Tag Archives: #southasianhealth

Mind Matters.

Mind Matters: Mental Health in South Asian Americans

A recent article in India West reported that a higher percentage of South Asian Americans, especially between the ages of 15 and 24, had been found to exhibit depressive symptoms and a higher rate of suicide among young South Asian American women compared to the general US population. Likewise, studies have spoken of how South Asian immigrants have high rates of mental health disorders that go unaddressed.

Asian American Connect

Dr. Priyanka Thukral Mahajan
Dr. Priyanka Thukral Mahajan

Other studies have shown that immigrants from South Asia to the USA and their children face numerous mental health challenges.

“This could be on account of acculturation, that is cultural or psychological changes that occur as a result of prolonged first-hand contact between two different belief systems or cultures. Stress predominantly originates from their attempts to incorporate ‘American’ traits in their own culture. This eventually shows up as a cultural conflict. Multiple other factors contribute to this stress, including alienation and separation from their families and loved ones, language barriers preventing true socialization, uncertainty around their immigration status, financial stressors, as well as in certain cases, overt or perceived discrimination, and more generally, barriers to cultural integration,” says Dr. Priyanka Thukral Mahajan, Consultant Psychiatrist, Masina Hospital.

Conflict Concerns

Eventually, this cultural conflict leads to uncertainty around belonging. This is particularly more visible in the workplace. The effects of prolonged acculturation and discrimination result in a wide spectrum of psychological disorders over time. These include depression (primarily due to isolation, financial stress), somatization (i.e., self-interpretation of mental health symptoms as physical symptoms and not seeking help), anxiety (again on account of alienation), substance abuse disorders, especially alcohol.

“Such disorders have a dark underbelly, as they are one of the key reasons for increasing rates of suicides among South Asian immigrants in America. The tragedy is that all the above is neither widely known nor acknowledged. The issue is accentuated further by the challenges associated with seeking help from mental health professionals in the form of psychological counseling. If one gets into the weeds of the issue, one realizes that such immigrants have limited means of confiding their feelings with mental health professionals in the USA, given cultural barriers and differences. It is difficult for professional mental health professionals to understand their feelings and challenges, correlate with their culture and truly empathize with them,” adds Mahajan.

Ethnicity Woes

Dr. Sahiba Sethi
Dr. Sahiba Sethi

South Asian countries have been right in the center of the pandemic conversation throughout. Though the impact for South Asian Americans is even more convoluted. At the height of the pandemic, last year xenophobia gripped multiple countries and this community bore much of the backlash for no fault of their own. The lingering effects continue in a lot of pockets. The impact that it would have had on their mental health would be enormous. 

“Personal stories shared by individuals across the world via my online counseling sessions gave me an insight into the South Asian American community and their fears. The last 14 months, we have seen an increased prevalence of nonpsychotic depression, pre-anxiety, somatic concerns, alcohol-related disorders, and insomnia in general. Parents worried about their children’s safety have given rise to psychological symptoms correlated more with physical complaints of fatigue and pain in older adults. This was directly related to social media use, misinformation, xenophobia, and social distancing. The resulting isolation made a lot of people see the bad rather than the good in a community. Frontline workers reported guilt, stigma, anxiety, and poor sleep quality, which were related to the lack of availability of adequate personal protective equipment, increased workload, and discrimination,” says Sahiba Sethi, Counseling Psychologist, Ummeed Healing.

Apps as a Tool

Dr. Nabhit Kapur
Dr. Nabhit Kapur

Apps are just a click away, so are easy to access. 

“And some may already be socially isolated and experiencing loneliness which can worsen mental health. COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke,” says Nabhit Kapur, Founder President of PeacfulMind Foundation.

Apps help people connect in their native languages to a therapist who understands their culture and can empathize with their situation. Some of these apps are powered in the background by Artificial Intelligence.

“These apps help such immigrant patients deal with their mental health issues in a much better way. Their biggest advantage is the patient’s perceived lack of being judged by a third person, resulting in lower stigma towards using them as against meeting a mental health professional in person. This stigma is a huge barrier especially in the South Asian community given the cultural background. A key issue with such apps, however, is in certain instances the patients may not feel truly connected with the device, which can result in a decline in their usage over time. A recently launched app for this purpose is SAMHIN (South Asian Mental Health Initiative and Network). Another one that has been in existence for a longer duration is SASMHA (South Asian Sexual and Mental Alliance). These apps can help connect people who need psychological counseling, with various platforms, to seek support and find mental peace,” says Mahajan.

COVID Angle

Dr. Prakriti
Dr. Prakriti Poddar

Statistics reveal that only 23% of non-Americans in the USA seek mental health, against the 40% of Americans born in the USA. Patients from such communities find it arduous to find a mental health professional from their own community, who can understand their situation and truly support them. Covid-19 pandemic has further worsened the above dynamic. As is very well known, the sheer incidence of mental health issues has gone up significantly through this pandemic due to heightened financial insecurity, lack of social contact. For the immigrants, seeking medical help in these times has become even more challenging.

Prakriti Poddar, Global Head for Mental Health at Round Glass, Managing Trustee Poddar Foundation says, “a 2018 study found out that stress related to acculturation, trauma, and discrimination has been linked with depression, anxiety and substance abuse among South Asian Americans. Also, the COVID-19 pandemic has affected South Asian American communities by increasing stress and anxiety levels in terms of health concerns and issues such as employment and housing.  Due to the uptick in violence and hate against the South Asian American community, racism has also severely impacted the mental health of the community.”

Breaking Taboos

Dr. Aparna Methil
Dr. Aparna Methil

In India, it is an uphill task to change perceptions related to mental health predominantly due to the stigma associated with it. The challenge lies in creating the right kind of awareness about mental health problems and encouraging people to seek the right kind of help from mental health professionals.

