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“Psychiatrist illnesses are primarily caused by biological vulnerability because brain is a part of the body and mind is the function of the brain. Feelings, emotions, perceptions, reactions to threats or stress around us is not something that just happens in a vacuum. It happens because of a certain set of neuro-physiological reactions in response to our genetic makeup and our environment,” says Dr Jyoti Kapoor, Senior Psychiatrist from Paras Hospital.

While talking to Medically Speaking on the occasion of Mental Health Week special, Dr Kapoor suggested basic mechanisms to cope from mental health conditions and managing daily life stress.

Find out in the following snippets from the interview:

Covid-19 has had a profound impact on the mental health of everyone, including children and the elderly. What is the common yet significant impact of the pandemic? And what are the coping mechanisms that everyone should consider?

Dr. Jyoti: Pandemics and problems like that in our society or in our environment, when they come, create a lot of anxiety. It is a threat, something can harm us, something can hurt us. Something can be tested. And, with the COVID pandemic in full swing, there was a sudden wave of terror about a certain virus that humans had never felt before. So it led to a very high degree of anxiety. And looking at the world scenario, the global scenario, our country also took measurements. But why did we have to take both measures, including the lockdown and keeping ourselves safe, there was a vast shift in the way we lead our life. So we were no longer able to get out. We were no longer able to interact with people. We were supposed to wear masks and sanitise so often that we had never done it in the past. Because of all of that, the nervous system increases and gradually leads to mental health issues. So, as a result of anxiety and stress, primary psychiatrist illnesses such as obsessive compulsive disorders, anxiety disorders, panic disorders, and depressive disorders, are all triggered during this time period. So we are seeing more and more patients with psychiatric issues, anxiety disorder has affected almost everyone around the world, and we are trying to check or assess the and some research has been done in this area. Almost 40 percent of people who have suffered from Covid-19 have developed some sort of neurological or psychiatric disorder and those who haven’t suffered from Covid-19.

The second part of your question is the coping mechanism. Stress is part of our lives, and we have to deal with it by figuring out the best method that helps us manage stress so that it does not increase. Take, for example, one of the ways people cope with stress, such as drinking alcohol, smoking, or using drugs. That’s not a good coping mechanism because it might help you feel relaxed for a short period of time. But then it is also building up another level of anxiety and another disease. Overall, disorder, similarly, playing games on the internet, has come up, because that is again, an addictive coping mechanism that doesn’t help eat too much. Some people tend to do stress eating or junk food, bingeing on Netflix. All of this has been going on again as a coping mechanism. Because they don’t let us deal with the stress. They also create a secondary problem. So the coping that we require has to be something that can help us identify one of the sources of stress. Secondly, it helps us understand what taking or reacting to it means. By becoming, and she’s going to be hardly helpful because, you know, it’s a vicious cycle. Thirdly, it’s about finding that balance. Wherein, you are leading your life, focusing, or prioritising things that are important in your life, and everything else that is not in your control with some picking. So what we need to do is find a coping mechanism that is positive and that will focus on the positive. things around you, instead of focusing on what went wrong in the last two years. You would try to focus on what went right in the last few years, because there was a lot going right. Also, we have to be able to, but practise would be called their activity, which means that we are able to focus on things that have helped us. So the internet causes problems when it comes to getting addicted. But then the internet itself has been a real failure during this period. We’re in the know. And education and even telemedicine, and online consultation. Everything has been able to be done. So the internet is quite helpful, so these are coping mechanisms. Talking to people, communicating honestly, being more tolerant, exercising, or finding the opportunity to do things that you haven’t done, in part, because you were very busy. All of that is a positive coping mechanism. It definitely works in managing stress better.

How far is it that exercise can help a person cope with a mental disorder or mental illness, especially when they’re living alone?

Dr Jyoti:  A lot of research has been done in this area, when we exercise our bodies, we physically exercise ourselves. There is a release of certain chemicals called endorphins, which are natural painkillers. And also, they make us feel good. Secondly, when our bodies are meant to be active, So, there is energy, there is physical energy. Doing something creative, physical activities and healthy lifestyle changes help us channelize our energy in a positive direction, because there is a sense of achievement.

Rhythmic movement of the body is also associated with balancing neurochemicals which has been seen in dance movement therapy, and in psychiatry, we see that how the rhythmic action of the body kind of causes a certain rhythmic action, of thoughts of the brain. So we see it in dance movement, Zumba. So it impacts all sorts of goal-oriented activities that are generally done in a repetitive manner. We were there even when you were running.

