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Intimacy is an important aspect of our daily lives. So much so that, when we take a medical case history, it is right there with sleep and appetite among the biological functions. Yet, in our society, most women (and many men) are not comfortable embracing this fact. Somehow, intimacy feels like a tabboo. Something that we do not discuss openly, even with our romantic partners.

Before we delve into the problems, let us revisit the virtues of a healthy intimate relationship. Of course, it feels great! That is a no-brainer. But that apart, a good conjugal relationship contributes heavily to the couple’s physical and mental wellbeing. And it certainly strengthens their bond.

So far, so good. What then, is the problem? Looking at it from a woman’s point of view, there are a few hurdles –

Guilty Pleasure: Modesty is a virtue. Especially when it comes to a woman. Women are brought up on a steady diet of ‘what not to do if you want to be a lady’ right from the day they are born. And you know what, it sticks! The modesty factor is so deeply ingrained in a woman’s mind, that any intimate pleasure she experiences (more so if it is outside the confines of marriage) is invariably associated with shame and guilt. Even when it comes to married life, the conjugal relationship is mostly for the man’s pleasure. And often, on his terms. A wife’s role is to provide that pleasure, and occasionally, kids as a byproduct. No room for her pleasure. Frankly, most men cannot tell if their female partners are sated. But it is not that they do not want to find out. However, here comes the most surprising revelation. The female partners are not a big help in this regard. There is no communication coming forth from their end that could guide their partner. The man is left to his own devices to figure out what works for her. And unless he has a revelation, he is often as clueless after the fourth intimate session as he was after the first.

Ignorance is (not) bliss: On that note, the male partner is not the only clueless one. His female counterpart is often worse off. Women are so caught up in the endless cycle of shame and guilt, that they almost never find out what feels good. As is often pointed out during therapy sessions, each individual is different and although a lot has been written about the elusive G – spot, it is not universal. When it comes to intimacy, there is never a one size fits all. If a woman does not know her body, there is only so much that her man can do for her. It is a shame that most women do not know what their pleasure points are. But the unfortunate fact is that they are often too embarrassed to explore their bodies and fantasies. And logically speaking, if women are not helping themselves, you really cannot blame the men.

Abuse: Speaking of the blame, most women deal with abuse at some point.Some more often than others.And what is even more unfortunate is that mostly the abusers are male members of her family.While the event is traumatic in itself, what completes the cycle of mistrust and humiliation is that her own kin covers up the incident because the family reputation is at stake. It is no wonder that the girl in question grows up feeling it was somehow her fault .Her future intimate encounters with her man become traumatic as she revisits these old wounds every time. It takes years of love, care and therapy to undo this damage. Unfortunately, most women never speak to their partners of the past hurts or make it to a therapist.

Intimacy, as we see, is more than just a pleasurable encounter. It is more about self and trust. And if one finds it difficult to do so on their own, there is always a therapist who can help.

drdebasmitapsychiatrist

Have you ever had a wild fantasy? Have you ever wanted to beat up somebody to pulp? Or better still, kill them? Have you ever wanted to jump off the nearest rooftop? Have you ever wanted to cheat on your partner? For most of us, if we are being honest, the answer to all these questions is yes. We all have dark, forbidden thoughts, desires and feelings. The problem is, these are in direct conflict with our morality. We are taught to live by a code of ethics right from our childhood. The sense of right or wrong. Anything that jeopardizes our moral compass is difficult to accept. But the truth is, we still have these urges and impulses. What do we do about them?

Think for a second. What would you normally do? First, it would be difficult to acknowledge the feeling as your own. If you succeed in doing that, it is even more difficult to accept the fact. You are bound to be tormented by guilt. So, what do you do? You banish the thoughts and feelings to the more inaccessible corners of your mind. Relief. But for how long?

It is just a matter of time before they resurface and you are fighting more pangs of guilt, this time laced with a little frustration or anger. The inherent question you ask yourself is, “Am I a bad person?”

Let us review this.