“Mental health crisis can be attributed to the outbreak of Covid-19 and resultant loneliness, isolation, fear of loss of life, financial insecurity, job cuts, salary cuts, and overall economic uncertainty. The common mental health issues associated with the COVID-19 pandemic are stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear reported among Indians. Stress, anxiety, and depression have been closely related with the COVID-19 pandemic,” says Dr. Aparna Methil, Vice-President, Operations, Mpower. Mental health issues faced by South Asian immigrants in the USA are immense and one of the ways to tackle the challenge is to take the help of technology. After all wellness in a click matters the most.

Mental Health App List

Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.

 

Sleep Tight, Sleep Right

A good sleep cycle ensures optimal health, so monitoring how you sleep and practicing proper sleeping habits is essential for a healthy and fulfilling life. There are many adverse effects to improper sleep: Harvard Medical School found a strong link between depression and insomnia; one out of five Americans have obstructive sleep apnea; and an NCBI report also speaks of the elevated cardiovascular disease and type 2 diabetes mellitus risk observed in South Asian population and the potential of sleep interventions to minimize this disparity.

Mattress Matters

During sleep, our bodies repair themselves having a healing effect on our psychological processes as well. According to the Harvard Medical School, there are more than 70 types of sleep disorders with the most familiar being insomnia, obstructive sleep apnea, and narcolepsy.

“While several factors affect sleep quality and cause sleep deprivation, one of the major causes that can usually escape our notice is the mattress that you sleep on. A bad mattress can ruin your sleep, making it hard for you to fall asleep as well as stay asleep for eight to nine hours every night. It can also impact the blood circulation in the body, affecting the amount of deep sleep and rest you get during a sleep cycle. And if you have sleep-related health issues and even chronic back pain, then a bad mattress can further worsen your condition. Therefore, investing in the right kind of mattress is extremely important to improve your sleep quality,” says Chaitanya Ramalingegowda, Director & Co-founder, Wakefit.

Mattresses being made at the Wakefit factory.

A good mattress should distribute your bodyweight uniformly so that you do not wake up with pain in your neck, shoulders, and hips. The mattress should not unnaturally bend your spine thus causing back pain and postural defects.

Smita Murarka, Vice President, Marketing & E-commerce, Duroflex adds, “a comfortable and supportive sleep surface is the key to unlock great sleep. Our range of mattresses and research-backed and scientifically engineered to provide optimum support and comfort. Our signature range Duropedic has an advanced 5 zoned orthopedic support system that provides differential support for different parts of the body. This technology has been tested and recommended by doctors by the National Health Academy.”

Act Now

Lack of sleep can have significant repercussions on one’s physical and mental well-being. The weakened immune response, decrease your ability to concentrate, impair your cognitive function, increase the risk of injury and physiological ailments, cardiovascular diseases, diabetes among others. Lack of sleep can have an adverse on your mental health as well. It can impact your mood, ability to handle stress and reduce emotional resilience. If you are experiencing morning headaches, daytime fatigue, loss of focus, you must consider getting tested.

“The recently launched OneSleepTest by Ectosense with a small disposable NightOwl sensor is a comprehensive and reliable home sleep test kit that guarantees accurate results. It provides a verified e-report from a sleep physician and sleep coach assistance enabled by ResMed in 3 to 5 days post the test period from the comfort of your home,” says Dr. Sibasish Dey, Head, Medical Affairs, Asia and Latin America, ResMed.

Tech Talk

Digitization in the healthcare industry has revolutionized the diagnosis and treatment of sleep disorders and has brought it to our homes’ comfort. With cloud-connected technology and remote monitoring, most mild to moderate sleep disorders can be treated without having to be hospitalized and in a cost-effective way. With the availability of numerous sleep tracking devices and apps, it has become easier to understand your sleep patterns and even identify disturbed sleep reasons. You can wear tracking devices on your wrists, clip them on your pillow, or rest on the bedside table.

Balasubramanyam SV, Founder, Durfi Retail says “we recently rolled out India’s first Hempseed oil-infused mattress, Durfi is the first company to develop and marketing this product in India, this product also a blend of tech and tradition. Hempseed oil infused cotton candy memory foam mattresses are India’s first natural oil-infused mattress, the mattress surface is softer and cozy, the mattress provides great comfort to the body posture.”

Tools & Techniques

Aromatherapy is a holistic healing therapy that uses natural plant essential oils to promote health and well-being and can have a positive impact on sleep too.

Lotus seeds and milk from ITC

“Lavender, Marjoram, Chamomile, Sandalwood, and Neroli are the main ingredients that have shown properties of calming the nerves and promoting relaxation. They can be taken in the form of teas, rubs, in diffusers, in your bath or directly applied to the skin before bedtime. However, the right combination and formulation is important,” says Karina Kapoor, Brand Head of Puressentiel.

Bindu Gopal Rao is a freelance writer and photographer from Bangalore who likes taking the offbeat path when traveling. Birding and environment are her favorites and she documents her work on www.bindugopalrao.com.

 

The Power of Visualization: A South Asian Dream

Are you ready to achieve your goals and ideal life? 2021 is the year to renew, refresh, revitalize and move towards achieving your goals. Visualization is a tool you can use to realize your goals and attract what you desire. I use this tool regularly and would like to tell you more about it.

A Vision Board is a tool that is used to represent your intentions and goals to create your ideal life with images, pictures, symbols, numbers, positive words, and affirmations. It helps you clarify your goals.

