Post Traumatic Stress Disorder or Depressive Bipolar Disorder ?

It is very difficult to understand the workings of human mind.Some people go through ghastly tragedies,yet gather their wherewithal and start afresh;while someone else may come apart after witnessing an incident which was not even his direct concern.This reality was revealed explicitly to me when Arif visited my clinic Sahyog.

               First visit

Arif,a hefty football player,was 33yr old when he came to me;or rather was brought to me by his elder brother.He suffered from severe depression.So much so that he wept copiously as he sat in my office.

Both he and his brother told me intermittently that his problem started three months ago.He used to be a physical instructor in a modest school at that time but he left the job because of his disorder.

Six weeks ago he had consulted a psychiatrist who gave him in-house treatment for ten days.He was still on medication and though not cured (as you must have gathered );he wanted to stop his medicines.The doctor's prescription stated that he suffered from Depressive Bipolar Disorder.
Initial talks failed to reveal the reason of his depression.I gave him suitable advice and called him back after four days because he needed urgent help,and yet required some time to ingest what I had said.
              Second visit
This time he came alone.He was in a much better frame of mind.He told me that three months ago he had witnessed a ghastly accident after which he could not sleep for four days and thus the problem started.He had still not told anyone about it.
I pointed out that the mere decision to share this experience with me had considerably relieved him and he looked markedly better on that day.Therefore he should try to not keep things cooped up and share his worries with those who loved him.
He told me that he had started going to a stadium and watching children at play.This too had soothed him.I asked him to keep it up,coach them when needed and also take up a job.
               Third visit
Arif looked perfectly normal when he next came,he was even smiling!He told me that his wife and bhabhi(SIL)were very cooperative and he had no complaints on any front.He thanked me for my help and surprisingly,also expressed a desire to join Sahyog.

I guess the doctor diagnosed Bipolar Disorder because he was fine till he saw the accident and absolutely shattered the next.But ten days'stay in a nursing home could not bring out the cause of the disorder.

This case brings to light the necessity of counselling and medication going hand-in-hand.Medicines only give symptomatic relief and do not address the root cause.

How to Join the Mainstream after Depression / Anxiety.

Recovering from depression or anxiety is no mean feat-it asks for celebration.Only an ex-sufferer knows how relieving it is to be finally rid of this malady.Unfortunately recovery is not the end of the story-or the trial.A lot more needs to be done in order to be comfortable and in sync with the surroundings.This is because the mental disorder must have isolated that person to a large extent.

A mental patient is sad,worried and apprehensive most of the time.This enormously changes his facial expression and body language.For the worse.

Since his thinking as well as his emotions are negative and pessimistic,this  impairs his judgment and consequently his reactions.

Naturally his behavior deteriorates considerably.Being full of his own woes,he does not pay heed to how his behavior impinges upon others.

It is no wonder then,that all these changes must have impelled him to restrict his public appearances and interactions.

Post recovery the patient realizes  fully the import of his disease and the resultant isolation.He knows that he looks odd,not like he looked before the onset of the disease,that he is not as strong as he used to be and also that his behavior must have annoyed many.

These factors obstruct him from joining the mainstream even after he recovers.The passage from neo-recovery to full normalcy can be tough and painful.One needs to make deliberate efforts to mesh once again with the society.Given below are eight mantras which will speed up the patient's rehabilitation.

Take help from those who care for you.
Let them know in which way you want them to assist you.Do you want them to accompany you to a party or the daily morning walk?Perhaps you would like them to go with you on a shopping spree to update your wardrobe or organize a get-together at home?Merely talking to them about the misgivings which bar you from reclaiming your life will also make you feel better.

Do what you don't feel like doing.
Go out even if you feel more comfortable inside your home.Don't avoid looking people in the eye because you anticipate judgmental glances.Their curiosity will subside when they see that you have now recovered.Give it some time.
Start a casual dialogue whenever and wherever possible.Most will reward you with positive responses.Those who do not--it could be because of them and not you.Everybody cannot be expected to be in a cheery mood all the time.So don't personalize such instances.

Go there if you want to BE there.
A secret desire of all mental patients is to be like they were before the down-slide.A simple change in routine can take you there.Remember how you used to jump out of the bed and get busy with the day when all was well?If you want to be like you were in those days ,start doing what you did in those days.It is that simple.
It is true that anxiety and depression deplete energy and enthusiasm.Reverting to your original,hectic routine will appear impossible in the beginning.Start small.As you continue, you will pick up stamina.The joy you get from slowly assimilating with others will automatically add verve to your personality.

