Relapse, Craving, and Reinstatement

Drug abuse is a relapsing disorder. In fact, most drug abusers and

addicts have stopped or tried to stop taking drugs, only to eventually

relapse. So at any given time, most drug abusers are in fact relapsers.

Therefore, it is important to study relapse itself, and this is nicely

done in a variant of the self-administration model, as mentioned pre-

viously. It works by allowing the animal to learn to self-administer a

drug, such as cocaine, until the lever pressing is stable. Then, the

drug is withdrawn, and, as expected, the animal gradually tires of

lever pressing without a reward and the lever pressing behavior is

extinguished. This animal is now an experienced drug user, much like

most humans who have used drugs but have stopped. A human in this

condition likely thinks about the drug, and when stressed or

reminded of the drug, perhaps by some cue, craves the drug and per-

haps starts looking for a drug. The cue can be the sight of friends who

use drugs, the crack house, or even some white powder that reminds

him or her of the drug. Cues and their effects are very interesting and

currently studied. For example, Drs. Leslie Lundahl and Chris-Ellyn

Johanson recently found that drug-related cues set off cravings in

marijuana-dependent subjects.5 Getting even a small amount of the

drug (which is a cue) might set off a binge of drug taking. So, as you

can see, certain events can trigger craving, drug seeking, and relapse.

Now, let’s return to the animal that has experienced a drug but is

currently without it. If stress, such as a foot shock, is present or if the

drug is injected, the animal remarkably starts to press the lever that

previously resulted in a drug injection. The animal does this even if

no drug is given by the lever press (see Figure 2-4). Previous drug use

has conditioned the animal to look for the drug in situations that elicit

cravings in humans.

Lucky that we are not prey to drugs

 Some of us are lucky and we either have no interest in drugs or

can walk away from them at any time. Everybody’s brains are differ-

ent, at least to some degree, and have different vulnerabilities to drug

use. Surprisingly, women and men respond differently to drugs, and

so do adolescents and adults. Teens are a special concern because of

their youth and increased sensitivity to drugs. Many studies have

revealed why this is so and why some of us are more likely to get into

trouble with drugs than others. Stress, involved in so many health

problems, also feeds the demons of drug abuse. Our genetics also

play a role, but not an overwhelming one; we can still fight back.

Drug abuse and addiction are costly, not the least because of the

misery they bring. Because of this cost, society has invested in science

to combat drug use. It is paying off. We have found the demons, and

we can fight. But if you are new to the war itself, because of the

addiction of a loved one, a patient, or yourself, then prepare to arm

yourself to fight.

Unhealthy Beliefs

 

Beliefs that are unhealthy have, at their core, explicit or implicit, rigid, powerful demands, usually expressed as MUSTs, SHOULDs, HAVE TOs, GOT TOs, e.g. I absolutely must not be rejected. Unhealthy demands are not based on reality.

Rigid demands have three powerful unhealthy derivative beliefs:

1. Awfulising – an unrealistic assessment of badness where negative events are viewed or defined as ‘end of the world bad’ or 100% or more bad.

Example: ‘It would be awful if I’m rejected’, ‘It would be the end of the world if I am rejected and therefore I must not be rejected.’

2. Low Frustration Tolerance (LFT) – the perceived inability to tolerate frustration or difficulty even though we do tolerate it. We do not spontaneously combust and die in the face of frustration and difficulty.

Example: ‘Rejection is unbearable’, ‘I can’t stand it’, ‘It’s intolerable, therefore I must not be rejected.’

3. Total Damning of Self or Other – rating the self, another or the world in a totally negative way, based on a condition.

Example: ‘Rejection proves I’m a failure or worthless or unlovable as a person, therefore I must not be rejected.’

These beliefs are unhealthy because they generate emotional disturbance or unhealthy negative emotions like anxiety and depression. They are unrealistic, do not make sense and are unhelpful to you. They sabotage the achievement of your goals

‘People are disturbed not by things but by their view of things’

 ‘People are disturbed not by things but by their view of things’

This often quoted phrase of Epictetus (Stoic philosopher) is at the heart of the Ellis model. 

The intent behind Ellis’s work and his theory was to:

• Help people clarify their emotions, behaviour and goals.

• Identify the unhealthy beliefs that are at the heart of their emotional problems and 

that sabotage their goals.

• Dispute them and replace them with their healthier version in order to get better 

through consistent and constructive action.

• Finally, to generalise the change to other areas of life.

Epictetus’s quote can be conceptualised by the ABC diagram which follows.

It is not the event, but the belief or view you hold about the event, which is at the heart of 

emotional states. Emotions, thoughts and behaviours can be healthy and functional, or unhealthy and dysfunctional. The event can be something that has happened in the past, 

something that is happening now or something that could happen in the future. It can also 

be real, imaginary, internal or external. Internal events can be thoughts, images, memories, 

physical sensations or emotions.

National Anti-Drug Addiction Day

 Substance Abuse, an Enigma a Hidden Epidemic

National Anti-Drug Addiction Day is observed every year on 2nd October. The aim of the day is to make India free from drug and to preserve the talent. Father of the nation Mahatma Gandhi condemned the use of drugs. Drug addiction leads to chronic brain diseases. 

Drugs are one of the greatest evils for our society. It not only affects the individual but also the society. It causes loss of ability to make rational decisions and takes precedence over everything else – career, family, loved ones, friends and even civic sense. 

Going through the process of realization, People are trying hard to come out of this evil but Pandemic has thrown several challenges in their path ahead.

