i see myself as a pendulum
bouncing back and forth
between arrogance and doubt
i see myself swaying here and there
coming back in the centre
swaying away again
i think to myself may be i am the one seeing
may be i am the bolt staying
i think i get tired i think again
i step back and observe
all this drama i create
laugh at it,it makes me cry at times
i say enough is enough
bring it on
whatever it is
i will go with the flow
i will free myself to just be as it is
i question this ‘i’
it is blurred than before
i question this ‘i’
and wooooof here it passes by
I look in the mirror and think to myself this woman looks familiar,I look again and I see ,her reflection in me,
She is imperfectly perfect
Which gives me space to accept my own imperfections
She is sensitive ,she is sweet ,but has her own mental cobs
She is impatient and anxious
But has all the love in the world to give out…
She did her best,she ever could
I grow up and learn ,my mom did her best
She is getting tired
I want her to grow
So what if she is old
She still can glow
I thank her for everything
And want her to know
We will be fine by ourselves
She can let us just flow
Why wait for her birthday
Or mother’s day to go
I love my mother
But she will always love me more
My legs hurt
My back hurts
But most of all my mind hurts
I lose sleep
I lose peace
But most of all I lose my self
I shriek in pain
I cry with disdain
But most of all I embrace my insane
Things lose meaning
People become endearing
But most of all know nothing…
These pangs of growth
Something says are good
I hold on to faith ,thats all I brood
My first fifty milligrams…
50 mgs of a drug,
A drug that i have been prescribing without a second thought or hesitation to so many of my patients since almost 6 years now…
50 mgs of a ssri ,a drug which i remember my father taking when i was a baby and getting back to his normal chirpy self,20 mgs of its brother drug which my mother has been taking since long.
50 mgs of an ssri aand here i am questioning my ability as a mental health professional,or is it a part of my illness?
i ponder i procrastinate,i suffer even after knowing that this might help
i delay,i think ,i judge myself,
50 mgs of an ssri for the first time and i feel low about it,it is a sinking feeling,most probably a symptom of my illness
june 2020 i take my first 50 mgs of ssri,and i feel ,empathise and understand all those peoples plight,who hesitate taking psychotropics ,who refrain from opening up about it ,and suffer for longer they could,this pill shaming runs deep,it is embedded deeply,difficult to overcome and uproot …
pill shaming can be defined as the negative reaction and responses that one receives when they are taking medications
it is usually seen with mental health issues or menstrual issues,i would restrict this blog to psychotropics…
so why is it there and why do we justify it?
- IGNORANCE: many of us including myself minimize our distress,invalidate our feelings of despair and say to ourselves ‘ah this happens to everybody”it will get better on its own’ ‘it is not severe enough ,that i need to take meds’ ‘my distress is not that bad that i warrant taking medicines’ well i know how it feels,especially when your judgement is clouded ,i fortunately had my mother and reliable seniors who helped me get over my procrastination and reservations related to being on medicines.
- within the mental health community,mental health professionals at times themselves engage into pill shaming, majorly psychologists and alternative therapists(not at all generalizing,i have my share of very good and aware psychologists) and they believe ,that since the medicines did not work very well for them,or some other modality worked better,it is not the right path for anyone else,on the other hand due to the stigma associated with mental illnesses ,people who have genuinely benefited with pharmacotherapy do not open up about it.
- Within the medical fraternity as well,people consider psychiatry to a non scientific or vague subject,even though recent advances and studies prove that apart from environmental and psychological factors,biological causes of mental illnesses are equally or even more important,
- for example like there is insulin resistance in diabetes,similarly in depression the neurotransmitter serotonin has deficient levels in the brain,and just like giving insulin injections,diabetes can be put under control ,giving antidepressants can help in treating the biological etiology of depression, like stress can aggravate diabetes ,it can affect the mental health as well,like exercising and dietary changes help with mild insulin resistance,similarly they might help with mild depression and anxiety symptoms as well,when we are diagnosed with diabetes,we get conscious about everything and take our medicines regularly,because we are well informed about the ill effects of not taking the meds and the effects are clearly visible and evident,but for mental illnesses we take a different approach,just because it is not visible and we are not well informed about the adverse effects it can have on our quality of life
- on our work and functional efficiency
- Our physical health and immunity
- our relationships and social standing
- it can led to life threatening events like suicide
effects of pill shaming:
- the lag between the onset of distress and treatment is increased massively ,we delay seeking help,the solution to it is reaching out to people you trust,seeking professional help and letting the experts decide along with your agreement on what will be the correct line of treatment,ask questions whenever in doubt.we as mental health professional are already trying and will keep trying to reduce the stigma and burden of mental illnesses from our side.
