Symptoms

Conditions such as anxiety, depression, panic attacks, lucid dreams, phobia, insomnia affect our mental health. Overthinking plays a very huge part when we talk about mental health. Many people tend to think too much about the situations which will probably never happen. People don’t have control over how much they overthink. There are many solutions to overthinking if you search it up on the internet but, in reality, it’s not very elementary. You can experience these conditions at any point of your life, no matter the age, sex or ethnicity. Some people can be more prone to depression than others because of well, life situations, peer pressure, sexual identity and whatnot.

According to a study by WHO, half of all mental health conditions start by 14 years of age. Adolescents are at greater risk of mental health conditions due to their stigma, discrimination or exclusion, or lack of support from their parents/friends. As per the same study by WHO, suicide is the third leading cause of death in older adolescents because of mental illness and lack of access to help/therapy. There is a growing consensus that healthy development during childhood contributes to good mental health.

Lancet’s Study

Lancet has found the efficacy of “brief lay counsellor delivered, problem-solving intervention’’ for mental health problems in adolescents from government schools in Delhi. This is for adolescents who can’t afford to pay for therapy sessions. The premium for Adolescents (PRIDE) is a six-year research programme dedicated to making psychosocial interventions for improving the mental health of adolescents in India. “The study established that with limited resources and counselling intervention, we can give practical tools to adolescents to manage and deal with their mental health issues. This also makes mental health treatment accessible to those from underprivileged sections of society,” says Dr Kanika Malik, a clinical psychologist. The programme is going really well and is pretty successful. More than 250 adolescents were enrolled for the programme between August and December in 2018. For the treatment, they made a problem-solving booklet in a comic format to keep up with the interest of the adolescents. The book has many chapters which teach the kids to deal with domestic problems. This is very important because domestic life can be a major source of stress for the students and they don’t have the resources to tackle these situations but the comic book gives them tools to work through them. Not only did they distribute the booklets but also hired and trained the members of the community to counsel students.

According to a study by the lancet, more than 99% of adolescents and children with mental health problems remain undiagnosed in India. If these students receive proper treatment right now, they are less likely to suffer from serious mental health conditions in the later stage of their life. The initiative that lancet took for these adolescents is exceptional. 

Vulnerable Teens 

Another problem that students face while growing up is whether or not they should tell their parents about what they are going through. Adolescence is a very crucial period in our lives. Your decision-making power is not the best at this age. Parents are also requested to listen to their kids, to understand them, to tell them that it’s normal to feel this way. Many kids have abusive parents which makes it even more difficult for them to go through the illness. 

Look out for yourself and other people

 Mental illness is a very serious condition and it should not be neglected. Your brain is just as important as your heart and other body parts. It can only handle so much. Also, we should not forget the fact that we are in the middle of a pandemic right now and this COVID situation is not helping. This is for all the parents, if your kid is struggling, love him/her. This is for all the people who have friends with mental illness, support your friends.

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In India, as reported by the National Mental Health Survey (NMHS) 2015-16, nearly 15% of Indian adults require interceding for mental health issues and at least one in twenty Indians suffer from depression. According to the recent WHO report India is the 6^th most depressed country with 258,000 reported suicides in the year 2012. The report also mentions that around 80% of Indians don’t seek treatment after getting diagnosed with depression, mostly because of the stigmatization of mental health in Indian society.

Reasons for Depression:

• Hormonal changes in the brain of a human being.
• A person who always thinks negatively or perceives the conditions with a pessimist approach more likely faces stress loneliness and anxiety.
• Some people who constantly experience violence, hatred, abuse, poverty, and relationship disputes easily tend to fall in depression.
• Sometimes genetics plays a major role in making a person vulnerable to depression as it runs from the parents to their children and affects them without external causes.