Drugs & India

More than 3.1 Crore Indians have reported using cannabis in 2018.  Among them 89% of drug addicts are Opioid dependents. Approximately 1.18 crore people use sedatives or non prescription purposes. This consumption highest in children and Adolescents India is home to six crore alcohol addicts, more than the population of 172 world nations including Italy. The prevalence of alcohol use is 4.6%, with male: female ratio being 17:1, followed by cannabis at 2.8% and opioids at 2.1%. Coming to harmful and dependent use, 19% of alcohol users use it in dependent pattern, whereas 0.25% of cannabis users use it in dependent pattern

Prevention better than cure

Today's youth face many risks, including drug abuse, violence, and HIV/AIDS. Responding to these risks before they become problems can be difficult. One of the goals of any drug prevention program must aim to help the public understand the causes of drug abuse and to prevent its onset. Drug abuse has serious consequences in our homes, schools, and communities. The use of all illicit drugs and the inappropriate use of licit drugs is considered drug abuse.

Prevention science has made great progress in recent years. Many interventions are being tested in "real-world" settings so they can be more easily adapted for community use. Scientists are studying a broader range of populations and topics. They have identified, for example, effective interventions with younger populations to help prevent risk behaviors before drug abuse occurs. 

Drug Abuse Prevention Starts with Parents

Drugs, including tobacco and alcohol, are easily available to children and adolescents. As a parent, you have a major impact on your child’s decision not to use drugs. Most likely, children in primary school have not begun to use alcohol, tobacco, or any other kind of drug. That is why primary level is a good time to start talking about the dangers of drug use. Prepare your child for a time when drugs may be offered.

Drug abuse prevention starts with parents learning how to talk with their children about difficult topics. Then, the programs offered by school, sports, and other groups can support what you have started. As a parent, you have a major impact on your child’s decision not to use tobacco, alcohol, and drugs.      Prevention starts when you start talking with, and listening to, your child.  Help your child make good choices and good friends.  Teach your child different ways to say “No!”

Wanted to Come Out

Knowingly and unknowingly people get trapped in Drug Addiction.  Most people start to take drugs for experiment, fun and curiosity while some succumb to peer-pressure.  Some come out early and some gets stuck.  Those stuck suffer more and more they are disparate they started even using some of life saving medicines as drugs.  When situation deteriorates from physical and psychological health aspects, then the person realizes how depth he went into this mud filled dirty world.

But when realization comes and the person tried to look for option that can bring him out, unfortunately only 1 in 20 drug addicts in India get treatment.

Treatment Options Available

There are many options that have been successful in treating drug addiction, including:

• behavioral counseling

• medication

• medical devices and applications used to treat withdrawal symptoms or deliver skills training

• evaluation and treatment for co-occurring mental health issues such as depression and anxiety

• long-term follow-up to prevent relapse

A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.

Complications during Pandemic

The stress and isolation of the COVID-19 pandemic are presenting enormous challenges for these individuals, but ultimately the altered realities of healthcare may create opportunities to reach more people with services and possibly even increase the reach of recovery support systems.  Significant increases in many kinds of drug use have been recorded since March, when a national emergency was declared and our lives radically changed due to lockdown and the closure of businesses and schools.

The national drug de-addiction helpline witnessed a huge spike in calls in April when the lockdown was in full swing, receiving 4996 calls, the highest for a month since January. Even the total number of calls between April to June at over 9400 was higher compared to 8208 calls received from January to March.

In fact, there was a 200% rise in the initial days after the imposition of the lockdown from March 25. Compared to an average of 90 calls a day from 15th to 21st March normally, the helpline received 266 calls a day from March-end to April 5.

Overcoming Challenges 

The good news is that policy changes facilitating telehealth and expanding access to medications for opioid use disorder may compensate somewhat for these problems. People with opioid use disorders can now begin treatment without an initial in-person doctor visit, which used to be the rule. The stresses of the pandemic and the social isolation resulting from distancing measures may take an especially great toll on people trying to achieve or in recovery from an Substance use disorders. Three quarters of a recently conducted survey respondents reported emotional changes since the beginning of the pandemic, especially increased worry (62%), sadness (51%), fear (51%), and loneliness (42%). These emotions increase the risk for relapse, and unfortunately, circumstances since the pandemic have made peer support, for instance in 12-step meetings and similar groups, much more difficult.

While online recovery supports may not be an option for all and cannot fully capture the in-person experience, here, as in the realm of treatment, teleconferencing tools and smart phone apps are helping some people adapt to restrictions on physical gatherings.  

COVID-19 continues to be an uncertain, ever-evolving reality, and its impacts are particularly being felt among those with addiction and those in recovery from substance use disorders. At this point, there is very sparse data on how SUDs are affecting COVID-19 susceptibility and outcomes, although findings are emerging slowly. As we think about and support this community, this month and every month, we need to imagine and implement new ways of facilitating treatment delivery and needed recovery supports under these new circumstances.

Suicide A New outlook! Being Certain in times of Uncertainties

Is life so tough that we cannot survive?

There’s no doubt about it: life is hard. It’s a given. Life is so hard we don’t even realize how often we walk around complaining about how hard life is anymore.  It’s kind of trending, in fact.

But there’s no doubt that life is also amazing and wondering, and with the bad stuff always comes some form of goodness, even if it doesn’t feel that way at the time. If you’ve ever found yourself crying into your hands wondering why life is so hard, you are definitely not alone.

But humanity is slowly, albeit painfully slowly, starting to realize that a lot of the bad things that happen to us do not actually happen to us, they are just things that happen.  It’s our negative attitude or disposition that turns neutral circumstances into something full of despair and anger, confusion and frustration.

You got it: emotions, thoughts, and feelings. They are what make life so damn hard. But there are other things too. Here are four reasons why life continues to be so hard for you.

As if life has no value?

We could live life — perhaps as animals do — without judging whether it is good or bad, meaningful or meaningless, or worthwhile or not. However, we do not. We make judgements about the value of life, concluding that life has no value or great value, and then may attempt to convince each other that we have placed the proper value on life.

