Mental Matters - Special Edition on Mental Health

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IITB’S OFFICIAL STUDENT MEDIA BODY

Mental Matters In the light of an ever increasing rise in mental health issues, it becomes immensely important, and almost mandatory to bring a well informed discussion about mental health to the fore. The silence and stigma have to break, and we need to realise how real and tangible it is.


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Mental Health

So, mental health, huh? It’s just being extremely sad, right? ‘I had arrived at my gateway to a new and happening life. But it wasn’t long before I started slogging, and over time, college began feeling like a pressure cooker. There was this huge chunk of people to meet (read ‘impress’), activities to attend (‘fit in’), quizzes to withstand (or slog again), and, of course, the pressure to keep up with my family’s (luckily) moderate expectations. “But dude, sabke saath SAME hi hai, chillax! Don’t be a wuss,” I calmed myself. I was one of the few people who actually wanted to pursue my field of engineering moving further ahead. But as shallow as my perception of higher studies was, the insti’s socio-machau environment only boosted my enthu only so much. I persisted however, trying to maintain good-enough acads, while also trying to make it into football, a sport I loved, at the inter-IIT . But slowly, with the super heavy course load, juggled with my busy football schedule, maintaining my grades became a mammoth task. I started to miss out on many forms of outings or ‘wing bonding’. Going out occasionally to chill became a luxury. I was just running myself so thin trying to be the ‘perfect’ college student. It almost seemed as if I was setting myself to fail, with the sheer amount of expectations I had for myself. At first, I sought to seek help at the wellness center, but by this time I began experiencing intense mood swings. I found myself crying uncontrollably, only to feel normal after 30 mins. I started skipping classes, avoiding people, coming to face with wingmates became a hassle I couldn’t bear. Later, in my 2nd year, I was diagnosed with bipolar disorder as my symptoms worsened. I was ditched out of the football team, because I’d missed too many practices, and wasn’t truly ’part of the team’. Feeling defeated, I was suggested by my psychiatrist to talk to my HOD, which led to a medical leave. Everything simply seemed downhill from there. I would keep observing different people everyday, and I would keep wondering if anyone else could relate to what I was going through. It was the loneliest experience.’ The above is an anecdote about a student portraying the grim details of their suffering and subsequent diagnosis of their mental illness.

India is facing a serious mental health crisis, with an estimated 56 million people suffering from depression and 38 million from anxiety disorders. Mental distress is believed to be a key reason for suicides, the largest cause of death for people in the ages of 15-29. Data from the Asian Journal of Psychology suggests 2 in 5 people in college may be suffering from some form of depression. With India having one of the largest student populations, this needs urgent and effective addressal lest the silence on this issue consume hopes and aspirations of its victims. The aim of this article is not just to inform you of the disheartening, albeit real, facts but also to provide an understanding of and sensitisation to its challenges that many might go through. We hope this heralds a much-needed discussion, usually suppressed by lack of knowledge, embarrassment or even fear, and dispels the misinformed opinions of the causes, symptoms and solutions to mental problems. To see this article create a lasting and positive change in our attitude towards this silent parasite, will be to see it achieve its intended goal. “India is staring at a possible mental health epidemic”, - President R. Kovind But before taking on this daunting task to tackle mental health, it might help to know what ‘mental health’ really is. According to the WHO, being mentally healthy is “a state of well-being in which the individual realises their own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to their community”. Thus, ‘mental health’ refers to how we think, feel and act as we face life’s situations, how we handle stress, relate to one another; and it influences the way we look at ourselves, and others. Basically, we can break down mental health into 3 segments. Emotional well-being includes a general sense of contentment with our lives, being ‘interested’ in the activities we associate ourselves with, while being able to feel all emotions, even the occasional sadness, anxiety or loneliness. Psychological well-being includes liking most parts of one’s own personality, being good at coping up with the responsibilities of the day, and having good relationships with others. Social well-being refers to the feeling of being part of a community, having something to contribute to it while also being able to critically make sense of how the society works. Mental health has been often thought-of as a purely positive effect. Yet, overlooked is the fact that mentally healthy people experience all humanly-capable emotions, happiness and contentment, as well as sadness, loneliness and anxiety, which are all part of a normal life.


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Why Bother at all? It should be essential to note that our mental health is, on a subconscious level, at the core of how we interact with our environments, be it in personal matters, relationships, our sexuality, professional situations, or even in social circumstances, like partaking in groups or organisations etc.

