Bipolarity

2006-08-27T07:44:00.000-07:00

I am posting this from Kolkota where I am on a week-long visit. I attended a meeting of heads of schools at Teacher's Centre to share ideas on special education and mainstream schools mainstreaming.

I also visited Earthcare Books run by Vinita Mansate.

Ayesha Das, whom I have come to be with, runs an English Landuage Centre called Read on, a wonderful place in a beautiful compound.I hope to put up photos on Tuesday. Ayesha's is a constant inut of inspiration and affection. She cares and shares unstintingly. Read on's books now includes Tanvir's Five Rupee Helicopter, the outline of which story Tanvir gave us the day after her chemo, four days before she passed away, assuring us that she had ten more outlines she would give us for stories in the Empathy Books series, which Tanvir believed in so much.

2006-08-19T09:25:00.000-07:00

Tanvir passed away two months ago today by Gregorian time. This posting marks this watershed event in our lives and endorses that memory is carried forward in work...caring...sharing...daring...but not staring...!

Afshan, a young enthusiastic, young woman visited us on the 15th and spoke to Aditi Mukherjee about Tanvir and a special place at 'Sudarshan" to understand Tanvir's vision and carry it forward in her memory. Anvar Sultana, the only person whom Tanvir accepted to work with her in a remedial school-based programme, and Zenobia Rustomfram, who was in close touch with Tanvir professionally over many years, were with us when Afshan had formally come earlier to explore possibilities with Sheel and Usha Raman at www.spark-india.biz.

I hope those who read this will add to the blog and/or get in touch by mail spark_india@rediffmail.com . Post to Miss Lakshmi Rameshwar Rao, "Sudarshan", 3-5-819 Hyderguda, Hyderabad 500 001, INDIA.

The current issue of Teacher Plus carries our tribute to Tanvir, posted on this blog earlier. Please let us have your address so that we can send you a printed copy of the magazine.

2006-08-15T09:12:00.000-07:00

Happy Independence Day

Flag hoisting "Sudarshan",
Hyderabad, 15 August 2006

2006-07-10T21:13:00.000-07:00

Remembering Tanvir

Tanvir Iqbal passed away on June 19. The cancer had finally got her-- the brain, lungs and the bones.

Tanvir’s frail frame deceptively hid a strong and powerful personality. She fought the final illness till the end with great courage and dignity. The twinkle in her eyes and the impish smile continuously allowed us to live in hope. She taught us how not to despair.

Tanvir got her Master’s degree in Linguistics from Osmania University and joined the M.Phil course with a Junior Research Fellowship from UGC. Halfway through the course she decided that Speech Therapy was to be her vocation. She moved to Ahmedabad and got a degree in Speech Therapy before moving on to Kansas, USA to specialize in Special Education. She was now well equipped to start her practice in Hyderabad as a consultant for those with speech/language and learning disability. Apart from the extensive formal training in the field, Tanvir had the singular distinction of not mechanically following the techniques and material developed in the West. She was very particular that her clients be situated and treated in the context of their existential reality. Thus she was also wary of labeling them with the readymade diagnostic categories. This involved constantly improvising techniques and teaching material to suit the requirement of each client. It was a difficult job but Tanvir was not to be put off by the enormity of the challenge.

In everything, Tanvir was a perfectionist. She would never allow herself to get complacent and very often subject herself to unfair self-flagellation when the outcome of a particular intervention did not meet her expectation.

It is very difficult to separate Tanvir the ‘professional’ from Tanvir the ‘person’. She seemed to be wearing the same hat –whether it was with her client or with the family/friends. It was the hat of ‘empathy’. Although she demanded perfection from her own self, she could empathize with the shortcomings of the ‘other’. In her interaction with the others she had the special ability to be non-judgmental. All of us who were in touch with her knew that she was not only empathizing with our problems but was also absorbing a part of our pain, frustration, failures and anxieties like the proverbial Neelkanth. There were occasions when we would have been provoked to behave badly. But not Tanvir. Not a harsh word would pass her lips. She was the therapist for the family, friends and anyone else who came in contact with her. Such fortitude, and generous ‘giving ’of her ‘self’ was not easy and surely took its toll.

Tanvir was one of the first few subscribers to Teacher Plus < www.teacherplus.org >. She continued to support it till the end. She was also the ‘spark’ in Spark-India. It is a loss that would be very difficult to repair.

We, the people she left behind, may not hope for Time to heal. We owe it to her to learn to cope with the gap and manage our lives the way she did with hers – with fortitude and dignity.