When you mention these physical activities, such as cardio gym and everything. So it happens that people have motivation to do so, especially in times of depression, when they’re living alone and they have nothing to motivate them. People have been working from home for the last few days throughout the lock down. So how do they should get motivated?

Dr Jyoti: There is a time when you realise that you are having symptoms, you’re not feeling happy, not feeling like doing anything, but you still can do something. And then there comes a time when you’ve already gone into what we call clinical depression or clinical syndrome. When that time occurs, when despite knowing that you should be doing but you are not able to do it till the time when you need to see a professional or you may need to take medication. Before that when you know that you are developing issues, you have to take the next step right there and then. One way to do it is to take some time for a certain activity. So we say that the discipline he ordained and put pressure on us to make a timetable because I have to do the exercises from 6:30 to 7:30 in the morning. Let’s start that. And then you tell yourself that, okay, even if I’m not able to do it but at 30, let me just start it. Let me just do it for 5 minutes. We often tell people that okay, you get ready, get dressed. If you feel like doing it, do it, otherwise, don’t do it. And let me tell you, nine out of 10 people who start doing it for five minutes will end up doing it for 30 minutes. The second thing is to focus on an activity that you enjoy doing. You don’t do something just because somebody else is doing it.

Music is a very helpful tool during this time, so put on a music that will immediately make you tap your feet. So do an activity that you enjoy, set a better time for that activity, and if possible, do it with somebody else, because when we are not motivated, sometimes it helps if you are surrounded by people who are doing it. So if you are home and you’re not meeting anybody, then your partner, your friend, somebody can do it with you. And if you can’t do it either way, then nowadays there are online classes. I think these three things can help you if you develop a routine and you’ll be able to pursue physical exercise.

Whenever a person confronts someone or has mental health issues, they say that it is all up in your head. Is it really all up in their heads. And if not, then how is it that someone can develop mental health issues chronically?

 Dr Jyoti : You think that you are imagining it, but it’s not that you’re imagining being sad. Who wants to be sad? Who wants to be anxious? Who wants to be upset? Nobody does. Telling somebody that you are doing it to yourself is like telling somebody that you are making your stomach upset. But then again, everybody’s stomach gets upset after eating something wrong. So if you have a problem, you need to treat it. Even if you did it by eating something wrong. They need to treat it first before you can take preventive action and make sure that doesn’t happen again. Psychiatrist illnesses are primarily caused by biological vulnerability because brain is a part of the body and mind is the function of the brain. Feelings, emotions, perceptions, reactions to threats or stress around us is not something that just happens in a vacuum. It happens because of a certain set of neuro-physiological reactions in response to our genetic makeup and our environment. That is, we are a certain way when we are born and based upon our environment will develop a strategy.

So if I see a spider, my heart starts racing, my hands tremble, and I start sweating. What am I going to do? I’m going to avoid the spider, isn’t it? It’s an unpleasant feeling. I don’t want to see that spider because it makes me feel so uncomfortable and scared. This is what we do when we are faced with a threat. Now somebody else who is not scared by seeing  spider would obviously laugh, asking, “Why are you afraid?” What we need to do over there is to acknowledge the fact that this particular person has a problem, which is triggered by a spider. Spider is not the cause, it’s a trigger. So we need to treat it. And how do we treat it? By understanding what a phobia is. There are medicines, there are cognitive behavioral therapy procedures. Systematic desensitization, which are starting to deal with it. But it’s the process.

You just mentioned that there are therapies for all of them. How do they avoid a trial session? And how do they know what treatment should be received? They are in need of them. They need counseling, or they need medication, or they need the services of a psychologist or psychiatrist. How do they approach it?

