maladies of the mind..

“The lover, lunatic and the poet are all of imagination compact”, remarked the Bard, perhaps signalling that all of them have intense emotional experiences, which we all do have. The term lunatic, inappropriate in all times is invalid now, and mental illness is the description that has replaced it. Mental illness is not just about emotions and their intensity or lack of it, it is an umbrella under which many maladies are contained. Even for this googling generation, almost all mental illnesses are conveniently or comfortably labelled as depression. Depression is just one of the many mental illnesses that affect humans.

Depression though a very commonly used, and rather misused term ( as many use it to call from degenerative brain pathology, technically called Dementia to simple difficulties in social functioning, as in personality disorders), is not just one type. We have all experienced losses and failures and felt low, sad and even at times despondent because of those events. This is called secondary depression. It is a reaction to an unpleasant event in life. Generally this would pass off in time and we would get back to our social and functional adequacy.  And then, there is another one called Major or Primary Depression.

Major Depression is not event related. It can strike anyone anytime, as it is a disorder of neurochemical transmission. Though there are some factors like hypothyroidism, diabetes, certain medications, and some genetic factors that can predispose one to a Major Depressive Disorder, it is essentially a biochemical disturbance that can only be treated with medication. In the currently raging fad that makes people shrug at the very mention of a prescription, MDD is a ripe field for quacks and fakes to swindle people and waste their time in getting early and proper treatment. On this, we shall see later.

What happens when MDD strikes? The person loses sleep to begin with, and gradually loses interest in all that he was involved passionately earlier. It mars his concentration, reduces his functional competency, makes him see the world dark, pushes him into a self- withdrawal, refuses him to take care of himself, and this ‘darkness visible’, can at times push him into a suicidal rumination and attempt. Depression can be considered as a serious emergency because of its potential life-taking possibility.

MDD apart, mood dysregulation can also manifest as a BI-POLAR disorder in which a person alternatively exhibits severe depressive sadness and switches imperceptibly into a ‘manic’ phase that is marked by incongruent elation and disturbing exuberance. This shifting mood makes not just the person unpredictable but also his relationships vulnerable. This again is a major mental illness and can be treated only with medication.

Mood apart, thought is what makes a man function- personally and socially. A severe form of thought disorder in which even perceptions get disarrayed is called SCHIZOPHRENIA. This is a very severe mental illness and it affects all social classes, both sexes, beyond religious and national boundaries in the age group 15 to 45. Unless detected and treated early, schizophrenia can devastate an individual’s life. This again is a neurochemical dysfunction coupled perhaps with a genetic transmission. This is one mental illness that is most researched and even now is the focus of scientific psychiatric investigation. Medication alone can handle this malady.

Schizophrenia is characterised by again loss of sleep and withdrawal in the beginning. But as time passes the individual loses focus in almost everything and is seen going further into himself. Though the affected alone can hear voices talking to him, threatening him and commenting on him, the outsider can still identify this symptom of ‘voices’. The patient would start muttering to self, not like what we all do when stressed or rehearsing for a stressful event, but muttering and alternatively appearing to listen as though he is in a conversation with a non-existent being. Besides hearing voices and responding to them orally or at time by acting out the ‘received ‘commands, schizophrenia is also characterised by delusions. These false beliefs are not induced as in the religious charlatans ‘money making mockery of the public. These delusions are baseless convictions in which even an innocent child can appear as a sinister evil conspiring and planning to harm the patient. These paranoid delusions are very common in schizophrenia. Again, it has to be reiterated that only medication can help these suffering individuals, because of the increasing popularity of  the stylish fad  wondering whether counselling alone would not suffice as therapy. You cannot counsel a schizophrenic patient, because he does not have insight- the reasoning of reality that makes him accept that he is sick. His hallucinatory voices and delusional convictions are unshaken in any conversation that tries logical reasoning. Unless the neurochemical balance is corrected, he will not listen, and therefore not understand.

Another important and common psychiatric illness is Obsessive Compulsive Disorder. Unlike in schizophrenia here the affected person is aware of his problems but absolutely incapable of doing anything to come out of it. OCD is again not a rare illness. It can be seen even in literary descriptions, like the Lady Macbeth lamenting on the inadequacy of all the perfumes of Arabia to wash her stain. OCD is characterised by repetitive actions done consciously but without voluntary control. Unless a specific number of times an act is done the individual becomes stressed and distressed very much. There are tow types of OCD symptoms one is repetitive cleaning and the other repetitive checking. A variant of these two would be repetitive acts that may be guffawed away as quirks or habits. We check because we are scared, we clean because something is dirty. Fear and shame are the underlying emotional disturbances in OCD. Regarding OCD, certainly medication is the first line of treatment. But since the individual can listen to sense and comply with therapeutic instructions, some behavioural modification techniques when taught alongside the prescription would help in recovery.

