Recovery Oriented Blog for Mental Illness

I have recently started a new blog, because I felt that I needed to strictly focus on recovery in serious mental illness, as a theme by itself and calling it any other name would not do justice to my commitment, engagement and research. I have, in the past, tried writing on this blog about mental illness related encounters I have had. However the purpose of the new blog is slightly different.

The new blog is committed to one single theme. All my mental ‘illness’ oriented work would go on that blog as it is also my desire to share with the lay intelligent reader whatever knowledge I interact with, in the course of my phd research. Since a researcher by definition tends to be looking into a vaster expanse of information, data, analysis and study than someone who is not a researcher, for reasons of social good and making research accessible, people could routinely offer small chunks of that knowledge to the wider audience. This is my attempt in that direction.cropped-website-hope-image

However research is not an easy journey to make, for it is largely solitary and a tough act of balancing one’s financial needs, professional goals, study commitments, family responsibilities, domestic routines and you name it. I cannot say I am in any enviable position except that to reduce the monotony of my work, I have started teaching classical music to a few youngsters- it is a breath of air for me. Of course I continue learning with my own guru also- another breather!

This blog post is basically to re-direct anyone who is connected to me for the above reason, to redirect their gaze in a more appropriate corner. You can well imagine that I am likely to post little on this blog, while my focus lies in recovery. However peace is close to my heart and at the heart of all my efforts. If one can help even a single person come into their own center, attain a little peace- they will gradually create their own peace and spread it further as well. I call the new blog- recovering self, because only in re-covering ground that people lose due to setbacks which are called mental illness, do we become our WHOLE SELF again- the self that we were intended by Mother Nature to be. The recovery blog is only meant to be a little offering in wholeness, a testimony to the work I am doing as well as a knowledge sharing blog- diminishing stereotypes about mental illness, challenging convention and offering alternatives.

Hope it accomplishes the intention of its birth.

Understanding our vulnerabilities toward achieving stability

I have a question for you if that’s ok. When you mean you recovered, do you mean you understood the root of your depressions and manic states, your bipolar disorder? Was there meaning, trauma in your life that led to that? And do you not suffer from that anymore? I hope these are ok questions to ask you. (E.L.)

My present blogpost is a response to this query from someone. I think it is befitting that I should answer to an earnest question in an honest manner. I am writing this post specifically so that I can share it with others and not have to make the effort again.

In response to the first question, whether I understood the roots of my depressions/mania- Yes indeed. As well as the triggers.

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This dog knows it can get attacked by its fellow dogs, and so it chooses to sit on someone’s wall and jump inside the house, if other dogs came after him. He knew he was vulnerable and kept the distance from the rest of the mongrels. Why not learn from animals?

What our triggers are – are our vulnerabilities. If one can isolate that it is a great victory and the best way to identify that would be a therapeutic dialogue with a therapist who is kind, wise and non-leading. It is not so easy to find such a person and that is the greatest challenge really.

Dear E. suffering is a part of our human destiny- but it does not have to annihilate us completely- we can live with it peacefully, we can make sense of it on a day-to- day basis and we can find better ways to make sense of things, alternative worldviews and conceptualizations.

Let me explain with an example. I currently suffer from a lot of spinal issues- which is quite painful. But I try to not let it affect me all the time in the day. yes some part of the day it certainly pins me down and when I lie down it just comes over me like a flood. I cannot even sit on the computer for any reasonable length of time that a doctoral reseracher would be expected to. And since spine is affected- so are my arms, legs and feet! I could be a ball of pain- but then I decided I cannot let it have the better of me. I cannot NOT do anything. 

SO, I am not going to compete with another phd candidate who can possibly study eight hours a day- but I will certainly try to do my two today and possibly a little more tomorrow, if tomorrow is not the same as today. This is how we build up our mental muscle- you don’t do it in a day. You do not become another person, you just learn to live with yourself a little more peacefully, more centered, greater equipoise. 

I hope you get the picture- if not please feel free to ask further.

