Psychiatrists & Desi Community

Lifestyle Relationships
1

What steps I as an individual, or we as a group, can take in encouraging people of Desi communities in general & Pakistani community in particular to to go visit a psychiatrist? If this is to be done on an individual basis (recognizing the fact that Pakistanis as a community are not always coherent) then how do you start such a conversation with someone? How should I approach him/her so that they don’t feel I am labeling them “insane” or anything similar but only want them to get some professional help in time of emotional crisis or depression?

I have many friends, most of them students, who have a very hard time coping mainly with the culture shock or the financial problems that arise after immigrating or coming to USA (or west in general) for studies. They become increasingly depressed, defensive & at times bitter about everyone else. In my opinion, so far away from their family’s moral support they need professional help before their concerns/worries start permanently being part of their personality. Its so difficult to approach someone in this situation & advising him about professional help because of the misunderstanding of the role of a Psychiatrist in our community/culture.

2

Are you nuts?

3

Sorry that was politically incorrect. What I wanted to ask was

Are you insane?

If someone is already having financial problems, the last thing he should do is to go pay a psychiatrist. Instead you should give him ideas (and recipes) for selling halaal sandwiches outside the mosque on Fridays. Thats a gold mine. I am heading that way right now, and I know they will be terrible, but will still be selling like hot-cakes. Bad example, I know.

4

[QUOTE]
*Originally posted by Faisal: *
Sorry that was politically incorrect. What I wanted to ask was

Are you insane?

If someone is already having financial problems, the last thing he should do is to go pay a psychiatrist. Instead you should give him ideas (and recipes) for selling halaal sandwiches outside the mosque on Fridays. Thats a gold mine. I am heading that way right now, and I know they will be terrible, but will still be selling like hot-cakes. Bad example, I know.
[/QUOTE]

this is actually a very good exmaple. We did the same thing for a family and they are doing great.

5

[QUOTE]
*Originally posted by Faisal: *
If someone is already having financial problems, the last thing he should do is to go pay a psychiatrist. Instead you should give him ideas (and recipes) for selling halaal sandwiches outside the mosque on Fridays. Thats a gold mine. I am heading that way right now, and I know they will be terrible, but will still be selling like hot-cakes. Bad example, I know.
[/QUOTE]

Your idea reminded me of our local mosque. The imam told ppl to do the exact same thing u said above...but it turned out to be terrible for our mosque. Ppl started bringing stolen watches, stereos, and electronics...and that brought the police...so we had to cancel the whole thing. Some of the ppl had such good business that they skipped namaz and sold their stuff. Now thats bad.

6

tsk tsk tsk :nono1:

7

Ahmadjee Bhaijan, you mean Shrink (or social worker, or psychotherapist) not a Psychiatrist. Depression due to culture shock or due to financial instability is not what you need a Psychiatric care for….it is mental illnesses such as Anxiety, Mood disorders, Schizophrenia, etc, that you need to see a Psychiatrist for.

8

:smack:

See that’s what I am talking about … such ignorance & lack of awareness.

Usually all universities have licensed counselors that provide FREE help to all students. And these councilors can be viewed as those diagnostic doctors who then refer to specialists (psychiatrist) if they think there is a need. The insurance that the international students at our university are mandatory to have (by INS law I suppose) usually covers a good amount of the psychiatrist treatment & that’s the cheapest & worst one in the whole state. It’s just a misconception to those who think it costs more to go to a psychiatrist than going to a medical doctor.

The back ground of my thread is a string of events & my own personal experience with people who have psychological problems. A former Pakistani student (graduated when I was a freshman or so) committed suicide last weeks in CA. Little that I knew him I was certain he had some issues but my brother who was good friends with him told me that he was suicidal even during his student life. This summer we had a fiasco with an Indian student who locked himself up in the room & threatened to kill himself with a knife. His roommates left him thinking he will get over it. When he didn’t come out the whole day, they panicked & it was a mess. And neither him nor my brother’s friend had any financial problems. This fall semester alone, the international office has recommended 15 or so students out of approx. 50 to go see the counselor, 90% of them from south Asia. According to the counselor office only 3 made appointments.

I suspect that social problems in bigger cities with bigger Desi communities are far more than the small predominantly student community I live in.