Aditi Mukherji, family and friends and members of < www.spark-india.biz>

2006-07-10T06:33:00.000-07:00

"Sudarshan", Hyderabad www.spark-ind ia.biz
Lakshmma, who cooks and cares for us

Group photo from left: Kamakshi, an author,Tanvir, Sheel and me

Ooty (May 2002)

2006-06-26T13:44:00.000-07:00

One of the last articles Tanvir circulated:

2006-06-25T15:25:00.000-07:00

Good Morning on another Monday of a new working week.

I tried to upload, without success, some photographs of Tanvir on holiday in Ooty (2002), after treatment fpr primary breast cancer; looking radiant, as her name means. We joked about it often during the month of her radiation therapy.

I'm also glad to postpone the decision about whether or not to put them up, because I do not know how Tanvir would have wanted it or in fact any that may read this.

2006-06-23T08:26:00.000-07:00

I am posting this, once again, to mark the day. Sunday will probably be when I settle down to working on this blog to give it new meaning if that is possible. Tanvir teased me about it from the day of the first post and would perhaps still be in despair about my hard sell.
Be that as it may, I give a quote here that I would have wanted to share with Tanvir and that I think she would have liked and known to be true:

"Education is the one thing that we are willing to pay for and not get!"

For Tanvir, education, was a passion, a reality that was not made more meaningful with the qualifier "quality". She participated upto her last moment of life with us, in a joyful and effective teaching-learning yin-yang. I hope we, each one of us whom she has touched, will share together to live and continue the dream that was her life.

2006-06-22T07:43:00.000-07:00

This post has been created to maintain continuity before the turn of the day.

2006-06-21T08:06:00.000-07:00

It has been a day of work at Spark-India. Sastri, who works with us, was unwell and taken to hospital. He also has serious and immediate problems with his landlord. Sheel spent a long day at Azim Premji's order, getting in place plastic covers on for books they want for a reading project in Madanpalle, A.P. Plastic became an issue but perhaps that has nothing to do with matters of this blog. I also have begun to accept that life is not worth issues (no pun intended).

The obit in today's Deccan Chronicle brought in condolences from many people.

We have all known it somewhere, but now in Tanvir's passing I realise how much she has meant to how many people. Childhood friends, families of those she has been associated with professionally and so many more; she had given Raghu, the boy who came into our lives 15 days ago to drive, smal educational aids as presents for his children, one of whom had a birthday today. He was in tears as he left earlyfor the party in his house.

We hope we will be able to organise a meeting in her memory, perhaps in the first week of July.

Thank you for all the messages on the blog, in person, on the phone, in the mail, through people and in your hearts. As Rahel said when she was told that we would never see Tanvir again, "Why not? She is in our hearts and we can see her whenever we want to!" And 12 year old Arudra, "She was really such a nice person."

2006-06-20T07:56:00.000-07:00

Tanvir's last journey to her grave, in Shanti nagar, Hyderabad was via the mosque after the
1 o'clock prayer. It would also have been her first experience of prayer at a congregation in a mosque as women do not go to the mosque. Her aunt Pyari Khaka, older than Baji, was at Aghapura with the other zanana. Tanvir was laid ar rest with her mother, in the graveyard where her father is also buried.

2006-06-19T09:56:00.000-07:00

Tanvir passed away at 6.40 pm today in hospital where she was in ICCU for a brief 15 minutes.
The burial is tomorrow. Roofi was with Tanvir when she breathed her last. Tabbi left last night to return to the US. The family is gathered at her home in Aghapura.

2006-06-18T08:30:00.000-07:00

Spent time visiting vetran school principals, Mrs Vanita Bhushan, Lumbini School and Mrs Marie Periera of Johnson Grammar. Neither is doing well healthwise.

Tanvir is still rather unwell.

2006-06-17T05:48:00.000-07:00

Signs of the chemical war to destroy the baddies have begun to show on Tanvir. The good cells are also being destroyed with the bad and there is fatigue and weakness. I fear that this will continue, probably increase, as we get into the next week. Tanvir will require care which I hope we will be able to provide adequately. So will Baji who is naturally worried at the "bad turn". I hope the reasuurance will set her mind at rest a little, that this was expected earlier and will pass almost before we know it and Tanvir will gain in strength in a matter of perhaps only three or four days as next week progresses .

2006-06-15T08:24:00.000-07:00

Good news!!!

The chemo went well. There was no reaction during the treatment and her body accepted the chemo IV following which she was also able to eat a little lunch.

Now Tanvir will have to recuperate from the weeakness and debilitation that will be caused and prepare herself for the next batlte. The second chemo has been slated for 6 July if all goes well. And all wii go well I know.

