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Corporate Mental Health

Mental health problems among the corporate employees is noticed to be high, due to high stress, work pressure, irregular work timings, sleep deprivation, conflicts at work place, high expectation of self, ambitious nature etc. People can silently suffer from this problem without being aware that they are having a reversible condition. A person who faces low motivation suddenly may just be having features of exhaustion or depression, a person who avoids parties and travelling may have Social Anxiety Disorder. In mental health many of the problems can be treated and one need not withhold for fear of discrimination.

A person's career growth is based on his/her work performance for which education, attitude, skills and overall performance contribute. The growth is centered on the skills a person can demonstrate at work place; if a person has good public speaking skills, then he/she can do interesting presentations and this brings career advantage. If a person demonstrates skills in managing people effectively however difficult they are, then he/she grow in people oriented fields like administration and marketing. If a person is mortally scared of travelling even to a known destination, it will paralyse him/her with restrictions.

Substance abuse

Substance abuse can be found in the form of daily consumption of alcohol, taking tablets and intake of marijuana, heroin and other substances to induce intoxication. This habit can be formed out of social compulsions to drink in parties and then it can become a devastating habit. Similarly being adventurous in trying out drugs can get them hooked on to it on a permanent basis. Those who take such substances can also have underlying emotional problems in terms of failures in their personal life, career or some other major disappointments.

Psychological problems

Self-esteem is another major issue, which influences a person's behaviour and performance. A person with very mediocre capabilities can think very high and mighty about self. If a person develops such superior self esteem then he/she can become dysfunctional as he/she will start feeling superior over others, will tend to have a condescending attitude towards the juniors and colleagues, will be over sensitive and can also be very explosive with their expressions. They will also be oblivious towards the damage they do to others and as to how others feel about their explosive expressions. On the other hand a person with low self-esteem can be very docile and be an under performer as he would constantly devalue himself and consider to be incompetent. This can lead to underperformance by the person, which would affect the person and also the company.

If a rude superior is shouting at the top of his voice, because he is not able to deal with the situation, what the subordinate does will be detrimental to his personality. If the subordinate, on the first instance of screaming, responds assertively then the behaviour of verbal abuse may diminish, on the other hand if the subordinate takes all the abuse quietly then the abuser will feel encouraged to repeat such undesirable behaviour. Accepting to perform an unfamiliar work because of the inhibition to say 'No' just to satisfy the superior for the moment and then tossing themselves for blindly accepting to perform the work would be habitual for someone with lack of assertiveness. They will also not be able to perform the work leading to disappointment with themselves and to the people who had delegated the work. In an effort to please a person they will end up causing loss of time and irritation about the incomplete work.

'All work and no play can make Jack a dull boy'; similarly, those who keep scheduling tasks without taking a break and relaxing can experience 'burnout'; a condition in which they get emotionally and physically exhausted.

Psychiatric problems

Corporate staff can experience psychiatric problems secondary to various life situations and personal problems. The common types of psychiatric conditions that affect corporate staff are depression, anxiety, somatisation and obsessive-compulsive disorder. In anxiety disorder the person will have an unknown fear or fear of some particular situation like making a presentation or travel. The anxiety can cause palpitation tremors, sweating and make the person lose his ability to think rationally. The anxiety can be caused by an irrational fear. In depression the person will experience lack of interest, low mood and increase or decrease in appetite and sexual drive. In obsessive-compulsive disorder the person inspite of knowing the futility, will keep repeatedly doing things like washing, hoarding useless objects, keep washing hands or be totally preoccupied with the orderliness and neatness of the place. Similarly a person can also develop symptoms of a medical illness without actually having the medical problem or be over concerned about their general physical health.

Treatment

Mental Health problems are treated with psychiatric medication, counselling and Psychotherapy. Meeting a psychotherapist and discussing the symptoms and real life situations will enable the therapist to diagnose the nature of the problem. Some of the mental health problems can be overcome by a simple work up on the personality or on coping skills of the person. Some psychological problems and psychiatric problems may require specific intense psychotherapy over a period of three months or so, depending upon the severity of the illness.

Many workshops and skills development programmes are available nowadays, but those with low self-esteem and those not comfortable with groups may not benefit from such workshops. They may require individual attention in a customised form in therapy sessions; also they may perform better as individuals rather than in groups.