Going back to the beginning of this blog, if most of us answered yes to either of these questions, that would make a world full of bad people. The truth is our urges are not governed by moral principle. They are primal instincts. Morality is a concept we developed in the course of our evolution, for the sake of a crime free society. It is imperative that we pass our urges through our moral filters before acting upon them, if we are to live in a peaceful community. But we cannot disown our instincts. They are part of us.

Let us look at a real-life example.

A young boy who has grown up watching his mother getting abused by his father. The father, however, is an attentive and responsible parent, ready to do anything for his son. The boy is aware of this, and he loves his father. Despite that, he has this urge to beat up his dad for the way he treats his mother. And he is shocked and guilt-ridden by this revelation.

A brilliant scholar in her thirties suddenly finds herself falling head over heels over a colleague, despite being in a steady relationship. She describes it as akin to a teenage crush. She is unable to focus on her work or her boyfriend. To add to her worries, her friends are judging her for this. What she herself finds most difficult to accept is the fact that she is behaving like a starry-eyed teenager, forfeiting everything for a silly crush. Something her logical brain does not agree with. The frustration, guilt and anger she feels as a result makes her go spiraling into depression.

I could give you hundreds of such examples. But I think I made my point. It is perfectly alright to have “immoral” desires. That does not make you a bad person. It simply makes you as human as the rest of us. So unless you are signing up for sainthood, acknowledge these desires, accept them as they are, tell yourself it is alright and move on. If you need help along the way, reach out to us, anytime.

DrDebasmitaPsychiatrist

People have plenty of reservations before visiting a psychiatrist. It is surprising to know how many of us still think we can cure depression just by listening to pep-talk. You must wait till you are raving mad to actually see a psychiatrist!

Today’s blog is a much needed mental health myth buster.

Myth 1 – You can treat mental disorders by simply meditating.

If that were the case, antidepressants would never be invented. The truth is the mind is a function of the brain. There are plenty of neural circuits in the brain and there is a fine balance of neurochemicals that run these circuits. When the balance is disrupted, we suffer from mental disorders, be it anxiety, depression, mood swings or frank psychosis. Meditation is a great way to fine tune these circuits, but not in a disordered brain.We first need to restore the balance of neurochemicals before we fine tune them. In fact, meditating can worsen some mental disorders like schizophrenia.

Myth 2 – Once you start taking medications for mental disorders you cannot quit

This is one of the commonest questions patients ask before they start taking the medicines. The answer is a big NO. Unless you are suffering from a chronic disease like schizophrenia, you do not take pills for a lifetime. However, the meds need to be tapered off, meaning the doctor reduces the dose gradually before stopping them. If you stop taking them suddenly, your symptoms recur. So it is better to trust your doctor’s judgement on this.

Myth 3 – Medicines make you drowsy and idiotic

Of course not. Not all psychiatric medications put you to sleep or hamper your ability to think. If your pills are doing that to you, simply speak to your psychiatrist. He/ she will find an alternative for you. No big deal.

Myth 4 – Addiction is just a bad habit

It is true that addiction is a bad habit. But it is so much more than just that. The brain neural circuits rewire themselves on long term usage of addictive substances. Also, the body gets used to the continuous presence of the recreational drug. It then becomes almost impossible to suddenly quit without medical help. There are often severe withdrawal symptoms, both physical and mental, some of which may be life threatening. For example, alcohol withdrawal may precipitate epileptic attacks. Sudden heroin withdrawal causes acute bodily pain, so much so that the patient often wants to commit suicide. It is judicious to seek a doctor’s guidance when considering de-addiction.

Myth 5 – Counselling is better than medications

Though most people prefer counselling sessions to medications, it is best to let your psychiatrist decide that. A patient with severe depression, for example, cannot be cured by counselling alone. Nor can a patient with severe obsessive compulsive disorder. Medications are absolutely necessary here. It is fool hardy to refuse medications in such cases.