Dr Jyoti: The problem with most of us is that we don’t prioritise our health. It is not like we  don’t have money. We think it’s all right to spend money on clothes, on shopping, going out with friends, buying a cell phone, or a new model, but investing in talking to somebody. Why would I give money to somebody to just talk to me? So I think that there is a bias there. That is why it is kind of a problem. Of course, there is a population that is not able to afford any of the other luxury items that so health again, becomes an issue for which we have several hospitals and government hospitals, all of which have psychiatric treatment. All of the medical colleges and government hospitals in the country have a psychiatrist set up. The truth is, a psychiatrist is supposed to deal with both milder problems of stress as well as major problems like schizophrenia. It’s not like if you went to a doctor in a government set up, they are just going to give you a pill or medication. They are also going to assess you like any other psychiatrist, so you can seek out a psychiatry facility in your vicinity, which are in the government set up and not in the private sector. Obviously, at some point in time, medical insurance will come in handy and we’ll take care of the psychiatric problems, but till the time we have that this is the option. The third thing is that when you ask to be able to figure out who to go to, to understand, see, there is always a sort of a hierarchy when it comes to diagnosis and treatment. There used to be a time when there used to be family physicians who would you go to with any problem and they guided you. So if you have a general practitioner or a family physician, you can directly go to them and they will guide you whether you should see a specialist, or psychological intervention. Finally, if the person who has going to clinically assess you and diagnose is your psychiatrist. Generally, you go to a GP who refers you to a psychiatrist, but because we don’t have any such system, you can go to a psychiatrist who would be assessing you clinically and it would be able to draw up a management plan.

If you have a problem, talk to a professional, mental health specialist, psychiatrist, psychologist, your college counselor, your school counselor, your GP, your pediatrician, or your family physician, but go talk to a professional who has a basic understanding of what psychiatry or psychological issues are and then try to have some face because most of these problems are treatable. The unfortunate thing is feeling that you’re not going to get treated. Many of these problems are treated.

Depression and mental stress are realities of today’s generation and people, especially when it comes to people between the age group of 15 to 25 years. This time period brings a lot of opportunities for a time of change. What are the possible ways to deal with those changes and both stressful and depressing times? What is your message?

Dr. Jyoti: Most psychiatric illnesses have a starting point between 15 to 25 and we also know that most suicides today happen in the 15 to 25 year old age group, which is sad because it is the most productive time, it is a young age, which is developing, integrating and building a personality. So why is it happening? It is obviously because of the extremely stressful period or the lifestyle issues that we are seeing. What we need to do is go back to the basics and correct that work because we need to prioritize ourselves. If we not, okay, how are we going to help or what is the point of having a great career and a lot of money if you’re not going to enjoy it. So there are three basic things that need to be focused on by everybody if we want to have the ability to manage stress. One is a disciplined routine. We do not prioritize our sleep pattern generally. We think that we can sleep any time, wake up any time, burn the midnight oil. Disciplined routine which includes sleeping in the night and getting up in the morning is important because our circadian rhythm, our body clock is according to the sun rise and sunset. Second is proper diet. Diet has a major role to play when it comes to physical as well as our mental health because if we are not having the building blocks of our b odily systems in the right amount and the right nutritional value and we are putting in toxins in our body, then obviously it is going to have a negative impact on us. Most of the conditions like attention deficit disorders and stomach related issues and lifestyle disorders, like diabetes, and hypertension are linked to diet. So we need to have fresh, wholesome diet, nutritional diet full of nutrition. And the third important thing is regular exercise because our body is supposed to be moving and we are having sedentary lifestyle. We got lifts, we got cars and we got the remote control. This has gradually led to sedentary lifestyle. So we need to be able to exercise. These are basics.

Thing that comes is Stress Management. Stress Management is just will be a part of our lives. You have to be able to manage it. So being aware that I’m stressed, knowing how stress affects me physically, emotionally, in my mood, in my productivity and then doing something about it and what do you do when you take the a break, you prioritize your things. Give ample time to yourself first. You something that excites, you makes you happy. Not because we are going to get a sort of a medal for it. So I often say if you want to paint, don’t do it for putting it out on exhibition, do it because you enjoy painting. So you don’t have to do things for a goal because unfortunately, in our society are brought up thinking that whatever we do should be able to give visible result in the form of a score on a scorecard. And finally, after that is time management. So if you are able to manage our time better, we have time for everything. Most of the time we tell people to exercise, they say we don’t have time.

We all have those 24 hours in a day and we are the one who You have to decide what needs to be done, because you need to put yourself first or you have to put a movie first. So, what is it that you want? So, I think these basic things, we are able to start early on in our life, then the vulnerability reduces. Our parents are not wrong when they’re telling us to eat and sleep on time, but of course, none of this works once the system has broken down. Once we are struggling with the thoughts of obsessions, negative thoughts, anxiety, fears, phobias, irritability, emotions, not wanting to sleep, eat, or do anything, we must reach out to someone, bring our system to normalcy and then we start with the processes. Once we are healed, we start the process of preventing the onset of these problems, also. So we can all do it. You need to just know what we want. So prioritize yourself, love yourself, be responsible for yourself and then everything falls into place.