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The horrors of bipolarity

Mood swings. Manic ups and depressive downs. Stress adding to more stress. Finally homicidal and suicidal tendencies. These would be only some of the events that bipolar people experience. Medication can control the condition but many patients reacts to drugs and so have to stop. Others do not react well and live through a fog when medicated. So control comes at a high cost. Antidepressants combined with mood stabilizers combined with anti-psychotics….just the thought of this potent combination give me the shivers. These are not your ordinary run-of-the-mill medicines. These have side effects and down sides. Antidepressants have just been shown to be about as good as placebos for bipolarity! Above all  people with bipolar disorder can never stop taking medicines. And this is the saddest part. Early diagnosis, sensible treatment, sensitive care at home are just the starting points.

The difficulty for care givers is that bipolars have no compunction when it comes to exploiting other people.  In extreme cases patients have to be institutionalized against their wishes. And to watch this happen can be heartbreaking. How much of the bipolarity is inherited and how much comes through childhood trauma is hard to say. Full manifestation often happens later. In young adulthood. Although experts say there are significant signs at earlier stages which parents are either unable to or unwilling to recognize. Unacceptable acts of selfishness. Inordinate show of temper. For caregivers seeing these unpredictable highs and lows is nothing short of traumatic. Parents berate themselves on not doing enough. Husbands and wives go through guilt and worry. Friends who cannot take the swings disappear, driven away by confusion and fear.

The debate between nature and nurture in this context continues. Even if there are genetic causes of bipolarity all experts agree that upbringing and family environment have a big role to play. Problem is that not all parents know what to do and how soon. Diagnosis of bipolarity is becoming easier and while this is a very good development what we need is education for family and friends so that they can ‘protect’ themselves even as they try to help those who suffer from it. We need to mobilize community support if necessary but the stigma attached to mental disorders prevents many people from even considering giving or taking community support.


Infant deaths in India: the shortest journey on earth

March 12, 2012

Today’s story in the Times of India has an alarming headline on page 4. The rest of the story though has only slight links with the headline. It confuses issues and misleads readers. The story is on infant mortality in India. However, crib deaths and deaths from hospital acquired infections are two separate reasons for infant mortality and need to be investigated separately.

Infant mortality rate: total47.57 deaths/1,000 live births
male: 46.18 deaths/1,000 live births
female: 49.14 deaths/1,000 live births (2011 est.)

Premature birth is a leading cause of infant deaths even in large cities such as Mumbai. Overall the rate is dropping but not fast enough. India’s target against the MDGs is way off the mark. When comparison is made with countries such as Nepal or even Bangladesh I wonder if it is even fair. India’s population is huge, its resources stretched and its geography a huge challenge. Having said this, it is also clear that political and to some extent even social will, has been lacking when it comes to managing infant mortality.

Being an obstreperous nation, we have parallel conversations going on in this context: should we spend our energies on ensuring fewer births or on ensuring all infants survive after birth? Who asked people to have children anyway. Then there is the relentless rise in adult chronic conditions so should the limited resources be spent here, or in reducing the birth of children who are likely to add to this burden, or in saving the lives of those who are being born and die because of neglect and preventable causes? Full immunization of children is a goal worth protecting because this protects the future. Genetic disabilities: should these be discouraged through genetic testing? These survivors place a different kind of burden on families and public health resources.  The arguments for and against go on.

I wonder if our slow achievement rate on infant deaths isn’t also influenced by our cultural karmic mindset.

More dangers than we can count in the wrong kinds of food…

So much research in the past has gone wrong that today regulatory bodies are jumping to the other extreme and banning food ingredients even before anything conclusive has been established. The latest in California is to ask carbonated soft drinks to lower levels of caramel coloring in their products. Because the chemical that gives the color is said to be carcinogenic although this research has only been done on mice. The drinks manufacturers say that the amounts contained cannot possibly do this kind of harm to humans. But the authorities are adamant. These drinks are consumed in large quantities all over the world, they are possibly the most aggressive – even if it is charmingly done – when getting to consumers and working on consumer loyalty and fidelity.  They have become lifestyle icons. What goes into some of these has been a subject of discussion for a long time. Addictive substances, some say, akin to nicotine. Additive that no one knows anything about. The formulas are secret! High sugar levels were once considered the most dangerous. With ‘diet’  and zero calorie versions these drinks were supposed to become safer.  Not so says some new research. They continue to be harmful in other ways.

