LOUDSPEAKER

THE Summer 2016

Amplifying the voice of mental health

MOODS AND EMOTIONS

20
An Unquiet Mind:
a memoir of moods and
8 madness
How Can We Use
Music To Handle
29
Our Emotions?
HEALTHY USE
OF TECHNOLOGY
AMONG YOUTH

6 32
Emotions on Handling Difficult
the Go… Emotions

...Plus Our Regular Features

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1
Amplifying the voice of mental health
 NIMHANS Centre for Well Being
A Centre for Mental Health Promotion
#1/B, 9th main, 1st Phase, 1st Stage, BTM Layout, Bangalore– 76.
Phone: 080-26685948 / 9480829670 email: nimhans.wellbeing@gmail.com
www.facebook.com/nimhanscentreforwellbeing

Mental health for persons with medical illnesses

Marital enrichment services

Stress management

Trauma recovery

Brief psychotherapies &

counseling services

Enhancing positive mental health

Services
Family counselling

Parents support group

Offered
Support in intimate partner
violence

Prevention & early treatment for addiction

Enhancing parenting skills & child mental health

Services for healthy use of technology

Workshops & training programmes in mental health

Elderly helpline & mental health helpline

Youth well being

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2 Amplifying the voice of mental health

 LOUDSPEAKER
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Amplifying the voice of mental health

Editor

Dr. Prabha S. Chandra

Professor of Psychiatry
Coordinator
NIMHANS Centre for Well Being

Editorial Team : (Left to Right) Meena K.S, Prasanthi Nattala, Manoj Chandran, Sub Editors
Prabhu Dev, Padmavathy, Prabha S Chandra, & Taranum Taj
Dr. Prasanthi Nattala
Editor’s Note Associate Professor of Nursing
NIMHANS

D
riving to work every morning on one of the busiest roads in Bangalore,
I spend my time during the inordinate wait at signals, watching
people’s emotions. Dr. Meena K.S.
Assistant Professor of
The annoyance in the driver behind me who honks even when one is at a Mental Health Education
red light, the smile on an auto driver’s face when he is having an interesting NIMHANS
conversation with a customer, the surprisingly friendly banter between a
transgender woman with bright red lipstick when she asks for money from
a young man on a motorbike, the desperation of an elderly woman who sells Smt D. Padmavathy
jasmine flowers on the road and of course the occasional person who flies off In-charge Staff Nurse
the handle on the road, swearing at someone who overtook him. NIMHANS Centre for Well Being
Emotions are all around us and often control the way we behave and respond
to situations. Emotions and moods influence the atmosphere of our families
and our work place in several different ways and are hence worthy of our Editorial Board
attention. Emotions are also contagious and a smile can cascade into positive
feelings of people around you while a frown can cause just the opposite. Mr. Manoj Chandran
Most emotions are fleeting, like clouds, and pass on without lingering. Mr. Prabhu Dev
However, sometimes emotions can remain as the predominant mood or they
can get intense, causing distress to the person and the people around. It is Ms. Tarannum Taj
these emotions that are worrying and need professional help. Many of us may
not be aware of the nature of our feelings and find it hard to articulate them
or even label them.

In this issue, my efficient editorial team at Loudspeaker and the expert authors
attempt to bring together various aspects of emotions . We address several
Conceptualised and produced by
aspects of moods, ranging from road rage to encouraging expression of feelings
in children. We also discuss Bipolar Disorder, the extreme and sustained form NIMHANS Centre for Well Being
of emotions becoming pathological and the role of music on our emotions.

As the singer Manna Dey croons in the song from the film Anand - Cover photos:
Zindagi, Kaisi hai paheli haaye Sunita Chakraborty
Kabhi to hansaaye
Kabhi ye rulaaye
Photo Credits:
(What a riddle this life is. Sometimes it makes us laugh and sometimes it makes us cry)

So as we continue this journey that is life, we hope this issue of Loudspeaker

will help you understand this riddle better, if not the solution to the riddle!

Printing of the Magazine funded by: Dr. Ramachandra N National Institute of Mental
LOUDSPEAKER
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Moorthy Foundation for Mental Health and Neurological Sciences Health & Neuro Sciences
Amplifying the voice of mental health
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 LOUDSPEAKER
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Amplifying the voice of mental health

Contents

6 Emotions On The
Go…
Fr. Rajeev Joseph
Dr. Seema Mehrotra

How to put a brake

to negative emotions
and enhance safety
while on the road.

14
How Can We Use Music To
Handle Our Emotions?
Dr. Shantala Hegde

8
Ageing And Elder Care: Making An Elderly Family
“Without music, life would Member Feel More Secure
be a mistake” said the famous Dr. Santosh Loganathan
philosopher and composer,
How to make an elderly family member feel
Friedrich Nietzsche.
emotionally secure, particularly in these days when
nuclear families are on the rise.

What Is Bipolar Mood Disorder? How Can You Help Children To Express Their
Dr. Muralidharan. K Emotions Better?
Dr. Kavita Jangam
Certain insights into Bipolar Mood Disorder, a serious, Ms.Chaitra Holla
but treatable mental illness.
Helping children to express their emotions,
particularly as they are at a phase where they are

11 very sensitive to the changes in their environment,

and have an innate need to discuss what they
observe around them.

17
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An Unquiet Mind: A Memoir Of Moods And Madness
Mr. James Joseph
Dr. Krishna Prasad M

It indeed takes a great deal of courage to write

26
about one’s own illness, and Kay Redfield Jamison, I Feel Like An Outsider - How Persons With
Professor of Psychiatry at Johns Hopkins School of Schizophrenia Can Understand Other People And
Medicine does not have any less in measure.

20
Communicate Better
Dr. Urvakhsh M. Mehta

How to improve social interactions among

individuals with schizophrenia.

29
22 Healthy Use Of Technology Among Youth
Managing Emotions In The Workplace Dr. Manoj Kumar Sharma
Dr. Paulomi M Sudhir
Ms. Janhavi Devdutt Promoting healthy use of technology among the
youth, especially during this era when the internet
Recognizing the importance of emotions and their has revolutionised how we communicate, and has
role in workplace interactions. opened up entirely new forms of social interaction.

Emotions And Eating: Feeding Your Feelings! Handling Difficult Emotions

Dr. Preethi Sinha Dr. Poornima Bhola

How to ensure that negative emotions do not Gretchen Rubin, chronicled her one-year search for
promote unhealthy eating. the secrets of happiness in her bestselling book

