Reaching out !!!!

 Imagine, for 2 years living in your own world and not being in touch with reality. Making connections that are not really there. For you your behavior is justified. For others it might seem normal with just some increased irritability and anger issues as some changes. They might justify it in their own way for you. So no-one really knows what is happening, when in fact a disorder called schizophrenia is the backstage performer.

Extremely hard to imagine!!!

But its a true story for Maqsood (name changed) 21 years young guy from a small village in Partur taluka of Maharashtra. He was living like this in his own world for 2 years. It made him irritable and gave him anger issues. People around him thought he was just off with slightly different behavior from others. No one knows that a disorder like schizophrenia or psychosis or any mental health disorder exists in actuality.

Its not everyday that an ASHA worker attends a workshop on general mental health where she actually understands that behavior  changes are actually mental health issues and if treated correctly can make the life of the person and others around a lot better. One such ASHA identified this person as, might be having some disorder and asked him to visit me as a doctor for his anger issues. 

When he entered the clinic he was calm, listening to our block coordinator, following instructions as to where to wait, and when to approach doctor. Being exhausted after seeing "kaafi" patients, my quality of communication with the patients had decreased and I just wanted to finish the OPD and go back home. Since "my home" would be 2 hours away from the clinic, I was still skeptical about taking in detail history.

His perceptions about others conspiring against him obviously alerted me to listen carefully. So listening to this guy helped me to understand that what he was genuinely complaining about couldn't be actually the true story. Some leading questions made him tell about his auditory hallucinations which he had not told anyone about since 2 years. These voices sometimes used to encourage him or used to put him down. I explained to him that they were not real and that the pills will make them go away. This made him smile with relief and he was already feeling better.

The diagnosis that this was a disorder and could be treated with medicines is a huge relief for most of the patients with schizophrenia. Similarly a man whose wife had schizophrenia was going to go to baba for "jhad phuk". But he came to the OPD and when explained to him that it was schizophrenia, he said, "Now that I know this I don't mind if she doesn't becomes normal, at least I know what the problem is! If somebody would have explained like this earlier we would never have thought of going to the baba"

The simple act of defining the problem eases out the way towards getting a solution!! 

Long time no blog. This blog I had left incomplete till today. Just a snippet of what it looks like to diagnose mental health disorders for the first time in an area with very little awareness if such problems.