Published to coincide with World Mental Health Day, October 10.

On December 31 last year I asked MM’s editor if I could write about ‘my’ mental illness. Not waiting for a reply, I wrote to him again saying I would totally understand if the answer was a ‘no’. On January 2 he replied: ‘Why, of course you should, provided you also…’ What he meant was don’t make it just about yourself. So the point is well taken!

Mental health and illness are personal and equally societal. American writer John Updike puts it well: “We take our bearings, daily, from others. To be sane is, to a great extent, to be sociable.” While I had hoped to write about my mental travails and, in the bargain, gain some clarity myself, try as I might, I couldn’t string out sentences on what to say, how and how much to say, or whether to say it at all! To be sure I jotted down ideas and discovered that there was a reason for my unease. Anosognosia, not simply denial or a lack of willingness to accept a mental illness; it is a deficit in the brain’s ability to recognize and process information about one’s own condition. And yet, let us not forget that Madras or Chennai is a pioneer in mental health, with the Institute of Mental Health having been around for over two centuries. Boom!

Then I put down some queries and met Dr S. Swathik at his clinic in Kilpauk. I also corresponded and discussed with others. There are three brief life stories including mine and insights from a recovered schizophrenic.

Dr Swathik had felt a connection with psychiatry even as an intern in Madurai Medical College. Matters of the mind challenged him like a puzzle he was being pushed to solve. Life sometimes puts us in a state of instability vis-a-vis our distinct thoughts, emotions and behaviours. But when for some the instability becomes prolonged, intense, or frequent — whether individually or together — it signals illness. Instability that leads to harmful behaviour toward others or oneself requires urgent treatment. Generally, when it is a question of mental illness, people tend to trivialise it saying, ‘it’s all in the mind’ thereby suggesting that it is imaginary and not serious.

On his thoughts on the Bhavad Gita verse: “For him who has conquered the mind, the mind is the best of friends; but for one who has failed to do so, his very mind will be the greatest enemy,” Dr Swathik would rather use the word ‘regulate’ instead of ‘conquer’ because the latter sounds overambitious and controlling. We are better off facilitating a free flowing traffic of thoughts. Religion and spirituality should enhance our wellbeing and we should do the right thing for its own sake not out of fear of sinning and punishment.

There are conditions not tackled merely by talking with a trained professional. They need treatment with medicine to correct imbalances in brain neurotransmitters. Both disturbing and disturbed sleep patterns can lead to exhaustion and aggravate certain mental disorders.

The doctor’s advice to prospective students of psychiatry: Anyone who is curious to study the mind, is up for challenges, and is patient and empathetic, is welcome here. As for the mental pressure of practice, they are trained to handle it and need have no fears. A cardiologist is not any more susceptible to heart failure than a psychiatrist is to losing his mind.

Dr Swathik’s parting advice: I may be learned, intelligent but if something happens to my mind, I do not know everything about it just because it is ‘mine’. Taking help is not a sign of weakness. Though the mind is a part of me, it doesn’t define me, its failings don’t make me a failure.

Dr Lakshmi Vijayakumar, who founded the Chennai-based Sneha in 1986, writes extreme selflessness can lead to burnout, loss of identity, or even resentment; excessive selfishness can result in isolation, strained relationships, and reduced social support. Balance is achieved when a person is able to care for his/her own physical, emotional, and psychological needs without neglecting his/her responsibility and compassion towards others. She says that belief in religion and spirituality has a positive influence on mental health.

Sneha offers unconditional and confidential support to anyone feeling distressed, depressed or suicidal. Its volunteers are available on all days on the helpline 044-24640050/60 between 10 am and 10 pm.

You can visit their centre in RA Puram any day between 10 am and 6 pm if you feel like sharing in person. The address is on www.snehaindia.org. You can also chat with Sneha through their website on any day between 7 pm and 1 am or email (help@snehaindia.org). All their services are free.

Dr. Shreevidya, a practising physician for 22 years in Chennai and now the Medical Director of Preventive Health Care at Apollo Hospitals says “Mental and physical health are closely linked. Medical screening in asymptomatic people revealed more than 50 per cent have underlying mental health problems. In women, hormonal issues can be a pointer. Maintaining work-life balance and seeking professional help promotes good mental health.”