2006-06-14T16:42:00.000-07:00

Hi!

Today is the first IV chemo. Treatment starts at 9 am and will go on through the day in the intensive care unit at Hyderabad Nursing Home.

2006-06-11T21:24:00.000-07:00

It is a new working week and Tanvir and Tabbi are set for an appointment with the neurologist who Dr Srinivas advises they meet before the chemo on 14 June.

What must be reported is the party at Aghapura yesterday. On Sunday, Tanvir organised for her cousin Rafi's son Zayd to play the keyboard at which he excells with self taught ingenuity. Aditi Mukherjee and her daughter Kasturi were there. Unfortuately Tanvir's ward, Amina's daughter had to stay at home because she has broken out into measels and I left suddenly because of the sudden onset of a cold.

2006-06-08T07:07:00.000-07:00

Tanvir's sister, Tabbi, arrived this morning and her brother, Roofi is coming in tomorrow. They will be here at the time of the first IV chemo on the 14th/15th.

Sheel is back tonight from Delhi with good news for Spark which includes designer Vinay Jain's agreeing to do Teacher Plus design when the magazine, now owned by Spark-India, goes monthly in January 2007. Work on the Spark-India and Teacher Plus websites has got cracking and we look forward to moving ahead with the Azim Premji project in Madanapalle.

2006-06-07T06:15:00.001-07:00

We spent a day at "Sudarshan". The linear accelerator was not working, we were informed in the morning so there was no radiation. The last three radiations which started yesterday, target the cerebellum as a booster since this is the region diagnosed as most affected. Up to now the radiation was of the whole brain. Yesterday new markings were made on the mask using a simulator.

2006-06-05T12:23:00.000-07:00

We went for the last but third radiation yesterday. Dr Krishnam Raju, Chief Radiaton Oncologist, tells us that the TEMADOL equivalant regimen, if required later in the course of treatment, will only be five days a month. This will have to be used if the cancer cells in the brain have not been eliminated by radiation which cannot be repeated and since chemo does not pass the Blood Brain Barrier.

I have been surfing for insights into Ravi Dayal's life and work. He is represented mainly by the books he published. Understated in every way, Ravi was an editor first and most essentially. His manuscripts were still hand edited the last time I asked him. Ravi never worked on a computer.

2006-06-03T23:57:00.000-07:00

A day of gathering ourselves together for the first Monday in June; the month when the monsoon breaks; it has arrived early this year. There is a gentleness in the air. We will see a resurgence of life. Schools will reopen.

Today's post records my sadness at the news of eminent publisher, Ravi Dayal's passing away yesterday in Delhi within 24 hours of lung surgery for cancer. Ravi was in a class of his own, a cut above the rest in world publishing.

Ravi knew me more than I did him as he saw me grow in the publishing industry. I have his letter of recommendation, written in hand; I value the letter which places me in context where he knew me best - as a business competitor - and I cherish the important experience of having known him. I am with his wife, Mala, daughter, Naina, and Sardar Khushwant Singh, Mala's father, in their sorrow.

2006-06-02T07:09:00.000-07:00

Good news for Tanvir on the front of a medical therapy avenue opening by virtue of a gene she is identified ti have.

The test on the original biopsy block that was still available indicates that Herceptin can be included in the IV cocktail. Yo may also like to check HER when it was launched in India in 2004 and an update.

2006-05-30T19:42:00.000-07:00

It is a sad morning of connectivity for me in the virtual world of bipolar sufferers. Evie Bear, a known name in bipolar e groups, a nurse herself by training, lost her life to the hand of her own action. I learned about it on the message board today while routinely checking her whereabouts. Evie Bear was my first contact with alice and has provided sound advice and stability that is so very fragile. We joked about her being The Bipolar Bear.

Illness and disease. Bipolarity and Cancer

Tanvir has entered the last week of radiation. It has been a picnic thus far - what with idlis and juice, drives and sunsets.

The next phase IV chemo together with oral chemo continuing, is no cakewalk. The IV chemo will be administered in a three-week cycle starting 15 June. Tabbi will be here. So will Sujata Madhok from Delhi and her daughter Ragini.

2006-05-27T20:41:00.000-07:00

The day of rest and recuperation.

2006-05-27T05:34:00.000-07:00

I have not met Tanvir today.

Aditi spent the day at Agapura after the doctor's appointment she went to with Roofi.

Our e community is growing and old personal links are being re-establishised.

2006-05-24T15:40:00.000-07:00

A routine has fallen into place.