(For those who read my blog with any regularity, pardon me I am not able to write however much I may want to thanks to the cold and my bone issues. But hopefully with summer coming soon, the months ahead would be better. Thank you for staying connected)

 

Caregiver’s stress or psychiatric emergency

On Saturday, the past week, a woman in her early forties, came with her mother and child to see me. The person who needed a counseling intervention was her mother, who came in with a deeply disturbed state of mind. I felt her inner fabric had been suddenly jolted due to a shock and catapulted her into a state from which she could not recover, with her own means.

According to the description of the daughter initially, and later corroborated by the mother herself, possibly two significant events in her life had lead to that. In the distant past, she had lost her spouse, in 2009, which possibly triggered off a grief which could not be duly addressed, or if it was it was not assimilated properly. However, the lady lived a fairly active life despite that, with one of her other daughters, in Bombay. In the recent past, the daughter who accompanied her to meet me, moved from Bombay to Goa, with her family, in response to her husband’s need for better work prospects. That set off another degree of anxiety in her heart, which remained unarticulated.

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All of a sudden the daughter became unwell (she had a bipolar diagnosis) due to adjustment stress in a new situation, whilst otherwise she had been quite stable for long years and off medication of any sort. The news of her daughter falling sick made the mother panic, and her anxiety took a turn for the worse- pushing her off the brink and rattling her fragile balance significantly.

When she came to meet me, for her daughter thought the next intervention required would be counseling/therapy, her discomfort and constant talk made me immediately decide that this was not someone who needed counseling support but immediate relief from her ‘symptoms’. The talk was ceaseless, she was frantic, tearful, anxious, repetitive, and kept saying that she would not take any medicine. The daughter was trying her level best to seek out any intervention that would work for her. I decided within five- seven minutes of listening to her that she would not have any effect of counseling, and requested her to take homeopathy, which she had been taking earlier as well.  But it had not been effective of late. I even referred my own doctor to them, lest their doctor have a limited repertoire, which is mostly the case with homeopathy. Before coming to meet me they had tried other ‘treatment’ options of reflexology, possibly reiki and other things.

I called up my doctor and also made her talk to him, and requested him to intervene, give a prescription which would be followed here in Goa. This is not something that we do frequently- because every doctor needs to meet their patients face-to-face. Doctor sa’ab was kind enough to relent, seeing the lady hysterical, and reporting lack of interest in anything in life, suicidal ideas, and several other indicators.

However , the catch in the whole picture was that she kept saying, that, if my daughter (indicating to the woman with her) comes back to Bombay I will be fine. This was a peculiar situation, because her deepest attachment seems to be with her daughter who is already married with a child of her own. The mother is so deeply attached to her, that it is almost like a parasitic attachment.

They stayed with me for over an hour, but since I had decided earlier, I did not put a bill on the exercise. What is the point of taking money when the recipient is not ready for what you have to offer- I cannot be a mercenary like a ‘professional’ if I remain untouched by human suffering, and focus just on the money that my practice can bring me. The more I thought about it, the more ethical I thought my decision was. Of course I could have told them to leave quickly, but considering they had come a long way, I just let them stay and talk about how to go about it and of course explaining to the daughter the medicines the doctor  had prescribed, since it was me who had spoken to him not her.

The Next Action

Today is Monday, and according to me today the whole routine would have fallen in place. However the daughter called me up today before noon and said her mother was refusing to take the medicines and had gone back to her earlier prescription of homeopathy. She reported a further hardening in the head and was unstoppable. I felt anguished to hear that. I had seen the mother to be a headstrong lady and I could see she was making it difficult for everyone around her to deal with the situation and only making it worse, in every possible way.

That brought to mind the last resort of psychiatry. I thought there was no option but to sedate her to calm her down. It is a very sad thing when I myself have to recommend psychiatric medication to anyone, because I try the best that nobody should be pushed into it. But if there is no alternative left and the person is adamant, what else can the family do? Her behavior must be causing a great deal of stress to her daughter also, poor girl, who was bravely facing it, both in front of her husband and in front of her mother- keeping a calm exterior.

I thought for the time being the best option was to anyhow medicate the lady and help her calm down. Over time when things stabilize and she has had some sleep due to sedation, possibly she would look for other ways to deal with her stresses and the triggers. For now her franticness would only make others spiral into the same. Her daughter said she was herself thinking of the same, as nothing else seemed to be working for now. In other words, the difficulty a family faces, pushes a person into forcible psychiatric intervention. The only trick is that at a suitable time the person has to be weaned away from psychiatric medication, because psychiatrists themselves will never prescribe it!

