Wednesday, 12 June 2013

Empowerment and suicides

Talking to the car mechanic gave me an idea of how the patient coming to a doctor's clinic or emergency room must feel like.

If I can feel so ignorant about a car, which is man made; surely the human body is much more of a complex creation of nature.

It was like this guy was telling me- "we need to take the kidneys out as they need a wash and the liver, thanks to the wine on weekends does look like it is not going to last your next health check up... so be prepared to have that replaced and the heart....well it doesn't help that your body is so heavy and the fact that you run it so little...." I just had to agree to whatever he was telling me because I have no clue whatsoever, about how a bloody car works. Needless to say every health check for the car runs into hundreds of pounds subtracted from my bank account.

Sadly not all human organs are so easily replaced. Today I read a facebook post about Jiah Khan's suicide and the fact that his ex boyfriend being arrested for abetting suicide was just unfair and gives women a chance to blackmail men into commitment.

All this macho talk about- "women should be strong" "Relationships are not the be all and end all of one's existence" "Parents should have given her better values so that she did not get herself in this situation" etc etc is all very well but the fact remains that for a young beautiful girl with so much potential, to be driven to take her own life, she must have been in a very sad and horrible state of mind. She must have needed help which wasn't forthcoming in our society and she could not bring herself to ask for that help.

Just around the same time we heard of suicides amongst celebrities and celebrity children, I happened to see a young beautiful and pregnant girl who was crying and saying things like- "I want my baby to be safe" "It has taken me a long time to ask for help" "I have been searching the net for ways to kill myself"

I don't often feel like this, but while talking to this desperate girl, I actually felt like bursting into tears myself. To put things in perspective suicide is amongst the top 4 causes of maternal death in UK and has recently become the leading cause of death in women aged 15-49 in India. Second is childbirth, earlier it used to be at the top.

I asked this girl if it would help if we admitted her into hospital and she said-"I can't change my brain, it doesn't matter where I am and who I am with"

When we started reading psychiatry in medical school, we realised that there was such a thin line between the normal and abnormal. We had all encountered people who were Obsessive compulsive neurotics, the uncle who checked the garage door lock at least 3 times after turning away from it, the aunty who was getting an allergy to soap, from washing hands all the time...etc etc.

But significantly mental illnesses are just like physical illnesses. You don't say, your mum should have brought you up better to ensure you never had a heart attack. Yes, had you not been overweight, inactive, alcoholic and smoker (i.e. had not had a brake fail or a broken windscreen), there was lesser likelihood of meeting with an accident/ heart attack but yet having everything in perfect working order, doesn't guarantee anything.

Similarly, being born wanted, having loving parents; who along with loving you, loved one another, having a good education, having friends etc etc must shield us from mental illnesses which have more of an environmental causation but yet there are a host of illnesses which are genetic, endogenous and are not brought on by circumstances and depression leading on to suicidal thoughts is one of them.

Laws in India reflect the fact that suicides amongst women have been found to have a strong association with domestic violence. Dowry deaths and deaths from fires were many times staged as suicides. But now men are considered guilty unless proven otherwise. I have known married women with children on long term prescribed medication for depression,  where husbands were arrested and considered guilty when the woman decided to kill herself. Collateral damage from the laws meant to empower women.

Yes we need to enrol ourselves and our children into daily inbuilt art of living classes, where we live healthily, have a healthy balance of love, togetherness, friendship, companionship, tolerance and self reliance but mental illnesses have long been neglected. The result is that going to a shrink carries a stigma. There isn't the level of awareness or infrastructure to help people when they need help but don't know who to turn to.

Kiran Bedi used to write a column where she used to ask the question whether the education system in India is failing the young women, who after having worked for and completed post graduate degrees still consider their lives a failure if their spouse decides to reject them.

Empowerment is a big word, difficult to understand and much more difficult to achieve with or without laws and in laws.

So long!


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