Symptoms of Depression:

• Fluctuating body weight
• Energy loss or fatigue
• Feeling irritated or agitated
• Finding oneself guilty and worthless
• The feeling of being left out
• Reduced concentration power
• Lowering interest and pleasure in activities and works.
• Suicidal thoughts or constant thoughts about self-harm

Present Scenario

Normally, people in the midst of lockdown have confined themselves in their houses which might be necessary for the amelioration of the nation but when it comes to the mental health of an individual, without any medical treatments or personal measures being taken many people are going through major repercussions like depression, anxiety, frustration, fear, etc. and these sort of feelings within a person has resulted in the upsurge of activities like domestic violence and suicide attempts. Usually, people tend to find solutions for such problems through an intense consumption of alcohol and drugs but improper awareness, the looming threat of a pandemic, fear of joblessness, and lack of medical facilities available in hospitals have caused amplification of this issue.

Confirming to the Ministry of Health and Family Welfare, India requires around 13,000 psychiatrists. An ideal ratio to be attained is 1 psychiatrist for 8000 patients but at present, we have 3500 psychiatrists which are about 1 for 2 lakh or 200,000 people. Regarding clinical psychologists, we need 20,000 but we have only 1000 working clinical psychologists. Though we are doing much well in the manufacturing, supply, and export of PPE kits yet it’s a need of the hour to fill this gap between the patients and the doctors required for mental health treatments by the government.

Social media has become an alternative way of living a life for us where due to loneliness people have presumed social networking sites as a second world. We have already witnessed cases of suicides due to a lesser number of likes and public views on social media handles of a person. Current so-called modern communication tools have resulted in remoteness from personal/physical engagements and gatherings.

Due to lockdown, we have started utilizing video calling tools that are leading towards a virtual life rather than a real one. Though it must be helping us in the continuation of our regular schedules it has now led to such disorders and has started affecting humans both mentally as well as physically. A human is called a social being but soon this sentence will reverberate as a fantasy and unfortunately, in the end, these social beings will find themselves as introverts.

Medical Treatments and Therapies for Depression

Though it is one of the most lethal disorders, it can be treated which must be done as soon as the illness gets diagnosed. The general method for getting it treated is with medications and psychotherapy or with the combination of both. When these solutions don’t work electroconvulsive therapy and brain stimulation therapies are the options that are mostly explored.

Considering the medications, anti-depressants are the most recommended medicines to treat depression which may improve the brain’s way of using certain chemicals that manages the mood and stress of an individual. They may usually take 2 to 4 weeks to deliver some positive results. Such kinds of prescriptions should never be taken without the counsel of a trusted doctor because an over-dosage or mistakes in the courses of intake of an antidepressant can cause serious side effects.

Psychotherapy is another option which is also termed as ‘talk therapy’ or ‘counselling’. It can help to reduce the symptoms of depression. Methods such as interpersonal therapy (IPT), cognitive-behavioural therapy (CBT), and problem-solving therapy are the approaches for the treatment of depression.

If the above mentioned medical treatments don’t give expected results then electroconvulsive therapy (ECT) plays a major role in the treatment of depression. The treatment includes continuous sessions which may be thrice a week for almost two to four weeks but may cause few side effects like confusion or memory loss. However, now due to the advancement in the method of ECT, it has become safer and more effective for the patients. The procedure though is not painful and a patient is put under anaesthesia. There are many more methods to treat this mental disorder which are being studied by the researchers and the doctors and soon may be utilized for the better and more accurate treatment of the illness.

Yoga to Overcome Depression

Yoga alone should never be considered as a treatment for depression but should complement with proper medication and other options after proper consultation with the doctors. Regular yoga will definitely help a person to overcome stress and will give strength to think optimistically and makes a person optimistic. Yoga includes asanas, pranayamas, and also yoga philosophies.

Yoga Asanas:

• Dhanurasana (Bow Pose)
• Janu Shirsasana (One-Legged Forward Bend)
• Setu Bhadasana (Bridge Pose)
• Matsyasana (Fish Pose)
• Pashchimottanasana (Two Legged Forward Bend)
• Hastapadasana (Standing Forward Bend)
• Marjariasana (Cat Scratch)
• Adho Mukha Svanasana (Downward Facing Dog)
• Sirsasana (Headstand)
• Shavasana (Corpse Pose)

These asanas help in releasing the tension and negativity from the systems of the body.

Pranayamas to relieve anxiety:

• Kapal Bhati Pranayama
• Nadi Shodha Pranayama
• Bhastrika Pranayama
• Bhramari Pranayama

These pranayamas are done by focusing or putting attention on the breath to relax and free the mind and erase thoughts that procreates anxiety or depression.