Myth 6 – Vitamins/ medicines can increase the intelligence quotient of kids born with below average intelligence levels

It is simply not possible. This unfortunate truth is often difficult for parents to accept. As such they run from pillar to post seeking a cure for their child, often administering unknown herbs and medications to the child. The adverse effects of these remedies could be dangerous.

Myth 7 – ‘Fits’ occur as a result of being ‘possessed’ by unholy spirits

It is shocking how firmly that belief is held by people. Only a small percentage of such patients are brought to a doctor. Most run from one faith healer to another without any cure. The truth is these fits are a result of a common psychiatric condition called ‘dissociative disorders’ and are treatable, provided the patient complies.
The list of such myths is never – ending, even in the present century. Hopefully, this article has addressed some of the common ones. For further queries, feel free to get in touch.

DrDebasmitaPsychiatrist

There is a belief in certain communities that we die each night while we sleep and are reborn each morning. I like to look at life that way. It changes my outlook towards life.

The Attitude of Gratitude

Each morning is a new life. Another opportunity to start over. And I am grateful for that. I thank God for having another day to live. We typically have a hundred things to be frustrated about each day, but we rarely count our blessings. Once I got into the habit of counting them, I realized the blessings more than balance the grievances. Reminding myself this every morning starts my day on a positive note.

The Positivity Journal

Many people maintain a journal chronicling their day. Mine is a little different. The entries only mention the good things about that day. A good meal. A patient who recovered. A walk by the river. Watching the sunset with my family. It is these moments of joy that make life worth living. And it is a shame not to celebrate them. Each morning as I go through the journal entries, I relive those moments.

Exercise

I insist that my patients get daily physical exercise. It is crucial for maintain good mental and physical health. When we work out, our brain releases lots of happy chemicals. You could call them natural antidepressants. Nothing like getting a morning boost of happiness! However, most people I know complain that they do not have enough motivation to keep going after a few days. I have a trick for that! I simply keep my exercise regime varied and interesting. It is actually something I find myself looking forward to daily.

Breakfast

I make it a point not to skip the most important meal of the day. Many patients tell me they simply do not have enough time in the morning to sit down for breakfast. This is not done. The body has been fasting overnight and it needs the morning dose of glucose to function properly. If it is denied that, symptoms like fatigue, irritability, inattention manifest themselves. No amount of tea or coffee can help with that. It is therefore better to wake up ten minutes early than skip the morning meal. Saves one a lot of trouble in the long run.

Work

I usually find it best to work on my pending projects first thing in the morning. You know, the ones that I have been procrastinating with for a while. As the day wears off, I usually have plenty of preoccupations to postpone these for yet another day. Better to finish them off when the energy and motivation is still high. And this achievement is duly noted in the positivity journal!

That more or less rounds off my mornings. Not that I do not have cheat days! But as I have learnt over the years, a little discipline and organization reaps huge benefits. And mornings are the best time to invest in one’s health and happiness. Afterall, I am determined to make it a very good morning, every day of my life!

DrDebasmitaPsychiatrist

The sight of worried parents sitting in the psychiatrist’s clinic with their kids is commonplace today. The question that very commonly comes up during such discussions is whether there is anything wrong with their parenting style. Today, we are going to discuss the basics of modern-day parenting.

The common challenges parents face

• Limited manpower – With the advent of nuclear families, we no longer have grandparents, uncles and aunts around the house. Hence, the burden of parenting rests solely on parents and the hired help.
• Multitasking – When both parents are working, they have to juggle their workplace and home regularly. Micromanaging so many things with so little support become quite difficult.
• Long absence – The child usually spends a major part of the day with the hired help or at daycare facilities. The parents’ absence for so many hours is a major hurdle to the child-parent bonding.
• The ubiquitous internet – Children get hooked to smartphones, computers and online gaming at a tender age. This makes them averse to socialization and decreases their concentration abilities drastically.
• Diluted boundaries – Growing up in nuclear families means children are privy to all that transpires between their parents. If parents squabble often, the child picks up on the trend. It then becomes very difficult to discipline the child.
• Competitive academic environment – Every child is made part of the rat race to excel in academics at all costs at a very tender age. Lessons become less fun and more of a daunting task.
• Lack of outdoor games – Children rarely go to parks and playgrounds on a regular basis nowadays. The lack of outdoor play areas, suitable playmates and the constant academic pressure are the reasons most parents come up with for this.