Tanvir spends the day at 'Sudarshan' participating in Spark-India's, now gently reassuring, humming activities. Tanvir, being Tanvir, makes everything work towards maximizing its potential and not weighing anyone down. Take the recent instance of first one and then both linear accelerators breaking down. (A linear accelerator, LINAC, is the device most commonly used for external beam radiation treatments for patients with cancer.) Radiation was rescheduled for the evening: an irritation causing interlude, with great potential for being a high priority event to justify a 'damn India', aside. Well, Tanvir wants to keep to an evening schedule now and is delighted that she can sleep off the 'woosiness' radiation causes at night and wake up bright eyed and bushy tailed to head to 'Sudarshan' for the day go for radiation as an evening outing.

Shyamala, our friend from Trichur was here for a couple of days. It was really good seeing you, Shyamala. Sabaahat, or Roofi, as he is known to many, is in Hyderabad but Tabbi, their sister Tabassum, has not been able to leave Chicago because, Mariam, Tabbi's youngest, a bubbling 10 year old little girl, hurt her ankle while playing with her brothers and cousins, all older. We hope all is well.

Today, Tanvir and Roofi are meeting Dr Srinivas with the blood report which...well...our lay eyes say, WBC count, RBC, Hemoglobin etc all seem O.K. there is something else and then there is a report due of the smear Dr Srinivas did himself the last time...we'll wait and watch. Aditi Mukherjee and Roofi will meet Dr Srinivas tomorrow.

2006-05-20T19:44:00.000-07:00

Exploring the Blood Brain Barrier

2006-05-19T18:31:00.000-07:00

2006-05-18T16:20:00.000-07:00

Hi!!

The last post was at the beginning of the week. All is going as it should be with Tanvir's care. I am establishing extensive connectivity...as I explore more and more, the electronic world of gizmos.

I checked the comments on the last posting and feel that there should be a more detailed update:

Dr Srinivas, whom we met on Wednesday, was encouraging (platelet and WBC counts stable; he is checking abnormal cells reported, himself as he also has an MD in pathology). He said radiation could continue; the 8th of 23 factions was administered yesterday. Treatment is continuing and Tanvir's spirits are high. As she says, " I can see, now, that I am not exactly unpopular".

Some popularity chart buster this!!

We all know what she means to us.

2006-05-15T05:52:00.000-07:00

A good beginning to the week.

Tanvir's first blood test reports came in today and to our lay but anxious reading and rereading, discussions over the phone, etc., etc., it seems to indicate that really we should consciously leave such things related to prognosis and interpretation to the medical team. Tanvir is fixing an appointment with Dr M. Srinivas for tomorrow. I will accompany her. Sabahat has fixed to come to Hyderabad starting the this week end and we should be able to coordinate and work together towards what is best for her care, which she will require more and more of we know, over the next few months. I hope that we will be able to provide this care consistently, such that she will be allowed ease herself away from being responsible for its direction.

2006-05-13T08:37:00.000-07:00

Hi!!

There will be more to add when I find the will to update. I have a weak end a head

I have read and seen over the last twenty years, the irredeemable damage that has been done to the ecosystem of our delicate planet, Earth. We have to preserve what we are left with. There is the most important wonder of the world of living things...the magic property…an unexplainable capacity of that which remains alive, to reproduce, regenerate and forgive for the damage it has suffered, caused by ignorance and selfishness or even disease and harm wrought by illness. This is an affirmation of life in the face of pending, galloping destruction.

Given above is my response to a Save the Amazon campaign that the young Indian Sufi singer, Dhruv Sangari, e-mailed in to us. Dhruv sang at @Sudershan on 5 February 2006 and we listen to recordings, over and over again, impatiently until the next winter afternoon's dream.

2006-05-11T21:10:00.002-07:00

Hi!

There were important issues concerning Tanvir's treatment and care.

One is of the role friends play among and with the other important players, especially doctors and family. Then we must not forget to mention the crucially important people in our lives who are there because they are in employment with us, Vijay, Mahinder, Lakshmamma, Amina and the numerous others who come in and do what is far more than the call of duty.

I met the doctor yesterday. I thought it was necessary because I had been there during the course of her surgery and treatment of primaries five years ago, and present in her care and follow up. Perhaps it is a matter of credibility. But that is and will remain an unresolved matter.

I started the conversation with the reply he had given Tanvir when she had asked about the prognosis when Aditi Mukherjee had met Dr M. Srinivas, to chart treatment: that she leave prognostification to him and the medical team. I explained to him that I would have to be an anchor in Hyderabad and am supported by Tanvir's many friends and well wishers. He was happy to be reassured of the support she had and emphasized its need in care and recovery.

