INTERPRETER OF MALADISE

Interpreter of maladies

Dr. Nighat Ara, Psychiatrist, Counsellor and Therapist

Dear Dr Ara,
I have a long family history of psychological disorders. My grandmother is believed to have suffered from a mental illness, although it was never diagnosed. I have Bipolar Disorder and my brother has epilepsy. Two of my cousins are also ill and under medication but I am not aware of the diagnosis.

Now I have a son, seven years old. He is very shy, like I was in my childhood and doesn't want to mix with children of his age. I am very worried.

I understand that he may be perfectly okay in later life but what I really want to know is how should we treat him as a child? What sort of atmosphere should we maintain within the family to ensure he grows up healthy and fit?

Thanking you.
Babu

It appears that you are concerned about your long family history of mental illness and pondering about its impact on your son. I believe you have genuine reasons to have some concerns given the fact that your family tree does show some pattern of transmission of mental illness and neurological disorders at different levels.

I definitely appreciate your attitude to do your best in parenting your child to abort the risk.

It is probably worth mentioning here that although Bipolar Disorder is suspected to be primarily biological in origin, environmental factors do play an important role in the course of the disease. Interestingly, Bipolar I and Bipolar II disorders show different genetic predisposition. Genes seem to play a more significant role in transmitting Bipolar I disorder. Some studies report that the morbid risk of bipolar illness in relatives was found to be 5.7 percent.

Family studies have repeatedly shown that first degree relatives of Bipolar I disorder probands are 8-18 times more likely to have the disease than are the first degree relatives of control subjects. The likelihood of having a mood disorder lessens as the degree of relationship widens. Ironically, a genetic mutation can also make a person susceptible to Bipolar illness even in the absence of a family history.

I don't think you need to do anything extraordinary to protect your son. Perhaps practicing healthy parenting skills and maintaining a healthy environment are the best gifts we can all offer to our children to ensure their healthy growth.

There is usually much talk on dysfunctional family life and problematic parenting than on healthy living. Actually health like wholeness is somewhat elusive. When I try to write on healthy living it inadvertently becomes a discussion on disease in disguise. Stress and crisis are part of normal life. Any denial of this reality is essentially programmed for failure. We observe unhealthy automatic defences in others and laugh about it but the momentary realisation that we are no different is very pivotal in making changes.

Typical shyness in a seven year old child should not be alarming. It is interesting that you have experienced similar shyness in your childhood too. It is not unlikely that a parent becomes overtly protective or reactive to a child when the child reaches an age at which the parent himself/herself had suffered a difficult time in life and carries unconscious/conscious memories of that period.

Nobody wants to make the same mistakes as their parents but early life exposure to adverse situations tends to wire the brain in a way to repeat the mistakes and follow the automatic programming. Adverse environmental factors (neglect, coercion, chaos, mixed messages, pressure at school, being bullied by friends etc.) need to be identified and intervened in a timely manner. Unfortunately it may not eliminate the possibility of the onset of the disease altogether in a heavily genetically predisposed person but can surely influence the disease course in a positive way.

You have been diagnosed with Bipolar Disorder, what type of Bipolar Disorder is it? Regulating the stress factors in the environment and enhancing the inner capacity to deal with stress and crisis along with medication often bring dramatic results in case management.

Your mental health has a direct impact on your child. You just don't transmit the genes, your behaviour directly influences the environment in which your son is growing up.

On another note, it is important to keep in mind that excessive parental anxiety can be damaging for the child's self-confidence and self-esteem. Your son is not going to be the exact replica of you anyway. He has inherited 50 percent genes from his mother too which will give him some leverage. Believe in his uniqueness and let him be who he is. Remember a problem child is often the index patient and the family is the background patient when it comes to mental health issues.

Shyness is not sign of illness, it can best be regarded as a personality trait. In this case, personality is yet to evolve in a seven year old boy. Your son doesn't want to mix with children of his age. Is he comfortable mixing with older or younger children? It needs to be further explored as it is hard to draw any conclusions from this little information. Intellectual or emotional maturity is not always aligned with chronological age.

