AIIMS Psychiatry professor Nand Kumar has developed a deep understanding of urban angst by talking to each patient at his OPD
A burnout is a scenario where you do not like doing the job you once loved
AIIMS, Psychiatry Department OPD, Thursday, 12 noon: It is mid-week, by which time the spillover rush from the weekend is expected to settle. But Professor Nand Kumar’s patients mill around him, vying for attention, stretching well past lunch hour. A 30-year-old complains of burnout and wants to know how he can keep on doing the job he hates because he needs the money. Another restless young woman complains of insomnia that has made her irritable and socially disconnected. Yet another young man has issues dealing with road rage.
One would wonder why Dr Kumar spares so much time listening to mundane issues instead of more serious mental health concerns. “But this is just as serious. At least, people are honest enough to admit they have a problem and are coming forward to deal with it in the early stages. This could save them from slipping into depression and more complicated issues of mental health,” says he, positing a counterpoint. That has helped him map mental health disorders of the city, burnout at work emerging at the top.
“A burnout is a scenario where you do not like doing the job you once loved. That’s because you have been exposed to chronic interpersonal stressors over a long period of time which nobody has bothered to address. So, you feel exhausted, frustrated, overused and valued less, alienated, cynical and detached. Very few know that burnout and depression are not the same. The first is still a manageable problem, the last takes longer and needs a different treatment protocol. We suggest some lifestyle modifications, change the complainant’s perception of the workplace, encourage social and emotional connectivity with peers and reduce digital addiction, all of which neutralises the feeling of victimhood and isolation,” says Dr Kumar. The next big concern in exam season is performance anxiety in students, especially those preparing for competitive entrance examinations to institutions.
He sees around 70 mental health patients a day, their unique experiences giving him an opportunity to understand mental health disruptors at a granular level. “People have started paying attention to issues like anxiety, depression, maladjustment and insomnia. Earlier we used to see a majority of patients with schizophrenia, bipolar disorder, Post-Traumatic Stress Disorder (PTSD) or Obsessive Compulsive Disorder (OCD). This means that people are reporting triggers before they degenerate into a full-fledged disorder, which makes it easier for us to bring them back on the rails. This OPD now has people trying to come to terms with a job loss, a divorce, family conflicts and other trauma,” says he.
Does the trauma induced by COVID-19 have anything to do with it? Dr Kumar is not sure but admits that people have been exposed to the vulnerability and fragility of life for a prolonged period and do not want their lives to be broken down to pieces. So, they are more self-aware and not even averse to the medication that he advises in some cases.
AIIMS caters to a large cross-section of society, a fact that has made Dr Kumar sensitive to the varied needs of his patients. “Most underprivileged patients lack cognitive maturity and usually manifest their mental depression through physical discomfort like body ache, fatigue, sleeplessness and listlessness. So, when we prescribe medication to them, the acceptability is much more. But the psychological sophistication is higher in the privileged classes, especially those in their 20s and 30s. We manage this group with lifestyle modification — walking, yoga, balanced diet — and medication. We recommend breathing exercises because they reduce anxiety and modulate the autonomic nervous system,” says Dr Kumar.
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He has also analysed how men and women react differently to mental health disorders. “The bodily symptoms, like headache and fatigue, are much more in women than men, who are more prone to angry outbursts and mood swings,” he adds. Dr Kumar introduced brain stimulation techniques at AIIMS but now learns much more from the stimulating conversations he has with his patients.
https://indianexpress.com/article/health-wellness/young-people-cities-burnouts-depression-8479584/
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