I am happy to be accepted by Tanvir's 8O year old aunt, Baji to all, with whom Tanvir shares a house. I spoke to Tabbasum, Tanvir's youngest sister in USA . Tanvir has been in touch with both her and their middle brother, Sabahat, but she must now the responsibility of caring for herself, as she has over these last five years of remission will have to be offloaded from her.

According to Tanvir I love event managing and seem to be in my element. Perhaps I am just the anchor here as people will come and go taking their turns in caring for Tanvir as she enters the battle today with the first side effect raising its dragon head and being countered with the first side-effect control medication being prescribed. It is not likely that this blog will post further on that though it requires comment on how much discussion and speculation there is in bipolar circles regarding pills or meds as it seems is now the term. There is also a lot of self medication by those who suffer.

This requires real and serious participation. There are alternatives. My artist friend Sheba Chhachhi is using Tibetan medicine and testing the parameters of recovery from worrisome allopathic diagnostic findings using allopathic monitoring technology. Her's seem to have been worrying signs for which she would have immediately been put under the surgeon's knife, she says. Greetings and wishes to all those who walking on an alternative path, for good health, long life and happiness.

Tanvir doctors are gentle and understanding. Srinivas told her and Aditi Mukherjee, when they met him to chart out the course of action, to leave the prognostification to him and for the shoulder if she could bear the pain, it would be advisable not to radiate.

Tanvir messaged friends today and spoke to Firdausi in the morning. Firdausi lives with her family in Australia and she has said she has said she will come for as long as required. Surinder is coming on Sunday from Bombay to spend the day with us at Sudarshan, where Tanvir comes to spend the day after radiation in the morning. It is from here that Spark - India runs its office. Tanvir goes home every evening to relieve Amina who looks after Baji at Agapura

Tanvir has taken upon herself to teach and bring Amina's daughter, Asra, into regular English medium schooling from June. Asra bounces around looking after Baji all day whether Amina is there or not and Tanvir nabs her from play and pumps her with English through activity and all the other toys and games that she has a sand makes use of judiciously for joyful and effective rapid learning. Asra has been assured of a seat in Princess Esin Girls High School in June. We could have hoped for for better and the reassurance to Tanvir from Anwar that Tanvir should not feel stressed out on account of Asra, that she would take responsibility for Asra. Thank you everyone!!

2006-05-10T10:54:00.000-07:00

Hi,

This blog started as a kind of online CV, like a few others, though not many. Most of the bipolar blogs are very professional and I am wondering whether to try and link some here. There was a very flattering letter in my mail from a doctor Zia Nadeem asking to link her site. More work on that later but I was very excited.

Right now this is becoming like a daily diary - a journal which everyone recommends as the panacea of all problems and useful record for treatment, legal matters and research and reflection. I have never ever been able to discipline myself to do such journal writing, which the masters say is good discipline for developing writing skills which I have always wanted, least of all when I was depressed. I could. When I was manic the flow of words never stopped. I have never been on a money spending spree when manic but I have written and much of it shows itself up from time to time in tattered scraps of paper with scribbles or as in the last episode 2000, the year before Tanvir's cancer was first detected and treated, reams of computer printouts.

Patients often at first resist medication, as I did because, they fear it will deprive them of their energy. It does. But the balance for which right medication is essential lifelong makes it possible for us to work at shaping our energy.

2006-05-09T10:46:00.000-07:00

Tanvir's treatment for cancer secondaries starts tomorrow - radiation of the head for advanced and advancing met in the brain, secondaries beginning in both lungs and a bones' hot spot

2006-05-06T21:58:00.000-07:00

It is a new day and I have new e initiative(s) to share and invite your participation in and contribution to: a new mental health support group that may be of interest and music Password and User name will be emailed on request.

2006-05-06T05:46:00.000-07:00

I noticed my rather "extreme personality" in early adolescence. I am still extreme. I have become a virtual freak. Perhaps it is this passing off as a "trait" what may in fact be early signs of a disorder, that is a red herring in accurate and timely diagnosis and intervention. It sticks. This diagnosis of personality. I'm concerned and so is Tanvir that this is not escalation that may soon require medical intervention. There's enough reason to go to a virtual community and outsource e sufferers. But I am concerned about how this blog develops and gets used.

2006-05-05T03:09:00.000-07:00

Hi!!

Is anyone listening? Perhaps this self expression in a public diary is therapeutic. ..like medicines...whatever anyone may say, if your cocktail is working, stick to it.