On that note we parted over the phone- me with a resignation that only when people are willing to get well and be compliant to recommendation of any sort, does an intervention work. Some people make difficult patients- they resist everything, for they know the better of it. I cannot but feel sorry when people have to be administered psychiatric medication, but I always hope that it would be a short term measure. Of course if the patient is complying, like me myself, homeopathy can work very well.

I do not see any recourse except for a devious manner of giving the medication or per force- which actually amounts to a human rights abuse. So that brings in the ethical dimension, as well as the dilemma- what could have been done alternatively? What can be done now? I am not sure today and I leave this post with this query.

Everyone will have a different response to this situation, but how does one decide. I do not know if they will come back to me, because they need not. But I will be around to support them in future, if they choose to. The mother certainly needs counseling to help her deal with the sense of loss that she is suffering from, and to help her focus on what is present in her life, rather than clinging on to adult children, who need to fly away from the nest, towards greener pastures.

I also hope that the daughter would not be unduly troubled by her mother’s suffering, as it creates a scope for her own suffering to surface once again.

On the last note, I am also wondering whether the mother’s suffering is not another face of the caregiver’s burden of looking after a child with bipolar and being tuned to her needs in an obsessive, fussing manner. But there is no way to find out about that, because I had no time to talk to them about their life together. Only this much could be ascertained within the scope that we had, once I felt it would not be proper to dig further into her psychic matrix. Whether this is an ’empty nest’ syndrome, a psychiatric emergency or another form of caregiver’s hyper-reaction to her daughter’s situation, piercing through her own frame, it is difficult to ascertain at this stage.

The First Thing about RECOVERY from mental illness- a readiness to accept it is possible

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A few years ago when ‘Orkut’ was still going around, a young woman sent me a query, seeing me respond to something about bipolar disorder. She sent me a list of ‘symptoms’ and asked me if it amounted to bipolar- was she bipolar by any chance? I was perplexed to receive the query in the first place- it seemed as though she wanted to be classified as bipolar. It was as though it were a club for the privileged and she wanted to part of it! Nothing is farther from truth, for those who have been there, know the suffering of everyone, once gets a mental illness diagnosis. Nobody who is really ‘bipolar in disorder’ wants to be there, rest assured- it is NOT the club I would have chosen for myself. In fact this post is about recovery and why we want to recover from the suffering, rather than remain its captive for the rest of our lives- a captive of moods that imperil your very life, existence and fabric. Schizophrenia equally or more so.

This is also one of the attitudes that I encountered in the course of my own long association with bipolar. To be honest, once the association starts, there is no going back- there is no stepping out of the field of experience any more. I cannot go  back to my pre-psychosis days, for instance. Of course it has brought much by way of experience, (and I have been tough enough to put myself through the rigour of seeking knowledge out of the enterprise)

What was recovery then?

One of the most difficult things, for even me to accept was the possibility of recovery. No matter what anyone would say, I would not believe that recovery would mean going off psychiatric medication. To me recovery was the fact that I was ‘stable’ (not having psychotic breakdowns any more) and relatively functional in most domains of life- from writing, singing, teaching, performing to other social sides of me. But to be off psychiatric medication only the fools would attempt it! Little did I know that someday when I would think of recovery from serious mental illness, it would really begin with the end of psychiatric medication.

Co-morbid conditions notwithstanding (I suffered from thyroid malfunction for 13 years due to lithium, and then due to valproate, there was liver malfunction, which I have not been able to recover from. Apart from this there was PCOD and other issues) I would not believe that someone could go off psychiatric medication and never have a relapse of any sort. To the extent, that I remember that there was a senior psychiatrist in the All India Institute of Medical Sciences, one of the premier institutes in India, who suggested to me that possibly I need not remain dependent on medication for the rest of my life. I was still in my twenties. I was so shocked at his suggestion, that I though possibly he did not understand bipolar very well! I did not go back to him- the fool that I was. Possibly if I had, I would have got off psychiatric drugs long back. But nay, I had to go round the mulberry bush for another decade easily, before I would be able to come to that clarity.

