The white Pigeon…

He was a White Pigeon, one of its kind.

He was a White Pigeon, alone in the crowd.

He was a white pigeon, he loved one of his kind.

He was a white pigeon, cornered by them all.

He was a white pigeon, he fell for another one.

He was a white pigeon, told not to love the one.

He was a white pigeon,called names by the grey ones.

He was a white pigeon, free to be trapped in his own world.

One fine day,the white pigeon,found a white hawk.

he was a white hawk who was in love with a swan,he was also called names and trapped in his world.Together they formed a bond,a bond that lasted until the dawn,they flew above them all…

there were white birds as beautiful as any other one,trapped in their own worlds…

#loveforall#stopthediscrimination
Sexuality is a spectrum.


Grief and life.

raat bhar yaad aati rahi’

Well today I’ll be writing about ,grief…

So basically grief is a fancy term given for the subjective feeling one has ,when one survives a loss ,loss of a loved one ,loss of a bond or affection that was formed.

Although mostly it is used and focused on the emotional response to loss , it also has physical , behavioral, social, spiritual repurcussions.
It is sometimes also used synonymously to mourning,though mourning is the process of getting over grief.

The first response to loss ,DENIAL or disbelief ,which is manifested as searching behaviour ,pinning ,missing ,yearning , longing and protest.
The duration of this phase is also subjective like the response ,some take minutes while others take weeks to get over it.

followed by denying the event, ANGER takes charge manifested as anguish,frustration,irritability,the anger might be displaced on others,or self one tries to take the situation in control,when actually one doesn’t have any control over it. we commonly ask “‘why of all people me!!”‘ we blame God ,we blame ourselves ,we blame life.This phase might last for months together.

BARGAINING ,we are trained this way ,when we desire something that is hard to get we bargain, we bargain with others ,we also bargain with the almighty,” please get this done,i will give up on non vegetarian food.”
“please ,let me see her for one last time,i will never ask for anything else” ,aren’t we designed this way??Breaking the hope ,is tough,this shatters,there is no chance,things can be reversed.
which leads us to the next phase

DEPRESSION ,in this stage one shows the clinical signs of depression ,that is withdrawal ,being alone ,sleep disturbance ,hopelessness ,sometimes suicidal ideas ,guilt, loss of interest in previously pleasurable activities.
Not everybody goes through this phase and the severity is also variable and subjective.

The final stage is ACCEPTANCE ,people realise the inevitability of death , seperation and accept the universality of the experience.
ideally when there is proper resolution ,people can talk about the experience and facing the unknown.

Speaking of it generally ,ALL of us ,at some point or the other in life have to face separation from the loved ones ,face losses, either to death or to life .

“In my abode there is neither birth ,death,old age or disease. Going there one never returns”

Shree Krishna


Sublimation

screenshot_20190203-2139372447434748354093294.jpg

Sublimation refers to the change from solid to gas without passing through the liquid phase, metaphorical for the change from solid bulked up emotions, anxieties, insecurities to feeling lighter and better.

They had to part ways, there was no other way,she loved him allot,he was scared to acknowledge .They met when both were vulnerable,both needy in someway,both craved for company,they were happy to have found each other,there were fireworks initially.She missed his laugh the most,he was such a comedian,she missed the non sense they did together.But, it wasnt meant to be,may be, they thought they had met earlier things would have been different.She was sad ,felt emptied again,felt miserable again.But, she could not flaunt her sadness,she could not tell anyone ,no one,but herself.She looked at her paintings,looked at her candle jars ,why had she stopped?Time had coagulated over her.She could not love him ,not allowed so she picked up her brush and painted the canvas yellow and black,he loved yellow.They parted forever .But,she felt less empty less lonely.

He was cheated upon by his wife and friend,he had loved her since forever,he was 35 now and divorced since 5 years,he did not want another relationship,he said his emotions had died,he felt betrayed,he was hurt,sadly he still loved her,he loved his babies,But could not have them now, he missed her smell ,she smelled like first rain,he missed her nose,cute as a button.He looked at his flickr account,remembered he had taught her how to click pictures, he missed her,he cleaned up his lens and tripod and set out in his car into the wilderness.

Her daughter got married ,son moved out for college ,husband got transfered and dearest dog died,But she had to be strong,strong for everybody,she was the soul of the family ,she could not afford to breakdown.She looked at her harmonium ,remembered the times when they all jammed together,all of them musicians,she smiled and registered herself for a music class.She still felt lonely at times but much better than before.She sang herself out of the misery.

