THE LOUDSPEAKER - MENTAL HEALTH FIRST AID

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Monsoon 2018

LOUDSPEAKER

Amplifying the voice of mental health

How should Children

6

Survive in a Competitive Environment?

8 HOW TO HANDLE

ACADEMIC FAILURE? 10 How to Minimize Conflicts with the Elderly in Families?

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How to Reach out to a Person who is Suicidal?

Handling Adolescents Effectively

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Loneliness in 17 Late Life THE

...Plus Our Regular Features 1 LOUDSPEAKER Amplifying the voice of mental health

NIMHANS Center for Well-Being A Center for Mental Health Promotion #1/B, 9th main, 1st Phase, 1st Stage, BTM Layout, Bengaluru– 76.

Phone: 080-26685948 / 9480829670 email: nimhans.wellbeing@gmail.com www.facebook.com/nimhanscentreforwellbeing

Mental health for persons with medical illnesses Marital enrichment services Pre-marriage preparation Stress management Trauma recovery Brief psychotherapies & counseling services Enhancing positive mental health Family counseling Parents support group

Services Offered

Support in intimate partner violence Prevention & early treatment for addiction Enhancing parenting skills & child mental health Services for healthy use of technology Cognitive and psychological enhancement Youth Well-Being Workshops & training programs in mental health Elderly helpline & mental health helpline TH E

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Amplifying the voice of mental health

THE

LOUDSPEAKER

Amplifying the voice of mental health

Editor Dr. Prabha S. Chandra Professor and Head of Psychiatry Coordinator NIMHANS Centre for Well-Being

Chief Editor:

Dr. Prabha S Chandra Editorial Team:

Dr. Prasanthi Nattala, Mrs. Padmavathy D, Dr. Meena.K.S. Mr. Manoj Chandran, Mr. Prabhu Dev.

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Editor’s Note

he monsoon season brings with it an end to the scorching summer JGCV VJG ENGCPUKPI TCKP CPF VJG HTCITCPEG QH RGVTKEJQT VJG ĹżTUV whiff of raindrops on hot mud.

It is also a time when we stay indoors and spend time with family. A time HQT TGNCVKQPUJKRU VQ DNQUUQO CPF C VKOG HQT TGĆ€GEVKQP QP YJCV CTG VJG OQUV precious ingredients of our interactions.

This issue of Loudspeaker we have decided to focus on the family - on children and the elderly. How do we handle the loneliness of later life, how can different generations live under one roof in joyous harmony, what qualities should we celebrate in our children and how do we handle adolescent turmoil.

We also introduce the RoSes Cafe at NIMHANS- where the healthy snacks served are perfect for the wet weather.

We hope you enjoy this issue.

Wishing all of us the most precious gift of all- the value of beautiful relationships!

Sub Editors Dr. Prasanthi Nattala Associate Professor of Nursing NIMHANS

Smt. Padmavathy D In-Charge Nursing OfďŹ cer NIMHANS Center for Well-Being

Editorial Board Mr. Manoj Chandran Mr. Prabhu Dev

Conceptualized and produced by NIMHANS Center for Well-Being

Cover photos: NIMHANS Center for Well-Being Photo Credits: Ms.Suvarna Agarwal and Mr.Abhijeet.S Fellowship Scholars, Department of Mental Health Education, NIMHANS

Printing of the Magazine funded by: Dr. Ramachandra N Moorthy Foundation for Mental Health and Neurological Sciences

National Institute of Mental THE Health & Neuro Sciences

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Amplifying the voice of mental health

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Contents

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How should Children Survive in a Competitive Environment?

Dr. K John Vijay sagar Children should be taught to learn from their failures.

8 10

*QY VQ /KPKOK\G %QPƀKEVU YKVJ VJG 'NFGTN[ KP (COKNKGU! Dr. Lakshmi Nirisha P Communication is extremely important in TGUQNXKPI EQPƀKEVU

How to Handle Academic Failure?

Dr. M. Manjula Every individual is unique and has his or her own potential, so do not compare yourself with others.

How to Reach out to a Person who is Suicidal?

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Dr. Santhosh Kumar Suicide is a multifaceted problem for which there is no single cause, but, suicide is preventable cause for death.

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Handling Ado doleesc s ents Effe Ef feect c ively Dr. Me Dr Megh gha Mahaja jaan “II can do it it;; it it’s ’s no bi b g de eal al;; wh hy wo w n’ n t th hey let me? e?””

Th hes e e li line ness mu ust st be soun unding ng famil ilia iaar to all thee parents of a gro owing wing adolescent. Th ad her eree is no FKHſEWNV VKOG VQ Q RTC T EV EVKE KEG G discipline wit ith yourr chi hild d than during g the th he teen n yea ears rss.

L neeli Lo line ness ss in Late Liffe

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17

Mental health First aid for Alcohol /Addiction Issues

Dr Sesha haadr d i Se Sekh khar ar Cha hatt ttter erje jeee

Dr Linda

Loneli Lone line nesss iss no not neece cessaril iy il ab bou outt be bein i g al alon o e. Ins on nste tead ad d, it i iss thee pe perc r ep ption n of be bein ing in g al alon onee an nd isolatted e thatt matterss mostt.

If the person wants help to cut down on drug use offer help.

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24 What Qualities should you praise in your Child?

Ms. Padmavathy D

2U[EJQNQIKECN ĹżTUV CKF HQT FQOGUVKE XKQNGPEG Dr. Ajay Prakash Domestic violence is one of the most common crimes against women which is prevalent throughout the world.

Appreciating our children when they display positive behaviors, would go a long way in building their character and shaping them into honest citizens of this country.

25 Yoga is Unique Mr. Pradeep Jakka Yoga is a unique and encompassing philosophy about how we live our lives. It unites the body, mind, and soul, thereby making this journey of life calmer and OQTG HWNĹżNNKPI THE

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How should Children Survive in a Competitive Environment?

6JG VGTO ő%QORGVKVKQPŒ ECP DG FGſPGF CU CP CEVKXKV[ or condition of striving to gain or win something by defeating or establishing superiority over others.

Competition can be a double-edged sword for kids, promoting positive values under the right conditions but creating negative environments that are demotivating under the wrong ones. Competition can be healthy when it provides feedback to kids about their performance and improvement, when winning is not the sole or primary objective, and when kids get to learn about themselves under challenging situations. Competitive environment helps children learn crucial life skills like critical thinking, decision making, problem solving etc. On the other hand, if competition creates a “win at all costs” situation, it can impact children negatively.

Some strategies to foster healthy competition in children: Reducing undue stress in academics: In the area of academics there is often too much

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importance given to marks and ranks, which OCMGU VJG EJKNF WPFGTIQ UKIPKſECPV UVTGUU 5QOG parents and teachers exert undue pressure on children to make them secure highest marks or rank. There is constant comparison of the child with other children and frequent demeaning statements are made. Competition in academics is quite intense during 10th and 12th standard exams, as the marks obtained in these exams are often used as a criterion for admission to various colleges/ courses. Parents and teachers need to understand each child’s abilities and have reasonable expectations with regards to their academic performance. Adequate support needs to be provided both at home and school for children to ensure that children are able to handle academic stress. Healthy competition in academics is useful for children as it helps them to get adequate motivation to do well in academics. Children have to develop regular study habits rather than the practice of studying for long periods of time just before exams.

