This article is part of Second Thoughts, a series on mental health in India.
Almost exactly a year ago, I went on a Tinder date. T and I were both nervous. Our hands shook when we reached for the coffee. Strangely, though, we spoke with the candour of friends. I brought up my bipolarity. We talked about depression, anxiety and suicide. I had never thought mental health could be an icebreaker, but there I was, delighting in my every confession. I laughed heartily.
To T, I must have come across as someone who enjoyed his mental illness. On that day, she would have been on point.
My publishers had released my memoir, How to Travel Light, in October 2017. In it, I had documented my decade-long struggle with bipolarity. A few readers said I had been brave and courageous. My own joys, however, had more to do with vanity. I had written a book. The reviews largely suggested it had been well received. I had been invited to some literature festivals, where I had spoken about my ordeals with humour. I’d drawn a line. Once understood, my bipolarity was almost innocuous.
Sitting on T’s couch, day after day, I tried to hide my conceit. We had chosen friendship over intimacy. My initial disappointment gave way to relief. I wanted this relationship to last. I did not want to let her down.
At work — I was the editor of a reputed travel magazine at the time — I impulsively decided to forsake stability for ambition. “I don’t just want this to be the best travel magazine in the country. I want it to be the best magazine,” I told my already stretched team. Though I hadn’t forgotten my psychiatrist’s prescription — “You will sleep for seven hours every day” — I began flouting it.
There was always some work that needed to be done. On the odd occasion, I would even forget my morning dose of Lithium.
At T’s house, somehow, the stress didn’t affect me. In March, she told me she would like to take our friendship to the next level. By then, I hadn’t slept soundly for a week. Giddy with happiness, I found a fresh excuse to stay up, telling an old friend, “I don’t want to sleep because if I do, I think she will disappear.”
Sleepless and increasingly impetuous, I left Mumbai to make a pitch for my magazine in Delhi. I was prickly enough to leave the meeting halfway. “I’ve heard enough. I think we’re done,” I told a stunned executive. Even my bone-headedness had to have some swagger. I was already in the throes of mania when I returned home. I stopped near a slum to buy cannabis. I was rolling a joint when the bell rang.
Disturbing the peace
Though confused to see three friends outside my door, I felt glad to be remembered. When they said they were staying the night, I didn’t think it was because they didn’t want to leave me alone. I thought we’d be able to have the party I suddenly craved. I hid the marijuana in a place where no one could find it. These friends had seen how the drug had turned my life upside down. More importantly perhaps, they had read my book. My bipolar mind couldn’t handle the turbulence of cannabis. They knew that only too well.
T was out of town. I missed her, but her absence also meant I had no fetters. When my friends were asleep, I stood by my window and smoked my stash. By the next morning, I realised they were keeping vigil over me. Having divided the day into shifts, they passed on the baton of my wellbeing to each other with a cheeriness I found infectious.
“The force and restraints used on me seem, perhaps, like an obvious violation, but I had become a danger to myself and those around me.”
Reading How to Travel Light, I declared to my friends, “This needs an update.” I wanted the prose to be crisper, but they had mistaken my disappointment for self-awareness.
I locked myself in the bedroom and impulsively began calling former employers and ex-girlfriends. I was yelling at my parents over the phone. I was punching my fists against the wall. My mania was apparent to everyone but me. In ten-odd years, I had never tried to harm myself, but this time, I stood in front of my mirror with a chopping knife, wondering which incision would hurt less, one made from left to right, or the other way around. When a friend interrupted me with a knock on the door, I pinned her against the kitchen wall and bludgeoned my head with a wooden spatula. She took the sharp objects from my house over to her place.
Until then, my mania would usually take weeks to spiral, but this time, I was intractable in just a few days. I had alienated my psychiatrist in Kolkata, and when it became clear I was going to be institutionalised, I began slapping myself uncontrollably. When the doorbell rang, I was already kicking and screaming. I shoved a doctor and bit an orderly. They tied my hands, dragged me down the stairs and pushed me into an ambulance. In there, three men held my feet and shoulders. As the vehicle began to move, I saw a friend give chase. He wanted to give me my slippers. He was right. I’d need them.
In the past nine months, I have gone back to that day often, sometimes obsessively. It’s both easy and clichéd to think of myself as cattle. The force and restraints used on me seem, perhaps, like an obvious violation, but I had become a danger to myself and those around me. I had forgotten the rules that govern society, and my loved ones were being kind in wanting to remove me from it temporarily. Once inflicted, though, violence has a habit of making victims. I am no different. I still ask if bouncers should be more humane.