One important comment that friends, Gita Ramaswamy and Neha Kumar made and I wrote to one person who had come upon "Bipolarity" at random and responded privately by e mail immediately, is that perhaps a blog is by its very nature a diary that is public. So I must make daily postings of happenings beginning today.

So here we are exploring the world of virtual sharing. I've joined Bipolar Disorder support groups, and chat rooms. There's been an explosion. I am cautioned that this may trigger an upswing.

Who knows.

There's reason enough to be stressed and look for diversion in a virtual community of e sufferers. There are unpleasant experiences, but that's no reason to give up. This discovery is not a new one, but blogging seems wonderful.

The photo posted is of Rahel who lives with her father, Giridhar and mother Rekha on the floor above in Sudarshan", the 70 year old colonial bungalow set in a compound in the heart of Hyderabad, India.

Soon we will have postings of others. Ashima Roychowdhury, a friend of 25 years from Delhi doesn't seem to know what "bipolar" nor is she really aware of what my problem is. Perhaps she should read my blog.

Check Andrew Solomon and Kay Redfield Jamison

2006-05-03T10:44:00.000-07:00

Like may other Bipolars, when I start on an upswing I talk excessively, in paragraphs, as someone said. This is the outpouring of doggerel that emerged from my chaotic mind with a semblance of insights before everything became garbled and I was hospitalised for the last time in 2002...

The Formal's Informal in Form

Given here below for reference
In tentative outline
Are words we use in English
To teach language all the time.

In sum, they're various parts of speech
Some adjectives, verbs and nouns
We pair them by their meanings
For sight, origin and sounds.

Couched well they are in nonsense rhyme
It suits our purpose fine,
Unbecoming it is for us to fuss
Or call the method mine

Teach school children how to pun
Word play to make our learning fun
They will always play and run
But there's work still to be done

No doubt they'll quit their screaming,
Perhaps they'll cease to shout
School's a place for dreaming
Turn all things inside out...

2006-05-03T03:38:00.001-07:00

TAKING CHARGE OF OUR BODIES,
A health handbook for women,

Veena Shatrugna, Gita Ramaswamy, Srividya Natrajan

Penguin India 2004

Interview 1998

‘My family took me to a psychiatrist because I was dancing around naked and weeping a lot… I needed care. I used to have depressions, followed by ‘highs’, one after another. During a high, I have excessive energy and feel extremely creative, but there is no staying power - a lot of ideas but no way of harnessing them. A lot of sexual energy… I usually feel great. It is difficult to predict or know if a mood (high or low) is coming on. When ideas are getting generated, I don’t know whether that’s creativity or my manias. I just can’t get a sense of which is which even after so many years. My parents usually come down when I’m high, but it’s generally too late., I’ve had a serious car accident, I’ve fallen off a building and suffered severe physical injuries, I start drinking uncontrollably. ‘I have no social life. I’ve given up jobs, I’ve not been able to cope with work, even friends have given up in the face of repeated occurrences. The doctor gave me Serenase, but I wasn’t warned about the side effects. I had lock-jaw-like seizures, which were as bad as the ‘highs.’ I’ve had Lithium which upsets my stomach badly . Now as I do my own reading, I know about the side effects. Presently, I’m on Valpirin to control the mood swings.

"Those who have experienced the prison of manic ecstasy will testify that the active support of those we love, meeting with others who have suffered similarly, honest factual information and a doctor who is capable of accepting our judgement are all vital in gaining a true acceptance."

2006-05-02T06:53:00.000-07:00

My friend and primary care taker.

2006-05-02T05:53:00.000-07:00

THE STROKES WITHIN,
‘Miscellany’, The Sunday Statesman Review,
31 July 1994.

RASOOL wanted to paint. "Everyone should paint" his parents said approvingly "and Rasool is talented". So Rasool started going to painting classes in the evenings after school. He was an eager student and learned quickly. He learned how to handle the brushes with care. He was taught that some brushes were good for thick strokes and others more suitable for fine strokes. He learned how to mix colours and keep the
palate clean to spray and to sketch.
Rasool was soon a skilful artist. His pictures had the right foreground, the required background and well balanced proportions. He worked hard and practiced regularly. He drew pictures of houses and bridges, animals and birds,insects and flowers. He studied the complicated structures of the human body and reproduced them perfectly. But Rasool was not happy.