It is not just philosophers who perform these evaluations. Many people, whether they realize it or not, compare their own lives, or life in general, to their expectations or desires, and then render a judgement about whether life, as they have experienced and view it, measures up to the standard they have adopted to judge it. There is a wide range of sophistication with these evaluations and judgements. At one extreme are simple, commonly uttered statements such as «life is good» or life is terrible, where it may be unclear how the person reached the conclusion they did.

Why we are succumbing to pressure and stress?

Be careful not to confuse pressure with stress – they are quite different. Pressure can be a very positive quality. Experiencing it, yet feeling calm and in control, can spur people on to achieve great things. It’s only when it keeps building and that sense of calm and order is replaced by a feeling of being out of control that stress happens, and has a wholly negative effect.

Whether you can’t stop snapping at people, can’t stop drinking, or can’t stop thinking stupid thoughts, feeling out of control can be frustrating. Sometimes it’s scary, and sometimes it’s exciting… until we wake up the next day and realize what we’ve done.

It’s normal to feel out of control every once in a while. We all make mistakes and do things we regret. But if you find yourself losing control all the time, there’s probably more going on.

Logical decisions take more brain power than emotional ones. The more distracted we are, the harder it is to think logically. Here are just a few things that can make it harder to control your behaviors:

Why worry about things you can’t control when you can keep yourself busy controlling the things that depend on you?”

 Transform your stress in to challenge?

You constantly hear how bad stress is for you: it’s damaging your health, jeopardizing your relationships, and hurting your performance. While these risks are real, recent research is showing that work strain, when managed correctly, can actually have a positive impact on productivity and performance. So how can you take the stress you thought was killing you and make it constructive?

Stress is unavoidable. “We live in a world of ongoing worry, change, and uncertainty. You have to get used to it,” says experts. “Stress is an inevitable part of work and life, but the effect of stress upon us is far from inevitable, Stress can be good or bad depending on how you use it,” they say.

Experts advise the following five ways to manage the stress…

Recognize worry for what it is

Then, reframe the stress

Focus on what you can control

Create a network of support

Get some stress-handling experience

Think of stress as an indicator that you care about something, rather than a cause for panic then Focus on the task, rather than the emotion and finally Build relationships so that you have people to turn to in times of stress.  At the same time don’t assume your stress is going to last forever, don’t worry about things that are out of your control and finally don’t spend time with people .who are negative

Challenging suicidal thoughts are very important:?

Whatever is going on for you that has led to how you’re feeling right now is unique to you – but having suicidal thoughts is not. You are not alone, lots of people have thought about killing themselves and have found a way through. Having suicidal thoughts can be overwhelming and frightening. It can be very difficult to know what to do and how to cope. You may feel very depressed or anxious or you may just feel really bad and not know what the feelings are.

You may feel like you are useless and not wanted or needed by anyone. You may be feeling hopeless about the future or powerless, like nothing you do or say can change things. You may be blaming yourself for things that have happened in your life, and you might think it would be easier for others if you weren’t here. You may not even know why you feel suicidal, and think that you have no reason to want to kill yourself. Because of this, you may feel guilty and ashamed, and start feeling even worse.

It can feel much worse if no-one knows what you are going through or how bad you feel. You don’t need to be alone. There are people who are willing, able and available to help you.

Thinking positive in any circumstances can change you as person?:

Happiness and optimism were both linked to a lower risk of heart disease and stroke, with the most optimistic people having the greatest benefits. The study, published in the journal Psychological Bulletin, also found that optimistic and happy people tended to have healthier lifestyles. They exercised more, ate better, and slept more. In addition, they were less likely to have risk factors for heart disease and stroke, including high blood pressure, high cholesterol, and obesity. All of this is known to contribute to better heart health.

Does being happy or optimistic make the heart healthy, or does a positive attitude just encourage healthy behaviors? The study was not large enough to answer that question, but negative psychological factors—like stress and depression—have already been found to increase the risk of heart attacks.

Staying positive, then, may work the other way, such as by lowering blood pressure and cholesterol. Even if you aren’t upbeat all the time don’t let that get you down. Healthy eating and exercise are still an important part of lowering your risk of heart disease and stroke. There are also psychiatric interventions, like behavioral therapy, that can help you find a more positive outlook on life, even when confronted by your overly perky coworkers.

Being Proactive can help much?:

Positive thinking, or an optimistic attitude, is the practice of focusing on the good in any given situation. It can have a big impact on your physical and mental health.

That doesn’t mean you ignore reality or make light of problems. It simply means you approach the good and the bad in life with the expectation that things will go well.

Many studies have looked at the role of optimism and positive thinking in mental and physical health. It’s not always clear which comes first: the mindset or these benefits. But there is no downside to staying upbeat.

Smile more, reframing once situation, Positive hope on future, Focusing on Strengths keep one to be more positive.

 At the end, it is not your fight alone and you are not the only one fighting and facing such challenges is what ultimately brings back one from these dirty thoughts of suicide.  So nothing happens when you fight may be some time you may lose that’s it.

Be Positive and live with hope. Ultimately it is being certain during uncertainties will prevent one from taking these extreme steps.

This article is prepared for 10th September, World Suicide Prevention Day

Dr. Johnsey Thomas,

Lifestyle Psychologist and Strategist Health-Wellness

EAP Consultant Certified Cognitive Behavioral Therapist,

Aster Prime Hospital, Ameerpet, Hyderabad

 

AMEERPETASTER PRIME HOSPITALCOVID19

DR. JOHNSEY THOMASEAP CONSULTANT CERTIFIED COGNITIVE BEHAVIORAL THERAPISTHYDERABADLIFESTYLE PSYCHOLOGISTSTRATEGIST HEALTH-WELLNESS

Mental Health for All Greater Investment – Greater Access

Mental health is one of the most neglected areas of public health. Close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide. And now, billions of people around the world have been affected by the COVID-19 pandemic, which is having a further impact on people’s mental health.

