A One-Man Battle

“Oh my god, are you really crying over this? Don’t be such a girl!  Come on, be a man!”

Since their childhood, men have been taught to hide their feelings, masking their sensitive side with a strong and impassive exterior.

To cry is termed as “girly” and emotions are usually dismissed, asking them to “man up” as opposed to seeking help.

These kinds of social norms around masculinity can be extremely detrimental, especially when it comes to your mental health. It can make it really hard for many of us to acknowledge when we’re not doing too well and even harder to reach out to potential sources of support that can help us during that time.  The greatest evidence of male vulnerability is in suicide statistics. Among Canadians of all ages, four of every five suicides are male.  It was also found that men are 50% less likely to seek help, even from close friends or family.

Shawn Henfling Quote

As of February 4th, 2016, according to the Office of National Statistics UK, there is a significant gender gap in British suicide, with men more than three times as likely to kill themselves as women. The same scenario is seen in the case of people undergoing treatment for alcohol and substance abuse.

This paints a very clear picture. Women are more likely to seek outside help, while men prefer to bottle up their feelings. They aren’t inclined to talk about issues they might be facing, and as a result turn to alcohol or drugs for solace. With time, this leads to their abuse and manifests as a violent social behaviour. This is why men’s mental health is often termed as a “silent crisis”.

The first step towards helping yourself is to identify some telltale symptoms of depression and anxiety. These can include:

  • Increased anger or irritability
  • Eating disorders
  • Feeling tired all the time
  • Loss of interest in activities you usually enjoy
  • Constant anxiety and fear.
  • Increased need for alcohol or drugs
  • Suicidal thoughts or inflicting self-harm
  • Frequent violent outbursts
  • Obsessive thinking or compulsive behaviour
  • A feeling of hopelessness

These symptoms if gone unnoticed or not acknowledged on time can extend for months or even years. It can adversely affect your work life as well as your private life. If you feel like you might be facing the beginning of any mental illness, do not consider it as a sign of weakness or failure. Instead, seek help from someone you are comfortable with and trust me, they will be only too happy to help. It is perfectly okay to confront your inner demons by seeking outside help, and in no way does it make you any less of a man.

So to all men out there, remember, it does not always have to be a “one-man battle”.

 

-M.A. Ramya

Depression is real

Depression…..

A word which is thrown about in today’s age of left leaning liberal millennialism as if it means nothing…..
Does it ?

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I was sitting one fine evening looking at the rain pouring down, the drops smudging the dust on the windowsill, looking like tears cascading down the glass pane…..Johny Cash was crooning out Hurt in my ears and I was reading the Color Purple by Alice Walker. I looked up to see the beautiful sight in front of me, and cried. Spontaneous, sudden…..unexpected. I wiped my tears away to prevent someone from knowing what had happened. Seems like a routine situation save doesn’t it ? I thought so too. Till I couldn’t go back to the book. Because my mind kept racing back like the prodigal son it was to what had just happened. Trying to decipher why it had happened. And why I decided to hide it. Looking towards the rain splattered outside….I tried to figure out….Why ?

I hurt myself today
To see if I still feel
I focus on the pain
The only thing that’s real 

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I was depressed. If I told people I was….They would ask me to ‘suck it up’, ‘grow a pair’ and other such phrases which people throw around without a hint of knowing what the consequences are. I was told to know my life was good and hence I should not feel entitled to depression. I was told I am loved and I had no reason to be hurt…..that I was just a spoilt little brat. I wasn’t. You see, Depression like most things do not go away with entitlement. It is hurt. No, not like a pin prick or a car crash or even like cancer. It is the indescribable feeling of an asphyxiating child being pushed inside an empty grave while all he tries to do is figure out the one last soliloquy he needs to sing to give his life meaning. That didn’t make sense ? Neither does depression. It is the feeling where you feel crushed and helpless, but you do not know why…..

I wear this crown of thorns
Upon my liar’s chair
Full of broken thoughts
I cannot repair
Beneath the stains of time
The feelings disappear
You are someone else
I am still right here

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Next time someone tells you they are depressed, do not ask them to stop whining, do not presume you can help them…do not patronize them. Hug them. Let them know that the day they feel like ripping their face off in agony…..they can run and come to you. Hug you. Cry on your shoulders…..let them know that in a planet of over a billion people, they can turn to one. Trust me, the pain, the agony, the smoldering fire of madness which cannot be rhymed or reasoned with…all they need is the solace of a comforting fellow human. For the warmth of a human heart is the medicine to anything, while the jeers of human wrath is the ever present conservative hand shutting a person down. Let the depression sink in. Let it stay. So do you. I didn’t figure out the reasons for the tears yet….I never needed to. Loving friends and family ensured I finished my book in peace and enjoyed subsequent nights of torrential downpour in all it’s natural beauty. Depression is real. Not a social media whack, not a rich person’s perpetual whines…..It is a issue affecting the human psyche. In today’s fast paced world….We all have been depressed sometime or the other. And a depressed person needs support. Not antagonism. Support. Because depression is real. It is a red flag, an incessant drone at the back of the human mind…..Depression is real.