The child’s perspective

It is important to understand that the child is growing up with very little time and attention from family members, relying on the television and internet for recreation, and under a constant pressure to excel. Anxiety, depression, defiant behavior and internet addiction are the natural byproducts of this.

The solution

• Boundary setting – It is important to set boundaries between the child and parents such that the child is not a witness to couple fights, disagreements or adult conversations. This apart, it is essential that parents take some time apart to enjoy quality time with each other, so that the couple’s bonding remains strong.
• Quality time – Children crave attention from parents. If they feel ignored, the parent-child bond deteriorates rapidly. It is necessary to set apart an hour or two everyday where the family bonds together. During this time, every member should be present, physically and mentally, sans their ubiquitous gadgets. If this is a regular practice in the household, children feel loved and cared for, even if the parents have spent the greater part of the day at their workplace.
• Modelling – Children learn best by example. For instance, it is not enough to tell them that too much internet time is bad. Parents need to keep a tab on their smartphone time as well.
• Communication – All communication between child and parents should be clear and direct. Care should be taken that the child does not receive contradictory instructions from different adults in the family. Parents should remember that demeaning or criticizing each other in front of the kids is a strict no-no. It is also a good idea to verbally appreciate the child’s efforts regularly.
• Rewards – Children learn better when they receive conditional rewards for their good behavior. The incentives could be trivial things like the child’s favorite dish or extra half-hour play-time. But the conditions should be regular and non-negotiable. In case of bad behavior, the reward is simply withheld instead of punishing the child.
• Recreation – The game time for the child should be physical rather than virtual. Daily physical activity and outdoor games should be encouraged, even if that means half hour less study time. Discipline, good behavior, co-operation and socialization are better learnt on the field than at home.

In summary, we should reflect on the child’s emotional needs in today’s fast-paced world when rearing them so that they grow up to be emotionally-stable, confident individuals.

DrDebasmitaPsychiatrist

In today’s competitive world, none of us can confidently say that we are not stressed. We would all love to lead a stress-free life but we really do not know how to go about it. This article is your go-to manual for daily de-stressing.

We are distressed by external or internal factors that our set off the alarm signal in our brain. For example, our boss shouting at us or worrying about an upcoming examination. These factors are called stressors. Once the alarm signal goes off, the body and mind react on a fight-or-flight mode and all rational thinking goes out of the window. This is the basis for all anxiety disorders.
How do we prevent this?
There are logically 2 ways –

• Minimizing the stressors
• Increasing the internal resistance

A daily source of stress is the ubiquitous mobile phone. We are expected to be available at all places at all times. Even when we are home, we can hardly skip work calls and vice-versa. Do yourself a favor and switch off the work phone when you are home. Similarly, leave instructions that you are not to be disturbed with domestic decisions when you are at work. Once you start to compartmentalize your personal and professional duties, life will become easier and naturally, stress-free.

Another new trend is that of multitasking. If you think you will save time by working on the office presentation while doing your child’s home assignment, think again. Humans are not wired for such multi-tasking. As the brain constantly shifts focus between the two chores, it does not function very well and needlessly gets stressed out. So, it is best to do one thing at a time, with total focus.

Talking about increasing resistance, respect your biological needs and you will handle stress better. The body has three basic needs – sleep, appetite and sex.

Try to take all major meals on time. Most importantly, do not skip breakfast. The brain needs glucose to function. If you constantly make it run on low fuel, the stress will show. Similarly, it needs to rest and rejuvenate. It is mandatory to get at least 6-7 hours of uninterrupted sleep at night. The need for physical intimacy is also another important aspect of our biology, which sadly gets overlooked due to our fast lifestyle. A healthy sex life goes a long way in maintaining the body’s equilibrium.