Define your goals in your relationships, work, family, finance, or more by writing them down. To make it simple and more effective, let’s build yourself a Vision Board. Choose pictures and images that bring forth objects and experiences that you want to attract in your life. Take a board, or if you prefer things online, you could also use an online tool like a ‘Pinterest’ board. You can cut out pictures from the newspaper, magazines, and the internet which may speak to you about your goals, ideas, vision, and success. 

Add a happy picture of yourself to this collection! 

Try to organize your pictures to make them appealing to yourself. Bring forth your creative juices while working on your vision board. You can use markers or metallic pens to write quotes, positive words, and affirmations. 

Your vision board could be oriented towards a short-term or long-term goal or a specific area. I tend to create different boards for the various aspects of my life; relationships, health, job goals, finance, travel.

Place your vision board in a place that is easily visible to you. You may like it on your nightstand, worktable, fridge, or even on the lock screen of your phone.

I have learned that seeing it for 5 minutes when you awaken and just before sleeping are the most powerful times of the day. Seeing the images the first thing in the morning helps in creating what you want to happen or have. In addition, seeing these images one hour before bedtime keeps these images running through your subconscious mind at night in a replay mode.

What is Creative Visualization? You start to create mental images vividly and repeatedly in your mind of what you want to happen, in order to help that event come about in real life.

We have all heard the quote, “ A picture is worth a thousand words.”

We picture the images we want as IT HAS HAPPENED. Our brain and subconscious receive the message of what it is we desire and set the wheels in motion to make that wish come true. When we learn how to visualize correctly, the images we generate become a reality.  

Image from www.berries.com

Once you have created your Vision Board you can select and focus on one image. Find a comfortable place to sit or lie down, where you won’t be interrupted, and begin picturing in your mind what it is that you want. It could be an event you want to occur, a goal you want to achieve, or a personality trait, such as self-confidence or compassion, that you want to develop more fully. It may also be that you want to improve your health, relationships, or work life. 

See it clearly in your mind’s eye and really get into the experience. Give your imagination free reign, Imagine all the sights, sounds, smells, tastes, or tactile sensations you would expect to be there when your dream finally manifests as reality. Picture yourself inside the story, not outside looking in

Feel as it has happened, not happening. 

If, for example, you wish for your children to be healthy and well-balanced. Picture them in front of you – laughing, happy, caring, and loving. Listen to the sounds of laughter, the smell of the scent of the soap after the kids have showered, and the aroma of a home-cooked meal. Feel the joy of reaching out and hugging your children and the bonds of being together. 

For instance, a Bharatnatyam dancer who wants to achieve her goal to be an accomplished dancer has to have ambition, dedication, and a want to achieve her dream. While closing her eyes she imagines herself on stage in front of people, dancing with confidence and grace. The dancer can hear her heartbeat and the elation of the crowd. She feels the swish of her colorful attire against her skin. Her ‘abhinaya’ or the expression in motion should be felt like a warm feeling coursing through her body. In the ‘tilana’, she explodes into leaps and jumps, moving in all directions with the fast tempo of the music. The Bharatnatyam dancer hears the three clangs of the cymbals and knows that she has given it all. The more she visualizes this with all her senses, the more she will be able to achieve her goal. 

Athletes use visualization to help them achieve peak performance By picturing themselves flawlessly executing a difficult maneuver, they are more likely to execute the maneuver flawlessly when the time comes to actually do it. Speakers visualize in order to stay calm during speeches. 

The more real and detailed the experience is in your imagination, the more powerful the visualization will be and the sooner it will happen in your life as a reality. Repeat this a few times during the day. For extra oomph, try combining an affirmation with each visualization. The practice of visualization will help you achieve your goal. Have patience, focus on this powerful tool, and learn to enjoy the beauty of this magical resource. Go on to try building your Vision Board and using Creative Visualization and see the results!

Geetanjali Arunkumar is a writer, artist, life coach. She is the author of ‘You Are The Cake’.

Why Should You and I Care About Palliative Care?

Sukham Blog – A monthly column focused on South Asian health and wellbeing.

My wife’s oncologist recommended a palliative-care consultation during one of her checkups. This was the first time we heard about it and my wife, subsequently, received beneficial palliative care alongside her ongoing treatment for cancer. Since then, I’ve continued to learn more about palliative care and how it helps patients living with various kinds of serious illnesses. I’ve also realized that most people know very little, or are misinformed about palliative care. We need to understand this relatively new medical specialty; it can do a lot for us and our loved ones in the event of a serious health issue. 

Palliative care is specialized care for people living with a serious illness. It is a type of care focused on providing relief from the symptoms and stress of different kinds of serious and chronic, progressive illnesses, and is provided in addition to, and concurrent with, ongoing medical care. It supports the patient’s ability to feel better while undergoing treatments which could be intense and sometimes not well tolerated. The goal of palliative care is to improve quality of life for both the patient and the family.

To palliate is to make something – for example, a disease or its symptoms – less severe or unpleasant. Palliative Medicine is relatively new. It has its roots in the work of Cecily Saunders and Elisabeth Kübler-Ross in the 1960s. The term Palliative Care was coined in 1974 by Dr. Balfour Mount, a surgical oncologist at The Royal Victoria Hospital in Montreal, Canada. It was recognized as a field of specialty medicine in Great Britain in 1987, the same year that Cleveland Clinic started the first Palliative Medicine service in the United States. It became a board-certified subspecialty of medicine in the United States in 2006, just 15 years ago.

Let me repeat: Palliative care is specialized care for someone living with a serious or chronic progressive illness, focused on providing relief from the symptoms and stress of the illness, to improve quality of life for both the patient and the family. It is based on the needs of each individual patient and can be provided at any time during his or her illness, along with the treatment he or she is already receiving, regardless of the prognosis, expected trajectory of the disease, or age of the patient.