He was about to reach his retirement,he had started loosing his friends to death,he had started forgetting things,he felt inadequate,he felt numb ,he was sad very sad.But he could not breakdown ,he had nobody to fall onto,he looked at his library ,all the books were covered in dust,he picked up his favorite one which helped him gather himself.

she blogged and blogged and blogged to get over her failure .

well, sublimation is basically the gratification of an urge an impulse whose goal is retained but the mode and object are changed from a socially objectionable to a socially valued one. In sublimation, the feelings are acknowledged, modified and directed towards a relatively significant person.

It ultimately results in modest instinctual satisfaction results.

are we using sublimation here,yes we are.


where are we going wrong??

Please see this post is meant to throw some light on how to approach a person who has expressed suicidal ideas or has attempted and fortunately survived.

I will not be discussing the causes and preventive measures, which is a very vast and debated topic. But one thing that every mental health professional will agree to is that it is extremely unpredictable and anyone can do it and every idea and every attempt has to be taken seriously

A few warning signs which i can think of right now are:

  1. Talking, writing drawing or in any way expressing about death.
  2. Talking or expressing hopelessness, having no reason to live, being a burden to others, or not being there for the next day.
  3. Looking for ways to attempt suicide.
  4. Expressing a feeling of being trapped, desperate.
  5. Giving away possessions.
  6. Talking about life after death.
  7. The person who has been suffering from depression(psychomotor retardation), suddenly becoming active.
  8. reckless behavior.
  9. Absenteeism from work .etc.

suicideawareness

“Arent we all stars , meant to fall for someone else’s purpose “he said.

“This is it,i cannot handle life anymore,i want to just get over with it.”she said.

“Please give me some poison ,i want to end it all.” she said

“I want to kill myself” they said.

These are all(of many other) clear cut ‘red flag signs’.

Taking any of these signs seriously,one should take immediate help.

  1. End the silence and ask the question: ask the person if he or she needs help,ask them if they are thinking of attempting suicide.Ask.         Yes ,it is a myth that talking about suicide puts the idea in a persons mind.No it doesnt at all,Rather it helps venting out and can help in preventing it.
  2. Donot leave the person alone: there is another disheartening myth regarding suicide ,that the one who actually dies does not express about it ,and the one who expresses it will not do it. THAT IS A BIG NO!!. Expressing about it means that is person is calling out for help and that is what we are supposed to do.
  3. Donot keep the warning signs a secret!: contact someone you trust who can help you. SEEK PROFESSIONAL HELP by professionals i mean,mental health workers,which include, qualified psychiatrists,psychologists,mental health nurses,mental health social workers.Well ,suicide helplines are some what helpful,but it is sad that the functioning of these helplines in our country is questionable. For the medical students who are reading this,you can contact any of us residents ,for you reaching to us is easier than general population.You can come in the casualty at any hour,and during OPD hours that is from 9 am to 3 pm you can come to our OPD (room no.132,new OPD building ,sir t hospital Bhavnagar.) or the ward. We will take care of confidentiality.

One patient of mine once said “by the time someone is considered to need suicide prevention,the world has already failed them” it is sad but somehow true,approximately 90% of suicide attempts are done by people suffering from some or the other psychiatric illness(i was supposed to not mention about the predecessor of suicide, but i am still learning to put my frustrations and emotions out of my writings,the recent increase in number of suicides has raised the level of frustrations amongst me and some of my fellow mental health workers,no body can be blamed for it, but we are struggling really hard to break the stigma and myths regarding mental illnesses and their treatments.Anyways this was not meant for venting my frustration.

Well, i understand that hearing the words that i want to die, commit suicide or kill myself can come as a shock to hear and we find it difficult to how to react to it. There are a few common responses which i would like to question here :

  1. You are just trying to get some or need some attention”: well not everybody wants attention and even if one wants what is wrong in doing that? someone confessing to you that he or she wants to end his life means that he is asking for help and questioning their intent is demeaning their faith on you.                                Yes i agree there are illnesses where people indulge into deliberate self-harm, but that also cannot be taken lightly as which attempt turns out to be fatal cannot be ascertained.
  2. suicide is cowardly, it is a sign of weakness“: How exactly can one define strength?? It is an adjective and is always meant in relative terms, calling someone who is expressing his ideas of suicide to you,weak is like serving ‘shame‘ in a platter to them.                                                            It does not really help, rather it pushes them away from you. Most of us fear death and overcoming the fear of death is not brave but not cowardly either.
  3. Oh! your life stresses are so less, or your life is so good, why do you want to die, learn from me, or are you stupid to have done so just for such a petty reason“???: this might be true, yes people with stresses ,who have better or different coping mechanisms ,can cope with things whihch the patient in distress cannot ,but that does not mean that he or she is not allowed to go through his pain in his way, every person has a different mental and psychological makeup and comparing with others (which the person might have already done, and blamed himself for being defective.)                                         Does a lot of harm so one can try to refrain from it. i would like to quote a metaphor, i heard in a movie, “after a storm, some trees fall while some don’t, why? because they are different some might be giving more fruits but are weak in the roots.”
  4. Suicide is selfish” this is an invitation for guilt, one of my patients reverted to this, how is it selfish to free people who are suffering because of, so no it is not helping at all, and might reinforce it!
  5. you are just saying this, you actually don’t mean it“: imagine someone telling you that the pain you are having after a fracture is “you are just saying it, you do not actually mean it”??                                  it is very demeaning and dismissing, instead can we not take everyone who says so seriously??.

