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Bhooshan Shukla

@docbhooshan

Apr 30

A thread on one of the most popular misconceptions about mental health in India.

1. Most people can identify psychological distress and pain quite quickly. This is the good and easy part.
As humans we are born with the ability to sense emotions in others and sometimes ourselves as well.

2. What the identity as "source" or "cause" of that distress is where all the fun lies.
There entire thinking process and behaviour is dictated by their attributed cause. Entirely dictated by their own perception and conditioning (biases).

3. It is almost universal belief that there is ONE single cause of that distress/illness. People look for agency that will "neutralise" that perceived SINGLE cause.

Read 14 tweets

Bhooshan Shukla

@docbhooshan

Apr 27

A thread on medicalisation of grief.

1. In last six months. Five of my friends lost a parent. It can get overwhelming. Being a local to their parent's city i was involved in the process medically / supportingly / logistically.
Here are some observations about wrong use of antidepressant medications for the grieving.

2. Many left behind a spouse. Completely heartbroken and distraught due to the loss.

Unfortunately, their well wishing family physicians advised antidepressant prescription.

I have a serious disagreement with this. Hence the thread.

3. After such a profound loss. Death of a spouse of 40 years or more. A huge void is left in life. Sadness and grief is intense and in indian culture it is expressed by copious crying, re telling of last illness / last moments with every visitor.

Read 17 tweets

Bhooshan Shukla

@docbhooshan

Apr 9

#ChildMentalHealth #India

A 13 yr old with severe Obsessive Compulsive Disorder. He has to wash hands to reduce anxiety even temporarily.
It is so bad that his hands are white with painful linear breaks in skin (ulcers).

Referred to a child psychiatrist. Started on single medication (fluoxetine). Cognitive therapy not possible as child lives 250km away.
Excellent response to meds in 2 months.
This should be happy ending isn't it ?

But it is not....
A 🧵-

After those 2 months parents buy the tablet locally and continue for 3 more months and stop using it. All by themselves.

Symptoms come back within a month and they restart meds in half dose on their own for another 6 months. Majority of symptoms go away and some remain.

They decide to stop meds again and same story goes again.

After it all becomes intolerable, they come to me and ask for help.

My first duty after confirming the diagnosis is - to know whey keep stopping the medicine.
1. They can afford it easily
2. There are NO adverse effects of the medicine.
3. Their doctor was available on phone to guide so no issue of costs involved in repeated psychiatrist visits.

Read 10 tweets

Bhooshan Shukla

@docbhooshan

Dec 10, 2023

One more suicide.
A young doctor studying at THE most prestigious institution loses life to suicide.
I realised that he was following me on this platform. That realisation makes this even more sad at personal level. Was there any way i could have helped him and prevented the tragedy?

I dont know perfect answers to all these questions.
Attempting to write a few that can be helpful for all young adult students (18-25 age group) -

1. Irrespective of what your seniors tell you, mental health IS important.
It is based on combination of your brain chemistry, your formative experiences and your circumstances. There is no SINGLE cause or simple single remedy.
Getting help from professionals remains single most effective life saver as of now.

2. "Feeling hopeless" is a robust indicator of high suicidality. Anger with or without agitation and consuming intoxicants like alcohol are high risk factors. A combination of these three (hopelessness, agitation and alcohol) is lethal.

Watchout for that in yourself and your near ones.

Read 11 tweets

Bhooshan Shukla

@docbhooshan

Nov 24, 2023

A day well spent at Chitale Dairy at Bhilawadi. Thanks to @nikhilchitale and Chitale family.

Their milk and milk products factory is state of the art. Sharing few photographs-

Command centre powered by AI that detects break in pattern and activates action.

Packing machines.
A keen eye will notice "Nicrome" a pune based company that pioneered manufacturing of these machines in India @aparanjape rt from

Read 9 tweets

Bhooshan Shukla

@docbhooshan

Aug 31, 2023

#Psychotherapy #Reality

One thing that makes therapy relationship different in a beneficial way is privacy.
It is not about "confidentiality " (your information is not shared with others by treating team) only.
Therapy also helps people process their own difficulties in the solitude of their own mind and come up with their own conclusions, processes, emotions. They OWN the solution.

I see this process destroyed quite frequently by well meaning (and sometimes self serving) others in patient's life.

How? Pl read on -

Many adults have friends and family who help them in difficult times. Patients have already discussed their difficulties with these people before meeting a therapist.

For children, parents play a serious supervisory role out of concern and parental authority as well.

When such adults and children enter therapy, their near one's / parents often sit with them after every therapy session, eager to hear what happened in the session and "what did the therapist tell you?"

This is usually done by people who have not experienced GOOD therapy themselves. They are not aware of the importance of privacy to make therapy happen.

Read 12 tweets

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