NYA bhaijaan, I mean all of 'em. :slight_smile:

9

who think it costs more to go to a psychiatrist than going to a medical doctor<<<

Ahmadjee Bhaijan, Psychiatrist is a Medical Doctor. But I understand what you are talking about.

10

depression is diagnosis of a psychiatric disorder, which can only be made by a qualified Medical Doctor, almost always the psychiatrist (at least in Holland); after he has made the diagnosis he can refer that patient to other people, like psycho-therapists, social worker (which are NOT MDs, so they are NOT in the position to make medical diagnoses).

will be back with more :~)

11

Sorry. Your mentioning "financial problems" threw me off. I apologize :)

I honestly don't think many in Pakistan (including FOB's) would even know the difference between psychiatrist, psychologist, psycho-analyst or shrink... for them they have just one title "paaglaaN da daakter". Simple!

And therein lies the stigma of not going to one. Cz otherwise you will be labled "paagal" (in less sophisticated settings) and "mentally unstable" (in more refined settings).

Historically people in South Asia would not need to go to a professional shrink cz of the closeness of family structure, where for any given problem you can go and talk to an uncle, cousin, chaacha, maama, taaya or grand-parents. This, to an extent kept people sane. You are not labelled anything when you fall back on the family institutions or close family friends for advice. Over there, people still have time to sit down, listen and trouble-shoot problems for their friends, and life is not as harried as it is here.

The doctors who specialize in this field were largely left to care for patients suffering severe mental disorders, and the hospital is commonly known as "Pagaal-khana". Not very flattering.

With breaking family structures, and especially moving to other countries, this fall back option is not available. This creates a void. Some people fill it with friends, relatives, masjid ke maulvi saheb or calls back home, but this option may not be available to everyone, or they may not want to take advantage of it.

Stepping back, the first step is actually to realize that there is a problem for which you can't figure out a solution. Once you get to that conclusion, then it becomes progressively easier to figure out a way to resolve it.

I have no particular experience to know how these psychiatrists help or analyze their patients, so anything I say may be completely incorrect. To me, having a good circle of supportive friends seems a more viable option, rather than setting up an appointment and seeing a total stranger to divulge all your inner thoughts. For some reason it may seem like you have become a failure.

12

:) What the hell on earth a friend is for ?

Instead of telling your friend to seek professional help open your ears and listen .

Hopefully you might get some sawaab too

If they are people you only know and dont get along with them. Then be honest and tell them in pure english and make sure you are not using any urdu word. Cause in urdu you say "pagaloN key doctor key pas jein " . Atleast in english you can be a bit more sophisticated :D

13

Aj.. i think as some have already stated, a circle of good friends works best. i.e. people who can really understand and walk this individual through the frustrations.

I've had depressive periods twice during the last two years, and I was told I think too much and dont let my mind relax.. 'sawar karlena' as we say in urdu. I cant say much about interpersonal therapy, but medicine(Paxil) works very well and can expedite the process considerably. You can get a prescription for this un even from a walk-in clinic. So, medicine coupled with a good healthy non-pressurizing surrounding does the trick on most occasions.

But if its anything as serious as suicide attempts then that probably required better treatment.

14

Lack of education and awareness about mental problems in our culture is the root cause of this whole debate.

When offering help to somebody in distress. Choose your words carefully and address the root cause. At an individual level, spend time educating them and inform them that just like a doctor of the heart (cardiologist) specialises in ailments of the heart, the psychiatrist deals with the matters of the mind, ranging from mildest stress or worries to advanced forms of mental illnesses (which usually arise from such seemingly small tensions- but you dont need to scare them about it, chances are its a very small problem that can be addressed by a counsellor, psychologist or even a psychiatrist who would refer his patients to a counsellor or psychologist or a peer group if he feels they are in a better position to help)

Unfortunately, in our culture, most people dont recognise mental illnesses earlier. They are diagnosed by lay people only when they have reached advanced stages and show such symptoms as overt aggression, disinhibition, bizzare behavior etc etc. Even then they get labeled as being 'mad' or being 'possessed'. Schizophrenics are thought to be possesed by jinns, depressives are labelled as being under the spell of magic or evil eye waghera. The victim is then taken to the local pir or exorcerer and udher jo uss ka hashar hota hai. allah pak toba.