Mental disorders comprise a broad range of problems, with different symptoms. However, they are generally characterized by some combination of abnormal thoughts, emotions, behaviour and relationships with others. Examples are schizophrenia, depression, intellectual disabilities and disorders due to drug abuse. Most of these disorders can be successfully treated.

Yet, relatively few people around the world have access to quality mental health services. In low- and middle-income countries, more than 75% of people with mental, neurological and substance use disorders receive no treatment for their condition at all. Furthermore, stigma, discrimination, punitive legislation and human rights abuses are still widespread.

COVID – 19 & Hampered Response

The limited access to quality, affordable mental health care in the world before the pandemic, and particularly in humanitarian emergencies and conflict settings, has been further diminished due to COVID-19 as the pandemic has disrupted health services around the world. Primary causes have been infection and the risk of infection in long-stay facilities such as care homes and psychiatric institutions; barriers to meeting people face-to-face; mental health staff being infected with the virus; and the closing of mental health facilities to convert them into care facilities for people with COVID-19.

With the disruption in health services, countries are finding innovative ways to provide mental health care, and initiatives to strengthen psychosocial support have sprung up. Yet, because of the scale of the problem, the vast majority of mental health needs remain unaddressed. The response is hampered by chronic under-investment in mental health promotion, prevention and care for many years before the pandemic.

Mental Health Infrastructure and Challenges Ahead in India

In India, 10 per cent of the population has common mental disorders and 1.9 per cent of the population suffers from severe mental disorders. Schizophrenia, bipolar affective disorder (BPAD), depression, anxiety disorders, psychoses, phobia, suicide, mood disorders, neurotic or stress related disorders, post-traumatic stress disorder, marital disharmony, sleep disorders, alcohol dependence and substance misuse and dementia are becoming common problems in the general population.

Mental illnesses are not only underreported in India but are not reported at all. Still whatever data is available; it clearly depicts the dreadful stage that we have reached in terms of our mental health. A total of 197.3 million people in India are estimated to be suffering from any mental disorder. In our case maximum load of mental illness is coming from Depression and Anxiety disorder with a striking 45.7 million and 44.9 million being prey to it respectively, whereas 7.5 million are suffering from Bipolar and 3.5 million from Schizophrenia. And we also need to understand that people having mild depression may report and seek help more easily than someone having Severe Mental illness.

In context of the present COVID-19 situation where there is likelihood of grave mental health problems in communities, with the given challenges it is going to be an uphill task for the nation. It is estimated that 10 to 20 persons out of 1000 population suffer from severe mental illness and 3 to 5 times more have emotional disorder. 

With such a horrific state of mental health, our counter mechanism to deal with it lacks significantly. Although the Government of India has taken a number of commendable measures, but unfortunately having Law codes and Policies on paper doesn’t really help much if the implementation at ground-level is not ensured by all the concerned actors, especially State level Government and Civil society need to work together with uniformity.

The major challenges faced by Indian mental health system are lack of knowledge about the mental illnesses as well as lack of adequate mental health services. The inadequacy exists in both areas, for example, infrastructure and human resources. India spends < 2 per cent of its annual health budget on mental health which is far less than many countries of the world. 

We have a dismal status in mental health care resources. With a population of more than 1.3 billion only around 9000 psychiatrists exist. A mere 0.75 Psychiatrists cater to about one lakh population in India whereas the desired number is above 3, in US and Europe there are 16 and 10 Psychiatrists to serve 100000 population respectively. US have almost 30 percent of World’s total Psychiatrists. At State level only Kerala has 1 psychiatrist per 1 lakh population.

World Mental Health Day: an opportunity to commit

The World Mental Health Day campaign will offer opportunities, primarily online given the continuing pandemic, for all of us to do something life-affirming: as individuals, to take concrete actions in support of our own mental health, and to support friends and family who are struggling; as employers, to take steps towards putting in place employee wellness programmes; as governments, to commit to establishing or scaling-up mental health services; and as journalists, to explain what more can and must be done to make mental health care a reality for everyone.

It is nearly 30 years since the first World Mental Health Day was launched by the World Federation for Mental Health.  Since then it is observed that an increasing openness to talk about mental health in many countries of the world.  But now turn these words into actions.  We need to see concerted efforts being made to build mental health systems that are appropriate and relevant for today’s – and tomorrow’s - world.  With so many people lacking access to good quality, appropriate mental health services, investment is needed now more than ever.

Countries spend on average only 2% of their health budgets on mental health. Despite some increases in recent years, international development assistance for mental health has never exceeded 1% of all development assistance for health. This is despite the fact that for every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety, there is a return of US$ 5 in improved health and productivity.

Move for Mental Health: Let’s Invest

The world is already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching. During the past few months, the World Health Organization has issued, in collaboration with partners, guidance and advice on mental health for health workers and other frontline workers, managers of health facilities, and people of all ages whose lives have changed considerably as a result of the pandemic. 

That’s why, for this year’s World Mental Health Day, WHO, together with partner organizations, United for Global Mental Health and the World Federation for Mental Health, is calling for a massive scale-up in investment in mental health. To encourage public action around the world, a World Mental Health Day campaign, Move for mental health: let’s invest has been kicked off.