What goes around, comes around
Without a watch, it was hard to keep time in the Institution. When the yoga teacher walked in, you could guess it was 7:45 am. The lunch bell would go off at 12:30 pm, and every afternoon, at around 3:30 pm, you’d hear Chotu’s wails. Though he was in his 40s, Chotu looked 16. His body and mind had both failed to develop. The guards, it seemed to me, took some pleasure in bringing Chotu out of the ICU every day. They tied him to a chair that was placed squarely beneath the scorching sun, and for the next hour or two, they would laugh as Chotu struggled against his restraints and pleaded for help. Seeing me aghast, one of them told me, “If we don’t do this, he will only scratch his face till it bleeds.”
The Institution was first and foremost a rehab. Within a day of my arrival, I was befriended by an alcoholic businessman. I began hanging out with a bunch of kids in their early twenties. They had all been caught smoking weed by their parents and some of them, after being admitted to the Institution, were diagnosed with Borderline Personality Disorder (BPD). The girl in the room next to mine would cry inconsolably on some afternoons. Her thoughts, she confided, would unexpectedly take a suicidal turn.
Two weeks later, I felt I was over the hump. My manic behaviour, I told myself and the Institution’s therapist, was an aberration. I had too much going for me. I would not make the same mistakes again. Even though smoking cannabis was an effect of my mania, not its cause, I earned some trust when I promised I would abstain forever. A week later, my parents arrived to take me home. I’d missed them.
I sobbed when I saw T. My eyes welled up when I met my psychiatrist. My colleagues stood by the office gate, waiting to welcome me with a banner and music they played on their phones. I was again overwhelmed. My employers were welcoming. I had my job, but my nerves were brittle and frayed.
T came to spend the weekend with me. It became hard for me to hide the fact that my sleep was still patchy. My mood oscillated between euphoria and irritability. She could not get in a word edgeways.
Spending Sunday night with friends, I felt light-hearted. But within minutes of them leaving, I turned irate. I accused T of insensitivity and callousness.
“You don’t know what pain is,” I shouted at her. I began ranting about being sexually abused as a child. I even invented an infraction or two. Eyes wide, nerves taut, I asked T to leave my house. She refused. When she had locked herself in my bathroom, frantically asking my friends for help, I pounded the door. She said she’d leave on one condition — that I take my pills. I did, and she left the house. Home alone, I was impatient. At 2:30 am, I decided I’d go get a coffee.
T hadn’t left. She was standing in my building’s foyer. As I walked past her, I could see an ambulance parked on the other side. I kept walking. Before I could leave, however, a bouncer came from behind and clasped his hands around my chest. We knew each other by our first names.
“I typed my resignation letter, trying desperately to regain some control of a life that was fast changing.”
I walked into the ambulance without protest. From where I sat, I could see two of my relatives standing outside. I started bargaining. “Take me back to your house.” I then grew dramatic. “Send me back to Calcutta. I’ll never return.” Only T climbed into the ambulance with me. “Don’t wait for me,” I whispered in her ear. “I won’t come back.”
Within a week of being released, I was back at the Institution. Stunned by my own horror, I broke down. I once wailed so loudly, the guards confined me in the ICU for a day. I was inconsolable. By the time the doctors saw that my tox screen was clean, I had decided to quit my job.
“I fear I have exhausted my second chances,” I told my therapist.
I typed my resignation letter, trying desperately to regain some control of a life that was fast changing. My parents, I learnt, had informed my landlady I would not be renewing my lease. She was glad. I’d become the subject of some gossip in my neighbourhood.
T, I knew, had packed the box that was delivered to me three days after I had returned to the Institution. Along with my shirts and shower gel, she’d sent for me Tibetan prayer flags and six of my books she knew I treasured. Sitting on the armchair outside my room, I began devouring these books, three at a time. It was while reading Antonia Macaro’s More than Happiness: Buddhist and Stoic Wisdom for a Sceptical Age that I was able to make a breakthrough. Macaro, an existential psychotherapist herself, points out that it was a saying by Stoic philosopher Epictetus which laid the foundation for Cognitive Behavioural Therapy (CBT): “People are disturbed not by things, but by the views they take of things.”