What, specifically, does palliative care do? It provides relief from pain, nausea, constipation, neuropathy, shortness of breath, or other side effects and symptoms caused by the illness and/or treatment. It helps when patients and their families have trouble coping with the illness and are anxious, depressed, stressed, or fatigued, and enables them to better carry out their daily tasks and do the things they want. Palliative care can also improve the quality of life for both the patient and his or her family. 

What is meant by quality of life? That depends on the patient! He or she defines what is important at that moment and in the future. The palliative care team works with the patient and his or her family to understand what’s important and what matters most to them, and takes that into account to formulate a treatment plan and provide the best possible support to help realize those goals.

I used the phrase palliative-care team.  Care is provided by a specially-trained, multidisciplinary team that typically includes doctors, nurses, medical assistants, social workers, chaplains, and other specialists. This is because palliative care extends beyond a patient’s physiological and medical needs and addresses other factors that may be affecting their quality of life, including psychological, spiritual, and social needs. These needs vary from patient to patient. In addition, they can vary over time for a given patient.

Needs could include: help with figuring out what medications should be taken and when; thinking things through, and weighing options when faced with decisions on a suggested next step in treatment; help navigating the complexity of a large hospital when referred to different specialists or when various tests are ordered. Sometimes stress can overwhelm the patient, caregiver, or another family member, and they could benefit from having a caring listener, or just a hand to hold for a while. The costs of treatment are a huge concern for many of us, so the assistance of a qualified individual to sort through financial questions might be valuable. When serious illness brings up existential and spiritual questions, trained chaplains could provide answers, solace, comfort, and a compassionate presence. Nutritionists who understand the patient’s diagnosis and condition can help address dietary concerns.   

Palliative-care specialists treat people living with many types of serious and chronic illnesses, regardless of their age, stage of the disease, and whether or not they are still receiving curative treatment; these include cancer, congestive heart failure, chronic obstructive pulmonary disease (COPD), kidney failure, Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis (ALS), and other life-limiting diseases. Pediatric palliative care is an upcoming specialty. During the current pandemic, it’s an essential part of treatment for those who have contracted COVID-19.

Many confuse palliative care with hospice and believe a recommendation for palliative care implies the patient has a condition that will imminently end his or her life. This is not correct. Palliative care can be very useful for those managing a long-term illness. Quality research provides evidence that the early introduction of palliative care provides all the benefits described above, and results in fewer hospitalizations, a reduced burden on the family, and greater satisfaction overall. Hospice is a form of palliative care for those patients judged to be approaching end of life – and typically have six months or less left to live – who decide to focus on comfort instead of prolonging treatments.

Most private insurance plans, as well as Medicare and Medicaid, cover palliative-care services in hospitals and nursing homes. However, you should always consult with your insurance provider to understand your coverage in detail.

I hope this has helped you better understand Palliative Care and dispel any related misconceptions. 

Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death, and bereavement. Contact the author at sukhaminfo@gmail.com

Sincere thanks to Drs. Neelu Mehra at Kaiser Permanente, and Kavitha Ramchandran & Grant Smith at Stanford Health Care – Palliative Care Physicians who have contributed greatly to my understanding of Palliative Care.

With sincere thanks to Trung Nguyen at Pexels for the use of her beautiful photograph.

Eat Yourself To Health

Viruses are smart, they are masters of survival. They can hijack our body’s own mechanisms to live and multiply. During a productive infection, viruses hijack, multiply and destroy the cell that they call home for a very short time. Bacteria and parasites have also devised various intelligent and opportunistic methods of attacking the human body. To protect ourselves from these infectious agents, the immune system is the frontline of a preemptive defense, while some infections may be controlled by therapeutics. 

Vaccines are the most overtly and urgently effective route to control these infectious agents as they specifically direct the body’s immune defenses against these intruders in multiple ways. However, we can take the initiative to maintain a strong healthy baseline. In addition to stress alleviation and staying active, we can consciously incorporate a few things in our diet to hone our intrinsic defenses. One aspect of this could be accomplished with a few spices, herbs, and condiments that we are familiar with. 

Spices and herbs have fragrant oils that impart the flavors that we know and love, but they also pack alkaloids and other compounds which can have specific effects on the human body. Although detailed ayurvedic knowledge about the effects of these dietary inclusions exist, this article is meant only to raise awareness, and not delve into the depths of beneficial and harmful aspects of the few spices mentioned below. 

Black pepper

Dubbed the ‘queen of spices’ and ‘black gold’, pepper is native to the Malabar coast of Kerala, and was the original spice that fueled the European spice trade. It was the mainstay for introducing pungency and heat in Indian cooking until the Portuguese introduced chillis to India in the 16th century. Among other effects, pepper has antipyretic properties. However, another important property of piperine, an alkaloid in pepper, is to increase the bioavailability of other compounds. That is, it increases the absorption of other chemical entities that are by themselves not readily absorbed. This leads us directly to the next spice, turmeric.

Turmeric

Hailing from the ginger family, the root of turmeric is used as a spice with a familiar hue. In addition to imparting a rich yellow color to food, turmeric is known for its antiseptic and anti-infective properties. Curcumin, an alkaloid in turmeric, also has anti-inflammatory and anti-oxidant properties and has been studied extensively for its properties in ameliorating diseases, and in promoting general health. However, curcumin is not easily absorbed by the body, and combining its use with black pepper improves its absorption.