24

32
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 Emotions on the Go…
Roads tell us the stories of the joys of travel as well
as our frustrations. Many of us spend about an hour
or more of our wakeful time on the road on a regular
day. There are so many different emotions that we
frequently experience while on road, as a driver, a co-
traveler, a passenger in a cab, or a pedestrian. These
emotions come from what may be happening off
the roads in our life as well as what happens on the
roads. Have you noticed that there are times when
we may take out our vehicle in order to experience an
emotion or a mental state (e.g. excitement, a sense of
control/freedom) or to get relief from an unwanted
emotional state (e.g. boredom, anger, helplessness)?
Some also report speeding up in order to get relief
from negative moods. Such experiences remind us
about our vulnerabilities on the roads and caution
us about the need to apply the brake on emotions
and the associated risky behaviours at the right time.
They remind us about the thin line between narrow
escape and fatal error.
There are multiple triggers on the roads that are
potentially bothersome. It is true that there are
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6 Amplifying the voice of mental health
a number of external reasons for the negative
emotions we experience: the unrelenting traffic,
the bad road, the vehicles spitting thick black
smoke and the blinding dust, the erring drivers
and the incessant honking. Some of these can be
altered by judicious and committed actions of the
government and the citizens, but there are those
little things that we can do as individuals too,
which can make a difference. For instance, when
we are feeling sad or fatigued, slower reflexes may
hinder quick responding. It may be useful to use
our own uplifters/energizers such as talking to a
supportive buddy, or a taking a power nap, before
starting on a drive. At other times, we may be in
the amber zone of emotions (e.g. feeling a little too
excited or anxious) that makes it difficult for us
to focus. Reminding ourselves to slow down and
focus on the task at hand may be useful. The red
zone of emotions (e.g. feeling angry) is clearly a
signal to take a brief pause to cool down. Taking
a few deep breaths, listening to soothing music/
humming and calming self-talk like “Let me put
it on hold” might help. Our ability to manage our
own emotions wisely is sometimes really tested
due to challenging road situations. Our response
to such frustrations may at least partly reflect how
we respond to challenges in life, in general.
The other way of looking at our road experiences and
behaviours would be to see the emotional triggers
on the road as opportunities for us to learn, practice
and strengthen certain skills. Oh no, no… we do not
mean stunts, weaving/zigzagging skills or getting
into racing competitions (for these, it is wiser to join
a rider’s club)! We mean practising the art of staying
patient, staying as calm as possible and responding
intelligently rather than reacting impulsively to
provocations. It means learning to tell ourselves that
‘I am not going to let others or the road situations
provoke me into driving irresponsibly’. So, it is
about ensuring that it is we who are driving our
vehicle, and not our emotions taking us for a ride.
Roads also give us enough opportunity to notice and
appreciate the goodness of others, even if you think
that we have to look really hard and long for that!
Have you heard some of these uplifting stories: the
Dr. Seema Mehrotra
Professor
Department of Clinical Psychology
NIMHANS, Bengaluru
truck driver who stopped (despite all the honking
and the protest behind him) and gave time to an old
man to cross the road in the midst of torrential rains
on a narrow lane… or a pillion rider who got down
from the bike while waiting for red light to turn green
and lifted a huge piece of stone and kept it away to
avert a road accident… or the good Samaritan who
turned into a traffic-manager for thirty minutes in the
scorching sun to clear the maddening traffic-jam on
a super-busy junction with no traffic police? Can we
offer such small acts of kindness and courtesy forward
and create a ripple effect? Be Kool and Ride Kool!..
Fr. Rajeev Joseph
Clinical Psychologist
St. Joseph’s Hospital
Registrar, Jothirbhavan
Institute of Theology & Spirituality
Kochi, Kerala
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 How Can We Use Music To
Handle Our Emotions?
A narration by Mrs. Sangeetha
“Without music, life would be a mistake” said
the famous philosopher and composer, Friedrich
Nietzsche. This is completely true in my case, having
completed more than five and a half decades of my
life. As a widow and mother of two children, my
life was completely busy until my children decided
to move away from home in search of better career
opportunities. The sudden emptiness and sorrow
that followed was immense, and it was my interest
in music that helped me come to terms with this
change. I started listening to my old music collection
of film songs and classical music. I started listening to
music regularly, and I would keep the music player
on while I was carrying out all the household chores.
This way, I could focus my mind on the melody of
music, and also keep myself away from the boring
saga of mega serials on the television which only
enhanced negative emotions. I even dusted my old
musical instrument, the veena, and started playing
some basic lessons I had learnt in my childhood.
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This brought back my old childhood memories,
and I felt like a young student. There was a new
goal and meaning in my life. Music not only evaded
the feelings of emptiness but made a lot of positive
changes in my life.
Myriad benefits of music
An entertainment...
Music, at its very fundamental level,
provides entertainment. Self preferred music can
be one’s best companion whilst doing routine
household chores, such as cleaning, washing and
cooking, and while travelling. This will also keep
our mind engaged. We often learn new songs and
lyrics while humming along. This engages our
ability to memorize new things. An even rhythm in
music entrains us as well as entrains our inherent
biological rhythm. When we walk or talk there is
an inherent rhythm in it. Rhythm, which is a key
component of music, can impact our heart rate and
thereby our arousability.
 A method to revitalise...
Music has the power to revitalise our mood.
Listening to self chosen music in the morning
hours and relaxing music that has calming effect
in evening can help us energise and calm down
during dawn and dusk, respectively. Listening to
a slow to medium paced rhythmic music can be a
good companion during morning or evening walk.
Slow paced instrumental music can facilitate good
sleep as soothing music has an impact on our brain
electrical and chemical activity.

A stress buster...
Music can be a good method to distract from
unwanted thoughts and even physical sensations
such as nagging pain which responds poorly to
medication. Actively and passively engaging in
music is known to release natural pain killers known
as endorphins. Listening to music also lowers the
levels of stress hormones known as cortisol.

Facilitates emotional catharsis...

Music chosen to match our present
emotional state can help us to vent out the emotion
(emotional catharsis). Thoughts and feelings that
we find difficult to express through words can be
expressed or experienced via music. Music can also
enhance our capacity to empathise with the emotions
of others.

engages emotional components attached with the

Juggles up past memories...
past memories. Often this brings solace.
Music can juggle up past memories or
shared emotions with family, friends and loved
A brain gym...
ones. Dwelling in the past and remembering the
Actively engaging in music, such as singing
past is one of the methods of introspection. Music
or playing an instrument, gives a strong sensation
therefore not only engages mental processes but also
of thrill or feelings of accomplishment. It activates
strong emotions. Apart from providing deep
sensations, actively engaging in music involves a
host of cognitive, emotional and motor processes
which are important in maintaining our overall
mental fitness.

The beauty of using music is that it can help

us achieve more than one of the above mentioned
domains at any given point in time. Self preferred
music can entertain, revitalise, distract from
unwanted thoughts, relax and activate a range of
mental processes at one go. Indulging in music
will surely have greater impact when compared to
passive listening. Age is not a barrier and becoming
a professional musician need not be everybody’s

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 goal. But learning some form of music can be part of
everybody’s routine. Music is considered as the best
exercise to keep our brain, our mental and emotional
processes, fit.

A few take home messages..

• Music engages many mental processes.

• Familiar music is good, but music that is

unfamiliar may also have positive impact.
Various features of music such as volume,
density of notes, rhythm, timbre, minor or
major notes etc. have strong effect on our
musical experience.

• Actively engaging in music is always superior

to passively engaging in music.

• There is no age limit to learning anything

new, including music.

Dr. Shantala Hegde

Assistant Professor
Department of Clinical Psychology
NIMHANS, Bengaluru

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What is bipolar mood disorder?
Bipolar Disorder or mood disorder is a serious but
treatable mental illness that influences the mood states
of a person in an unusual way. Bipolar Disorder (BD)
is characterized by two phases, namely: the “Up” Phase
or manic episode and the “Down” Phase or depressive
episode. Persons with BD could experience these
episodes or phases in an alternating manner and often
have normal mood in between them. The up feeling
or the mania, lasts for more than a week. The down
feeling or the depression usually lasts for more than
two weeks.
How is bipolar disorder (BD) different from the
normal everyday ups and downs that we experience?
BD is different from the normal mood swings: the
ups and downs that people go through, often in
relation to the environment. Bipolar symptoms are
more powerful than that. They can negatively affect
relationships and make it hard to attend school or
work. They can also be dangerous as people with
BD may try to hurt themselves/attempt suicide. It is
extremely important to be aware of these symptoms
in order to seek help for oneself or others immediately.
What are the symptoms of bipolar disorder?
Symptoms of a manic episode are:
• A long period of feeling “high” or extremely
happy, or feeling extremely irritable and angry,
lasting more than a week
• Feeling more energetic or powerful, often
involving oneself in many activities and not
completing most of them
• Being easily distracted
• Having racing thoughts
• Sleeping less than usual but still feeling
refreshed
• Having unrealistic belief in one’s own abilities
or identity
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• Behaving impulsively and taking part in
pleasurable, high-risk behaviors, such as
spending sprees, impulsive sex, and gambling
which is unusual for the person