The lobbies that want to either curtail consumption of these products, make them change formulas or generally make sure that children in particular do not get ‘hooked’ too early in life, are getting stronger. It would make good marketing sense for companies to take each of these problems and start looking at solutions sooner than later. They probably are, but if they go the route of tobacco companies we should expect a great deal of legal hassling and tough resistance and not that much concern for consumers. Perhaps we need a special ethics code for food companies after all.

CRY…….Health of the Child in India under threat

It is time we made health a fundamental right for children in India.

 On March 8th 2012 I attended a Corporate Social Responsibility Summit organized by CRY (Child Rights and You) in Mumbai.

It was an effort well made, an event well-organized and it brought together some illustrious and well-known experts, corporates, NGOs and communicators to discuss an area that enjoys corporate lip service, provides brands with good opportunities for back slapping and adds a little luster to corporate conversation just when it is in danger of getting stale!

CSR, however, as the day long deliberations showed, is neither a well understood word nor is it a ‘space’ that can be easily defined. While some panelists felt that a lack of definition did not matter and in fact allowed a constituent to  ‘invent/innovate’, others said that unless you knew what you were supposed to do you would end up wasting time and money with no measurable impact.

Health was a recurring theme. But whose responsibility was it? The Government alone? The Government and the corporate sector? We got no firm answers. But the fully engaged audience agreed that the start of this discussion was long overdue. Many of the CSR projects discussed had the health of children as key focus.

Malnutrition was discussed and statistics shared. It is not confined to just the poor. It is present even among the middle and upper middle classes. So it is not the shortage of food but wrong eating habits that create this situation.  India is one of the countries where obesity is growing and malnutrition has risen to alarming proportions. But who should take responsibility for fixing these skews? The Government is more in the regulatory mode and less willing to act as an enabler. The State has repeatedly reneged on its promises of more and better health. Business is willing to take up some of the slack but not unless a business case can be made for this involvement. Nothing wrong with this argument except that intervention is seldom sustained for as long as it is needed, to make a measurable social and demographic impact.

The consensus was that malnutrition in India among children, pregnant and breast feeding mothers can be tackled if companies, NGOs and the State make the resolve to do something that is sustained over the optimum timeframe. In this context Dr. Parasuraman of the Tata Institute of Social Sciences left us with an intriguing thought : Sustainability must not be ‘colonized’ by capitalism.

Here is research that reverses the commonly held belief that we cannot take good decisions under stress.

Health & Family

If you’re trying to make an important decision while the baby is crying, the boss is shouting on the phone and the cat has chosen this moment to think outside the box, you might want to take a breather and wait. A new review shows that acute stress affects the way the brain considers the pros and cons, causing it to focus on pleasure and ignore the possible negative consequences of a decision.

The research has implications for everything from obesity and addictions to finance, suggesting that stress may modify the way people make choices in predictable ways.

“Stress affects how people learn,” says Mara Mather, a psychology professor at the University of Southern California and the lead author of the review. “People learn better about positive than negative outcomes under stress.”

For example, two recent studies looked at how people learned to connect images, such as letters from an…

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Indian healthcare policies…who are they for?

Private pharmaceutical companies, both Indian and MNC,  have spoken up more and more often on what they think is in the best interest of India. We hope that by this they mean the people of India, but that is by no means a given. No doubt business must see to its own interests first but in the area of health, not without keeping patient and public needs squarely in the front. When the government announces that it will give free medicine to the poor in a large number of town and cities through government-owned chemist/dispensary outlets, we wonder what kind of struggle will take place in the backrooms of corporate offices to negotiate prices that can actually support this subsidy.  The government is by no means the hero of this story. Unfortunately for us the intended beneficiaries of all these good measures, there are no heroes on whom we can rely. Government control on prices is bad, letting market forces play is at times even worse because the first to get hit are the poor. So it would be fair to conclude that unless pharmaceutical players find a way to address prices and cost effectiveness in a  mutually acceptable these types of government maneuvers cannot be controlled.

Legislated Sleep!

