 So Ratha, I had a question that in the process of self-assessment and deciding what's good for me. I mean I've done this about like three or four times in my life. The first time around I went to group therapy and then discovered that that's not the place for me. And it took me about two months to realize that I had to do the one-on-one session. Actually it was on me but the psychiatrist at that time who decided that no, I mean it's like I require individual therapy. The second time around I started with a form which I wasn't even sure if it was right for me. And I don't even know what that school of counseling was. And I think for two years I kept feeling like I'm going two steps backwards until I finally discovered someone who was practicing CBT. I don't know how to frame this question but I'm sort of wondering and you did point out this in the slides where you talked about that if I feel miserable do I need to take stock. But I'm wondering like are there sort of parameters of criteria that could help you to do a self-assessment better or if there is also this sort of coincidence that happens. Do you mean an assessment of how therapy is going or do you mean an assessment of how am I going? No sir at the start if I know that okay I want to go for therapy but I don't know like you know what is the school of thought that I really want to choose or you know what is the approach I want the counselor to take. I don't know if one can do that self-assessment by themselves or is just that you go via referrals and discover that this is the right person for you or this is not the right person for you. Okay see to some extent there is a little bit of that some types of problems are better dealt with with some modalities kind of thing. So but I think that this approach it depends a little bit more on which way of looking at human beings resonates with you. You know for instance let's say I see myself as a fairly cognitive person that for me to follow something it needs to make sense to me and you know I like things kind of logical and organized and ordered and I'm looking for that kind of structure and organization in my life then CBT may be more suitable. If what I want is maybe more to be able to sit back and explore or become aware of bits of myself which I'm not aware of otherwise and I'm saying I know that things are not okay but I can't completely describe why they are not okay then a dynamic therapy might be more useful. So and of course if you have a relationship problem then systemic becomes kind of straightforward. But yeah so all forms of therapy and all form and most therapists can deal with most types of issues perhaps the only distinction I would kind of really make is if there is a psychiatric condition as well then somebody who has training in psychiatric conditions like a clinical psychologist or a psychiatrist might be more useful. Otherwise I think it really depends so much on the quality of the professional who you're meeting rather than any big external guideline. Right so I think that was the one affirmation I was seeking that eventually it doesn't matter who you are seeing. Not really because you know while I'm saying that if you have a psychiatric issue see a clinical psychologist I know several counsellors who I'll happily refer clients to depression with because I know they know how to deal with it. Right so it is I think quite individual in that sense. Okay and what is the sort of line in terms of when you know you just have to kind of follow the medical advice instead of choosing for yourself. Like I know there have been instances in my life where I've been told you know why don't you go ahead and take an antidepressant and I've resisted that most often because of the fear that I don't want to be addicted to these. But I've always thought that line for myself because that's the will power I bring to myself but I don't know at what point for an average individual this line you know where how is this line decided if it's decided. Okay now the ultimate decision of whether you will be benefited by medication or not from the professional standpoint is taken by psychiatrists. Psychiatrists are the people who do the diagnosis and being the doctors of course they're the only people who can actually prescribe. No one who is not a psychiatrist if you're not a psychiatrist you're not allowed to prescribe. There are certain markers in terms of your functionality in terms of the symptoms that you're showing that will help us a psychiatrist kind of take that call. Yeah I do find that with many conditions like with a psychotic disorder which is a major mental disorder where you don't have contact with reality in general we would suggest medications as being useful but with depression anxiety these things which kind of fall more within the normal range of experience we often leave it to the clients to decide and I've many times spent several sessions with clients talking about medication looking at pros and cons helping them to weigh and make that decision and helping them to figure out even if I start medicine then you know how can I do it in such a way that is effective for me. At the end of the day you will do something or continue to do something if it's working right and so I've had clients who visited taking medication for several years finally taken it and then come and said oh my god why did I not do this before this is my life is so much better now and I've also had clients who have been on medication or tried medication and found it's not really making any big difference to their lives. So I think again that there's quite a bit of individual variation in these and you know what I might say to clients who are thinking about this is that it's a two month trial you can try it if it works you continue if it doesn't you can always talk and just one last response since you mentioned it psychiatric medications are not addictive in fact we are careful that they are not addictive and so that is something except for benzodiazepines sleeping tablets one set of it which is not really even prescribed very much these days nothing else is actually addictive so that's not something that you need to worry about. Thanks for clarifying that misconception I think I've seen a couple of cases where I've had very close friends who have been on a business and I've actually seen a case of somebody who forgot to carry her medication was going for her field work to a village and then suddenly decided she's not going to board the train because she doesn't have a medication and she's not going and I was like oh my god I don't want to be in this situation I don't want to see that I don't have a life without my medicine. See I think that a better analogy or parallel for psychiatric medications to drugs recreational drugs which you can get dependent on is stuff like insulin or blood pressure medicine basically you know there are there is a biological component to this as well and you can have neurotransmitter disturbances etc and you need that medicine to keep that in check so that you can be free to kind of do the therapy and explore the other things that you need to and yes there are