Symptoms of a depressive episode are:

• A long period of feeling sad or “low” most of
the time, often crying without any apparent
reason, lasting for more than two weeks
• Feeling tired or slowed down, less energetic
than usual
• Loss of interest in activities which were
enjoyable before, including sex
• Having problems concentrating
• Loss of self-confidence
• Negative thoughts like one’s future looking
bleak and that one has become a burden to
others
• Thoughts about death and bereavement
• Suicidal thoughts/attempts
• Decreased sleep and appetite, sometimes with
weight loss
Who develops bipolar disorder? What causes
bipolar disorder?
Anyone can develop bipolar disorder. It is equally
common in males and females. It usually starts
in the early twenties, but can also affect children
and elderly. In some women, it can occur during
pregnancy or after delivery. Once diagnosed, it
is a lifelong illness, although it can be controlled
effectively with treatment.
The exact cause is not known but research into the
causes of bipolar disorder is ongoing. Sometimes
bipolar disorder runs in families (genetic cause),
though it may not affect all family members.
Abnormal brain structure has also been associated
with bipolar disorder.
How is bipolar disorder diagnosed?
The diagnosis of bipolar disorder should be made by
a psychiatrist or a mental health professional.
The diagnosis is made after a careful psychiatric and
medical evaluation. Some investigations are advised
to rule out common medical problems, like thyroid
disorders, anaemia, diabetes and brain disorders.
There is no laboratory test to diagnose bipolar
disorder.
It is often not easy to diagnose bipolar disorder as it
co-exists with other conditions like attention-deficit
hyperactivity disorder, alcohol or drug abuse and
some neurological/endocrine disorders, to name a
few. Consultation with a doctor is a must to diagnose
this condition.
Self-diagnosis is best avoided. It is important to
consult an expert immediately if you or someone
known to you has symptoms of bipolar disorder.

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What is the treatment for bipolar disorder?
There is no cure for bipolar disorder. However, it
can be treated effectively and kept under control
like other medical disorders like diabetes and
hypertension. For severely ill patients, admission
to the hospital may be necessary.

All patients will require treatment with medications

and/or psychotherapy. Antipsychotics and mood
stabilizers are the commonly prescribed medications.
Some patients may in addition require medications
for sleep. Patients should take medications regularly
and attend follow-up, as prescribed by the treating
doctor, to keep the disorder under control. The doctor
will monitor patients for common side effects of the
prescribed medications. Some patients, particularly Where can one get treatment for bipolar disorder?
in the acute phase, may require treatment with Treatment for bipolar disorder is provided
Electro Convulsive Therapy, commonly referred to by all hospitals with a specialist psychiatrist.
as ‘shock therapy’ in lay terms. NIMHANS provides treatment for at least 2000
new patients with bipolar disorder each year.
Psychotherapy/counselling is prescribed in addition Consultation at the earliest is best for any patient
to medications. This is usually for patients who are with bipolar disorder.
having depression or who have difficulties in social/
occupational functioning.

Any co-existing medical conditions, like thyroid Dr. Muralidharan K

disorders, would require appropriate treatment. Additional Professor of Psychiatry
It is important to seek treatment early for the disorder Department of Psychiatry
to be controlled more effectively. NIMHANS, Bengaluru

Of Loss, Coping and Surviving

Life is filled with so many emotions - Happiness, sadness, love, hate, tears, laughter and many more.
Emotions are the innate feelings of an individual and words can never fully express how much someone
means to us. Language and verbal expression may however provide comfort, solace, hope and even
inspiration following the death of a loved one. All of us have emotional vulnerabilities that can drive
our behaviour for better or worse. Each of us as individuals have our unique experiences and each of us
may react differently according to the circumstances we face. Few years ago, I had a precious loss “My
Mother”. This was also a time when I was at the critical juncture in my career. Losing the person I loved
and admired the most had me totally shattered. There was a block in my thought and I didn’t know how
and what to express. My surroundings were loud but I couldn’t hear anything.

Despite the huge loss, I always felt her presence. Indirectly her thoughts would strengthen my will power.
She taught me many beautiful lessons but nothing that could help me handle this most challenging time
and accept new changes without her. However, one realizes that life doesn’t stop, whatever happens. I
still carry within my heart a dull and lasting ache where once I felt love and security. I also realize that
it is important to continue my search for the happiness the way my mother always desired.

Ms. Taranum Taj, Assistant Coordinator, NIMHANS Centre for Well Being.

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Aging and Elder Care: Making
an elderly family member feel
more secure
In this rapidly changing society, the traditional
joint family system is paving the way for nuclear
families. As a result, the support base for the elderly
is gradually eroding. Aging family members can
often become lonely and socially isolated. Loneliness
can be compounded by medical problems, death
of dear ones, family disputes, etc. However, there
are families where the elderly continue to live with
their children and grandchildren. Caring for an
older person at home can be challenging, but can
also be a very rewarding experience. Here are a few
tips that you can follow to help your aged family
member feel secure:
• Listen: With age, the hearing and seeing
ability of the elderly decline. They cannot
often hear what is being said, so one may
have to repeat what he or she has to say.
Be patient, allow them time to express their
thoughts, move close to them and speak
clearly. Spend some time to understand what
they are saying and feel genuinely involved.
One needs to be patient as their responses
and reactions may have slowed with age.
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Observe if they are able to see things clearly
while they move about. Help them see a
doctor for their vision or hearing issues.
• Daily routine and activities: Make sure
they have a routine for themselves despite
all the others in the family being busy. This
could involve some activities which they love
doing. If one insists that they want to continue
an activity every day, for example visiting
a friend, try and arrange it, as it may be
something that your loved one really enjoys.
Discuss with them what other activities they
may want to do – it could depend on their
interests such as reading, gardening, watching
their favourite television show, having a cup
of coffee with friends, a walk in the park,
spending time with grandchildren and so on.
Sometimes they may want to get back to their
interests they had years ago such as writing or
poetry etc., but could not find the time to do it
then. Facilitate these interests to the maximum
extent possible, as it may really improve your
loved one’s well being.
• Social support and socialisation: Talk to
the older adults and keep them informed
about your life as well. Try to have joint
family activities now and then; it could
be a visit to a relative’s place, or attending
a family wedding, going out for lunch or
dinner, going to a place of worship, or
maybe taking them to their favourite movie
or play. See if you can arrange for meetings
with some of his / her old friends to cheer
them up or have your relatives come over for
lunch/ dinner and to spend time with them.
Accompany your loved one to his/her doctor
and discuss his / her health. Caring for an
ageing person requires financial support as
well. Offer support- it may include offering
to pay bills, clearing loans, providing with
medical costs and support for daily expenses.
Elderly family members may resist taking
your help. Speak to them, reassure them
and explain why you want to help them.

• Travel: Take time off from your own busy

schedule to relax and unwind. Once in a way
take your elderly family member to his / her
favorite tourist destination. Make it a family
affair or involve his/ her close friends. Be sure
to ask them if they plan a religious pilgrimage

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 grandchildren; this may often create a
generation gap and loss of communication.
Let that not stop your children from bonding
with them. Create a common activity where
both children and grandparents spend
time and enjoy- it could be watching a
TV show, playing a family game, a visit
to the park, etc. Children can learn a lot
from the wisdom of their grandparents.