Mental wellbeing is how we respond to life’s ups and downs. In this simple mental wellbeing definition lies deeper meaning and implication for our lives. It includes how a person thinks, handles emotion (emotional wellness), and acts.This important part of who we are has multiple meanings. These traits—which are all actually skills we can practice and develop—are all part of mental wellbeing:Self-acceptance Sense of self as part of something greater Sense of self as independent rather than dependent on others for identity or happiness Knowing and using our unique character strengths Accurate perception of reality, knowing that we can’t mind-read and that our thoughts aren’t always true Desire for continued growth Thriving in the face of adversity (emotional resilience)Having and pursuing interests Knowing and remaining true to values Maintaining emotionally healthy relationships Optimism (hope—the mindset that things can improve)Happiness that comes from within rather than being dependent on external conditions Determination Action (in contrast to a passive mindset and lifestyle, waiting for things to get better)

The business benefits of good mental wellbeing

The business benefits from increasing a workforce’s mental wellbeing are significant.Businesses that invest in building and maintaining good mental wellbeing report higher productivity and sales, more creativity and customer satisfaction.Importantly, the business becomes known as a good place to work making it easier to recruit and retain the best workers.The business case When thinking about the business case for mental wellbeing, keep these thoughts in mind:Mental wellbeing is one of the most valuable business assets – Like any asset it can be developed, maintained or neglected.Business puts a premium on mental performance – Today’s economy depends in large part on employees’ effective mental and behavioural performance and productivity.Minds do the heavy lifting – In many workplaces, it's our minds and not our bodies that do a business’ heavy lifting. A healthy mind creates solutions better, as it’s more creative and innovative, giving a competitive edge.Both thinking and feeling are involved – Products and services are made by people who need to think, focus, meet deadlines, cooperate, communicate, be empathetic, trustful and be resilient.Mental wellbeing affects turnover – Unhappy, dissatisfied or disengaged employees are more likely to take time off, turn up but not be able to work, leave a workplace, and/or suffer injuries. These have massive cost implications (MSW Research, Carnegie Study, 2012).Depression is as important as heart disease – Businesses recognise the obvious risks and effects of cardiovascular disease far more than the less obvious symptoms and impacts of depression. But these two conditions are the main reasons for lost work time through employee disability and early death (NIMH).Managing health and safety risks associated with stress is a legal requirement - See the Employers' legal responsibilities section.

Time to Meditate

Meditation practice a way of life  What is meditation?Meditation isn’t about becoming a different person, a new person, or even a better person. It’s about training in awareness and getting a healthy sense of perspective. You’re not trying to turn off your thoughts or feelings. You’re learning to observe them without judgment. And eventually, you may start to better understand them as well.Meditation is a skillLearning to meditate is like learning any other skill. Think of it like exercising a muscle that you’ve never really worked out before. It takes consistent practice to get comfortable. And it’s usually easier if you have a teacher. We’ve got you covered there.Meditation has been around for thousands of years, but only recently has the Western world really explored the science and mental health benefits behind this practice. In fact, there are a plethora of research studies readily available that explain the health benefits of mindful meditation. One of the most fascinating? Mediation is a great natural remedy to sleep.It's meditation practice, not meditation perfect There’s no such thing as perfect meditation. Sometimes your focus will wander or you’ll forget to follow your breath. That’s OK. It’s part of the experience. What’s most important is to meditate consistently. It’s one of those things where the journey is more important than the destination If you find yourself tossing and turning on a regular basis, here are three reasons you may want to incorporate meditation into your nightly wind-down routine:
LOWER STRESS AND ANXIETY Reducing stress and anxiety levels are one of the greatest reasons to meditate. Meditation helps to lower cortisol levels by promoting a relaxation response in the body. Cortisol is the hormone that directly impacts stress levels. At night cortisol levels should naturally decrease so your body can relax and fall asleep. But when under constant stress, cortisol levels stay elevated, which leads to a whole slew of health-related problems.
ENHANCED SELF-AWARENESS In relation to focusing on the present, meditation helps you direct your awareness on your current thoughts and emotions. The discipline of practicing living in the present helps you gain understanding and control over yourself. This, in turn, can help you to understand how you relate to others as well.Understanding and accepting yourself for who you are can lead to a greater sense of confidence and self-image. Being able to know yourself and what triggers different emotions in you can be a great starting block for other positive health changes.
BETTER SLEEP Do you ever have trouble sleeping? If you do, meditation could be a perfect tool for you to use to overcome those nights that you just can’t seem to fall asleep! PubMed came out with a study that concluded mindful meditation can be extremely helpful for allowing people to have a restful night’s sleep and combating insomnia.
CONCLUSIONNow that you know the amazing benefits of adding meditation to your life, it is time you give it a try. Even practicing five minutes of mindfulness before hitting the hay can improve sleep and overall well being in more ways than you might think. Not to mention, what better way is there to end a long day than with the tranquility of intentional meditation? Your mind, body and soul will thank you.

BENEFITS OF MENTAL FITNESS

Ability to build and sustain fulfilling relationships

Ability to deal with stress in positive way

Acceptance and adapt to change

Attitude of Gratitude

Being Resilient

Composed and Self-confident

Flexibility and agility of

mind to learn new skills and,

Meaningfulness and

purposefulness in activities, behaviours and relationships

Passion for life, 

ability to laugh (self as well) and enjoy life.

Sense of contentment and fulfilled

Strike a balance between work and play, rest and activity, etc.

Rational thinking

Balanced use of emotions

Human Psyches- The Power House

Our human psyches possess, as capacities, a variety of astonishing resources. By uncovering and reclaiming these innate resources, shared by all of us by simple virtue of our human nature, we can more easily understand and resolve our intrapsychic and interpersonal difficulties as they arise. These resources, the four facets of the Self, or the four dimensions of our human wholeness, wait within us, but we might not even know they exist until we discover how to access them, cultivate their powers, and integrate them into our everyday lives. There's a facet of the Self associated with each of the four cardinal directions: north, south, east, and west. Describing the Self in this way is in keeping with traditions around the world that have mapped human nature onto the template of the four directions (and the closely related templates of the four seasons and the four times of day: sunrise, noon, sunset, and midnight).

