A personal perspective of PTSD / Mental Health of a physically challenged person # Mental Health Day

 By Malini Shankar

Digital Discourse Foundation

I might as well start with my own example. I am a physically challenged person. I was born normal and perfectly fit; but a childhood accident caused a severe head injury as I fell backward during play time while perched on a ground floor balcony grill; - crashing my skull base against the Fiat car door handle. It paralysed me within minutes. I was one month short of my eighth birthday. As I drifted off into comatose and became unconscious about 15 – 20 minutes after the fall, I became distinctly unaware of my surroundings, it was the start of a life-long battle with destiny and the grit and determination to fight death, to save my own life and breathe; it traumatises me to this day every moment - awake or not.

I distinctly recall chasing a light at the end of the tunnel … or in my case it was light at the bottom of a dark stairway… I felt like I was chasing the light, I was convinced that my life, my breathe and my soul was being taken away by that divine light… my life was being stolen from my own body, from my chest.  Now I wonder if I was angry with the Lord at that moment.

The neighbourhood doctor late Dr. Dhananjay was brought in by my grandfather who ran out as I started drifting off (that was the last thing I remember before waking up in the hospital early next morning); Dr. Dhananjay diagnosed a severe head injury and concussion and referred me to Neuro Centre in  NIMHANS Bangalore on that fateful evening on 23.04.1977. In the shocking circumstance it did not occur to my family to call an ambulance Dad packed injured unconscious me into the back seat of the car resting my head on grandma’s lap, my sobbing mother sat in the front next to Dad and my poor younger sister, utterly panic stricken was squashed into the leg space in the back seat - I was later told - and they rushed me to Neuro Centre in NIMHANS. Excellent care and therapy in Neuro Centre in NIMHANS (an Institute of National Importance recognised by WHO) for 14 days as an in-patient, and my parents made sure that after a good seven years of treatment that included Physio therapy, Yoga, Ayurveda, Acupuncture I could become self-reliant again, although a permanent disability of 60% remains.

The sheer amount of anger that accumulates in the chest of a survivor of PTSD cannot be fathomed by anyone other than the survivor of near death experience itself. Why am I losing my life? That awareness in one’s soul is so utterly cruel, looking back.

It is not self-pity but an existential threat, quite literally so. It is impossible to explain in mere words the psychological conflict one faces after such trauma. No amount of counselling will help but positive attitude goes far. Family support is at the centre of healing from PTSD. The anger only builds up while facing abuse and stigma from society. So … logically pet animals and the unconditional love they offer are therapeutic to the extreme levels. Emotional dependence on pet animals can border on Obsessive Compulsive Disorder!

Putt Puffy my feline daughter. ... 

The other lesson is: for bio mechanical impairments like head injury related dysfunction and mobility impairment, physio therapy is the one and only solution. Ayurveda Unani or massage does not work. These are soothe saying hopeful mendication only.

Coming back to Post Traumatic Stress Disorder or PTSD it plagues the life of anyone who has faced medical trauma or near death experience. Even persons who have suffered child sexual abuse apparently face PTSD as Psychology makes advances in research. Earlier I think it was referred to as brain fog.

PTSD as a psychological phenomenon gained currency when American soldiers who served in war torn Iraq started returning home and found themselves playing out violent thoughts on innocent by standers on American soil.

PTSD evokes violent behavior from the victim who may victimize others – like the traumatised American soldiers and our own CRPF men have displayed on occasion. Just this week an IPS officer in Haryana in India has killed himself with his service revolver presumably. His IAS officer wife attributed stress to his suicide.

Soldiers and their families are particularly vulnerable as they often miss out why they are called upon to kill terrorists, thieves, criminals Naxals or anti-social elements. We have seen upset soldiers running amok and killing with their service rifles.  Others are known to hit family members / caregivers etc.

One sexual abuse victim who developed Bi-Polar Syndrome is documented for violent behavior. It is so difficult to evolve closure in such circumstances. 

I once recall an unaccompanied Passenger living with a Mental Health Issue on an Air India flight from New York to Mumbai called the airhostess on the button, and when she came to enquire he slapped her tight on her face. Lesson here: People living with mental health issues should not travel unaccompanied.The air hostess was not only shell shocked, but none in the cabin crew knew how to respond. 

Imagine if a passenger checking in at the airport says I am a person living with a mental health issue. The ground staff as of today are not trained in SOP to deal with the situation. What maybe the percentage of propensity to violence of this passenger? Is he or she accompanied by a care giver? Should (s)he be given any medication during the flight and what dosage? What are the likely side effects (s)he suffers from during the flight duration from the medication? These questions need clarity, documentation and definition of SOPs # SDGs 10, 16.