Encouraging extracurricular activities: In these days we see the sad reality of children not having any time for extracurricular activities.

Competing in extracurricular activities helps children to socialize with others and develop the skill to work in a team . Parents should encourage children to participate in extracurricular activities based on the child’s interest and not pressurize them into activities just for the sake of participating in competitions.

Helping children to learn from failures: Children should be taught to learn from their failures. The love conveyed by parents towards their children should not depend on the number of ranks secured or prizes won in competitions.

The process of preparation for a competition is more important than the outcome. Children and parents have to understand that success or failure in any competition depends on many factors including child’s performance, performance of others, number of competitors, type of tasks in the competition etc. Very often the entire blame for failure or poor performance is placed on

the child, who is made to feel guilty. In some children, this can lead to adverse impact on their mental health with onset of psychological disorders like depression. Another scenario which emerges due to this is intense anxiety in the child leading to avoidance of any situation that requires some performance that will be evaluated. The child has to be taught effective ways of coping with failure in a competition.

Children should be encouraged right from the beginning to participate in competitions in order to give their best performance, regardless of the results. This will help to reduce the negative impact of failure on the child’s mind.

Kavya is a 14 year old girl studying in 9th Standard. She is a bright student and has always UEQTGF ſTUV TCPM KP JGT ENCUU TKIJV HTQO .-) She is interested in music and has won several prizes in solo and group singing competitions.

4GEGPVN[ -CX[C KU ſPFKPI KV FKHſEWNV VQ EQORGVG with a couple of her classmates who are doing very well in studies. In the recent mid-term GZCOKPCVKQPU UJG OKUUGF VJG ſTUV TCPM D[ C margin of 4-5 marks. Kavya became extremely upset after the result. She stopped attending music classes and spends most of her time with studies. She keeps telling her parents that she will surely secure 1st rank in the exams.

How can the parents help Kavya?

They should make her understand thatx They are always available for her x They have faith in her abilities x She needs to believe in herself x Success and failures are part of life x She needs to cultivate a positive attitude and learn from her experiences x She need not neglect her music and singing as they are needed for her overall well-being.

Dr. K. John Vijay sagar Professor Dept. of Child & Adolescents Psychiatry NIMHANS

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How to Handle Academic Failure?

Case vignette 1: Sheela is a 12th standard girl from a village background. She is an only daughter of a father who is a school teacher and a mother who is a homemaker. She had dreams of becoming a doctor, which was encouraged both at home and in the school as she was good in studies and always topped the school. After her 10th standard she chooses a college in the city as it is considered as a IQQF EQNNGIG 5JG ĹżPFU KV UVTGPWQWU VQ VTCXGN HTQO her village to city every day and to manage both tuitions and classes on a daily basis. She is unable to study as much as she wants as she needs to travel daily to attend college and tuitions. She experienced lot of stress thinking about exams and is afraid she may not make it into medicine. After appearing for two papers she felt that she will not get the expected marks and is contemplating suicide.

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Case vignette 2: Sanjay is an MBBS graduate from a middle class family. He has been attempting to ENGCT GPVTCPEG VQ IGV KPVQ C 2) EQWTUG CPF JCU DGGP staying away from home for about 2 years in order to attend coaching classes at different places. He did write all entrance exams, however could not clear even one, while his girlfriend could succeed and was planning to join. His parents have taken loans for his MBBS education. He is unable to decide whether he should continue to prepare for exams without working, in which case his parents have to take more loans. He also has fears about the possibility of him not being able to clear exams, pay the loan and losing his girlfriend. He developed depression due to the stress of failure and worrying about the future.

The above examples show that failure means perceived inability to achieve one’s own expected IQCNU QT HWNſNN QVJGTUŏ GZRGEVCVKQPU (CKNWTGU CTG WUWCNN[ FGſPGF D[ VJG KPFKXKFWCNU VJGOUGNXGU 5Q a failure for one person need not be considered as a failure by another person. These meanings are generally learnt from the society and the people around an individual. It may be explicitly told to the person or learnt by observation and internalized.

However, reality is that everybody has to face failure in some area or the other at different times in life.

Particularly in the Indian context, academic failures are very common due to increased competition and limited opportunities (as illustrated in the above two examples).

Handling academic failures: Some tips which can help to deal with academic failures are: a. Have more than one academic option rather than UVC[KPI ſZGF QP QPG IQCN ECTGGT +V KU KORQTVCPV to know that there are several options and each one of them have equal value. No course is superior to other and there is a lot to do in each ſGNF b. Identify the causes for failure and try to rectify them. When not able to identify, seeking help would be useful. c.

Often modifying method of study/practice would help.

d. Do what pleases you and try not to do things to make others happy. For example, do not choose a course of study just to please others or follow the rest of the crowd. If the expectations are guided by what others want, it creates anxiety. e. Every individual is unique and has his or her own potential, so do not compare yourself with others. f.

Have realistic goals. Always try to match the goals you set with your abilities.

General tips to handle disappointments 1. It is important that children are taught to accept ups and downs in life and also to persist in the face of disappointments.

3. Not accepting failures would leave us with a dissatisfactory life. The truth is that failures teach us resilience and skills to cope and problem solve.

4. When not able to cope with disappointment it is better to seek help and advice from others. It may even be necessary to seek professional help.

5. Learning about stories of successful people would give insights into the fact that most successful people are those who have made most mistakes but never gave up.

6. It is also important to understand that without struggle any success does not make sense and one will not be able to enjoy life.

7. One’s happiness should not depend on the result but the process of reaching it. When we cherish each and everything (good and bad experiences) on our way to the goal, the satisfaction is experienced throughout rather than waiting for the end result.

8. To tolerate emotions during the crucial period is most important. It is also equally important to take decisions rationally and not emotionally.

9. Remember that time is the healer. What appears intolerable at the moment may not seem so after sometime. So one should give time for things to settle and try again.

“I have not failed. I’ve just found 10,000 ways that do not work.”

- Thomas Alva Edison

“Disappointment is just the action of your brain readjusting itself to reality after discovering things are not the way you thought they were” - Brad Warner Dr. M. Manjula Professor, Department of Clinical Psychology, NIMHANS

2. It is also important to understand that intelliIGPEG CNQPG KU PQV UWHſEKGPV HQT UWEEGGFKPI KP life/academics. Hard work and perseverance are equally important.

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*QY VQ /KPKOK\G %QPƀKEVU with the Elderly in Families?

Increasing life expectancy (currently it is 66 years) has 80% of the elderly are supported by family. The shown a growth in elderly population by more than dependency increases with medical and problems 20% in the last decade. Urbanization, modernization such as dementia. Often older individuals lose their and decline in joint families has taken away many ability for decision making, and with this the onus of the support systems which elderly relied on. The often falls on one family member. This brings about trend of globalization which a sense of being burdened started in the early 1990s, among the caregivers. Sibling Mr. R is 70 years old and has recently lost also brought in change in the rivalry is another important his wife, after which he had started to live cultural ethos of our country TGCUQP HQT EQPƀKEVU KP ECTKPI with his elder daughter and her family. because of exposure to other for the elderly where one of Subsequently Mr. R’s elder daughter cultures. This has changed the children perceives that how the younger generation he or she has been forced to and son have begun quarreling about his relates to the elderly. All take up the responsibility. future care and responsibility. these changes have given rise to situations in which %QPƀKEVU UVCTV UOCNN CPF Mrs. M, 65 years old, has been living EQPƀKEVU DGVYGGP VJG GNFGTN[ become bigger. Caregivers with her son for many years.

