4 December, 2020

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Deconstructing Depression

By Annahl Anbini Hoole

Dr. Annahl Anbini Hoole (MD)

Sadness is a normal emotion we all feel reacting to difficult events in our lives. Sadness usually passes with time. Clinical depression, however, is a mood disorder. It is harder to deal with and can interfere with your everyday life. An often taboo subject in our country, it was recently brought into the limelight at WHO Sri Lanka’s and the Ministry of Health, Nutrition, & Indigenous Medicine’s Depression: Let’s Talk – an advocacy campaign commemorating World Health Day 2017. Depression is an illness, stigmatized by fear and ignorance; our cultural stoicism encourages us to either hide these symptoms or socially exclude those who cannot. Understanding depression is important to finding its cure.

WHO says 300 million worldwide suffer from depression with over 800,000 from Sri Lanka – compared to 400,000 in 2006. Although 1 in 8 Sri Lankans suffers from a mental illness, only 40% receive treatment. In 2014 WHO reported Sri Lanka as having the 4th highest suicide rate among 172 countries.

Like many Sri Lankans, Americans, and millennials, I grew up thinking “depression” was a fancy term for ingratitude or self-pity. The stigma surrounding mental health disorders leads people to hide their symptoms and refuse treatment. Mental wellness is not only important to each individual but to the whole country. Depression is associated with lower workplace productivity, increased mortality from suicide and other illnesses, and a higher risk for other mental disorders and substance abuse.

Presentation:

Major Depressive Disorder (MDD) is defined as experiencing 5 or more of these symptoms continuously for at least 2 weeks:

  • Feeling sad or anxious or hopeless;
  • Sleep changes –sleeping too much or too little;
  • Losing interest or pleasure in hobbies/daily activities ;
  • Change in activity –more or less active than usual;
  • Feeling guilty or worthless;
  • Decreased energy or fatigue;
  • Trouble concentrating or remembering, inability to complete activities;
  • Appetite or weight changes;
  • Thoughts of death or suicide.

If you are experiencing any of the symptoms above, please visit your doctor – diagnosis is best made by a mental health professional. Symptoms may present differently in different people. In women more typical symptoms might be sadness-anxiety with decreased energy; whereas men are more likely to be easily irritable, have difficulty concentrating, and more likely to turn to alcohol/cigarettes/drugs. Females are affected more than males. Elders are less likely to complain of being sad but more likely to feel worthless and complain of body aches/pains. Depression is common in older people, who are at higher risk for suicide. It is most common among25-44 year-olds; incidence decreases with age.

There are different types of depression: MDD, dysthymia (symptoms of depression that last 2 years with episodes of major depression and periods in-between of less severity), perinatal/post-partum-depression (depression associated with child-birth), etc..

Post-partum (meaning after-childbirth) depression affects 1-in-6 women. Along with symptoms above, you may experience feeling overwhelmed/unprepared, inability to bond with your baby, guilt, or feeling irritated/angry/resentful towards your baby or others.

Causes:

Depression is caused by chemical imbalance, but also a combination of genetic, biological, psychological, and environmental factors. Physical/emotional abuse, certain medications, death of a loved one, family history of depression, major life changes/stress (e.g. divorce, moving, losing a job), social isolation, medical conditions, seasonal changes, or substance abuse. Chronic conditions like heart disease, obesity, AIDs, dementia, Alzheimer’s disease, and cancer contribute.

Prevention:

Although there is no way to prevent depression, there are certain ways to help. If you are undergoing a stressful time, take measures to control your stress and get rid of negative thoughts, for example by talking to someone about it or through mindfulness meditation. Get help early and take measures to prevent relapsing.

WHO reported in 2014 that “As many as half of all mental health disorders start by age 14…most go unrecognized and untreated which later leads to serious consequences to mental health through life.” Suicide is the second leading cause of death in 15-29 year olds. An underestimated problem we have in schools and universities here is bullying(hazing/ragging). A study in Finland by Dr. Sourander (published in JAMA Psychiatry) found that within the study 20% who were bullies as children needed treatment for a mental-health problem as young adults and 23% who were bullied needed psychiatric help by age 30.  Thirty-one percent of the bullies and bullied had psychiatric problems, with the highest rates within the study of depression, anxiety, schizophrenia, and substance-abuse. A 2013 study at Duke University confirmed bullies and the bullied have a higher risk of depression, panic-disorders, and behavioral-education-emotional problems. Bullies are more likely to have been bullied themselves.