"This is not painting", he would think to himself and when he spoke out his thoughts aloud his mother would reassure him that it was indeed. "Your are too much of a perfectionist, she would say comfortingly "that's why you are not satisfied" and untrue he'd think to himself as he continued to draw his pictures with care andattention.
But this is not the painting I want to do he'd tell his father. "You are too ambitious", his father would say "you are lucky to be in one of the best colleges of art", and Rasool would remain silent for what his father said was both true and untrue. And
yet there seemed to be more to painting than that.
Only Rasool's teacher said over and over again, "Rasool you must look to find form. There is form in the formless and in the formlessness there is form. You
must look to find the essence Rasool. That essence you will find if you look not only at the outside but within yourself...", and Rasool would argue that he studied his models in the greatest detail and she'd be silent.
"You really are very, very clever", Rasool's friends said admiringly when they saw his picture and they persuaded him to make souveniers and mementos, picture-
post-cards and greeting cards, portraits and landscapesfor sale. Rasool's work soon became very popular. He was an industrious worker. If there was a demand he
could supply and he looked at his work. His pictures were really quite pretty and they sold adequately.
"Perhaps I'll be happy if I sell more and more", he would think to himself. But all his heart and all his mind told him that he was not painting the way he wanted to paint. He worked hard and established his style. "That's Rasool's" people would say to one another.
Suddenly Rasool began to find that he no longer could work. His fingers grew stiff and his hands became numb. There is nothing wrong the doctors reassured
him. "Perhaps you are working too hard". But Rasool knew that the reason lay elsewhere. He could not see but his eyesight was perfect. His head felt empty. He
spent long hours gazing out of the window.
The window framed a tree crown and he watched the branches sway in the breeze as it blew and became still again when it stopped. The green buds on the tree flared into a brilliant orange in summer. The flowers withered away and fell. A koyal had its nest in the tree top and Rasool looked as it sang into the rain.
One day Rasool received a message from his teacher. She had grown old now, she said, and needed help. Would Rasool be able to take art classes ? Would he teach this boy, the carrier of this note ? Rasool laughed to himself. What and how could he teach he wondered.
Years had gone by without his knowing it. He had not painted a single stroke. Others had perfected the art on his behalf and the business carried on. He, now a well established name, wanted to learn to paint. Would his teacher teach him ? And even as he sent his teacher the message his memory stirred and her words came back to him.
"You must look Rasool", he heard her repeat. "Paint it over and over again. Each day it will be different. Paint until what you paint, your painting and you are one".
Rasool took the child's water colours and crayons from him. He sat up in front of the window which framed the Gulmohar tree and began to paint.

2006-05-02T05:34:00.000-07:00

A FEARFUL GIFT,
Hindustan Times,
11 January 1992.

"Hi. It's me," Nima's voice, rather too cheery came over the phone. "I felt like a chat."

"It's five in the morning Nima," Kshamil responded cautiously. "Is everything okay?" knowing that things were not in fact all right.

Nima had been feeling weller and weller with each passing day. She had energy and ideas more than she could sustain. Her weight had dropped. Her friends had stopped seeing her. She was irritable and impatient they said.

Kshamil knew from his own experience that this morning's cheer was yet another indication of a high.

"It's alright if you don't want to talk. I thought you'd understand," and the line was quickly disconnected.

Later in the day Nima called again to say she needed to see the psychiatrist and would Kshamil go along. In the evening when Kshamil went by her house it was locked. Nima had had herself admitted to hospital.

Haliperedol would contain the ecstasy. The Lithium Bicarbonate Nima had been on for five years would probably by continued in an increased dosage. Pacetane would contain the side effects both known and unknown. This was Nimas tenth episode. She had never, she said, felt the sense of hopelessness, self doubt, tearfulness and anguish that characterise depression.

Depression and elation are probably the oldest recorded emotional disorders and have been described by Homer and Hypocrites. Over the centuries come accounts inexplicable moods ranging from periods of prolonged joy to utter despair.

In 1854 Jean Falret, a French psychiatrist, published a description of a cyclical phenomenon "la folie ciculaire". In 1896 the German psychiatrist Emil Kraepehn proposed the name "manic depression illness" to characterise recurrent episodes of depression and elation. Today increasingly this phenomenon is being known as unpopular and bipolar mood swings in patterns of recurrent depression or recurrent elation (unipolar) and recurrent depression alternating with bouts of elation.

Kshamil's history had been charted as bipolar — long periods of depressive hopelessness followed by destructive ecstasy. He had broken out of the cycle and with it broken with all that had been his past security, plunging into a reality of the unknown present.

This was when Kshamil had had no option but to confront the 35 years of what had seemed to be cheerful adjustment. Without warning this changed to an emotional disorder — an illness — a horrifying damnation conjuring up images of violent unpredictability — sheer madness.