- once starting,we hurry to taper or adherence to medicines is poor,which can lead to frequent relapses,solution to this is again asking your doctor,till what time you will have to take the medicines and reminding them to taper it when they and you feel it is right.
- people often have to struggle with negative beliefs about themselves,thinking they are ‘less than’ if they have a mental illness or if they need medications,these feelings feed shame,it makes people feel alone and isolated.
- talking about side effects ,they can be a powerful deterrent if someone is already ambivalent about taking medicines,often side effects subside once our bodies acclimatize to the medication,some might even persist.Like any other treatment the pros need to outweigh the cons,that i why we advocate holistic approach towards treatment,where both the patient and the doctor have a role in deciding the treatment plan,no doctor will ever force you to take medicines(unless there is a lack of insight and your life is at stake”
These believes are pervasive and deep rooted in our culture as a whole, but is even found in some self-help books or mutual-help support groups .It is never helpful to shame individuals struggling with mental health issues and to discourage them from getting help in the same way that they would for any other medical condition.
take home message
Mental illness is not a moral failing or a lack of motivation and it doesn’t only affect people who don’t try hard enough or who are weak,Instead, mental illness is a chemical imbalance in our brains, and in order for us to not experience symptoms or active illness, we need to seek out and receive ongoing treatment.
It is okay if you have been reluctant about your mental health,it is okay if you have been resistant and biased again taking medicines,it is okay if you have procrastinated and questioned your doctor about the decision,be sure about it,clear your doubts,information(from the right sources) is the greatest tool to reduce anxiety,and please reach out, you are never alone,it is not worth this much suffering…
Ps:SSRI: Selective serotonin reuptake inhibitor
we had an aquarium ,when i was a kid
we let the fish poop,eat and die in it
would let the dirt settle,making the water unclear…
would make the fish less visible…then once in a month when it would get very dirty…
we would get our hands dirty and put the fish in a smaller vessel,when we moved them,they would gasp for their air i.e. water for a while,some would struggle and fall on the ground…
most of them would get back to normal,once put back in the jar…
some would get sick and recover while some would succumb…
would that stop us from cleaning the aquarium?
would not cleaning it regularly prevent the deaths?
would the dirty aquarium not become like a gas chamber?
would it not lead to sickness ?
well im on the journey of cleansing my minds aquarium,i have opened my long standing wound for dressing
it pains, it hurts, i shriek i cry…i go quiet…
i know it hurts my vicinity as well,but can the flow ,can the journey be stopped?
i am trying hard,really hard to see clearly but in vain,the water is dirty,stagnant,the settled dirt has surfaced…
but i can do nothing but wait…holding on to faith ,giving up on hope…
i am waiting patiently,patiently to see clearly…
Contd. On the second page…
well it has been long since I wrote something related to mental health, I like anyone else am not immune to procrastination, anyway, finally, I could motivate myself enough to write,
without beating around the bush much, let me get to the point here
she was 14 years old,childhood sexual abuse ,positive family history of neurosis,trying to win the rat race took a toll on her mental health,manifesting in the form of long long nights which seemed never ending,the frustration of watching other people sleep peacefully was something noone else could ever decipher,
12th standard board exams ,dreadful most physics paper,pcos,and an ambition to become a doctor ,became too much for her to take,11 pm she went to bed,her mother brother and dog sleeping in the same room,she shut her eyes tight,physics questions moving in her head,motion momentum etc etc,her heart racing faster,she needs to sleep she thought to herself,oh what if she doesnt sleep the whole night,her performance will get hampered ,she will not score marks,she will not do well,she needs to sleep anyhow she thought to herself,she could hear her doggie snore,it was 12 am now,she had to wake up at 7 am to revise one last time,7 hrs of sleep ,good enough she thought,her mother woke up ,and exclaimed “u are still up,sleep now”and this increased her apprehension,oh i really need to sleep she thought to herself,her heart pounding ,she couldn’t lie down now,got up paced around in the other room,took her book out and started reading,she could not focus ,but did not give in,kept reading,1:30 am ,2:00 am and she was wide awake,went back to her room,chanted some mantras,but no her sleep had a mind of her own tonight,was playing hide and seek ,never to be found,she shut her eyes again,just like this she struggled till it was 5 and when she has lost all hope she fell asleep to wake up at 7 with a headache,took the exam…
One of the most significant human behavior,universally demonstrated in all animal species is sleep,it is something that is required by the brain to function.also, one the vegetative functions,very commonly affected in almost every mental illness,sleep is something we dont pay much importance to,whether the sleep disturbance is singularly present or associated with other symptoms,sleep hygiene is something that has been found to be helpful in maintaining regular sleep pattern.