Tulsi

Otherwise called Holy Basil (appropriately called Ocimum sanctum in latin), tulsi is more associated with religious ceremonies and Ayurveda than with cooking. It is related to, but distinct from, the basil used popularly in Thai cuisine. I have often wondered why tulsi is not used in Indian cooking given its amazing flavor, but it appears its religious associations preclude its use in something as mundane as food. Tulsi is an adaptogen, in addition to having several other medicinal properties, including antibiotics, and blood pressure control to name a couple. As an adaptogen tulsi is advocated for general wellbeing and stress reduction. Tulsi when added to tea imparts a soothing flavor, and occasionally adding a couple of fresh leaves (for those of us who have a plant at home) or a pinch of dried tulsi leaves while brewing a cuppa makes for an excellent beverage.

Oregano

Since we are in the age of fast food, and Italian food can be a popular healthy option, oregano is a spice that we are all familiar with although it is not commonly used in Asian cuisines. In terms of flavor, it is a close cousin to ajwain belonging to the cumin family that is used in Indian cuisine, but the plants are not related. Oregano packs an intense flavor and has several essential oils, including thymol, which are thought to be antiseptic among other properties. Oregano can also be taken for general well-being, and both tulsi and oregano can potentially boost the immune system. Not surprisingly, they belong to the same super-family of fragrant herbs, Labiatae.

Garlic

The medicinal properties of garlic were known to several ancient cultures, and its health benefits are thought to range from digestive to respiratory and circulatory systems but, of current relevance, it is anti-microbial. The pungent odor and taste of garlic are due to sulfur-containing compounds that are released when it is cut or crushed, and the best known of these is called Allicin. In addition to being anti-bacterial, allicin is also thought to have anti-viral properties. Other members of the garlic family, including onion, share the same compounds, but in reduced amounts.

This article is not advocating the ingestion of these spices at the level of a therapeutic or dietary supplement, but only regular inclusion of these as spices in day-to-day cooking. It is also not an exhaustive list of all the benefits these spices are thought, and known empirically, to confer. Several other spices and condiments that we are familiar with also have beneficial health effects: cumin (jeera– anti-parasitic), ginger (anti-inflammatory), fenugreek (methi seeds– anti-bacterial and laxative), yogurt (pro-biotic), cardamom (blood pressure control), cinnamon (anti-microbial), green and red chillis, and so the list goes on. Finally, it should be mentioned that cooking could destroy a percentage of the active principles and the ensuing health benefit, and frying (including seasoning or tadka) would inactivate a higher percentage.

So, a periodic shot of rasam may not be a bad idea. In fact, variations on the theme of this thin soupy concoction are found in most Asian cuisines. Mix in different spices for variety: pepper, turmeric, lemon, cilantro, lemongrass, oregano, basil, neem leaves, garlic, red chilies, and others to complement your daily creativity and menu. It adds variety, in addition to providing an excuse for an excellent sinus-clearing aperitif! 

L Iyengar has lived and worked in India and the USA. A scientist by training, she enjoys experiencing diverse cultures and ideas. She can be found on Twitter at @l_iyengar and at www.liyengar.com.

Charting a Course For Renewal

Sukham Blog – A monthly column focused on health and wellbeing.

As 2020 drew to a merciful close, our editor sent me a note suggesting we begin the new year with a focus on renewal and the environment around us. I filed that thought away as I began a break from my normal routine for a few days, but it kept nibbling away at a corner of my subconscious.  Having lived through a crazy, head-spinning, and gut-wrenching year, we were all ready for a reprieve in 2021; aching for relief and deliverance from all that we had endured. We fervently wished and prayed for change, for that time of renewal and return to normalcy. Instead, we were visited by the horrendous events of January 6th and their aftermath. Like so many others, my world stopped spinning for a few days as I watched in horror – and then re-played in slow motion – the brutal assault on our democracy and our very way of life. All the while, news about the pandemic did not get any better either. Did we not turn the page on our calendars? Had we flashed back into the dark abyss? 

It took me two more weeks, but I’ve finally begun to breathe again in the past few days. My usual, optimistic self is peering out cautiously from that dark recess. Now it’s time, I tell myself.  Now it’s time for renewal, time for change, time to emerge from one of the darkest periods in our lifetimes, dare to hope, and strive for a return to normalcy.

Oh, normal sounds so good now!

“Renewal is associated with a Stop,” writes Bob Dunham, “Stopping is not just Pausing. Stopping is open to choose a new path, not just resuming the old one. With Stopping, we don’t just pause and rest to resume the game. In Stopping, we reflect and choose whether the old game is worth returning to, whether there is a new and different game to play – perhaps a game that is healthier, more meaningful, valuable, and loving.” 

I think that’s the perfect mindset for us as we make our way out of the tunnel we’ve been in for so many months, and into that sunshine that awaits us. Let’s not kid ourselves, a steep hill still lies ahead of us, and it will require grit, determination, and collective will to help each other to the top of the ridge and descend towards our new normal – whatever that may be.  However, we can get there if we choose. Of that, I am now convinced.

I associate renewal with the cycles of nature.  There is a rhythm to the cyclic process of creation – the birth, nourishment, and growth of plants and other living species. Let’s take a leaf from Mother Nature’s playbook. Barb Schmidt, a teacher of spiritual practices and author of The Practice, points to Springtime as a metaphor for our lives. We can focus our attention on living in the world and “feel rejuvenated and motivated to make our lives and the world a more beautiful place,” she urges. We need to see “the beauty that is already present in each moment by bringing our attention right where we are: right where we need to be—right here in the now.” We need to train ourselves to build this awareness that gives us access to that inner light, pursue our purpose, find meaning, and thrive. Looking inwards to nurture our inner world will help us blossom in the world outside. And along the way, we can plant a few flowers and trees for the others around us to cherish.

Let’s heed Barb Schmidt’s advice.  Let’s resolve to conquer the hill that remains before us, and in doing so make this our time of renewal! 

