Yes. It’s different.

A few days before the wedding Si asked me how I felt about getting married. Smiling, I said “Well, it’s a good way to finally get to know you.” When two people get married after an 8 years long relationship, they hope like hell things stay the same. Do I feel any different after the wedding?

Yes.
It’s like becoming an important part of something much bigger than me. I feel entrusted with a higher level of responsibility and I feel confident that I can live up to it as I feel deeply connected and resourceful. I feel closer to Si than before if that’s possible. I feel stronger and well supported by many. It feels a million times healthier than being the ‘lone wolf’ I have been for a long time.

Our loose 10 day itinerary explores the godly province of Himachal Pradesh in North India. Today we are at ‘The Mirage’ in a tiny village, Andretta.

Andretta is a traditional hub for painters, actors, potters, ceramic and other artists. Norah Richards, an Irish play-write established this focal point in 1924 through her passion for local art and culture.

The artistic heritage of Andretta is evident from the presence of a fascinating pottery museum and a quaint art gallery within half a kilometre, on the village “High Dirt-track”. Being here is tranquil and uplifting. People here are warm, kind and eclectic. They smile generously and look content. Their simplicity is exquisite. Si and I dream of spending more of our time around here.

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I am not my diagnosis.

While I continue to struggle to figure out Twitter, forget how to update my website, get confused while recording podcasts, consistently get my innumerable passwords mixed up, stay oblivious about Instagram and Snapchat, the digital world gallops ahead.

Digital Interventions in mental health Conference 2017 was recently held in London. It explored topics across psychiatry, technology and culture to identify innovative ways of addressing mental health needs.

Dr Becky Inkster is a Neuroscientist, passionate about digital interventions in mental health, social media data analysis, genomics, molecular biology, and neuroimaging. She co-founded Hip-Hop Psych as she is passionate about working with hard-to-reach, disadvantaged groups and youth culture.

‘Views from the street’, ‘Prison transition tools’, ‘Beyond the bullets’ and ‘The Digital Psychiatrist’ are some of the workshops that were conducted at the above conference. The range of topics was rather fantastic. It was aimed at improving our understanding of how social media is helping to create and facilitate new spaces for mental health practices and support, exploring the benefits of social media and social networking to improve a sense of identity, self-expression, community building and emotional support through examining a few popular international examples. Participants and facilitators engaged in interactive sessions to understand how new tools for self-expression via pictures, videos, captions and short personal narratives can help break down the stigma surrounding mental health and perhaps even lead to more people seeking help. They explored how to empower young people to use social networks in a way that promotes their mental health and wellbeing, how to harness the power of social media to nurture mental health innovations that the future holds.

Impressive stuff. I carry on doing what I do. I write another article for the Huffington post – Darkness to light. I talk about my darling Saagar and emphasise the importance of us, the people, educating and empowering ourselves so that we can help ourselves and each other through the light of knowledge and empathy. I continue to speak with ordinary people living extra-ordinary lives. Here is a conversation with Sara Muzira, mother of the beautiful Simba. Both, mum and son are artists. She talks about the state of inpatient mental health services in her experience and things that can be made better for patients and their families. Thank you Sara.

 

 

 

 

 

 

 

 

 

 

Day 989

Accidental findings

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In the mid 80s, Dr Vincent Felitti ran an Obesity clinic in America. Many people enrolled and hundreds of pounds were shed by them. But he found that the drop-out rate from his programme was as high as 50% despite good results. He did not understand this and went back to look closely at patient notes.

“I had assumed that people who were 400, 500, 600 pounds would be getting heavier and heavier year after year. In two thousand people, I did not see it once. When they gained weight, it was abrupt and then they stabilized. If they lost weight, they regained all of it or more over a very short time.”

The turning point in Felitti’s quest came by accident. He was running through yet another series of questions with yet another obesity program. How much did you weigh when you were born…when you were in first grade…when you were in high school…when you first became sexually active…

One female patient replied – “Forty pounds” and broke down in floods of tears, “I was four years old.” He found similar common themes emerging from various stories and went on researching this subject for the next 25 years.

The obese people that Felitti was interviewing were 100, 200, 300, 400 overweight, but they didn’t see their weight as a problem. To them, eating was a fix, a solution like IV drug user calls a dose a “fix”.

Eating made them feel better. Eating soothed their anxiety, fear, anger or depression – it worked like alcohol or tobacco or methamphetamines. Not eating increased their anxiety, depression, and fear to levels that were intolerable. For many people, just being obese solved a problem. In the case of the woman who’d been raped, she felt as if she were invisible to men.

