Dear Ms. Ara,
They say, 40 is the new 20 but I am finding it hard to accept the fact that I am 40. Recently, I've started feel fatigued and tired, physically as well as psychologically. I am irritable, and lose my temper frequently. I am also plagued by problems with arthritis and hypertension, all of which has been diagnosed very recently. And there is also the feeling of emptiness. I go out a lot with cousins and friends, but find it hard to blend in, as I used to do before. What is wrong with me?
- Confused

They also say age resides more in mind than in body. How old or young one feels seems to matter more than the chronological age of that person. Some women (you sound like a sister!) are big on numbers and some numbers (e.g. 16, 40, 50 etc.) carry more meaning than others. Some numbers hit them harder by bringing up the unresolved repressed issues back to the surface. Midlife crisis is not an uncommon condition.

Women feel even more confused in whether to take pride in their grey strands and wrinkles or to hide it with hair dye and anti-wrinkle cream. Now-a-days the media is bombarded with “look young” commercials glorifying youth only and degrading the natural aging process. Cosmetic companies making big money exploiting middle aged people's insecurity. Of course, this is not a golden era for older people when society is busy worshiping youth.

Aging is a paradox and often has multiple truths in it. Unfortunately we are often trained to perceive things dualistically (“either- ors”) and think in dichotomies (e.g. good or bad). In this process we actually miss out a lot that lies in between.

The feelings arising from aging sometimes can neither be explained by rational thoughts nor by an intellectual process. Attitude towards life and personality traits would contribute largely whether to take 40 as a new beginning or a slow ending. Subjective reality (a complex interplay of perception, expectation and environment) will dictate one whether to consider “age” as a gain or loss, growth or decay, celebration or mourning.

We are a generation who grew up hearing the derogatory comments about women being “kuri te Buri”. No wonder, this stigma will haunt us in our 40's at the latest. We get mixed messages from society like “hide your age” and then “act your age”, how can you do both at the same time? Social cruelty and discrimination towards older women becomes more apparent as they are being treated as sexless beings as opposed to older men who are esteemed to be potential partners for women of any age group. I believe as long as a person is capable of taking care of self, s/he is a young person irrespective of age.

The feelings of tiredness, fatigue and irritability could be symptoms of Depression (endogenous or reactive), anxiety disorder, stress disorder, addiction, etc. Losing temper quickly might be a sign of failure to cope with the underlying feelings in a healthier way. The feeling of emptiness is worth exploring in a therapy session. A pervasive sense of loneliness or disconnection can also be an emotional outcome of past trauma or an intensely negative life experience. A thorough psychiatric assessment will be helpful to determine the next course of action.

Hypertension and arthritis are the kind of illnesses that tend to run in families and the typical time of onset is around middle age. These are often called psycho-somatic illnesses as they tend to aggravate under a stressful period of life or soon after the emergency stage has subsided.

Any chronic illness (hypertension, arthritis, etc.) can also induce a superadded psychological condition by interfering with the functioning ability and productivity. Besides, a grieving period is often necessary after being diagnosed with a chronic illness to finally accept the loss of physical fitness and to eventually get adjusted to the daily medications, routine check-ups, etc. However, proper management of hypertension and arthritis is important to maintain the quality of life.

Side effects of medicine should also be taken into consideration. Any genetic predisposition to mental illnesses multiplies the risk of psychological complication at this stage. Some women start having premenopausal symptoms as early as in their forties.

If symptoms persist for a period longer than a couple of months, please consult a physician and if needed get a referral to a psychiatrist.

Dear Dr. Khan
I had a root canal done a few months ago. I still have the dull ache. It's a very mild pain, and so far hasn't worsened. I was hoping it would go away after the root canal. It comes and goes several times throughout the day. Please help.
- Roksana

Dear Ms. Roksana,
There are three possibilities for pain after root canal treatment-
1. The root canal was performed properly, and you're experiencing normal postoperative pain which will disappear with time.
2. For some reason the root canal did not eliminate the problem.
3. The diagnosis was incorrect, the root canal treatment was inappropriate, and the original problem remains untreated.
Only time will tell which of the three possibilities applies, although let's hope it's the first. If the symptoms persist, a return trip to the dentist is indicated and he/she may advise for further X-rays to check the possible source of pain. By the way, do not forget to make a crown (cap) on your root canal treated teeth.

Dear Dr. Khan,
I think dental caries is a common problem, especially in children. How can we prevent dental caries?
- Mokbul

Dear Mr. Mokbul,
Proper brushing, food habit and regular dental check-up can prevent dental caries. Every child should do fissure sealant to prevent dental caries. This is a protective layer, which greatly prevents dental decay. If your children are 9-13 years old, then go to your dentist for fissure sealant.