Do not be engrossed in your own self all the time.
Depression does this to people.They examine their body,notice how it has changed and worry about every tiny twitch or pain.If you think only about your body,your ailments and your life all the time;many disturbing facts will emerge--facts which have no significance at all,which beset lots of other people too;those whom you consider normal.
Therefore make it a point to refrain from obsessing about your own self and kill this train of thought as soon as it starts.Think about other people,their lives and the challenges which they have to face.Be mindful of your surroundings to the extent that you forget to worry about yourself.

Do not compare yourself with anyone.
If you compare yourself with those who have not been through this travail as you have been,you will definitely find yourself lacking and feel dejected.Don't do this,You are still in the early stage of picking up the threads of life.Instead, compare your yesterday with today.Keep up the tempo and things will get better and better.

Be grateful for what you have.
The tussle with a mental disorder must have been torturous no doubt.But even then,you managed to come out of it.What was it that enabled you to carry on till you recovered ?Was it your family,friends,colleagues,doctors,your 
intelligence or a sound financial backing?Whatever it was--be grateful for it.

Be alert for the triggers which are likely to pull you down.
Stressful events cannot be ruled out of life,but it helps to formulate a method of dealing with them.I have enunciated mine in this post.Whenever faced with a crisis,remind yourself that nothing is permanent and this too shall pass.Positive thinking will protect you from a relapse.

Set a daily goal for yourself.
While you were not at your productive best you must have been absolved of many legitimate responsibilities.Take them up again.Even if you are one of those lucky ones who do not have much on their plate,who do not need to earn a living;find something to occupy you or you will fall back upon excessive rumination.
Decide the previous evening what you want to do the next day.Pursue a neglected hobby,learn something new,organize your files and documents,discard what is not needed,clean up your wardrobe,rectify or discard the defective equipment or gadgets---ah well the list could go on and on,but I think you get my point.

Just keep going and building up your life once again.You did it when you were a tiny babe,you can very well do it today. 

A Bit of Philosophy,Lots of Logic and Splashes of Humor

The above three have enabled me to survive the shocks and upheavals which came my way.It is not as if I have been exceptionally lucky with the life conditions in which I found myself.It was a mixed basket as it is for everyone else.But the above mentioned attributes helped me to carry on with minimum collateral damage.

Whenever I had to face an ordeal I reminded myself that life was a kaleidoscope of both good and bad or joy and sorrow and I ought not to expect only good things for myself.I would look at those who were worse off than me,visualize a worst-case scenario,admit that things were not so bad and heave a sigh of relief.

If things spiraled out hand I got so busy coping,that the thought of sitting down to brood or lament my misfortune never entered my head.It was not a conscious decision--it happened automatically and for this I am ever grateful to my maker.My first priority has always been to analyze the problem logically--keeping my emotions at bay.This has helped me to sort out the tangles and maintain my equilibrium. 

There were times when I was maligned badly,blamed for what I could never have done, and I could do nothing except cry over my misfortune.Those were the times when I gave in to my emotions.After a while,when I was all done with the tears,I would take refuge in the thought that if someone had wronged me s/he shall one day pay for it.That was the end of the matter for me because I have a firm faith in the theory of karma.I did try to understand why someone had behaved as s/he did and it helped to cool me down too,but emotional abuse or victimization do leave permanent scars.That is the truth.I can forgive but not forget.

Humor has acted as a shield to protect me from an innate urge to be blunt,like when I was expected to respond,but could not say the truth without being rude I would take recourse to saying something silly.This saved the situation from taking an ugly turn.It is thus a handy tool in awkward situations.I am deficit in the golden mean known as diplomacy,only learning as I go along.

A touch of humor at the right moment can also assuage emotions and nip anxiety in the bud.Like,if I see a dear one taking too much stress from an annoying development my first instinct always is to play it down by saying something funny.This distracts the other person,s mind and the problem diminishes in stature.

Humor-whether in print or visual media- has always been my pet stress buster too.A TV serial Sarabhai Vs Sarabhai instantly comes to mind,or Jaane bhi do Yaaro.

As I look back down the years I realize that the above attributes were just a part of who I am--not a consciously though out strategy.Is it my DNA?Perhaps!
What is yours?