Also, take time out for short breaks between work assignments. Relax, take a walk, listen to music, chat with your friend or simply take a siesta. Do anything that helps you unwind.

These subtle changes, if introduced into our daily routine, can produce unbelievable results when it comes to handling stress. Here’s hoping you go from distressed to de-stressed soon!

drdebasmitapsychiatrist

There is scientific truth behind the saying, ‘an empty mind is the devil’s workshop‘. Whenever we are not focusing on the task at hand, our brain goes on the autopilot mode. And this is the crux of our woes. Let us see how.

Say you are eating your breakfast before going to work. Nine time out of ten, your mind is wandering to other more ‘important’ things. For example, you are running late for work. Even as you realize you have to take your kid to school on the way. And when you do get to office, you have to finish yesterday’s pending assignments before your boss inundates you with fresh ones. So on and so forth. As a result, you barely notice if you had cereals or toast for breakfast. You see, even before you leave home, you are already in panic mode. That is just the beginning of a very long a day. No wonder that by nightfall you are tired. If you pay attention, you will notice that this pattern continues day after day. We either obsess over the past or worry about the future, never really living in the present.

So what is the way out? Imagine what would have happened in the above example had we given the breakfast before us its due attention. Science has shown that we are able to entirely focus on one thought at a time. And the moment we focus our mind on something, the brain’s autopilot mode switches off. Since this autopilot is the source of all our random worries, we are spared the misery. Sounds easy enough. But it is easier said than done.

Enter mindfulness. The idea here is to be entirely aware of the present. This includes our surroundings and the workings of our body and mind. If we are able to do this every moment, the brain learns to intensely focus on ‘living’ and switches off its autopilot. The constant habit of worrying disappears. The quality of your life elevates.

You will be surprised to learn that we are really captives of our own mind. It is not the external stressors that suck out our life force, it is our habit of ‘living in our heads’ that does the trick. No matter how much we worry, we cannot change the past or the future. We only get ourselves worked up and anxious. Once we learn to let go of the worries and focus on the matter at hand, we are free from the shackles of anxiety disorders – the bane of our generation.

That being said, mindfulness does not develop overnight. It requires proper training and diligent practice.
If you are interested, reach out for help from a professional and get going!
drdebasmitapsychiatrist

Before we begin, let us understand what we mean by ‘assertive communication’. It is a style of communication where you get your point across firmly yet politely, remembering that both you and others have rights.
Let us explain with an example. Say, your friend asks you to join him for a movie. You would rather stay home and complete an important assignment so you need not work throughout the night. And you are not really crazy about the movie in question. But you do not want to offend your friend. You are sure if you refuse, he will take it to heart. So you go to the movie, all the while worrying about the assignment and not really enjoying .At night you lose sleep over the assignment, and curse yourself for agreeing to go in the first place. But then, how could you have refused?

Let us analyse this rationally. You took so much trouble because you could not say no. I think most of us can relate to this, in various situations. Coming to think of it, had you explained your situation to your friend, and made plans for another day, he would hardly have taken offence. In all fairness, your friend has the right to your companionship, and you have the right to decide when you must prioritise work over pleasure. This is assertive communication. You said no, firmly and politely (explaining yourself thoroughly and apologising of course) and made plans for another day respecting the rights of both.

In case you are wondering, what happens when we are not assertive? We end up blaming others (say, our supervisor for giving us extra assignments) and ourselves (because we could not tell him/her that we are already buried in incomplete assignments). And then we get anxious because we have more on our plate than we can handle, and depressed and frustrated when we are unable to meet deadlines.

People come to us every day with anxiety, panic attacks, depression, anger issues and believe me, in many cases, the root cause is lack of assertiveness. It is therefore just not enough to address the effect (say, anxiety or depression) but also the cause (communication skills).Only then is the therapy complete.