Even if, unconsciously, my mind was looking for an anchor, I had had enough of chaos. Epictetus, I thought, wasn’t too shabby a fixation.
The Institution’s therapist, also a CBT practitioner, had told me she would want to work on my memories of abuse. “I want to know why you bring up your abuse every time you are manic,” she had said. She looked delighted when I told her, “All I know is that I was abused for four years. It was a terrible thing, but I make it worse by harping on details which are honestly a bit murky. Take sodomy, for instance. I’m not sure if I was sodomised, but I feel as if I was.”
Though aware that all my life’s circumstances had taken a turn for the worse, I had begun to enjoy my isolation. I was trying to narrate to myself an account of my days that was not coloured by either exaggeration or sentiment. My therapist, though exacting, was also compassionate. Every time she met me, she would ask me to repeat after her, “I’m not special.” I’d begun to feel free of expectation.
My second stay at the Institution lasted a month. Even Chotu’s cries did not bother me. When my therapist told me my parents were coming to get me, she gave me one last exercise. She asked me to list my rational and irrational beliefs and wants. Under ‘irrational wants’, I wrote, “I probably don’t deserve it, but I wish T and I would be together. I really wish she would stay.”
Why I will not ‘survive’
In the past six months, I have jumped every time the doorbell has rung unexpectedly. My epiphanies at the Institution, I realise, have not brought my subconscious the closure it needs. Ever so often, I dream I am being abused again. Earlier, I’d be on the lookout for thoughts that were conspicuously manic, but with that project having failed so disastrously, I now try and monitor my every thought. My mindfulness is conditioned by my fear. It is hard to think of a day I am unworried.
“By not acknowledging pain and suffering, we are turning a blind eye to the trauma and violence of mental health disorders.”
This, regrettably, is the kind of stuff my therapy sessions are made of. Before finding a CBT practitioner who had the empathy to prop me up when I am at my lowest, I had seen three other therapists this year. When I told one psychoanalyst I’d grown tired of freelancing and had decided to look for a job, she asked, “But who is going to give you work? Hasn’t your career been interrupted too often?” Days later, after aborting my job search, I did see her point. I didn’t need to be employed to have agency.
Driving into Bandra one night, I was pleasantly surprised to see that an NGO had bought billboard space to spread mental health awareness. The fine print, however, was troubling. I felt irked that participants of the campaign had been called “survivors”. The word seemed to suggest that clinical depression, BPD or bipolarity were all one-time freak occurrences, similar perhaps to a natural disaster. Once survived, they could be beaten. I wanted to scream at the poster, “You suffer mental illnesses. You don’t survive them.” I stopped myself. That gesture would have been worryingly manic.
India’s fledgling mental health discourse is at risk of becoming a casualty of correctness. To be a ‘survivor’, you must have the capacity for social levity and economic productivity. Of the 150 million Indians who, according to NIMHANS, need urgent mental health intervention, most are sadly sufferers.
By not acknowledging pain and suffering, we are turning a blind eye to the trauma and violence of mental health disorders. In our efforts to banish stigma, we are doing a disservice to patients whose everyday struggles are anything but ordinary.
Living in milieus that prize constant functionality, being dysfunctional for a week or even a month can quickly turn a temporary crisis into a full-blown disaster. Conformity brings with it a stress that can sometimes surpass the pressures of sudden and great expectations. For us to be empathetic, and more importantly, for a society to be just, we must allow the afflicted their interruptions.
Usually, one needs to be privileged in order to manage a mental affliction, and there are, of course, some lessons we can learn by emulating the forbearance of the fortunate. Most Indians, however, are being denied the care they need. With ‘Second Thoughts’, my HuffPost India series, I hope to see how sufferers are surviving the absence of assimilation and of mental health systems.
Reporting on mental health can be upsetting, but T, I think, is getting used to my brooding. She occasionally makes me coffee when I sulk. My hands still shake when I reach for the cup. These days, though, it’s more Lithium than nerves.
Shreevatsa Nevatia is the author of How to Travel Light, a bipolar memoir.
This article is part of Second Thoughts, a series on mental health in India. Write to us here: firstname.lastname@example.org
If you or someone you know needs help, mail email@example.com or dial 022-25521111 (Monday-Saturday, 8am to 10pm) to reach iCall, a psychosocial helpline set up by the Tata Institute of Social Sciences (TISS).