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Posts Tagged ‘counselling’

The whole of last week saw all news papers covering the story of Britney Spears’ hospitalization, for the second time in a month for her mental illness. She has been diagnosed as suffering from Bipolar Disorder. Before we discuss what exactly is Bipolar disorder, lets have a peep at her life story so far:

Britney was born in December, 1981. That makes her 26 years of age now.

In 1993-94, when she was just 12 or 13 years of age, she gives a singing performance with Christina Aguilera and Justin Timberlake.

When 17 years, she releases her first Album “Baby one more time” that sells 25 million copies!

In the year 2000, She co-authors two memoirs with her mother.

In the same year she goes public about her relationship with her boyfriend Justin Timberlake. In 2002 she breaks up her friendship with Timberlake.

In 2003 MTV music awards function, she lip-locks with Madonna that shocks the entire audience. In the same year, she wins a Grammy award for best dance!

In January 2004, she marries her childhood friend Jason Alexander and the marriage ends after 55 hours!

In the same year she befriends Kevin Federline, a backup dancer. And in September 2004 she says “I do” in a surprise  marriage to Federline. She wears a designer wedding gown that cost her $26000.

In September 2005, they beget their first child, a baby boy.

In September 2006, she gives birth to another baby boy. During her 6th month pregnancy she poses sitting nude for Harper’s Bazaar magazine.

In 2007, she gets a divorce from Federline, citing irreconcilable differences.

In the same year she goes for a new hairstyle – going bald!

She gets in and out of Rehab centre for drug abuse and binging and alcohol.

In between her stays at Rehab centres, it was said that she even tried to hang herself once. I have no authentic info on this.

Same year, 2007, Federline files for custody of 2 boys and as she fails the drug test and also due to poor parenting skills, she loses temporarily custody of her 2 children to Federline.

In August 2007, she tries to make a comeback at MTV Video awards function and disappoints everybody with an awful performance.

In November 2007, she pays $120,000 to Federline as Lawyer’s fee.

Next day her new album “Black out” is released and does a roaring business!

In January 2008, she loses custody of her children to Federline. She is hospitalized for an evaluation of her mental status and is proclaimed as suffering from Bipolar disorder. She is discharged after two days.

On 31 January, she is hospitalized again and declared sick requiring longer stay and treatment for Bipolar. Britney alleges that her mother is sleeping around with her ex husband Federline.

Her mother gains legal control of her affairs from her manager who was allegedly using drugs on Britney and mismanaging her funds!

On February 6th Britney is discharged from the hospital much earlier than expected.

My goodness, what a roller coaster story of Britney’s life events!

You must be gasping for breath after reading her story…………………..

But it is all very sad. A teenage celebrity turning out to be a divorced mom at 26, losing custody of her 2 children and ending up in hospital for Bipolar treatment! …………….

What is Bipolar disorder???

Bipolar disorder was earlier called by the name Manic Depressive Disorder. As the name suggests, it is a Serious Mood disorder with extreme swings in mood – swinging from one pole of Mania to another pole of Depression! Hence the name Bipolar.

We all experience mood swings on and off. More so the teenagers with the onset of puberty and hormonal changes and changing expectations from parents, teachers, peer group etc. But these swings become a psychological disorder when the moods swing on and off in a day, in a week, in about two weeks, continuously for over two weeks and it totally turns the daily routine topsy-turvy.  The mood can change from elation to depression in cycles. 4 such cycles that may disrupt family and occupational relationships and routine work within a period of 12 months call for an evaluation by a psychiatrist. When the person is in manic state, he/she experiences elated mood, over confidence, requires less sleep than usual, is in a high energy state, may become restless, hyper active, irritable, argumentative, lose inhibitions, may indulge in drugs, smoking and alcohol, may even go overboard with sexual relationships. They may experience a sense of grandiosity, believe that they have high abilities and power, the sense of judgement lowers, may go on a spending spree, lavish reckless spending, will think the world is under their feet! They try to create situations with impulsivity, with shock value that gets the whole world’s attention.

You see many of these descriptions suiting Britney’s life happenings stated above.

This elated mood can last for a prolonged period or slowly fade giving rise to a feeling of low, a mood of depression! During this phase, they suddenly lose that confidence, start feeling inferior, lose interest in activities loved earlier, may withdraw from socializing, may experience a sense of hopelessness and worthlessness, may get suicidal ideations, may even attempt to take their life, become sad, irritable and anxious, sleep excess or very little, over eat or eat very less, low energy levels and fatigue, crying spells and may indulge in excess smoking, drinking and drugging, wrongly believing that all this would bring solace to their troubled heart and mind!

Again you can see so many of these depressive behaviours occuring in Britney’s life events.

These two moods may occur side by side or one long spell after the other, sometimes experiencing remission or rest from these swings and have normal moods and normal routine activities. The disrupted moods can cause havoc in a person’s life style. Just now you have read how Britney’s lifestyle changed from one episode to the other in such swift sweeping style!