This was a brief overview. Hope you enjoyed reading. If you find yourself wondering how to go about being assertive, feel free to ask.

drdebasmitapsychiatrist

We are living in a fast-paced world where everyone seems to be multitasking. It is a race against time out there. No wonder clients often come to us with complaints of poor concentration. This article gives an overview of the science and art of concentrating better.

Do not –

Become a slave to the ubiquitous smartphone – The importance of digital detox cannot be over emphasized. If we are continuously scrolling through innumerable newsfeeds, the brain is overloaded with enough junk to last several lifetimes. When we peek at the phone notification between work assignments, a residuum of this useless information is retained in the brain. This drains the limited attention reserve. As a result, we are unable to focus adequately on the task at hand.
Multitask – Though it may seem prima facie that this gets a lot of work done in a short time span, the quality of work is often poor. It is because whenever we are shifting from one task to another, a residue of the previous task still holds our attention, leaving only a fraction of our attention reserve available for the next task. Following this logic, imagine what will happen if we juggle four-five tasks simultaneously. It is a recipe for disaster!

D0 –

Set definite goals – The key to getting any work done in time is to set a doable deadline. The stress is on doable. This is because we often come across people who set ambitious deadlines after elaborate planning at the beginning of their workday, only to accomplish nothing productive in the end. Know how much you can handle and deal with one deadline at a time. This is especially true for students and people who freelance at work. With no deadlines imposed from outside, structuring a workday is a challenge they must take up daily. The more structured your work schedule, the better you are able to concentrate on the task at hand.
Take short breaks in between – Many people complain that they have been sitting at the desk for the entire day with very little to show for the effort. Had they taken short breaks in between, they would have fared better. The brain works on the reward mechanism. If you know you can go for a round of badminton once you finish the current assignment, your brain makes all possible efforts to get the job done on time. Plan little rewards for yourself after each completed assignment and see how much you accomplish.
Just stick to these four fundamentals and watch your concentration skills improve in no time!
drdebasmitapsychiatrist

Life with dementia can be very challenging, both for the patient and the caregivers. Let us understand why.

Dementia is primarily characterised by memory loss or amnesia, as it is known in medical terms. The patient remembers his/her younger days just fine. But when it comes to recent memory, it falters. Let me explain this further. Say you ask the patient to describe his/her wedding day. It will be an almost perfect description. But ask them what they had for breakfast this morning, and they are clueless. This gets worse with time. Often he/she finds it difficult to find the way back home when he/she has ventured out. As the disease progresses, they finding the way back to the bedroom from the kitchen becomes a tedious task. In later stages, patient forgets learned activities, like how to dress or undress. They also have difficulty identifying relatives or friends whom they are seeing after a while. Recalling people’s names becomes a challenge. What is interesting albeit pathetic is that they often forget how they themselves look. It comes as a shock for caregivers when the patient refuses to identify himself/herself in the mirror. Slowly, they lose track of day, date or time.

Added to these, a separate set of problems emerge. Their behaviour changes. That is to say, family members are surprised to note that patients are suspecting people of stealing their valuables, sleeping erratically, getting mad at caregivers over trivial issues or getting fearful for no apparent reason. Sometimes they hear voices others cannot hear or see apparitions. Despite repeated reassurances, they are convinced of the existence of these unseen and unheard entities, to the point that they can be seen muttering to themselves, when actually they are having a conversation with these apparitions.

Is there a solution? The answer is there is no permanent cure. We cannot reverse the disease process. But we can slow down its progress in many cases. There are drugs for doing just that. But the medications are not one size fits all. The psychiatrist will pick and choose the right drug depending on the patient profile and tolerability of medications. That is to say, we want maximum response with minimal adverse effects. This apart, they need support for daily activities. This is where the role of caregivers comes in. Your psychiatrist will explain how to take care of the patient and these instructions need to be followed diligently for good results.

As I always say, the psychiatrist and caregivers need to put in a team effort to give these elderly persons the life with dignity that they deserve. To sum up, life with dementia is difficult, but it is not the end of the road.

drdebasmitapsychiatrist