• Techno savvy elder: Have a computer or a

phone with internet at home which your
loved one can use during leisure. Help
them have an e-mail account and link up
with relatives and friends. Include him/
her in your family’s Facebook or WhatsApp
account. Some of your old parents may have
never used the internet. Teach them to use
the internet and browse. If you have relatives
or friends in other cities or countries, help
them have video conversations with them.

Remember that elderly are like children. When

they receive support and encouragement for
their efforts it helps them feel more positive
about themselves.

Surprise them on their birthdays and

anniversaries. Make them feel loved and
or they would want a more relaxing holiday. cared. Help them to age beautifully!
Travelling can brighten their spirits and make
them feel more connected with the family.

• Bridging generation gap: Ageing family Dr. Santosh Loganathan

members usually love spending time Associate professor
with grandchildren. However, they may Department of Psychiatry,
not be agile in supervising and caring for NIMHANS

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 How can you help children to
express their emotions better?
5 year old Anu discussing with her mother…
Anu: Mummy, you know today two times I
cried in class.
Mom: Why dear..
Anu: I don’t like Ishant. He is very bad and I
am very angry with him.
Mom: What made you to get angry at him?
Anu: He did not play with me today.
Children are very sensitive to the changes occurring
in their environment and they have innate need for
discussing and informing whatever they observe.
Moreover, children can be overwhelmed by their
emotions related to these environmental changes.
Children have similar emotions as adults. As the
children find it difficult to verbalize more about the
incidents, they tend to express it with the help of
their emotions.
On the whole, children can be quite expressive and
are often able to express their emotions honestly in
various situations.
“I am angry with my classmate”
“I feel uncomfortable with someone”
“I am scared that you will leave me”
“I am upset you are ignoring me”
“I am very happy for the doll that you got for me”
This giant wheel is Soooo big giant . I am surprised”
“I am confused about what happened to that old
grandpa”
Children have a natural tendency for expressing
their emotions and adults can help them to express
themselves in a much better way.
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 “I think you are ANGRY with your friend for not
playing with you”

“Are you SURPRISED about it?”

“Are you SCARED of going to that place?”

“I know it can be DISAPPOINTING, if you don’t

win the competition”

These kinds of reflections by adults will help their

children to understand what exactly they are feeling
and how to name the emotions. Reading books to
children also helps them understand and recognize
their emotions better. At the same time, asking
children to reflect on their daily experiences would
help them in expressing their feelings.

Regular discussions:

Spend quality time with your child and discuss what

happened in his/her school. When you ask the child,
how was your day at the school, they get encouraged
to express about the events and how they felt about
it. Adults can just listen to them and observe their
emotions without judging them. Parents can also help
the children to clarify the reasons as to what made
them experience a particular emotion, and so on.
These regular discussions not only help the children
to express their emotions and opinions but also helps
in introspecting about their own behaviours.

Use of media:

Recognizing and acknowledging emotions:

Help children recognize and name their emotions.

For this, adults must acknowledge their child’s Drawing by a child who experienced abuse
emotions. Whenever a child is finding it difficult to
verbalize how they are feeling, adults can name their Sometimes children find it difficult to discuss their
expressions and emotions. concerns with adults. There are many reasons why

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18 Amplifying the voice of mental health

children are unable to do so. It can be their fears,
hesitation, anger, or lack of language abilities. Under
such circumstances, medium such as storytelling,
play, facial expressions, drawing and colouring, and
writing journals can be used to help children express
their emotions. Use of such media helps children
to open up much faster and express their emotions
without fear of being judged. These medium are
very useful in certain conditions where the child has
been traumatized, confused and fearful due to any
incident such as abuse, mishap, or loss.

Helping children to manage their emotions:

Sometimes, children express their emotions in ways

that are problematic, e.g. throwing things when
demands are not met or crying when frustrated.
Children learn to manage their emotions by
observing adults. Thus, adults can be good role
models for children in terms of demonstrating how
negative emotions such as anger, disappointment, Adults can use various strategies to help children
frustration and fear can be handled. Discuss and express their emotions in an appropriate manner.
demonstrate healthy alternatives for managing Spending quality time with children, providing
emotions in difficult situations. attention to the child’s feelings and emotions, and
listening to them non-judgmentally, encourages
Father: Today I had a very bad day. them to express and handle emotions better.

Child: What happened Papa?

Father: I lost my wallet while walking on the

street. I was so angry.

Child: So what did you do?

Father: I was angry, but then I calmed myself

down, took a deep breath and felt relaxed. Then
I called my friend who helped me to get back
home.

Ms. Chaitra Holla Dr. Kavita Jangam

Psychiatric Social Worker Assistant Professor
Dept. of Psychiatric Social Work Dept. of Psychiatric Social Work
NIMHANS. NIMHANS.

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Amplifying the voice of mental health

19
 An Unquiet Mind: a memoir of
moods and madness
Kay Redfield Jamison
Vintage Books, A division of Random house
Inc, New York
With a new preface, 2011 (first Vintage Books
edition 1996)
ISBN: 9780679763307
Pages: 224
Price: U.S. $15.95
It indeed takes a to her work was in her
great deal of courage own words in both
to write about predictable and not so
one’s own illness, predictable ways.
and Kay Redfield The book is divided
Jamison, Professor into four parts; The
of Psychiatry at Wild Blue Yonder
Johns Hopkins begins with the story
School of Medicine of how an air-force
does not have any pilot sacrifices his own
less in measure. life to save the lives of
She describes in children that includes
this memoir her the young Kay in a
journey of recovery playground. From
in her personal then on she never saw
battle with manic the sky for its vastness
depressive illness. or beauty but rather
Therefore, what is as a stark reminder
striking about this of the imminence of
unique description death. The daughter
of recovery is that of a meteorologist
this is by a mental father from whom
health professional. she inherits the genes
The book raises for manic depressive
several pertinent illness wants to take
questions including up a career in medicine
whether people as she volunteers
with mental illness for a candy striper
should write at all or nurse’s aide. The
about their illness; travails of the illness in
she though “writes adolescence alter the
from her heart” as trajectory as she goes
“she ratchets up the on to pursue a career
stakes by a notch or in Psychology. Even
two”. The reaction as she has become a

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20 Amplifying the voice of mental health