Now to come to minor mental illnesses, one can see the entire human emotional and social spectrum. From simple anxiety which we all experience and conveniently describe as non-existent butterflies in the stomach, to severe panic in which we cannot get into a lift or even close the toilet door when we have to use the restroom, there are a wide range of problems. Most of them are self-remitting, that is short lived and event related. Some like Phobia persist and do not go away even with total insight and high level intellectual capability.

Dependency on drugs or people can also be a psychiatric problem to be addressed. Addiction is another area of mental illness. Besides these, mental retardation, dementia, personality disorders, relationship  problems, learning difficulties and many more come under the group called psychiatric illnesses. Even the problem encountered by many doctors who are frustrated explaining to their patient that there is no physical problems, but find them coming again and again- the problem of what was once called hypochondriasis is a psychiatric illness. A once popular word, another misnomer that is still in usage- ‘hysteria ‘is also a mental illness.

Hysteria was named thus as the Greeks believed that the uterus of the woman was moving all over her inside and making her do bizarre things. This is now described under two types. One is conversion’- where one converts a psychological problem into a physical one. A common example would be having a headache when one is angry and unwilling to go to bed with partner. The other is ‘dissociation’- where the individual dis- associates from reality to escape stress or seek attention. This is commonly manifested in our country as ‘possession’- by a God or an Evil spirit, according to their cultural milieu. Here the individual though initially behaves involuntarily, at some time enjoys the attention he or she gets and goes on to exhibit the behaviour as and when time permits and need arises.

This is a very, very brief outline of mental illnesses. This may not help you to understand them all. But to identify any mental illness look out for- 1) sleep disturbance, 2)lack of focus in work, conversation and self-care 3) unusual and inappropriate speech or behaviour even if it is only for a brief period, 4) emotional imbalance of inappropriately extreme sadness or elation, 5) a gradual decline in occupational, social and interpersonal spheres of life. If you notice these take the individual to a doctor. Don’t Google and conclude, don’t get swayed by the promises of quacks, don’t ask the opinion of every non-medical person ranging from your auto-rickshaw driver to your jobless neighbour. Mental illness is treatable and in many cases curable. Help them to get their life back.

This was written for ‘THE WEEK’ mental health special issue October 10, 2015 (http://specials.manoramaonline.com/THEWEEK/2015/Mental-Health/experts/various-mind-disorders-symptoms-therapies/index.html)

jealousy

“I wish I were jealous- of myself,” remarked a poet, apparently aghast at his felt incompetence. He may have been depressed at the time, feeling that his vocabulary bank was drying up or he may have been simply suffering from an inferiority complex comparing and thereafter feeling incompetent to rub shoulders with Homer or Goethe. He could just have begun his trip on jealousy.

Jealousy is not the exclusive domain of poets and artists. All of us have experienced jealousy. Though it is not principally categorized as an emotion, jealousy is a feeling that evokes strong emotions. Every human being has been jealous. Winged birds and their flights beyond visual boundaries evoked jealousy, and the zealous human invented the air-plane. The jealous do sometimes channelize their energy into creativity; but, more often than not, the jealous get crushed under the weight of their own desires.

Jealousy snarls at the mind only when there is a comparison; a comparison that is clouded by a wish; a wish that reminds one of one’s own inadequacy or another’s supremacy. There have been innumerable words written on the difference between jealousy and envy. Though being envious is considered a destructive mind set, jealousy has its word origin in a positive feeling – zeal and the desire to emulate. In the Shakespearean tragedy was Othello jealous and was Iago envious? Who was destructive? Is destruction only external? If envy is the fire that is lit to burn down another’s palace, jealousy is a flame that can gut down one’s own hut.

Though, from time immemorial, moralistic ethical teachings have advised humans to avoid jealousy, it has survived and even thrived. In modern times, jealousy is actually promoted. Every advertisement sells an idea that makes you zealous to ‘earn’ that commodity. Earnings- whether economical, social or emotional, always stir feelings of jealousy. You generally want something because you `know’ that someone else can afford that. The zealous are just the masked jealous. To emulate is a yearning, not for self-fulfillment, but for a social sanction. Jealousy is usually not about having, but about not having. To have or not to have is, not a need based decision. It is the product of desire. To kill desires and live in peace is the simplistic teaching of every messiah known and unknown  in this world. If happiness is the basic pursuit of humanity, then the peaceful smile and the graceful simplicity of the portrayed Buddha and Jesus should have evoked tremendous jealousy. Jealousy always spurs one to imitate the object of jealousy and achieve whatever is considered as the other’s achievement. Yet no one has jealously or zealously tried to emulate  Buddha or Jesus, except perhaps for some self-proclaimed God-men or Godly-men who of course have a different agenda to follow.