Cognitive Behaviour Therapy is a specialised form of counselling and psychotherapy, to help patients overcome their emotional problems, correct faulty process in thinking, feeling and behaviour. Patients can develop illogical thoughts, faulty way of thinking, (ex: I am good for nothing, others usually do not respect me etc). Such faulty thought patterns can provoke intense negative emotions. Similarly out of fear of failure they can avoid doing certain activities, which can lead to problems in their life. (Ex; public speaking, avoiding exams)

The therapist enables the person to recognise such patterns of distorted thinking and dysfunctional behaviour. The therapist alters distorted thoughts and dysfunctional behaviours using systematic discussion and carefully structured cognitive and behavioural assignments. The patient's work in a collaborative relationship with the therapist to identify problems and strategies to overcome the problem.

Initially a very detailed assessment is made about the problem the person is facing, their personality, their strengths and weakness. The central principle of cognitive-behavioural assessment is the ways in which an individual behaves are determined by immediate situations, thought process, mood and the individual's interpretations of them.

In Cognitive Behavioural approach the therapist aims to help the person to develop skills to overcome the present problem. The progress of the therapy directly depends on the way patient performs the assignments, stays committed to the therapeutic goals and his efforts in working out various strategies. The cognitive and behavioural exercises would be like challenging the automatic thoughts that he/she is no good or is deficient in many ways compared to others etc The patient is expected to participate actively by collecting information, giving feedback on the effectiveness of techniques, and making suggestions about new strategies.

Eating Disorder

Are you aware that there is something called Eating Disorder!

Yes, people can have problems with their eating habits when they have psychological problems or faulty ideas about their body image. We all learn to eat in our childhood and presume that it goes on without any problem. Eating Disorder is a very common condition among women that goes unnoticed. Woman is the one who serves food for the family members and makes sure everyone takes sufficient food, but when it comes to her eating habits she makes a lot of compromises. Sometimes if someone eats more or if there is a guest, there may not be enough food, in that case many women just drink some water or milk and go to sleep. It is ok if it happens once in a while but if it happens regularly about three times a week then it can affect the person's health.

The present fashion of being 'thin' has resulted in more number of young girls and ladies getting into the habit of eating less or missing meals. Young girls seem to give more importance to being fashionable than being healthy. Inspite of available evidence that, to reduce weight, a person has to do a lot of exercises many ladies just reduce food and it leads to many nutritional and health related problems. It is not wrong to get fascinated by our beautiful slim heroines and girls on the fashion TV and want to look like them. But the fact is these heroines and girls eat well and do lots of exercises in their free time. In the west it is normal habit for people to go for walks in nearby beautiful parks even while it is freezing cold.

Those with eating disorders have a tendency to misinterpret what they see in the mirror, they may see a normal shaped figure or even if they are thin they will think they are fat and out of fear of gaining weight will start avoiding food.

Medical problems due to Eating Disorders
•   Loss of Fat
•   Problems in thyroid
•   Intolerance to cold
•   Affects muscles in the heart
•   Pain in the abdomen
•   Constipation
•   Irregular periods
•   Skin problems
•   Affects bones
•   Affects the teeth
•   Being mentally dull
As there is a habit of eating less there is also a habit of eating more than required quantity. As such our Indian food is very tasty so we tend to eat more than the required quantity. In European countries people eat food, which are not very tasty, but of nutritional value, so they stop with the required amount. But in South Indian food we give make dishes with so much taste sometimes we tend to lose control over how much we eat.

In general we may eat more because of the tasty food, but people with eating disorders eat more when they tensed or worried excessively about their weight. After eating they will try to vomit the food, sometimes even by putting their hands inside their mouth. This is more prevalent among women who remain alone during the day, particularly in Indian women who are living abroad as they are alone in the house during the daytime.

Tips to remember
•   Men in the house should make sure that the ladies have sufficient quantities to eat and they are taking the food regularly.
•   It is good to look thin but by doing exercises and not by starving.
•   When you cook food make sure there is some extra portion.
•   If you are worried or tense try to talk to someone or write down your thoughts avoid eating to reduce tension.
Case Study

A 27-year-old lady living with her husband and 6-year-old daughter in a high raised flat approached me for the problem of eating excessively and then starving for many days. She has the habit of getting tense when she is alone at home thinking of various problems, to overcome the tension she started eating large amounts of food and will try to vomit because of the heavy feeling and fear of putting on weight. When she came for psychotherapy it was found that she was scared of the future as her husband was in a temporary job. So when she had to stay alone during the day time she started thinking about her daughter's education, professional education and marriage and got very tensed. In psychotherapy it was found that she was brought up with the attitude that only if there is a permanent job she can feel secure. This faulty attitude, which was deeply imprinted in her mind, was changed with the facts as to how her husband being a doctor has been changing jobs every two years and how that has only increased the income and the present state of job market is also such that people like to keep changing jobs for better prospects. Following the change in the attitude she stopped getting tense, which prevented her excessive eating behaviour.

