Mending minds

If you are excited by the human psyche and have compassion for the mentally ill, you will do well in psychiatry, says Pranab Ghosh.

Case 1: Padma, 55, was afraid of venturing out. She was scared of street dogs, birds or even harmless stray cows. The dogs would bite her, the birds would dirty her with their droppings, or she might just step onto the cow dung — so she thought. She confined herself to her house for 12 years until her brother took her to a psychiatrist.

Case 2: Harish, 45, was afraid of lifts. Every day, he walked up to the 13th floor of his office building, until his wife made him see a psychiatrist.

Padma was given intense counselling and was gradually exposed to the world beyond her home, which included a trip to the zoo, where the doctor accompanied her to help her overcome the fear of animals. And Harish, following effective counselling, was asked to use the lift regularly.

Both underwent behaviour therapy, a form of psychotherapy that aims to help patients change their behaviour through a series of discussions between the doctor and the patient. Both are now free of their problems. Welcome to the world of psychiatry. “It is the branch of medicine dealing with the mentally ill,” says Dr SC Malik, director professor in psychiatry and senior consultant at Sir Ganga Ram Hospital. “It is a specialty that is involved in searching the causes of mental illness as well as their management.”

The scope of psychiatric treatment in India has increased over the years. “People earlier had the notion that psychiatry is about treating psychotic disorder, which means treating grossly disorganised behaviour — behaviour of violent people, of people who are not in touch with reality,” says Dr Rajesh Rastogi, senior psychiatrist and head, department of psychiatry, Safdarjung Hospital and VM Medical College, New Delhi. But things have changed. “Today, psychiatry is also about treating adjustment disorders — marital disharmony, adjustment problem between parents and adolescents, minor neurotic problems, drug addiction etc. It teaches people how to manage stress.”

Modern living is full of stress, which leads to anxiety, and the man in the street is not aware of it to the right degree. “The individual Indian, like any other world citizen, may or may not be aware of the nature of stress and anxiety, and unless these reach a disorder level, may not be too concerned with them,” says Dr Alok Sarin, consultant psychiatrist, Sitaram Bhartia Institute, New Delhi.

Dr Padmapriya Chandran, senior resident, department of psychiatry, Safdarjung Hospital and VM Medical College, is more categorical. “Indians are largely unaware of the importance of mental health,” she says. Dr Rastogi agrees: “Often, people are not aware that mental illnesses are treatable. They, especially those in the rural area, do not know about the places where the treatment is available.” Media, both electronic and print, can and does play an important role in spreading awareness, he points out.

There are, however, not many doctors around. “The number of psychiatrists in India is around 3,000, much lower than the number in developed countries,” says Dr Rastogi. The reason for the shortage may be attributed to the limited number of institutes in India imparting postgraduate training, and the fact that many doctors have gone abroad for better scope, he feels. The shortfall, however, means there is that much more scope for young entrants.

Author: Pranab Ghosh

Date: 13th Jan., 2010

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