WHO reported that in Sri Lanka, 7% of adolescents (13-17 years of age) attempted suicide at least once, 9% considered suicide, and 39% experienced bullying (within the month preceding the research alone!).

Most Sri Lankan university students/alums I’ve talked to have experienced some form of hazing; it is too often treated as a common “rite of passage” done in good fun – eerily similar to Trump’s “boy talk” or “locker room talk”. Untrained teachers, principals, and advisors, havea detrimental effect on not only the students and institutions but on society as a whole. Teachers must be capable of spotting students needing help.

My experience shows how untrained teachers become part of the problem. At a Colombo school I had students tear up my books, throw my back-pack on the ground and step on it (in front of a teacher who laughed), lift up my uniform calling me a lesbian because I considered shorts underneath more decent, and had a principal insult my parents and family multiple times. When I complained about this to a teacher, I was told to pray about it; she asked prying questions about my home-life which she tried to convince me was unhappy, and told me that the bullying is likely my fault. I avoided school and disliked subjects I used to love. Thankfully I had a strong support system in my family and lovely American teachers and advisor in my Pennsylvania high-school whose encouragement has resulted in my MD. There are those less fortunate that the system in Sri Lanka has failed.

Listening and supporting your children and giving weight to their fears and emotions are important. If it is something you feel unequipped for, seek advice from a mental health professional.

Post-Traumatic Stress Disorder (PTSD):

PTSD, often accompanied by depression, is a disorder that develops in some after a shocking or dangerous event (e.g., war, tsunami); symptoms must last a month before being classified as PTSD. PTSD patients might re-experience the event through flashbacks or bad dreams, sometimes triggered by certain places or objects. They may avoid places or events or thoughts or feelings, feel tense and easily startled, or be prone to sudden angry outbursts, or have difficulty sleeping.  They may also have trouble remembering certain things that occurred at the time of the event, feel guilty or be negative, and lose interest in hobbies they used to enjoy.

Treatment:

A visit to your doctor or a mental health professional is the first step towards treatment. Although reading this article and consulting WebMD might make you feel you have depression, a doctor can properly examine and interview you to rule out any other illness that might present like depression. Take heart that when we read a textbook on mental illness symptoms, it might feel as if we have all of them. It is because many of these symptoms are normal and become an illness only when they are pronounced. This is why it is important to let a specialized doctor be in charge. Seeking help is the most important step. Depression, like diabetes and hypertension, needs proper treatment – it’s not something you can “shake off” or “get over,” and without proper treatment can lead to a relapse. Your doctor might recommend anti-depressants (which can take 2-4 weeks to start to work) or therapy, where you will learn to change any negative habits or ways of thinking. 

Of help are exercising, time with caring friends or relatives. Alcohol and illegal-drug usage worsen your symptoms. Most valuable is talking to a mental health professional. Most religious institutions, like churches, also offer help when needed. Help Hotlines you can call in Sri Lanka are:

SUWASARIYA: 071 0 107 107;

Sumithrayo: 011 269 2909 or 011 269 6666;

Courage Compassion Commitment Foundation: 1333.

If you know someone who is depressed, threatening suicide or self-harm, do not ignore it. Be understanding and patient, encourage them to take part in social activities, and most importantly do not disregard his or her feelings.

Because depression is also genetic, in our “arranged marriage” society, prospective spouses are reluctant to marry into families where the illness is noticed. Such families avoid treatment to contain gossip. This becomes a vicious cycle as non-treatment leads to worsening. Depression, like most diseases, is treatable and manageable and need not be hidden. Genetic is not synonymous for destined. Fearless, open conversation about mental health will promote awareness and encourage people to get help. Ignorance breeds fear.

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Latest comments

  • 2
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    It is worthwhile studying to see whether there is relaion between one’s religious beliefs and the individual becoming depressed.. Depression is common among those who believe only in materialistic world and the corresponding values. They want to be in the fast track rat race; if they could not conform to that they get depressed and think committing suicide because of the so-called failure.

    Long ago, the suicide was mostly among young lovers who would not be able to come together because parents were against the affiar. I think, now it is mostly those who can get through the exams and those who can not succeed in the life.

