Showing posts with label mental health services. Show all posts
Showing posts with label mental health services. Show all posts

Monday, November 23, 2020

My father is always forgetting... has he got DEMENTIA?

Dementia is a neurocognitive condition that affects people over 60 years of age.  It is characterized by short-term memory loss, confusion, sleep reversal, and odd behaviour. 



Find a brief introduction to this complex condition in this video in three languages:

English: https://youtu.be/SS8upBPfsfk

Hindi: https://youtu.be/WesEr0KHM78

Kannada: https://youtu.be/QXCEdKxcnew

Find out more about dementia in an earlier article of mine that was published in Deccan Herald.  Also read about the effects of meditation on ageing.  A recommended book on end-of-life care is Being Mortal.


Resources:
Background music: Cosmology by Evocativ
Pictures: 
https://loonylabs.files.wordpress.com/2015/10/dementia.jpg?w=550&h=422
https://upload.wikimedia.org/wikipedia/commons/thumb/a/ad/Alois_Alzheimer_003.jpg/220px-Alois_Alzheimer_003.jpg

Sunday, June 11, 2017

Book conversations: White Magic

I have referred several long-term alcohol dependent patients to rehab centres.  But they rarely ever come back to share their experiences - that is, if at all they do go on to have a successful rehab.

The few who have been to rehab in the past have only recounted horror stories of how staff verbally and physically abused them, how they were tied up and/or tortured, and in some cases, how they had to jump over the compound to escape the 'prisons' they were in.  

Naturally then, with White Magic I was curious to find out the insider's account of what it is to go through drug rehab as a patient.  I was hoping for a balanced account of the successes, happy outcomes, unsuccessful attempts at rehab, and the difficulties faced by staff and patients alike in battling a notoriously recurrent and exasperating problem that is drug addiction. 

I am sorry to say I was left disappointed...

What we get in this book is a personal account of the author's rehab experience in one particular centre called The Land, which we are told operates very differently from the rest, and has high success rates.  That's fine...I am okay with that bit, even though the author does not comment on the effectiveness of his own rehab experience in the end.  

However the rehab experiences of Nath or his fellow programmers recounted here are very few.

Instead the majority of the narrative is filled with the maverick founder Doc/Bhai's life story, whom, it is plain to see, the author lionizes.  Everything about his difficult birth, his dysfunctional family life, his headstrong attitude, and his struggles through life as he sets up the rehab centre initially at home, and later at The Land are described as in a biography.

More than anything, his multiple affairs and love life are described in lurid details.  Bhai comes across as a cantankerous Casanova who beds anything that remotely resembles the female of the species.  Sorry to scoff, but this is not what I wanted to find out from the book.

In spite of all this, I did manage to find a few things worth remembering: that the idea of rehab is not to run away from the drug, but to run towards a fulfilling life; that any goal is achievable as long as one aims high and works towards it; and that the power of belief in, and the act of prayer to an impersonal higher power can in themselves achieve more than the rigid belief in any one particular faith or its god.  

Few more things that rankle: there is a generous use of cuss words; not just from the programmers, but also from Bhai himself.  And they all smoke like chimneys in rural England.  It is as though the rehab program does not consider the harmful effects of nicotine.  Instead, cigarettes are inhaled in preference to oxygen, and their non-use is applied as a punitive measure against some transgressions in The Land. 

The writing is mostly excellent, although there are quite a few sentences which I had to read again to coax the meaning into my (thick) head.  Nath does mention that his 'soup'y writing may not appeal to one who has no interest in the subject of drug addiction or rehab - or indeed, enlightening oneself about the life-story of Bhai.  I agree with him there... 

Only go for it if you enjoy reading biographies of eccentric individuals and their flamboyant lives.



Image source: http://ecx.images-amazon.com/images/I/41DCiZrqCGL._SX311_BO1,204,203,200_.jpg

Sunday, June 14, 2015

Visit to Chittadhama - NGO for homeless mentally ill patients

They say everything happens for a reason.  So it seems with my visit to Chittadhama - the rustic haven in Heggadadevanakote (H D Kote, about 50 km from the centre of Mysore).  It is a residential unit set up by a few benevolent doctors for the rehabilitation of homeless people with mental illness.  


