of healthy life lost. The highest DALYs attributable to mental illness and Substance use disorder were found between 10-29 years of age. Majority were due to depression, followed by anxiety and then Drug and alcohol disorders. As compared to 1990, the rise in disabilty from these causes in 2010 were 37.6% higher. These findings show the striking and growing challenge that these disorders pose for health systems in developed and developing regions. In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.

 

Day 585

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The Dragon Café is starting to feel like second home. Every Monday morning I look forward to going there for a cup of tea (and homemade banana bread) after work, meeting interesting people and being introduced to new dimensions of mind, body and spirit. Now I know some of the names and faces. I am turning into a regular and people are getting to know me too. It feels great.

This afternoon I attended a very simple but smart chess workshop and an art display by a Child and Adolescent psychiatrist and some of his patients. He talked about one of his patients with Selective Mutism, Megan Winton (self portrait above) who could not speak at all outside of her home but now does public talks on her artwork. He discussed their creativity process, the positivity of art and wellbeing and the crossover between service users and providers.

I also met with a passionate artist from a group called ‘Mental Spaghetti’ that brings together marginalised groups of society and the general public to help reduce stigma, enable social interaction and to encourage artistic practice in people of all abilities. They are working on an exhibition titled ‘Cross Pollination’ with the aim of blurring the lines of ‘Us vs Them’ (ie. service providers vs service users).

All those years I spent stuck inside a hospital building seem like such a waste now. We all are the same humans, yet there is a such a wide gap between the social model and the medical model of illnesses. I am intrigued to step out of my little world and see all these imaginative, inclusive and heart felt ways of dealing with people.

I wonder if Saagar would have enjoyed any of these things. I think he would have been a stunning percussionist and a very funny mimic. I think he would have had fun if he would have got this far. Oh! There I go again…

 

 

 

 

 

Day 584

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On the one hand there is mental health and on the other there is mental illness. It is possible to have no mental illness but poor mental health. For instance, one may not have a diagnosis but may be terribly unhappy, drinking excessively and taking drugs to cope with the stresses and strains of life.

On the other hand, it is possible to have a mental illness and be in a state of good mental health. For example, someone with a diagnosis of a mental illness who is able to feel good and function well with the help of friends and family, talking therapies and medications.

And then there is everything in between. At all times we are all on a spectrum. Our vulnerabilities are different at different times. They determine our ability to handle stuff thrown at us. Sometimes it feels like we have ‘too much on our plate’ even if there is very little on it. At other times, our plate might be truly full but we can cope.

I wish I had heard of ‘Happiness hour’ before. It is one hour spent on ourselves, doing something we enjoy doing, if possible everyday – taking a soak in a warm bath, watching TV, going for a walk, doing yoga and meditation, listening to music and so on. It keeps us feeling good and increases our capacity to manage our lives better. I have been consciously grabbing that hour for myself at least three times a week and it does make me feel better and stronger.