When a person of any age experiences pain around the heart region, dont we take it seriosly and ask him to seek a professional opinion? similarly, there is nothing wrong by suggesting a professional mind healer. If the person is EDUCATED properly, then he might not get offended, but owing to his cultural upbringing there is a slite chance that he might, but thats ok, its better to be safe than sorry and address this issue. explain to him kay he's lucky to be in perdes where we have better help available for people like him and that it is not a big deal really and it certainly doesnt mean that he's going mad!

Also, speaking to friends and relatives helps therefore encourage him to talk and open up. Also school/ college teachrs and counsellors can be of immense help. if you suspect a person of getting suicidal or if he or she has confided in you (early signs: previos attempt, change in behvior..likes to talk about suicide and death, makes statements of hopelessness and worthlessness, starts giving valued things away, preoccupation with tying up loose ends..sudden elation in mood, increasingly calling home or meeting friends) then its YOUR moral and ethical responsibility to ALERT relevant authorities like teachers, parents, counsellors and provide all the information you have obtained. Dont think of this as a breach of trust..you would be doing a great service as a friend believe me. a 1993 youth risk behavior survey revealed 1/4 of all high school students had seriously considered attempting suicide in previous 12 months. The figure is perhaps higher in desi students. many a lives have been saved at psychitric facilities. Under law here, one can restrain and hold a person (using force if necessary) and treat him at a psych facility until he gets better.

Thanks for posting this important topic. I think evrybody needs to read more about mental health problems. Its one of the most ignored subjects in our culture. bye

15

Re: Psychiatrists & Desi Community

Start by giving them someone to talk to, like yourself. The way to make it more acceptable is to position them as doctors and let people know that seeing one does not imply some loss of (wo)manhood. It requires a cultural change.

[QUOTE]
*Originally posted by ahmadjee: *
What steps I as an individual, or we as a group, can take in encouraging people of Desi communities in general & Pakistani community in particular to to go visit a psychiatrist? If this is to be done on an individual basis (recognizing the fact that Pakistanis as a community are not always coherent) then how do you start such a conversation with someone? How should I approach him/her so that they don't feel I am labeling them "insane" or anything similar but only want them to get some professional help in time of emotional crisis or depression?

I have many friends, most of them students, who have a very hard time coping mainly with the culture shock or the financial problems that arise after immigrating or coming to USA (or west in general) for studies. They become increasingly depressed, defensive & at times bitter about everyone else. In my opinion, so far away from their family's moral support they need professional help before their concerns/worries start permanently being part of their personality. Its so difficult to approach someone in this situation & advising him about professional help because of the misunderstanding of the role of a Psychiatrist in our community/culture.
[/QUOTE]

16

Thanks hmcq, at least someone made an attempt to answer the original question. :)

It's very hard to ask someone to get some professional help. The only effective way is to get involved in their life & catch them on a sunny day, when they are not already too depressed-and these days are few & far between. One of the counselors at the school was kind enough to follow me to a students apartment & pretended to be my friend. During our conversation he talked him into coming to his clinic.

17

me old chap....ahmed....what the hell r u on about....how many of ur friends who r in such hardship pray 5 times a day....in the days of the Prophet they had many hardhips then what we r now...what did they do....run to some Psychiatrist......man....u know what....app loog apni daal rooti bhool kai McDonalds pai zaidah zoor dai rehey hou.....there is a saying...kanwa challa hans ki chaal ...apni chaal bhi bhool giya....

18

very often what we need there is to almost push ourselves on them and take them out and make them enjoy the sunshine. It is not that people dont want to see the sunshine but sometimes all the need is the push and the motivation from a friend that means, we REALLY want you to come and enjoy this with us. It would just not be the same without you.

its the way we express ourselves. In the west where the family unit is so small that you dont have support elements its such a shock that people need the extra push and very often the people who are already here assume they are just been arrogant or lazy. The cultural interaction is essential and if care is not taken can be very adverse. The shrinks are great but they are often viewed as a very negative thing. Just imagine what you would think if someone told you they were seeing a shrink.

Anyway great idea and good to hear it worked out.

[QUOTE]
Originally posted by ahmadjee: *
Thanks **hmcq*, at least someone made an attempt to answer the original question. :)

It's very hard to ask someone to get some professional help. The only effective way is to get involved in their life & catch them on a sunny day, when they are not already too depressed-and these days are few & far between. One of the counselors at the school was kind enough to follow me to a students apartment & pretended to be my friend. During our conversation he talked him into coming to his clinic.
[/QUOTE]