Self help apps for mental health: Choosing and using wisely Dr. Seema Mehrotra

/ or provides an initial online assessment process that helps you understand the nature your problem; Look for any research-basis for the contentof the app as may be provided bythe developers. It may also be useful to check out if an app has been developed by well trained mental health professionals or in close collaboration with them.

Utility and limitations of self help apps:

Well-designed, structured self-help apps, particularly those that involve interactive elements and incorporate some level of individualized support/ human contact (e.g. over phone/sms/email) have been found to be effective in dealing with common concerns such as depression and anxiety of milder severity.

But, even a well-designed app may serve little purpose-unless used appropriately and consistently fora sufficient duration. Hence, look for interactive features that sustain your use; and help you actually apply whatever you learn.

Also, a self-help app should help you to achieve improved functioning in the real-life context rather than result in excessive time spent in the online world

Sanjeev is an engineering graduate and has been attempting to clear his third year semester exams but could not succeed, he is unable to attend his regular classes as well. He developed a fear of being judged by his parents and friends as he could not succeed in his exams. He started to play games as a tool of distraction from his worries. Later, the hours of gaming increased to an entire day. As he spends more hours in gaming he avoids talking to his parents and friends and becomes more anxious and restless with regard to talking with people in person and worries about his future.

at the cost of your engagement in real relationships, tasks and responsibilities.

A very essential point that users of self-help apps need to remember is that self-help has its own limitations and one must be aware of this. Here are a few scenarios which often imply that one must go beyond self-help app and consult a trained professional: when one’s problems are not improving, when one’s condition is severe or worsening or when symptoms are interfering significantly with one’s functioning, when one is not able to apply the suggestions in the app or when the app content does not seem to be personally relevant or useful.

Remember! Taking care of yourself does not mean exclusive dependence on self-help. It includes being able to reach out and seek professional support at the right time!

Dr. Seema Mehrotra

Professor Dept. of Clinical Psychology NIMHANS

Do you Love your Gadgets more than anything?

Love for Gadgets

The list of modern day gadgets is exhaustive and it includes laptops, ipads, ipods, videogames, smart phones and play station. Many have at least one factor which creates an appeal or love for the gadgets among young people. Here are various reasons why youth love gadgets.

Wonders of wonders: New technology, new updates gets upgraded every day in latest gadgets and this makes the youth feel that work would become easier and that gives an enthusiastic appeal.

When a youth uses a new laptop or smart phone, the first question would be “Is it a new laptop? What is the configuration?” “New phone, android which version? Or Apple?”. So getting updated with a newer technology and having latest electronic gadgets gives an individual a Wow effect.

Brand status: Having latest gadget from a popular brand could provide a status symbol to youth. Youth who does not care about newer gadgets, still tend to have a curiosity to know about the latest one available in the market. Sometimes due to peer pressure they may force their parents to get one for them as having a branded gadget displays position and status among peers.

Smart work: Gadgets practically allow people to do many things in a few minutes like easy money transactions, payment of bills, and any information that an individual needs is made handy. Recently, laptops are also designed in ways that are best suitable for individual needs such as playing games, office use, graphic designing and animation and others. Everything is available at their finger tips!

Entertainment: Electronic based entertainment technology has progressed from early radio to internet connected SMART TV, and entertainment is brought to a newer level. A feature packed smart phone allows people to download music and video or stream online. Further, installing useful apps help youth to stay connected with each other.

Coping mechanism: Among youth population usage of electronic media consumption has become a means with which to of manage their problems or compensate for social life. Online communication can improve their self-esteem during problematic situations as they tend to get social support from media. Instant messaging at times of stress can provide immediate emotional relief and allows users to vent negative emotions

So what are the Impacts of using Gadgets?

Positive impact: Gadgets and gaming can improve youth strategic thinking and creativity. Gadgets become the sources for learning and sources for fun and entertainment that will help them to distract from daily stresses of life. As people are well connected to each other through various social networking sites, it becomes a platform where people of all ages share their views from anywhere. This interconnectedness throughout the world is growing rapidly due to internet use. Most of the schools have been converted to techno schools where electronic gadgets are used to improve students’ engagement and for promoting classroom learning. This has helped students to improve their learning and perform complex cognitive tasks.

Negative impact: Online activities may improve their technical skills but they can affect their life skills drastically. As youth spend most of the time on devices, they refrain from outdoor activities with friends and family. Indulging in violent games may create a tendency for violence in the youth’s minds. It can also lead to physical health issues like musculoskeletal problems, eye strain, lack of sleep, etc. This may lead to psychological issues like anxiety in facing real world situations, stress, loneliness, sadness, guilt, low self-esteem etc. They may face social problems like difficulties with maintaining relationships, isolation from the external world etc.

