1. How does one make time to be happy when there are deadlines to be met every day?

Constant stress is one of the major causes of depression. In the region of Okinawa, Japan’s southernmost region with a sub-tropical climate, there are about 50 in 1,00,000 people who are older than 100 years. Putting it more poetically than purpose, they refer to Ikigai as ‘the happiness of always being busy’. Everybody has an Ikigai. If we know what it is, it shapes our days. If we are unsure what our raison d’etre (the most important reason or purpose for someone or something’s existence) is, we still carry it in ourselves. And it is broader than our passion or desire. Instead, Ikigai combines four elements: what you love, what you are good at, what the world needs, and what you can be paid for. Individuals are part of a moai, or a support group of people with similar interests who look out for each other.

Finding your purpose:

One of the promises the book makes is that it helps find our purpose. The secret to a long life is not to worry. Choice is in your hands, the situation isn’t. A person is happy not because everything is right in his or her life. He or she is happy because his or her attitude towards everything in life is right.

‘Happiness’ tools:

( A) Plan your day in advance with a to-do list, which will help you manage time better.
( B) Do the difficult part of your exercise when your mind is fresh.
( C ) Set realistic long-term and short-term goals.
( D) Address your barriers.
( E ) Before sleeping, prepare your checklist and plan your next day.
( F ) Get adequate rest.
(G) Focus only on the positives.
(H) For any new task, prepare for the worst. Also, this shouldn’t hamper you from trying next time.

2. How can we inculcate self-confidence within ourselves?

(A) Practice who you want to be, to be the best version of yourself. Self-esteem is how you think about yourself as a person – how you treat yourself, and believing that you are good and worthy no matter what setbacks you face in life. So it’s not necessarily about being perfect, or having everything go exactly how you want. It is simply about being alright with yourself no matter what happens, or where you’re starting out, and being able to accept everything about yourself — both strengths and your weaknesses.

The difference between healthy self-esteem and narcissism is that the narcissist really doesn’t have high self-esteem. Narcissism is just a defense for low self-esteem. So a narcissistic person is busy making sure that nobody knows how badly they feel about themselves, and they do it by taking advantage of other people and putting other people down. But with healthy self-esteem, you feel good about yourself, you like who you are, you’re content with you who are, and you can also feel that way about other people. You don’t have to disrespect them to make yourself feel better.

(B) Do not be afraid to fail. The only way you learn is by failing; it is not the failure, but what do you do after you fail. Do you give up or does it boaster you? Keep challenging yourself by always trying to step out of your comfort zone, and be ready for failures. As Michael Jordan said, “I can accept failure, everyone fails at something. But I can’t accept not trying.”
(C) Keep no space in your heart for doubt. Choose faith in the power of God, hard work, love for your peers, country, parents who are working hard to give you their best. Choose excellence to the doubters and haters
(D) Prioritise yourself. If you don’t take control of your time and your life, other people will.
(E) Read and write.
(F) Be supportive towards one another. One person’s failure shouldn’t be your success.
(G) Know your own value.
(H) Empower yourself with a good education. Something better will happen if you are willing to work hard – remember the power of hope.
(I) Have fun!
(J) Be messengers of God through truth and compassion.

3. How does one deal with pressure to excel?

Do it for yourself. Expectations are hopes and beliefs that are focused on the future, and may or may not be realistic. A need is something that is necessary for healthy relating and living. A desire or want is a preference about something you would like to have or possess.
Maya Angelou said, “Do the best you can until you know better. Then when you know better, do better.” There are just so many unrealistic standards out there. By nature, we tend to make comparisons, so of course when a woman’s comparing herself to what she sees in advertising or the media, she’s going to wind up coming up short. She’s going to feel like a failure. And if her self-esteem is already low, she’s going to blame herself, and feel like she’s the reason she isn’t living up to this image of the perfect woman, who never yells at the kids has this high-powered job, does everything perfectly and balances the chores and the house work and all that. If you’re not doing that, you’re going to feel flawed and inadequate, and think it’s about you, rather than recognising that we’re bombarded with some seriously flawed and unrealistic advertising.
Perfection is not the expectation.

4. Is it necessary to be ambitious?

What is your definition of ambition? When can you walk the fine line between pushing the bar and feeling content? To quote Aristotle, there is “healthy ambition”, “unhealthy ambition”, and “lack of ambition”. Healthy ambition is individually enabling and socially constructive. People see it as the essence of progress, virtue and character Those with ambition take action, set goals and build meaningful things. While unhealthy ambition is inhibiting and destructive, and more akin to greed and the essence of corruption. Those with this ambition take from others, cheat, swindle and are ruthless in getting what they want. Without this ambition, it is synonymous with laziness. To me, it seems that the latter problems of ambition are mostly because ambition is a selfish pursuit. In other words, ambition is bad when it centers around your ego and self-aggrandizement. It could be from a creative urge. An ambitious novelist might craft an engaging epic because the vision pulls her forward. It could be from a desire to change the world for the better.