    Anyway, depression and suicides should be low among buddhists as buddhists are laid back (mahavamsa mindset), believe in karma, let the life go by, so accept most of the failures in life with equanimity. I think buddhists are good at forgetting life’s failures and proceed.

    Multinational pharamceutical companies also handle mental disorders only with medications which is not working. That is why Buddhist Psychotherapy, various meditation techniques are becoming popular among the westerners. Because, they prescribe the same tablet for every disorder and as soon as it is stopped, the person goes haywire and is worse than the earlier.

    In Sri lanka youth should be taught, the materialistic success in life is not everything and life is far more precious than that. Go to the rural areas to see or how simpletons live very relaxed lives without getting worried about what they missed.

    Buddhism has some thing called “vicissitudes of life” because of which people should not go to extremes.

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      How could then Buddhist people make more suicide than Muslim people in SL..study how many Tamil or sinhasles do suicidal attempts compared to Muslims in SL? It is your faith can guide you too …you do not have any fAith in hereafter life …next life …you will be in incarnations…so it Tamil and Sinhalese do not care about suicide…poor people I’m wrong side of belief..

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      There are lots of literature on religion beliefs and depression leading to suicide, particularly focusing on Budhism. I recall my former colleague Damien Keown did some research in Buddhism and suicide in 1990’s. It was published in ‘Journal of Budhist Ethics’ in 1996. I think the article is called “Buddhism and Suicide: The Case of Channa.”

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    Dr. Annahl Anbini Hoole,

    You can consider yourself lucky because you escaped to the USA.

    “My experience shows how untrained teachers become part of the problem. At a Colombo school I had students tear up my books, throw my back-pack on the ground and step on it (in front of a teacher who laughed), lift up my uniform calling me a lesbian because I considered shorts underneath more decent, and had a principal insult my parents and family multiple times.”

    At Jaffna College it is the teachers who in addition to wide spread corporal punishment (banned by the missionaries but introduced later when the missionaries left!) bully and mock the children. Unfortunately tearing an exercise book or practical work and throwing the pieces on a child is a regular event. So is insulting the parents of the children.

    The reason behind this ugly behaviour is totally untrained teachers and principals mostly chosen from the “walk in” category of friends and relatives of the existing staff.

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    I find the article very informative and written in simple laymen’s language.
    Tying religion or practice to episodes of depression is akin to violence is due the food one eats. Life is not as simple as that. Admittedly religious teaching and practise can contribute to the wellbeing but its not the panacea.
    In our part of the world there is a big stigma about depression and mental health. It is a taboo
    Some of the great personalities in the world to name one, Abraham Lincoln; One of best, if not “the” best president of America had suffered from depression from an young age and peaked when he lost his first love. There are others; Winston Churchill one of great war time leader too had suffered from metal illness from time to time
    In the West the attitude is changing, in that people do not write off a person because one had been depressed.
    Perhaps clinical depression would need different treatment to balance the chemical imbalance. I am no doctor!
    Happiness is the word. Pope Francis in his Good Friday this Easter gave an excellent sermon on Happiness. I suggest those interested to read same or perhaps I could add same in the CT column

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    Dr. Hoole,

    The article is well written, and thank you.

    May I add that there are other criteria for MDD which was not mentioned in the diagnostic criteria you provided:

    a) symptoms must cause clinically significant distress or impairment in social, occupational or other important areas of functioning. In other word: feeling sad everyday, insomnia, weight gain by 5%, fatigue etc for 2 weeks does not make you MDD UNLESS it affect your work or social network etc.

    b) Having the symptoms in you mentioned due to bereavement, financial ruin, natural disaster are not MDD. In other words, if you have most of the symptom after somebody dies, its not MDD.

    Also want to point out ‘chemical imbalance ‘ such as serotonin as a cause of depression is highly controversial. The pharmaceutical companies in the USA prefers chemical imbalance model. The president of American Psychiatric Association failed to provide evidence of chemical imbalance model when asked by team of psychologists. Even though SSRI works for depression in some cases, chemical imbalance as actual cause of depression is challenged by many well known studies.

    AJ

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      AJ
      Yes it is a very good article as I have mentioned in my previous post
      Your quote
      “Also want to point out ‘chemical imbalance ‘ such as serotonin as a cause of depression is highly controversial. The pharmaceutical companies in the USA prefers chemical imbalance model. The president of American Psychiatric Association failed to provide evidence of chemical imbalance model when asked by team of psychologists. Even though SSRI works for depression in some cases, chemical imbalance as actual cause of depression is challenged by many well known studies”.

