April 2008 Edition
Jehangir Rashid
Srinagar
Aworrying trend in Kashmir has been the growth of Post Traumatic Stress
Disorders (PTSD), a mental condition that has been affecting ordinary people.
Two decades of political uncertainty and the occurrence of natural disasters
are said to be contributory factors.
Dr Arshad Hussain, one of the Kashmir Valley’s leading psychiatrists, says
very few people talk about their mental problems since they fear others will
consider them insane and therefore an embarrassment.
Dr Arshad is a psychiatric consultant at Government Medical College (GMC)
Shri Maharaja Hari Singh (SMHS) hospital and Psychiatric Diseases Hospital,
both associated hospitals of GMC, Srinagar. Dr Arshad has been treating people
affected by mental disorders since the last seven years. He spoke to Civil
Society about PTSD
Why are so many cases of PTSD being reported?
Prior to 1989, PTSD was absent in society. It was only during the conflict that such cases came to be noticed. Once armed conflict became a permanent feature, people used to get upset and tense every now and then. The condition of people living in the countryside was alarming as they would face tough situations on a regular basis.
Ninety percent of these cases are conflict related but in the recent past some natural calamities, like the devastating earthquake ofOctober 8, 2005 and the snow tsunami of February 2005, have taken place. All this has led to an increase in the number of PTSD cases. The prevalence of such cases is less in Srinagar city as any unwarranted action by the troops gets noticed by the media. Therefore, they tread on a cautious path. The occurrence of PTSD cases is more in the districts. Fresh cases are coming from rural areas. With the passage of time, old cases may settle down. Since the situation has improved over the last few years there have been very few additions. The life time prevalence of such cases is between 17 to 25 per cent. But if conditions improve, numbers may go down.
How does PTSD affect the lives of people who suffer from it?
The trauma affects people in three ways: negative, neutral and positive. Under negative, people get depressed and then resort to extreme steps such as suicide. These people lose hope and are not encouraged to take forward steps in life. Then, there are people who, despite falling prey to mental disorders, are not affected in the real sense and they take each and everything in their stride. Under the positive category, the affected person somehow gets encouraged and takes up challenges. Their disorder does not make any ifference to them. Classic examples of PTSD are people who are greeted by past events every now and then. These people are disturbed by flashbacks, vivid dreams and recurrent unfortunate incidents. They do want to come out of this but somehow the ghost of turmoil and conflict haunts them on a regular basis. They are stuck with trauma and are also distressed to the hilt. Right now two or three patients affected by PTSD visit me on a daily basis. At the same time some follow up cases also come. PTSD renders a patient socially and occupationally defunct.
Why are more women prone to PTSD?
Females are more prone to PTSD since they form the least survival group. It has been observed that middle-aged females between 35-55 years of age and young men between 20-40 years are somewhat prone to mental disorders since they are hogged by tension and other related things. They usually come with simple disorders such as headache and palpitations. Since they are in the prime of their lives, they get mentally disturbed whenever they feel that things are not going in the right direction.
Are people seeking treatment? Do they get cured?
Once they realise that they are going through some disorder they seek medical advice. But they go to other medical specialities like ardiology and neurology before finally visiting the psychiatrist. In 1999, I carried out a survey and it was surprising to know that it takes four to seven years for a person affected by PTSD to reach the concerned doctor. Patients suffering from PTSD start showing improvement after eight weeks of treatment. It is important that society supports PTSD patients so that they are able to start life afresh. In most cases it has been seen that the economic position of the patient leads to the mental disorder. In many cases, complete remedy is not possible. I believe the solution lies outside biology.
Do we have enough psychiatrists to cure such patients?
No, we don’t have enough psychiatrists, but we are improving as two psychiatrists are being added to our numbers every year. Right now we have 16 psychiatrists. Our average is better than the national average. There are only 3,000 psychiatrists for one billion people n India and at the same time we are losing talent to other countries. I have a couple of offers from Australia, but I want to do something for my society and that is why I have decided to stay back.
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