Often there and the younger generation form a system that prevents would be arguments about her son’s have increased. any change, and thus the EQPƀKEV TGOCKPU WPTGUQNXGF family, especially that her grandchildren (COKN[ EQPƀKEVU COQPI 6JKU OCMGU KV FKHſEWNV VQ have not been respecting her and so on, caregivers of the elderly compromise and resentment and this is causing a lot of tension in the Mr. R’s situation is not among the members family…. uncommon. In India 75 to becomes deep rooted.

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+PVGTIGPGTCVKQPCN EQPƀKEV Mrs. M’s situation is something which most of us come across. Common reasons include communication styles, habits, lifestyle, differences in expectations. With increasing age the physical and mental abilities decline, which impairs the elderly’s capacity to adapt to new situations.

MANAGING CONFLICTS WITH THE ELDERLY: Recognizing the problem /QUV QHVGP HCOKNKGU QH GNFGTN[ EQPUKFGT VJG EQPƀKEV VQ be a natural part of life and fail to act. Recognizing CPF VCNMKPI CDQWV KV KU VJG ſTUV UVGR VQYCTFU TGUQNXKPI C EQPƀKEV Communication Communication is extremely important in resolving EQPƀKEVU 4CVJGT VJCP TGCEVKPI VQ C UKVWCVKQP QH EQPƀKEV it is important to respond which is essentially trying to understand each one’s viewpoints. Hasty heated EQPXGTUCVKQPU FQ OQTG JCTO CPF GUECNCVG VJG EQPƀKEV rather than resolving it.

Controlling negative emotions Elderly and their families experience emotions such as anger , frustration , sadness, powerlessness which KPVGTHGTGU YKVJ VJG CDKNKV[ VQ TGUQNXG C EQPĆ€KEV /QUV often the elderly and the caregiver feel victimized and they fail to understand the problem. While resolving VJGUG EQPĆ€KEVU KV KU KORQTVCPV VQ MGGR VJGUG PGICVKXG emotions in check and approach the problem as objectively as possible. Objectivity should not be confused with emotional disengagement, and the elderly need to know that they are loved.

Being open to change Resistance to change in the elderly and others can CNUQ GUECNCVG C EQPĆ€KEV 'NFGTN[ KPFKXKFWCNU PGGF VQ try and adapt, even if they are unable to completely accept the change. But on the other hand the other members should also understand the needs and expectations of the elderly.

Compromising What we should understand is that, the resolution VQ VJGUG EQPĆ€KEVU KU PQV GCU[ QT UKORNG CPF CV times a complete resolution may not be possible.

All concerned individuals need to attempt to accommodate and compromise instead of trying to win the argument.

GORNQ[GGU CPF CUUKUV KP TGUQNXKPI EQPĆ€KEVU /GPVCN health professionals also play an important role in assisting the elderly and their family to assist and EQRG YKVJ EQPĆ€KEVU +P UWOOCT[ EQPĆ€KEVU YKVJ VJG GNFGTN[ ECP DG effectively managed by: x Listening to what each one has to say x Responding rather than reacting x Communicating effectively to prevent misunderstanding x Attempting to adapt rather than expecting an ultimate solution x 4GOGODGTKPI VJCV EQPĆ€KEVU CTG PQV VJG GPF DWV can lead the way to betterment.

What can the elderly do? x Sitting back and enjoying their freedom, rather than wanting to take all the decisions themselves x Improving their views on younger people regarding upbringing of children, budget, clothing etc x Allowing younger people to take their own holidays and outings x )GVVKPI QWV QH ĹŽXKEVKOĹ? OQFG K G HGGNKPI persecuted/victimized to gain attention x Being supportive to the younger people in the family.

What can the young people do? x )KXG VKOG CPF EQOOWPKECVG YKVJ [QWT elders x Just listen to them, they feel respected x Learn from their wisdom x Make your decisions, but keep them informed, they feel valued. x )KXG C UWTRTKUG %GNGDTCVG VJGKT DKTVJFC[U and anniversaries, invite their friends. x Teach your children to be affectionate with the elders, and be respectful towards them.

Dr. Lakshmi Nirisha P MD Psychiatry Department of Psychiatry NIMHANS

When need for external help is felt do not hesitate to ask. Numerous counselors work with families and THE

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How to Reach out to a Person who is Suicidal?

5WKEKFG KU FGĹżPGF CU UGNH KPĆ€KEVGF FGCVJ YKVJ evidence (either explicit or implicit) that the person intended to die. Every 40 seconds a person dies by suicide somewhere in the world . More than 8 lakh people worldwide commit suicide every year, and at least 10 times as many attempt suicide. There is no single explanation as to why people die by suicide. However, many suicides appear impulsive DWV ECP QHVGP DG KFGPVKĹżGF KP VKOG CPF RTGXGPVGF Suicide is complex and tragic but often preventable.

This article will attempt to describe how to identify suicidal tendencies in people and help them.

Warning signs People with suicidal tendencies may exhibit the following signs : x Reduced interaction with other people, including loved ones. x Appearing unhappy most of the time. Frequent crying spells may be present. x 5KIPKĹżECPV EJCPIGU KP UNGGR FKUVWTDGF UNGGR QT sleeping excessively) and food intake. x Sudden increase in alcohol, tobacco or other drug use. x Showing rage or talking about seeking revenge. x Displaying extreme mood swings. x Expressing negative views of self and the future like “I am going to failâ€?. x Expressing in words or actions, that they feel trapped in life, like there is no way out, or TH E

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VJCV VJG[ CTG WPCDNG VQ ĹżPF C UQNWVKQP VQ VJGKT problems. x Talking more often about death, expressing wishes of dying as a means of escape to end their suffering. x Planning for the future after their demise by trying to get their affairs in order (giving away valued possessions, creating a will) or entrust others with responsibilities like taking care of loved ones. x Looking for ways to kill themselves including seeking information about the possible methods (ease, the lethal dose of drugs, amount of pain) and/or seeking access to drugs, weapons, etc.

How to talk to someone who is suicidal If you suspect a person of having suicidal ideas, it is advisable to approach them promptly and directly.

You can express your concerns directly to the person and also describe the changes in them that have led you to be concerned. The person can be directly asked the following questions: x When people are stressed or troubled they often think of death, have you had any such thoughts? x When people are feeling low and depressed, they may have thoughts or plans of hurting themselves, have you had any such thoughts at any point of time recently?

Avoid questions like “Are you suicidal?� as these questions may convey a lack of understanding on your part.