Well, i have only had a little experience (4 years) of dealing with patients who express death wish and the only thing which i feel one can do it, taking it seriously, not judging the person, trying to understand his or her situation and just listening.

Of course, seeking help from professionals and taking the appropriate treatment for the underlying psychiatric illness cannot be missed.

The new mental health care act 2017 has decriminalized suicide i.e. “Notwithstanding anything contained in section 309 of the Indian Penal Code, any person who attempts to commit suicide shall be presumed, unless proved otherwise, to have severe stress and shall not be tried and punished under the said Code,” . So even the law has accepted it to be done under severe stress ,can’t we look at it that way?

A person who is accepting suicidal ideas is already very sensitive ,so we can try being a little understanding towards them and weighing what we say .

Your life is precious, you are wanted and you might not see it but there is always some solution available.

i request you to reach out.

p.s. : i am looking for reliable suicide helpline numbers,will update and add as soon as i find some.

https://woundedshrink.wordpress.com/2017/09/09/room-no-501-contd/

https://woundedshrink.wordpress.com/2017/07/12/room-no-501/




Personality testing ,instead of ‘kundali’ matching ,may be??

15232154_1209636205749866_1898907540785750338_n
Being in the field of mental health, coming in contact with almost 50 people on an average in a day makes me realize the extent of dissatisfaction and frustration in modern relationships.
Here I am talking about marital relationships specifically,
We very commonly encounter people on the verge of separation, divorce or in case of premarital relationships breaking up…it is a major stressor and plays a vital role in mental health.
also, we encounter people with post-separation anxieties and grief reactions…the reasons in my opinion may be like followinga major reason I feel is the changing status of women in our society today.
1.In the  majority of modern or semi-modern households, girls are brought up as equals to their male siblings, are empowered, educated, encouraged directly or indirectly to be independent and earn for themselves, which is a very welcome change, and I being one of the empowered ones, feel blessed to have been brought up like that.
But, at the same time, our boys have grown up seeing their mothers being dominated and openly or behind the closed doors their rights being violated.So they come into relationships with a sense of entitlement, that is hidden somewhere in their unconscious.
Which leads to an ultimate clash of egos, nobody is ready to surrender…and dissatisfaction.
2. personality is comprised of both temperament and character traits
I also feel a clash of personalities leads to distress and discomfort.
now to make it simple, all of us have a different personality and mostly are unique in our senses. But, at the same time, there are certain traits that can help determine someones temperament grossly(for detailed assessment there are psychological tests)
those temperament traits are:
  1. harm avoidance vs risk-taking
  2. novelty seeking
  3. reward dependence
  4. persistence

temperament dimensions.
apart from these, there are many other determinants of personality.
when people of two different personality traits come together, initially there is excitement and novelty,  later it becomes difficult to adjust,
which is why I think that matching personalities is of more use than matching kundalis before getting married (disclaimer:kundali and astronomy are beyond the scope of my understanding and I am not completely against it as I don’t know much about it, but personality assessment is something I’m am positively confident about).
For proper assesment, you need to visit either a psychiatrist or a clinical psychologist.
3. Another reason which I think leads to discord in relations is the lack of feeling of being loved…
Well, Dr. Gary Chapman an anthropologist and a renowned author of the book ‘the five love languages’ suggests that there are five emotional love languages — five ways that people speak and understand emotional love.
  • words of affirmation
  • acts of service
  • receiving gifts
  • quality time
  • physical touch.
according to him, people have  different love languages and thus, their expression is different,
so knowing the love language of your partner helps in establishing a healthy and satisfying relationship.
though very abstract, this concept has some validity and is being used by many around the world.
the book can be easily purchased online and at the end of the book , there a questionnaire to determine the love language of your partner as well urself.
i am attaching a link for the book.
4.apart from these factors, in India it is rightly said that marriages are not between
two people ,rather it is between two families.So before getting married it is essential
to determine the values and customs of the family of your partner,along with it the
mindset and openness to change,adaptability,i think this is more important than
marrying into your own caste or religion per say.
PS: This is my point of  view,i donot mean to insult or hurt anybodies sentiments ,there are certain issues which cannot be resolved such as domestic violence and i donot suggest to take those things lightly ,seek help whenever you require and always rememeber this is just a part of life and is not your complete life.
you can send me a msg if help needed.

schizophrenia…the basics.

