Inside Kashmir's Mental Health Catastrophe: Shattered Lives, Depression and Trauma
According to the 2015 report of Médecins Sans Frontières (MSF), Doctors Without Borders, some 1.8million (45 per cent) adults in Kashmir have significant signs of mental stress. — Photo by Mohammad Abu Bakar
Zeenish Imroz reports from Srinagar's Institute of Mental Health and Neurosciences how generations of Kashmiris have been battling various psychological illnesses and acute mental trauma after long years of conflict, violence and shutdowns
Zeenish Imroz | Caravan Daily
SRINAGAR – Beside the cold white wall of IMHANS – the Institute of Mental Health and Neurosciences — a girl in her twenties, pale and lifeless, dressed in light grey, sits outside a psychologist's room. Anxiety is prompting her to rub her left wrist with the other. She gazes at the roof with sadness, "God! Please relieve me of this agony!" She cries while her mother holds her firmly.
As the tiles of the narrow walls of the IMHANS freeze, a 20-year-old boy tries controlling his emotions by shaking his legs. The bright jeans ripped at the knees is labelled on the sides by the 'Take me to New York' insignia.
The door screeches as it turns, breaking the silence that enveloped the room. On the other side of the door, clinical psychologist Gousia is speaking to a 45-year-old woman from Kulgam. Asifa, a mother of three, fears her son might land in the hands of security personnel any time. At the mere sight of an army personnel, she would get panicky. Her thoughts haunt her and she locks herself in a room.
Asifa's anxiety started building up after her village witnessed frequent CASOs and curfews during the 2016 militant uprising. Over the last five months, she had shown significant improvement in symptoms, though her mental health was affected by the shutdown following abrogation of Article 370.
Blaming the communication blackout for most of the mental health issues, Gousia says she had to start from a clean slate as the patients' conditions started deteriorating after August 5.
"We had to initiate the treatment from zero with every patient, many of whom had become asymptomatic. Everything happened so suddenly that people got paranoid. The abrupt communication shutdown resulted in the reappearance of symptoms in patients who were improving their conditions by way of regular counselling and medication," says Gousia.
Kashmir has been placed under an unprecedented communication blackout after the government abolished the special status enjoyed by the province and bifurcated the state into two Union Territories.
It's been two weeks since Noora has talked to her son, who works in Oman. The 75-year-old woman walked 3km to her relatives' house in Natipora. As she crossed the wooden door, her face turned red. She is breathless and hysterical, "Do something! I want to talk to my son," cries Noora. The relatives try to connect her call via someone in Mumbai. Noora moves to and fro while her husband tries to console her. A patient of Bipolar disorder, Noora is on anti-psychotics. After hours of restless anticipation, she beats her forehead, sobbing through the conversation with her son.
Since August 5, the business sector in Kashmir is experiencing a loss of thousands of crores, this having serious consequences to the businessmen in the state.
Srinagar's Institute of Mental Health and Neurosciences.
An apple trader from Shopian, Arif is not able to harvest apples from his land. He says he was held at gunpoint by army personnel. They asked him not to sir out, and stay indoors.
"Who has the courage to speak in front of them? Everyday, I witness my annual income ebbing in front of my eyes. I am not able to harvest my crop. So helpless am I," says the 40-year-old from the apple bowl of Kashmir.
"He sweats all day, he has panic attacks and palpitations. Initially, his family took him to a cardiologist, but he was diagnosed with a psychiatric problem," says Nadia, another consultant of psychiatry at IMHANS.
While the shutdown affected the apple trade largely, the businessmen in the city are facing serious problems on other fronts too.
Owner of some business outlets in Kashmir, 32-year-old Ghulam Ahmed from Batamaloo is caught in debts, leading to depression. He is downcast as he enters the psychologist's room. Ghulam's eyes are filled with tears as he narrates his financial stress. He looks at his 3-year-old son and says in a broken voice, "I have kept the keys of my shop with my boss. In case I die, he may do whatever he wishes with my property to repay my debts." Ghulam has not been able to open his shop for the past three months.
Due to the restrictions in mobility since August 5, the psychiatric patients on medication were having difficulty buying drugs. Also, many drugs were out of stock, resulting in a relapse of their condition. Many patients who had anxiety or depression years back and were off treatment found they were seized by these again.
Although public transport is rare to find in these days, the number of patients has doubled the concentration of OPDs in psychiatric hospitals and clinics in the Valley. "This had a direct effect on the people. As a population, it was a collective trauma, people fear the loss of their Kashmiri identity and an attack on their individuality, sometimes with religious connotations," says Dr Majid, a psychiatrist working at the district hospital in Pulwama.
According to the 2015 report of Médecins Sans Frontières (MSF), Doctors Without Borders, some 1.8million (45 per cent) adults in Kashmir have significant signs of mental stress.
Around 41 per cent of adults in the Valley have symptoms of depression, with 10 per cent meeting the diagnostic criteria for severe depression. An estimated 26 per cent adults in the Valley are living with symptoms of anxiety-related disorder. Nearly one in five adults (19 per cent) is living with significant PTSD symptoms, with six per cent meeting the diagnostic criteria for PTSD.
Among many others, 6th class student from Pulwama, Navid showed signs of distress due to the current lockdown and complained about a fear of night raids, sleeplessness, palpitations, headache, and anxiety related to examinations.
At the District Mental Health Programme (DMHP) held by CFS coordinator and animator for mental health screening, involving mental health professionals of the Child guidance and well-being centre (CGWC) on September 19, 2019, it was observed that children of South Kashmir are politically aware of the situation to a large extent, and hence are psychologically affected by the abrogation of the state's autonomy.
Among the new lot of patients, students in significant number are worried about lack of access to study material for examinations and of the incomplete syllabus-related coaching. Nadia concludes saying, "In the heart of hearts, everybody is sad, not just because of the business or work, but somewhere we are emotionally attached to the Article and Kashmir."
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