Do not hesitate to ask the above questions, fearing that such questions may put thoughts of suicide into the person’s mind. Rather, asking such direct questions may encourage the person to open up and disclose self-destructive thoughts, which offers you an opportunity to help. A list of what to do and what not to do while talking to a suicidal person is presented below: What to do: x Be patient and calm x Express concern like “I understand your feelingsâ€? “I will do my best to help youâ€?. x Reassure them and encourage them to express their feelings and also vent their emotions . x Be non-judgemental x Summarize from time to time to show you are listening x Do not hesitate to clarify if you have any doubts x Thank the person for sharing his/ her feelings What not to do: x Argue or debate about their feelings x Be judgmental about the person or the concept of suicide x Minimize their problems x Use threats to prevent suicide x )KXG JQNNQY CPF GORV[ TGCUUWTCPEGU NKMG Ĺ‘EJGGT upâ€?, etc. x Interrupt with your own stories, draw comparison between their problems and yours or others’.

x )CKP VJG RGTUQPĹ?U VTWUV CPF VT[ VQ RNCEG VJG OGCPU of suicide (drugs, weapons, etc) out of their reach x Involve other loved ones of the person in offering help x Seek professional help preferably after taking the RGTUQP KPVQ EQPĹżFGPEG +H VJG RGTUQP TGHWUGU [QW should still consult a professional and express honestly to the person that you will be doing so. x Suicide helpline numbers are available.

Encourage them to contact these numbers when they are having thoughts of harming or killing themselves. Some of them are listed below: ž NIMHANS Centre for Well Being (Bengaluru) – 08026685948 or 9480829670 ž SAHAI (Bengaluru) - 080 – 25497777 ž Sneha (Chennai) – 91-44-2464 0050, 91-442464 0060 ž Lifeline Foundation (Kolkata) – +91 33 24637401, +91 33 24637432 ž Sumaitri (New Delhi) – 011-23389090 ž Maithri (Kochi)– 91- 484 – 2540530 ž Nagpur Suicide Prevention Helpline – 8888817666 ž The Samaritans (Mumbai) – 022 6464 3267, 022 6565 3267, 022 6565 3247

To determine how serious the threat of suicide is, ask the person about issues that draw attention to his/ her immediate safety: x Any plans for suicide: how, when, where, etc. x If he/she has already secured the means to carry out the plan x Past history of suicidal attempt x Alcohol or other drug use that can affect decision-making.

How can you help the person who is suicidal? x Don’t leave the person alone for any period of time x Encourage the person to call you at any time and share concerns or worries. You can reassure the person saying that you are available via phone or message at any time THE

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¾ Aasra (Navi Mumbai)– 91-22-27546669 ¾ Maitreyi (Pondicherry) – +91-413-339999 ¾ Connecting India 18002094353

(Pune)–

9922001122,

¾ Roshni (Secunderabad)– 040 790 4646 ¾ Saath (Ahmedabad)– 079 2630 5544, 079 2630 0222 x No-suicide contracts: Try to draw a written agreement with the person that he will not act QP JKU UWKEKFCN VJQWIJVU HQT C URGEKſGF RGTKQF QH time (this time period should be renewed until the person is no longer suicidal).

Myths and facts about Suicide Myths

Facts

Once suicidal, always suicidal.

Being suicidal is short term and situation URGEKſE

Using the word “Suicide” can implant suicidal thoughts.

Talking openly gives the person an option to discuss.

Occurs in persons with mental illness.

Not so. Mostly depends on situations.

Happens without any warning.

Warning signs are present, either verbal or behavioral.

Someone who is suicidal is determined to die.

Many are ambivalent about living or dying.

Hence emotional support will help them.

People who talk about suicide do not mean to do it.

No. The person is actually expressing his anxiety and depression.

Finally, it is highly important for the helper to take care of himself/ herself as providing support to a suicidal person can be exhausting. Suicide is lethal but preventable. You are not alone in helping someone in crisis. There are many resources available to assess, treat and intervene. Crisis lines, counselors, intervention programs and more are available to you, as well as to the person experiencing the emotional crisis.

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“Place your hand over your heart, can you feel it?

That is called purpose. You’re alive for a reason so don’t ever give up.”

Dr. Santhosh Kumar Senior Resident in Primary Care Psychiatry Program.

Tele-Medicine unit, NIMHANS

Handling Adolescents Effectively

“I can do it; it’s no big deal; why won’t they let me?�

These lines must be sounding familiar to all the parents of a growing adolescent. There is no more FKHſEWNV VKOG VQ RTCEVKEG FKUEKRNKPG YKVJ [QWT EJKNF than during the teen years. Teens will often begin to rebel against limits more forcefully and getting them to listen is hard because they don’t think they need them.

Limit setting thus becomes a critical issue during this vulnerable period of a teen’s development.

6JKPM QH KV VJKU YC[ $WVVGTƀKGU JCXG VQ RWUJ VJGKT way out of the cocoon; the cocoon is the limit on the DWVVGTƀ[ +P VJG UCOG YC[ [QWT NKOKVU CTG VJG EQEQQP on your child. He’s going to get out someday and grow and move on. But it’s good to make sure that he pushes a little and shows that he’s really ready.

And you can only tell if he’s ready by how much he struggles or how much maturity he shows while pushing against the limits.

Certainly the “Limit Setter� is one of the roles of effective parenting. Balanced limits build trust

between parents and teens. To help you strike a balance between being overly strict and overly permissive, the following may help: Parents of teens should listen respectfully to their teens’ ideas. We can ask questions and offer our view but it is not helpful to criticize or belittle them.

Be clear about the rules. By making the rules well known to all, your teen can’t plead ignorance for breaking one. Additionally, involve teens in setting rules for themselves. They will be more likely to respect the rules, if they understand the reasons behind the rules. For example, when setting your teen’s curfew, decide together on the time he or she must be home. This may help the teen be more responsible in following the rule. Both parents must agree on every rule that is set, to avoid room for any uncertainty.

Limit the number of rules you impose. Avoid being a “micro-manager�. Instead, determine which rules you consider truly essential.

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Don’t overreact. Overreacting to actions and attitudes that don’t actually hurt anyone, shifts the focus away from what really matters. For instance, if you don’t like your teen’s latest music or fashions, but they are not inappropriate, ignore it. Save your energy and the impact of your directives for the bigger issues, such as respect for others, academic responsibilities, etc., which will help your child eventually create a framework for successful living.

Follow through. Believe in the rules you set, and once you put them in place, be consistent and stick with them. When parents keep their word, it models reliability for their children. Your rules will have no value whatsoever if you fail to back them up.

Work together on consequences, too. There’s got to be a price for stepping over the line. However, the following to be kept in mind: x &QGU VJG RWPKUJOGPV ĹżV VJG ETKOG! )TQWPFKPI him/her for a week may be too harsh when she’s 20 minutes late for dinner, but reasonable when she misses curfew by two hours. x Is the consequence clear? Saying, “If you miss curfew, you can’t use the car.â€? is vague. Saying, “For every 30 minutes you’re late, you lose your right to use the car for one dayâ€? makes the cost clear.

Teens turn out best when their parents monitor their activities. It’s good to be involved in teen’s life. When teens announce that they are going out, parents can ask them gently about where they are going and what they will be doing.

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Listen before you act. Sometimes teens honestly do have a valid reason for breaking the rules. For example, it is entirely possible that they got late as the person who was supposed to provide the ride home showed up late. Hear your child out before you reprimand him or her.

Change the rules when it is reasonable and appropriate to do so. Revisit the rules from time to time with them as teens age and show increasing independence, and revise them accordingly.

Remember the power of praise. Remember to compliment your teen for handling life well. Much of what he or she is learning now is new, and verbalizing what a good job he or she is doing can FQ YQPFGTU HQT [QWT VGGPĹ?U EQPĹżFGPEG CU YGNN CU JKU or her willingness to cooperate with you.