Serene Mind to Tranquil Life

Everything we think, learn, see and do shapes you brain and alter your life. But sometimes it's difficult to make conscious choices in a busy day. So here are few ideas acan give 360 degree change in your life.

Learn the Art of Meditation 

Spend some Moments in Nature

Have Attitude of Gratitude

Set a clear Goal for the day.

The Art of Listening

Watch a documentary

Do something you love

Spend time with people who inspire and uplift you

Add Physical exercise as part of life

Have zeal to Ave have Learn new

Learn escape from procrastination

Be a reason for Smile

Develop Habit of Reading

Try organising your table

Try Brain Exercise games

See the world through a child's eyes

Unleash your creativity and inner Potential

THE BENEFITS OF MENTAL STRENGTH

THE BENEFITS OF MENTAL STRENGTH

 BENEFITS OF MENTAL STRENGTH

It’s often easy to feel mentally strong when life is going well, but at times problems arise. A job loss, a natural disaster, an illness in the family, or a death of a loved one is sometimes inevitable. When you’re mentally strong, you’ll be more prepared to deal with life’s challenges. Benefits of increasing your mental strength include:

• Increased resilience to stress—Mental strength is helpful in everyday life, not just in the midst of a crisis. You’ll become better equipped to handle problems more efficiently and effectively, and it can reduce your overall stress level.

• Improved life satisfaction—As your mental strength increases, your confidence will also increase. You’ll behave according to your values, which will give you peace of mind, and you’ll recognize what’s really important in your life.

• Enhanced performance—Whether your goal is to be a better parent, to increase your productivity at the office, or to perform better on the athletic field, increasing your mental strength will help you reach your full potential.

HOW TO DEVELOP MENTAL STRENGTH

You’ll never become an expert at anything by simply reading a book. Athletes don’t become elite competitors after reading about their sport nor do top musicians increase their musical abilities by simply watching other performers play. They also have to practice.

The following thirteen chapters aren’t meant to be a checklist that you either do or don’t do. They are a description of habits that everyone falls prey to sometimes. It’s meant to help you find better ways to cope with life’s challenges so you can avoid these pitfalls. It’s about growing, improving, and striving to  become a little better than you were yesterday.

Why You NEED to Read Declutter Your Mind

Why You NEED to Read Declutter Your Mind

.... anyone who recognizes how their untamed thoughts are interfering with their focus, productivity, happiness, and peace of mind.

Declutter Your Mind will be a good fit if you:

• • Often find yourself trapped in anxious, negative, and unproductive thinking
  • Lose valuable time, focus, and energy because of overthinking and worry
  • Feel frustrated and confused about how to stop negative and compulsive thinking
  • Have experienced times of high stress, agitation, anxiety, and even depression as a result of mental overwhelm
  • Find yourself looking to money, possessions, work, success, or prestige to fill a void of emptiness or sadness you feel
  • Feel so busy, overwhelmed, and stressed that you’ve lost touch with who you really are
  • Find yourself turning to distractions, alcohol, drugs, and other compulsions to numb yourself to painful thoughts and feelings Would like to change your priorities and learn to manage and understand your thoughts so they don’t rule your life
  • Get complaints from your boss, spouse, or family members about your distraction, disengagement, agitation, or constant stress Simply desire a more centered, calm, and peaceful lifestyle

The bottom line?

If you desire to have a simplified, calm mental life—and to reclaim some of the time and emotional energy you give up to overthinking and anxiety—then you’ve come to the right place. Throughout this book, you will not only learn the skills you need to declutter and manage your thoughts, but also discover actionable strategies to implement immediately.

We have a lot of ground to cover, so let’s jump in and discuss why we are so trapped by our thoughts, and how it’s impacting us.

Thought for Good Times

• Do what you love and love what you do.
• Control what you can control 
• Sit in tranquility and meditate
• Concentrate on your strength and work on your weakness
• Always remember something is better than nothing
• Thinking positive is better than positive thinking 
• Acceptance is the key to lead.
• Great mind discuss ideas
• Transform problems into challenges 
• human mindset otherside grass is always green. 
  

Exam Phobia

Exam Phobia

“EXAM Phobia is nothing but irrational thinking. Exams are always stressful.  Sometimes it is far beyond our expectations and preparation; what is coming in exam & what is not. Many negative thought processes enters our head when exams enter in our life. We become nervous, tensed & unhealthy because of such environments and conditions. We face many problems in preparing for exams, physical and cognitive problems like memory failure during exam; fast heartbeat, vomiting, stomach ache, etc are the symptoms which body feels when we face examinations. Phobia has no place in student’s life who have self confidence and belief in self and God.  We have to combat tactfully and with a sense of balance in all aspects of life. So what are you afraid of? Develop a positive attitude and thinking to face any exam phobia. 

Positive Notes:

• The quickest way to do many things is to do one thing at a time.
• “The plus symbol is made with 2 minus symbols!"

Attitude upgrading:

• Plan to reward yourself for your hard work

Techniques to Challenge

• Work out a time table
• Concentrate on difficult subjects but do Math and Language regularly
• Leave time for revision
• Take ample breaks in between
• Eat right, exercise and be happy
• Prioritize and manage your time
• Don’t hesitate I asking help 
• Avoid talking to friends who get stressed very easily 
• Write down everything you feel like you need to do
• Watch a film, a TV show, play cricket or listen to some music that makes you feel good.
• Take a warm water shower or a bath can help relieve stress.

On the big day 
• Don’t study all night before exam
• Start early to reach before time 
• Arrange all your equipment in advance. 
• Do some of the relaxation techniques so that you are calm and focused. 
• Don’t wind each other up with ideas of what might or might not come up in the exam. 