      This is very true. The pharmaceutical industries the big 5 ,thrive on “ill-being” (to coin a phrase), misery , and not wellbeing. We have evidence in the 90s, how they ganged upon on the treatment for HIV and Aids by artificially hiking up the price, which meant people poor in countries couldn’t or able to afford the treatment. Until Bill Clinton (CHAI) with Bill and Malinda Gates intervened by getting cheaper generics from India.This another story for another day

      The cancer treatment is another classic one. Cancer is not a decease but a deficiency in B17, I believe and which you find in natural fruits such as Apricot.
      As for SSRI myth, it is a man made one; in that there is nothing better than our own immune and defence mechanism; the sheer ability of the body to adjust, given the right condition is literally amazing.
      You need see the root out causes before dishing the pills and in the process fattening the purses of owners of the pharmaceutical companies
      claiming patent rights for ever

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        I agree with you. The diagnostic criteria for MDD provided in the article was obtained from DSM 5 (the current DSM). Even the current DSM 5 states “Although extensive literature exists describing neoroanatomical, neuroendocronological, neurophysiological CORRELATES (emphasis added) of major depressive disorder, no laboratory test yielded results of sufficient sensitivity and specificity to be used as a diagnostic tool for this disorder” (p. 165).

        Even the DSM admits that there is a correlation, but no causation. Therefore to infer that depression is caused by imbalance in neurotransmitters, such as SSRI, is statistically and clinically flawed. In addition if it is indeed caused by such imbalance, we should be able to do a laboratory test to confirm that. But the DSM tactfully said there is no laboratory test without mentioning why.

        More importantly former president of American Psychiatric Association dodged the question when we asked her to provide evidence of chemical imbalance.

  • 0
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    Dear Doctor,
    Religious oppression was one of the predominant causes, out of two, which caused major depressive disorder in me. I’ve been dealing with it all my life. Just wanted to say that your explanation is accurate.

    Most may foolishly argue that spirituality and religion would inoculate against this. This only shows how much they really know.

    Thank you for voicing this.

    Afthab

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      [Edited out] Comments should not exceed 300 words.Please read our Comments Policy for further details.

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      in 3 parts please.
      She is writing stories for a job at who. whoo hooo even Theresa May a vicars daughter does not talk about funding further because it is of no use to the patients.
      Cognitive Therapy Or Yoga and Meditation Or Tai Chi which many Europeans travel for then get cured and come over teach- it works.
      It takes 14 years of university and clinical work even in the Uk to be a psychiatrist. 1.e 5 years as doctor and 9 years of psycho.
      We have all read Freud and Jung so we prefer the truth.

      Here is a true story of a woman- It’s what I call Mindfulness or 4th gem of Buddhism or 7th path.
      I cured a lifetime of suicidal depression after drugs and therapy failed. Here’s how:

      1.I realized I was surrounded by assholes and unsupportive people so I got rid of anyone who was abusive or contributing to my depression
      2.My biggest problem was my thoughts. I knew what I was thinking about all the time was what was depressing me and wasn’t working for me, but I didn’t know what to replace it with. I learned that cognitive therapy is changing your thoughts. I learned how to replace my negative thoughts with positive ones by focusing more on solutions than my problems. I knew what I didn’t want but very little about what I did want. I had to shift my time around and started spending more time creating a new life.
      Cont- in 3 parts please.

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      3.I started asking for people who exceeded my expectations, who were more than I thought I deserved, who were supportive and inspired me and had qualities and ways of doing things I admired and wanted to learn how to do for myself to show up in my life. I said things like “what would it take to have some great new friends to show up in my life?” When you ask questions out loud or in your head it will bring you answers and new awareness. Things you ask for, will start showing up. (You get what you think about whether you want it or not!)
      4.Having a support system is great, but I also began to realize I am enough. As soon as you discover this you’re well on your way to healing. When you become more confident and self reliant you will never feel alone again.
      5.I am are very powerful words. Pay close attention to what you say after those words because that creates your reality. You become the owner of what follows. Instead of saying “I’m by myself” like you did above you can say things like “I am capable of healing myself”.
      6.You know what’s best for you. Just ask yourself! What do I want? What’s the answer you hear in your head? Start trusting yourself and your inner voice.
      7.Make a list of everything you want in this new life of yours. You’ve probably spent a lot of time focused on what you don’t want, but if you really want to change your life, what does this new life look like? Where do you want to live, what do you want to do for work, what kind of lifestyle do you
      Cont part 3