Trivia: As of 2016, it is hard to believe but India actually spends 0.06% of its health budget on mental healthcare, which is proportionally less than what Bangladesh spends (0.44%)*

A compromised mental health does not restrict its effects to isolated areas in one life. Their impact almost always extends to aspects involving one’s lifestyle as a whole. Our mental and physical well-being are also inextricably intertwined. An unkept mental health renders one more susceptible to a waning physical and physiological health. For example, patients of severe depression have a higher risk of developing cardiovascular diseases. To be clear, lack of a mental illness does not necessarily mean in large that someone is completely mentally healthy. Come to think of it; not many of us give heed to how mental health can manifest in our life, caring more about our physical health than mental health. This is mainly because of poor awareness, or availability of ‘instructions’ to maintain our mental ‘software’ system in good health. That it needs regular maintenance, just like everything else. Thus, we need to understand here that maintaining a mental health, in a overall ‘smooth’ condition, is important to consider. Especially considering that, as students, we are in a stage of life where our actions and decisions now can hugely impact our years to come; and those near to us may be affected by our decisions, we have to realise that our mental health may affect us in the long run. Did you know? For this reason, lots of organisations have started promoting the ‘Mental Health Day’. Popular among millennials, they would use the day (also known as a self-care day) to catch up on sleep, take a long bath, do yoga, see a therapist, go for a run, or practice mindfulness. Many view these as necessary, as taking a day off for self-care or mental health can improve job performance for the rest of the month) Considering the huge impact that our mental health has on our lives, it becomes imperative to know more about mental health issues, and trying to identify them if we are experiencing any of the symptoms. It is also important to learn about mental health so that we can identify those among us affected by mental health issues, so that we can take a step forward to becoming an unbiased, well informed, and understanding friend.

* https://www.indiatimes.com/health/healthyliving/mental-illness-is-the-most-common-disorder-in-india-and-yet-theleast-understood-261380.html


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Of a Mental Health Challenged While it is possible for issues related to mental health to manifest in overt ways like violence, unpredictability and oblivion etc, it is more common to see them materialise subtly in our day-to-day life such as pangs of anxiety, avoidance of social gatherings, mood swings etc. Mental health issues can sometimes be hazy on the front of actual intensity, so it becomes imperative to know what really qualifies as a mental illness, something that needs urgent care. What does being mentally ill even mean? While it is perfectly natural to ‘feel low’ on certain days more than others; If we’re finding ourselves habitually avoiding friends and social interaction, or worrying about things out of our control; if we are not able to carry out day-to-day things normally, it indicates seriousness. Some of the most common symptoms for what qualifies as a ‘mental illness’ include: Changes in sleeping and eating habits; excessive sadness or worry, changes in social habits, physical fatigue coupled with mental strain, mood swings, or in more severe cases, suicidal thoughts, etc. One of the most common mental health issues, depression, is typically associated with feelings of pessimism, guilt, loss of interest in daily activities, insomnia, difficulty concentrating, irritability, loss of appetite, anger or sadness in relationships, etc. Anxiety, on the other hand, is typically associated with symptoms like constant fear of failure (socially and academically), have trouble concentrating, a blank mind, being stressed, and sometimes, having panic attacks. To reiterate: It is normal to experience a number of these symptoms in various commonplace situations. When the extent of these is such that our daily life gets impaired from usual functioning, we need to consider them as being of serious magnitude. The aforementioned constitute, in no way, an exhaustive list of mental disorders. Despite their prevalence and synonimity with mental health illnesses, there are a variety of conditions like personality disorders, post-traumatic stress disorder, schizophrenia, obsessive compulsive disorder, neurocognitive disorders etc., each with their own characterising symptoms, that have an even more debilitating impact than anxiety and depression. Factors which contribute to a compromised mental health: When it comes to us as college students, there are many such factors. For one, the pressure to cope up with the system can be overbearing, including getting good grades, the apprehension of building a good resume, etc. (In the case of freshers, this coupled with the newfound freedom of choice could be overwhelming). Financial