FINAL THOUGHT: Teenagers are usually ready for abstract ideas. Ask them questions that will allow them to begin considering their future responsibilities, e.g., “What kind of a father/ mother/ husband/ wife do you think you will be?

When you talk with teens about their future, and the responsibilities, they may then develop a sense that the rules are not for “us�, but for them and their future.

Dr. Megha Mahajan DM Dept. of Child & Adolescent Psychiatry, NIMHANS

Loneliness in Late Life The worst part of holding the memories is not the pain. It’s the loneliness of it. Memories need to be shared. —Lois Lowry The word, to start with New York Times, 25th March 2009 quoted “loneliness leads to poorer physical and mental healthâ€?. BBC news on January 31st, 2011 pronounced loneliness as a “hidden killerâ€? of the elderly. Loneliness has been FGĹżPGF KP FKHHGTGPV YC[U # EQOOQP FGĹżPKVKQP KU Ĺ‘# UVCVG QH UQNKVWFG QT DGKPI CNQPGĹ’ 6JG QVJGT FGĹżPKVKQP is “Loneliness is not necessarily about being alone.

Instead, it is the perception of being alone and isolated that matters mostâ€? and is “a state of mindâ€?. “Inability VQ ĹżPF OGCPKPI KP QPGĹ?U NKHGĹ’ Ĺ‘(GGNKPI QH PGICVKXG and unpleasantâ€? and “A subjective, negative feeling TGNCVGF VQ VJG FGĹżEKGPV UQEKCN TGNCVKQPUĹ’ Ĺ‘# HGGNKPI of disconnectedness or isolation.â€? etc., are the other YC[U VQ FGĹżPG NQPGNKPGUU

far-off places in search of economic betterment.

Even if they live within the country, due to the spread of Western ideas such as “spacing, privacy, individualism and non-interference,� nuclear families are becoming the norm even in villages.

Surprisingly even in joint families, the elders may feel lonely owing to the denial of due respect, concern and care by youngsters. The younger generation in their busy lives may not be sensitive to the needs of their parents (often unintentionally).

Loneliness, a disease?

Till date loneliness is being treated as a symptom of mental health problems; however, for elderly (aged 60 years and above), loneliness has become a disease in itself. Loneliness being a common human emotion A 70 years old retired headmaster who sought is however, a complex and help expresses to his doctor - “ Do you know unique experience to each how it feels when there is no one to say a individual. It has no single simple good night, no one to scold or express common cause, so the anger to, or to get a shoulder when you really prevention and treatment need, or to just share a story when you want; for this damaging state of do you know how it feels to be really alone?� mind considerably differs.

The man in his mid 70s expressed this fervently

It is also important to make a distinction between solitude and loneliness. Solitude is enjoyed by people and it leads to creativity, self-realization, and is totally an approach for developing one’s individual space. It is often considered and cried in the outdoor chamber. as an essential component for spirituality and self – Pathological loneliness growth. On the other hand, loneliness is a state of Pathological loneliness has its roots in a medical mind, a feeling of emptiness, separateness, and it model consisting of a host, an agent, and an often becomes a compulsion. When it develops into environment and is thus, a disease. The problem due dysfunction, it is perceived as stress; and combined to pathological loneliness is increasing worldwide with physical aging,; the situation turns out to be a and needs to be handled as a disease, not just as a toxic cocktail. situation or a symptom of a disease or a mere social concept. It has been described as the major problem Aging India CUUQEKCVGF YKVJ QNF CIG CPF KU VJWU KFGPVKſGF CU CP The reduction in fertility level, reinforced by a appropriate condition for therapeutic intervention steady increase in life expectancy, has produced or prevention. fundamental changes in age structure of the population that in turn leads to the aging population.

Loneliness and old age The older population of India, which was 56.7 million It is generally accepted that loneliness frequently in 1991, was 72 million in 2001 and is expected to results in a decline of well-being and may cause grow to 137 million by 2021. Today, India is home to depression, suicidal behavior, sleep problems, one out of every 10 senior citizens of the world. disturbed appetite, and so on. The pathological consequences of loneliness are found more Socio-cultural scenario among those adults who develop personality and An emotional and psychological problem tormenting adaptation disorders, such as overconsumption of the elders is loneliness. This is due to the growing alcohol, loss of self-esteem, extreme forms of anxiety, “empty nest syndrome�. The children go away to powerlessness, and stress. Loneliness predisposes THE

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a person to physical diseases too as it has adverse impact on immune, cardiovascular, and endocrine system. Consistent, overwhelming and pervasive loneliness can lead to chronic stress which can ultimately culminate into serious physical disease.

For instance, feelings of loneliness and being alone have been found to be associated with motor decline in old age, functional decline and mortality, memory KORCKTOGPV CPF NGCTPKPI FKHĹżEWNVKGU #N\JGKOGTĹ?U disease (dementia).

Loneliness: the Indian picture In India, in addition to increasing population of the elderly, changing living situations (living alone or living with relations and non-relations) are the main demographic breeders of loneliness. Some other factors like widowhood, increasing dependency ratio (10% in 1961 to 13% in 2001) as well as economic dependency (86% rural and 83% urban females& 51% rural and 56% urban males); and solvency are major contributors for developing loneliness.

Moreover, environmental factors like type of family, social network, transportation issues and place of residence, population migrations etc., are also some QVJGT UKIPKĹżECPV EQTTGNCVGU QH NQPGNKPGUU 9QOGP CTG reported to be more at risk for loneliness and isolation VJCP OGP 0CVKQPCN 5CORNG 5WTXG[ 1HĹżEG 0551 QH India on the condition of aged in 2004 indicated that 1.23 million men and 3.68 million women are living alone and faced loneliness. Other Indian statistics reveal that about 3% of elderly men live alone while another 3% live with other relations and non-relations and among elderly females 8% live alone and another 7% are reported to live with other relations or nonrelation. This number is increasing day by day.

What can we do to help?

Several researchers report interventions for loneliness. These interventions are to be individualized to control expectations as per personal GHĹżEKGPE[ CPF KORTQXG ECRCEKVKGU VQ UQEKCNK\G Behavioral training and feedback regulate behavior and reduce loneliness. Thus, loneliness is a treatable, rather than an irreversible condition. Apart from TH E

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planned interventions, there are some other useful UVTCVGIKGU VQ ĹżIJV CICKPUV NQPGNKPGUU NKMG MGGRKPI oneself busy, sharing feelings, involving self in activities such as spending time together, discussing problems, maintaining interactions, helping others, developing quality relationships with people who share similar attitudes, interests and/or values, collecting good thoughts and managing unfortunate happenings, connecting to groups of self-interest, obtaining treatment for physical ailments, and staying in contact with family and friends.

Some Tips to Help Beat Your Aging Parent’s Loneliness - Spend quality time, cherish your past memories.

- Communicate frequently.

- Socialize at regular intervals.

- Check out community resources for elders where your parents live.

- Take them to events they may enjoy.

- Involve them/ ask their advice on important family decisions.

- Consider teaching your elder to use technology to rebuild and retain connections.

- Create a remembrance album.

Tips for creating a remembrance album x Collect the pictures of your loved ones x Write down your memories that you wish to share x Write about your favorites such as- your pet dog, awards/prizes won, any historical events, your hobbies etc. x Write messages for your loved ones – word of advice, best part of them, good bye x Organize your memories; you can also decorate your remembrance album x You can even make a scrap book of your memories!