Families and Medication

This brings me to the idea that mental illness has a way out, and medicine is not the only way it works. A few years ago, I had referred someone to my own homeopath, who also had a bipolar diagnosis. He was a younger man, in his early 30’s then. He went and took the homeopathic medicines and started getting better. Unfortunately his life and situations were such that they drove him towards alcohol in the past. Due to his psychiatrist’s advice he stopped drinking while on medication. So once he started getting better with homeopathy, he started drinking again.

His parents started arguing with me that due to homeopathy he was back into drinking again! Nobody starts drinking because of medication – but due to stresses in their daily life, which they are trying to deal with in ways that they understand best. He was unwilling to come into therapeutic dialogue, because that was not something that could have any outcomes as far as they were concerned- it was only for fire-fighting (dealing with emergencies, such as his panic when his wife was pregnant). He would really not come into any clearing- just live his life, do his stuff and then in the evening go out to drink with his friends.

Anyways, the summary of that story is that the boy was brought back into psychiatric medication, because (sadly enough) he could not deal with his parents’s opposition to homeopathy on the one hand, on the other  deal with the reasons that caused him the suffering- which were all embedded in his family dynamics and the family communications, as I could make out quickly.

His father had been dominant all his life (though not in an unkind manner), even as he grew up. It undermined his selfhood and when he grew up, he could not get over the criticism that would come to him from the paternal side, which made him remain ‘small’- as though ‘incompetent’ or ‘incapable’, in spite of being a young man, married and with a child too. Parents can undermine children and, without knowing, mothers become a another pillar of support to the patriarchy which torments young boys – they never understand that their suffering comes from what goes on in their families- not any biochemical imbalances. So how can medicines rectify something which is simply not there– but is there in how people are talking and construing one another?

Most people think that those who recover do so because they are lucky or they have done something special, which they themselves cannot do. The reality is that they have worked on those sides of them, which others are ignoring repeatedly. And getting past parental domination should be on everyone’s agenda- including the parents, to be certain. And this is not meant as an offence. That autonomy which needs to develop in teenage, never develops due to parental over-concern. So parents, if you are reading, please understand your child’s distress is a function of your engagement too- please do not be offended by this statement, because that is not my sentiment. I want to bring this to your knowledge, to help you think of newer ways to go over the same paths.

Otherwise, families will continue to suffer for decades and decades and nobody will know the way out. Please be kind to yourself and your loved ones- but not over-kind.

Emphasis on Recovery- whose focus should it be

The overriding concern of psychiatric services till date has been management of mental illnesses– by any number of drugs and services. Whatever counseling or therapy has accompanied these services, the dominant role has still been played by the model offered by psychiatry (in other words, the DSM)

I am not writing a critique of psychiatry here, because it is unnecessary. It may have had something good to offer, to a lot of people, facing crises, but it does not offer recovery as an option- that is a certainty. If you are willing to submit to its ideas and experiments, newer and newer drugs will keep appearing and they will keep promising newer outcomes; NOT RECOVERY among them.

When recovery is not even an agenda for psychiatric services, to expect that people will get well and fully recovered, just by taking psychiatric drugs and nothing else, is nothing but ignorance. I for one, know from myself and scores of others that, no psychiatrist ever tells a patient that they can go off medication or they can be on their own without drugs (unless they are working in government hospitals, where they are not always working for profits). The bigger issue is that patients and their families keep looking up at doctors to give them the cue that they can be off drugs! They never have the courage to take their own decisions- for everyone who has known psychosis or extreme mood states knows the perils of them. Of course, even if family caregivers tell psychiatrists that their loved ones do not require medication, because the initial symptoms have subsided, they do not pay heed. From self experience, I documented this as part of this research article in 2011.