faculty she has little insight into her own condition
and “within three months of becoming a professor
she is ravingly psychotic.”
A Not So Fine Madness is all about her flights of the
mind into mania and plunges into depression as
she misses the “rings of Saturn”. In mania, the ideas
and feelings are fast and frequent like shooting stars,
shyness goes, the right words and gestures are suddenly
there, sensuality is pervasive as she gradually becomes
irritable, angry frightened and finally there are only
other’s recollections of her behaviour with a bitter
aftermath to deal including bounced checks, lost
friendships and ruined marriages. Then there is the
phase when “she is just like the rest of us”. This part
also details her long and lacerating black suicidal
depression. The reluctance to graciously accept
Lithium reaps her bitter harvest. Surprisingly, being
a Psychologist by training she appears to be a strong
proponent of biological psychiatry emphasising
the unique place of Lithium in managing manic
depressive illness. Lithium prevents her disastrous
highs, diminishes depression, clears out the wool..., slows
her down, gentles her out and makes psychotherapy possible
but ineffably psychotherapy heals. This part concludes
with her tenuring into Associate Professordom.
The third part – This Medicine, Love begins with
her engaging relationship to an Army Psychiatrist,
David Laurie. His tragic death in Kathmandu brings
a closure to this relationship. The chapter describes
her grief, the people who helped her in the grieving
process. This is the period in her life wherein after the
initial reluctance to accept treatment she had begun
to realise the benefits of taking lithium; as her lithium
levels are optimised, she becomes more productive
contributing many chapters in an authoritative
textbook on manic depressive illness, of which she is
the Co-Editor with Frederick Goodwin.
In The Unquiet Mind she argues that the term “Manic
Depressive illness” best captures the disorder it
represents, rather than the increasingly popular
bipolar disorder as she goes on to state her illness in
DSM-IV diagnostic terms. Her mantra for doing away
with stigma is not just to deal with semantics such
as madness or crazy, but rather more tellingly with
successful treatment, advocacy and legislation. Her
interesting and easy encounters with Nobel Laureate
Dr. Watson of the double helix DNA fame, and the
famous Danish Psychiatrist Mogens Schou (whom
we learn has a family history of manic depressive
illness) provide insights into the biological and
genetic research for this highly heritable disorder.
This last part also raises another important question
of whether people with mental illness can treat
other people with mental illness. There are no easy
answers though. She succinctly puts it across “the
privilege to practice is exactly that, a privilege it is,
not a right”.
The author also touches upon the sensitive issues
of gender inequality and the status of non medical
professionals in the realm of clinical psychiatry as
she leads the affective disorders clinic and stands
up to these. The “Oysters” and “Mouse-hearts” of
the world are disappointing but they are a harsh
reality. What is also real is the presence of insensitive
physicians like the one who tells her “You shouldn’t
have children. You have manic depressive illness”.
In contrast, it is also reassuring and real that she
found warmth in her family, support from her
friends, colleagues and acceptance from lovers.
The book is an easy read not only for professionals
but lay-readers too. For the student of literature there
is vivid prose and sheer poetry, for the sophomore of
phenomenology there is excellent clinical description
of mania, depression, cauldronous mixed states and
also grief, for those interested in psychopharmacology
there is all about lithium including the rare side
effects such as on accommodation of the eye, but
the memoir has strikingly little about what she
underwent as psychotherapy. Finally and most
importantly, in this deeply human endeavour there
is a lot to learn about personal elements of recovery.
Reviewed by: James Joseph, Krishna Prasad M.
Psychiatric Rehabilitation Services NIMHANS,
Bengaluru
Mr. James Joseph
Psychiatric Rehabilitation Services
NIMHANS, Bengaluru
Dr. Krishna Prasad M
Associate Professor
Psychiatric Rehabilitation Services
NIMHANS, Bengaluru
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Amplifying the voice of mental health
21
 Managing Emotions in the
Workplace
Emotions, simply stated, is your ‘energy in motion’.
It is a mental state accompanied by a range of bodily
changes, expressions and actions.
As emotions are an integral part of human nature and
lives , it important to manage them effectively. Emotion
regulation is a process that involves recognising
and modifying emotions, and the experience and
expression associated with them. Effective application
of emotion regulation skills contributes to effective
interpersonal interactions and better mental health.
People spend a large part of their time at work. Thus,
researchers have come to recognise the importance
of emotions and their role in workplace interactions.
demand on an individual’s emotion regulation skills
– both in terms of stressful workplace conditions
(e.g. policemen) as well as part of the job profile (e.g.
service industries like hotels, hospitals.).
Emotions in workplace include:
• emotional labour (efforts to portray emotion
expressions that are not authentic, but guided
by the display rules of the organisation during
interaction with customers),
• emotional work (genuine emotion in interaction
with customers),
• emotion - with - work (emotion stemming from
interactions with coworkers),

Workplace behaviours and overall health of the

organisation are influenced by the emotions
experienced by employees. Effective emotion
regulation helps alleviate stress, contributes
to workplace competence, enhances employee
motivation, reduces conflicts and improves health
and productivity of the organisation. In addition to
day-to-day events at work, some jobs place greater

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22 Amplifying the voice of mental health

 • emotion - at - work (emotion from non-work
sources experienced in the workplace),
• emotions toward work itself (where work is the
target of the feeling).
Frequent experience of negative emotions (anger,
frustration, uncertainty, humiliation and anxiety)
without appropriate expression has been linked
to multiple indices of physical health and poorer
psychological well being.
The experience of emotion is often due to the
interpretation of the situation and its meaning. The
same situation may give rise to different emotions in
different people. The difference lies in the appraisal
of the situation. Modifying the way we think about
a particular situation can help modify the experience
of the resulting emotions. Or one may change the
outward expression of an emotion after it has been
experienced (smiling at a rude customer, even when
we feel angry with him/her). With greater emphasis
on team work, interpersonal aspects of emotion
regulation cannot be ignored.
Other ways of managing emotions include situation
selection i.e. increasing or decreasing our chances of
being in a situation that will give rise to the emotions
we would not like to have or want to avoid (e.g.
postpone meeting a volatile boss if he/she is already
in a bad mood); situation modification i.e. modifying
the situation directly so as to alter its emotional
impact (e.g. using humour to diffuse a potentially
tense situation) and distraction i.e. focusing attention
away from emotional aspects of the situation. We
could also learn ways that could potentially reduce
the intensity of our emotional responses- for example
using relaxation to bring down anxiety.
Positive Emotions and the Workplace
Positive emotions help people consider more
creative, expansive ideas, actions, and solutions.
When employees experience positive events at
work, they are also likely to have better social
relationships, thereby reducing stress, with greater
work engagement and psychological well being.
Factors Increasing Risk of Negative Emotions
Experience of stressful life events or challenges,
work-life conflicts, harassment presenteeism (being
at work despite a sickness that justifies absence,
consequently, work performance is under sub-
optimal conditions) are some factors that increase
risk of experiencing difficult emotions at the
workplace.
Role of organisations
Attending to employee emotions, considering
emotional costs and benefits of their decisions,
helping them resolve their issues will go a long way
in having a happier and more productive workforce.
Identifying triggers for negative emotions, training
managers in positive management behaviour,
communication skills and conflict management is
important to develop a healthy emotional climate at
the workplace.
Emotions are intricately woven into the fabric of
workplace experiences and determine the quality
of our relationships. Thus, effective management
of emotions at the workplace is an important step
towards better mental health.
Dr. Paulomi M Sudhir
Additional Professor
Department of Clinical Psychology
NIMHANS, Bengaluru
Ms. Janhavi Devdutt
PhD Scholar
Department of Clinical Psychology
NIMHANS, Bengaluru
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Amplifying the voice of mental health
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 Emotions and eating: feeding
your feelings!
How many of you turn to “food” when you are 4. Do you often eat up to the brim even if that was
stressed, lonely, upset, angry, or happy? Does food not your intention? And does it trigger a feeling
act as your acts as your emotional support, during of guilt?
hard times and participate in your joys and sorrows?
In other words, is food your ‘best friend?’ If the 5. Do you suddenly feel hungry often and crave
answer is ‘yes’ for yourself or someone you know, for a particular food item, at times, even when
then you should continue reading. Although hunger you have had a recent meal?
is a life instinct, there is a deep relationship between
eating and emotions. What we eat and how much we
eat are influenced by our mood. The problem arises
when the eating is only or majorly influenced by
our emotions and feelings. You are not then feeding
yourself but feeding your feelings and emotions!

This can be quite detrimental as you just stuff

yourself superfluously and with unhealthy food.
The longer it continues, more is the unnecessary
weight gain and physical problems. It also brings
shame and guilt, which further add to the stress. Do
you need to wait till this juncture to understand that
feeding your feelings is not good and food in this
way can’t be your friend?

Let us talk about how to identify that eating and

emotions are going on the same track.
1. Do you eat whenever your mood is not in the
usual mode; may be when you’re upset, lonely,
angry, or happy?
2. Was it difficult to handle these situations when
you couldn’t eat for any reason?
3. Do you feel powerless in front of food?