Treatment

Eating disorder is normally found in people who have poor self-esteem and negative self-image. It is also found among those who have minor psychiatric problems like anxiety disorder and depression. The best form of treatment for these disorders is Cognitive Behaviour therapy; it is a very effective form of psychotherapy in which faulty thought, thinking process, faulty beliefs and attitudes, faulty emotional reactions are identified and changed through interesting real life exercises for the mind and behaviour. The behaviour therapist will give them diet charts to follow to enable them to have sufficient nutritional intake. The therapy will help them to stop misinterpreting their body shape arbitrarily as a thin one and enable them to have more objective opinion and to include certain reliable friends' opinion. Most importantly the therapy will enable them to stop depreciating what they are and what they do and develop a good self esteem.

Mind Matters

Is Anger destroying you?

Anger Management-What You Need to Know

Anger destroys a person's health, personal life, career and even social life. A casual family window-shopping trip can turn out to be the most distressing trip for the entire family if a family member gets into an anger outburst either with a family member or stranger. Says Dr. Ravi Samuel, a psychotherapist; "Anger is an emotion ranging in severity from mild irritation to intense fury. Its impact is psychological, and it can impair a person's ability to think rationally and logically." He continues, "Anger is also accompanied by a physiological arousal to respond verbally or physically." Is it not getting common these days to see two people on the road swearing at each other?

A Powerful Emotion

As we attempt to comprehend the factors that trigger off anger, it becomes vital to understand that biologically, the amygdala (also known as the 'feeling brain') experiences emotions prior to the thalamus (known as the 'thinking brain'). This explains why a person, spurred by anger, tends to indulge in certain verbal expressions and physical acts. "Anger is caused by interpreting external events as an insult to a person's dignity or that of others and can further intensify by repeatedly pondering over such events", adds Mr. Samuel.

A Growing Concern

Stress, interpersonal conflicts and the distressing break-down of relationships can have an adverse effect on some people and can manifest itself in difficulties in controlling anger. Anger has become a common problem today for almost all age groups, irrespective of gender.

"Children are being brought to my clinic by parents concerned about their child's destructive activities and uncontrollable behaviour", Mr. Samuel states. "Executives who are troubled by their inability to deal effectively with their teammates, also seek my help. Moreover, housewives too, when faced with deteriorating relationships with their spouse and children, approach me for guidance."

It has been discovered that anger can be influenced by genetic factors and social circumstances too. Also, people from disturbed family backgrounds may display a greater predisposition to anger. Mr. Samuel adds, "On the other hand, anger is an emotion that should be expressed. However, you require knowledge to help you handle this powerful emotion."

Implications of Anger

Anger is known to have a huge impact on a person's mental and physical health. If overlooked, it can lead to problems such as high blood pressure, stroke, heart attack, insomnia headaches, digestion problems, abdominal pain, loss of hair and skin problems (eczema) too. It can also lead to disorders such as anxiety and depressive disorders.

"Suppressing anger, however, without dealing with the underlying cause or emotion, can also have a negative effect and can lead to passive-aggressive behaviour and hostility", reveals Mr. Samuel. "Being assertive without being destructive is the best balance you can learn in dealing with this emotion. Physical violence towards people is certainly abusive behaviour, which I seek to actively discourage", he states.

"There are several techniques, such as relaxation techniques and cognitive restructuring, which can be practiced to overcome anger", assures Mr. Samuel. "However, in cases of uncontrollable anger, a psychotherapist will also have to work on the person's self-esteem, emotional coping techniques and problem-solving capabilities."

While some people seek timely help when their relationships get affected due to poor anger management, there are others who even opine that anger is a 'life skill' that they are equipped with. "It is such people who are likely to suffer from the impact of anger on their mental and physical well-being and this can also adversely affect the quality of life of people around them", emphasizes Mr. Samuel.

Anger Management Techniques

CBT is a combination of cognitive therapy, which examines undesirable thoughts, attitudes, and beliefs (known as cognitive processes) and behaviour therapy, which focuses on the behaviour adopted in response to such thoughts. With the help of structured techniques, a CBT therapist seeks to identify the thoughts that cause distress.

CBT encourages challenging negative beliefs to gain a realistic view of situations. This involves a collaborative effort between the therapist and client, to work on the client's problems and help equip the client with beneficial skills to overcome distortions in thought patterns.