How do we lift the weight of the past year off our shoulders, build this inner awareness, find that inner light and begin afresh to pursue our purpose? First, stay away from resolutions. Around 40% of people in the US make resolutions when seeking a fresh start, as at the beginning of a new year. Resolutions create expectations, and can very soon become burdens. Instead, focus on specific outcomes. Pick out a purpose that you care about, that is meaningful and important to you. Whenever you are able to do so, take small concrete steps to achieve that purpose, without focusing on the time it might take to reach that goal. As long as you stay connected to your purpose, you will get there.

Tailor your expectations and demands on yourself. We have all been through a period of tremendous stress that is not going away just because we started a new year.  Reduce the pressure on yourself by focusing on and prioritizing self-compassion. The uncertainty that has plagued us over the past year is not going away soon. We’ve all come to expect some level of predictability in our day-to-day lives, without which we find it challenging to make plans. This makes it extremely difficult to set and achieve goals for ourselves. The way around this dilemma is to set smaller, shorter-term goals. 

Achieving one such goal before setting the next one assures a higher chance of success; it’s a way to deal with uncertainty that helps to build confidence, morale, and a sense of accomplishment. These small wins “add up over time” and keep you motivated, says Natalie Dattilo, a clinical health psychologist with Brigham and Women’s Hospital in Boston.  They help set yourself up for success.  Another key is practicing gratitude; which Ms. Dattilo believes, has the power to bring about positive changes in us. And along the way, do not forget to make the time to do something – however small – that will brighten the day for another – be that a parent, child, sibling, neighbor, friend, colleague or stranger. Bringing light into another’s day will brighten your own.

Find purpose, set micro-goals, practice self-compassion, self-care, and gratitude. Reward yourself and help another.  Dr. Susan McDaniel defines renewal as the state of being made new, fresh, or strong again—to restore, replenish, revive, re-establish, recover.  An appropriate definition in our current context! 

Chart a course for your own renewal, one that is healthier, more meaningful, valuable, and loving.

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community. He is also a columnist for India Currents. 

With sincere thanks to Ms. Poonam Singh for the use of her beautiful photograph.

Sunset

Pause and Look Back: 2020 Wellness Themes

Sukham Blog – A monthly column focused on health and wellbeing.

As we draw the curtains on a tumultuous year and look forward to better times in 2021, we should pause to take stock.  Let’s reflect on the year we’ve endured; acknowledge and accept the tough, troubling, earthshaking times we’ve lived through – buffeted by the pandemic, and the economic, social, and familial hardships so many of us have endured.  Grieving for the loss of a loved one and for the forfeiture of a way of life, while living through a rising tide of social and racial injustice, intolerance, and hate. Let’s acknowledge these difficult times and accept them. Accept, acknowledge, then look forward.

Let us prepare ourselves for the better times ahead with a new sense of purpose. Determine to look after ourselves and those whom we love better than we did this year. Let’s not make another New Year’s Resolution that is sure to fall by the wayside in two weeks; instead, let’s make an implementable plan we can follow every day.

Each of you knows where you must look to develop your own personal, tailored wellbeing plan – one that addresses Body, Mind, and Spirit.  To get you started, I offer some learnings from the Sukham Blog articles I wrote for India Currents this year for your review and reflection.

Article: Mitigate Chronic Inflammation (Image by Hal Gatewood at Unsplash)

In Love Your Body: Mitigate Chronic Inflammation (February 2020), I described how inflammation is part of our immune system’s defensive mechanism, playing an essential role in healing and controlling infection. However, when this immune response is constantly and repeatedly triggered, this chronic inflammation can cause cumulative damage that could lead to diseases such as type-2 diabetes, heart disease, Alzheimer’s, cancer, and depression. I described what we should do to prevent chronic inflammation or mitigate its effects. Social isolation, psychological stress, disturbed sleep, chronic infections, physical inactivity, poor diet, obesity, and exposure to environmental toxins all contribute to increased chronic inflammation. Review this article, consult your doctor, and create your own 2021 roadmap to combat chronic inflammation and make lifestyle changes for a better tomorrow.

Article: Just Write, It’s Good For You

I discussed writing as therapy in Just Write, It’s Good for You! (July 2020). Research tells us that writing can improve physical wellbeing by boosting immune functioning as well as mood. Writing about your thoughts and feelings for just 15 to 30 minutes a day, three to four days a week can ease stress, grief, and loss. The benefits include better sleep, fewer symptoms of illness, and more happiness among both adults and children.

The following month, in Learning to Embrace Aloneness (August 2020), I described the difference between Loneliness and Aloneness. While loneliness is a manifestation of missing someone or something, aloneness is a state of mind where one takes advantage of being by themselves and uses the opportunity to draw strength, peace, and connectivity with oneself and with nature, to seek our own inner light. Take steps to explore your aloneness!

Article: Lonely In a Crowd (Image by Aziz Acharki at Unsplash)

Loneliness that is left unaddressed, on the other hand, can be harmful. It is an epidemic in our society, as discussed in my second February 2020 article: Lonely in a Crowd. We now understand that loneliness is an emotional state created when we have fewer social contacts and meaningful relationships than we’d like; when we feel no one knows and understands us.  We feel disconnected from people even though they are all around us.  Research shows that it is a risk factor for many illnesses.  Understanding this and learning to watch for signs of loneliness both in ourselves and in those around us should be part of our wellbeing action plan for the coming year, paying special attention to both the young and the elderly in our lives.