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If it is “yes”” to any of these questions or if the doctor
has advised you to change your food-habits but you
aren’t able to do so, it means you need to deeply
analyse your eating behaviour. Maintain a food and
mood diary and see how many times you answer
“YES” to these questions.
Once you have recognised that your eating and
emotions are entangled together, then please don’t
get upset. You have already made the first step as
you know what the problem is. There are broadly
four steps to be followed to handle this:
1. When you proceed to food
i. Ask yourself whether you are really hungry or
is it a craving for specific type of food.
ii. Check your feelings and what precipitated
them.
2. Deal with the feelings-emotions through
activities other than eating:
i. Take 4-5 deep breaths/ practice Yoga.
ii. Go for a walk/ play sport/ exercise.
iii. Read something of your interest/ listen to
music (these materials should be readily
available to you).
iv. Write a journal on your feelings.
v. Talk to your friend or relative/ spend time
with your pets.
vi. Take a hot bath or shower.
3. Stay away from food in these situations:
i. Say to yourself
• A big “No” and “ Stop”
• Your goal and what to do if it is not
achieved
ii. Prefer- “I CHOOSE TO EAT HEALTHY
FOOD” rather than “I have to eat healthy food”
4. Change the behaviour and attitude towards
eating:
i. Perform a small ritual before eating, such as
expressing the meaning of food to the life
and gratitude to all who bring this healthy
food to you
ii. Sit while eating. Don’t engage in other
activities while eating.
iii. Restrict eating to Eat 3-5 small meals a day
However, remember that it’s quite okay to break the
rules once in 5-7 days!
The problem could be in any of the above steps,
which you find difficult to resolve on your own.
However, the consequences would be the same-
weight gain and feelings of shame and guilt. If
this happens, YOU SHOULD MEET A HEALTH
PROFESSIONAL WHO CAN HELP YOU AT THE
EARLIEST. YOU CAN CLIMB TO THE TOP,
YOU JUST NEED A LADDER.
Dr. Preethi Sinha
Assistant Professor
Department of Psychiatry
NIMHANS, Bengaluru
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 I feel like an outsider - How
persons with schizophrenia can
understand other people and
communicate better
Suresh’s family was excited for him as he began his
engineering degree – his long cherished dream. Soon
his parents noticed that he spoke less and seemed
worried. They thought he was taking time to adjust
to the new environment. Within a week they got a
call from his friends that Suresh was disturbed, and
had grown extremely suspicious about his teachers.
After consultation with a psychiatrist they learnt
that Suresh had been hearing voices of strangers
conspiring against him, and this was when they
also learnt about his diagnosis – schizophrenia.
After learning more about the illness, his parents
recalled how Suresh, now 20 years old, was
behaving differently in the last 1-2 years. He had
nearly stopped meeting his friends, got into frequent
arguments with his parents, had struggled to cope
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26 Amplifying the voice of mental health
with his studies, often blaming and suspecting his
friends and teachers for his problems. Suresh later
confided that over the last year or so he had been
hearing voices of strangers that had increased over
the last couple of weeks.
Individuals with schizophrenia have difficulties in
understanding how other people think (perspective
taking), recognising emotions correctly, and
communicating adequately and appropriately with
them. These ‘social cognition’ deficits may co-occur
with problems in general cognition like concentration,
memory, reasoning and planning. More often than
not, they precede the more dramatic symptoms
of hallucinations and delusions, and persist even
after. These are often unrecognized and may
contribute to formation of delusions. For example,
one may misinterpret actions or emotions in others
and conclude wrongly that he or she is in danger.
The inability to see alternative perspectives and
correct these misinterpretations could then lead
to a delusion. Understandably, the worlds of these
individuals grow smaller as time passes, making
them feel like outsiders even at home.
like badminton, football or basketball, can also be
an easy and fun-filled substitute for such exercises.
Just like physical exercises build our muscles, brain
exercises can sharpen our cognition. These may range
from reading for a course and writing an exam, to
more specific tasks like solving puzzles, crosswords,
Sudoku, mathematical problems or playing games
like scrabble. It’s not without a reason that the age-
old saying goes “use it or lose it”!

Once we have our general cognition honed, social

understanding and communication can be enriched
using the SMART strategy. Of course, a doctor will
be able to tell us where can one get more help in this
regard. Prerequisites to apply this strategy include
an opportunity to socialize and have fulfilling family
relationships, as well as the drive or motivation to
engage in these situations.

The first step in SMART is Seeing Emotions.

Identifying our own emotional state requires us to
reflect upon our mood in a given situation and be
aware of physical signs of different emotions (e.g.,
pounding heart and sweating can happen when
we are very worried or very excited, while sadness
manifests as low tone of speech and slow actions).
Recognising our own emotions helps us identify
emotions in others. Paying attention to facial (eyes,
mouth and eyebrows) and vocal (tone of speech)
cues is particularly helpful.
Schizophrenia is a brain disorder that occurs due to
subtle changes in brain functions of thinking and
feeling. It often begins during adolescence and has
genetic underpinnings. While medications are an
important component of treatment, especially for the
delusions and hallucinations, there are certain other
exercises and strategies that can be used to overcome
the more difficult social and general cognitive
deficits in schizophrenia. These strategies work
on the premise that the human brain is malleable
and changeable, being able to unlearn and relearn
specific behaviours over a period of time.

A social interaction is an inter-personal exchange

that occurs between two or more individuals. It
includes an exchange of emotions, thoughts, words
and actions. Understanding social situations is a
first step in ensuring proper communication, and
this requires both general and social cognition.
Researchers have found that aerobic exercises like
cycling, swimming and running, not only increase
the size of important brain structures like the
hippocampus (responsible for memory), but also
improve memory and concentration. Playing a sport

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Amplifying the voice of mental health

27
Next, we need to have Mind Awareness. As with
emotions, this begins with being aware of our own
mind (i.e., our thoughts, intentions and judgements,
examining the pros and cons of our decisions). This
strategy will also help us understand thoughts and
intentions in others. A useful way of doing this is
by asking yourself, “What would I do/think in this
situation if I were in his/her place?” This approach
would go a long way in taking perspectives of the
other person in order to understand him/her better
and avoid misunderstanding. Not jumping to any
conclusions and having a flexible mindset is another
useful tactic.
appropriate responses and again obtaining feedback
from others.
Lastly, being Thoughtful or meta-cognitive about
the entire interactive process and its outcome gives
us an opportunity to alter our responses according
to the situation. Meta-cognition, in simple terms
refers to the process of thinking about thinking. In
this context, it applies to being thoughtful about our
own as well as others’ emotions, thoughts, words
and actions. This skill provides us the feedback to
modulate our responses on a time-to-time basis,
depending on changing social scenarios.

The next step is that of an Appropriate Response.
Understanding emotions and thoughts guides our
response in words or actions. A planned, reflective
response is likely to be more useful in conveying what
you want, than a spontaneous, reflexive response. It
is a good practice to be aware of our strengths (e.g.,
fluent speech, expressive body language and good
eye contact) and weaknesses, while communicating
during social interactions. Often these are obtained
from feedback that others give us (see below).
Weaknesses can be rectified or learnt by observing
someone whom you admire, imitating and practicing
Finally, visiting the doctor regularly, voicing your
concerns – psychological or physical, illness related
or medication related, personal or family related,
and taking the prescribed medications, goes a long
way in preventing the more disturbing delusions
and hallucinations, which if recur, can worsen the
cognitive deficits.
Dr. Urvakhsh M. Mehta
Assistant Professor
Department of Psychiatry,
NIMHANS, Bengaluru

ALCOHOL IS NOT THE ANSWER TO

LIFE’S PROBLEMS
One notion that seems to prevail in the society – to some extent propagated by the media – is that using
alcohol helps to relax or deal with stress. Several individuals who use alcohol blame family issues or
other problems for their drinking. But fact is that problems exist for alcohol users and non-users alike.
The difference lies in the way the problems are handled. For instance, a non-alcohol user would deal
with stress or problems by seeking advice from family members/ well-wishers, or just waiting for time to
resolve things, if nothing is working. But among alcohol users, the tendency may be to reach for a drink.
However, alcohol does not solve problems, it compounds them, besides adversely affecting one’s health.
It is not life circumstances that cause a person to use alcohol; rather, the circumstances may just maintain
alcohol use in certain individuals, who get used to using it as a way of coping, over a period of time. The
principle here is to break the link between everyday stresses and alcohol use, and gradually learn to deal
with problems/stress the way a non-alcohol user would.

