Counselling to caring: What it takes to be in good health mentally

Mental wellbeing needs the support of friends and family. (Photo: Shutterstock)

Namrata KohliNew Delhi

More than 50 per cent of the youth (aged 18 to 24) in India have poor mental health, according to a report by Sapien Labs Centre for the Human Brain and Mind. Poor employee mental health costs Indian companies $14 billion annually as it leads to absenteeism, attrition and other problems, said a Deloitte survey of 4,000 workers in 2022. One out of every eight individuals in the world suffers from depression, according to an estimate by the World Health Organization two years ago.

So, what exactly is mental health all about? “The core of mental health is flexibility," says Dr. Ramani Durvasula, a US based clinical psychologist practicing in Los Angeles. She says – “It’s almost like physical health - let’s say a physically fit person has flexibility in muscles and joints, a mentally healthy person has flexibility in their psyche and has adaptability. It is a self-awareness and awareness of others. It’s the ability to engage in novel problem solving and not get stuck on a singular solution. It’s the capacity to be able to self-regulate and to self soothe. When there’s disappointment, there is a capacity to cope with it. Very mentally healthy people have extraordinary flexibility, no matter what trauma they have gone through, they are resilient.” 

Post pandemic, the spurt in mental illness has been significant. According to the World Health Organization (WHO), anxiety and depression prevalence increased by 25% globally. “At TATA 1mg, we've witnessed a notable increase in requests for mental health assistance, both from leading corporations and individual retail customers. This surge has intensified following the COVID-19 pandemic, as individuals grapple with heightened stress levels in their daily lives,” says Dr Rajeev Sharma, Vice President, Medical affairs, Tata 1mg. 

What are the signs and symptoms of mental illness? And how would a layperson know that s/he is actually grappling with it. “Signs include panic attacks characterized by palpitations, sweating, shortness of breath, sudden and intense fear, chest pain or discomfort, trembling, nausea, chills or hot flushes. Or changes in sleep pattern, insomnia, excessive daytime sleepiness, fatigue, irritability, waking up frequently or mood changes,” says TATA 1mg’s Dr Sharma.

Treating the Mental Illness 

Once you identify that “all is not well” with you or a family member, your go-to person should be the family’s general physician. “I am of the opinion that the primary family physician needs to be empowered a lot more. I don’t think we have the kind of experts in terms of ratio to population that every person in the first episode of depression should rush to a psychiatrist... that’s not a doable thing,” advises Dr Samir Parikh, Chairperson Fortis National Mental Health Program. He believes that a family physician can decide whether the patient requires a psychiatrist or a psychologist for giving the psychological first aid.

What is the cost of this session? According to Noida based 49-year-old Sakshi Kashyap, a work-from-home consultant who is taking consults for her 15-year-old daughter Mahika having bipolar disorder, “It is Rs 2,500 for a 45-minute-long session with a clinical psychologist. The fee is the same, whether it is online or offline. The consultations are better offline but online tends to be more convenient and works for us now that we have met the expert in person several times and they know my daughter really well. It's an ongoing process with consults once every week or once every fortnight running into several months.”

What do the experts do? There’s obviously no single cure-all button that can optimize our mental health. A combination of therapies, resources and lifestyle changes are used to treat mental illness. Psychotherapy, which is also known as talk therapy or counselling, involves conversations between a trained mental health professional and an individual or group. Support groups or therapy sessions provide a platform to connect with others who have experienced mental health challenges. These groups offer a sense of community, understanding and the opportunity to share coping strategies. Antidepressants, anti-anxiety medications and mood stabilisers are among the commonly prescribed medications. Complementary treatment such as acupuncture, yoga, or music therapy may also be used alongside traditional treatments.

Mind coach Gita Nath says she starts a “transformative journey” for her clients by listening to them and probing what is causing discomfort and pain. “I gradually direct them to question their limiting beliefs, become mindful of the triggers and take the first step on the path of transformation. Gradually but definitely, they are able to rewire their mind, lead purposeful and happier lives,” she says.

How to Improve Mental Health

There are several ways to keep yourself mentally fit. Consider your diet. Try physical activity. Doing exercise offers a range of mental health benefits, including relieving stress, lifting mood, helping you fall asleep faster and sleep longer. Generally, there is a correlation between mental state and body function and mental state could be reduced by physical disease and depression.

Cut back on social media. Says 47-year-old homemaker Zehra Quereshi, mother of 18-year-old Zahaan who is having anxiety and depression issues, “Constantly consuming information about other people’s lives may cause someone to compare themselves and promote feelings of low self-worth, which increases feelings of anxiety and depression.” Her counsellor advised her son to go for a digital detox, and spend less time on social media. And part of the digital detox therapy has been to keep the phone away and at bay- in the drawer or outside his bedroom while sleeping. He also engages in alternative and more meaningful activities such as connecting with real people rather than virtual friends. He has been asked to turn off notifications or deleted social apps from his phone.