An increasing number of us are becoming caregivers for a family member or a friend, as I describe in my May 2020 article The Caregiver Crisis, becoming responsible for his or her physical, psychological, and social needs. While caring for a loved one can be an enriching and rewarding experience that brings out the best in us, long-term care demands sustained attention and is physically exhausting and emotionally draining for both the giver and receiver of care. This leads to increased stress and anxiety and affects relationships.  Understanding this, and planning ways to get respite and avoid burnout is an essential part of any wellbeing roadmap.

Article: Can I Find Happiness? (Image by Zac Durant at Unsplash)

Finally, an upbeat note to round out this brief survey. Earlier this month, in Can I Find Happiness? (December 2020), I talked about my own quest for this elusive state of being. While it is different for each of us, happiness is a combination of frequent positive emotions, plus the sense that your life is good. Each of us can develop that sense by seeking to build a life of meaning and purpose—to move beyond just surviving to flourishing. By building practices into our lives such as cultivating kindness, regular exercise, healthy eating, pursuing goals, discovering spiritual engagement, staying positive, and showing gratitude, we get improved life satisfaction and wellbeing, and learn that the happiness we seek is not out there – it is within ourselves, waiting to be found!

Notice how it’s all interconnected? 

I wish each of you peace, joy, good health, and success in developing and implementing your wellbeing roadmap. See you in 2021!

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community. He is also a columnist for India Currents. 

With sincere thanks to Dawid Zawila at Unsplash for the use of his beautiful photograph.

Happiness- Zac Durant Photo

Can I Find Happiness?

Sukham Blog – A monthly column focused on health and wellbeing.

I believe I’m a reasonably happy person, whatever that means. Sure, I’ve had ups and downs and dealt with disappointment, failure, illness, stress, loss, grief, and death. Most of us have. In retrospect, however, I’ve been mostly satisfied and content, felt good about things and stayed positive. Is that happiness? I wasn’t certain I had a good answer – until now.

On the flip side, I clearly know when I’m not happy. I was not happy through my failures, in stressful situations, and when I lost loved ones. I’ve grieved. I’ve cried. I have felt alone. I was anything but happy then! We read and hear a lot about unhappiness these days. I often see people around me who clearly are not in a frame of mind that I would call happy. 

I thought about all this and began to ask: what is happiness? How does one become happy? Can one acquire happiness and stay happy? I’m here to share the results of my research and reflections with you.  

I began by looking up happiness in the dictionary.

“The state of being happy,” it read.

So much for dictionaries! The word ‘state’ in this definition was a clue, however. After some more reading, I concluded that we typically use the word happiness to describe a mental or emotional state that derives from our perception of our circumstances at any given time. We assign a value to that perception; when this value is positive, we are ‘pleased’.

Our feelings move into the spectrum of pleasant emotions, somewhere in the range from being satisfied or content, through a feeling of joy, to intense pleasure. By this definition, we can be happy one instant and unhappy the next. The change from a happy to unhappy state occurs at the speed at which our perception of our circumstance changes. Material gains fuel a feeling of happiness for a while but can soon feel hollow. Adding that second scoop of ice cream to my bowl satisfies my urge for dessert, and makes me happy until I think about its impact on my blood glucose level! We can be in a ‘state of happiness’ for a few fleeting moments until our perception alters.

While this conclusion is not very reassuring, we shouldn’t downplay the importance of this kind of happiness. It’s good in general to be in a positive or ‘happy’ state as often as we can, provided that state is not the result of misperceptions. We also need to understand this kind of happiness, and its role in the context that I describe next.

Another way in which we often use the word happiness is to describe something other than a transient emotion or state of mind; we use it in the context of our overall well-being.  This is a different ‘state’ of mind that relates to our assessment of where we are now, or where we are likely to be at some future point in our lives; we use the word in the context of our life satisfaction.  Happiness flows from a feeling of accomplishment. This subjective assessment of our state of life is central to driving our ‘state’ of happiness. By altering our assessment, we can arrive at a different conclusion.  

Does that mean that we can choose to be happy? A choice made by adopting a different view or perspective of our circumstances?

Book: The How of Happiness
The How of Happiness by Sonja Lyubomirsky

A review of scientific studies provided further clues. Dr. Sonja Lyubomirsky, Distinguished Professor and Vice-Chair in the Department of Psychology at UC Riverside, and author of The How of Happiness: A Scientific Approach to Getting the Life You Want, is a leading authority on this subject. She has studied happiness, and how and why it can shift over time. While happiness is defined in different ways for different people, she says, it is “a combination of frequent positive emotions, plus the sense that your life is good.”

Geneticists and neuroscientists have shown that genetics and heredity play some role in determining “baseline happiness” and subjective wellbeing.  For instance, around 50% of cases of major depression are attributed to genetic causes, while the rest stem from psychological or physical factors. The general consensus in the scientific community is that your happiness is only partially determined by your genes; most of it comes down to lifestyle and other environmental factors that you can control.

What are the factors and how do you control them?

A branch of psychology known as Positive Psychology provides answers. Coined by University of Pennsylvania’s Professor Martin Seligman, one of the influential thinkers in this area, Positive Psychology studies the character strengths and behaviors that allow individuals to build a life of meaning and purpose—to move beyond just surviving to flourishing.  Researchers have identified several key ‘elements’ of a good life and practices for improved life satisfaction, wellbeing, and happiness: build healthy relationships and learn to express your thoughts and feelings. Cultivate kindness. Exercise regularly and adopt a healthy diet. Do what you like doing and pursue a goal – find your ‘flow.’ Discover spiritual engagement and find meaning in life. Identify and use your strengths.  Adopt a positive mindset: be optimistic, practice mindfulness, practice gratitude. Learn to forgive. Get involved in community and service.

Happiness is not a goal; it’s a life-long process that is in our control.