The complex web of hormonal imbalance that follows such trauma creates havoc on the patients, their care givers and family. It is of critical importance to highlight and bring out the positives in such situations.

Thanks to the grit and resolve of my Father and positive emotional support of my Mother and a lot of support and encouragement from my grandparents I could finish my post-graduation and a whole gamut of other courses including German language and culture, Journalism, Filmmaking, Disaster Management, culinary skills, photography, Yoga, Creative English, Classical Music and so on.

My school Principal Sri C.H. Chandrashekar… whom I even today worship as a God welcomed me personally into my new School even though I was 3 months late in joining the new school because of treatment demands, he permitted my very anxious Mother to sit in the children’s library while I attended classes. Mr. Chandrashekar told my parents that I be allowed to attend school, mingle with other children to relax and smile. I was generously exempted from home work, monthly tests and not allowed to write the final exams too as I was also one year underage. This one year of emotional transition of an extroverted friendly loquacious child to a withdrawn child can be accounted by brain fog; however school staff and classmates, but most critically my parents made such a huge difference. I may not have been allowed to write the final exams, but I read from cover to cover the Readers’ Digest’s 1974 publication Mysteries of the World Around Us. So, back in 1977 – 78 I developed a deep interest in Geology and had read about the Hawaii Tsunami of 1946 and the Iceland Volcano of January 1973. Other positives – my school classmates loved me infinitum… Four of them in particular became my childhood angels – BK, Uday, Prashanth and Shilpa… the boys called me Laughing Gas… and even today  these four people give me such a warm smile. Bless them my angels.

The attempt at inclusive education back in 1977 made me a confident adult. I can today look back with pride on 43 immigration stamps on my passport, and a few credible accomplishments as a Journalist.

Today there are counselling centres with trained staff at the call to address the needs of PTSD sufferers. But I can tell you from personal experience of 48 years of living with PTSD… that a smile heals. I have cheerfully accepted that I am physically challenged and proudly flaunt my accomplishments despite mobility impairment and psychological morphing from extrovert to introvert! I have no problem accepting that every visitor home - be it maid servant, cook or physiotherapist, … I enjoy socialising with them, … enjoyment from cooking comes only when I pop my cooked food into the mouth of someone I love…

An honest and sincere expression of every emotion is a blessing not something to be afraid of. Not easy to be so tough and resilient, believe me, but the bottom line is positivity.

Some relatives deride me as lame, limp and emotional. May the Lord Above help them by better sense prevailing on them… Yes Gandhian thought of passive resistance has deeply influenced my reincarnation. There are other unscrupulous elements who take advantage of differently abled people like me ofcourse but I cannot compromise on speaking the truth and living honestly in conformance to my own core values.

When she died at the jaws of a street dog I could not stop grieving. I miss her so much. She was all of 16 months old and was pregnant. What a tragedy she died. I have very fond memories of her, thinking of her gives me a heart warming smile. Guess such loving memories are part of the healing process, oh but I miss you so much my Dear Puffy. 

She was a divine princess. But she felt duty bound to guard my bed ... her territory! Rest in Peace my dearest divine Puffy.  

Mobility impairment means loss of limbs, voluntary control of many body functions, loss of speech and memory, lack of sleep, secondary diseases due to hormonal imbalance may follow, weight gain; disfigurement, societal stigma, … these are challenges enough; The compromised body tissues, impaired or dysfunctional nerves, bones, flesh, tendons, ligaments does not allow one to sleep in peace. I for one cannot sleep comfortably on my left or right, back or prone. I don’t remember falling into stupor ever… except on occasions of jet lag. Society needs to understand the need to support Children of a Lesser God, not to deride or make fun of them or people like me. 

Imagine an illiterate guy - a domestic helper at home calling me “useless and mentally deranged” and taking it upon himself to certify that I am suffering from some unknown ‘mental derangement bordering on madness’ after suffering a head injury induced paralysis. People like him threaten the very life and security of vulnerable people like me. If I have to accept his idiocy as part of my pardon and culture, then my cynicism should also be accepted too. Fair right? No, but our society stigmatieses the differently abled and condemns people like me. Logically then, abuse of physically challenged persons must be criminalised. If there is a helplne for handicapped people and if I call them, and seek action against emotional abusers action has to be take n against the, right? There is a need to create a phone helpline for people with disabilities. Karnataka - a very progressive state - has mental health helpline, Women’s helpline, children’s helpline and Elders helpline but not one for People with Disabilities. #SDGs. Just pause to think of the impact his comments have on my emotion and I have to grin and bear it because I am educated so I have to pardon and understand his illiteracy. 

© Malini Shankar