Felitti went on to further explore the  impact of childhood trauma on people and coined the term – ACE, Adverse Chilhood Experience. He found a strong co-relation between the number of ACEs and early death.

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Film: https://www.youtube.com/watch?v=v3A_HexLxDY

 

Day 957

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At 26, she finally sought help. She is bright, has received fabulous education, is brought up in a stable, happy household and has travelled extensively. After graduation she got a great job in the city of London but came to realise it was not right for her.

After a tempestuous patch, she has landed on her feet. Great wisdom has come to her in abundance. She has discovered that her family is her strength. She can trust them. Her mother walks right beside her, growing with her, every step of the way. She now appreciates her dog more than ever before. A drive to the coast and a stroll by the sea with a loved one is not something she takes for granted anymore. Yoga is now a part of her daily routine. Gardening brings her peace. She spends her time colouring picture books and drawing sketches.

Her creativity is finding expression. Zaynah lives with Borderline Personality Disorder and writes a blog – Not a simple mind. Her life is not easy but it is a hundred percent authentic. She shares it generously. She is determined to help others. While Facebook constantly incites her to compare her life with that of others, she knows better. She can tell real from fake. She understands she is in recovery. It’s a zig-zag road but it’s good. Yes. All this learning at 26!

“Recovery isn’t about getting back to how you were before, it’s about building something new.” – Anonymous.

In the recording below, Zaynah talks to me about her diagnosis, her recovery and the changes in her life:

 

Day 952

A surgeon’s wife writes

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The Dark side of Doctoring is an insightful blog written by a surgeon.
The common themes that push doctors into dark despair are:

1.Loss of control.
2. Loss of support. 6am. Repeat.
3. Loss of meaning.

One would think that those who look after other people would know how to look after themselves and their colleagues. Not so at all.

Thank you Dr Eric Levi.

 

Day 951

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Who? The young. 

1 in 6 people is an adolescent. More than 3000 adolescents die every day from largely preventable causes, according to a new report from WHO and partners. That amounts to 1.2 million deaths per year.  Many key risk factors for future adult disease start or are consolidated in adolescence. Adolescent mental health and well-being are often overlooked.

In 2015, more than two-thirds of these deaths occurred in low- and middle-income countries in Africa and South-East Asia. Road traffic injuries, lower respiratory infections, and suicide are the biggest causes of death among adolescents.

Most of these deaths can be prevented with good health services, education and social support. But in many cases, adolescents who suffer from mental health disorders, substance use, or poor nutrition cannot obtain critical prevention and care services – either because the services do not exist, or because they do not know about them.

“Adolescents have been entirely absent from national health plans for decades,” says Dr Flavia Bustreo, Assistant Director-General, WHO. “Relatively small investments focused on adolescents now will not only result in healthy and empowered adults who thrive and contribute positively to their communities, but it will also result in healthier future generations, yielding enormous returns.”

Suicide and accidental death from self-harm were the third cause of adolescent mortality in 2015, resulting in an estimated 67 000 deaths. Self-harm largely occurs among older adolescents, and globally it is the second leading cause of death for older adolescent girls. It is the leading or second cause of adolescent death in Europe and South-East Asia.

“Improving the way health systems serve adolescents is just one part of improving their health,” says Dr Anthony Costello, Director, Child and Adolescent Health, WHO. “Parents, families, and communities are extremely important, as they have the greatest potential to positively influence adolescent behaviour and health.”

At long last, the world is waking up and so is the World Health Organisation.

Podcast:
In conversation with Meera S and Dr George at Business FM, Malaysia:

Doctor in the house: Adolescent Health

Day 944

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The Great Master

All I manage to read these days are short stories. Partly due to my abbreviated attention span and partly because the time has come when I ‘should’ start wearing reading glasses but I don’t. I get by, by increasing the font size and by reading for short periods of time. Also by squinting a lot.

‘The First Forty nine stories’ is a collection by the Nobel prize winner, Earnest Hemingway. In the preface he says, “In going where you have to go and doing what you have to do and seeing what you have to see, you dull and blunt the instrument you write with. But I would rather have it bent and dull and know I had put it on the grindstone again and hammer it into shape and out a whetstone to it, and know that I had something to write about, than to have it bright and shining and nothing to say, or smooth and well-oiled in the closet, but unused.”

After devouring the collection, I read up about him and was saddened to find that he suffered with depression and died of suicide. Here’s an example of the sensitivity and vulnerability of his characters and the simplicity of his story telling style. It’s called ‘Cat in the rain’.

https://soundcloud.com/user-474898075/new-recording-2