“Happiness takes work,” says Professor Laurie Santos, Head of Silliman College at Yale, “You don’t just hear about the science of happiness and instantly feel better. You have to change your behavior. It takes effort every day.”

The quest for happiness dates back more than 2500 years to Buddha, Socrates, Confucius, and others. In his fascinating book Hiding in Unnatural Happiness, Devamitra Swami points to the teachings of the Srimad-Bhagavatam that happiness “comes to the completely enlightened, self-realized soul.” Today’s scientists are rediscovering much the same insights!

If we look outward in our quest for happiness, we are looking in the wrong place. We will find lasting happiness only if we seek it within ourselves!

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community. He is also a columnist for India Currents.

With sincere thanks to Zac Durant at Unsplash for the use of his beautiful photograph.

Lonely in a Crowd

An eight-year-old boy clutches his ball looking forlornly around the schoolyard at the other children playing, talking and calling out in small groups. People moving by a young woman walking along a busy sidewalk are unaware that she hasn’t spoken to anyone in four days. An elderly man watches passersby from a park bench. Since his wife’s death five years ago, he sorely misses a companion to share his daily ups and downs. 

Loneliness manifests in different forms making it an epidemic that impacts nearly half of all Americans, according to a recent article that quotes former U.S. Surgeon General Vivek Murthy as saying “during my years caring for patients, the most common pathology I saw was not heart disease or diabetes, it was loneliness.”  

“I totally agree,” says Dr. Neha Narula, a clinical assistant professor and primary-care physician at Stanford. “Research has shown us that it’s a risk factor for many diseases and has become a huge problem in the last 10 or 20 years.  Even though we are more technologically connected, the rates of loneliness have actually risen.”

Social science researchers define loneliness as the emotional state created when people have fewer social contacts and meaningful relationships than they would like — relationships that make them feel known and understood. “A lot of people think loneliness and social isolation are synonymous,” Dr. Narula says, “however, social isolation is physically not having people around you, whereas loneliness is a subjective feeling of being alone; of being disconnected from people even though they may be around you.  It’s very important to differentiate between the two and realize that it could be hard to recognize that your family and friends can also have these feelings of loneliness.” In short, if you feel lonely, you are lonely.

Dr. Narula frequently sees social isolation and loneliness in her practice. Urban centers like the Bay Area are melting pots that draw transplants from different parts of the world with different cultures, languages and lifestyles who come there for work, many bringing their families. They face many challenges adjusting to a new way of life, including loneliness. A few patients open up and willingly share their feelings; more often, she finds them either shy or nervous, with some unwilling even to acknowledge loneliness because of the huge stigma associated with it. Spouses and family members who do not work are especially susceptible because they lack even the social aspect of the workplace, and sometimes face additional barriers of transportation and language. Regardless of ethnic, social or cultural background, loneliness is more common in adults over 45; however, there’s a higher prevalence in seniors – those over 65. Studies show that nearly one-fifth of seniors live alone and over 40 percent report feeling lonely on a regular basis.  Family physicians increasingly observe it in adolescents and pre-teens as well, who tend to be very active on social media, but have difficulty forming real relationships.

“Evolutionarily we needed social connection to survive,” Dr. Narula points out, “over hundreds of thousands of years, we humans were able to survive as a species among much stronger animals due to the advantage of our brains and our ability to communicate and work as a collective species rather than as individuals. Fast forwarding to 2020, we need to remind ourselves of the importance of finding those people who will help us survive in terms of our health and life span.” 

An abundance of research shows that loneliness is a risk factor for many illnesses, just as smoking is for heart disease and lung cancer. In particular, a Harvard study that followed people for over seven decades established the inverse: one of the clearest indicators of physical health, quality of life and longevity is how happy people are in their relationships. 

Loneliness is an evolutionary phenomenon designed to make humans seek protection in a group for survival by triggering a physiological response: the release of stress hormones like cortisol. In small doses these hormones help solitary humans be more aware of surrounding dangers. However, repeated long-term occurrence results in damage to health leading to high blood pressure, increased inflammation, a weakened immune system, and consequently a reduced life span. Additionally, without the emotional support of family and friends, people who are lonely often stop exercising, overeat and tend towards substance abuse, further compounding impact on health. Research shows that the reduced life span linked to loneliness is similar to smoking 15 cigarettes a day. Poor social relationships were associated with a 29 percent increase in risk of coronary heart disease and a 32 percent rise in the risk of stroke. The impact of higher inflammation on the immune system is particularly severe on the elderly; immunity declines with age, and this serves to accelerate that decline. Isolation can be especially deadly for seniors in the event of an emergency like a bad fall or a heart attack. 

We should take action at individual, community and societal levels to acknowledge and normalize loneliness, and work to remove the stigma that makes it a taboo topic.  “We can be the medicine that each other need,” says Dr. Murthy. Let’s begin with an honest examination of our own condition. Next, let’s pay attention to family and friends, making sure that they feel like they are connected, are able to express their feelings of loneliness and where needed, help them find solutions. Shaping the circumstances and communities we live in can do much more than medicine can. Recognizing that it was a public health challenge, British Prime Minister Theresa May appointed a Minister for Loneliness to her cabinet in 2018 to implement a cross-government strategy to combat it. More societal and governmental action along these lines is needed.

We are an ingenious people. Let’s work together to develop creative solutions to help each other – especially the young and the elderly – develop and lead more connected, healthy and fulfilling lives. No one in our midst should be or feel alone.  

Sukham Blog – This is a monthly column focused on health and wellbeing.  

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community. To find out more contact the author at sukhaminfo@gmail.com.  

With sincere thanks to Aziz Acharki at Unsplash for the use of his beautiful photograph.