Depression Treatment Options


However the client should be aware of the treatment options so that he /she can discuss with the consultant. Broadly speaking, the treatment of depression rests on two factors Medication, and Psychotherapy or Counselling.

  • Medication is required for moderate and severe depressive disorder cases.
  • Counseling and psychotherapy serves as an edge in treating depression and need to be started simultaneously along with medicines.
  • You should continue the full course of psychotherapy even if you are feeling better to prevent a relapse.
  • Suddenly stopping antidepressants can precipitate a relapse. Medication needs be tapered gradually under your doctor’s supervision.

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ACID ATTACK AND ITS IMPACT



In a male chauvinistic world, woman is considered to be the property of man. Be it a spurned lover, a suspecting husband or a man who is shooed away when he wants a relationship, each feels humiliated and wants to take revenge against the woman. The easiest way to hurt the woman in such instances is throwing acid on her. It makes the man feel immensely and rather sadistically satisfied if the woman is disfigured. Experts believe that the foremost reasons behind this barbaric act are easy availability of acids and illiteracy among the masses. The overwhelming majority of the victims are women, and many of them are below 18 years of age. These attacks are often the result of family and land dispute, dowry demands or a desire for revenge. There are umpteen instances in history of how women were treated in times of war or conflict. With the advent of industrialization and inventions, acid has come handy to these egotists in their bid to disfigure women. Acid throwing could well be described as the attempt to control or subjugate women.

Victims of attacks not only undergo severe physical trauma but also traumatic changes in the way they feel and think. Psychological trauma is caused by both what the terror victims suffer during the attack, as they feel their skin burning away, and what they suffer after the attack with respect to the disfigurement or disabilities they have to live with for the rest of their lives. Victims suffer psychological symptoms such as depression, insomnia, nightmares, paranoia, and/or fear of facing the outside world, headaches, weakness and tiredness, difficulty in concentrating and remembering things, etc. They feel perpetually depressed, ashamed, worried and lonely. Usually, acid burn victims suffer severe psychological symptoms for years, if not forever, because they are constantly reminded of the violent act by their physical scars. The feeling of lack of hope and worth may never leave them.

Social and Economic Consequences
Acid burn victims face a lifetime of discrimination from society and they often become lonely. They are embarrassed as they think people may stare or laugh at them, and may hesitate to leave their homes fearing adverse reactions from the outside world. Victims who are not married are not likely to get married and those who have suffered serious disabilities because of an attack, like blindness, will not find jobs and earn a living. Discrimination from other people, or disabilities such as blindness, makes it very difficult for victims to fend for themselves and they become dependent on others for food and money.
It has, therefore, been argued that acid attacks need to be classified as a separate offence and harsher punishment needs to be prescribed. It has been further stated that the new law must include guidelines for handling/supporting victims economically, socially and psychologically, and provide compensation. In fact since acid is so readily available across the counter in medical and other stores, acid attacks are a relatively cheap and effective way of committing acts of violence against women. Buying hydrochloric acid is as easy and cheap as buying a bar of soap; a litre of acid costs anywhere between Rs. 16 and Rs. 25.
There is, however, no law to regulate acid sales except for the Manufacture, Storage and Import of Hazardous Chemicals Rules, 1989 (amended in 2000), and this only applies to industrial situations. Furthermore, there are no regular inspections and stock checking for acid sales as there are for explosives. It has been argued by some that controlling or regulating acid sales is an impossible task, as acid is used for many things including car batteries, etc. Thus, the deterrence should come in the form of stringent laws that punish the perpetrators. However, Bangladesh, a country with the highest incident rate of acid attacks, has passed a law in 2002 to control acid sales. Thus, acid violence can be tackled on both fronts simultaneously with harsher punishment on the perpetrator and control over the sale of acid to stop it from getting into the hands of criminals. International commerce of sulphuric acid is controlled under the United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988, which lists sulphuric acid under Table II of the convention, as a chemical frequently used in the illicit manufacture of narcotic drugs or psychotropic substances.
Nitric or sulphuric acid has a catastrophic effect on human flesh. It causes the skin tissue to melt, often exposing the bones below the flesh, sometimes even dissolving the bone. When acid attacks the eyes, it damages them permanently. Many acid attacks survivors have lost the use of one or both eyes. But the scars left by acid are not just skin deep. In addition to the inevitable psychological trauma, some survivors also face social isolation and ostracism that further damage their self-esteem and seriously undermine their professional and personal futures. Women who have survived acid attacks have great difficulty in finding work and, if unmarried (as many victims tend to be), have very little chance of ever getting married. In a country like India this has serious social and economic consequences. The New York Times (Dec, 26, 2001) reports that kerosene as well as acid has fast become the weapons of choice for attacks on wives in India. The major victim of attacked is Women(47%) and Men(26%). Children(27%) could not escape from the attack. Sometimes domestic animals or birds are also victimized. The sad fact is that women who have been victimised by these attacks are mostly at the hands of someone known and close to them.
Landmark Judgement
Referring to the compensation to acid victims, the Law Commission, headed by Justice A.R. Lakshmanan, quoted the landmark judgement of the Honourable High Court of Kerala in the State of Karnataka in the Jalahalli Police Station vs. Joseph Rodrigues case (decided on 22 August 2006) wherein the accused was convicted under Section 307 of the IPC and sentenced to imprisonment for life. A compensation of Rs. 2,00,000, in addition to the trial court fine of Rs. 3,00,000, was to be paid by the accused to the victim’s parents. The acid attack deeply scarred the victim’s physical appearance, changed the colour and appearance of her face and left her blind. However, in many cases throughout India, punishment often did not take into account the deliberate and gruesome nature of the attack but only rested on technicalities of injuries. It is apt to recall here that the Law Commission also proposed a law known as ‘Criminal Injuries Compensation Act’ to be enacted as a separate law by the government. This law intends to provide both interim and final monetary compensation to victims of certain acts of violence like rape, sexual assault, acid attacks, etc., and should provide for their medical and other expenses relating to rehabilitation, loss of earnings, etc. Any compensation already received by the victim can be taken into account while computing compensation under this Act.

Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit


Pune ST bus driver runs amok killing 8 people, injuring over 30 people and smashing 37 vehicles before he was forcibly brought to a halt by two youths. The man appeared dazed and glassy eyed and was later discovered that he was suffering from schizophrenia, a mental illness. 25 million people suffer from schizophrenia in our country and an attempt is made to rehabilitate them and make them economically…Edit

RAAVNA… Mystery of loving your captivator?


The last emotionally packed and paradoxical sequel of the film Raavana wherein Rajini, disillusioned and suspicions of her husband goes onto meet Veera, her captivator was quite baffling. Why would Rageeni need to confirm the truth with Veera, her abuser, whom she knew barely for 14 days as against her husband who loved her for so long? How will Rageeni deal with her conflicting emotions now if she decides to go back to her marriage? Although most of us who have seen the movie ‘understand’ Rageeni’s emotions; if we try and socially or logically analyze it, we will be at a dead end. While the situation doesn’t make sense from a social standpoint, does it make sense from a psychological viewpoint? The answer is – Yes…its called the Stockholm Syndrome!

Stockholm syndrome is a psychological shift that occurs in captives when they are threatened gravely but are shown acts of kindness by their captors. Captives who exhibit the syndrome tend to sympathize with and think highly of their captors. When subjected to prolonged captivity, these captives can develop a strong bond with their captors, in some cases including a sexual interest. Psychiatrist Frank Ochberg, widely credited with Stockholm Syndrome’s psychiatric definition, describes it as “a primitive gratitude for the gift of life,” not unlike that felt by an infant.

Is Stockholm Syndrome limited only to dramatic situations like kidnapping and hostage? Surprisingly, it is more common than people realize it to be. We all know it under the name of “Domestic Violence”. People are often amazed at their own psychological conditions and reactions. Having worked with couples for a number of years I come across many such cases in my clinical practice. Some of the most surprised and shocked individuals are those who have been involved in controlling and abusive relationships. When the relationship ends, they offer comments such as “I know what he’s done to me, but I still love him”, “I don’t know why, but I want him back”, or “I know it sounds crazy, but I miss her”. Recently I’ve heard “This doesn’t make sense. He’s got a new girlfriend and he’s abusing her too…but I’m jealous!” Friends and relatives are even more amazed and shocked when they hear these comments or witness their loved one returning to an abusive relationship.

