Teens and Depression-All Facts,No Fiction-Last Part

You can read the first part of this case history over here.

My counselling sessions with Manish continued for slightly more than a year but the status quo did not change much.He was even scared of giving the class 10th,11th and 12th exams but he joined three coaching institutes,one after the other,hoping that one of them would prime him to sail through the JEE and finally,B.Tech from an I.I.T.The strain of this staggering load and the fear that he lacked the ability to attain his aim increased his anxiety manifold.

After having refused many a times to give the 10th board exam,Manish finally did give it and passed with 80% marks.He was now studying for only 2-3 hrs per day but this provoked adverse comments from his grandfather. Manish began to have angry outbursts and one day broke his mobile.

I asked him if his current routine,though minimal,was causing him such a lot of stress,what would happen when the pressure increased?The poor boy asked his lecturer if he thought he could pass the JEE and the teacher replied in the affirmative.

So he carried on valiantly,but he was uptight all through the 11th class.He would miss an appointment or walk in on the wrong day.Even the decrease in his study hours had failed to soothe his nerves.He gave the final exam for class 11th in this frame of mind and got a supplementary.

Till now I had only subtly hinted that his over ambition was the cause of this snafu because we counselors are not supposed to give direct advice or be judgemental as far as possible.But I had to change my strategy when one day he laid open his heart.He was afraid of ghosts and had been researching paranormal events.He talked about existential issues and claimed that he had done astral projection too.He had also gone to the Brahma Kumaris in search of peace.

All this revealed that he was exploring various avenues to gain a grip on his mind and get rid of anxiety.His behavior was quite ominous and I thought the time had come to call a spade a spade.I reminded him that all his problems had started after he decided to wear himself out for the JEE exams.His body and mind tolerated the strain for 4 months but cracked down after that.

He was motivated to evaluate the consequences of the decision which had ruined his peace of mind and also instilled many fears in him.I did not want to scare him about the onset of a mental disorder but I merely said that the unrest in his mind ought to be his first concern-it would not allow him to succeed in anything.It was for him to gauge what was causing that stress.And remove that cause.If he was mentally fit,he would succeed in any career and it was better to be a happy teacher,clerk or whatever,than a depressed engineer.

It was obvious that he was being goaded by his family to achieve a target way above his level.Maybe he had even internalized their ambition.After all who does not want to climb up the hierarchy?But all the rungs cannot be climbed in one leap.And if you put a gigantic load on your mind it is bound to give way.Both these misadventures had turned his world upside down.

Twice he was put on psychiatric medicines but the root cause of his stress remained unattended. Finally one day,he and his family could both read the writing on the wall:he dropped the idea of giving the JEE exams.

If only he had been allowed to plan his career using his own judgement or allowed to back off when he found the strain too much,he would not have had to endure so much stress and  confidence deficit.He was on the brink of succumbing to depression but I am glad he retraced his steps in time.Better late than never.

Teens and #Depression-All Facts,No Fiction-Part One

A WHO report states that "one in four teens in India of 13-15 age group have depression."Most of these cases go unreported,only a few seek help.

One such fifteen year old boy (let's call him Manish)was referred to me by his class teacher.He was accompanied by his grandfather,with whom he and his sister lived.His parents lived in a nearby village.He was studying in 10th class.They had come to me in Oct,five months before his 10th board exams.

He complained that he did not feel good,could not recall what he had studied and felt that he would not do well in the exams.He was under severe stress.His grandfather,being a teacher,was very understanding.He had taken him to a psychiatrist,but the medicines prescribed by the doctor made him so sleepy that Manish discontinued them.It was after this that they had come to me.

Manish told me that six months ago he had resolved to study hard and crack the JEE Exams.He had also joined a coaching class to prepare for the board exams.Everything was fine till two months ago-when he began to feel that he could not cope with the studies.He was losing confidence in himself and feeling depressed.

I asked him to narrate his daily routine. It was like this:he went to school early in the morning and returned at 2 pm,finished his lunch by 2.30 pm,studied till 3.45 pm,attended the coaching class from 4-7 pm,dined at 8 pm,studied again till 10 pm and then went to sleep.At 4 am next day the whole cycle would start again.Sometimes he woke up at 3.30 am ,feeling nauseated.

It was pretty obvious that the boy was burning himself out,but he was cognizant of only one fact,that he had to study hard and get a B.Tech from an IIT. On the other hand depression was making inroads into his personality.It was possible to reverse the process at this stage but I could not have said it in so many words.It should have come from inside him:whether he could or could not achieve his ambition;and whether he was willing to attain that coveted degree at the cost of his mental health.

I advised him to take things easy,not slog so hard,and start a physical routine like exercising,running,jogging,walking,yoga or meditation-whatever suited his temperament-in the morning.I assured him that this would refresh his mind,curtail his negative thoughts,and improve his mood and morale.I also gave him some tips to boost his confidence.He was asked to report again after four days.

Second visit
Next time Manish was accompanied by his grandfather and uncle.They disclosed that he had not studied at all for the last 15 days.That morning he had been crying bitterly,saying he was not ready for the exams.

It was obvious that Manish had set the bar too high,but on whose bidding?Was it his own ambition,peer pressure or family pressure?I felt that the family was behind this,but this was only a calculated guess. Manish was too decent a guy to blame his grandfather for his difficulties.It was going to be tough to make him see the futility of ruining his health in this way.

The immediate challenge in front of him was the pre-board exam.I suggested that if he shelved the JEE exam preparation for a while and concentrated on the 10th board exams,he would be less stressed.

His sleep had improved but he had not started exercising as yet.I asked him to make the required changes in his routine so that he could relax and ease the burden of studies.Relaxing in between bouts of study would enable him to better grasp the matter and retain it too.He agreed to do so.I asked him to come after one week.