I had met one of the senior psychiatrists who visits the place while I was discussing another case with him.  He casually happened to mention about this place and the work that his organisation, Chittaprakasha Charitable Trust, was carrying out.  I was immediately interested in it.  I asked him if I could visit the place with the team.  He kindly agreed.

The visits are usually planned for the fourth Sunday of every month.  I had to wait on Mysore Road at about 6:30 am, as the hired Toyota Innova picked up visitors from various points in Bangalore.  I was the last to be picked up.  The senior doctor I had met earlier introduced me to the other members of the team; there was another senior psychiatrist and an ENT doctor - both worked in a prominent private hospital in Bangalore - and a software engineer who was the Trust's treasurer.  

We were in a hurry to reach the place in time, as it would take up to 4 hours or more to reach H D Kote.  Apart from seeing the residents, outpatients would also have to be assessed.  But we needn't have worried.  Because the driver seemed to be in a greater hurry than any of us.  He expertly tailgated several vehicles, overtook other vehicles by avoiding them by the skin of the teeth, and generally upset the already frayed equilibrium of other road users.  

To make matters worse, it was a very busy Bangalore-Mysore highway that Sunday, and it seemed as though the four lanes were woefully inadequate in accommodating all the buses, cars, two-wheelers, tractors, jaywalkers and animals plying the road.  The driver seemed to be immune to all requests and remonstrances from us to take it easy.  In the end we were just happy that we got to the place and back, all in one piece!

We stopped near Maddur along the way for breakfast.  After a quick bite of idli-vada, washed down with tea, we set off again, and reached the place at about 11 am.  The road in between Mysore and H D Kote was surprisingly well laid out.

A crowd had gathered near the entrance - outpatients who had arrived from nearby villages and tribal areas.  Two members of the ream generously offered to take me around the place before we got down to business.

Chittadhama - literally, Haven of Mind - is set in the rural part of H D Kote is a 4 acre plot of land full of greenery.  In the centre is the single-storey building which houses the inmates.  The keys to the building were handed over by Sudha Murthy of the Infosys Foundation. 

The staff have tended the land and managed to grow a host of useful plants and trees: coconuts, bananas, turmeric, guavas, mangoes and other fruits and vegetables.  The place also has sheds for donated cows and rabbits.  We were offered fresh tender coconut water while we went around.


H D Kote itself is a stone's throw away from Nagarahole National Park, and is known for its elephant training camps.  This is also the reason why I found electric fence all around the Chittadhama periphery - to keep out rogue elephants.

Later, while we were heading back to Bangalore, one of the doctors also said that a snake - most probably a krait - slid past barely a feet away from him.  That is when I realised that I had been lucky not to have run into a snake or an elephant when I had ventured out on my own to take a few pictures later!

I mostly assessed the outpatients.  The residents were seen by one of the senior psychiatrists, to ensure continuity of care.  I was surprised that even among the visiting patients, I got to diagnose a variety of conditions - dementia, anxiety, psychosomatic illnesses and depression - apart from the usual psychosis and schizophrenia that one gets to encounter in these settings.  It was also easy to prescribe medication, since the Trust has also provided for basic supply of essential drugs.  We had the same lunch prepared for the residents - ragi balls, rice, lentils and an egg side-dish - all cooked by the staff from local produce.


There are about 25 residents in the residential unit.  These are people who have been absconding from their homes due to various reasons, but mostly due to mental illnesses such as schizophrenia.  One of the enthusiastic staff members, fetched a photo album for me to see.  In it were photographs of residents when they were initially found on the streets in a disheveled state, and later looking very presentable after being properly groomed by the staff.  There were also touching photos of residents reuniting with family members when they were sound enough to tell the staff where they came from, who could then arrange their reunion.
  
In a country where mental health services are underdeveloped and under-resourced, and stigma towards those with mental illness is rife, the pioneering activities of this Trust are truly awe inspiring.

Overall, it was an uplifting experience, and I felt as though I had contributed, however insignificantly, to a noble cause.  I am just grateful to the the founders of the Trust for allowing me to help the homeless mentally ill patients.  I hope I will be able to continue my visits to this ongoing health camp every month in the future.