February 27, 2012

The Economic Times today has an editorial on the ‘Right to Sleep’ endorsed by the Supreme Court of India. The Court’s ruling now brings this right on par with the constitutionally guaranteed right to life. But no time frames are given and no one knows what is a ‘reasonable amount’ of sleep. The Court has given scientific and health reasons for this verdict. All well and good and it is true that the Supreme Court in India takes on the burden of fixing many social and business issues that would normally not fall under judicial oversight. There is a load of new research on  sleep deprivation  and its links to some serious life threatening conditions including Alzheimer. Most of us are unable to figure out why we cannot sleep as well as we should. A number of things have been suggested to overcome this. But they do not always work. So the responsibility to get 8 hours of sleep in every 24 hours is a responsibility we carry as people. And most of us resist as we should the temptation to take sleeping pills. There is one way however that is worth trying and which could yield better results than others and that is meditation. Done correctly there is no doubt that this relaxes the system enough for a person to get at least four to six hours of uninterrupted sleep. Actually for many of us this is enough. Disengagement in whatever way we can achieve it, is the first step to getting to sleep. The age old ‘burning the candle at both ends’ of course is the worst we can do to ourselves.

How much sleep is enough: a BBC story


Healthcare priorities in India…what is going so dreadfully wrong

February 23, 2012

The Mint today has two article on the state of health in India. There is a clash between the Public Health Foundation and the Planning Commission on whether Government should find more funds through fresh taxation to give free healthcare coverage to the poor.  The tax payers have already been taxed extra to provide for healthcare for those who do not pay tax. The tax payers and the public in general do not know where these funds have gone or how they have been used. So higher taxation is certainly not the answer to this problem. The argument that the state is responsible for providing access to basic health is valid. Health needs to be given the same status as education which shifted from being a constitutional directive to a basic right after a protracted fight by civil society actors. This is the crux of the argument the PHFI makes. The Planning Commission on the other hands wants more private industry participation in healthcare solutions in India. This too is valid. How the Commission plans to actually make this happen is unclear. Once again those caught in this trap are the people of India.

Here is a further example of how policies and priorities are scuttled by politicians:Corruption and the National Rural Health Mission

The Corruption of Yoga: Updated

February 2, 2012

Who should be allowed to teach Yoga? CNN is asking the right question. Are the answers also right?

January 25, 2012

Here is another take on Yoga and how it has been commandeered to do service in the interest of a particular practitioners personal vision. But there are some interesting new facts which make this article worth reading.

January 23, 2012

The latest in what is an unending desire to twist everything right into something almost entirely wrong. ‘Hot Yoga” which  is supposed to be practiced in a hot environment so that you can sweat out the toxins. And here we were taught that sweating is not the purpose of Yoga at all!

January 5, 2012

There are some completely unacceptable phrases in this article published in the New York Time on January 5, 2012. All through the use of the word “extreme” in the context of Yoga makes this irresponsible writing.  While there is reference to BKS Iyengar there are no references to the Bihar School of Yoga. Contortion and holding poses for unbearable lengths of time is not Yoga. This is what happens when you take ancient wisdom out of its traditional context, export and modify it till it is corrupted into a monstrous parody of its original manifestation. Clearly the teachers and students mentioned in this article are worse than the blind leading the even more blind. This article is based on a soon to be published book on the “risks and rewards” Yoga. How authentic can it be with these half baked theories tossed about?  The article is filled with examples of people who attempted to do what the fully fit would with pre-existing physical problems. No one checked no one cautioned.  A little more thought would have convinced the writer that this is not the fault of the system but of the teachers and those being taught. Worst of all is the complete absence of any cases where the therapeutic aspects of Yoga have been conclusively established. What we were told when we learnt Yoga and what we taught our students was how NOT to push the body beyond what is tolerable and how to avoid certain types of asanas if there were physical problems of any kind. You did not start doing anything before a doctor checked you out. You did not push and persist if there was the slightest unease in any movement, twist or bend. You decided how long you would hold a pose and no one insisted you stand on your head and damage your brain. Listen to your body, we were told and use your common sense. You are your own best teacher at all times.

A Med Diet Plus CoQ10

Add Coenzyme Q 10 to a diet rich in olive oil, nuts, whole grain, fruit and vegetables and you get double anti inflammatory benefits.  This means more protection against heart disease, osteoporosis, Alzheimer’s, diabetes and arthritis. 

CoQ10 is available naturally in animal products. This limits access to vegetarians. Experts believe that our normal diet may not be able to give the full measure of CoQ10 required to fight disease risk, particularly in aging adults. Supplementation becomes necessary.

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