Stockholm Syndrome (SS) can also be found in family, romantic, and interpersonal relationships. The abuser may be a husband or wife, boyfriend or girlfriend, father or mother, or any other role in which the abuser is in a position of control or authority. In relationships with abusers, a birthday card, a gift (usually provided after a period of abuse), or a special treat are interpreted as not only positive, but evidence that the abuser is not “all bad” and may at some time correct his/her behavior. Abusers and controllers are often given positive credit for not abusing their partner, when the partner would have normally been subjected to verbal or physical abuse in a certain situation. An aggressive and jealous partner may normally become intimidating or abusive in certain social situations, as when an opposite-sex coworker waves in a crowd. After seeing the wave, the victim expects to be verbally battered and when it doesn’t happen, that “small kindness” is interpreted as a positive sign.

As relatives or friends of a victim involved with a controller or abuser, our normal reaction is to consider dramatic action. We become angry, resentful, and aggressive at times. A rule of thumb is that any aggression toward the controller/abuser will result in additional difficulties for your loved one. Try to remain calm and await an opportunity to show your love and support when your loved one needs it. Remember you can not help the victim till the victim does not decide to help himself / herself.

Taking the abuser’s perspective as a survival technique can become so intense that the victim actually develops anger toward those trying to help them. The abuser is already angry and resentful toward anyone who would provide the victim support, typically using multiple methods and manipulations to isolate the victim from others.

Any contact the victim has with supportive people in the community is met with accusations, threats, and/or violent outbursts. Victims then turn on their family – fearing family contact will cause additional violence and abuse in the home. At this point, victims curse their parents and friends, tell them not to call and stop interfering, and break off communication with others. Agreeing with the abuser/controller, supportive others are now viewed as “causing trouble” and must be avoided. Many victims threaten their family and friends with restraining orders if they continue to “interfere” or try to help the victim in their situation. On the surface it would appear that they have sided with the abuser/controller. In truth, they are trying to minimize contact situation that might make them a target of additional verbal abuse or intimidation. If a casual phone call from Mom prompts a two-hour temper outburst with threats and accusations – the victim quickly realizes it’s safer if Mom stops calling. If simply telling Mom to stop calling doesn’t work, for his or her own safety the victim may accuse Mom of attempting to ruin the relationship and demand that she stop calling.

In severe cases of Stockholm Syndrome in relationships, the victim may have difficulty leaving the abuser and may actually feel the abusive situation is their fault. Remember, the more you pressure the “victim” of the Loser/Abuser, the more you prove their point. Your loved one is being told the family is trying to ruin their wonderful relationship. Pressure in the form of contacts, comments, and communications will be used as evidence against you.

Your contacts with your loved one, no matter how routine and loving, may be met with anger and resentment. This is because each contact may prompt the Loser/Abuser to attack them verbally or emotionally. Try to maintain traditional and special contacts with your loved one – holidays, special occasions, etc. Keep your contacts short and brief, with no comments that can be used as evidence. Remember that there are many channels of communication. It’s important that we keep a channel open if at all possible. Communication channels might include phone calls, letters, cards, and e-mail. Scheduled monthly shopping trips or outings are helpful if possible. The goal is to maintain contact while your loved one is involved in the controlling/abusive relationship. Remember, the goal is contact, not pressure.

Don’t feel the victim’s behavior is against the family or friends. It may be a form of survival or a way of lowering stress. Victims may be very resistive, angry, and even hostile due to the complexity of their relationship with the controller/abuser. They may even curse, threaten, and accuse loved ones and friends. This hostile defensiveness is actually self-protection in the relationship – an attempt to avoid “trouble”.

The victim needs to know and feel they are not rejected because of their behavior. Keep in mind, they are painfully aware of their situation. They know they are being treated badly and/or controlled by their partner. Frequent reminders of this will only make them want less contact. We naturally avoid people who remind us of things or situations that are emotionally painful.

If the relationship has continued for over a year, they may require support and an exit plan before ending the relationship. Marriage and children further complicates their ability to leave the situation. When the victim decides to end the unhappy relationship, it’s important that they view loved ones as supportive, loving, and understanding – not a source of pressure, guilt, or aggression. The victim and the family may also require some counseling to undo the hurt, anger and guilt.

