Is it same as happiness?

It would depend on person to person, because not everyone lives the same lives, or with the same expectations, everyone has different understanding of the world, and vastly vague yet vivid meanings associated with what “happiness” means for them. It is generally believed mental health helps derive peace and feelings of content, but people often forget, that everyone struggles to exist and survive in this society, we just have different experiences and that is where the process of mental health/ wellness begins. So, to feel at peace, content or even happy, one needs to make peace with their past, which most of the times means confrontation of their distasteful past. So yes, mental health is comparable to happiness, on the long run, but efforts need to be put for it.

Can a person seem happier on the outside and still be struggling?

It is generally the narrative, in todays’ society, i.e., people portray themselves as happy to the world, whereas they are struggling to keep themselves from falling apart. No one is to blame for it, perhaps maybe us, when we give others power over our lives, when we let opinions of others influence our lives, when we let others’, expectations overwhelm us while we gradually cut down on expectations, needs and wants we have from ourselves until there are none. I believe, the people who struggle the most are the ones, who are too considerate, too polite to say “no”, have been reared/ conditioned to only obey and not to question, who have difficulty expressing themselves, and such. So yes, it is possible for a person to seem happier on the outside and still be struggling.

How do you explain a person that they need to visit a counsellor or therapist?

To answer that, we need to look at few general assumptions,

• Stigma associated with therapy in India

• The degree of insight in the person in need of therapy

• The severity of problem(s) experienced in life of the person in need of therapy

• How close you are to the person in need of therapy

• Previous experience with counseling/ therapy (If any)

Upon reflecting on the above-mentioned factors (at least), it would depend how the situation will be explained to the person in need of therapy. For example, a case of simple life adjustment problem, it would be necessary to create an environment that makes “X” feel comfortable, where the person of interest does not feel threatened (people who they feel most comfortable with should be there). They (“Y”) will help them make sense of the difficulties “X” has been going through, and then suggest “X” about therapy with carefully chosen words, explaining how it helps, and how it is going to help “X” deal with the problems they are experiencing. Maybe a couple examples of mutual people who took therapy and how their life is going.

Is mental health age specific? If yes which age group is suffering the most and if no justify?

It is not age specific, it can be experienced and/or addressed at any stage of life. The factors that differ are, the stages of life, the problems generally associated in that age group, or expectations from oneself and the ones others have from you in a particular age group. These factors are what determine the prevalence of mental health in any age group. As mentioned by National Institute of Mental Health, Young adults aged 18-25 years had the highest prevalence of Serious Mental Illness (9.7%) compared to adults aged 26-49 years (6.9%) and aged 50 and older (3.4%).

What are your thoughts regarding substance abuse among youth? How does it contribute to mental health issues?

I think children are always given excuse by their parents that, “ek baar ye kar lo, phir aaram he aaram hai” which nudges them on a different way, than the parents would want. After 10th/12th class, children usually go along with stereotypes established by their previous generation, where graduating from school is celebrated as a huge accomplishment, and casual indulgence in alcohol or smoking begins. Followed by negative life experiences in future and inability to face those events head-on, pushes them to seek shelter under the dependence of substance, and there starts a cycle of substance abuse. 

This scenario has plenty influencing factors some of which are –

• Who else indulged in substance abuse in family

• Family environment

• First exposure of substance

• Financial background

• Availability of funds to purchase substance

• Who introduced substance

• Nature of people in life (supportive/ critics)

Substance abuse alters brain chemistry with a lot of visible physical symptoms, and a lot of underlying health ailments and impaired brain functioning.

Is substance abuse age specific?

No, it is not. It again depends on a lot of factors. But children below 7-8 years of age do not have any inclination for substance use/ abuse, and then people above the age of 55 are less likely to indulge in substance abuse, as compared to those who have been introduced in early ages. There are cases of substance abuse, that often leads to acts of domestic violence and abuse of physical nature in Indian society at present.

How would you react if you notice something in someone close to you who is not acknowledging the fact that he/she needs to see a therapist?

Depending on the severity of situation I will pursue the matter. If it is general stress management problem or depression, I would help them be aware of the defining symptoms they are displaying and suggest that they go and see a therapist. If the situation is severe, and the person is unwilling, I would contact an individual, that that person respects, fears, or holds in high regard, and ask them to insist/force the person to seek a therapist. This way, the feeling of fear/ respect would create a window of opportunity for therapist to work.

What actions can a person take to help someone who exhibit any signs or symptoms?

The person can educate themselves, learn more about the situation, and then try to create more awareness about the situation within the family, so that the situation is viewed as any other life problem and not as taboo with a stereotypical lens. And help can be provided to the person in need, without creating a big deal about it in the family.

How affective and cost affective are school based mental health treatments for special needs school children?

Lately schools have been doing their best to uphold the name, by doing everything and anything they can to keep the standard high, even if it means hiring a separate counselor and psychology teacher. And if there are cases that a counselor cannot help, they refer those cases to other clinics or hospitals that have better infrastructure to facilitate the needs of the child.

How can one bring up the conversation of mental health with someone suffering?

This again depends on case to case. Factors that you can look for are –

• How comfortable the other person is with you

• How much you know the other person

• Has the other person shared their troubles with you

• Does the other person feel comfortable confiding in you

• Where the conversation is taking place

• If you have what it takes to present sensitive topics in a subtle way 

Does exercising or yoga help?

Yes, it does. It is scientifically proven, that when we exercise and work out, be it yoga, our body releases certain hormones, that help you feel good, (endorphins). It helps us become more confident and in control of ourselves, feeling which increases with respect to the progress we make.

What advice would you like to give out to the family of a patient?

I would suggest them to be considerate, patient, informed and supportive of the patient, throughout the process of counseling/ therapy, because when patient is at rock bottom, when no one stands there to help, it is family that does, and does so unconditionally. If family choses to help in the counseling process, the effectiveness will increase and there will be significant development in the way patient used to live life, and how they can life.

How should one deal with orthodox people referring to mental health as a taboo?

The people with orthodox way of thinking need something that they can see or witness themselves. Which is not the case with therapy. The narrative going on for centuries, that people with different/ special needs or abnormal way of functioning are insane or mad; being conditioned with this thought process for most of their lives, wanting to stay the way they are, by ignoring the problem, rather than acknowledging it, like an ostrich does upon seeing a problem, is something that is difficult to address. Education and awareness about psychology and allied sciences is the most appropriate way I can think of, that can help desensitize such orthodox people.