By Rimli Bhattacharya
Millions suffer from mental health but feel scared to spell out for the stigma attached to it. I have been counseling for years and have come across cases who couldn’t get cured without the intervention of a professional psychiatrist. In this interview, I speak to Dr. (Mrs) Bharati Dattatray Patil on issues of mental health and addiction. Dr. Patil is an M.D. (Psy), D.P.M, D.N.B (Psy), M.I.P.S from Mumbai University. She is attached to various hospitals and rehabilitation facilities, located in the western suburbs of Mumbai and practices relentlessly, often jeopardizing her own personal life. She had been a lecturer of Psychiatry at Sir J.J. Hospital Mumbai. Her published works include “Sexual Misconceptions of Semen” (Indian Journal of Behavioral Sciences) and “Sexual Misconceptions of Sexual Act” (Bombay Hospital). Her case reports include “Neuroleptic Malignant Syndrome” (Archives of Indian Journal of Psychiatry) and “Monosymptomatic Delusional Pseudocyesis” (Indian Journal of Behavioral Sciences). She has also authored articles on “Psychiatric aspects of Epilepsy” (Indian Journal of Clinical Psychiatry) and “Dementia” (Biological Psychiatry). She had been the Medical advisor for Zion pharmaceutical company and is the medical examiner for Nursing School of Mumbai University and was an Executive Committee Member of Bombay Psychiatric Society. She is a Fellow of Indian Psychiatric Society and her specialization includes de-addiction, psychiatry, counseling, psychotherapy, sexual problems, and old age related problems, mainly dementia.
In a roomful of patients, Dr. Bharati was kind enough to spare some time for me, where I could ask her certain questions on mental health and addiction related issues. Excerpts of the interview:
Rimli Bhattacharya: Why did you choose psychiatry? Were you deeply influenced by human minds?
Dr. Bharati Dattatray Patil: Psychiatry was chosen by me as one of my family member suffered from mental ailment and I was deeply impacted by it. He was suffering from clinical Schizophrenia and I was desperate to read on human minds. Post my MBBS, I got into psychiatry and my journey started.
RB: Give us the names of the various psychiatric ailments which you have come across in your career.
RB: Is broken childhood a reason behind majority of psychiatric issues? Or are genes involved?
BDP: Both are reasons behind psychiatric illnesses but it depends from patient to patient. In my opinion, broken childhood and early childhood experience are the reasons behind psychiatric ailments. Child sex abuse is one of the major reasons behind psychiatric ailments and I have come across in several cases in my career.
RB: How do you maintain a professional composure during a session with a patient? How much stamina is needed? How do you refresh yourself and prepare your mind for the next person?
BDP: We are used to emotional detachment and we see the cases from a patient POV. We do not get personal. Our aim is to treat the disease and not to get emotionally involved. Mental stamina is required more than physical stamina and we see each case singly. As I said mental fortitude plays a major role and I have that patience in me.
RB: Do the psychiatric sessions with a troubled patient affect you as a person?
RB: How do you encourage a patient to speak about their mental issues?
BDP: We explain them as to why we are asking the personal questions. Some patients are reluctant and there lies the major trick in cajoling the patient to open up. Sometimes they do not open up in the first therapy and it takes numerous sessions to get into the patient’s mind. The patient needs to develop a confidence in me and that is when they open up. Mental cases are complex and you cannot expect a patient to be friendly with you. Sometimes they are violent.
RB: Talk about a time you had to deal with a crisis situation. How did you handle that situation and what was the outcome?
BDP: Yes there were violent cases and I was about to get physically assaulted. However, given my professional expertise I could bring down the case to a normal situation. Like I have been dragged to the family court by a patient’s family whom I had treated. That as a doctor is a setback but I need to deal with them on a regular basis. I had to leave my practice and had to sit in the family court to attend a hearing who had filed a case against a schizophrenic patient handled by me. It is very taxing sometimes, especially when I have my own family and patients to deal with.
RB: Is there a particular segment in psychiatry that you specialize in or prefer working with?
BDP: I prefer working with addicts and patients suffering from OCD.
RB: Psychiatric ailments are on the rise, along with suicides. What is your say on this?
BDP: Yes, it is on rise because of the lifestyle changes, peer pressure from parents on the child to perform, poverty, domestic violence, sexual abuse, hormonal changes, and family disputes. Unable to bear the stress, the patient sees suicide as an escape route and that is sad.
RB: What role do you think Psychiatrists play in the overall health care system?
BDP: Psychiatrists play a major role. Globally mental and substance use disorders are very common. Around 1 in 6 people (15% – 20%) have one or more mental or substance disorders. India has around of 68% of suicides from mental ailments, so now you know where we psychiatrists stand in comparison to a general practitioner.
RB: In your experience, what qualities in a patient must be present in order for them to more likely experience a favorable outcome?
BDP: Patients should have the insight that s/he is suffering from mental ailment. Family support and financial support also creates an impact. In addition they should follow the therapy as suggested by the practitioner. Listen to the psychiatrist, follow the medications. Open up to us. Talk therapy is very important and as I said it can only be possible once the patient has an insight of his/her mental illness.