strain to be able to afford an education, comparisons with peers in terms of spending capabilities, and stress about how to graduate with a good salary all play a part to undermine mental health. The lack of a clear ‘path’ to achieve these (life) goals could further worsen the load on one’s mental wellbeing. There can also exist issues arising out of unhealthy relationships (while healthy relationships can in turn reduce mental health problems). Sexuality is also another important factor to be considered. Despite global recognition of the rights and existence of individuals with diverse sexual orientations, much of the LGBTQ population still faces a lot of hatred and discrimination. The conformative pressure imposed by the society can manifest in fear of rejection, and can culminate in issues like anxiety, depression, and personality disorders. The same can be said of people belonging to other marginalised groups. Especially in such communities, the incidence of suicides is very high. The growing influence of social media can exacerbate issues -- apart from disruptive usage of mobiles and social media, it increases the pressure to appear perfect among peers. In particular cases like for those with social anxiety, it can be a platform to express themselves, but it is also a curse in the sense that the previously stated possibilities can take over. For those among us who are engaged in Positions of Responsibility (PoRs), or in sports, or work-intensive techteams, etc., it is possible to be affected mentally due to strenuous work regimes and increase absenteeism/escapism, further giving rise to tension among colleagues. Not realising early onsets of mental health issues, could more often than not end up in the escalation of the issue, hence it is always advisable to analyse the situation and identify if something is wrong, even at the slightest onslaught of known symptoms.


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A Sadness Shrugged off It is considered pretty normal conversation to say, “I have the flu,” or “I have a headache.” Those of us facing mental health issues, however; may not be comfortable talking about things like depressive disorders in our day-to-day life. For example, owing to the negative connotations associated with it, a person actually diagnosed with OCD may not be open to sharing about it because of how people misuse the word ‘OCD’. This reluctance manifests in many ways. For example, we may worry that sharing things with our friends will not make any difference, if they don’t understand our problem. And if anything, it may add to the judgements we may have to bear. We may feel friends are only good to share a happy time with, and fret about spoiling the jolly-go-merry time we may already be sharing. The same apprehensions hold with those of us who think we are sharing too much with our friends. “ My family was quite open in general, But when I look back, I realise that we shied away from the important topics. Mental health was rarely discussed, but when it was, it was always in a negative light. At no point did any of my relatives tell me having a mental disorder, theoretically at this point, was acceptable — I could tell by their hushed tones, and their quick dismissals, that mental illness was not an option.”

Despite the blanketed ease in brushing issues under the carpet, hiding will never really do any good. No matter what chaar log think, when we pretend everything is alright, we hurt ourselves because we are creating a false expectation for our behavior, and this may end up indirectly hurting others like us facing similar situations. Keeping it under cover from our families, thinking we’d be ‘failing them’ or causing our loved ones ‘unnecessary stress’, and that we should deal with it on our own, may not be the best way to go about it. Calling in sick to work under the pretense of a physical illness, when we’re, say deeply depressed, can be considered an act of deception. ‘Hiding up’ is this act of both keeping mental illness hidden from the community and not doing anything to treat the illness itself. It is really important to address such situations, as they can be exacerbated into more dangerous scenarios.


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Dealing with it? TRIVIA: Findings on the reviewed rates of psychiatric treatment usage across 37 research studies, show that between 30 to 80 percent of people with mental health concerns never receive treatment. From this analysis, the average non-treatment rates for specific disorders were: schizophrenia (32%), bipolar disorder (50%), panic disorder (55%), major depression (56%), generalized anxiety disorder (57%) obsessive-compulsive disorder (59%), and alcohol dependence (78%). It’s also acknowledged that these rates are probably lower than the actual number of people failing to get treatment. It may appear scary, we might think that there will be some “negative” consequences while dealing with our issues. When in reality, if we approach it with openness and positivity, and accept that all of us can be vulnerable, those ‘consequences’ will appear much smaller compared to staying true to ourselves. Realise it’s not just you - Numerous successful personalities have now started addressing the fact that their lives can also be messed up, and need not ‘have it together’ all the time. We often tend to come up with our own explanations for feeling down like, ‘it’s probably all up in our head’. This only leads to the issue proliferating under a masked excuse as if being unique only to us. We should remember that there are countless individuals who deal with varying degrees of anxiety, depression, or the like, every single day.

lately. This process of sharing and venting out our feelings can be therapeutic, relaxing and makes us feel that there is somebody who is listening to us. Realise that seeking help doesn’t make you any lesser of a person - Contrary to people’s uninformed opinions, seeking help will only indicate our courage to be able to look beyond the stigma and reach out for help. It indicates that we value our well being and are willing to take that step to come out this. Remember if one decides to come this far, one is anything but weak. Get professional help - As clichéd as this sounds, we should acknowledge that professionals like counsellors, psychiatrists and therapists are all there to offer support and help people out. We may be doubtful of how effective it might be, but there is no harm in trying, thinking of it as venting out to a friend. We can think of it as an investment to know ourselves better, which may end up making us feel better, with some patience.