It is obvious that we all are jealous only of those whom we can easily emulate. A CEO of a MNC can only become jealous of the CEO of another MNC. He normally would not be jealous of the President of India or the USA. Jealousy is therefore based on assessment of opportunities. A columnist would become jealous of a Nobel laureate in literature only if he believes that he has the same potential to create similar works. An author generally is never jealous about an artist. A dancer does not feel jealous about a musician.  There are however, some people who just cannot take it when others win – deservingly or otherwise. These people cannot bear when some one else is in the centre of the spotlight. This is a different game altogether. This is envy- most frequently misused as a synonym for jealousy. Envy is actually an irrelevant, inappropriate and non-productive feeling. In envy I would even hate the plume of a peacock.

Just as how envy is about hatred, jealousy is actually about love! It is love of and for oneself. In a psychosocial perspective, our self is a broad enough term to include our primary family. It is in this societal context that this form of jealousy makes a loving parent become jealous of another’s child and other parents who have won more. When the coveted object is not a social applause but a personal psychosexual gratification, one feels jealousy when the object of love is actually in love with someone else. The primary concept of the mind in these cases is that one deserves much more than one gets, and one deserves so much because of the intense and immaculate self-love. This self-love is not narcissism which by its self consummated nature creates a monument of pride in one’s own mindscape. Narcissism and pride are inseparable while jealousy is essentially about one’s inability to achieve. Narcissism is about having in abundance while jealousy is always about insufficiency. Narcissistic self-love would look down on others while the jealous self-love would keep looking up at others.

Yearning and itching to reach the pedestal that another has reached creates various forms of unrest in the mind. There is sadness that one has not reached the line, and then comes a paranoia that there is a cosmic conspiracy preventing one’s deserved success. The blame game begins. Gods and stars are blamed for not formulating the right design called luck, society and family are blamed for not giving the right breaks. The whole world is blamed for not being capable of understanding and accepting true greatness. The mind sulks. The sulking mind falters. Everything is perceived with disbelief. There is lack of faith in others leading to doubts about self-worth. There is anger. There is bitterness. Simpler things become harder to do. Failures begin. Infinite circles of pain, paranoia, anger and sadness begin. Then and thus, jealousy becomes envy.

Emotions are the mind’s reactions to external events. Emotions though intense are not permanent. We all become angry or sad at times, but the same intensity of the feeling does not last for days and months. In the case of envy and jealousy it is different. Though envy and jealousy are also emotive responses to external events, they cast a deeper impression in the mind. They cloud the mind and colour the perspectives. Everything is viewed through the green-eyed glass of jealousy. Nothing is the same anymore. The affectionate competitor becomes the nasty winner and relationships become superficial societal obligatory chores. Once jealousy sets in, the mind begins to doubt. Even the sneer hides a fear. Contempt becomes a camouflage for failure’s self-inflicted wound. This state of mind can alter the route of life and lead to a downhill blind alley. It is in the best interest of oneself that one needs to encounter and handle feelings of jealousy and envy.

A  psycho-philosophical understanding of emotions declares that there are just three types of feelings – the pleasant, the unpleasant and the neutral ones. Jealousy of course is unpleasant- not only during its acute experience but also in its tragic aftermath. There is only one way to deal with these unpleasant emotions. One has to identify, understand and accept the pangs, causes and confusions of jealousy. The technique is simple. Just start watching the advertisements on the media. It is actually the moral right of every advertiser to entice more than educate, therefore just watch non-judgementally. Products are offered. Advantages are described. Even social reputations are challenged. But just watch. A product is offered for sale. To buy or not should be based on whether one needs it or not. Now examine the need to buy or have. Is it to enhance one’s own pleasurable moments of life or just to display in a corner without even noticing the dust gathered on it? But there are times when we can fall in love with an artifact and empty our purse to possess it. Even this will not create future unpleasantness, except perhaps when the credit card statement does not tally with your bank balance. Uneasiness and unpleasantness begin only when you want to buy or have something simply (and only) because someone else has it. It becomes more unpleasant when you realize that you cannot afford it. So the best way to overcome jealousy would be to become capable enough to afford whatever you want. Capability enhancement is the key. When you are immersed in a full-time activity like enhancing your skills, economy or relationships, there will be not be any time to be jealous.

Just learn to begin to be jealous of yourself.

written 2006