Music, dance, and art are also curative therapies. On 7^th April, 2024 Rishab Rishiraj Sharma, the youngest and last disciple of the legendary Pandit Ravi Shankar, is performing live at Siri Fort auditorium in New Delhi and the concert is titled “Sitar for Mental Health”. An advocate of music, mindfulness and mental health wellness, Rishab has taken the “Sitar for Mental Health” tour worldwide in the last year covering multiple shows in India, the USA, Canada, and South America. He performed live at the "Howdy, Modi!", a grand event that took place in Houston, Texas in presence of the then President of US Donald Trump and India’s PM Modi and was also the first Sitarist to be invited to perform solo at the White House by US President Biden and VP Kamala Harris for the Diwali event. But apart from his musical achievements, Rishab is a vocal advocate for mental health awareness and has been open about his struggles with anxiety and depression. He believes that music has the power to heal and has used his platform to raise awareness and funds for mental health organizations.

According to Dr.Sonia Puar, Clinical Psychologist, Center For Child And Adolescent Well Being (CCAW), “Curative therapies specially for mood disorders such as depression and anxiety include dance, music, art. These have been found to be very effective because they help the child to engage in something and they are mindfully occupied, which is therapeutic in itself. So dancing is effective because it helps them to move their body, get a better sense of themselves. Primarily in such situations, a child is having a negative self-view so when dance is added it boosts their confidence, and they have a better sense of their body too. So, movement helps in that manner. When we talk about music and art they tend to soothe our nervous system. They are very effective in anxiety disorder. So, dance is known to be effective in elevating depression whereas music and art because of their soothing abilities kind of tend to regulate our nervous system which helps us in controlling our behavioural problems and anxiety disorders. It kind of reduces the arousal of our nervous system and brings a balance.”

Dr Puar deals a lot with children and says what is most common amongst children are Neurodevelopmental disorders such as ADHD (attention deficit hyperactivity disorder), autism and specific learning difficulties. So, with neurodevelopmental disorders because there is some difficulty seen in academics right away, and academics being one of the important parameters of success one can say, the  parents are able to identify early in the day and these children tend to see the doctor/expert much earlier than others. Otherwise, anxiety disorders are the highest in children. But they go undiagnosed, they don’t really get treated until they become very severe. But other emotional disorders go undiagnosed or remain undiagnosed for a very long period of time. Mostly children grow up and they come as adults who then figure out that they had difficulty in handling emotions right from their childhood but it remained undiagnosed.

There are many short term and long term programs on breathing, yoga, meditation which have proven to be good for mental well being. Take the case of Isha Foundation’s Inner Engineering Program which has had an impact on lives of many people. “Within two years of doing Shambhavi kriya, I have come out of 20 years of depression,” says Pune based Pranav who says he was in depression for almost for 20 years from 5^th standard till 2020 and didn’t even know about it until during pandemic when he was initiated into Inner engineering program/ "You may not be able to fix the whole world, but you can at least fix yourself. This is why Inner Engineering." Says Sadhguru adding –“If you learn to create the right climate in your body, mind, and emotion, your health, wellbeing, and joy – everything will be taken care of. Mental illnesses are on the rise like never before because we have not taken charge of our own body, mind, emotion, and energy. You need a little bit of engineering. What I call “Inner Engineering” is a technology for inner wellbeing, creating a chemical basis for a blissful existence. If you are conscious, you can activate your system in such a way that simply breathing is an enormous pleasure.”

Thinking constantly has become our habit and our slavery.  Taking some time out for silence brings back the freedom and joy all of us long for. Meditation enables individuals to generate peace and joy within themselves, and achieve clarity. According to Daaji Kamlesh Patel, Guide of Heartfulness & President of Shri Ram Chandra Mission, “Meditation is a powerful tool that can help today's youth stay mentally fit and navigate the challenges of life with greater clarity and resilience. By practising meditation, young people can effectively address the issue of mental thought pollution that often clouds their minds and hearts.” He adds that meditation is not just a personal wellness tool; it is also a tool for reflection, contemplation, and introspection. It helps individuals bring out their goodness and refine their discernment abilities, leading to better judgments and choices. Additionally, meditation aids in reducing stress and tension, which are often precursors to many modern diseases. With regards to how long and when to meditate - You can meditate any time and for as long as you like. Ideally, early morning is the best time to meditate, as it helps us begin the day with clarity, high energy levels, reduced stress, and improved focus and determination. It is certainly a good start. It acts as a tonic for the whole day. I would say, start with 20 to 30 minutes of meditation, and as you become adept, slowly increase the duration for an hour.

Osho's teachings on dance, laughter, and deep breathing are reflective of the interconnectedness of mind, body, and spirit. Dance and laughter are other ways to keep mentally fit. Says Swami Amit Saraswati, Meditation Facilitator & Programs Coordinator, Osho Dham, “Dance, according to Osho, is not just a physical activity but a form of meditation. He says, “Dance seems to be one of the most penetrating things, in which one falls into a harmony. Your body, your mind, your soul all fall into a harmony in dancing. Dancing is one of the most spiritual things there is. If you really dance, you cannot think. If you really dance, the body is used so deeply that the whole energy becomes fluid.”

He says, “Make laughter your prayer. Laugh more. Nothing releases your blocked energies as does laughter. Nothing makes you innocent as does laughter. Nothing makes you childlike as does laughter.”

Mental health is more than the absence of mental illnesses. It is the foundation for well-being and effective functioning of individuals. It includes mental well-being, prevention of mental disorders, treatment and rehabilitation.

 

This table gives the cost of various mental health programmes.