Sufferers and their families recoil when told the diagnosis. Coming to terms with it is a long and painful process. Doctors mentioned that it by just be physical — the production of lithogenic acid impaired.

In the 1940s while experimenting on the effects of the urine of manic patients on animals John Cade administered lithium to the guinea pigs to reduce the toxic effects of the urea. He noticed that the animals were quitened and making an inductive leap tried lithium as a sedative in excited patients.

This chemical element is closely related to potassium and sodium which are the most common metals occurring in the body's cells and fluids as components of dissolved salts. Carefully regulated within narrow limits because of toxicity, lithium quietened manic patients in one to three weeks. The effect was different from that of hitherto used sedation. It reduced excitement, slowed overactive thinking and decreased impulsiveness without causing drowsiness.

Further experiments indicated that its continued use prevents recurrence of manic psychotic episodes. In the course of these studies it was found that in-patients with bipolar disorders lithium acted as a mood stabiliser in both directions — preventing low as well as high swings.

Emotions result from a complex interaction between memories, current events and their personal significance. We cannot pretend to understand the nature of the mind, consciousness and those much-vaunted human attributes of will power, perception and judgement. What is abundantly clear is that they are easily overrun and made worthless by uncontrolled mood swings.

Explanations of the cause of these mood swings vary from the effects of the lunar cycle to the theory that seasonal mood changes are a carryover from the animal kingdom with depression being a form of hibernation. Twin studies indicate that genetic inheritance may account for up to 70 per cent of mood disorders.

A number of investigations into the effect of loss and stress in depression show that those with depression report three times as many stressful life events before their mood change as others of the same socio-economic background. There is evidence to support the idea that the loss of a parent during childhood is associated with depression in later life.

During the '80s Lithium was the preferred allopathic therapy for controlling mood disorders and preventing their recurrence, but despite its increasing use in psychiatry it had side effects: Toxicity, diarrhoea, vomiting, dehydration, weight gain, under activity of the thyroid gland and kidney malfunction.

Yet psychiatrists have begun insisting less and less on blood tests to scrutinise lithium levels and prescribing the drug more and more liberally despite the fact that it was commonly found that lithium may in fact have only marginal positive effects while producing toxicity in addition to one or more other side effects.

Less harmful than lithium in the bicarbonated form in which allopaths prescribe it is lithium in its trace element available abroad as a gluconate. Similar to homeopathic and biochemic formulations in its functioning, lithium traces are administered for periods of two to three months at a time and when the swing in one or other direction appears combined with homeopathy. This has been known to be beneficial and without side effects.

During the '90s and continuing today is the use of Sodium Volporarate and Carbamazepine.

What is crucially important is the accurate and timely identification of the swing.

While one bout of elation or depression casts a temporary gloom, for those dragged from pillar to post by recurrent swings of mood life becomes a walking nightmare. Bout after bout shatters their self-confidence and deprives them of family and friends.

"Why does she go on like this. I feel down too but have to keep going. If only she had will power. I don't understand her…"

Disorders are never a part of an individual's dreams. When it interludes into our lives our responses vary from rage to despair, conflicting as it dies with other aspirations, destroying all that we held dear, a mental battle follows. Each victim has to come to terms with the reality that this illness more than any other is a metaphor.

To have your mind and life within control once more becomes the object of living. Meditation and yoga, prayer and temperance, medicine and philosophy all find a place in this quest for the restoration of equilibrium and equanimity. But the single more important factor is support.

Even one relationship that remains undestroyed and unchanged represents the confidence that there is belief that things will be well again. A right balance of medication and therapy are crucially important but the support of friends, acceptance of a genuine kind are indispensable in rebuilding and living life once more.

Most people who have experienced the prison of manic ecstasy will testify to the fact that the active support of those they love, meeting with others who have suffered similarly, honest factual information and a doctor who is capable of accepting your judgement are all vital in gaining a true acceptance.

Mood swings are disorders of emotion and consequently emotional bonds alter. Those who have not suffered similarly find it hard to relate to the reality of the suffering. At first those around will encourage you to seek help, take an interest and be willing to invest their time and energy in doing what they can. Often these are frantic attempts born of guilt. As time passes they may lose heart in the face of prolonged or frequent swings. As your own understanding and sense of familiarity with your emotional states grows, liasing among family, friends and medical support become easier.

Understanding is the crux of the matter in the acceptance of this fearful gift that brings upon you realisation that your life is both your boundless and ecstatic energy and the prison of your meaninglessness and despair. Somewhere between lies the balanced moderation that constitutes normal functioning. Like the actor on the stage you return to it enriched by the realisation that in fact it is neither.