-- Dr. Prasanthi Nattala, Associate Professor, Dept. of Nursing, NIMHANS

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 Healthy Use of Technology
among Youth
With the advancement of technologies, the Internet
has revolutionised how we communicate and its flow
has enabled and opened up entirely new forms of
social interaction, activities, and organization, with
its widespread usability and access. The emergence
of social networking websites such as Facebook®,
Twitter® and Orkut®, have not only made it possible
to find existing acquaintances via net and renew
communication but also have created newer patterns
of socialisation and interaction in the virtual world.
Thus the metaphor “global village” is often used to
describe how the Internet has shortened distances
between people and facilitated the flow of information.
According to the Pew Internet Study 2013, 92% of
Internet users say the Internet is a good place for
getting everyday information, 85% say the Internet is
a good way to communicate or interact with others.
75% say the Internet is a good place to conduct
everyday transactions, 69% say the Internet is a good
way to entertain themselves in everyday life.
Life has become easier with 3 characteristics of
technology: 1) Accessibility (easily available), 2)
Convenience (one can do anything as per availability
of time) and 3) Euphoria (feeling of goodness after
completion of task). The sense of well being associated
with technology use, leads to excessive use of the same.
It also leads to unhealthy habits such as avoidance of
offline interaction, outdoor activities, development of
irregular food habits or sleep disturbance etc.
You can screen the unhealthy use of technology by
answering the following four ‘C’ questions in yes or
no options:
1) Craving (continuous desire to be on the
technology);
2) Control (losing control whenever on
technology);
3) Compulsion (it has become “a have to activity
for you”) &
4) Consequences:
A) Physical (experience health eye strain, pain,
fatigue)
B) Social (stopped going out, decrease social
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Amplifying the voice of mental health
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 interaction with, preferred to spend time
on technology)
C) Psychological (using it as a way of coping).

If the answer is ‘yes’ to 3 or more of the above,

then the individual is engaging in excessive use of
technology.

You can promote healthy use by:

 Acknowledging the problem- Accept that it is
interfering with other daily activities;
 ASK- Overcome your hesitation to seek
help; discuss with your family members or
counsellor and seek active help to promote
healthy use of technology. As the child get older, keep family communications
about the Internet as open and positive as you can.
 Develop alternative pleasurable activities.
Do not criticize his or her technology use. Talk with
For instance, you may be using the internet
your kids about their online friends and activities just
to manage negative mood states (i.e. sadness,
as you would talk about other friends and activities.
loneliness, boredom, etc). Instead, try
developing other activities to manage the mood
Set Rules for Internet Use: Lay out rules for Internet
states – e.g. start an outdoor hobby, interact
use, setting clear expectations for your child online
with neighbours, meet up with friends, etc.
habits. A good set of rules should include things
like the amount of time children are allowed to be
Talk About It online, what types of content are appropriate as well
Talk with your children about the Internet, and as proper online conduct .
encourage them to see it as a shared, open environment
in which they have social responsibilities just as they Keep in mind:
would in any physical environment. The most successful rules are those that are created
collaboratively.
With open discussion, you can set expectations about
the behaviour you expect from them, curb negativity Discuss the rules frequently. Remind them that
and discourage behaviours such as secrecy, late evening the rules are in place to protect your family, and
browsing or thrill-seeking. You can guide guide them that strictly maintaining privacy online can lower
regarding online safety issues as well as educate them the risk of being targeted by online predators.
about cyber laws.
Tell your children that following the rules and
Keep in mind: keeping communications open will allow them to
Enjoy the technology along with your children, gain freedom as they get older.
and discuss the variety of ways in which it
brings new information into one’s lives as well as Balance Time Online: Maintaining a balance between
encourage them to share their opinion. entertainment and other activities in children’s lives
can be a serious challenge. The Internet has made it
Experience from research conducted in Indian context even more difficult, as the lines between entertainment
indicated that children develop psychological distress
due to their online experience as well as inability
to discuss with others Make yourself available to
your child ‘s questions and encourage them to share
their Internet experiences with you without fear of
punishment about what they read, see or experience.

Discuss the advantages of safe online interaction

with others, why children should stay away from
certain types of content and individuals.