And you could have it all
My empire of dirt
I will let you down
I will make you hurt
If I could start again
A million miles away
I would keep myself
I would find a way

– Soumyajyoti Bhattacharya

Image Credits : Google Images

Depression

I woke up today,
with an heart almost broken,
Bleeding tears through every crack left open,
My soul feels ice cold, and there’s voices in my head,
Silently screaming all at once,I don’t know if I’m alive or if I’m dead,

Everyday feels worse, I can’t keep my eyes open,
Everytime I shut them down, nightmares awaken,
I feel pain and I feel numb, paralyzed but shaken,
Hateful eyes spitting venom, my safe places all forsaken,

Will anybody miss me? Will anybody care?
Will they even notice when I’m no longer there?
I feel invisible, I’m choking on myself,
My mind feels claustrophobic like it’s crushing on itself,

It’s hard to go to bed, and It’s hard to wake up,
Like a dog without his bone, I feel lost and all alone,
I want somebody to know, I want somebody to care,
But I’m too afraid being judged, when I leave my feelings bare,

All my tears feel like acid, My voice is always broken,
I just want to see, a Human Being being human.

Just another cut, Just another scratch,
“What’s that little mark?” “No, that was just my cat”
Just another excuse, Just another lie,
“You wear bracelets now?” “Just fashion, why?”
Just another tear, Just another scream,
“Vishal, were you crying?” “No, Just had a bad dream”
It’s not just a cut, or a tear or a lie,
It’s always just one more, till the day that I die.

– Vishal Muralidharan

Recognizing the warning signs of Suicide in people & helping them

 

According to the WHO, on an average, one person commits suicide every 40 seconds.

Suicide is a complex phenomenon and not an illness in and of itself. Suicidal ideas and attempts are important to look for and evaluate. Unquestionably it is hard to predict who will attempt suicide but, it is possible to characterize the risk aspects keeping in mind that it is a risk and not an absolute prediction.

Some of the common predictors of suicide are persons undergoing extreme/ acute emotional distress of any cause. This could be symptoms of depression or other psychiatric disorders, there could be acute changes in interpersonal relational status, any acute loss/ change in financial status. This is the one characteristic that is most obvious to outside observers who could be friends, family or well wishers of the individual. This is a time when all those who care for the person suffering could express their support by “Just being there”.

Hopelessness as a thought characteristic is significantly associated with suicide. This is basically a sense of there being no future for the person. This could occur in the context of again life stresses such as a breakup, financial losses. Persons experiencing hopelessness may appear listless, not interested in looking towards the future – even towards the immediate future – not wanting to go out, dejected and saying as much.

Substance abuse whether alcohol or other drugs especially increases the risk of suicide in individuals. It has the ability to impair a persons world view and make things appear more bleak than they are.

There are other risk factors that are associated with suicide attempts including a prior history of suicide attempts or self injurious behaviors, family history of suicide, exposure to suicide in a family member or significant person, and exposure to physical or sexual abuse. These factors may increase the possibility that the person experiencing distress currently is at a higher risk of harming self.

So, what can any other person do to help their loved one?

Families and friends are scared of hearing the word suicidal in the context of their loved ones. Rather than jumping to conclusion that they need to be taken to a psychiatrist/ counsellor, the easiest thing that can be done is to be there for the person in distress. This would involve just being present, letting them know that you are there to help if they need and most importantly there is someone if they want to talk.

The sense of having someone nearby who cares for them has a significantly soothing effect on individuals.

A patient, non-judgmental hearing of the persons woes before asking the question “How can I help?” will also go a long way in helping persons put their current problems in perspective. This would enable them making better choices in the form of not harming themselves. Finally before closing, it would be helpful to finish with a sense of hope in the form of saying something like “If there are problems, then there must be solutions and we can find them together”.

-Dr. Shiva Prakash

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Note from the LonePack Team:

People who’re going through a tough time find it difficult to ask for help. It could be anyone from our silent classmate, to the girl we sit next to on the bus.

Can we help show our peers that the world is not devoid of hope anymore?

So reach out to them, and write them a message. LonePack will publish them all on their Facebook “Wall Of Positivity” on Sept. 10th, which marks World Suicide Prevention Day.
Send in your message and share to keep the chain of positivity going. Do join us in spreading some joy and showing some support to the people who need it.   