Friendships are more about emotional or intellectual connections which can overcome the age factor. Sometimes shy introverted kids are the targets of bullies which will cause them to withdraw further in social set ups.

People tend to acknowledge their ill health at different levels. Some identify it with a mild sneeze while others have to fall flat on their backs or be half dead to admit their illness. Everybody has mental power, some more and some less. In order to grow together healthy in a family, beware of the current dysfunctions.

Any progressive dysfunction has the potential to destroy a family system and victimise the members. Family members search for ways of coping with the pain. Any person who cannot afford to look at the pain of the family crisis will need defences as self-protection.

Mental illness is a stigmatised subject, families dealing with it tend to be secretive and children learn "not to talk" or "not to trust" others as it brings trouble for them. "Shyness" can eventually become a protective mechanism or a survival tool. Again health and family dynamics are not static in nature, rather in constant motion. So, be flexible in addressing those.

A problem child will make changes as long as it doesn't threaten his/her basic need (for example, if being awkward draws more attention from parents than being average "normal", then the child might prefer to adopt the dysfunctional role to enjoy the indirect reward from it.)

It is not always easy to identify dysfunctions and replace it with healthier substitutes without expert help. However, it is surely wise to try it on your own before seeking expert help and at least finding out the road blocks. Often the problem has the luxury of a long developmental period while treatment is brief and concise. General awareness and early intervention can definitely cut back the developmental period and increase treatment efficacy.

My best wishes for you and your son.

UNDER A DIFFERENT SKY

Reflections and resolutions of one mind or maybe many…

By Iffat Nawaz

"I don't believe in 12 ams, man made madness! I don't want to keep track, I don't want to watch the ticking clock nor the falling ball. I want 5 hours of silence between the 31st and 1st, non-ritualistic, non-revolutionary. I don't celebrate numbers or time. Perhaps I celebrate transformation, and that never happens in seconds.”

“Leaving town to watch the stars. 2011with or without you, with or without me. Counting stars near tea gardens while non-malaria prone mosquitoes sing me songs. We get intoxicated over whatever is available, whatever I found, whatever my friends brought, clear burning liquids and some coke. A few of us, away from the madness of Dhaka, away from all, still not far enough, we fix a date to return before leaving; a new year, a few insect bites, a few broken glasses.”

“I hate changes, television makes me dizzy, winter makes me nostalgic. I look back and I see darkness, I look forward and I see confusion. I need to scream, dye my hair, highlights in the front, low lights on the back. I need to raise my child to not be like me, I need to love more than I loved before. I hate changes, I will not change.”

“The last sunset of 2010 made me want to dive into the sky. The sky looked like the wing of 'mach ranga', golden hues with blue stripes. I wanted to drink it all, smother myself in light. I am in love, with you and myself. I want more.”

“I shall quit smoking tomorrow. Okay maybe not tomorrow, I still have a whole carton of cigarettes left and my nicotine gum has expired. So I will quit on the 5th or the 7th. Seriously I will.”

“Can I call you around 12 am? Will you be too busy? Can I steal you away from all that's around you? Though I have no rights to ask? Will you pick up my phone call? Do I even dare ask? I know the answer already, but my tongue still speaks faster than my mind, I know the answer, but I still ask.”

“My home is showered with lights, 'tuntuni' bulbs, I am drenched with the light of someone else's wedding bliss. My verandah is happy with this sudden decoration, gloating with borrowed happiness like magic. The smell of hair spray and perfume drift in an out, golden brown bodies giggle close to me, I don't see them sitting in my room. My verandah peaks to steal a glance. We take the last breaths of this year, the new year smells fresh with white toothed smiles.”

“I wash away my day under the water, wash away my life, my year. My love awaits around the corner, in the other room, in the next street, in another country, continent, waiting, standing alone somewhere. Will you reach me this year? Such a long journey… I must prepare. I wash away my fears, for the last time this year.'