The purpose of this post is to address the basics of schizophrenia, and it is meant for all my readers medicos, non-medicos, psychiatrists and non- psychiatrists.

  1. Schizophrenia is a serious and long-term mental disorder affecting approximately one out a hundred individuals. (1%)
  2. It was first described by Emil Kraepelin about 130 years from now.
  3. The term was coined by Eugen Bleuler, has Greek origin, schizo (split) and phrene(mind) to describe the fragmented thinking of people with the disorder. His term was not meant to convey the idea of split or multiple personalities, a common misunderstanding by the public at large.

schizophernia affects multiple aspects ,including mood,thoughts,cognition,behavior,working capacity.

for the diagnosis of illness the symptoms should be present for atleast 6 month.

patients suffering from schizophrenia most commonly are preoccupied with the belief that other people are conspiring against them,are trying to harm them by one way or the other.They hold this belief very firmly and it is as true for them as day and night are for any of us,thus they get agitated when me challenge their belief.

patients might have other common symptoms like hearing of voices,when actually their is nobody talking around them.

apart from these a common symptom is that ones spouse is cheating on one.

social withdrawal, Hostility , extreme reaction to criticism. Deterioration of personal hygiene. Flat, expressionless gaze. Inability to cry or express joy or inappropriate laughter or crying. Oversleeping or insomnia are other common features…

these symptoms help us to identify a person suffering from schizophrenia.

many a time during clinical practice, we come across patients and relatives requesting for neuroimaging to confirm the diagnosis of psychiatric illness,but the thing is neuroimaging is not contraindicated, but might not even be very helpful, as there are not many specific findings suggestive of schizophrenia found on neuroimaging(CT scan, MRI). Therefore the only way to come to a conclusion for the diagnosis of Schizophrenia is on the basis of the clinical features.

once we are fairly satisfied of the diagnosis,we treat the patient.

for the treatment there are various drugs ,stimulant procedure and psychotherapies,which we choose depending on many factors including the patient profile,availability ,affordability ,efficacy and potency of treatment.

Yes, schizophrenia is a chronic illness like hypertension or diabetes but with less clear evidence of the etiology, therefore treatment mostly has to be continued for a long time if not lifelong.

questions we frequently encounter when dealing with patients suffering from schizophrenia and their relatives are:

  1. can one inherit schizophrenia?

answer: yes there is a genetic contribution to almost all forms of schizophrenia, the chances of a monozygotic(identical) twin to have schizophrenia if the other twin is suffering from it are 50% which 4 to 5 times of dizygotic twins.

2.can a person with schizophrenia, ever be cured??

answer: research and literature suggest that approximately, 20 to 30 percent of all schizophrenia are able to lead somewhat normal lives.

3.how long should the treatment be taken?

answer: It depends upon the response a patient shows on treatment, the literature suggests, approximately 70% of patients treated with any antipsychotic achieve remission.

4. Can a person suffering from schizophrenia get married and have children?

answer: well, this is also very subjective and depends on the condition of the patient,it cannot be generalized every patient is different.

But, marriage is not at all a suggestible treatment of schizophrenia.

these are few of the many questions patients ask us regularly and few of the ones that i can recall.

World Schizophrenia Day is celebrated on May 24 every year. It aims to bring awareness about schizophrenia and reduce stigma towards people affected by this mental disorder.

Since 1986, Schizophrenia Awareness Week (SAW) is held in May every year. This year, Schizophrenia Awareness Week is marked from the 20 to 27 May 2018. This coincides with the week of World Schizophrenia Awareness Day. The theme for this year’s SAW is ‘Do What You Can Do’,asking people to join in taking action to beat stigma and promote inclusion.

Please note that research is going on to find more specific theories of the etiology(cause) of schizophrenia and the treatment.