So, tell me, did you spread some positivity today?

-The LonePack Team

Image Credits: flickr.com

Is being OCD=Perfectionist?

We all wish to be perfect and do our work well. To this aim, we utilise some skills that enable us to channelize our behaviours so that we don’t spend too much time on doing routine chores – e.g. keeping the keys, wallet, shoes etc in the same place everyday, trying to leave work the same time each day to beat the traffic and so on. These things we learn as a result of our experiences and sometimes the difficulties we face. Persons who we call perfectionists invariably have a reasonably good “error checking” system in place and thus, are able to use the above mentioned skills to their benefit. The easiest example to consider would be the character Wasabi from the movie Big Hero 6 who would quote – “a place for everything and everything in its place”.

But, just imagine a scenario where the above skills go haywire and then we have people focusing on the trivial details with an inability to stop the process of error checking. This is not based on any prior learning or a misinterpretation of prior learning taken to absurd levels. Then we have people who are unable to control their impulse to make sure that things (even trivial ones) are placed “exactly right”, doing things over and over (whether it be checking, counting, cleaning or whatever) to “just to be sure”, having illogical/ magical beliefs and so on. This would intrude on their daily functioning and would impair their ability to do the most basic things with any efficiency. This would be OCD or Obsessive Compulsive Disorder.

Obsessions could be anything – a thought, an image, an impulse to do something.

One common feature of obsessions include the fact that at some level, the person having them identifies them as illogical, unnecessary, excessive, intrusive and distressing.

Compulsions are any behaviour(s) aimed at reducing the anxiety that is created by the obsessions. They could be things like doing things a particular way, or doing it repeatedly, or a particular number of times.

Its important to recognise that there are people who are obsessive about certain things and that makes them who they are but, this is different from people with OCD who dislike this part of themselves that prevents them from living a full and happy life.

-Dr. Shiva Prakash

How do I know if it’s just a phase or if it’s something serious?

Psychiatric diagnosis are not made on the basis of checklists  – even though the checklists are very helpful

Depression and related mental health problems are complex and have multiple “causes”. This is important to understand before anyone is to answer the question of whether some is simply dejected due to the life events or is depressed as in ill. The current understand of depression and related mental health condition is that they are Bio-Psycho and Social in nature. This means that they have causes and effects in each of these three realms namely biological, psychological and social.

Let me explain this further with a few examples with depression as the core illness category. There are individuals who experience symptoms of depression such as continuous low mood that does not improve in any situation, crying spells, lack of interest in all activities, changes in sleep and appetite, energy levels and so on and so forth in the absence of any clear environmental precipitating event. Here we would consider a diagnosis of Depression (i.e. biological cause) if the symptoms cause sufficient dysfunction. Now on the flip side, persons with depression (whether life situation related/ biological) have a tendency to be more sedentary (or be less active overall compared to previously). This leads them to have a higher risk of developing certain lifestyle related disorders including elevated blood pressures, risk of cardiac disease and so on. Here the diagnosis has changed certain aspects of biology. There are similar effects and causes in the psychological and social realms.

A diagnosis of depression is made after understanding the context of the emergence of symptoms, the symptoms themselves and the degree of impairment in functioning afforded by the symptoms.

Now, how do we integrate this knowledge with what we already know. The first thing is that psychiatric diagnosis are not made on the basis of checklists (even though the checklists are very helpful). A diagnosis of depression is made after understanding the context of the emergence of symptoms, the symptoms themselves and the degree of impairment in functioning afforded by the symptoms.

Impairment is the core of what psychiatry would aim to reduce.

What is this impairment? Of the many definitions available, the easiest to use is that impairment is the difficulty that mediates the long term outcome related to the illness. Basically what does this illness do that prevents the person fulfill his/ her role. In order to reduce the impairment (again which is Bio-Psycho-Social in nature), treating the underlying symptoms will be essential in a biological, psychological and social fashion.

So, the long and short of it would be that the degree of dysfunction/ impairment, in the context of the presence/ absence of sufficient number of symptoms while keeping in mind the context in which the symptoms emerge determine whether a label of depression is applied to a person or not.

Finally the person who is suffering does not care about whether they have a label or not, all that they care about is not suffering as much – whatever the person who is willing to help can do.

-Dr. Shiva Prakash

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Age Groups Vulnerable to Depression?

Depression is a common problem throughout an individual’s lifespan. Statistics suggest that about one in 20 individuals would have suffered depression at some point of time in their life. But this data is not representative of all individuals. There are some common risk factors that increase the risk of having depression. One of the most common risk factors is experiencing interpersonal violence in any form. This may be

  • physical and emotional abuse and neglect in childhood,
  • bullying during school ,
  • social ostracism in teenage and college,
  • domestic and workplace related violence of any sort in middle and older adulthood.