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      want, where would you like to travel to… etc. Kind of like a bucket list. Dream big. As if money were no object and there were no obstacles in you way. What does your new life look like? Write it all down in a journal or I like to use the note pad on my phone and then I’d email it to myself for safe keeping and I could look back on it later to see how much I’d accomplished.
      8.You have the power to create a new life. Every day of our lives we make choices. Choice that keep us stuck where we are. Choices that set us back. Choices that move us forward. Take absolute responsibility for these choices and you now have absolute power. Where are you now? Where do you want to go? Become who you meant to be. How do you get there from here? By heading in that new direction, one step at a time.
      9.Sometimes what we think, feel and believe gets conflicted. I had to sort out things I learned growing up from what I believed was the truth. I rejected a lot of beliefs that were put on me from other people, my parents, teachers, family, friends. A book helped me sort this out. Living Through the Meantime
      10.I also learned how to put my ego into check and free myself from suffering with a book called “The Power of Now” by Eckhart Tolle. This shut down a lot of my negative self talk and killed my “pain body”.
      End.

  • 1
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    Yes, thank you for a good article

  • 4
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    Dr. Annahl Anbini Hoole (MD)
    There are no known drugs in the world to cure anxiety, pain, addiction, 100% poverty or too much of wealth.
    Anxiety and pain are interlinked.
    Faith and patriotism are the incubators of wars.

    How VR could break America’s opioid addiction
    Can virtual reality really soothe pain? Jo Marchant meets the doctors who say yes, and who hope this is a solution to the country consuming 80 per cent of the world’s opioid supply: the United States of America.
    ‘If cash or a gun isn’t safe there, your pain meds aren’t safe there’ © Parkin Parkin
    “It’s like a crawly feeling inside,” says Judy. “You get hot, then chilled, and you feel like you want to run away.” The 57-year-old has short dark-grey hair and a haunted expression. She’s breathless and sits with her right leg balanced up on her walking stick, rocking it back and forth as she speaks.

    Judy explains that she suffers from constant, debilitating pain: arthritis, back problems, fibromyalgia and daily migraines. She was a manager at a major electronics company until 2008, but can no longer work. She often hurts too much even to make it out of bed.
    Read more:http://www.independent.co.uk/news/long_reads/how-vr-could-break-americas-opioid-addiction-a7707866.html

  • 3
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    “”Deconstructing Depression””–Dr. Annahl Anbini Hoole (MD

    Recently at a hospital in Bristol England when a young white woman jumped off the cliff to death with her 4 day old baby. Good Samaritans, `Practitioner`Psychiatrist, Social worker and NHS all claimed that she `Was middle class, articulate, and took her life- something in the lines of Killary Clinton- I came I saw and He(gaddafi) died.
    We are waiting to see how the family of this woman takes up the case.(she was married to a young black man- perhaps seduced because her family neglected her)
    Why hundreds of women are suing the NHS over vaginal mesh surgery: ‘It felt like I had cut glass inside me’“I knew the minute I woke up from surgery that something was wrong,” says Dawn Martin, 55. “It felt like broken glass down there. I could barely empty my bladder. It was agony – and it didn’t stop. I called my GP in tears saying ‘please sedate me so I don’t have to be in this pain anymore’. I thought it would never end.”

    Martin, an advanced NHS nurse practitioner, is one of thousands of women who have had severe reactions to transvaginal mesh implants designed to treat pelvic organ prolapse and incontinence after childbirth. She had four children over five years in her twenties, and two decades later, found her incontinence was worsening. When she heard about the simple mesh, she hardly needed convincing.

    http://www.telegraph.co.uk/women/health/hundreds-women-suing-nhs-vaginal-mesh-surgery-felt-like-had/#comments

  • 1
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    I can nor remember the exact chemical name whether it is cortisol or cortisterol. Recently, one buddhist monk in SLBC explained how massaging, removes body stress caused by depression and how meditsation techniques helps. Certainly there are different types of depression by looking at the society.

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      Adrenaline, Cortisol, Norepinephrine are major stress hormones, they are produced when you are stressed, in order to prepare for ‘fight or flight’ mechanism. You must be referring to Cortisol.