Image result for world schizophrenia day 2018

John Nash was one of the greatest thinkers in mathematics of the 20th Century. And, thanks to his biography: A Beautiful Mind, and the award-winning film of the same name he was also one of the best-known patients with schizophrenia of the same period.

https://www.livingwithschizophreniauk.org/john-nash/

Dr.john-nash


love…

Well well well,somethings in life are very difficult to express and understand.love is one of those things.

the meaning of love according to Viktor Frankl,is the only way in which one can grasp another being in the innermost core of his personality.

nobody can become fully aware of the essence of someone else unless he loves him…

by loving a person one sees the essential traits in the person and also the various potentialities he or she has.

it is a medium by which one can find the meaning of life…

i rememeber the first time we met,it was our college canteen ,the old one.

he was sitting there amongst all other seniors ,unlike others he seemed not interested,he was tall lanky ,dark not the best looking person,but he had a charm about himself at the sametime.

i instantly got attracted to him(not romantically),and wanted to talk.

he seemed uninterested,until he saw my shoes .i was wearing sneakers under my salwar suit.he found it really cool.while the other seniors did not seem very pleased.

we met again and again and again .he became my mentor,my friend, guided me in my studies and was there for me in my tough times like a rock.he was carefree unlike me,he was bold unlike me,he was outgoing unlike me,yet he never jugded me.neither did i.people did not speak very well of him.

but , i made up my mind to learn from my own experiences,he seemed innocent and cautious at the same time.

extremely determined,hardworking and competitive,he challenged me always to realise my potentials.it was a bond that had opened me up.i had my fears ,he had his.I had my limitations,he had his,we did not judge.

was that love,yes it was.

we were lucky for our friends, for our families to have accepted us wholeheartedly,otherwise, would the love ever fade.no it would not.

today he is a part of my journey to find my meaning of life,i have always wanted to be with a partner who helps me grow,i have questioned it many times.when i look back to the years ,yes he has ,he has healed me allot.

i have accepted him with his flaws, he has accepted me with mine.

i respect his space, he respects mine.

i know in my head, no matter what happens he will be by my side.Now it is my turn to help him, help him grow, I have my own ways, he has immense potentials, every one of us has, it just needs a little nurturing and a tiny amount of LOVE.

i am not very fond of public display of affection, but I know he will smile (may even cry)

on reading this one.

 

 


the essence of my existence…

my search for the meaning of life

51w6zAgrzTL._SX313_BO1,204,203,200_

Well, it has been a while since I have written.I was actually absorbing things before delivering.

what has made me write this??..

today I completed reading a book which is a life changer precisely and going through it has been a therapeutic experience on its own, it is like meditation, so I wanted to share the wisdom I have gained after reading it.

secondly, today is valentines day, yes, of course, it is not as important to us as it used to be earlier, still, some amount of limelight we can throw on it for old times sake and for the great memories it has given us.

what is so great about this book??

firstly, it is written by Dr. Viktor E. Frankl who was an Austrian (Jewish) psychiatrist as well as a neurologist.

But, more importantly, he survived the dreaded Holocaust.

Secondly, the book is simple yet very intense, each sentence holds a meaning one has to read between the lines, the lines which themselves are very meaningful.Dr. Frankl has very intricately and with clarity illustrated his extraordinary journey of survival, survival in the most brutal situations possible (though he has tried to tone down the level of brutality).

The moment one starts reading it, one is gripped by the hope he instills into the reader.

yes getting carried away while describing the book is easy and unavoidable for someone like me, cause at this instant I am spellbound by it.

but, not making it a book review, I would quote a few lines about life and love inspired by the book and other sources.

life ,of what little wisdom i have,isa gift,a gift that is wrapped up in various layers,each layer when removed brings in an irreversible change in us,each layer when removed has a meaning.But,the process of changing the wrapper is difficult,full of joys ,stressors ,achievements.The meaning of life ,differs from man to man and from time to time.every person is unique,absolutely unique,his abilities,his opportunities,his struggles are unique,so is his meaning of life.

EACH man is questioned by life at some point or the other ,their meaning of life,their purpose of existence.

searching for the same and trying to answer it helps one to look at the bigger picture and ultimately gives one enough strenght and hope to cope with a given situation.this helps a person to actualise his full potentials.

I remember reading a quote of Mahatma Gandhi where he says, when you are having difficulty taking a decision, think whether your action will help the poorest person you have seen?

will that was his meaning of life, that was his altruistic way of thinking.

the problem we are facing today is meaninglessness,there is no meaning in our conversations, no meaning in our attitudes and no meaning in our existence, the society today has become achievement oriented if someone is achieving something he or she is supposed to be happy.but, I think after reading the book is that life has a much bigger purpose,a bigger meaning.one should live each day as if it is a new life altogether and one can correct or relive one life again, better than one did earlier.My meaning for life currently and since the time i have known has been serving, serving people who need it, it has become my motivating drive, explains many things that i do.

DSC_0818

hope i have been able to put my point of view forward,I am still learning to write .bookreview