CORPORAL PUNISHMENT & ITS IMPACT ON CHILD


Raunjovit, 12 year old boy from a top notch school of Calcutta committed suicide by hanging himself after he was subjected to corporal punishment at school.
How could such incidences be avoided?
• Parents need to take active interest in their child’s school life. This will give them some indication or a prior notice if something is upsetting the child at school. Prevention is always better than cure.
• Parents themselves should believe that disciplining a child does not require them to be punitive. They should be against the proverb “spare the rod and spoil the child”.
• Parents and teachers should educate themselves and actively seek each others support on effective disciplinary methods through discussions during PTA meetings.
• Parenting is not an inborn talent or intuition, rather it is a skill which can be learnt by attending Parenting seminars.
• If you are still facing behavioural and disciplinary issues with your child, consult a child psychologist. There may be deeper emotional issues which require professional help like Play Therapy.
• It is a known fact that children find it difficult to express emotions verbally. Play being a natural mode of communication for children, children use play to communicate their emotions and resolve them. Play Therapist are trained to help children deal with difficult emotions using play as a medium for communication.
Why Should Corporal Punishment Be Banned?
Corporal punishment should be banned for the following reasons:
1. It has no place in the education of children.
2. It perpetuates the cycle of abuse.
• The research shows that children who are beaten and abused are more likely to be prone to depression, low self-esteem and suicide. The simple fact that corporal punishment as a disciplinary measure is not part of any education curriculum indicates that educators at every level know that corporal punishment has no place in the classroom. Discipline can and should be taught be example.

• Corporal punishment is often an outlet for adults’ pent-up feelings rather than an attempt to educate children. Many schools urgently need more resources and support, but however real adults’ problems may be, venting them on children cannot be justifiable. In any case, hitting children is ineffective in relieving stress. Adults who hit out in temper often feel guilty; those who hit dispassionately find they have angry and resentful children to cope with. Life in schools where corporal punishment has been abandoned in favour of positive discipline is much less stressful for all.
• Evidence all over the world indicates a strong relationship between high rates of corporal punishment and higher rates of poor academic achievement, dropouts, juvenile delinquents, incarceration and spouse abuse. There appears to be a strong link between corporal punishment during the growing years of a child’s life, and his/her easily becoming a perpetrator (of violence) later in life.
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Respect vs fear. Respect should not be confused with fear. “Good” behaviour due to fear of being punished means that a child is avoiding punishment, not showing respect. Corporal punishment can appear to be effective when it results in immediate compliance, but its negative short and long term effects are well documented. The negative emotional impact of corporal punishment in fact impedes learning and undermines the teaching and learning process.
Children learn to truly respect people and things when they appreciate their intrinsic worth. When teachers demonstrate respect for children’s human dignity and integrity, children themselves learn to respect themselves and others. When teachers discipline children in positive, non-violent ways, children learn that conflict can be resolved without undermining this respect. Positive forms of discipline are designed to ensure that children learn to think about others and about the consequences of their actions. There are many materials available to support non-violent classroom management which can be adapted and translated for use in every country.

Discipline vs punishment. Discipline is not the same as punishment. Real discipline is not based on force, but grows from understanding, mutual respect and tolerance. Corporal punishment tells children nothing about how they should behave. On the contrary, hitting children is a lesson in bad behaviour. It teaches children that adults find it acceptable to use violence to sort out problems or conflicts.
Discipline problems should not be confused with discipline solutions. It is important to distinguish between problems with discipline in schools and the ways in which schools respond to those problems. There is a tendency for teachers who are against prohibition to point to children’s behaviour as demonstrating the need for corporal punishment. But children’s behaviour does not necessitate a violent response. Discipline problems in school result from a combination of many factors, including those relating to the child’s individual circumstances, the school environment, the nature and perception of the teaching profession in a particular country, the adequacy of the curriculum, etc. Poor school discipline represents a failure to identify and address appropriately the causes of the perceived problem; it does not result from a failure to inflict corporal punishment on children. Addressing disciplinary problems requires creative, empathic, supported, respectful and professional interventions, not beating and humiliating learners.
The Positive Disciplining measures should be introduced both at school and at home. It identifies four solutions that begin with the letter R: Related, Respectful, R reasonable, and Revealed in order to be effective. Their respective meanings are given below:
• Related means that it is directly linked to the misbehavior in some way;
• Respectful means that teachers retain a respectful posture when dealing
with a student;
• Reasonable means that the consequence or solution doesn’t contain any
additional punishment; and,

• Revealed means that the student knows in advance what the consequences
will be.