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CONFIDENTIALITY OF PSYCHIATRIC CONSULTATION

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Introduction One question that often bothers people whenever they are going for psychiatric consultation, especially if it’s their first time visiting any psychiatrists or mental health professionals is confidentiality of the consultation. They ask varied questions like ‘Will my family members know about this?’ ‘What if my employers or colleagues find out?’ ‘Will my spouse get to know about this?’ and so on. These are genuine concerns and should be addressed by the mental health professionals at the outset emphasizing on confidential nature of psychiatric consultation and its different aspects. Mental Health Care Act, 2017 One must be first aware that mental health in India is governed by the Mental health Care Act (MHCA), 2017 which came into force on 29 th May, 2018, repealing the older Mental Health Act (MHA), 1987. The changes and amendments were made in line with United Nations Conventions on Rights of Persons with Disabilities, 2006 which India ratified in 2007. In MHC...
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Hustle Culture and Toxic Productivity : Workplace Mental Health

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  Introduction Can overwork kill? It seems so. A few of us may have heard about Karoshi , a Japanese term which literally means ‘Death from Overwork ’.   Initially limited only to Japan, this occupational phenomenon has become increasingly prevalent and even predominant in several parts of the globe.  A brief recap is that following World War II, Japan’s economy was in tatters. To give a boost, everyone started putting in extra hours and soon the economic boom began. However, everything comes at a cost and the price for this was beginning to be paid by people’s lives when the overwork induced deaths began to be reported in the late 1960s. As always, nobody heeded to the warning signs and instead of decreasing, the numbers kept mounting. The ‘Tech Era’ However, over the next few decades, instead of making workplace reforms, this kind of over consuming work patterns spread to other parts of the world, thanks to the tech revolution of the early 1990s. This led to ‘H...
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WORLD MENTAL HEALTH DAY

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Every year, on October 10, World Mental Health Day is celebrated across the globe to highlight the importance of mental health.  Mental health is not merely the absence of mental illnesses. According to World Health Organization (WHO), " mental health is a state of well-being that involves realizing one's abilities, coping with stress, working productively and contributing to society ." We often seek help from mental health professionals only after we have exhausted all other options and while engaging in psychological therapies and/or taking medications may be the first step towards our mental health, it is, nonetheless not the last one.  In fact, we need to take care of our mental health from early on and not just when we have reached the limits of our psychological resources and unable to cope up. Mental health issues are not something that happens overnight, although the symptoms might progress rapidly over days or even hours. For almost every case, subtle changes h...
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THE PURSUIT OF THE PERFECT SCHOOL by Dr. Suhasini Das

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  THE PURSUIT OF THE PERFECT SCHOOL ‘ Education is the manifestation of perfection already in man.’ – Swami Vivekananda   With my daughter on the verge of finishing her pre-school in a few months time, the recurrent topic that pops up in every conversation with other parents is 'Which school have I selected for her admission?' The anguish and struggle of desperate parents seeking the best school fot their daughter has been well-depicted in the Bollywood movie, Hindi Medium and despite movie's message being loud and clear, there seems to be no end to parents' anxieties.  However, when one reflects over this question, a lot seems redundant on several other fronts.  A Brief History of Modern Schools Modern schooling, as we know today began in the British era.  The modern education system was introduced and catapulted into action and prominence by Lord Thomas Babington Macaulay , a British historian and politician, who on February 2, 1835, proposed ...
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Psychological and Social Aspects in Mental Illnesses

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  Bio-psycho-social model Most of the psychiatric illnesses have a bio-psycho-social model of origin, meaning they have a biological component which could be some genetic vulnerability, autoimmune mechanisms, neurodevelopmental defects (during the brain’s development) and so on. They also have psychological component which include their thought patterns, emotional aspects, behavioural reactions to stress and other life events, coping skills , temperament and personality traits. The third aspect is social which includes family dynamics , interpersonal relationships, social structure and the patient's relationship to various social elements. Most of our mental health issues develop due to interaction between these three aspects of the individual. In our medical profession, we tend to pay more attention to the biological aspects, often ignoring the other two domains. However as I learnt and studied psychiatry, I realised the importance of Psychosocial aspects. ...
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Mother's instincts in early years of parenting.