Meditation is the method that should be followed daily because when a person gets too anxious regarding a threat or for varied reasons the muscles of a body get tense and the body starts sweating and scientific research has proven that meditation can significantly reduce the level of stress hormones.

The ancient yoga philosophies mention about two important principles of yoga, ‘yamas’ and ‘niyamas’. According to this principle, niyama teaches about the value of containment whereas the Aprigraha principle guides us in overcoming greediness which has always remained a reason for anxiety. Another principle called the Shahucha principle glorifies the cleanliness of the body and mind. These principles also mention healthy eating habits and a proper lifestyle for a perfect livelihood.

Lastly, praying to the god and keeping positive group of company around ourselves can keep our faces smiling and can breed peace and joy in our lives.

Conclusion

The recent committing of suicide by a well-known actor Sushant Singh Rajput has left us astonished and where depression is said to be the reason for the unfortunate step he took. These problems can simply get solved by sharing our feelings with the near and the dear ones and consulting trained professionals in due time. Unfortunately, the lockdown has kept few people away from their close relatives and friends even then suicide should never be a choice because “suicide does not end the probabilities of life getting worse but it eliminates the possibilities of it ever getting any better.”

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This article is about ‘Bella Clifton’ and her fight with BPD.

Bella Clifton was a 9-year-old girl when she saw her parents fighting every day and night. Little as she was, in that environment of hostile and distressful, her child-like mind started believing that people leave when we need them the most. Although her parents reconciled after years of arguments and fights but her subconscious mind was still lost in those years of her childhood. 

During her teenager days, she lost some of her closest friends and became more & more depressed. She had a feeling of insecurity & fear of rejection. So, she never made very close relationships. She was emotionally imbalanced, full of sadness and the cloud of self-worthlessness thoughts started following her. She even started questioning her existence. Those events made her lonelier. She was feeling empty inside her own. 

Borderline personality disorder or BPD is a serious Psychological Disorder, often confused with bipolar disorder. According to the most recent DSM-4-TR lists nine categorical criteria for BPD, five of which must be present for diagnosis. 

The nine Psychological criteria are as follows:-

1. Frantic efforts to avoid real or imagined abandonment.
2. Unstable and intense interpersonal relationships.
3. Lack of a clear sense of identity.
4. Impulsiveness in potentially self-damaging behaviours, such as substance abuse, sex, shoplifting, reckless driving, binge eating, etc.
5. Recurrent suicidal threats or gestures, or self-mutilating behaviours.
6. Severe mood shifts and extreme reactivity to situational stress.
7. Chronic feelings of emptiness.
8. Frequent and inappropriate displays of anger.
9. Transient, stress-related feelings of unreality or paranoia.

Discussion

Borderline personality disorder (BPD) is one of the group B-type of personality disorder. It is common in a psychiatric environment with a recorded prevalence of 20%. In BPD comorbid depression, anxiety spectrum disorders & bipolar illness occur more frequently & the lifetime risk of having at least one comorbid mental disorder approaches 100%. It is more common in women, higher in the urban population. It was originally used in psychodramatic circles to describe people with a marked instability. (source)

People suffering from borderline personality usually have a traumatic childhood experience such as separation of parents, sexual assault, or physical violence. The world of a borderline, like that of a child, is split into black and white. At any particular moment, one is either “good” or “evil”; there is no grey area. Splitting is an escaping mechanism from anxiety. A person suffering from BPD desperately seeks out new relationships; for solitude, even temporary aloneness is intolerable than mistreatment. 

BPD is often accompanied by- anxiety, anger, depression, panic attacks, sleep disturbance, episodes of frequent mood swings.

In Bella’s case, it was her traumatic childhood which made her a patient of BPD. At first, she wasn’t ready to go to a psychiatrist but after lots of convincing and arguments with her childhood best friend, she gave in. Bella was prescribed with some mood stabilizer, anti-depressant and sleep-improver. Her psychiatrist recommended her a clinical psychologist and the journey of her DBT session (therapy for BPD) begins.

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