When stress can be fatal - Article for SHB Social Foundation

I found earlier this week that a former colleague, a wonderful kind, gentle and knowledgeable human being, passed away last week. Of a heart attack.

Over the past week, after I shared a post on this on Facebook, I received a few messages from people sharing that they too had themselves suffered a heart attack from severe stress, or knew someone up-close who had gone through this.

I remember that colleague and I talking last year when one of his other team members had died suddenly of a heart attack. He had known that guy well for years and was deeply saddened…mentioned that he had been going through a lot of stress recently…wondering if that had brought on his untimely demise?

The kind of stress that builds up, brings on a heart attack, a fatal one…?

I don’t know what was the cause of his death. But then when I look around, stress is palpable with so many of us. All those sources of what causes stress aren’t going to go away suddenly. But we all need to know that stress needn’t be here to take shelter in our lives.

Let’s hope each of us can do our bit to chisel it away bit by bit – meditate, exercise, yoga, dance, sing, meet, laugh, talk, cry…Help ourselves, and help those around us.

We also need more of us actively reaching out to others for help – be they our family, friends, others in our network or our neighbourhood. Somehow, stress tends to get pushed under the carpet – thinking this shall pass. But how many of us are conscious that it has built up to a stage where it has already caused tremendous harm to us!

I can’t be thankful enough that organizations such as SHB have been tackling this through its Listening Post initiative – a talking space, that recognizes that the simple act of talking, and having someone to listen to you, can be therapeutic. May the tribe grow, and may all of us dealing with stress avail of these services wherever they may be available.

This article was first published on SHB Social Foundation

Understanding mental illness in India, and the rights of the mentally ill - Article for SHB Social Foundation

A few days ago, my fourteen year old daughter was watching a Hindi crime show on television. It showed a lady attempting suicide by jumping off a flyover, when she was stopped just in time by the detective, and she was warned, “Madam, what are you doing? Don’t you know attempting suicide is a criminal offence in India?”

For a moment, I couldn’t decide who looked more confused, the poor lady on the flyover or my daughter, who turned to me to ask why this was a criminal offence. All I could come up with as response was “I know it is a criminal offence, but I don’t really know why. Maybe that’s one way to discourage people from taking their own lives…?”. My response sounded lame, even to my ears. 

When I checked later, I found that while an attempted suicide is illegal in some other countries too, the intent is not to “punish” those who have attempted to take their own lives. Rather it is aimed at enabling the state to intervene so that it can assess the mental state of the person, based on which their treatment can be enforced. Someone who has attempted suicide typically does not (or is not supposed to) get arrested, jailed, and tried for the “crime”. However despite the noble intent of discouraging another suicide attempt, viewing an illness from a criminal lens has felt heartless and impractical. 

Therefore it was heartening to read about the Mental Healthcare Bill 2016, passed by the Indian Parliament this week that has decriminalized attempt to suicide and acknowledges that a person is suffering from mental illness at that time and will not be punished under the Indian Penal Code. The government shall have a duty to provide care, treatment and rehabilitation to a person having severe stress, and to reduce the risk of recurrence of attempt to commit suicide.

It is being hailed as a landmark and progressive bill that addresses many other crucial factors of mental illness in a patient-centric way and aimed at ensuring that the patient’s interest is safeguarded

• Definition of mental illness – as a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgment, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life, and mental conditions associated with the abuse of alcohol and drugs. It does not include mental retardation which is a condition of arrested or incomplete development of mind of a person, specially characterised by subnormality of intelligence.
• Rights of persons with mental illness – The Bill addresses crucial aspects such as the right to access mental health care and treatment; free treatment for such persons if they are homeless or belong to Below Poverty Line. And right to confidentiality and to live with dignity and no discrimination on any basis including gender, sex, sexual orientation, religion, culture, caste, social or political beliefs, class or disability.
• Advance Directive – A person with mental illness shall have the right to make an advance directive that states how he/she wants to be treated for the illness and who his/her nominated representative shall be.
• Mental Health Authority – Set-up a Central Mental Health Authority at national-level and State Mental Health Authority in every State with which all mental health institutes and mental health practitioners including clinical psychologists, mental health nurses and psychiatric social workers will have to be registered.
• Mental Health treatment – specifics of the process and procedure to be followed for admission, treatment and discharge of mentally-ill individuals.