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Other common risk factors include academic difficulties, physical illnesses, loss of significant relationships, financial difficulties, family history of depression and social isolation.

Typically, people in the age group of 40-60 years have the highest rates of depression possibly due to accumulation of stress over their lifespan. The risk of attempting suicide is higher in teenagers and young adults especially in situations of acute crisis while the risk of committing suicide is much higher in the elderly.

Over 60% of the calls to suicide help hotlines are made by people in the age group of 35-54

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Therefore, rather than asking if certain age groups are predisposed to depression, it would be more helpful to think in terms of “Are certain groups of individuals facing various life events more likely to develop depression?”  An important thing to keep in mind is that all these are risk factors and not causative for depression. Ideally this information should be used in the context of helping individuals in various life situations that may predispose them to depression.

Once again, it is important to realize that not all those who face the situations mentioned above suffer depression. Also not all those who suffer depression face these issues.

The most important thing to remember is to try and have a non-judgmental outlook and to offer our support to those going through a tough time.

-Dr.Shiva Prakash

Image Credits: Google

In what ways can Depression manifest?

Continuing from the previous discussion, we have noted that depression as an entity is different from sadness or grief. It has some clear biological underpinnings that differentiate it from the others. But, what is evident is the symptoms. Major depression/ clinical depression typically presents with a characteristic cluster of symptoms:

  • Persistent and all-encompassing low mood
  • Fatigue and decreased energy or increased restlessness
  • Loss of interest in all pleasurable activities of the past
  • Difficulty concentrating, remembering details,
  • Associated anxious/ empty feelings or irritability
  • Pessimistic thoughts of helplessness, hopelessness, guilt, or worthlessness
  • Thoughts related to death, suicide and suicide attempts
  • Changes in sleep patterns, appetite (usually reduced) and increased physical complaints

While these are the common symptoms, over the lifespan, depression may present itself in many ways. This may accidentally lead to people stating that they don’t have clinical depression even though they are suffering and at times finding it difficult to function. Symptoms of depression in childhood may differ from the above mentioned symptoms in that there may be features of aggression, anger, excessive crying. Children may also manifest a more reactive mood as compared to the persistent and all-encompassing low mood seen in older individuals.

As children age into preadolescence and adolescence, there may be an increase in irritability associated with reduced social interactions and isolation, reduced or increased sleep, sometimes associated with increased appetite and craving for high carbohydrate diet. Typically, this is more than “adolescent problems” and is associated with dysfunction typically in the form of academic decline, conflict with authority, use of drugs or alcohol. Typically college going people manifest symptoms that include characteristics of symptoms found in both adolescents and adults with a general increase in exposure to drugs and alcohol use, and an increase in self injurious behaviors. As people age, there is a greater likelihood of emergence of physical symptoms of depression.

Keep in mind, that while knowing the symptoms of depression is important for you to seek help, self -diagnosis of mental health issues may do more harm than good. A detailed clinical evaluation by a clinical psychologist or a psychiatrist is essential to make a diagnosis and start treatment.

-Dr. Shiva Prakash

Image credits: Anna Borges / BuzzFeed

What is the difference between Sadness and Depression?

Human beings experience emotions. The most common emotions that we experience are happiness, sadness, fear and anger. Of this sadness is a normal human emotion that we all experience in life when we experience something unpleasant – this could be related to a loss, or a disappointment or the like. It is important to recognize that sadness happens to all people but, it does resolve itself over a period of time.

On the other hand, depression is a complex neurobehavioural disorder characterized by a cluster of symptoms. Persons suffering with depression usually have problems that affect their feelings, behaviors, physical health and overall functioning. Typically persons with depression do not spontaneously feel better as in the case with sadness.

The symptoms of depression are varied – the most characteristic being persistent low mood that would appear to pervade all activities of the individual, a lack of interest in all pleasurable activities and a general sense of tiredness. Physically persons suffering with depression may experience problems with sleep, reduced appetite, increased fatigue, increased physical aches and pains. This may be accompanied by varied thoughts of a negative nature in the form of low self-esteem, not having a hope for the future, a sense of helplessness and so on.

Sadness is natural and fleeting. Depression is a medical disorder that will respond to treatment of a psychological and medical nature. Depression is one of the leading cause of disability as per the WHO. It is associated with significant problems with functioning in the form of not being able to do their work, chores or even studies. It can however be treated with proper help allowing people to lead a normal life once again.

                                  – Dr. Shiva Prakash

Image credits:White Swan Foundation for Mental health