clients who as long as you know as long as I'm taking my medical insulin my sugar is fine as long as I'm taking my antidepressant I'm okay that can happen. Thanks thanks this was quite useful I have two other quick questions since there are none so far one is regarding what is your personal take on the relationship between diet and mental health and I'm asking this because there was a time when I was having serious sleep disorders and one of the advice given to me at that time was that maybe try a low carbohydrate diet to figure things out and again I feel like I'm either too self-analytical or maybe I'm an edge case where I then discovered as a result of switching to that diet that the salt is usually a trigger for me to get very anxious and that there's this sort of reinforcement cycle between eating salty snacks and getting on a high and then you know eating the salty snacks to get on the high again so that cycle keeps going. So I mean I was just curious to know if you had a take on this and if you don't have one then obviously you could sort of say that and then I'll ask my last question after this. I think definitely this whole awareness of nutrition and how it impacts our physical as well as mental health it's really kind of taken off in the last few years and a lot of the initial research definitely seems to be promising. As a clinician I can tell you that like the story you told me about the salt I've heard several stories about how stopping sugar made me feel much less depressed or shifting you know eating healthier means that I wasn't waking up as much in the middle of the night because my stomach was full. There are also you know theories of like pineapples I think that have foods which have antidepressant properties or foods which are supposed to calm you down. At the moment the research on this is not really like conclusive it's more like it's beginning. So this is something which I would sort of say definitely as a therapist I would keep my eye on as a client I would suggest that everyone keeps their eye on but at the moment it's more often experiences where you experiment with yourself and you just figure out okay I function better in this particular mode. So my last question maybe we could then conclude the statement is being made so often that today's times are unprecedented and you know that you can't really compare what you're going through right now with you know what like you simply have no benchmark to compare what you're going through right now. So I wanted to understand your take on this statement these are unprecedented times what does it mean because for some of us we've not internalized this statement but you keep hearing it just as you keep hearing the statement am I audible on. So I think your take on this statement that these are unprecedented times and therefore you know your advice or your sort of personal perspective on how should we look at ourselves and the vulnerabilities that we feel currently and whether it really makes sense to say that there is really no comparison to what's happening right now is that how we need to look at it. I think unprecedented in the sense okay I don't think there was anyone who expected that the world will just shut down for 2020 this kind of physical restriction on our movements on our just a basic sense of freedom or agency or getting things done this everyone in the family actually being stuck at home this has not happened for centuries and so it is I think for everyone a fairly new experience in our lifetimes also we are used to thinking of you know human beings and sciences being on top of everything and viruses and all can come and go but I think again we're kind of saying that we're not as much on top of things as we might have hoped to have been so is this an experience which hasn't really happened before I won't say it's never happened before but it is definitely definitely unusual how do we respond to it initially I think I saw a lot of you know there was that immediate reaction either of a lot of anxiety or kind of feel quite relieved to have some breathing space and say I don't have to go to work for two months it's not so bad now I'm finding that more and more people are dealing with other collateral fallout of this of losing their job or of saying okay it's not like I don't have house help for two weeks I don't have house help for the rest of the year we have to change the way in which we do things at home my income which used to be so much has dropped down to so much and I don't know when it will increase again so I think that there are all these collateral things also which people are dealing with how should we respond to it see one thing I think is that as human beings are quite adaptable and you know we respond to all kinds of different circumstances and we change and we adjust to them and I think we will change and adjust to this as well I see us doing it in different ways it's the first month that I needed to do only online sessions I disliked very much but now I've got to do it because I know that I don't really have options psychologically I think we need to accept uncertainty right now and that's what I find most difficult for people to do we need to accept that we don't really know exactly what's happening exactly when this will end we have hopes and we have theories and but we can't really make very huge plans based on that I find that those who are able to sort of accept the uncertainty adapt and modify what they are doing in order to what to say order to respond to the circumstances who develop their personal relationship with coronavirus you know like one person maybe like I'm very very scared of this and that's my personal relationship another person may say I know what I need to know like I've learnt that okay here I should wash my hands and there I should wear a mask and as long as I follow my protocols I'm not really bothered about what the virus is doing outside think about what your personal relationship with this virus is and think about whether that makes sense to you or whether it's something you want to modify I'm not sure if that addressed all parts of your question because it was quite a few things so if there's anything else just let me know I think there was this one statement you made which was I think quite spot on for me I don't know about the others but the feeling of like I was on top of things earlier things were under my control but that's not the case anymore right now and I think that you know just that statement really nailed it for me because that's the kind of person I have been and now to kind of you know accept that can I always be on top of things even there's uncertainty I think maybe that pushiness is something that could be made I don't know like what's the right word but I think maybe that feeling of trying to be in control and this desire to be in control maybe that could be let go off but yeah 30 years because I think definitely and control is what I was thinking of when you were speaking as well those of us who we like to know and predict and you know have this overview and be in control of what happens we're finding it much much harder to really