So whose focus should recovery be, if patients have to recover? I just asked my mother this question awhile back. In fact, in the blog post I wrote before this, about the dilemma of caregivers, I had mentioned about my mother being a very active and militant sort of a person, which she is- not to take any nonsense, to give speeches wherever need be, and in general to stand up for causes that she finds justification in (quite radical actually). Even her mother was a radical in her own time, who the then PM of India, Lal Bahadur Shastri (or was it Jawahar Lal Nehru?) had invited to be part of the parliament. She had declined because one of her children was quadriplegic and there was no one to look after him. In other words, their children have been one of the key priorities of women in my family.

No matter what her personal position in other domains of life,  it was she who was more recovery- focused than me! I was in no condition to even consider recovery as an option, for with great perseverance I had come to a point where I had achieved a certain measure of ‘stability’ (an absence of diametrically opposite mood states), and I knew that with the given dosage (valproate mostly) I could go on and on for years. I would not worry about any more fluctuations. It was another matter that for years the fog in my brain would not lift, the heart was always heavy, the body always tired and moods relatively low- but I accepted that as a part of being ‘bipolar’, and disorder was there to stay.

Mummy would not accept that. From ayurveda to homeopathy, to any other system of medicine that could yield results, including naturopathy, yoga or what have we, any new- found person, anything, even an astrologer would work- as long as her child could get some succor. I do not really see that tenacity in a lot of people, who are willing to let medical science decide the course of action for them. No doubt, the haze in mental health is so huge, most parents will never get to researching of the kind my mother could read or comprehend, or what most other researchers access and read, especially in the context of critical psychiatry and psychology. I even work in language to see how language impacts mental health- and what are the complexities of the phenomenon.

Recovery is Coming into Light 

In some advanced countries of the world, as I noted earlier in this article, recovery has become an important focus for caregivers. But these are welfare oriented countries, not where health care spending is routinely cut to add to defense budgets or give bailouts to big industrial houses.

Recovery is only going to be a focus in cases where people are not worried about making profits out of healthcare. Yesterday a senior and retired professor of Psychiatry sent me some of his writings, in which he is talking of the utility of home based care in which a caregiver who is a trained professional would go to people’s homes and offer guidance and support not only to the main ‘patient’ but also their family caregivers. This is also the sort of model which has been followed in Finland, where they have accomplished recovery to such an extent that they have practically emptied out psychiatric wards in hospitals. Their model of social psychiatric, services embedded within the community, is taken as an exceptional model by all standards.

However, to make that model a reality one would have to create the sort of social, cultural, political, and financial infrastructure that Finland created for it to succeed. As of course the willpower that we wanted our people to recover. Do we really? Who has the jobs to offer if more people join the workforce, if they want to be married and want housing, if they want everything the way everyone else does? Who wants that psychiatric medicines should be consumed and psychiatric wards should remain active and abuzz with human footfalls? Surely not parents or caregivers.

So whose focus should it be that their children and loved ones should become well? Those whose interests are tied to the perpetuation of psychiatry? Will parents wake up and see reality?

Will they understand that they do not need to fight for more psychiatric services, but better education systems, and health care (not mental healthcare)?

Will people ever understand which wolf is wearing the sheep’s clothing?

On a parting note, in case any parents are reading this, please work with those psychiatrists who are employed in government hospitals, not private clinics, because they would be glad to assist your children/loved ones be on the lowest possible dosage of drugs, and not prescribe unnecessary tests, unless absolutely required. They are the most likely people who would have a recovery focus. Meeting some psychiatrists I too have gained that impression. All of them are not feeding the pharma-industrial complex alone- some genuinely care for patients.

The suffering of family caregivers- WHO AFTER ME…

‘Who after me’- is a question which every parent whose child faces a disabling condition, which requires their care-giving, support and engagement, has to deal with. There are many ways to look at this question- to look at the individual side of the question, or look at the social side of the question. Since one cannot but act only at a small level in the short run, I will begin by answering this question at an individual level.

Personal history

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In fact, let me begin my question with myself. When I was extremely ill, my parents handled my full-fledged responsibility; I lived in their home, and they went to teach in their respective institutions (in Delhi University, both of them), while my grandmother and one dog was the remaining family. I was completely incapacitated, would not get up till 10:30 or even 11:00 in the morning on certain days. The depressions were so huge that life was completely unlivable. But whenever the skies would clear up, I would pick up my pieces and start mending the frame somewhere- I mean the frame of my existence.