Above all, don’t let us forget, in the process of growing, that our parents are getting older too.

They too have a life, some beautiful memories and a birthday to celebrate!

Dr Seshadri Sekhar Chatterjee MBBS, MD Post doctoral fellow )GTKCVTKE 2U[EJKCVT[ NIMHANS

/GPVCN JGCNVJ ĹżTUV aid for Alcohol / Addiction Issues

What are drug use problems?

They are problems related to using drugs (e.g. alcohol, cannabis, sleeping pills, narcotic substances like opioids, ecstasy, cocaine etc..) at levels which can cause harm either immediately or later. The harm is not only to the person using it but also to others around/ related to the user.

Problems leading from the use of alcohol and other psychoactive drugs include: 1. Impaired ability to take right decisions 2. (COKN[ QT UQEKCN FKHĹżEWNVKGU G I TGNCVKQPUJKR YQTM ĹżPCPEKCN RTQDNGOU 3. Legal problems 4. Injuries following drug use (e.g. as a result of accidents, falls and violence) 5. Mental health problems (e.g. panic attacks, psychosis, suicidal thoughts, behavioural problems and mood disorders) 6. Medical problems including damage to heart, brain and other organs

drug: 1. &KHĹżEWNV[ EQPVTQNNKPI VJG COQWPV QH VKOG URGPV using or the quantity used 2. Needing more of the drug to get the same effect 3. Problems in cutting down or controlling use 4. Experiencing unpleasant stopping or reducing

symptoms

when

Approaching the person about drug use problems. x Try to talk to the person in a quiet and private environment x While approaching be calm and reasonable x Ask the person about drug use without making any assumptions of your own x 9JGP VJG RGTUQP ĹżPKUJGU VCNMKPI TGRGCV DCEM what you have heard them say and allow them to clarify any misunderstandings x Focus of the conversation should be on the person’s behaviour not their character x Use “Iâ€? statements instead of “youâ€?statements

How to recognize the signs of being addicted to a THE

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Ŗ Take on the person’s responsibilities Ŗ Cover up or make excuses for them Ŗ Deny the person’s basic needs If the person needs other supports Inform the person of supports they may turn to (e.g. hospitals/treatment centers, family members) and allow the person to decide which would be most appropriate.

What to do if the person is in a drug affected state

(e.g. “I feel worried/angry/frustrated when you…” instead of “You make me feel worried/ angry/frustrated…”) x Do not get drawn into arguments or discussions about other issues x Do not criticize the person’s drug use x Do not call the person an “addict” or use other negative labels x Be non-judgmental x Ask the person if he/she would like information about problem drug use or any associated risks.

If he/she agrees, provide him/ her with relevant information about local services x If the person wants help to cut down on drug use offer help What to do if the person is unwilling to reduce drug use Do not feel guilty or responsible for the person’s decision to keep using drugs. It is important that you maintain a good relationship with the person.

Let the person know you are available to talk in the future.

Do NOT: Ŗ Use negative approaches (such as lecturing or making them feel guilty) as these are unlikely to promote change Ŗ Try to control the person by bribing, nagging, threatening or crying Ŗ Use drugs with along with the person TH E

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Stay calm and assess the situation for potential dangers to the person, yourself and others. Ensure safety. Talk with the person in a respectful manner using simple, clear language. Be prepared to repeat simple requests and instructions as the person may ſPF KV FKHſEWNV VQ EQORTGJGPF YJCV JCU DGGP UCKF Do not speak in an angry manner. Try to prevent

the affected person from engaging in dangerous behaviors, such as driving a vehicle or operating machinery. Tell the person that it is dangerous to drive even though they may feel alert, and if not willing to listen, call the police.

How to deal with adverse psychological reactions Aggression: x Talk in a calm, non-confrontational manner. x 5RGCM UNQYN[ CPF EQPĹżFGPVN[ YKVJ C IGPVNG caring tone of voice. x Try not to provoke the person; refrain from speaking in a hostile or threatening manner and avoid arguing. x Use positive words (such as “stay calmâ€?) instead QH PGICVKXG YQTFU UWEJ CU Ĺ‘FQPĹ?V ĹżIJVĹ’ YJKEJ may cause the person to overreact. x Consider taking a break from the conversation to allow the person a chance to calm down. x Try to provide the person with a quiet environment away from noise and other distractions. x If indoors, try to keep the exits clear. x If violence has occurred, seek appropriate emergency assistance.

the following signs or symptoms: - Irregular, shallow or slow breathing - Irregular, weak or slow pulse rate - Cold, clammy, pale or bluish coloured skin x Severe alcohol withdrawal signs include:

Panic attacks

- Fever

Take them to a quiet environment away from crowds, loud noise and bright lights and monitor closely, and in case of deterioration seek medical help.

- Seizures

Psychosis, mood disorder & suicidal behaviors Intoxication can lead to many problems in behavior and the use of some drugs in vulnerable persons can lead to severe mood changes, suicidal behavior or serious behavioral disorders called psychosis (having visions, believing falsely that the person is being harmed, impaired judgment). Such conditions should be treated as emergencies and the person should be immediately taken for medical help.

Alcohol related emergencies x The person may be continually vomiting, unconscious, may have head injury

- Confusion - Hallucinations In the event of the above emergencies, the person must be shifted to the hospital for immediate medical attention.

First aid is important to save life, prevent medical complications, and bring to control behavioral RTQDNGOU +V KU VJG ĹżTUV UVGR VQ IGV VJG RGTUQP JGNR HQT his or her addiction.

Dr. Linda MD Psychiaty, PDF, Center for Addiction Medicine, NIMHANS

x Alcohol poisoning is suspected when there are

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2U[EJQNQIKECN ſTUV CKF HQT domestic violence Meera is a 33 year old married woman and she works in a garment factory. She has two children, both girls.

One day Meera looked unusually preoccupied and troubled. A colleague of hers noticed this and asked her what was wrong. Meera started to cry and after giving her colleague gave her some support and words of consolation, she opened up about herself and her life. She told her that to the world, she and her husband made a picture perfect couple but the reality of her marriage was entirely different. She has been married for 10 years now but lives under constant fear that she or her daughters may say or do something that will upset her husband. Every evening after returning from work, her husband would start verbally abusing her, and sometimes WPFGT VJG KPƀWGPEG QH CNEQJQN YQWNF GXGP DGCV JGT and their children. He has even asked her to leave home in the middle of the night and bears a grudge against her for not bearing a male child and takes his hatred and frustration out on their daughters as well. Meera’s in-laws also support their son and refuse to intervene in this matter. On asking why she continued to be with him for so long, she replied “I have nowhere to go, I can’t burden my parents and siblings and it is hard for a single woman to raise 2 girl children in this society. What will people say TH E

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about me and my daughters?”

The above case is just one of the few examples of women in our society. Despite such adversities, women often don’t seek professional help for the injustice they are exposed to. Domestic violence is one of the most common crimes against women which is prevalent throughout the world, cutting across boundaries of culture, class, education, income, ethnicity and age.

Women are made victims in a patriarchal society, especially in a country like India, where women have a disadvantaged position in society compared to men. Men as a result do not give due regard and respect to their partners which often becomes a source of learning for their children who in turn carry forward these attitudes when they get married.