deal with the fact that right now there isn't there's very little you can do to control things Great so I think maybe that's a good note to end oh okay there's a question here which is does burnout need therapy Abhishek Mishra is asking if burnout needs therapy Abhishek if you would like to speak your question let us know I can unmute you Baratha please go ahead Could you tell me what you mean by burnout? Yeah let me unmute Abhishek Amok can you unmute Abhishek because I'm not able to Abhishek you can speak your question you're unmuted Thank you so this is related to actually work burnout because I have seen there is a very slight difference between actually going to a depression this is my personal experience it's not with respect to anyone else so I had a very similar experience probably there will be very little bit difference but when I was in depression I did not go through therapy but I just managed it somehow but same sort of scenario is happening with me when I'm going through the work burnout so it's like a stress anxiety and a lot of things okay now burnout is actually the main for the psychological distress that you feel as a result of work and so depression and anxiety are actually the common forms in which burnout manifests a sense of hopelessness a sense of sort of loss of meaning in work not being able to control feeling very motivated many of the features of burnout are actually very similar to depression and so in that sense I'd say yes there's no question that burnout therapy can help with burnout yeah thanks I don't have like further questions I'm still figuring out yeah because some of my friends suggested you know you should talk to this psychiatrist and also but I am not pretty convinced about that because as I actually I never mentioned it's also because of exhaustion so probably I should also put some restrictions around my work see like I like I put earlier in the slide when you notice a problem with yourself I think you know you do need to kind of look around at your life and your environment and see if you can understand where that problem is coming from and if that problem is coming from for instance you're saying I'm too tired because I have too much work to do and not enough hours to do it that circumstance is something that needs to change if you did seek therapy your therapist will actually be helping you to figure out what are all these things in your environment which you need to change and helping you to make plans or strategies to change them as well so this is not necessarily mutually exclusive territory you can do it on your own like I said you can do it with the help of a self-help book you can do it with the help of friends and family you can do it with your therapist okay thank you so much great thank you so much Ratna for doing this I know that this has been a lot of effort including yesterday's rehearsal and then re-bumping the presentation I sincerely hope everybody enjoyed the session and if any of you have topics that you'd like which is the organization that has oh there is a question here Yogita is asking a question saying how do you have the difficult discussion with someone who you think needs to see a therapist but they don't see it Yogita you can also feel free to ask your question we can unmute you Ratna did you capture the question? Yeah I got the question and I think it's a very good question because invariably if you say to someone maybe you need to see a therapist the implication is do you think I'm mad like you think there's something wrong with my head and it feels like an accusation or it feels like a criticism if you say you need to see a therapist because we often also use that no and when we're frustrated with people we see how you go get help kind of thing and so yes it is a difficult discussion to have Yogita but I'd suggest that you start with looking or getting the person to talk about what are your experiences what are you struggling with what are you doing to help yourself where is this working and where is this not and then it's a good point to say look you've tried all this but you're still stuck here so why don't you go and see a professional who might be able to help you with this and maybe that will help Yogita would you like to ask a further question to Ratna ok Yogita seems to say ok Yogita you're unmuted so you could continue to ask a question if you have a question or if you want to share something ok Yogita is still muted so would you be able to unmute Yogita once again sorry technology is not very great sometimes I don't know if I can be heard but the question is more related to someone who is probably closer to their 70s and they've had years and years of layers of stuff form over their personal experiences or has molded who they are and you tell them and at some level they agree that yes of course I need to see someone but they don't do anything about it so I was just trying to figure out how do you sort of either you take charge and you get them to do it you sit through the first session with them or I don't know it's something that is something that I think very often it is especially with older people but yes there are some people who may feel it sounds like a good idea but I'm not too sure whether I want to do it the idea of sitting down and talking to a stranger can feel quite uncomfortable depending on your cultural background and kind of how you're made up as well it can be useful to you know if you have that initial discussion and they say yeah it looks like I do need help maybe what you could do is to say okay I'll help you to find someone I'll fix the appointment for you and as you said I will bring you I'll take you for the first session whether you sit inside with them or whether you just get them there and wait outside and at least you've got them to the point where they've tried it once they've tried it of course they will decide okay I will do more of this or I will not do more of this and you may not really be able to help that part of it but often you know there is a certain sense of inertia with getting things started and when when you are distressed or when you are depressed that inertia is greater and as a friend or as a family member if you can help by doing the organizing and the legwork it can actually be quite nice quite useful okay that's helpful thanks okay great I think it's 803 there are no more questions that we just hop on to youtube once there are no more questions I think we can call this a wrap like I mentioned if you have topics that you'd like Kilda who's the organization that is hosting sessions on mental health on fitness on habit on food science etc please do write to us on editorial.haskeek.com or better still go to haskeek.com slash Kilda and you will see places where you can leave comments ideas for topics we'd be very happy to help because the whole idea is that these are unprecedented times and I am audible and I think we're all in this together so maybe let's just make a good company together and go through this together so on that note have a good weekend stay relaxed and be gentle on yourself thank you Ratna okay thank you all right bye bye bye