One thing was clear- my siblings were both in the US, and had lives of their own, and I, the oldest, was with my parents, who both went to work. In other words, at the prime of my life, in my 20’s and 30’s I was sitting at home doing nothing, but some study, some reading, writing and singing. I could not imagine that my parents would keep on working and I would just spend the rest of my life that way. I was troubled, useless to myself and the world around and there was nothing I could do, would do or go meet anyone. (whatever exceptions were there in music or writing happened on days which were not so bad). There were no friends from any dimension- school, college or neighbourhood, no relatives who knew anything or if they did, they pretended to act ignorant, and there was nothing but a great spiritual stagnation.

At a very critical age of my life- at 35, I decided I could not live the life of my parents, I had to figure out my own. What would happen when they would not be around any more? I would have no skills to deal with anything. I would have no income of my own, no friends, no relatives to fall back on, nothing at all…where would I go and what would I do? So that brings me to the question of this post- the question that all parents face, whose children are incapacitated from doing the day-to-day actions of living and participating in life in ways what gives them hope , courage and happiness.

When I got well, whose story is written elsewhere in research, the one thing that progressively became important for me was to see whether this recovery was a chance or random act, or was it happening among others too and what pathways they were adopting to get there. This has been the general direction of my research as well- towards recovery solutions. So if I just come back to the first question, one has to see whether someone like me can act at an individual level or a social level.

At the individual level, one can engage with one person, nay one family at a time, help them comprehend distress, help them rehabilitate and recover the manner I have done myself or now hold many other hands- towards recovery solutions. I do not think people cannot recover- no matter what span of time they have been ‘ill’. But it is just like saying that someone who has been used to walking with crutches will now learn to run. So how to bring the turnaround and who will bell the cat- the suffering? Before they drop their crutches, they have to gain courage that they can indeed walk, that their limbs have strength and they will not tumble, just because they will let go of the crutch, which they have been depending upon for so long. (the crutch metaphor is only a metaphor, no intention to allude to another ‘disability’)

What can one person do?

I am very clear in my mind , that I cannot bring social change- that is for the government to accomplish for they alone have that many resources that they can empower, employ, and rehabilitate hundreds of people. However, that does not mean I cannot do anything at all. I, or anyone like me, can only deal with one person at at time. There are many people who create organizations in the hope that they can mediate with the government and bring in more interventions at a macro level which can transform society. Often a lot of times, these people have no model by which they want the change to come about. I do, because I AM THE CHANGE MYSELF, not just the change-maker, or someone fighting for change, without a concrete plan of action.

I believe that people can recover. Needless to say, I have seen them recover, both from bipolar and schizophrenia; I need not delve into other things of a less distressing nature, not that they do not make life difficult in any way. The only thing we can do is then from this prototype of recovery, to create more recovery outcomes. If recovery could be accomplished by the government then perhaps the whole country would have healed by now, and there would have been no problems.

Maybe some people have hope in the government and its systems, I do not. I think it is only up to me to do what I can and bring all resources I can, to reach out to the widest number of people- both families and individuals to let them know, first of all, that recovery happens all the time, many recover, and it happens all around the world- not just in resource rich countries.

The concern of parents that comes from the WHO AFTER ME question is a reflection of the unending suffering of both parents and their children who have become permanently dependent, thanks to a system of continued infirmity. I know one thing for sure, that if one remains dependent upon psychiatric medication, nobody can recover. Yes, you will most certainly become functional in many domains of life, but independent living, and handling life stresses- that can never happen. Each one of us (including John Nash) who recovers, anywhere, has gone off psychiatric medication at some or another stage of their life, by creating alternative resources, no matter what. So who after me, is a confirmation that the path of rehabilitation that they have followed has actually disabled their child, and made him/her permanently dependent, rather than making them recover any aspect of their lives.

A few months back, I was talking to Dr. K.S. Jacob of the CMC, Vellore on the subject of continued medication, and he brought a startling insight to my notice- that only one- third patients require long term medication. I was so shocked to hear that, because in my 18 years of psychiatric dependence, my psychiatrist NEVER EVER told me that I could go off psychiatric medication, no matter how many times I would implore him to help me reduce the drugs. Certainly he brought them down to a minimum, but no way he would say I could go off them. I would have to continue them for the rest of my life, what did it matter?