Tips for Healthy use of Gadgets:

Set up a gadget free time after study time/ working hours: If an e-mail pops up after work hours try not to react to it immediately - it can wait till the next morning. Switch off your mobile phone at night. Set boundaries for friends/colleagues as to when to call you post college/work hours. Don’t force yourself to be answerable to everyone on your social media or phone messaging app.

NOTE: If you or someone in your family/among friends is affected by gadget-addiction, take professional help.

Dr Manoj Kumar Sharma

SHUT clinic Dept. of Clinical Psychology NIMHANS

Ms. Archana R

Junior Consultant Dept. of Clinical Psychology NIMHANS

Fatherhood

What are the common anxieties an expectant father can face?

Anxieties revolve around the sudden change in role and status, the responsibilities surrounding the pregnancy and parenthood, fears for the health of the mother and the baby. Sometimes doubts creep in: will I be able to cope? can I negotiate the turns? do I have the time? Can I multitask? Can I lose out on hobbies? Can I manage the rituals of childbirth, the sleepless nights, balance work life with home responsibilities? The new father may have to manage chores that he may never have done in his life!

What about the joys of fatherhood?

Overwhelming emotions of ecstasy, excitement and happiness at seeing someone who is “my creation”, wondering who s/he resembles, may be experienced. The new father may suddenly mature as a person, always want the best for the mother and baby, become more caring and more patient, savoring the little things his little one is achieving with everyone around!

How can a father contribute towards the mental health of the mother & baby?

A father can try to understand the feelings of the mother, share with her the joys and deepest fears, make her comfortable with the pregnancy, support her through the pregnancy, help her practically with the chores and responsibilities at home, take care of the medical checks, share baby care after birth, take turns with the mother at night in attending to the baby. A strong father-mother dyad provides safety and security to the baby, while playing and responding to the baby’s needs develops and strengthens bonding with the baby. In fact, fathers can sometimes be good mothers to both the mother and the baby!

When the mother feels sad or worried, what can a father do to make things better?

Some roles that the new father can play: Giving time, making sense of the sadness and worries, sharing feelings, practically supporting physically and emotionally, making small adjustments in life, providing comfort, staying around, helping with childcare, sharing chores, spending time together, talking about their feelings and worries, taking care of the mother’s nutritional needs and ensuring she gets enough, identifying if she needs to meet a doctor, taking care of her physical health.

Dr. Krishna Prasad M

Associate Professor Psychiatric Rehabilitation Services, NIMHANS

How can suicide among the youth be prevented?

A college student aged 20 years, after a relationship break up overdosed himself with sleeping pills under the influence of alcohol, feeling cheated and betrayed. He withdrew himself from the company of friends and confined himself to his hostel room. He hardly slept at night and his friends observed that he was not as well-dressed and groomed as before. Alcohol use had suddenly increased and he was prone to mood swings. He chose a suitable time to end it all when his room-mate was away. The room-mate returned early and found him unconscious. He was admitted to the ICU of the local hospital but did not survive.

Warning signs of suicide:

Many suicides occur with warning signs as in the above case: withdrawal from friends, poor grooming, mood swings, sleep disturbances. Very often, thoughts of getting away from everything, death wishes, plans for suicide will have been shared with a person in the vicinity. Risk factors such as use of alcohol and a recent relationship breakdown cannot be ignored. Often, there are other additional risk factors such as academic difficulties and failure in exams that may be important in students. Easy access to drugs such as sleeping pills and sometimes other substances of abuse may be lethal as in this case. Other factors such as lack of social support, unemployment, migration to a different social environment, social discrimination, financial woes may be important precipitants of a crisis. Mental illness such as mood disorders and schizophrenia may go undetected, very often due to barriers in early identification or treatment. This may be because of lack of awareness or the stigma surrounding mental health problems and suicidal behavior.

Preventive strategies:

Various methods of suicide prevention can be useful, including restriction to access to means of suicide such as ligature points for hanging in hostels, erection of barriers to jumping from heights, smaller pack sizes of medicines, stringent firearm policies and safe storage of pesticides. An important measure to prevent suicide is to improve access to treatment of mental health problems. Counselors can be made available in schools, colleges and workplace, who may then refer to professionals when needed. Helplines for crisis and exams, including those specifically for suicide run by NGOs and the Government can be important nodes of prevention during a crisis. Crisis centers including those that are gender specific for women can play an important role in early identification of persons at risk. Gatekeeping: In the case illustrated above, peers, teachers or counselors in the college or hostel could have served as gate-keepers. A gatekeeper is anybody in the community who believes suicide can be prevented and is willing to give time towards prevention. Gatekeeper training programs empower them with the skills to identify warning signs and risk factors, stratify risk, provide immediate intervention for safety and instill hope in vulnerable individuals. Peers are crucially placed to provide crisis support and to serve as gatekeepers because they are accessible, available and share a common milieu.

Teaching life skills such as making informed decisions, building healthy relationships, solving problems, communicating effectively, coping with stress and emotions amongst others are important components of school and college mental health programs.