Confidence seems to be a common ingredient in ambition. Believing one can do things which are hard to accomplish seems to be a prerequisite for any kind of ambition.

Vision is also important. Being able to imagine an alternative state of affairs and create it in enough detail so that you can venture forward and realise it, is also essential.

Tenacity and persistence matter too. No truly ambitious effort will succeed without friction, so if you stop at the first sign of resistance, you won’t achieve anything.

5. How does one overcome guilt?

(A) People often judge themselves based on the blame or false accusations emanating from others, which they believe to be true.
(B) It’s common to take the blame for others’ behavior when we have poor boundaries or low self-esteem. Victims of abuse or sexual assault frequently feel guilt and shame, despite the fact that they were victims and it’s the perpetrator that is culpable.
(C) Guilt should be distinguished from shame, where you feel inferior and inadequate, Shame isn’t constructive. Instead of enhancing empathy and self-improvement, it has the opposite effect. You feel irredeemable.
(D) It is not unusual for people to feel guilty for not meeting the expectations of their parents.
Guilt causes anger and resentment, not only towards yourself, but towards others.

Dealing with guilt:

(A) A little guilt is good. Yes! Guilt actually encourages people to have more empathy for others, to take corrective action, and to improve themselves.
(B) Self-forgiveness following guilt is essential to maintain self-esteem, which is key to the enjoyment of life and relationships.
(C) It’s pointless to try to live upto someone else’s expectations. Others’ desires and values have more to do with them.

6. How to handle stress?

It is very important to train your mind to be positive.

– Accept your failures and take them in. Allow yourself to react.
– Don’t let a temporary setback define you as a failure.
– Be constructive and learn from the situation. Try to convert every situation good or bad into an opportunity. Ask yourself – what did I learn, how can I re-route, how can I do it a bit differently this time?
– Remind yourself that every time you try something valuable in life, you will definitely necessarily not succeed. Keep in mind, your sense of self esteem, purpose and to give your best to everything with passionate drive and focus.
– Be on a quest to learn something new every day. “Ever tried. Ever failed. No matter. Try Again. Fail again. Fail better.”
– Dabble in creative pursuits without fear.
– Have the courage to hold on to your dream and pursue it with passion.Make it your purpose by educating and preparing meticulously with dedication, pure intention, commitment, discipline and intelligent hard work.
– Remember the world comes around to help you.
– Have realistic expectations.
– Have self-love, self-confidence.
– It is okay to not be okay on certain days and situations.
– There is a force greater then you, which will guide you.
– Keep a place pristine in your heart, where no one can enter.
– It is your control, your choices to make in life.

7. By emotionally confiding in a someone, do we make ourselves more vulnerable?

A suicidal person is always communicating through his/ her cues – be it verbal, behavioural or cognitive. We do not listen. There is a window – for the psychiatrist to listen to a depressed person and prevent him or her from committing suicide. The exact cause of mental illness is not known. Studies show it is caused by a combination of biological, environmental and psychological factors. So no, it is going to make you stronger when you are talking about it and addressing it.

8. What is depression? Is there a means of finding out if someone is truly depressed, especially because people tend to use that term very casually today?

Everyone feels sad or irritable and has sleep difficulties once in a while. If these issues affect your ability to think, feel and handle daily activities, and if the symptoms last at least for 2 weeks, then the person maybe diagnosed with depression. It varies in severity as mild, moderate and severe, and could last anywhere from months to years. It is persistent, pervasive and interferes with your daily activities. You try to find purpose and meaning to your life. It is alright to be sad, but not to be depressed. It is alright to be afraid, but not anxious. It is alright to be angry, but not aggressive.

Specific signs of depression:

Verbal cues: “I don’t feel like living, I want to sleep and not wake up, I want to be peaceful, This life is not worth living, I don’t want to be a burden to anyone. If I’m gone other people will be happy.”

Behavioural cues: Insomnia or sleeping too much, tiredness and loss of energy, changes in appetite (decreased appetite and weight loss, or increased cravings for food and weight gain), the use of alcohol or drugs, agitation or restlessness (for example, pacing, hand-wringing or an inability to sit still), slowed thinking, speaking or body movements, frequent complaints of unexplained body aches and headaches, which may include frequent visits to the doctor, social isolation, poor school performance or frequent absences from school, lesser attention to personal hygiene or appearance, angry outbursts, disruptive or risky behavior, or other acting-out behaviors, self-harm (for example, cutting, burning, or excessive piercing or tattooing), making a suicide plan or a suicide attempt.

Psychological or emotional cues: Agitated, restless, not interested, repeated thoughts of suicide, fFrustration or feelings of anger – even over small matters, feeling hopeless or empty, irritable or annoyed, loss of interest or pleasure in usual activities, loss of interest in, or conflict with, family and friends, low self-esteem, feelings of worthlessness or guilt, fixation on past failures or exaggerated self-blame or self-criticism, extreme sensitivity to rejection or failure, and the need for excessive reassurance, trouble thinking, concentrating, making decisions and remembering things, an ongoing sense that life and the future are grim and bleak,frequent thoughts of death, dying or suicide.

