Psychiatry and Society

Festivals as a source of stress? Festivals are meant to be a time of happiness, enjoyment and family togetherness. However for some it can be time of great stress   and can adversely affect mental health. The extended festival season starts around Independence Day (15th Aug) and extends right up to New Year including Ganesh Chathurti, Dusshera, and Diwali. Vacations have a positive effect on well-being. However, these effects fade soon after resumption of work (de Bloom 2009). These four months of celebration are associated with psychological distress and mental health problems for many individuals and their families. Festival distress (Harion 2009) Expectations take their toll on the family . Festivals are a prime time for couples to come in for counselling with relationship problems, problems with in-laws, siblings and their children. 'Don't we get to celebrate at least once in our own home?". They end up celebrating each in their own parental homes at Pune a...

Microscopic picture of the brain showing amyloid plaques and  neurofibrillary tangles first seen by Alois Alzheimer in 1907 The diagnosis of Alzheimer's disease became headline news when the defence counsel of a prominent citizen of  Pune stated they were awaiting results of his brain MRI to finalise the diagnosis of dementia. Recently a patient's medication was stopped when his neuro-physician declared there were 'no plaques on MRI so it is not a case of Alzheimers'. The caregivers returned to me when his behaviour problems recurred. Dementia including that of the Alzheimer's type is a clinical diagnosis (Grand 2011). Dementia is characterised by a triad of Progressive deterioration of mental processes ( cognitive abilities ) Behavioural and psychological symptoms of dementia ( BPSD ) Difficulties carrying out day-to-day activities ( activities of daily living or ADL).   Alzheimer's Disease is commonest dementia after 65 years of age Alzheime...

Parental supervision protects boisterous children from injury: More time unsupervised corresponds to more injury  “To my parents we were just two girls in the bedroom” . What exactly was going on? Without adequate supervision the parents of this teenager never found out; the memories returned to haunt her in adulthood. Studies comparing children with and without parental supervision show that lax parental supervision is associated with injury in toddlers and preschoolers; conduct problems in school going children; and road accidents, addictions, gambling and sexual risk taking in teenagers. Parental supervision has three dimensions (Gitanjali 2004) Attention - watching or listening  Proximity - within or beyond reach  Continuity - constant, intermittent, or not at all  Two factors determine the degree to which a child would be left unsupervised (Morrongiello 2008) Parent’s conscientiousness  - the more conscientious the parent more the sup...

Depressed mood or sadness lasting two weeks or more requires treatment. We all feel depressed, sad, or ‘blue’ occasionally. Moods and feelings change in response to events in our external environment. Usually depressive feelings or sadness last for a day or two; longer in case of loss or bereavement. However, if these feelings of sadness and hopelessness persist for more than 2 weeks and interfere with daily life, it indicates a clinical depression. Depression is the fourth highest contributor to the global burden of disease.  Clinical depression is a treatable illness. Many people never seek treatment due to lack of awareness, lack of access to mental health care, ignorance, or shame. Signs and Symptoms The hallmark of Clinical Depression is a pervasive depressed mood . This depressed mood is not responsive to positive events. There is associated slowness of thinking and movement; and there are thoughts related to guilt, self-blame, hopelessness and suicide . These f...

Rejection experienced in an intimate relationship can trigger unexpected aggression with sometimes fatal consequences. A working woman in Pune was stabbed to death in her home when she spurned the marriage proposal of a good friend. Another 17 year-old girl from Hadapsar was stabbed in the stomach for rebuffing the overtures of a relative. Why would a man assault a woman after professing his love to her? Many instances of aggression arise from events where an individual perceives he is not sufficiently loved or valued in the context of an intimate relationship. People differ in their readiness to perceive and react to rejection . The desire to belong is a basic human need. Some maintain equanimity while others over-react in ways that harm their relationships and their well-being. Hostility and aggression are among the most destructive reactions to rejection. Low self-esteem, depression, jealousy, self-neglect and a breakdown of daily routine are other painful outcomes of being reje...

Mobile phone induced EEG changes Cellular phones affect the brain to cause injury and death through inattention and reaction time delays. Cellular phone radiations also induce abnormal changes in brainwaves. Here we are not concerned with the potential for death due to the cancer generating properties of GSM radiation. We are concerned with the direct and immediate adverse effects of cellular phone conversations. Cellphones continue to kill their users in Pune . At least two people died crossing the Hadapsar railway tracks while engrossed in conversation. One of them was oblivious to shouting onlookers warning him of the oncoming train. Another cell-bewitched user fell off his eighth-floor balcony while conversing. And of course cellphone use while driving continues to kill despite the ban. All this is besides the cancer risk that the WHO (2011) is unable to disregard. How distracting is a cellphone conversation? Any extraneous demand on attention will distract from performance...

Discrimination of mentally ill persons by hospitals A young woman with psychiatric illness was refused admission at a leading tertiary care hospital in Pune. The reason - “mentally unstable patients are known to cause harm not only to themselves but to others as well. The hospital lacks facilities and infrastructure for catering to psychiatric patients.” A similar unwritten policy of denying inpatient care on grounds of psychiatric illness exists in at least one other large corporate hospital in Pune. We have already stressed the importance of access to healthcare for persons with mental illness . We will now further explore the stereotype of harm in mental illness. The stigma associated with this stereotype has an adverse impact on timely delivery of healthcare to persons with psychiatric illness. Are mentally ill persons likely to harm other hospital inpatients? Hospital and healthcare settings have the highest levels workplace related violence across all industry sect...