While we all do worry about and take care of our physical health, how many of us truly think about and try to ensure our emotional well being?  Our emotional well-being impacts how good we feel and how well we work. It even impacts our physical health in more ways than we realize – blood pressure, headaches, ulcers, etc., are all very often physical outcomes of psychological problems.  And all too often the cure we attempt fixes the symptoms rather than the cause.  

 

The blues can hit anyone, anytime – summer or winter. You have a big event coming up, like your wedding or your child’s wedding, a big promotion that gives you more responsibility, more visibility – all good things…. but then there is the anxiety that creeps up. Of course, if things don’t go your way – did not get the much anticipated promotion or a relationship ended – there is a bigger and more complex box of emotions to deal with.

 

All of us go through such events in life.  Sometimes we are able to maintain our emotional balance and sometimes things seem overwhelming. This isn’t about being emotionally strong or weak; it is often about how much stress we are under. So, how do we watch out for when the usual anxious pangs begin to turn into panic or even panic attacks? Or, the blues just don’t go away. Given below are some  general guidelines that work for children as much as they work for adults:

 

– Diet and sleep. Take care of your diet and your sleep. Tired and hungry children are known to be cranky, and so are adults! Stick to a regular bedtime and bedtime routine, get enough sleep, and eat healthy.

 

– Exercise. Exercise is a well researched component of the treatment strategy for mild depression and anxiety. Exercise helps the body secrete endorphins, the feel good neurotransmitters. It also tires the body and helps in cases where sleep is disrupted due to stress.

 

– Interests and hobbies. Find some interests or hobbies that you enjoy pursuing. It could even be part of work that you do. Joy and wellbeing is experienced in what psychologist, Csikszentmihalyi, describes as “flow”.  It has been described as moments of “effortless concentration and enjoyment”.”Flow” is not passively watching TV or sitting in the sun (which can also make you feel happy), it is engaging in any activity which completely holds your attention, like reading a good book or connecting with a close friend. It involves actively pursuing some goals you set up for yourself – it could be at a game of chess or a business deal you are negotiating. 

 

 – Calm at bedtime. Bedtime or in general night time is usually not the best time to try and resolve conflicts or reflect on your worries. You will often only lose sleep and magnify you difficulties. In the light of day rationality prevails better and problem solving is definitely better after a good night’s rest!!

 

– Mind-body connection. The mind and body are definitely connected. And Indians or Asians, in general, are known for somaticizing or expressing emotional pain in the form of physical ailments. Consciously or otherwise, we tend to allow ourselves our physical aches and pains and even seek help for them, but not so for our emotional pains. Watch out for the elderly relative who just lost her spouse and seems to be coping fairly well. Most likely her blood pressure and diabetes have worsened!! Severe panic attacks look very much like heart attacks. When there are no physical reasons for a medical condition, look at the emotional. Addressing emotional stress in such cases is of prime importance.

 

– Meditation. Learn meditation or find ways by which you can get into a meditative state. An intense game of tennis or a long run can be meditation in action as it helps remove all thoughts and worries from the mind and compels one to focus on the immediate moment.

 

– Voluntary work. Volunteer when you can. Nothing works better to put our problems in perspective than closely interacting with or witnessing how difficult life is for a section of our society, be it the terminally ill, street children or people less privileged than us. This is a strategy that also works wonders with teenagers. It also helps give life a greater sense of purpose and meaning.

 

– Unclutter and prioritize. Unclutter your life. It is not important to be a super mom, super worker or super anything. Delete things from your to do list that you have a hard time juggling and are not essential to do. 

 

– Love thyself. Finally, learn to love yourself!! Nobody else can be as critical of you as you can. Beating yourself up for small or big mistakes will only make you feel miserable. Also, perfection is an unachievable goal!! Develop some positive self talk and try to be your best advocate.

 

– Professional help. Most importantly, seek professional help i.e., counseling or psychotherapy. If you are losing sleep, losing weight, or gaining weight, get help. If you are self medicating by using sleeping pills too often or using alcohol to uplift your mood or help relieve stress, get help. Depression preceded by the death of a loved one, separation, or divorce most often leads to suicides. If you are going through any of these experiences, consider help. Also consider help if you are feeling depressed after loss of employment or any such dearly held and significant goal. If you observe anyone engaging in uncharacteristic behavior or behavior that concerns you, get a consultation. Professional help benefits not only those who are suffering from a severe psychiatric disorder but also those facing interpersonal issues. In addition, it is not just for fixing problems: if you want to be proactive, and untangle some of the tangles before they become problems, seek a consultation. And, when you do seek professional help ask the provider about his or her level of training and experience.