9. How can I speak to and help someone with depression? What is the best thing to say or suggest to a person under depression who has approached me?

Suicide is a permanent solution to a temporary problem. Life is not about how we handle our success but about how we handle our failures. In acute phase they have a sense of three feelings – loneliness, helplessness and hopelessness.

80 percent say it out loud but we seem to not listen. Sit down and talk to them. Sometimes they aren’t able to acknowledge it. Listen and validate what they are going through with empathy and open-mindedness without being judgmental. Frame them around what they are going through. Address learned helplessness – like a pressure cooker, the moment they release their thoughts, it simmers.

– Do not compare.
– Reach out (Talk) and refer.
– Educative institutions need to be aware and provide support in a positive manner
– Increase your inner resilience
– Make the youth understand that depression or other mood disorders are not ‘mental illnesses’ and there is no stigma attached. It is a temporary normal phase and they will get over it.

For those suffering:

Don’t wait too long to get evaluated or treated. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications (pharmacotherapies), psychotherapies, brain stimulation therapies and other methods can effectively treat people with depression. It may be extremely difficult to take any action to help yourself. But as you begin to recognise your depression and begin treatment, you’ll start to feel better.
– Try to be active and exercise.

– Try to spend time with other people and confide in a trusted friend or relative.
– Expect your mood to improve gradually, not immediately.
– Opt for coping skills and behaviour therapy

10. Apart from therapy, are there any alternatives to deal with depression?

Just as you may sometimes feel sad, occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety doesn’t go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships.
There are several different types of anxiety disorders that include generalized anxiety disorder, panic disorder, and social anxiety disorder. Some physical health conditions, such as an overactive thyroid or low blood sugar, as well as taking certain medications, can imitate or worsen an anxiety disorder. Anxiety disorders often occur with other related conditions, such as depression or obsessive-compulsive disorder. Anxiety disorders are generally treated with medication, psychotherapy, or both. Some people might benefit from joining a self-help or support group, while others use stress management techniques and meditation.

11. How important do you think, would be the role of mental health professionals during the ‘New Normal’ (post-COVID)? Considering the stigma that surrounds this discipline in our country, do you think it can be brought into practice? Would people be willing to reach out for help as they try to cope with whatever is happening?

One of the foremost concerns emerging from the different aspects of COVID-19 is its impact on mental health. We need to strengthen telemedicine facilities to provide tele consultation to patients. As a result of COVID-19, online support has become a necessity. People are dealing with stress and anxiety related to their health, financial situations and isolation (with and without taking care of kids and managing to work at the same time) but are not able just to step outside of their home and seek support. In this vacuum we see the rise of online services – from hotlines and online psychotherapy, to newly emerging peer support and facilitated groups platforms. We are currently experiencing acceleration of the development and adoption of remote emotional support, but this is just the beginning. These services will be here to stay, long after we overcome the current pandemic.

Feeling a sense of stability in these difficult times:

– Train your mind to focus on positives. Avoid media, forwards and social media addiction
– Build inner resilience
– Practice a healthy lifestyle
– Pursue hobbies
– Use this time and energy to learn something new.

Not getting affected by bad news and preventing anxiety about the future:

– Build a structure and routine to work from home. Invest time productively into personal growth – courses, hobbies (painting and dancing in particular) and productive time with family that includes indoor board games and infotainment.
– Be extremely positive and productive.
– Reach out and help the community where ever possible..Offer support with PPEs, HPEs, weekly food packets, online counselling and so on.
– Avoid smoking
– Adopt a positive frame of mind by mindfully working at it. It is like exercising your physical body. Steps are to taken to exercise your mind positively with steadfastness and patient endurance.
– Exercise in the form of HIET or brisk walking for 40 minutes 4 to 5 times a week. This releases happiness hormones like endorphins and seratonins.
– Eat foods that boost one’s immunity like Vitamin C, Vitamin E, Zinc, Selenium, Calcium, Manganese and Magnesium rich food.
– Get 7-8 hours of sleep.
– Maintain ideal normal weight.
– Consume alcohol in moderation.
– Practice meditation and yoga
– Try out a new hobby.

12) What are your thoughts on inclusion about mental health education in schools (at the primary level itself)?

The psychological impact of this disease on the youth is manifold. There are anxiety disorders, fear, exhaustion, thus leading to rebellion and failure to practice social distancing. Only time will tell what the long-term effects on the youth are – from increased screen time, lack of outdoor exercise and overeating, decreased quality time with parents, lack of physical contact with peers and teachers, missing out on structure and routine, and in some cases, an increase in verbal and sexual abuse. Take this opportunity to create a new world.

These notes are part of Dr Renuka David’s webinar lecture at the WCC in Chennai. No part of it may be reproduced without her permission.