Mental health is getting a great deal of attention across the world, yet in India, understanding of mental health issues and mental illness is abysmally low. People tend to separate physical wellbeing from mental wellbeing, assuming that these are unrelated issues.
People in urban areas, especially young people, consider it more acceptable to “self- medicate” with alcohol and drugs such as marijuana, rather than take a medication that would significantly reduce depression and anxiety, with minimal side effects. (See links below)
Since starting practice in India, I get asked a lot of questions about what I do, a few of which I have shared below.
“I am not sure I am in the right place”
I see a lot of patients, of all ages, all educational back grounds, gender, who say to me when they walk into my office, that they are not sure if they should be in my clinic….
What is a psychiatrist? Is it the same as a psychologist?
A psychiatrist is a doctor with an MBBS and an MD (or a DNB, or Diploma in Psychiatry) in Psychiatry. Depending on the patient’s condition (notice the word “patient” as opposed to “client”), a psychiatrist is trained in counselling or therapy and can prescribe medications. Psychiatrists treat mental health conditions such as depression, anxiety of various kinds. They can also help you understand and work through family/ personal issues without medications- commonly known as counselling.
Psychiatrists treat more serious illnesses such as Bipolar disorder, Schizophrenia which cannot be treated with therapy/ counselling alone.
A psychologist on the other hand, is not a doctor. She or he might have a PhD in psychology or an advanced degree in psychology. Psychologists do not prescribe medications. They are especially trained in “talk therapy”, in other words, counselling. There are courses in India where lay people can get trained to be counsellors. These people might not have a degree in psychology .
“I have thought about my situation for months, how can your medicine help me think differently?”
Medicines cannot change who you are or how you think. Medicines help with symptoms such as feeling low (with negative thoughts), inability to feel motivated, hopelessness, helplessness, poor sleep, poor appetite, feelings of anxiety, panic etc. If the symptoms of mental illness are controlled, one has the potential to make better choices.
Psychiatrists can help you process information differently too. “Cognition” or the way one thinks can affect relationships, emotions and decisions. Changing the cognition, therefore the emotions related to a situation can impact decisions.
“Are you going to tell my friends about what’s going on with me” or “I don’t want you to tell my parents….”
Like any other health professional, confidentiality is paramount. Psychiatrists don’t talk about their patients unless a patient specifically asks us to communicate information to another individual. In my practice, I cannot maintain confidentiality if a patient is thinking of harming themselves or someone else. In case of an underage teenager, parents need to be a part of the care. Almost every other interaction is kept confidential.
“Do I have to take these medicines for ever?”
Unlike a lot of chronic illness that people suffer from, common mental illnesses such as depression, anxiety are “curable”. A percentage of patients might need long term medications, significantly higher percentage of people need medications for only few months. A combination of counselling and medications are likely to have the best outcomes.
“Months ?!! Do you want me to take these medications for months?”
Unlike antibiotics or pain medications, medications for mental illness such as depression and anxiety take anywhere from 6 weeks to 12 weeks to start to impact the symptoms. Patients might experience side effects such as dry mouth, stomach symptoms, headaches, giddiness, etc., for the first 2-4 weeks. Most side effects disappear in this time period and patient start to feel better, gradually.
The not so good news is that mental illness is on the rise. A lot of people in our country suffer from mental health conditions. Very few seek help.
The good news is, there is treatment. Treatments alleviate a great deal of suffering. Many of the illnesses can get completely better.
Get help, earlier the better!!!!
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