hygiene is something that we have heard very frequently during this pandemic
hygiene can be defined as conditions or practices conducive to maintaining health and preventing disease, so sleep hygiene practices help maintain healthy sleep patterns.ill be mentioning a few points for sleep hygiene:
dos and donts for good sleep hygiene:
- maintaining regular hours of bedtime and rising:sticking to a consistent sleep schedule is very important when it comes to sleep hygiene and cannot be emphasised enough. okay so talking in terms of the current pandemic situation keeping any kind of schedule is hard undoubtedly,still if you figure a way to maintain a regular timing for sleep ,it can pay major dividends for your health,the principle behind this theory being the circardian rhythm.it’s best to go to bed and wake up at the same time each day. This allows your brain to predict behavior and cue your body to wind-down or wake-up.
2. maintain a night time routine
creating a winding up routine before sleeping helps the body get habituated to and signals the brain that it is about to go into the sleep mode soon.winding up routine can ideally be started atleast an hour before the desired time of sleep,atleast 1 hour before sleeping one should try to shut out all other work.
3.Create a sleep sanctuary
- Your bedroom should be a sleep sanctuary! Soft lighting, quiet, and cozy. When the bedroom is devoid of visual and audio stimulants it allows our bodies to restore and refresh for the next day.Basically conducive to sleep,neither very hot nor too cold,comfortable bed and free from disturbing/stimulating sound,light or smell
4.use your bed exclusively for sleep and sex only:
- again about giving clues to the brain and making it used to the same,if one carries work or entertainment or anything else other than sleeping on the bed,our brain doesnt get the clue that going in your bedroom or bed is equal to sleep,why confuse our brains right.
5. tire your body:
- being physically active,and exercise helps you sleep better,but scheduling exercise earlier in the day atleast 3 hours prior to the sleep time,tires the body and helps in sleeping better.
6 .go to bed only when very tired and sleepy:
- to avoid tossing and turning in bed and avoiding the frustration of not being able to sleep.If after 20 or so minutes of laying in bed you do not fall asleep, you should get up do something calm or even boring. You don’t want to lay in bed awake for extended periods of time since this sets up an association of feeling angry, frustrated and depressed while laying in bed. You do not want negative feelings, associations or thoughts while in bed. Try sitting quietly in another room wit the lights off (bright light incorrectly tell your brain that it is time to be awake), or read something boring like the phone book (school books always work well for me). You want to avoid doing anything that is too stimulating or interesting, since this will wake you up even more. When you feel sleepy again, go back to bed and try again.
7. sleep journal :
- Documenting behaviors and habits by use of a sleep diary or sleep log can be useful to visualize what’s happening and how it influences you. As a sleep physician, I often use a sleep diary to track patients progress and adherence to sleep hygiene rules. Patients are often shocked when comparing their initial patterns to weeks to months later and seeing the dramatic difference and improvement.
1.use phones and tablets in bedroom:
- light from the phones interfere with the release of melatonin,which a sleep inducing hormone.It’s tempting to check emails or social media before we go to bed but this is a horrible habit to get into. This often gets our brain into task mode and the blue light from electronic screens can affect our ability to fall asleep.
2.take caffiene after the sunset:
- Caffeine can have a disruptive effect on your sleep. The most obvious effect of the stimulant is that it can make it hard for you to fall asleep. One study also found that caffeine can delay the timing of your body clock. These effects will reduce your total sleep time. caffeine is present in tea,coffee,cola,red bull etc.