It is high time that India discusses its mental health issues, and the increased focus of the government on mental healthcare is encouraging. Per the findings from the recent National Mental Health Survey conducted by the National Institute of Mental Health and Neurosciences (NIMHANS), at least 13.7 per cent of India’s population has various mental disorders; 10.6 per cent of them require immediate interventions.

The survey also points out that India’s urban areas are most affected with mental illness. And urban areas have a higher prevalence of schizophrenia, mood disorders and neurotic or stress-related disorders. This disturbing scenario could be due to fast-paced lifestyles, experiencing stress, complexities of living, a breakdown of support systems and challenges of economic instability. With continuing urbanisation, the burden is expected to rise and hence, there is a need for an urban specific mental health programme.

The survey also says that despite three out of four persons experiencing severe mental disorders, there are huge gaps in treatment. Apart from epilepsy, the treatment gap for all mental health disorders is more than 60 per cent.

Also, due to the stigma associated with mental disorders, nearly 80 per cent of those with mental disorders had not received any treatment despite being ill for over 12 months. Poor implementation of schemes under the National Mental Health Programme is largely responsible for this.

These are just some of the survey findings, and if you are interested, please do study the survey findings at http://indianmhs.nimhans.ac.in/Documents/reports/Summary.pdf .
Both the survey and the bill cover many critical aspects to do with gaining insights on the various aspects of the illness and its incidence, and its treatment and care. It is important that we understand these and also appreciate that passing the law is but one step. What is also needed is that we as a society – our caregivers, police, family, educational institutions, workplaces, etc. – are sensitised to the illness, to the rights of the mentally ill, and to taking timely action for their care and treatment.

This article was originally written for SHB Social Foundation 

Why The Potted Plant Parenting Way For Raising Teenagers Can Work Wonders (also published on Womens Web)

While our children grow up into teenagers nowadays, let’s understand the shift taking place in them and in their way of needing us.

Over the past few months, as I’ve spent more time at home, I’ve wondered why my teenage children sometimes point out that they missed me on the few occasions when I’ve been out. While it’s nice to know I’ve been missed, I thought it was rather strange because when I am around at home, they seem to be content doing their own things. And hours can go by when we haven’t talked to each other.
All of us parents and especially those of us with corporate or professional lives, struggle to spend more time with the family and children and make the most of ‘quality over quantity’.

I came across this wonderful article on New York Times talking about teenagers nowadays and the role of ‘potted plant parents’ in their lives. I loved this term and the article resonated with me as I think it makes sense for many of us, who as parents of adolescents, need to understand the shift taking place in our children. And understand the shift taking place in the way that our children relate to us and need us.

As our two teenagers have been growing up, we have been seeing the change taking place at our home. Dinner time together continues to be important. But often catching up over dinner or those “so, how was your day” conversations work only to an extent. That does not mean that our children do not want to talk about their day. Maybe they do not want to talk about it just then.

Also not all the activities that we used to do together when they were younger find common ground now in terms of timings or interests. In other words, as many of us parents of adolescents would know, they now need to be ‘convinced’ about joining us for activities. Activities that they would have all too readily jumped at or insisted on joining when they were younger.

This shift taking place in their behaviour is coming from the changes taking place in them as they grow and develop their independent views, interests and choices. This needs to translate into us understanding that shift in our teenagers, and respect that they can need us and connect with us differently during these years.

I have been experiencing that even if I’m just being around my children or taking the ‘form of blending into the background like a potted plant’, that time does matter to them. It may seem like we are not pursuing any common activity, nor are we having any conversation. But then sometimes they suddenly open up and talk. They share their viewpoint on something. Or show a song or video they like. Or seek advice on something that’s been troubling them.

As the NYT article rightly states this is as relevant for full-time working or travelling (‘fly-in, fly-out’) parents – both fathers and mothers – as they can stay connected with their teenagers nowadays “by regularly checking in by social media, texts and FaceTime — letting their kids know that even though they were away, they were still watching.”

So fellow parents of teenagers, let’s not fret if our children are doing their own thing. Let’s understand that they still need us in their teenage years, just that they need us differently.

Let’s embrace our potted plant parenting and enjoy these years together with them!

This article was also published on Womens Web