What causes this disorder?  It is found that it can run in families – mother suffering and later on the daughter also catching on to this, making it look like a genetically caused disorder. But it is not so in many cases. Both men and women can get afflicted with this at any age. But usually the onset is during adolescence. It can set off in middle age too. But more women seem to suffer from this as women tend to be emotional and are vulnerable to normal swings in mood due to the hormonal disturbances in every menstrual cycle. The brain chemicals can also cause this type of disorder in some. The life environment and events can trigger such episodes. They may go to any length to seek attention from others. Sometimes, these attention seeking behaviours can have shock value like some instances in Britney’s life – overnight marriage and divorce, lip-lock with Madonna, going bald on an impulse, shaving off such long lovely blonde hair. It is found that many with Borderline Personality Disorder exhibit this kind of mood swings. Many cases go undiagnosed for years before it becomes unmanageable and then psychiatric help is sought. In some cases Bipolar can be mistaken for schizophrenia and wrongly treated, specially when the person starts exhibiting psychotic features like hallucination (sense perceptions that others around do not see or hear) and delusions (wrong beliefs) (Britney may have had this delusion of her mother having relationship with her boy friend and announcing it to the whole world!)

Pharmacological intervention by treating with mood stabilizers can keep the disorder in control. There is no total cure as such. Traces of these behaviours can remain for long. Psycho education to the person and to the family can help manage this better. Psycho therapy and counselling done parallely with medication can go a long way in stabilizing the moods and carrying on the routine life activities without much disruption.

In Britney’s case it was a matter of too much too soon. A young person will not be able to handle so much of success and money and name and fame all at once. Those things can become a very big stress to the mind, though on a positive note. A firm back up of values passed on from parent to child, a positive direction to move on, good support from family and friends at the time of emotional crisis periods, keeping oneself away from abuse of substances, indulging in healthy hobbies and interests can all help alleviate this mental illness to a large extent and manage life with a positive outlook.

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I have decided to conclude the post today, however lengthy or short it may become !

We have discussed the various LD markers and also the probable causes. OK, Once we have identified a child with these difficulties, what do we do?

The child needs an assessment by an Educational psychologist or a Special Educator who may administer various tests to find out the its abilities in the areas of reading, writing, spelling and arithmetic. It is important to rule out any hearing or vision problems before conducting these tests. It is also important to collect information about the family history/background to rule out any serious emotional disturbances. If the child is suspected to be experiencing serious emotional disturbances either at school or at home, those disturbances need to be addressed first before proceeding with the tests.

The tests may be standardized psychological tests where norms have been developed earlier so that our child’s performance may be compared to those norms and its degree of difficulty assessed. Or psychologists can develop their own tests based on the criteria that a child of that particular grade/age needs to be proficient with. Some curriculum based tests can also be administered to find out the child’s grade level. A child is said to be experiencing Learning Disability if its performance is below 2 grade levels.For example, if a child who is in 4th Grade is only able to read and write at 2nd Grade level or even less, he could be having LD. If the child is good in arithmetic but not in languages or if the child is good in languages and is poor in computing the numbers, it could be a case of Specific Learning Disability. These labels are used only to exchange information between professionals and to understand the remedial measures required for the child, but not to demoralize the child or the parent. Professionals need to be extremely sensitive to the feelings of the parents and the child. We need to validate their feelings of shock, disappointment, disillusionment, anger or denial, that they may express when they learn about this condition of their child. Professionals need to offer counselling to the parents to make them understand that their child despite the difficulties, can still be able to come up in life in one or the other area of skill. Even academics can improve to a great extent given one-on-one remedial teaching, depending on the degree of disability – it could be mild, moderate or severe. Earlier the problem identified, earlier the remedial measures could start and better would be the outcome. Parents’ acceptance of the issue is the most important factor in proceeding further to seek help for the child to overcome the difficulties.

Remedial classes can be arranged by the school itself or parents need to identify such facilities in their area and the child can attend the classes 2 or 3 or 4 times a week according to its learning needs. Many schools in Bangalore have Resource Centres now that cater to the learning needs of these students. Their specific problems are addressed in these classes unlike in a regular tuition class. Teachers at school can be requested to reduce the burden of home-work to these students so that extra time can be devoted to the learning needs of the child. Teachers can also be requested to give due credits to the oral expression of these students than to evaluate them based only on their written expression.

Many parents realize that their child is having severe problems only when the child reaches the high school. Suddenly the syllabus also increases, parental and teacher pressure increase and the boy or the girl becomes self-conscious of the difficulties that they are undergoing and the insults that they hear from all sides, that they can get into depression. Their frustrations mount and they may become aggressive. Added to this would be the turbulence of entering puberty and various confusions that ensue. Counselling can help them realize their strengths first and then the weaknesses and how to overcome these weaknesses. It is important to keep in touch with the school teacher too to understand the academic and non-academic behaviour of the child at school. The school teachers who handle the child need to be sensitized of the difficulties the student is facing and how they can cooperate with the professional and the parent to mitigate the problems and boost the confidence of the child.