3.Take alcohol and tobacco :
- Anyone who drinks alcohol from time to time knows that beer, wine, or spirits can sometimes leave you feeling drowsy. But while alcohol, a depressant, can help you fall asleep faster, it also contributes to poor quality sleep later,so paradoxically alcohol is harmful for sleep structure.
- Nicotine disrupts sleep – and smoking can also raise the risk of developing sleep conditions, such as sleep apnea. if you are consuming both of these avoid taking them late in the day atleast.
4.taking afternoon naps :
Naps can be an effective tool in giving us a boost for that second half of the day, but they shouldn’t be used too close to bedtime or last longer than 20-30 minutes.
5. eat heavy meals:
- Avoid heavy and spicy foods at dinner. Gas-forming foods and hurried eating also cause abdominal discomfort, which in turn interferes with sound sleep. Limit your intake of gas-forming foods to the morning hours, and thoroughly chew food to avoid gulping air.
6.watching the clock:
- This also sets up a negative feeling of “oh no I only have X hours of sleep left” or “I can’t believe it’s 2 am and I’m still awake”. These obsessive and negative thoughts only contribute to your insomnia. Have an alarm set for the desired rise time and unless you hear the alarm go off, it doesn’t matter what time it is; it’s sleep time!
Apart from all this yoga,meditation and other relaxation techniques like the jacobsons progressive muscle relaxation helps in inducing and maintaining good quality sleep…
I am attaching two videos one a musical piece i love and has helped me sleep many times,another the technique i.e. jacobsons progressive muscle relaxation
Please note:Having mentioned sleep hygiene,I would like to emphasize that sleep disturbance can be a symptom of primarily other psychiatric illnesses also,so self diagnosis and medication may lead to implications in the quality of life,for which, seeking professional help is the only thing recommended.
i hope this helps ,feedback is most welcome.
Until next time Goodbye and take care readers,you can get in touch with me through my Instagram page
Pass it on and do return
@vickykaushal09 se prerit
@sirphira_ghumakkad ke dwara vilambit
People turn to God, and spirituality, when they experience suffering,I did too,turned to Bhagwad Geeta
Vishada means sadness or sorrow, and yoga means the state.(my interpretation)
The first chapter of Geeta is about Arjuna’ sorrow,and doubt,he was taken upon by grief ,grief of what lay in front of him,doubt about what is right and what is not.
Why was Arjuna filled with sorrow in the battlefield? Arjuna the mightiest warrior of all times,the learned disciple of Lord Krishna was sad?Did that make him any less courageous?
It was primarily because he was emotionally attached to his relations and family members . Attachment is a human value.People experience fear and anxiety at the prospect of losing something,in the prospect of seperation
Being human, Arjuna felt the same. His state of mind also revealed that he had preferences and biases in life. We all have likes and dislikes and Arjuna was not different. He had attraction for life and aversion to death. He identified himself with his mind and body, which made him feel vulnerable. Even if you have trained well under a spiritual master for long, in moments of crisis you may act like a normal human being and experience stress. It happened to Arjuna, although he too was well-versed in the knowledge of the scriptures and possessed the knowledge of the Self.
Sorrow is a modification of the mind, books in Psychiatry have also mentioned mania of extreme happiness to be a defence mechanism against sorrow.
Being sad and anxious to little extent in crisis situations like these are normal.You are not alone.
I am not alone.
Being Sad at times is normal, giving up at times is normal,we are not sages ,we are humans.We feel therefore we are human.
If you study life carefully, you will realize that sorrow opens our eyes to the truths of our existence. It makes us reflective and introspective.it gives depth, compassion and empathy.
Stop judging yourself for giving up. Be kind to yourself.
Learning important lessons from the difficulties and sorrows in your life makes you wiser.
Karma does the same. It chisels our thinking and behavior.Trust the almighty,times are tough ,but we are not alone,We are all connected in a collective consciousness,We are all a part of Him ,he is a part of all of us,Rekindle what you have always had, rekindle your spiritual being,sit with yourself meditate,help others,serve others .
Spread love and positivity.
we are in this together ♥️.
4:00 am in the morning,at the airport she started bleeding 7 days before she expected, unprepared she panicked in the washroom, boarding had started she could not go back to the shopping area,and when she decided to board and ask someone for help on board,a kind lady came for her rescue ,they did not even exchange their names and she parted with a sense of gratitude for a stranger and decided to always carry hygiene products so that she could help someone in need someday too .