Dear Dr. Khan,
I have dental caries in my incisors, which is visible. I have also noticed morning breath. I cannot take my breakfast before 10:00 am. Can I use mouthwash on an empty stomach? What should I do for those black spots, although I do not have any other complaints?
These days, I could not find your column regularly.
- Monir

Dear Mr Monir,
Yes you can use mouthwash on an empty stomach. Unless you take your breakfast, the typical morning breath usually stays. Any black spot means you have dental caries and you should go for dental filling. I will try to be more regular. Thank you.

Caramelized October Days

Sugar Dolls - giraffes, lions, warriors…blue, green, pink and white that's what I wait for when October come. That, and the Pooja shonkhas; Anondomela carrying new novels of Kaka Babu and Professor Shanku. My grand mother's house held a lot of dark cosy corners in old town Dhaka. And in those dark corners with the smell of caramelised sugar dolls and a freshly printed Pooja shonkha in hand, I spent my Octobers, while somewhere far dhol players created a comfortable loud bliss. Ma taught me to sing along with the beats:
“Ek dhama chal
Ek ta potol
Ek dhama chal
Ek ta potol”

I grew out of singing to that rhythm but the sound of October forever got defined by those anonymous dhol players; somewhere far, somewhere near, joyous like every kid's dream.

During those days, I was learning the six seasons of Bangladesh at school. When the rather dull books came to describe Sharat Kaal, the time between summer and fall, the dryness lifted up from the text papers and created fluffy white clouds; we sensed the smell of freshly cut harvest, the drawings had smiles in the corners of the farmers' faces. It was the happiest page in Amar Boi textbooks…the most memorable.

Perhaps because the season lasted for such a short time and it created such a different kind of bliss over the usually busy Dhaka, October stood out in my mind as a child. Our neighbours bought new clothes, shared special sweets, the red sindoor in their foreheads rubbed off on mine when we embraced. The sweet shops across the street where the vendors knew me by my nickname stopped by with packaged sugar dolls as gifts. My favourites. I didn't know how to eat them, always feeling guilty about taking the first bite, making my sugar giraffe or lion lose their heads. It felt more appropriate to kiss them lightly and welcome Durga pooja.

To feel the energy my father would take us out to see different Durga Pooja mandaps, a kind of festivity that still defines celebration in my mind. My mother with her big red bindi, my little salwar kameez, with a dragging orna we would became a part of the crowd walking in and out of different mandaps. I would stare at Durga's face, each one so beautiful, those slanted eyes, those ten hands, the definition of a strong woman; I understood it through that image even before I knew what strength meant.

Now sitting here in DC, while we forget what season it is, what and which day it is, I still welcome October. The Pooja shonkhas now arrive by mail from Calcutta. I stop by at the local Pooja around town, the temples here are beautiful, and Durga still stands tall with her elegance and strength. I still stare at her in awe, trying to take back a bit of what she holds, wondering if I was able to receive some of her blessing, through those eyes, through those hands. Around me 10,000 immigrant Bengalis also stare. We smile, we smell caramelised October, we think of our childhood, our adult years, the different faces of Durga, we know she exists, everywhere.

Anger management

The list of the benefits of controlling your anger seems to be infinitely long. Another infinitely long list is the harmful effects of anger. Make sure you do not encounter the contents of the second one…

Try to avoid negotiations, serious conversations and decision making while you are angry; you are unlikely to think rationally at that moment. First cool off. If possible, don't talk to your loved ones when you are in a very bad mood as stakes are high at that moment and you will get easily irritated and consequently hurt them.

Anger is a natural emotion and having it in the right quantity can actually be a positive thing. For example, if someone is unfair to you, getting angry will push you to make things right. But showing anger by a sudden burst of fury will do no good. Heed what Aristotle said about this- To be angry is easy. But to be angry with the right man at the right time in the right manner, that is not easy.

Let this be your yardstick of success on anger management. You may even like to forgive and forget if the incident that made you angry is a small one of little or no importance.

Suppression of anger is also bad for you. Activities like exercising and swimming can help to get anger out of you. Also try writing it out or discussing it with a close friend. Another good reason why you should write or discuss is that it helps you to analyze your anger. This will give you the scope to understand what actually irritates you, and, more importantly, it will help you discover the origin of your anger. Many times, anger is the cause of depression, or the consequence of other negative emotions like sadness and jealousy.

Here in Bangladesh the term “Anger Management” is not at all popular, which is, by the way, quite annoying as our country desperately needs it. However, meditation, yoga and listening to soothing music will work wonders for you.

By M H Haider