  • 0
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    Abrham Linkon’s Depression like situations should be because of past life habits. I have seen similar people who are pakisthanis.

    There is one Dr. Brian Weiss, a Jew, A sergeon from new york who turned into a Psychiatrist and treated such people with past life regression.

    whether you accept or not, most of the people live their past lives in this life. PAst life is the habits you have in this life but you did not learn it from any one such as your parents, from school, from friends etc., but, you have those habits.

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      Brian specializes in hypnotherapy. Most branch of psychologists do not endorse hypnotherapy as it has been proven to be ineffective. The courts in the US does not allow hypnotherapy to stimulate memories of witness, because it has been shown to produce false and unreliable memories. But Brian remains popular in NY but a controversial character in other parts of the US.

  • 0
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    Can one “Deconstruct Depression”? May be understanding and dealing with it.

    Could not workout the relevance of “My experience shows how untrained teachers become part of the problem. At a Colombo school I had students tear up my books, throw my back-pack on the ground and step on it (in front of a teacher who laughed), lift up my uniform calling me a lesbian because I considered shorts underneath more decent, and had a principal insult my parents and family multiple times … ”

    Is this an exaggeration? One may conclude that Lankan teachers laugh a lot and have a wicked sense of humour!! Do all Lankan school principals insult parents all the time.

    In most Lankan schools students are teased because of lower socio-economic status, caste, religion etc. These student never see a doctor but tackle it through mental fortitude.

    AA Hoole adds “……. American teachers and advisor in my Pennsylvania high-school whose encouragement has resulted in my MD. .. ” If the American schools are that great, why do so much shooting take place?

    Depression is in the same league as feeling euphoric, happiness, sadness etc. – certainly not a mental illness.

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      Some people never get it do they? Bad reading by this Pilai of a very pertinent article . Is Pilai a bully who laughs at his child victims in school?

      Has he not heard of the case filed against the Former Principal of Sir John Kothalawela College in Kurunegala by the National Child Protection Authority over the suicide of a female student on charges of causing stress to the victim, by reprimanding her? Man never heard of the school boy who had no shoes to wear and was laughed at and he committed suicide? Insensitive.

      Thank you Miss Annahl for this article. There are many students as young as in grade 5 and middle school who are very stressed and have got back on track after some level of psychiatric treatment. They needed the help for the teachers were part of the cause.

      All teachers should receive compulsory training in running child-friendly schools. Even the Wardens and teachers from the so called religious private schools should be trained for there are mafias in the name of religion who keep the church related jobs, prefect-ships etc among themselves and bully the children of co-religionists-families not in their set. Like the recent St. Thomas’ Mount Lavinia case.

      Beware! NCPA itself has many racists in it.

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        Kamini
        I read the article alright.

        Yes, victims of bullying may suffer depression. Family support is the tool that works best. The last resort is a doctor visit – they will probably prescribe something.

        It is too much of a simplification to conclude that the Kurunagala incident and the shoe incident can be prevented by “properly trained” teachers.

        A A Hoole described a personal incident and I raised its relevance. She goes on to say that she went to Pennsylvania and found a teacher who listened to her. She implies that the family support was wanting.

        I strongly suggest that you read my comments again and try and answer as to the relevance.

        By the way you warn that NCPA (National Child Protection Association) “has many racists in it” Why not raise it with NCPA?

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      “”Depression is in the same league as feeling euphoric, happiness, sadness etc. – certainly not a mental illness. “”

      `Manic depression` is a mental health issue.–
      Hormonal problems – hormonal imbalances might trigger or cause bipolar disorder. Environmental factors – abuse, mental stress, a “significant loss,” or some other traumatic event may contribute to bipolar disorder risk.

      unlike some she is from a family that uses `faith` to get about .

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    Brian specializes in hypnotherapy. Most branch of psychologists do not endorse hypnotherapy as it has been proven to be ineffective. The courts in the US does not allow hypnotherapy to stimulate memories of witness, because it has been shown to produce false and unreliable memories. But Brian remains popular in NY but a controversial character in other parts of the US.

  • 1
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    There goes jimHARDLY, a qualified psychiatrist or a psychopath what or whichever fits the bill. If you are a qualified psychiatrist, please seek advise ASAP. Its time you do some serious learning and not studying.
    Please don’t expose your ignorance on a platform like CT. Serious people read the comments not your insular and your hateful comments about plantation people in upcountry.