She lost her mother when she was 18 ,she was pregnant today,was struggling daily on how to do the right thing for her baby,her husband was there for her,but,it was not enough,he would try ,still that was not enough,a friend of hers who stayed near by,came for her rescue would spend time with her ,take her for walks,listen to her and just be there for her,this friend was the first person after her husband who took her baby daughter in her arms,she might not be in touch with this friend of hers ,but she will always be thankful and pray for her wellbeing.
She was going through an abusive marriage,he would not touch her ,but would curse her and yell at her,she could not share with her parents,she just could not bother them,her elder cousin came to her rescue,she listened to what the issue was, confronted the husband ,gave her a piece of their mind and stood there like a rock for her baby sister.
It was her final year of post graduation,she had emergency duties,her mother fell ill,just before her exams ,she had to choose between her mother and her degree,she was lucky to have a collegue who covered up for her and did emergency duties for 5 days at a stretch. They both might not be in touch today ,but always pray for each other’s well being.
They were not giving her maternity leaves ,her baby had to be breast fed,she and her friends protested,but the authorities did not pay heed,she would bring her baby to the hospital and her friends would take care of the baby when she would work.
She was touched inappropriately,would not let a male come near her,her neighbour was a single mother,she restored her faith in love and let her believe that all men are not monsters there are good men out there too.She eventually started believing her,and now knows her worth above everything else.
This women’s day I decide to stop judging and critisising women for their choices,if she wants to dress like that ,it is her choice,if she wants to not get married it is her choice,if she wants to pursue sports ,it is her choice,if she wants to open up ,it is her choice.
She is vulnerable,she is strong,
she is Caring,she knows how to move on.
She is loving,loves herself above all.
She will nurture you with all she has.
She will be there for you ,no matter what.
She doesn’t need a goddess status,the only thing she asks for is equality in opportunity, making mistakes,in finding love,and freedom to be.She loves her men,and knows where they come from,she knows they need her tender love,she understands they are not all at fault, plans to raise one of her own,someday above gender biases she wants to raise a boy or a girl who will be above these gender biases.Let us all support each other,look out for each other, acknowledge the divine feminity .
Two worlds and she was one.
She after allot of struggle had finally become one with herself.
But now there were two worlds.
She had to choose.
She had to choose for the first time ever,as till now it was always chosen for her.
The ball was in her court this time.
She had to choose between two precious things.
it was like choosing between two arms.
Like choosing between two children.
Like choosing between two eyes.
It was tough .
She felt torn apart.
Torn apart yet again.
She felt like giving up.
Letting go once again.
Two worlds and none were her.
She decided to let go of both the Worlds and make her own .
Many people face allot of difficulty in Taking decisions, decisions of daily life or important decisions and it is taxing ,very stressful at times.
Having difficulty taking decisions might be a sign of depression.When one is in the throes of despair, there may be a pessimistic view of reasonable options and an inability to act and think.People want others to tak decisions for them.
Indecision can also stem from anxiety.
Anxiety of making the wrong decision, anxiety of hurting people,of letting people down.The fear of making the wrong decision and then facing the consequences is paralysing for a few people.
Indecision might also be due to obsessive traits , obsession for perfection , difficulty in discarding old ,futile items (hoarders with a thought that it might be useful in the future).
So,if anyone of is having incapacitating difficulty(a little difficulty and weighing various options is normal) in taking decisions,the first thing you have to do is rule out any underlying psychiatric illness.
There are various exercises and techniques which help with this difficulty which is taught in behaviour therapies.
One of them is the pros and cons list.
In which one has to make a list of all the possible options , choosing and thinking of the options creatively and then Making a list of pros and cons .
One is also suggested to make a long term vs short term list of pros and cons.All of this done with the aim of productive and more thoughtful decision making.
Whether it is due to a psychiatric Illness or you are just in one of those phases of life where you are standing on the crossroads,you have to go either here or there.This helps and ofcourse discussions with people you trust makes things easier.
Insight into the problem is the first them in overcoming it.
And yes if it is due to the mental illness , eventually with all the other symptoms this will also improve on taking treatment.
So cheers it is not that bad,reach out,you are not alone.