Violence against women can be physical, sexual, psychological/emotional/verbal, and/or economical in nature, it can be real or a threat of physical, emotional, economical or sexual violence. Physical violence includes acts of physical aggression such as slapping, hitting, kicking and beating. Sexual violence includes but is not limited to forced sexual contact,

intercourse, and other forms of sexual coercion.

Psychological abuse includes acts like intimidation, constant belittling, humiliating, nagging and various controlling behaviors such as isolating a person from family and friends, monitoring their movements and restricting their access to information or assistance.

Economical violence can be denying a person money.

Violence may be a single incident such as rape by a stranger or ongoing as in the above example of domestic violence. Since exposure to such violence JCU KOOGPUG TCOKſECVKQPU QP OWNVKRNG FQOCKPU QH a woman’s life (physical health, emotional health, relationships etc.) it is essential for the person who comes in contact with women experiencing domestic XKQNGPEG VQ ſTUV GPUWTG UCHGV[ QH VJG YQOCP 5QOG of the following practical tips may help a woman experiencing violence, stay safe: ž Encourage the woman to store all her belongings and children’s essential belongings (including important documents like identity RTQQHU EGTVKſECVGU OCTMU ECTFU GVE KP QPG UCHG place, so that she can take them with her if and when she has to leave. She may also consider keeping important documents with a friend or family whom she trusts. ž Encourage her to take help from trusted family members or friends. ž Tell her to keep all possible harmful objects out of reach of the spouse. ž Ask her to always keep a mobile phone handy with numbers of trusted friends/family in speed dial; set it up for her if she doesn’t know how to. ž Ask her to prepare a safe place in the house where she can lock herself and her children so that they are safe till the time it is safe for them to step out. ž Prepare the woman to leave the house anytime violence happens. ž Tell her to call women’s organizations for help and to keep the numbers handy.

ž She may also register a police complaint to be on the safer side and not hesitate to call the police when in need. The woman will feel OQTG EQPſFGPV CPF UWRRQTVGF KH UJG IQGU VQ the police station accompanied by someone she trusts, and this may even be a case worker from a woman’s organization. ž Tell her to prepare the children as well to be ready to leave and educate them about staying safe. ž In case of leaving the house, the woman has to be prepared about the place where she is going to go after leaving the spouse, the woman has to be careful not to give her new address or phone number to people who may pass it on to her husband (that is, if she does not wish to be contacted by the husband). ž Explain to the children how they can stay safe, especially when they are in school or playing in the neighborhood. The woman may also avoid going to work for awhile or be escorted or take a different route to work and in extreme situations, consider a change of job or place of residence or school for the children. ž 9QOGP QHVGP RTGHGT VQ FGHGT VCMKPI C ſPCN decision—so, it would be important to say that her safety is priority over everything else.

It is also important for women to know where and whom to approach for help. There are organizations like Mahila Sahayavani and Vimochana which are well known in Bangalore and have been working towards empowering women survivors of violence.

NIMHANS has also set up dedicated clinics like Trauma Recovery Clinic and Awake Clinic to provide services ranging from supportive and individual therapies, telephonic counseling, referral and information services to prevent gender based violence. Contact Number for clinic: 080-26685948 or 9480829670 Dr. Ajay Prakash MBBS,MD Psychiatry, PDF Women’s Mental Health, NIMHANS

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What Qualities should you praise in your Child? ĹŽ#EVKQP URGCMU NQWFGT VJCP YQTFUĹ? 6JKU UC[KPI holds true with my children. I am always proud of my children for what they are. My older child is very gentle, humble, kind at heart, loving, caring and has many more human qualities but, he is less vocal.

There are many instances that made me feel this way about my child. Once, when he was just eight years old, we had a family get together in our native place.

All of us were happily enjoying our stay when he came to me with tears rolling down his cheeks and anguished expression on his face, and asked me to JGNR UQOGQPG RQKPVKPI JKU ĹżPIGTU VQYCTFU VJG OCKP door. I immediately went out to check and found two elderly people begging in front of our house. “Why should they beg? Please help them, they are too oldâ€?, my son said.

Similarly, one day we went to a nearby grocery shop and were returning home. There was a crowd gathered around a person who had fainted and all were inquiring what had happened to this gentleman. My child immediately grabbed the juice bottle from my bag and tried to feed the person and I was surprised that this thought didn’t strike me.

I have always praised and appreciated my son for these qualities.

I also have my younger child who is a good singer and mesmerizes everyone with his melodious songs.

He loves to have fun and is a good entertainer. I feel proud of their innate qualities and have always encouraged them in all their accomplishments.

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VTQRJKGU CYCTFU OGTKV EGTVKſECVGU CPF UQ QP $WV most of them don’t bother to reinforce qualities such as integrity, respect, compassion, and love in their child. I suggest that parents should appreciate their child’s positive behaviors and not just their achievements, such as: x x x x x x x x x x x x x x

Helping someone who is hurt Standing up for their friend/sibling Assisting the elderly at home )KHVKPI UQOGQPG YKVJ VJGKT QYP OQPG[ Caring for and being kind to elderly relatives Showing compassion towards others Providing opportunity to others Helping a weaker classmate Offering sincere advice to a friend /sibling )GVVKPI KPXQNXGF CPF VGCEJKPI C [QWPIGT UKDNKPI Valuing friendships Asking for forgiveness Making successful small decisions Accepting failures and trying again and again to succeed x Accepting rejection with grace and dignity x Appreciating what they have Appreciating our children when they display qualities such as the above would go a long way in building their character and shaping them into honest citizens of this country.

Ms. Padmavathy D Ph.D Scholar +P %JCTIG 0WTUKPI 1HĹżEGT NIMHANS Centre for Well-Being.

Yoga is Unique

Yoga is an ancient practice which originated in India, and its practice has become necessary in modern life. We are going away from nature and our quality of life is decreasing and this is responsible for our health problems. Health is a positive concept and positive health does not mean merely freedom from disease. Rather, it includes a jubilant and energetic feeling of well-being with an amount of general resistance and capacity to easily cultivate immunity CICKPUV URGEKĹżE QHHGPFKPI CIGPVU +V KU C UVCVG QH delight or a feeling of spiritual, physical and mental well-being and not merely the absence of disease CPF KPĹżTOKV[ 6JG CKO QH [QIC KU VQ GPEQWTCIG C healthy life style for physical, mental and emotional health and to attain happiness by getting rid of suffering. On 11 December 2014, the United Nations )GPGTCN #UUGODN[ 70)# CRRTQXGF VJG RTQRQUCN VQ EGNGDTCVG ĹŽ,WPG Ĺ? CU VJG ĹŽ+PVGTPCVKQPCN ;QIC &C[Ĺ?

What is Yoga?

6JG VGTO ĹŽ;QICĹ? KU FGTKXGF HTQO VJG 5CPUMTKV TQQV YQTF ĹŽ[WLĹ? OGCPKPI ĹŽ7PKVG Ĺ? 6JKU OKIJV DG interpreted as the union of body, mind and soul.

Yoga is thus integration of personality and is a healthy way of life.