IDEAS

Left with leftovers

'Happiness is making the most of what you have.'

Leftovers. We all have them, don't we? But what do we do with them? Keeping them in the refrigerator until a science project on mold develops is not really an option, but sometimes it's hard to know what to use leftovers for without driving the family crazy.

Probably the most important step with leftovers is making sure they are edible. We're not really saving any money on our family budget if that frugal dinner of leftovers sends everyone to the hospital with food poisoning. To keep leftovers in edible condition, cover and refrigerate within two hours of a meal, freeze to keep for more than three days, and thaw frozen leftovers.

Use leftovers carefully and think before you discard - even the most basic of foods can be creatively brought back to life in the form of soups, casseroles, sauces or stock. With a little imagination (and a helping hand from our recipes below) you can rustle up all sorts of exciting new meals from family leftovers.

Now, to do things correctly, we have assembled some tips for you to follow and make sure your leftovers taste even more delicious than when they were fresh.

Reheating leftover stuffing- for stuffed meats (for example, stuffed lamb chops, a beef roulade, or a lamb breast) you can refrigerate the stuffing without removing it from the meat. Use or freeze the leftover stuffed meat within 3 to 4 days. The leftovers may be reheated in the microwave or in an oven.

Uses for leftover cereal- Small quantities of cold cereal may be used as a thickening agent for tomato soup or for beef and chicken broth, or any other soup as desired. It may also be made into a boiled or baked custard or rice pudding. Cold cereal is good for binding together croquettes, scalloped meats, etc.

For leftover rice- Toss some garlic, onions, soy sauce and sesame oil in your frying pan. Add your leftover rice and whatever veggies you have at hand and voila! You have a new meal -- vegetable fried rice. For more variations, you can add bits of chicken or prawn, some pineapples, cashews, scrambled eggs and different sauces and spices.

Leftover chicken soup or salad- To make soup, add leftover chicken to a packet of chicken soup. Add two tablespoons of cream, some chopped fresh herbs and a sprinkle of paprika. Alternately, you can also add a tablespoon of curry paste and a tablespoon of yoghurt to make a light curry soup. (Add water to the pack of soup if the instructions require it). For salad, make up a salad of rocket leaves, dressed in Thousand Islands or Italian dressing at the last minute, and add sliced red onion, pine nuts, grated carrots and shredded chicken. Grate Parmesan on top.

Reusing the bread- If you have more than just a few slices left over when the bread starts to go stale, you can usually freshen it up for at least one more meal. Just spritz the surface of the loaf with a little water and bake it in a 350° oven for 5-10 minutes. You can use it the next morning or even later to make little homemade sandwiches with your leftover curry or fried chicken. Use your sauces and mayonnaise wisely, and you'll have yourself a whole new delicious meal.

Pickled veggies- Pickle leftover cucumbers, tomatoes and red onions by adding them to vinegar and sugar. Try any combination of these leftover vegetables as you please and use about 1/2 a cup of sugar per 6 ounces of white vinegar. Add additional sugar to taste, and if desired, a bit of basil. Let it sit in the refrigerator for several hours. This side-dish can last several days.

Leftover potatoes- You can cook leftover potatoes in a number of ways. Combine mashed potatoes with a little milk, onion and seasoning and make potato patties. Fry in a lightly oiled skillet until medium brown. If needed, add breadcrumbs for consistency. Shred or cube baked potatoes and sauté in a lightly oiled pan with onions, salt, pepper and garlic.

More vegetable delights- Make cheesy vegetables with leftover green beans, broccoli or cauliflower. Make a simple cheese sauce with cream cheese and a little milk. Precook the vegetables if needed. Cook on the stovetop on low or in the oven until heated. Jazz up the sauce with a little chili powder or dried scallions.

Now that you have plenty of ideas and suggestions on what to do with your leftovers, there's absolutely no reason to think that your food is going to waste. Whip up some new dishes with the old and you can throw a leftover party for your closest friends to come finish off your new inventions.

By Naziba Basher