Final Tips: 
 Be positive about your approach towards study 
 Prepare a smart schedule and follow
 Conscious of the blue print of the question paper-number of questions, types of questions, nature of questions and marks allotment. 
 Have positive attitude ‘I can’ and ‘I will’. 
 Start learning, build confidence, and destroy fear.
 Eat Fresh and Warm Food and Drink Fresh  and Lukewarm Water
 Listen to Relaxing Music and Practice Relaxation Techniques 

WILL BOUNCE BACK!

It is normal to feel Inundated, stressed, anxious or grieve, among a wide range of other emotional reactions, in the current situation. Allow yourself time to notice and express what you’re feeling. As we all face uncertainty about the virus, there are measures we can take to stay calm.
The word Resilience has its origin in the Latin word “resilíre,” which means, “to leap back” or as I like to say, “Bounce back”. Resilience helps to make the uncertain things in our lives certain. Knowing how to “bounce back” from adversity and life challenges is something that all of us are able to do – we just need to know HOW.

Grip over Anxiety
Thornton describes anxiety as an anticipated worry or rumination about something that might happen in the future. 
 “Don’t think of it as doomsday. Look at it as finding a new normal. Ask yourself, ‘How do I want to live my life right now with these constraints?’ 
Plan something Different 
If all us feel in this present scenario that it is unusual then we also need take unusual steps to combat it differently same routine will not work, for example writing an article on your past experiences, journaling, doing some household chores – baking cake your way or preparing food your style, plant a home plant, hone your skills through online platform, do something which you were planning since long time, take time smell roses. 
Practice Simple Mindfulness Techniques 
For example: 
Sit in a serene place or safe environment. 
A Hold your breath as much you can and then release smoothly. (3-4 times in one sitting)
B While holding your breathe count as many numbers you can then try to count same while releasing (3-4 times in one sitting)
C Five at once with deep breathing 
1. Clench your Fist (keep it on your thigh)   - 

2. Tautening your toes backward-  

3. Hold your abdomen inside- 

4. Tauten your shoulders upwards-

5. Closing eyes

At this point of time our focus should be on thinking positive come what may we will bounce back.

Dr Johnsey Thomas 
Psychologist  

Superseding the Negative THINKING (Worry)

One of the most widespread and damaging daily habits that people get caught up in definitely must be the habit of worrying. Extended worry deprives you of vitality, fervor and energy and leaves you physical and mental wreckage. Psychosomatic specialist point out that persistent worry is cause of various diseases such as allergies, cardiac trouble, high blood pressure and a host of other illnesses too numerous to cite.

The apprehensive mind is confused, alienated and is thinking pointlessly about a lot of things that may or may not true. Anxiety, really, is due to inactivity, apathy and at times over thinking; because when you get up, you do not have to think these types of thoughts. You can think of harmony, serenity, appropriate action, love and understanding. You can displace the negative thought with a constructive or positive thought. Your trouble is in your mind. You have a longing, the fulfillment of which would resolve your problem. But when you look at surroundings and circumstances as they are, an unhelpful thought comes to your mind and your desire is in dispute with your fear. Your apprehension is your mind's acknowledgment of the negative conditions.
In a nutshell when worry thoughts come to your mind, prompt you that Infinite Intelligence is fetching your desire, ideal, plan or purpose to pass. All conditions, circumstances and events are subject to alteration. Every created thing will some day pass away. The age-old saying: This, too, shall pass away, is always true. But your mind and Spirit, the personality of you, will never pass away.
That's superseding the negative Thinking.


Dr Johnsey Thomas 
Senior Psychologist 
Aster Prime Hospital Hyderabad

CORONA! FROM WHERE TO GET LEGITIMATE INFORMATION 

Seek information only from legitimate information sources only 

DURING THIS PERIOD HOW TO LOOK AFTER YOURSELF
Self-care in the wake of the coronavirus outbreak includes focusing on things you can control (like having good hygiene) instead of those you cannot (stopping the virus). Where possible, maintain your daily routine and normal activities: eating healthy meals, getting enough sleep and doing things that you enjoy. Consider creating a daily routine that prioritise your wellbeing and positive mental health. Activities, like taking a walk, meditating or exercising, can help you to relax and will have a positive impact on your thoughts and feelings. The Mental Health Foundation, for example, recommends that you see it as an opportunity that might have benefits like finally catching up on sleep.

HOW CAN WE MAINTAIN A SENSE OF HOPE AND POSITIVE THINKING
Try and focus on things that are positive in your life. WHO recommends finding opportunities to amplify the voices, positive stories and positive images of local people who have experienced the novel coronavirus and have recovered or who have supported a loved one through recovery and are willing to share their experience?

WHAT ARE THE RED FLAGS
One way to manage moments of distress is to identify key thoughts or physical sensations that tend to contribute to your cycle of distress and feelings of being overwhelmed. Our thoughts (“Why can’t I concentrate?”), feelings (frustration, worry, and sadness), physical sensations (tension, upset stomach, jitters) and actions (such as compulsively checking the latest COVID statistics) each feed into and amplify these negative emotional spirals. Addressing one aspect of this loop by, for example, actively reducing the physical symptoms (I use box breathing: breathe in for four counts, hold for four, breathe out for four and hold for four, then repeat) can de-escalate the cycle and help you regain control.

HOW TO BE COMFORTABLE IN YOUR NEW WORKSPACE
Be aware of your workspace, audio setup, and desk and chair comfort which can affect your posture and productivity. You may choose to wear work clothes or work shoes to help you feel prepared for work; and leisure wear to help you transition to personal time, just as you would when coming home from work.

HOW ONE CAN ACKNOWLEDGE THEIR FEELINGS
It is normal to feel overwhelmed, stressed, anxious or upset, among a wide range of other emotional reactions, in the current situation. Allow yourself time to notice and express what you’re feeling. This could be by writing them down in a journal, talking to others, doing something creative, or practising meditation.

