Summer 2015

LOUDSPEAKERTHE

Amplifying the voice of mental health

DEPRESSION

ABCof Antidepressants

City life and

MENTAL HEALTH City life and

MENTAL HEALTH

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...Plus Our Regular Features

Overcoming Forgetfulness

Help in Grief6 29

HallucinationsHelping in

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Editor

Dr. Prabha S. Chandra Professor of Psychiatry Coordinator, NIMHANS Centre for Well Being

Sub Editors

Dr. Prasanthi Nattala Associate Professor of Nursing NIMHANS

Dr. Meena K.S. Assistant Professor of Mental Health Education NIMHANS

Smt D. Padmavathy In-charge Staff Nurse NIMHANS Centre for Well Being

Editorial Board

Ms. Archana Nath

Mr. Manoj Chandran

Ms. Nagashree

Ms. Namratha Nagaraja

Mr. Prabhu Dev

Ms. Tarannum Taj

Ms. Shruthi Rajalakshmi

Cover photos: Sunita Chakraborty Photo Credits:

People who have gone through depression describe it in various ways. The most recent description that I heard was that it was like this years Bangalore rains. They come unexpectedly and create chaos in your life.

One moment the sun is shining and you think all is well with the world, when suddenly the dark clouds gather and before you know it, there is torrential rain, throwing your life completely out of gear. All the plans go awry, you dont know when the rain will end and sometimes you may not even find shelter to protect yourself. I thought this was an apt description of a condition that affects so many people but continues to be undetected and untreated in society.

This issue of Loudspeaker focuses on Depression. We have advice from psychiatrists and psychologists, about sadness and depression, about how to help someone who is grieving, how to care for someone with depression and basic information on antidepressants and the ` talking cures.

We also have stories and the lived experiences of people who have faced and conquered depression (at least for the time being). In addition there is latest scientific knowledge on why people have hallucinations, how the mind deals with pain, simple tips on improving your memory and what city life does to our mental health.

We were a bit apprehensive about peoples response when we released the first issue of Loudspeaker. However, there has been an overwhelming feedback and acceptance from patients and their families and from the public. We have had demand for more copies and more issues.

We hope you gain from reading this issue as much as we gained and learnt from putting it together.

We would like to know more about what works for our readers. Which articles do you like and what more do you want from us?

Please write to us at nimhans.wellbeing@gmail.com with your questions and ideas.

Please look for all the Loudspeaker articles on the NIMHANS website under the Patient Education section.

Editors Note

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

National Institute of Mental Health & Neuro Sciences

Conceptualised and produced by NIMHANS Centre for Well Being

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Amplifying the voice of mental health

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Amplifying the voice of mental health

Contents

Overcoming day to day forgetfulnessDr. Roopesh BN

Elderly people may experience difficulty in remembering names, address, routes, and in extreme cases, the faces of their family members.

How can I help my family member with Depression Dr. Sabina Rao

Individuals with depression cannot just snap out of it or get over it.

When does sadness become depression?Dr. Santosh K.Chaturvedi & Dr. Abhinav Nahar

I had worked very hard for my final exams, but, failed in two subjects. For the next few days, I felt extremely low, and would cry whenever thoughts of the result crossed my mind.

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8Mental Health in the City Ms. Shoba RajaIn India every day hundreds of thousands of people migrate to Mumbai, Delhi, Bangalore and other cities in search of a better life.

Finding a way out of depressionDepression is not a disease but a condition and you should seek immediate help if there are any signs of depression.

Beating depression; with a 4-pronged stick!Chances are the person isnt even listening to you, and just wants a space where he/she can share thoughts that are frightening, often taboo, and terribly hard to admit to.

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Dance your way to good mood .............................. 11Ms. Shruthi Rajalakshmi

The word dance seems to bring with it a sense of enthusiasm and pleasure.

The Science of Hallucinations ................................ 26Dr. G. Venkatasubramanian MD, PhD,

During these dreams, we see things and hear sounds with a feeling that they are real.

Helping in Grief ..................................................... 29Dr. Kavitha Jangam

It is also important not to judge how people exhibit their emotions about the loss, as it can vary from person to person.

White Swan Foundation for Mental Health ........... 37We spoke to Manoj Chandran, CEO of White Swan Foundation for Mental Health about the need for information to be spread in the mental health space and why the conversation on mental health issues should be in the public domain.

How does the mind handle physical painDr. Geetha Desai

When asked about her emotional wellbeing she said she was fine except for the pain

ABC of AntidepressantsDr. Srikanth Miriyala & Dr. Naveen Kumar C

Depression and anxiety disorders result from an imbalance in neurotransmitters such as serotonin, norepinephrine, dopamine, etc.

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Talking cures for depressionDr. Paulomi M. Sudhir & Ms. Systla Rukmini

Psychological therapies are popularly called talking cures based on the understanding that they involve a dialogue between a client and a therapist/counsellor.

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Amplifying the voice of mental health

You can train your brain to be less forgetfulMemory problem or forgetfulness is a common complaint among the elderly and even among adolescents. Some common examples of forgetfulness are misplacing mobile phones, laptops, goggles, keys, TV remote or documents; forgetting an assignment, appointment or other vital events on the calendar; being doubtful about whether we have locked the door or vehicle; forgetting an important item that we were supposed to buy from the grocery store; being unable to recall recently learned information and so on. Some of us are concerned about the extent of the problem and suspect it happens only to us and that these events maybe be indicative of an underlying illness.

Elderly people may experience difficulty in remembering names, address, routes, and in extreme cases, the faces of their family members. Are these normal? Can these instances be passed off as absent-mindedness or are they early signs of dementia?

To understand how to differentiate between forgetfulness and dementia, we must understand how memory is created. Our memory operates in stages. Information enters into Short Term Memory (STM) and then passes on to our Long Term Memory (LTM). The term used for the storage of information in the LTM is called encoding. Most of the information/ situations that we encounter in our daily lives are not necessary or important enough to pass on to the long term memory and most of it is forgotten. Forgetting is an important function to keep our brain from an information overload.

However, it becomes imperative to differentiate simple everyday memory lapses from the serious ones such as dementia.

One of the ways to determine this is to ask or know whether the forgetting is attention related? For anything to be encoded into your memory for successful recall, the information has to be properly

Overcoming day to day forgetfulness

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attended. If a person is not attentive while learning it or while doing a task, then there is bigger chance of forgetting. For example, if you have not paid attention to where you kept your keys while placing it, there is a high chance that you wont recall where you placed them, unless they were kept in their usual place. Similarly, not paying attention to your spouse when listing out grocery items might make it difficult to recall the list. Being preoccupied with many things or paying attention to many things at a time might also make it easy to forget. Likewise, when students do not use a proper reading techniques and if they do not revise at adequate time intervals, it might be difficult to recall information during an examination.

Apart from these there can be various other reasons for everyday memory lapses. Forgetfulness can occur due to stress, fatigue, boredom, anxiety, depression, sleep deprivation, vitamin B12 deficiency, thyroid problems, dehydration, side effects of some prescription medications, alcohol and drug abuse and age related lapses. It is only in extreme cases that forgetfulness occurs due to dementia.

One important way of differentiating everyday memory lapses from the more serious ones (e.g. dementia) is by asking oneself if the memory problems are affecting everyday functioning. Is it happening too often? Is it difficult for you to recall whom you met yesterday/day before or what you spoke with that person? Do you have difficulty recalling recently learned information, even when cues are provided? If the answer to any of these questions is yes, then you n