It’s never too late - We do not have to wait for someone to notice our distress. If the uneasiness continues despite attempts to get rid of it, then that is the most important cue in recognising that we should reach out for help. Even if Let it go for some time - While silence is surely not the answer, ‘taking a break for a while’ may do wonders. This ap- we take some time to reach out,we will not be missing some ‘train to betterment’. proach, while accepting the existence of the issue, moves ahead with this understanding. Deciding to unwind makes us consciously shield ourselves from stressors otherwise Whenever we decide to reach out, it is the taking a toll on us. This gives us some valuable time which perfect day to do so. can be used to introspect and reconnect with ourselves, including understanding our strengths and weaknesses and strategising accordingly.

Get involved with things you loved doing in the past This is a great temporary way to divert the mind from things which would otherwise lurk in our mind all day long. This is not to say that being busy makes it go away, but finding an alternative expenditure of ourselves can surely help. We can surely find something that we value, are good at or lends us a sense of purpose, or just about anything that gives us comfort. Talking to a close friend- It often helps to try talking to a very close friend. However, as pointed out earlier, if we are feeling unsure about it, we can try revealing a little bit about our difficulties to them and see how they respond to it. If they are being supportive and understanding, we can try opening up more and express how we are feeling

https://www.who.int/bulletin/volumes/82/11/en/858.pdf


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Ending remarks We could share everything or we could share nothing and our experiences are still valid. We have permission and the right to care for ourselves and our stories however we see fit. For those of us who experience mental health challenges, sharing may help the society immensely. It can validate us when we read someone’s story, that we’re not alone, that we have hope. Someone’s story could be the thing that leads us to finally seek help, to know that doing something about it is just as real. In some cases, it might even save a life. While it is courageous to speak about it, you’re not weak for choosing to hold back and maintain a certain privacy as well. Not everyone wants to share their struggles, yet that doesn’t make their struggles less real or make them less brave. And for the rest of us, we can agree, we might not be the person who could handle somebody opening up to us in the best way, but we need to learn to listen, being extremely careful of our words while not intruding into their space, and avoiding contextual jokes helping them ‘cheer up’. It certainly takes courage for someone to open up, the worst way to respond to the situation would be to assume they’re just ‘being lazy’ or ‘making it all up’. The least we could do is to be the non-judgemental friend, at least for the people close to us, for a start. We need to start addressing our emotions. We need to learn to be compassionate. We need to talk about mental health as if it were real.

Helplines Student Wellness Centre IITB:

022 2576 9070

AASRA Suicide Prevention Helpline (24x7):

022 2754 6669

i-Call Psychosocial Helpline:

022 2552 1111


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Editors’ Note Hello everyone, Mental health is a topic which is becoming increasingly discussed in much of the media these days. However, we as a country still have a long way to go in terms of how we tackle our people’s mental health. Through this special edition on Mental Health, we sought to throw some light on the different kinds of facets that are involved in this, hoping that the institute populace be sensitised towards general mental health in a holistic way. We have tried as much as possible, to do so in a concise manner, yet we acknowledge that one newsletter alone cannot do justice to the topic at hand, owing to its sheer scope and complexity. We do not intend for this edition to be used as a medical guide, but as a catalyst to spark much-needed discussion on the topic within the institute in the context of all our lives, as well as make readers more informed in general. We sincerely hope this edition serves its purpose in that direction. We also have a future edition in the pipeline, dealing specifically with mental health challenges in our own insti, which together with this more general edition, would help in unraveling a more exhaustive and nuanced perspective on the matter. We would like to thank the members of the Insight Editorial Board for their inputs as well as the design team for their excellent work on this edition. You can reach out to us for any feedback and suggestions by contacting the undersigned. We hope you have as insightful an experience reading this edition as we had creating it. Authors: Charit Verma, Kireeti Akkunuri, Priyash Singh Chief Editor: Aparajeya Dash Designers: Arnesh Mandal, Mrinal Biswas

The content in this newsletter is strictly the property of Insight and the Students’ Gymkhana IIT Bombay. If you wish to reproduce any content herein, please contact the Chief Editor or the Dean, Student Affairs, IIT Bombay.


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