HOW CAN WE PAY ATTENTION TO THE PRESENT MOMENT (MINDFULNESS)
Paying more attention to the present moment can improve your mental wellbeing. This includes your thoughts and feelings, your body and the world around you.
Some people call this awareness "mindfulness". Mindfulness can help you enjoy life more and understand yourself better. It can positively change the way you feel about life and how you approach challenges.

HOW DO I KNOW IF I’M UNWELL?
If your beliefs,thoughts, feelings or behaviours have a significant impact on your ability to function in what might be considered a normal or ordinary way, it would be important to seek help.

This is unlikely to be the writer’s retreat that you have long dreamt of. The suggestion that periods of quarantine might bring unprecedented productivity implies we should raise the bar, rather than lower it. Do not underestimate the cognitive and emotional load that this pandemic brings, or the impact it will have on your productivity, at least in the short term. Difficulty concentrating, low motivation and a state of distraction are to be expected. Adaptation will take time. Go easy on yourself. As we settle into this new rhythm of remote work and isolation, we need to be realistic in the goals we set, both for ourselves and others in our charge.

HOW TO MANAGE OUR STRESS THRESHOLD
Try to lay a solid foundation for your mental health and well-being by prioritizing your sleep, and practise good sleep hygiene (for example, avoid blue lights before bed, and maintain a routine around your sleep and wake times). Eat well (be conscious that you might be inclined to lean on alcohol, or other indulgences, to manage stress — this is understandable, but potentially damaging in the long run). Exercise: it will lower your stress levels, help you to better regulate your emotions and improve your sleep

MAINTAIN ROUTINE IS YOUR CLOSE FRIEND
It helps to manage anxiety, and will help you to adapt more quickly to this current reality. Create clear distinctions between work and non-work time, ideally in both your physical workspace and your head space. Find something to do that is not work and is not virus-related that brings you joy. Working in short bursts with clear breaks will help to maintain your clarity of thought.

Mask your Face not People

FEAR, STRESS, STIGMA IN TIMES OF COVID

Fear and anxiety about disease can be devastating and cause sharp emotions, particularly during uncertain times of Covid -19. It is important to take time for yourself to manage your mental health. Even though anxiety is a natural and anticipated likely reaction to the pandemic, too much anxiety can start to cause harm. Stigma has exacerbated the suffering from every major infectious disease epidemic in our history, and it will certainly play a role in the current Covid-19 pandemic. Experiencing stigma from others can lead to elevated depressive symptoms, stress, and substance use.

Tips to combat Stigma
• Know the facts about how the virus spreads and infection risk.
• Understand that anyone can contract the virus.
• Be kind; remember we are all human.
• Stay informed—but don’t obsessively check the news
•
Steps us handle Stress and maintain Mental Balance
• Focus on the things you can control
• Plan for what you can
• Take care of your body and spirit
• Be kind to yourself.
• Maintain a routine as best you can.
• Take time out for activities you enjoy.
• Get out in nature, if possible. Sunshine and fresh air will do you good.
• Find ways to exercise.
• Keep things in perspective.
• Count on your own strengths.
• Take up a relaxation practice. When stressors throw your nervous system out of balance, relaxation techniques such as deep breathing, meditation, and yoga can bring you back into a state of equilibrium.

Acknowledge your feelings. Whatever you are feeling right now, know that it’s okay to feel that way.

Dr Johnsey Thomas
Psychologist
Aster Prime Hospital

rejuvenating mind and simplifying life

Everything we think, learn, see and do shapes you brain and alter your life. But sometimes it's difficult to make conscious choices in a busy day. So here are few ideas can give 360 degree change in your life.

1. Learn the Art of Meditation
2. Spend some Moments in Nature
3. Have Attitude of Gratitude
4. Set a clear Goal for the day.
5. The Art of Listening
6. Watch a documentary
7. Do something you love
8. Spend time with people who inspire and uplift you
9. Add Physical exercise as part of life
10. Have zeal to Ave have Learn new
11. Learn escape from procrastination
12. Be a reason for Smile
13. Develop Habit of Reading
14. Try organising your table
15. Try Brain Exercise games
16. See the world through a child's eyes
17. Unleash your creativity and inner Potential

Mental!

Mental Strength is the ability to concentrate when you want to, as hard as you want to, for as long as you want to. 

Mental Flexibility is your capacity to switch from one mode of thought to another. It's a playful process as you toy about, find new combinations, and look in new directions. Mental Flexibility is artistry, holistic thought, creativity, brainstorming, and a bit of Zen, all rolled into one. 

When you want to put your ideas into action, you need Mental Endurance.

Mental Staying Power is the ability to sustain an increased level of activity without getting distracted or discouraged. It's the capacity to persist, to go the full mile. 

And when you want to add precision and flair, you need Mental Coordination.

Mental Coordination is timing, balance, and agility. It's the knack of gracefully orchestrating your thinking so that you can deal with several things at once, keep balanced within the face of uncertainty, learn for knowledge's sake, and strive for higher ideals. 

 It's these four basic qualities — Strength, Flexibility, Endurance, And Coordination — that make up a fit mind. Only by stretching, flexing, exerting, relaxing, moving your mind in different ways, performing different mental movements, does your mind get in shape.

BENEFITS OF MENTAL FITNESS

Ability to build and sustain

fulfilling relationships

Ability to deal with

stress in positive way

Acceptance and adapt to

change

Attitude of Gratitude

Being Resilient

Composed and Self-confident

Flexibility and agility of

mind to learn new skills and,

Meaningfulness and

purposefulness in activities, behaviours and relationships

Passion for life, ability

to laugh (self as well) and enjoy life.

Sense of contentment and

fulfilled

Strike a balance between

work and play, rest and activity, etc.

Rational thinking

Balanced use of emotions