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‘Anxiety is the most common mental health issue in children and adolescents,’ says psychiatrist

Children have to be brought up in an environment where they feel comfortable expressing their emotions, he says

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“In the last few years, especially after Covid, I don’t think there is anybody left who has not faced anxiety or felt helpless or hopeless at some point or the other,” says Dr Sameer Kalani, consultant psychiatrist, Sukoon Health. “Of late, people have actually been able to relate to mental illness as compared to just hearing about it,” he stresses, highlighting a positive change in people’s mindsets, from across all strata of society. Dr Kalani, who predominantly works with children, adolescents, and the elderly, lists common mental health issues in India and shares tips for caregivers; read:

Tell us about your time at Apeejay School, Noida.

I finished my 12th standard from Apeejay Noida around March 1999. My school journey was very interesting as I got the opportunity to be a part of several extra-curricular activities apart from academics. I particularly remember two school trips–Nainital and then to Jodhpur and Jaisalmer–which helped us bond with the teachers and children from other classes as well. Such kind of exposure prepared us better for our future interactions with colleagues, seniors, and juniors. What nurtured us was a healthy competitive environment at school among the students. Not once did I feel that the teachers were unwilling to help—they supported and guided us at every step. At school, I was scared of public speaking, but it was my teacher who pushed me to speak at some events and boosted my confidence throughout. Today, whenever I have to speak at a conference, I go back in time and think of those days.

Also Read: NCERT asks schools to identify students’ mental health issues

What are some of the common mental health issues affecting children in India?

The most common problem we see in children and adolescents is anxiety. Children are coming up with a lot of difficulties in terms of their academic performance, behaviourial issues, difficulty in paying attention, and so on. In the post-Covid environment, the problems are to do a lot with not being able to interact with friends or not stepping out. However, things have improved in the last few months. But anxiety is definitely the topmost issue that we as practitioners are coming across.

The other issue is that of children not being able to deal with stress. While there is more awareness about the problems children face, it does not help if one is unable to intervene at the appropriate age and time. There is no need to brush things under the carpet; we need to normalise it and then escalate to professional help if necessary.

Some of the other issues include psychosis, mood disorders, and attention deficit disorder. Adolescents, on the other hand, tend to experiment with nicotine and drugs, which can become a challenge later on. School counsellors play a very important role in these cases.

Children may often find it difficult to express themselves. How can parents help?

There needs to be a system in place. Children don’t just develop ideas about sharing their emotions on their own. All depend on the structure and environment we place them in, and they adapt accordingly. If the atmosphere at home is one where people share their feelings with each other and have meaningful family discussions, children will learn it automatically. It becomes very easy for children to express themselves because they know that they will be heard. However, we are usually brought up in a structure where they are worried about the repercussions of what they express, which needs to change. 

Second, there has to be a certain amount of monitoring of children’s online activity. Parental guidance is crucial not only in terms of screen time, but also the kind of content children are being exposed to. One should not be on social media for more than two hours a day. Children and adolescents are easily influenced by Instagram reels and try to match up with what others are doing. In schools and colleges, children can be taught about media literacy. At the same time, parents should also be aware.

Is there a gender difference in terms of mental health issues in India?

Gender differences are usually present in depression and anxiety and are more prevalent in women. In terms of suicidality, completed suicides are much more in men. Self-harm is more prevalent in women. In the case of substance use, bipolar disorder or schizophrenia, men and women are equally affected. There are a certain set of disorders specific to women like premenstrual syndrome, perinatal disorders, and menopausal depression. Eating disorders are more common in women than men.

Can you suggest some safety tips for those on psychiatric medication?

Correct diagnosis is the first step. When you take the medicines, you have to be in constant touch with the doctor because there is a certain interaction that is going to happen between the brain and the medicines. The effects being observed due to that will also become a part of the process of diagnosis. Once you are a few weeks into the treatment, then the doctor can explain better the kind of prognosis we can look at. The patient needs to be clear about the diagnosis, weightage of the medicines versus the psychological weightage of the illness. Last comes any environmental modifications that could be needed for better recovery.

What about mental health issues in the elderly? What are the challenges?

The biggest concern is to label their mental health issues as age specific. I have realised over the last many years that we often make the mistake of looking at their problem as part of the degeneration that happens due to age. However, when we diagnose somebody with dementia, especially in the early stages, there are a lot of interventions that can be done to improve their quality of life and longevity. Depression, on the other hand, can be absolutely reversed. The intervention I am talking about is not just through medicine but also some sort of companionship or getting them to be productive in some way. When you see symptoms in an elderly, do not take it lightly.

While taking care of a family member suffering from a mental illness, caregivers sometimes find it difficult to cope with the patient’s erratic behaviour or needs. How can caregivers tackle the problem?

One of the key mistakes is to think that the caregiver is fine and capable of taking very good care of the patient. When it comes to mental illness, it is not just the patient who is unwell. The whole family faces the brunt. The caregivers go through a certain emotional turmoil themselves, leading to what is known as expressed emotions, which can be in the form of criticism, hostility, etc. When we treat a patient, we do not just treat him or her but the whole family.

So, caregivers must understand that they are not alone. They should not think that they are absolutely fine. They need to be aware of the fact that they may need help too. They should reach out to practitioners not just for the patient but even for themselves.

Second, caregivers must de-stress and disengage and take care of their physical and mental health needs. Boundaries need to be maintained too because it often happens that they tend to forget about their own social, personal, and emotional needs while taking care of the patient.

Disha Roy Choudhury is a Principal Correspondent at Apeejay Newsroom. She has worked as a journalist at different media organisations. She is also passionate about music and has participated in reality shows.

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