Qualification : Peer Support
Wednesday April 18 2018 15:44 PM Comments 0
Growing up in a lower middle-class family, Anand felt that his parents’ roles were reversed, confusing him as a child. He saw his mother as the dominating parent managing the household, and his father as a timid ineffective person who made a poor role model for the young boy. Anand was not close to his parents, and grew up to be shy, reserved, timid, following the dictates of others. He began to rely on his imagination to create an alternative world for himself, making him more withdrawn from his family and circumstances. Unlike most youngsters, he almost never went out with friends. Another tendency he developed was “overthinking” or dwelling for days on small and big issues, especially unpleasant ones. As a result he slept poorly, brooding over his thoughts. Even if a personal or social event kept him engaged and happy for a few hours, he was unable to sustain the feeling of wellbeing for longer than that evening.
His family’s financial difficulties meant Anand could not go to college after high school. Providentially, a neighbour introduced him to a computer course which Anand found a natural interest and aptitude for. He did the course and went on to become a trainer, eventually working his way up to an executive career that can be regarded as ‘doing well’ by any standards. About 10 years ago, Anand got married. It was an arranged match, and survived some initial friction. He has 2 school-going kids now.
To his family and friends, and later to his wife and colleagues, Anand was just an overly shy, timid person, well-behaved and doing his work but keeping to himself. They saw nothing much wrong with him beyond a reclusive personality type. However internally, through the years of his youth, career and marriage, Anand has suffered from a mental turmoil that he describes as living in an inner world of imagination, mind voices, overthinking and lack of interest in the social world around him. Interestingly he would not discuss his mental struggle with family or friends, not wanting to trouble them. Perhaps, at some level, he may have lacked the confidence that they would understand or that it would help. At the age of 24, Anand started drinking and gradually began to rely on a couple of drinks on most evenings to help him tranquilise his mind and sleep.
A turning point came in the form of his children. Watching them grow up brought the realisation that it was up to him to give them what he himself had felt the lack of - a strong father and role-model. This realisation kept his mind off the thoughts of ending it all, and actually motivated him to seek solutions. An avid reader of books and online resources, Anand had already begun to understand that what he was suffering from is a form of mental illness and not just a personality type. But somehow, despite the motivation of his kids and the awareness of his problem, he just did not take the initiative to reach out for help, and continued suffering alone. His wife unfortunately was not understanding of his mental state and put it down to personality type. That and a constant hesitation to bother others around him, kept him suffering alone. When his wife objected to his drinking, he drank secretly. It is important to note that Anand’s lonely battle with mental illness was not due to shame or fear of social stigma or of losing his job. In his case, it was a feeling that this is his battle and there is no point in troubling others over it.
About a year ago, a regular health check-up that included a mental health questionnaire brought Anand’s problem to the surface. Noting a very high score on the anxiety and depression parameters, the doctor advised Anand to seek a consultation and diagnosis. Fortunately Anand had read enough to have the awareness that mental illness is much like a physical condition that, if diagnosed properly, could be treated. He decided to go in for an evaluation of his mental condition. Further questionnaires and discussion with his doctor diagnosed his condition as chronic depression (also known as Dysthymia). Due to his awareness, Anand was able to deal with the diagnosis, and despite concerns over affordability he decided to go ahead and seek treatment.
About 8 months ago, Anand was put on anti-depressant medication and talk-therapy (psychotherapy). The doctor also advised some lifestyle changes such as going out for a jog whenever he felt the urge to drink alcohol in the evening, and developing a hobby that interests him outside of his work and home. In addition, Anand learnt to use “Mind Tools” a smartphone App that helps depression patients articulate and challenge their negative feelings in a ‘thought diary’ and suggests activities they can do when they are feeling down. He also armed himself with more awareness, inspiration and useful techniques from online materials, books and Ted-talks.
Anand proved to be a cooperative and determined patient, which is very important in this treatment as the patient has to follow his doctor’s advice even if he does not feel like it, even if the tasks seem to make him feel worse (initially). To cope with this problem, Anand drew lessons from a book on ‘expecting the worst’ as a coping strategy for anxiety. For instance, he would go jogging fully expecting to feel pain, strain and exhaustion as inevitable, so when it was very strenuous it did not increase his anxiety and, when it became less strenuous, he felt rewarded. Each time he felt the urge to drink to make his mind tranquil, he forced himself to go out for a jog, and used a tracker to monitor his physical activity. The jogging had several benefits – killing time, keeping his mind in the present, preventing brooding, improving sleep, plus the bonus effect on his cholesterol. Most of all, it gave him a sense of accomplishment that made him feel good. The tracker helped him to see the ‘rewards’, motivating him. With this combination of determination, tools & techniques and faith in the treatment, Anand has now been able to cut his alcohol intake by 90%!
Another lifestyle change Anand made on the doctor’s advice was to develop a hobby that would keep his mind engaged positively. He took up collecting various memorabilia. Each time he collected something special, he found himself deriving a sense of satisfaction and accomplishment, which spurred him on. To collect the items he needed to interact with people from very different walks of life, most of them complete strangers. A year ago he might have sought to avoid this. But the shared interest in the item enabled him to converse with them and, surprising himself, he started enjoying these interactions. Today, when he speaks of his collections, one can see that not just the items but the memories of the conversations have created a lingering sense of happiness.
The medication initially prescribed to Anand had several side-effects such as tiredness, increased appetite and sleepiness, gastric discomfort, etc. Thanks to his feedback his doctor was able to switch the medication to ease some of the side effects, while Anand himself worked on other side effects such as weight gain by spending more time in the gym. Again, his determination to not give up and his cooperation with the doctor helped him cope.
Anand has made very good progress in overcoming his chronic depression. The medication, therapy and doctor visits are being tapered off. But Anand plans to continue his treatment for some more time. He also plans to maintain the positive lifestyle changes he has made (such as jogging), so that he can avoid any setback or relapse in future. If there is one regret Anand has, it is that he wasted many years of his life by not seeking treatment earlier.
If luck had not played a part in the form of the health check questionnaire, Anand might be suffering still. To his credit, Anand was already armed with awareness about his condition. And when he got the chance, he acted decisively to seek help for his condition. He was not ashamed to seek help, and he had faith in treatment. His journey underscores three things that Anand offers as his top tips to anyone who may be facing similar problems – be aware that mental illnesses is like physical illness – it can be diagnosed, treated and cured, be open in talking about your symptoms – don’t bottle it up, and most importantly act early to seek professional help – don’t wait for it to become alright on its own.
Anand benefitted significantly from only attending a short number of sessions. Even when he first presented to therapy, he had good insight and awareness into his difficulties with his mood. Although his mental health concerns were not severely problematic, they were starting to impact on his ability to connect with his family and perform at his best in the workplace. Anand was able to benefit from therapy because he admitted that he needed help. He was also incredibly motivated, and fully utilised the information and resources provided to him. With some assistance, he could critically examine the unhelpful cycle between his thoughts and behavior, and took active steps to shift them. He also found exercise particularly helpful in coping with his stressors. The resources provided to him included freely available online apps for improving mental health (moodtools), exercise recommendations, and information about the link between anxiety and sleeping difficulties.
Anand is an excellent example of how mental health and wellbeing should be a focus for all of us. Just as we focus on good nutrition when wanting to improve our physical health, we should also focus on improving our resilience and ability to cope with emotional challenges in order to improve our mental wellbeing. There is no shame in admitting that we are struggling, and that we need to help of others to heal.
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