    “I have seen similar people who are pakisthanis”. Another racist connotation to your argument. Is this warranted ?. A definite no is the answer

    Now you are an expert on Ab. Lincoln Hah…Hah . Read about him by himself. It might give you some insight about the great man. This may be bit too much for you!
    Stop your gutter politics and try to be hamane and human to your fellow beings. This is the best on the house advise you will get without seeing another psychiatrist . Good luck jh

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    Dr. AAH,
    For the most part a practical and useful article, well written in a style that many can understand. You were doing well till you got distracted and brought in Trump. :) Looks like you couldn’t help but to write some thing political and controversial to get some attention, like your father!

    K. Pillai,
    Regarding your question “If the American schools are that great, why do so much shooting take place?”

    You have to understand the enormous size and diversity of America to make sense. 90% or more of the country is similar to what the author describes. The rest of the 5% to 10% is what get’s reported in the news. Most American schools and universities are safe places where students never even think about being bullied or hazed. Also most schools provide trained and licensed counselors who can help students who need help with similar issues and they are all free. The students can get help without any of their friends knowing. The privacy laws applied to health related information is sacrosanct. People don’t worry what others will learn about them. This helps to get more people needing help to access it. Hope we can reach that level of operation in Sri Lanka one day. Thanks again.

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      Intrigued
      Thanks for enlightening me on the 90% of American schools.

      You accuse me of generalization based on what happens in the rest 10%.

      Did you see the rather unkind generalization by A A Hoole?

      Thanks for the pontification on the availability of licensed counselors in US schools. Americans complain that the service is inadequate.

      Yo say that in US the privacy laws applied to health related information is sacrosanct. I wonder. Whenever a person is shot dead by the US police, the victim’s records are almost immediately released.

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        K Pillai,
        I’m not accusing you of anything :) Just giving my explanation to your question with ground realities. Even if there is only 1% of the schools that have problem with shooting, that is terrible and I don’t want to minimize the problem. That is very well true and at the same time the authors experience is also true.

        Due to the size of the country and the way neighborhoods and cities have got structured over the years, many problems you see on TV are confined to certain pockets and majority of the population has no direct experience with such issues other than learning from the media.

        Regarding health records; What I said is true for people who are alive. In cases of murder or death, the local government and law enforcement can subpoena the person’s records and many times it’s leaked to the media or in some cases it becomes public records accessible by making proper request under the freedom of information act or some such thing. I’m not an expert on law or how things work in special situations. But this is not the case for normal living people in their everyday life. Hope that explains.

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    To me Buddhism seems to have generated Depression, when I was taught everything in life is useless and temporary – when I was around 15 years old. Basically I lost the energy and enthusism with daily events. I still feel same but then I had no courage to decide and give up Civil life and to become a Monk, but live almost everyday unhappily with a Family.

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      Nana you would be amazed to know that Buddhism indeed provides a remedy for depression. It is easier to live in a bubble but one day you will have to come out of it? Buddhism is the only path which provides complete peace in this life all other religions, one has to wait till one dies to go to heaven. Thru meditation one can reach a level of complete contentment. You seem to have either had a bad teacher of Buddhism or you have understood it wrong! Buddhism teaches four noble truth, stress, cause of it cessation and a path to reach it, just like a modern health professional who diagnose the problem, cause of it and then the s/he treats the cause of it. Buddha himself said when the snake is held from the tail it naturally bites if you hold it on the head you got a control of it. So please do learn the art of leaning something right rather than blaming the noble path which has helped so many millions and will continue to do so in the future too?? May you be well!

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        Dr Sunil
        The problem for many of us (including Buddhists) is that we expect supernatural intervention when in trouble. The Buddha did not dispense favours; nor did he dole out simple prescriptions or easy answers. So, people plead and pray and even offer bribes to gods.
        Answers to one’s problems are primarily within one. The realization of that noble truth is what Buddhism recommends.
        The Buddha also stated clearly that one should not accept something as true just because it came from him.

        To me, the best episode in Buddha’s life was his response to the woman who asked him to return her dead child to life: “Bring me a handful of sesame from a household that has not had a death”. The woman returned to the Buddha with her grief overcome.
        That piece of wisdom surpasses all the miracles that we are told about rolled into one.

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