RB: What areas of biological psychiatry are of particular interest to you?
BDP: Schizophrenia and OCD.
RB: What areas of psychological psychiatry are of particular interest to you?
BDP: Counseling and psychotherapy.
RB: When do you suggest ECT (Electro convulsive therapy)? Is it applicable for patients suffering from Depression, Schizophrenia, Obsessive Compulsive Disorder (OCD), Dissociative identity disorder (DID), Bipolar, and other mental ailments that we aren’t even aware of?
BDP: ECT is generally not used these days. Many new medicines have come up showing good results. Disadvantage with ECT lies in the fact that it affects the memory power and we generally avoid the patient to undergo the shock therapy. It also fetches involuntary motor tremors, speech impairment, and several other side effects.
RB: Why is sleep so important in curing psychiatric ailments?
BDP: It relaxes the mind and if the sleep cycle is disturbed, it exaggerates the mental syndromes. I always suggest sedatives in cases of acute psychiatric ailments.
RB: Do you think counseling helps in acute cases of psychiatric ailments?
BDP: No. In acute cases, one should be under a psychiatrist and medications and if need be can be under a counselor, though we psychiatrists also specialize in counseling.
RB: Has it also happened that even after being in treatment a psychiatric patient had committed suicide? If yes, what do you think is the reason behind this?
BDP: Yes, there are cases where the patient has committed suicide despite the treatment. Lack of family support, stress mode, and stopping of medications had led to suicides. That is what we try to address but we do fail sometimes.
RB: Do you think one can be completely cured of a psychiatric ailment like depression, bipolar, schizophrenia, DID, etc.? Or does the patient need to be lifelong on medication for ailments like blood pressure/diabetes?
BDP: Bitter truth is that most of the time the patient needs to be on lifelong psychotropic drugs.
RB: Any side effects of long term use of the psychotic drugs?
BDP: Yes, lack of sexual performance, memory impairment, and some psychomotor tremors.
RB: We have heard of mental asylums. Are those patients completely beyond the scope of counseling and medication? What kind of treatment do they receive in the asylums? What are their chances of recovery?
BDP: They are extreme cases of mental ailments mostly chronic schizophrenics and chances of cure are very less. They are very violent so they receive the shock treatment, along with medicines.
RB: You also handle addiction cases. Are they related to psychiatric ailments? If yes, then how? What are the various types of addiction that you handle?
BDP: Addiction comes under psychiatric ailment. It is the psychological disturbance and also the chemical imbalance in the brain which triggers addictions. I handle addictions like Alcohol, Charas, Marijuana, Meth, sleeping pills, inhalants, LSD. I am attached to de addiction center, Miracle Rehabilitation centre. Anyone suffering from these addictions can contact +91 9769000170
RB: We would like to know about a challenging case of recovery of an addict. Can you brief us on the same?
BDP: A case of twins addicted to marijuana. After treating them in the rehabilitation centre they are now in recovery phase. They dealt with restlessness, violent behaviors, involuntary tremors; they weren’t willing to get admitted to the rehabilitation center and even tried to flee. The recovery guys had to pick them from home. They had run away from the custody of the cops. Such was the case of marijuana addicts and there are lot more which cannot be covered in one session with you.
RB: In case the patient stops the treatment thinking that s/he has got cured, are there chances of relapse?
BDP: Yes cent percent chances of relapse. Stop the treatment only on advice of the doctor.
RB: Who is more prone to psychiatric, suicidal and addiction issues, male or a female? And why?
BDP: Females are more prone to these ailments and suicide. They don’t externalize their problems. The stress factor is more on females as she has to play the role of a mother, daughter, sister, and wife. The stigma of confining in someone that she is suffering from mental illness and lack of support leads to suicide.
RB: Do you have interest in pursuing research or have you been involved in research in the past?
BDP: Yes, I do. My areas of research interest lie in sexual dysfunction and mental illness, suicide attempters with and without personality disorders, borderline personality disorder in suicide attempters, prevalence of depression in general practice population and drug trials.
RB: Any plans to author a book on psychiatry and addiction issues?
BDP: Yes, I will ask you to pen that book where I will be providing the inputs to you. And I am serious. Mental health is no more a taboo and we need to speak openly about it. In fact, we had spoken about it that we will be jointly authoring that book.
RB: Any message to the society on how to maintain a healthy mind?
BDP: Take care of physical and emotional health; do not give a child an abused childhood. Try to identify your illness and see a practitioner immediately.
RB: What are the services you provide in your clinic?
BDP: We have a psychologist for counseling and testing, EEG facility, rehabilitation center for de addiction, long term hospitalization of psychiatric and geriatric patients like dementia.
RB: Thank you for your time.
BDP: Thank you
Note: Anyone suffering from mental illness and needs de-addiction recovery, Dr. Patil can be reached on +91 9823146370.
Rimli Bhattacharya completed Mechanical Engineering from National Institute of Technology. After obtaining an MBA, she worked in the corporate sector. Rimli is a trained Indian classical dancer, based out of Mumbai, India. She tweets at: @rimli76
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