(PS: I have not included pictures of residents and outpatients to preserve confidentiality) 

Details about the Trust and its activities can be found from their Facebook page:

Tuesday, December 9, 2014

Article on suicides in India (including helplines)

What factors increase the risk of suicide?  

What is the state of suicide management and mental health in general in India?  

What help is available for those contemplating suicide?

Find out in this medical educational article...






Watch suicide prevention advice in three languages here:







Tuesday, June 17, 2014

Books conversations: Em and the Big Hoom & Sepia Leaves (mental health themed books)


I am considering both these books together because they deal with the same genre: mental illness; and also because I read them back to back.

Jerry Pinto, who made his mark with Surviving Women presents this tale of his mother who had mental illness.  From the colourful descriptions of her condition, it appears that she suffered from bipolar affective disorder (BPAD) - a kind of mood disorder characterised by mood swings from depression to mania.  It further appears that she had a particular type called rapidly cycling BPAD - mood swinging between the two extremes at a rapid speed, or perhaps a mixed affective state - both depressive and manic phases co-existing in one episode of the illness.  

In any case, it is mental illness, and as with all mental illnesses, there are a lot of idiosyncrasies and eccentricities to cope with.  The care-givers - her family, struggle through the various phases of her mood, often finding themselves at the receiving end of her abrasive behaviour.

Inevitably, the apathy, the casual attitude, and the sheer lack of appropriate services equipped to deal with mental illness is also presented, which highlight the poor state of mental healthcare in India.  

Even more inevitably, electro-convulsive therapy, that hugely misunderstood and often misrepresented mode of management is also held up to scrutiny, not least because of the way it was administered in her case - without the knowledge of the family.

It is worth mentioning here that when used in a controlled and monitored environment, under general anaesthesia, with muscle relaxation, and in the ECT suite, it remains the treatment of choice for conditions such as severe depression.

Nevertheless, Pinto's writing style is unusual, but engaging.  He presents the main character as she was, without any explanation as to her unusual behaviour, and without trying to glorify or vilify the travails that he and the other members of the family go through.



Sepia Leaves by Amandeep Sandhu, once again considers the author's mother's mental illness - only this time it is schizophrenia.

He presents the signs and symptoms of the condition through the descriptions of his mother's emotional upheavals and behaviour.  Also brought out, simultaneously, is her strained relationship with her husband - the author's father - who, to ensure the upbringing of the author as a child, makes the cardinal error of bringing home a maid servant.  This is when the signs of his mother's illness really burst forth, with her heaping verbal and physical abuses on both her husband as well as the maid.

Suspicions, or paranoid-persecutory delusions, characteristic of schizophrenia, are evident in these descriptions, along with odd mannerisms and catatonic postures.  

A memorable sequence of the father's unexpected death and the lack of any substantial reaction to this by the mother is used as the beginning and as a recurring theme throughout the book.  These and other moments are narrated quite simply, unlike Em and the Big Hoom, but like it, without the need for any emotional over-involvement.

But then it is the content which matters here, and it is that you should look for in this work.


Both these works are worth going for if you are interested in mental illness - as a professional, as a carer, or indeed as a service user.  Reading them, I hope, would also help reduce stigma associated with being mentally ill, and encourage people in distress to reach out

I also hope that ultimately, mental health themed literature such as these would help build mental resilience in patients and carers alike.  I have explored the theme of resilience in a similar narrative of multiple mental illnesses in a family in the book, Lake Amidst The Seas.

Please watch/share my patient education videos on these topics:

Depression: https://youtu.be/8cYwQANYAy4

Antidepressants: 
https://youtu.be/tKBWRvifYRk [English]
https://youtu.be/iVUi79gp-gQ [Hindi]
https://youtu.be/RezGamhA_Ak [Kannada]

Schizophrenia:
https://youtu.be/3US7KzMth54 [English]
https://youtu.be/kIVGOX_6zFY [Hindi]
https://youtu.be/ewpwJSq9qr4 [Kannada]





Image sources:
https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1334380612i/13601144._UY475_SS475_.jpg
https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1265348892l/7695190.jpg

Film conversations: Dhurandhar & Dhurandhar The Revenge

Chapter 1: The movie-going experience Due to prior horrid experiences related to  popcorn prices rivalling real estate rates in Bengaluru, ...