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and education are often blurred. Modelling a healthy
balance between your online and offline activities is
a great way to encourage children to do the same.
Keep in mind:
Enforce rules about the amount of time your child
may spend online and the hours they are allowed
to go online. Help your child develop self-control,
discipline and accountability regarding Internet use.
Encourage and support their participation in
other activities — particularly physical pastimes
with other children. If your child is reluctant, look
for offline activities that tap into the same interests
your kids pursue online.
Watch for signs of Internet dependency. (If Internet
use seems excessive or begins to affect your child’s
school performance, health or relationships). In
that case, seek professional help at the earliest.
Get factual information
There’s a lot of content on the Internet that isn’t
helpful or reliable. While more online fact checking
happens today than previously, the ability of nearly
anyone to offer opinions or build websites can make
the Internet a confusing place for young people. In
that case, seek professional help at the earliest.
Train them to use a variety of online resources and to
always check, question and verify what they see online.
Keep in mind:
Start young. Even preschool students use the
Internet to look up information. Teach them early
to distinguish fact from opinion, and discuss ways
to recognise bias, propaganda and stereotyping.
Challenge your children to evaluate what they see
online by asking: What is the purpose of this site?
To entertain? To sell? Is the “About Us” section
authentic? Does a company or an individual person
sponsor it? Is it a public conversation? Finally,
challenge them to consider whether the Internet is
the best place to find the information they need.
Keep Personal Facts Private
Online privacy is vital to your family’s safety.
Ensuring that your kids communicate online only
with people known to them and your family can
help limit their contact with unsavory elements.
Still, as children grow older, they are bound to make
new friends online, and it is important to teach them
about keeping personal facts private.
Keep in mind:
Ensure that children keep facts such as their real
name, age, gender and location private. Discuss
how details in photographs can reveal more
information to would-be predators than your
child intends.
Many children routinely visit social networks
and blogs where they may post pictures, make
comments and write personal entries. Insist that
your children keep personal information private
and that they think twice before joining location-
based peer groups that may give away information
on their whereabouts.
Ensure that your children understand the
risks involved in making private or personal
information public online. Keep an open dialogue
about the people they come into contact with
online. Discuss and evaluate online relationships
as you would any other relationships in your
child’s life. 
Barrier to develop healthy use: The main barriers
manifest in the form of inability to see the problematic
usage of available technology, absence of alternative
activities to manage the situations associated with
usage and hesitation to seek help for developing
controlled healthy use of technology.
There is a need for developing other leisure activities
for oneself as well as for the children. So all of can
experience the feeling of goodness after the use of
technology.
Source:
Intenet and daily life accessed on www.pewinternet.
org/2004/08/11/the-internet-and-daily-life
Dr. Manoj Kumar Sharma
Additional Profressor
Services for Healthy Use of
Technology(SHUT) Clinic,
Dept. of Clinical Psychology,
NIMHANS, Bengaluru
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Amplifying the voice of mental health
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 Handling Difficult Emotions
Gretchen Rubin chronicled her one-year search for
the secrets of happiness in her bestselling book The
Happiness Project. Interestingly, she speaks about the
role that negative emotions can play in the pursuit of
happiness; as signals that something isn’t right and
that changes are needed.
All of us have experienced being overwhelmed
by intense and difficult emotions like sadness,
guilt, frustration, anger, shame, anxiety or fear. So,
how can we handle these emotions without being
overwhelmed or paralysed?
“Stop crying!”; “I’m fine” (even when you are not),
are statements that demonstrate how we tend to
deny or push them away our negative emotions.
The first step in learning to handle difficult emotions
is becoming aware and naming the emotion/s. Expand
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32 Amplifying the voice of mental health
your ‘emotion vocabulary’ and ask yourself: Are you
frustrated, worked up, irritated, furious, hostile,
enraged or are you unhappy, sad, pessimistic,
dejected, despairing, hurting, grieving? Sometimes
you could start with labelling your emotion as anger
and then realise that it is actually more a feeling
of sadness and loneliness; or perhaps a mixture of
many emotions. This can help you in your efforts
to understand your emotions and experiment with
a range of strategies to deal with them effectively.
Different strategies would be useful according to the
context and you need to judge which ones work best
for you. While some strategies focus on reducing
the intensity of the difficult emotion in the moment,
other approaches look at developing more adaptive
methods over time as well as trying to understand
the thoughts, contexts, patterns and origins of the
emotion.
Some of these strategies can be:
 Time out: It is sometimes uncomfortable, difficult,
or inappropriate to express intense negative
emotions in certain situations. A brief stepping
away from the situation to take the time to
compose yourself can be helpful.
Distraction and Soothing Methods: A flood of
 able to understand your emotions, regulate
emotions can be difficult to deal with. Try
engaging in activities to distract yourself for
temporary relief. This could be listening to music,
concentrating on some other task, engaging in
physical exercise or any other physical activity.
Exercise can also work as a mood elevator
through the release of ‘feel good’ chemicals in
the brain. Soothing strategies, e.g. taking a walk
and looking at the flowers in the park, enjoying
a special meal, taking a warm shower, can help
you cope with overwhelming emotions.
• Imagery: Temporary reduction in the intensity of
your difficult feelings can be achieved through
visualisation exercises. For example, you can
imagine putting your pain and sadness in a box
on a cupboard shelf and you will get back to
opening the box and sorting things out once you
feel calmer. Visualising a scene, place or event
that you remember as peaceful, beautiful or
happy can be a powerful method. You should try
and use all your senses and ‘see’, ‘hear’, ‘smell’
and ‘feel’ the scene in your imagination.
• Breathing and Relaxation methods: Learning slow
and deep breathing exercises, muscle relaxation
exercises are very important parts of your
emotion toolkit. Mindfulness methods use a
different approach; they encourage the mindful
acceptance of the difficult emotion while
recognising the impermanence of all emotions.
• Expressing your emotions: Once you have been
their intensity and what you want to convey.
expressing your emotions in the appropriate
context can be useful. A good way to make a
start is to say “I feel….” “I felt…” or “I have been
feeling….” . This is usually more effective than
saying, “You made me feel….” . It is important to
be specific about what you feel. Next you could
go on to express the source/s of this feeling as
well as anything you might want the other person
to do. Remember that we express our emotions
not only though our words but also the tone or
volume of our voice, our facial expressions and
our actions.
• Using your Support Network: Sharing feelings and
getting support from friends or family can help
you feel less alone and perhaps learn from their
suggestions and ways of looking at your situation.
• Understanding your emotions: A number of
methods can help you tease out the often complex
reasons for the upsurge of certain emotions.
Writing your feelings in the private diary, linking
feelings to specific situations, events, personal
beliefs or values or trying to list out the thoughts
associated with these feelings (e.g. Its wrong to
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Amplifying the voice of mental health
33
 feel this way; If I feel this way, I will lose control)
can give you a better understanding. This in
turn provides guidance for the steps to deal with
distressing thoughts or feelings.

• Understanding the other’s emotion: When difficult

emotions arise in the context of an interaction
with another person, efforts at understanding
your own emotions may not be enough. Trying
to step into the other person’s shoes and tuning
in into his or her emotions can sometimes lend a
different perspective.

• Help yourself in a safe space: Counselling or

therapy can provide a safe, confidential and
non-judgemental space for you to explore,
understand and manage recurrent patterns of
painful feelings.

As human beings in the world of relationships, * The Yale Centre for Emotional Intelligence (www.
emotional intelligence plays an importance role in our ei.yale.edu) has a range of innovative ways to
lives, influencing learning, relationships, creativity, harness the power of emotions and teaches people of
decision-making and our overall wellbeing. all ages how to develop their emotional intelligence.

Dr. Poornima Bhola

Associate Professor
Department of Clinical Psychology
NIMHANS, Bengaluru

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34 Amplifying the voice of mental health

 Gatekeeper Training for Suicide Prevention
Would you like to be a Gatekeeper?
• In our Gatekeeper Training Program, A
Gatekeeper is someone is someone who
believes that suicide can be prevented
in the community and is willing to give
time and energy for this cause.
• Gatekeepers could be anyone- teachers,
parents, neighbours, hostel wardens,
police or lay counselors.
training program which includes :
• Lecture cum demonstrations
• Role plays
• Video shows
• Case examples
This training is conducted by a team
comprising of Psychiatrist, Psychiatric
Nurse & Psychiatric Social Worker.

• A Gatekeeper should sound the alarm

when he/she identifies someone who is
very distressed, provide initial emotional
support and then refer them to a mental
health professional.

What do we do to help you be a Gatekeeper?

• For 20 people at a time, we conduct a

We now have a network of more than 500 trained gatekeepers

To enroll, contact: NCWB @ 080-26685948 / 9480829670

Printing of the Magazine funded by: Dr. Ramachandra N Moorthy Foundation for Mental Health and Neurological Sciences
 TRAUMA RECOVERY CLINIC
Psychological Trauma: The Invisible Scars
The clinic provides brief psychological interventions to adolescents and adult survivors of
trauma through one-to-one and/ or group counselling and psychotherapy. The interventions
are tailored to suit the unique needs of each client.

Indications for consultation include: Interpersonal trauma such as domestic violence, betrayal
trauma, trauma due to elder abuse, child sexual abuse, physical and sexual assault and traumatic
bereavement. Indications also include trauma due to self-harm behaviours, trauma due to
acqured disability, secondary trauma and specify in 2-3 words what is complex trauma.

Consultation days:
Every Wednesday 9:30 am to 12:30 pm.

To book your appointment, kindly contact:

NIMHANS CENTRE FOR WELLBEING
1/B, 9th Main, 1st Phase, 1st Stage, BTM Layout, Bengaluru 560 076
Phone: 080 26685948 or 9480829670
E mail: nimhans.wellbeing@gmail.com

AWAKE Clinic @ NIMHANS Centre for Well Being

Benificiaries: Women with Intimate Partner Violence
Services Offered:

• Tailor-made mental health interventions and counselling for women with intimate
partner violence.
• Trauma care for the victims of violence.
• Supportive and individual therapies to build self-esteem, self-confidence, coping
skills, problem-solving skills and communication skills of women.
• Telephone counselling.
• Referral and information services regarding available resources, legal rights,
shelter care.
• Support group for women survivors of intimate partner violence.
• Community based awareness and training programmes to prevent gender based
vio­lence.

Timings: Every 2nd and 4th Wednesday between 2.00 pm to 4.30 pm

Printing of the Magazine funded by: Dr. Ramachandra N Moorthy Foundation for Mental
Health and Neurological Sciences

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36 Amplifying the voice of mental health