What does a clinical psychologist do, and what does a psychiatrist do? As someone I know put it simply: clinical psychologists are like software professionals, and psychiatrists are like hardware professionals. Clinical psychologists work with people with a wide range of mental health difficulties and sometimes with people who have no major problems at all but are keen to further grow and explore their human potential. The problems that clinical psychologists help individuals deal with include relatively less severe problems, such as, dealing with stress/dissatisfaction at work, or adjustment difficulties due to a recent relocation, as well as more severe problems, such as, severe depression, or panic attacks that look like heart attacks. Clinical psychologists help individuals, couples, and families solve their problems through talk therapy rather than pharmaceutical interventions. Psychiatrists, on the other hand, step in only when mental health problems become more severe, which includes severe anxiety, depression, schizophrenia, etc. They focus on treating the chemical imbalances in the brain that accompany specific mental health conditions. Treatment is symptom based. So, the psychiatrists are the ones who will determine if medication is required, the kind of medication, and the dosage, whereas clinical psychologists will try to bring about change via changes in thought processes, behaviours, and emotions. Needless to say, psychologists need to work more regularly with their clients and often for longer durations than psychiatrists do. It is important to remember, however, that medicines alone cannot treat mental health conditions, at least not as effectively, or on a long term basis. Psychotherapy or Counselling is required in order to help individuals make long term and sustainable changes in their way of thinking so that they are better able to deal with various stressors in their lives, and lead more happy and fulfilling lives. What are the qualifications of a psychiatrist? A psychiatrist is a medical doctor. In India, to become a psychiatrist, a person has to earn an MBBS degree, followed by an MD in psychiatry or a DPM or DNB credential. Child psychiatrists specialize in the treatment of children and teenagers who suffer from a mental disorder and need medication, such as ADHD, depression, OCD, schizophrenia, etc. Psychiatrists typically see their patients once or twice a month for follow up. General practitioners also sometimes prescribe psychiatric medication but they are not trained in this field and may not have the knowledge or experience to distinguish between the various mental health conditions to be able to make the correct diagnosis. Also, psychiatric medication needs regular follow up in order to ensure that the dosage is accurate. For example, weight gain or weight loss would require modifications to be made to the dosage as the dose prescribed earlier will not work in an optimal manner. Also, side effects need to be monitored. What are the qualifications of a clinical psychologist? In the US, clinical psychologist is a title that persons who have completed their doctoral degree in clinical psychology (PhD or PsyD) can use after they have cleared the licensing exams. Psychotherapist or therapist is a title that can be used by people who have completed their MA in Clinical Psychology, MA in Social Work, etc. It is a more widely and generally used title and does not require a person to have cleared any licensing exam. Counselling degree is usually a separate degree in the US. People can do their Masters or Doctorate in counselling. The difference between a counselling degree and a clinical psychology degree is that counselling is more short term and focused on solving immediate problems, whereas clinical psychologists do more in depth and long term work with individuals. Also, clinical psychologists are the only ones trained to conduct comprehensive psychological assessments, including administering various IQ and personality assessment measures. For example, only a clinical psychologist would be able to conduct a comprehensive psychological assessment to determine whether speech delays in a child were due to learning disability or autism. Marriage and Family Therapy is taught at a few places separately as a Masters or Doctoral level program. However, marriage counselling or couples and family therapy is also taught as part of clinical psychology programs. In India, however, clinical psychology training is in its nascent stages. There is no professional regulation in this field; hence, anyone can use any title with little or no training. “Clinical psychologist”, “counsellor”, “therapist”, “marriage counsellor”, “child psychologist”, etc., are all terms that are used interchangeably and often have little to do with a person’s formal training. The most important aspect of clinical psychology or psychotherapy training is the practical aspect, and that is often missing in most programs of study in India. The diploma in counselling programs often either do not have a supervised practical training component or it is just not rigorous enough. Even the MA and PhD in Psychology programs are largely academic and do not focus on supervised practical training. Most of these programs also do not have a very strong specialization component wherein students could be exposed to the latest theory and practice methods in how to work with children and teenagers or with couples. Hence, it is very important that you ask your child’s therapist or marriage counsellor about their training, qualifications, and experience before you decide to work with them.