1DUGTXG MKFU YJQ CTG QH ĹżXG QT UKZ [GCTU 6JG[ CTG PQV UGNĹżUJ CPF VJG[ FQPĹ?V DGCT ITWFIGU QP CP[QPG They are always happy and it is our true nature. By removing the impurities of mind we will be innocent, childlike and happy. This can be done only through yoga.

Advantages of Yoga: Is your body in shape? Is it healthy? Do you waste lakhs of rupees on surgeries?

Many of us became like robots, very rigid and

OGEJCPKECN )QF JCU ETGCVGF WU VQ NKXG YKVJ GCUG 1WT DQF[ JCU VQ DG ƀGZKDNG +P VJKU TGICTF ;QIC KU C DQQP to modern life. It effectively cures lifestyle disorders such as diabetes, hypertension and obesity. Yoga is now accepted as a complementary therapy by many doctors, psychologists and psychiatrists. The Western culture is also accepting yoga as a healthy lifestyle.

Experts from renowned institutions India and all QXGT VJG YQTNF JCXG GORJCUK\GF VJG JGCNVJ DGPGĹżVU of Yoga in terms of boosting immunity (University of Miami), curing backbone problems (Vivekananda Yoga University, Bangalore), controlling high blood pressure (Yale University), controlling obesity (CSM Medical University, Uttar Pradesh). .KUVGF DGNQY CTG QVJGT DGPGĹżVU QH ;QIC 1.

Effective Functioning: Yoga not only improves physical strength but also helps to develop mental and emotional balance. Asanas or postures and meditation aid physical, psychological and emotional health. Yoga is JGNRHWN VQ MGGR QPGUGNH RJ[UKECNN[ ĹżV OGPVCNN[ alert and emotionally balanced.

2.

Reduces Obesity: Yoga helps to reduce overweight. Sun salutations and Kapala Bhati pranayama help in reducing obesity.

3.

Stress Relief: Pranayama, meditation and practicing yogic postures aid in stress relief.

Practicing Yoga even for a few minutes regularly reduces stress levels.

4.

Peace of Mind: We feel happy by visiting beautiful places. But we do not recognize that happiness is inside the mind. By doing Yoga, you will experience happiness and peace from within.

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5.

6.

7.

8.

Increases Immunity: Yoga develops immunity and protects from many diseases.

Conscious Living: Mind will not stay in the present moment. Most of us worry about future or think about past. This increases anxiety. Yoga and meditation helps to live our life consciously and bring our mind back to the present moment, enhance concentration and achieve success in life.

Renewal of Energy: By practicing Yoga, we will be energetic throughout the day and be active and alert.

Easy Movements: If we want to do our activities well, our bodies should be free from pain. Daily ;QIC KORTQXGU GCU[ OQXGOGPVU CPF ƀGZKDKNKV[ in our body.

CAUTION: Patients suffering with cancer, diabetics, heart problems, high blood pressure, HIV, multiple sclerosis and women with pregnancy should do Yoga with medical advice to avoid complications.

Yoga is not an Exercise Yoga and other exercises such as gym, walking and skipping have a lot of difference. In exercises, the

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emphasis is on strength of organs which improves ĹżVPGUU $[ RTCEVKEKPI [QIC FCKN[ VJG YJQNG DQF[ becomes rejuvenated. In Yoga, blood pressure will be stable whereas in exercise, BP increases. In Yoga, both voluntary and involuntary muscles will be activated, but in exercise only voluntary muscles will become activated. Thus, while both Yoga and GZGTEKUG JCXG UKIPKĹżECPEG ;QIC KU WPKSWG KP VJCV KV KU a lifestyle and not merely exercise. With International Yoga Day (June 21) becoming an annual feature, yoga has gained popularity like never before. Most institutions are making it compulsory, and gyms have introduced yoga classes in between the aerobics and zumba.

In conclusion, Yoga is a unique and encompassing philosophy about how we live our lives. It unites the body, mind, and soul, thereby making this journey QH NKHG ECNOGT CPF OQTG HWNĹżNNKPI Mr. Pradeep Jakka M.B.A;M.Sc (psychology); 2 ) & ) % 0'6 5'6 2J &

The ROSes (Recovery Oriented Services) CafĂŠ Dr. Sailaxmi Gandhi for the PRS team

The ROSes CafĂŠ is a new clinical initiative by

6JGTG CTG RQUUKDN[ QVJGT DGPGĹżVU UWEJ CU HGGNKPI

the Psychiatric Rehabilitation Services (PRS) at

more alert, attentive, sharper memory (cognitive

NIMHANS that engages persons with mental illness

skills) and interacting with others (social skills).

in the recovery process. This CafĂŠ is manned by a

Working here also gives you a sense of importance

team of recovering persons led by an instructor

as you earn money (only if you have been regular

who is also a caregiver. This CafĂŠ is consumer run

and working well) every week-end.

and supported by professionals. Work starts in the morning by 9 AM and goes on upto evening 4 PM. It

This initiative also looks at home based rehabilitation.

is well organized with three cadres for persons with

Work has commenced in the area of various

OGPVCN KNNPGUU ĹŒ CEEQWPVKPI CPF GPVT[ QH ĹżPCPEKCN

preparations such as rasam/chutney powder as

details in the computer (also involves placing online

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those who are on tube feeds or are convalescing.

withdrawing money using a cheque, etc.); cleaning vessels, grains and cutting vegetables/fruits; and

Here are some real time experiences of those working

cooking. This cafĂŠ provides healthy snacks such

here: “Working here makes me feel good�, “I look forward

as sprouts, kabuli channa, fruit salad, etc. and

to working in the ROSes CafĂŠâ€?, “At last I am allowed to

beverages such as tea/coffee/green tea/lemon tea/

use the knife and the mixie which I was not allowed to even

bournivita/buttermilk/fruit juice/carrot juice, etc.

touch at home�, “Cooking gives me a lot of satisfaction�, “I get to eat some of the snacks and also earn money on

The process of cooking has a multi-sensory therapeutic

weekly basis�‌‌..

effect. All the sense organs are stimulated. The bright vivid colours of various fruits and vegetables,

To conclude, in today’s world, cooking and serving

the tantalizing smell emanating from the cooking

food is a very handy skill. It enhances independence

section, the sound of cutting and washing, the feel

and is one of the instrumental activities of daily

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living, which will facilitate and enable the recovery

stimulation of one’s taste buds while consuming

of persons with mental illness.

yummy, delectable and scrumptious healthy snacks!

THE

LOUDSPEAKER

Amplifying the voice of mental health

27

PSYCHIATRIC REHABILITATION SERVICES introduces ROSes CAFE, a consumer-run, professional supported initiative in PRS that serves healthy snacks and beverages.

MENU Beverages Tea (normal, green, lemon) Coffee Bournvita Healthy Snacks (any one) Sprout Salad Mixed Sprouts Fruit Custard Sabudhaana Kichdi Steamed Sprouts Oats Cutlet Poha Dhokla

EAT HEALTHY AT AFFORDABLE PRICES OF Rs.10/15

But where?

Λ ŽŵĞƐƟĐ ƐŬŝůůƐ ƐĞĐƟŽŶ͕ PRS

Timings 10:30 am-1 pm

Call for orders / enquiry 080-26995289

Printing of the Magazine funded by: Dr. Ramachandra N Moorthy Foundation for Mental Health and Neurological Sciences TH E

28

LOUDSPEAKER

Amplifying the voice of mental health