Girija* (50) of Nungambakkam is an artist and art educator. Vivacious, she is married to a loving man and they have two daughters. She grew up in Kolathur with a father who was treated for schizophrenia. His delusions and the ‘voices’ he heard affected his social interactions. Girija remembers him as an avid reader with a curiosity to know people but because of his illness, had to absent himself from his government job for long periods and finally take early retirement. While he was treated by government doctors, the family had to seek help from private doctors too, paying fees that were high for their means. Her mother bravely faced the challenges of parenting. Two aunts, a teacher, some friends and her all-consuming-interest in art saw Girija through difficult times. Later, five of Girija’s marriage alliances fell through because of her father’s illness. He went missing on the day before her wedding but returned on the wedding night. All the stress told on Girija’s mother’s mental health too. Today, Girija observes that parents expect immediate results from their children and are sometimes ignorant of their learning disabilities.

Dr TR Gopalan, surgeon and former Dean, Sri Sathya Sai Medical College and Research Institute, Thiruporur, says mental illness is entirely treatable like diabetes and blood pressure. Treatment should be tailor-made to each person, as each responds to stress differently. Having medicines on time and visiting the psychiatrist regularly is a must. Caregivers should listen to patients. Being secretive does not help. Patients may have low self-esteem and labelling traumatises them.

Abdul*, a welding shop owner in Amaindakarai took to the bottle, grieved that his daughter on whom he had showered all his affection, wanted to marry out of their religion. But he won over his distress quickly when his family counselled him and he turned his mind to prayer. Work, worship and the desire for the wellbeing of his family keeps him going despite two major setbacks to his health.

The Schizophrenia Research Foundation (scarfindia.org) was founded in Madras in 1984 by Dr M Sarada Menon, Dr R Tara and their associates. According to R Mangala, its joint director, early symptoms of schizophrenia can be sleep disturbances, decline in academics/work performance, irritability, crying spells and neglecting self-care. Later, delusions and hallucinations can appear with significant deterioration in functioning and interpersonal relationships.

While overcrowding and pollution make people in cities vulnerable to mental illness, access to mental health services, better awareness and opportunities to explore new activities, hobbies and socialising keep them sane. SCARF has an outpatient department, a 40-bed hospital, a daycare and rehab centre in Anna Nagar. There is a 40-bed residential facility for men in Mahabalipuram and a 20-bed acute care facility for dementia in Tambaram.

“There’s still suspicion and stigma about schizophrenia and mental illness in general,” says Ganesh N Rajan. “Most employers and the public lack awareness. I could not ‘come out’ in Chennai and declare I was afflicted, despite being in remission, until after retirement. Mental illness has nothing to do with mental ability. Every act of self-control builds self-confidence. So pause when you sense negativity, inside and out. To care-givers, I say, ‘Take care of yourself first. Draw boundaries. Take some time on your own every day and insist that this is a non-negotiable with the person with mental illness’.” To the community, he says “Look at the ripples of awareness you can cause in whatever capacity, you never know how it may help someone somewhere.”

Dr Bhargav Srivelu, consultant psychiatrist at Veera’s Hospital, Mandaveli, and Apollo Greams Road, says, “City folk are more vulnerable to mental illness. Stigma towards mental illness is more among the educated, especially when it comes to accepting diagnosis and medication.” Young people who come to him with psychological issues are at first told by parents to ‘sort it out’ by will power, spiritual activities or listening to motivational talks. The way forward is to be open about mental illness.

Sheela* of Anna Nagar has been married for 35 years. She said yes to marriage with Prasad*, impressed that he was open about his mental struggles. Sheela imagined that a bit of TLC would make him better. But Prasad’s mood swings and rages – triggered by his anxious mother – were making him miserable. He was unable to stick to a job – there were many – after the first flush of interest.

Sheela tried to balance the constraints with her own earnings. All this stressed out the family. The upbringing of their only daughter too became a huge challenge to Prasad. After 19 years of erratic psychiatric treatment, he was diagnosed as bipolar. With regular medication and therapy Prasad’s condition improved as did the family’s quality of life. Sheela now realises that she mistook Prasad’s sadness, happiness and other such emotions – even when they were out of range – as normal while actually there were underlying issues.

For more than 30 years, S Vidyakar (myhelpinghands.org) and Vandana and Vaishnavi (thebanyan.org) have been serving the cause of abandoned mentally ill persons in the city, and their work must be acknowledged here.

Swapna Nair, a former teacher in DAV, Gopalapuram, and a counsellor for 15 years, says, “I believe that feeling heard can shift a person from hopelessness to possibility. I have seen how stress is not merely an external force, but a deeply personal response. And Chennai being Chennai, the pressures can easily feel magnified. Mindful breathing, exercise, and creative hobbies can regulate our emotional responses. Therapy isn’t about weakness, it is insight and giving yourself the right support at the right time. To my fellow teachers, I say focus on knowing your student rather than merely imparting knowledge.”

And so, just as the tide returns each day to Chennai’s shores, resilience can return to every life — when we learn not to fight the waves, but to ride them with purpose and grace.

* Names changed.