What did it matter to him that I had co-morbid conditions and I had gained so much weight that it contributed to a lack of self esteem and self worth? The mental fog that would waft through my brain at all times, never would lift for me to face any day of the year, any festival, any change of season with any ray of hope in my heart? I was just a patient who was a regular nuisance, because she would come and request a reduction in medication all the time.

Today when I look at my own recovery I am grateful to my parents that they let me make some important decisions of my life, including the choice to live alone, including the choice to come back home when one marriage did not work or more. I am grateful to my mother who never told me to take psychiatric medications, because she was quite open to other alternatives. In fact it was she who would regularly encourage me to try out new things and even eat them herself to offer me solidarity- one of them being the bitter leaf of ashwagandha that grew wild in my then home in Faridabad. Ashwagandha is known to be a mood stabilizer, and she would try getting me many sorts of ayurvedic pills and potions, or stand with me in queues of this or that vaidya.

I think one of the key people in my recovery are my parents, and they have always supported me in my choices, no matter how difficult they be. When I see other parents on the one hand I understand their suffering, on the other hand I see how they become the chief mechanism through which their children get medication for years and years on psychiatric drugs- for they never have the courage to look for alternatives. But like I said about mine, though they are the KEY PEOPLE, they are not the reasons for my recovery ALONE, in fact not in any significant way- if I did not have the scope to express myself through other means.

That is the sort of alternatives I am trying to bring together towards the recovery programs we are designing at Hamsadhwani- mostly for people suffering, but in one exceptional case- for parents too- The Caregivers’ Online Program, as part of which parents will not only get to meet many people who have recovered from serious mental illnesses but live lives just like anyone they know. Needless to say, psychiatrists who have a recovery orientation are part of the contributing experts as well as professors who have worked in clinical psychology and health psychology, activists who routinely meet and deal with people having mental illnesses.

Naturally enough all of us who work in mental health, regularly meet people- I also meet families due to my orientation towards family therapy, are more exposed to mental illness stories of people than parents who only know their one or two children or a few friends’ children with identical stories. It is only by exposure to new ideas can new solutions be found- for by now everyone knows that psychiatric medication can only go so far. We cannot solve the problems that we have created by the same thinking that created them (Albert Einstein). As Anil Vartak, the vice president of the Schizophrenia Awareness Association says, that solutions for mental illnesses can only come if those who have recovered actively set out to help more recover. That is also my effort via this program and that is why I have also roped him in.

Parents will have to continue worrying about their children permanently if their caregiving is so dependence-creating that they cannot enable their children to become functional, and self preserving. Instead of working on the deficit side of their children, if they can help them deal with their mental distress in ways that their existing strengths and abilities are only further consolidated, their worry about WHO AFTER ME, will never be a worry again, because after them, their children will be well enough to manage their own lives.

For that outcome to emerge they have to put their children in front, as agents of change in their own lives, and allow them to make mistakes and grow, rather than determine the direction of their growth all the time, proactively run around here and there looking for solutions and meeting all sorts of experts, all over the world.

ON a last note, I just remembered that my mother was a very active and valiant parent when we were growing up as children. She would actively fight against issues in the parent- teachers’ association in school and at another level in the politics of the teachers of Delhi University, among other things, such as women’s issues. However, I thank god that she never took up these roles in mental health, choosing instead to focus on me as the sole concern. In getting her priorities different from parents who created organizations to fight for the whole society, she created the scope for me to recover and possibly bring that knowledge to others, rather than keep debating with the government for more measures to deal with mental health. She did not have any hope from the government too, I reckon. No surprises, I am indeed her daughter.

Of course this is not to say that those who took these paths do not deserve recognition for it. I am certain in their own ways they may have contributed to some social outcomes, but has it also brought about a recovery in their own children’s lives? That is the key issue. If they have succeeded in that, then they may have a path to show to the rest of the parents, or else, it is we who have recovered, who have dedicated our lives and our youth, our homes and our families to the suffering of humanity need to take care of this responsibility.

And this is where I stand too.