NIMHANS and St.Johns Hospital are the two places where certificate of LD is issued that can be produced at the State or the Central Board of Education to avail concessions in Languages (the language of medium to continue and the other two languages can be dropped), or substitution of a subject with another(a student I know of selected Music instead of Maths in CBSE) or extra time to write in the exam (for slow writers) or even the services of a scribe(for the severely dysgraphic) can be sought.

The Central Government has also introduced National Institute of Open Schooling System (NIOS)  for 10th and 12th Grade level exams, the Certificates of which are considered on par with the Board Certificates, based on which the student can get admission into mainstream college later on. The advantage of NIOS system is that the student can choose 5 or 6 subjects of his choice from a variety of unconventional subject-combinations. The exams are held once in 6 months (April and October), the student is allowed to write exams in as many subjects as he is comfortable with, which he would have studied at his own pace. The student need to get registered in one of the approved institutions of NIOS syllabus, can attend regular school or schools that offer NIOS syllabus and pass the exams at his own pace.

In case of severely learning disabled students, it is very important to recognize their particular skills and start training them in any Vocation of their choice from the High school level itself. Many schools with NIOS syllabus also have in-house vocational training facilities. Parents need to understand that it is important to make the student self-reliant later on with a vocation learnt earlier, than force the student to pursue higher education when the interest and abilities of the student do not permit this.

To conclude the series of posts on Dyslexia or Learning Disability, that started with a mention of the movie Taare Zameen Par by Director and actor Aamir Khan and how the sensitive portrayal and treatment of the subject catch the heart strings of the movie goers, I would like to tell all the parents and teachers (and other readers) that it is of utmost importance to help any child build good emotional health first, then teach the child all the Life skills, like, communication, decision making, inter personal relationship, emotional management etc, and then give due attention to its academic health too. Recognize a child’s hidden potentials/talents, encourage the child to build on those potentials, acknowledge every desirable behaviour and every small achievement that the child scores, correct the undesirable behaviour with support and love and BE  THERE  EMOTIONALLY  WITH  YOUR  CHILD  ALWAYS – IN ITS SUCCESSES and MORE SO IN ITS FAILURES!

I would like to quote here (my favourite)  sensitive plea of a child to its parents –

“LOVE  ME  MOST  WHEN  I  DESERVE  IT  THE  LEAST;  FOR  IT  IS  THEN  THAT  I  NEED  IT  MOST” !

Series Concluded

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It has shocked all of us to learn that shoot outs have started happening in Indian schools! It saddens me very much that school students, instead of enjoying learning and playing with each other, have started killing each other! what has gone wrong and where???

The two boys who shot their classmate dead have confessed that they have no remorse about their deed as the other boy was bullying them to no end. That it was brought to the school authority’s notice, but went ignored, made the boys take this extreme step!

Why do children bully others? We understand that the bullies are themselves victims first and then they perpetrate it on some body weaker than them. Many a times, we find the elders agressing on the children severely, disproportionate to the mistakes that they may commit. Parents or teachers do not always give explanation to the child why he/she was punished. The elders, most often target the children to vent out their own frustrations caused by various life events. This kind of continued targetting makes the child very hard within. Also, the increased depiction of violence on TVs and Computer/Video games make the children lose sensitivity to others’ pain. They look upon violence as bravery and fun! Their values get mixed up and there is no one to give them proper guidance. The one who is severely punished at home may look out for someone who is weaker than them, who can easily become their target. In the current case, the children decided to take the law into their own hands to punish the bully. This chain continues and many children become emotionally scarred for life.

Here both the victim of bullying and the bully himself need counselling. We need to find out what is bringing about such a behaviour in the child. Who could be causing it – at home or at school or outside? It is very necessary that every school has an inhouse counsellor who can talk to children whenever they are disturbed by any issue. Just listening patiently to their grievances lifts the burden off their hearts. Counsellors can remain objective and non-judgemental about any of the confessions people make. Counsellors keep up the confidentiality of the matter. They try to help the client sort out his/her emotions and help them to think in positive direction. They teach assertive skills to the victims to stand up for their rights. This can go a long way in reducing many of the ills that are cropping up among student community.

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I read this in Times of India Wellness column recently and thought of sharing it with you. Read it and contemplate on it.

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Frustration is a shadow of expectation. If expectations can be dropped, then disappointments can disappear. With out expectations we are free to move into the unknown and accept what we receive with gratitude. This makes the breeze blow always and does not allow the dust to settle in our lives. When we open the window, the sunshine comes in, breeze blows and fragrance of flowers from the garden wafts in, all unexpectedly, that add freshness to our lives.

Life is pregnant with the unknown. Drop the past and die each moment and be born again to experience the new and unexpected. Then you will remain in an unfrozen state ready to flow along.

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case after case that i meet at my counselling centre come to me with a baggage of disappointments, unable to bear them, unable to drop them and move on in life. they get stuck, brood and brood and get into depression………………. if only we can imbibe the philosophy quoted above, how light hearted can we all be!

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