Case Study

45-year old Mr. Ranganathan, a very efficient manager in a multinational company, was faced with growing resentment from his staff and the management, due to his display of anger in trivial issues too. Mr. Ranganathan also found most of his ideas turned down by the Board of Directors. Aware of the implications of the situation, he approached Mr. Samuel.

On detailed evaluation, it was discovered that he displayed a highly condescending attitude towards the staff and derived a sense of mastery by shouting at people. His presumption was that his subordinates would perform their duties out of morbid fear and was even blissfully oblivious of the resentment and hostility.

Mr. Samuel identified his dysfunctional thoughts, faulty beliefs and undesirable behaviour. Using CBT, techniques such as 'mirroring' and 'benefit analysis', Mr. Samuel enabled Mr. Ranganathan to resolve his issues amicably and overcome his anger.

The 'mirroring' technique involves the therapist enacting the behaviour of the person, which helps put him on guard against such dysfunctional actions. 'Benefit analysis' is another technique in which the therapist enables the person to understand how his actions, if replaced with right behaviour, can be beneficial to him in several ways.

With CBT gaining a firm foothold on treating psychological issues, anger management techniques can provide respite to those in need of help in managing their emotions.

Divya Mohandas

Social Anxiety Disorder

Do you Avoid People?

1. What is Social Anxiety Disorder?

Social anxiety is found in both men and women, they are very normal people, except when they have to Interact with another person outside their immediate family members. They can be colleagues, classmates, people living in the same apartment etc. The anxiety is both with members of the opposite sex and same sex. They form close relationships with very few people inside the family and outside the family also. They will take a very long time to form such relationships. Invariably the person with whom they form relationships would also be a little socially shy.

2. Do people develop this in childhood or as adults?

A person can acquire it as a child or develop it as an adult. Socially shy parents or parent may teach the child to avoid unnecessary interactions, which the child may follow in the initial years, and then it becomes their nature to avoid people. In case of adults it can happen when successive relationships result in disappointment, rejection, criticism or being exploited financially or sexually.

3. How does it affect the person’s life?

The sense of AVOIDANCE will be so high that they will not hesitate to resign their jobs if their job profile necessitates interacting with people, they will drop out of a relationship if the other person starts getting friendly with others. Even if the salary is lucrative they will refuse promotion and remain in a self-defined comfortable zone.

If one of the married partner has social anxiety then when the other person gets friendly even with a person of the same gender they can misinterpret it as loss of interest in marriage, or even as being unfaithful. This can lead to enormous strain in the relationship and if the other person has to avoid they have to stay away from all relationships which may be realistically possible in the initial years but after a few years it can start leading to enormous frustrations.

These people will avoid parties they will find a good excuse to stay out of it. If someone manages to motivate them to attend a social gathering they will be silent spectators during the event and then they will only be thinking of as to how to leave the place. So seeing their discomfort and silent participation people slowly stop inviting them for social gatherings.

4. What is the treatment for Social Anxiety Disorder?

It has to be treated with Medicines and Psychotherapy. Social anxiety manifests due to faulty thought processing, dysfunctional beliefs and consequent anxious physical reactions. This can be either secondary to a traumatic real life experience or totally imagined.

Cognitive Behaviour therapy is very effective in treating this disorder along with anxolytic medication. In this therapy we enable the person to identify the initial experience, which lead to the formation of thought processes leading to social anxiety.

Formation of Social Anxiety
A negative life experience with someone or faulty teaching about socialisation

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Criticism or Rejection or Disappointment or Exploitation or self-doubts

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Formation of Faulty thoughts: I am incapable/It is better to stay away from people/Interactions only lead to disappointments/People will wonder why I am coming and talking/People will think bad of me, etc.

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Physical Anxiety: tremors, sweating, palpitation, dizzy feeling.

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Avoiding people.

5. On an average, what is the percentage of Indians suffering from Social Anxiety Disorder?

We do not have epidemiological data to answer this question. My rough estimate would be about 8 to 10 per cent of people must be suffering from this. Due to cultural restrictions women are more vulnerable towards developing this condition.

6. What is the biggest hurdle involved in fighting Social Anxiety Disorder?

a) People do not consider this as a problem; they just learn to live with it. Only if it grossly disturbs their vocation or marital relationships they look for some kind of treatment.

b) Indians have a tendency to expect medicines or their birthstone to solve their problems. Instead if they put in efforts on physical and cognitive exercises they can easily overcome this embarrassing and paralysing disorder.

c) People with social anxiety disorder AVOID situations, consequently they live a very restricted life, which they find to be comfortable and compromise with many aspects of life

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