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  Mother's instincts in early years of parenting.  Women are blessed with the responsibility as mothers. Mother instincts are so strong that initial years of motherhood becomes her prime importance than everything. She becomes a warrior , protector ,new lover and evolves to her new being with maximum attention to her children. She craves to accompany her child to stand on their own, until they are strong enough. She is always ready to support them whenever in need , no matter what. Support to the mother who is anxious about their care, worried about their safety and habits is under validated . She might have difficulty calming down at times, taking  blame at times, over  reactive at times  and guilty too. She is sometimes ready to sacrifice her important things for baby's care and safety. Sometimes it's her hormones and body changes making them  behave so, which may not look pleasant . Given the space to express her intentions could show some respect the mo...
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Mirror, Mirror, of the Mind- Metacognition!

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At some point in time, we must pause and start reflecting on our behaviours, ask ourselves ' Why am I behaving this way?'   if we want to bring any meaningful changes in our lives. This ability of self-reflection is one of the core process in bringing any sort of behavioural changes.  I believe that most of us know where we are going wrong or whatever we are doing is not helpful, however due to certain cognitive processes , we are unwilling or unable to reflect on our behaviours and hence we remain stuck in unhelpful patterns , be in the domain of relationships, work or struggling with unhealthy habits .  This ability to self-reflect, also called as Metacognition  is like a mind mirror, but for our own behaviours.  Mindfulness skills help us to increase our awareness of our behaviours in an open, non-judgmental way, thus gradually improvising on our self-reflection ability so that we begin to recognise our unhelpful behaviours and bring about necessary...
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Living in a Bubble

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Our Cocooned Lives My recent interactions with few of my undergraduate (MBBS) batchmates left me wondering how much circumscribed our lives have become. Although living in the same city, within a few miles from each other, despite the presence of internet and social media, we barely know each other. Even if I leave out the personal stuff, I hardly know anything about most of them on the professional front either. It is true that it is not easy to keep a track of everyone’s life in a batch of hundred and fifty. However , my list didn't stretch beyond five or six people. I thought I was the one living in a bubble, but it equally surprised me to discover that everyone was living a similar life - cocooned inside the shell of their routine life of work, household chores and kids, peppered with the occasional medical conferences. The Social Disconnection When I asked my friends from other fields (outside medicine), they too portrayed a similar picture. This is how disconnected we have be...
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Women's Mental Health Series: Menopause

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Menopause is not only the end of menstrual cycle but also of the reproductive capacity of an woman. Apart from humans, only a couple of other mammals have been shown to attain menopause (that is when they can no longer bear children).  Menopause and Perimenopause Menopause is the age at which the menstrual cycles come to an end and is marked by absence of menstruation for a consecutive 12 months. Most women attain menopause in their late 40s or early 50s (average age for Indian women being 45 ± 5 years).  A growing percentage of women are attaining earlier, below 40 years , which is called premature menopause . The causes include genetic causes, infections (mumps, TB), autoimmune diseases, smoking, drugs or following surgery to remove the ovaries which is called surgical menopause. They may experience more severe menopausal symptoms.  Although chronic stress may bring on earlier natural menopause, more research is required to confirm the association. However, several y...
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Women's Mental Health Series: MENTAL HEALTH ISSUES IN POST-PARTUM PERIOD

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The arrival of a newborn is often a source of great joy for both the mother and the family members. However, it also means a lot of adjustment and adaptation to a new and challenging situation, especially for new mothers. Physiological, hormonal and biological changes can increase a woman’s vulnerabilities for mental health issues.  The awareness around postpartum disorders is gradually improving and many women are opening up about their struggles, still there are many who have to suffer in silence due to several reasons. We must understand that silence is never the answer of any mental health disorder and when neglected, they can impact both mother and the baby, even beyond the post-partum period. There are several types of mental health disorders in the post-partum period: 1.     Postpartum blues: These are also known as “Baby blues” and are very common, often reported in upto 85% of women. The symptoms are crying spells, irritability, confusion and agitation...
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