Economic and Financial Implications of Mental Illness - An Open Letter to the Prime Minister

Economic and Financial Implications of Mental Illness

An Open Letter to the Prime Minister

Some Time in May, 2010-Abridged part of this Article was Published in the Economic Times on the OP-ED Page (Editorial) Page on 1st June,2010

Respected Dr. Singh,

In the Life of a Nation some dates are defining. For India, August 6, 2001 was one, when dozens of hapless chained mentally ill were roasted alive at Erwadi, Tamilnadu, when fire engulfed the Moideen Badusha Mental Home. Sadly, as we enter the decadal year of the monumental tragedy, Lessons of Erwadi largely remain unlearnt.

This letter solicits your attention to the existential, institutional and policy implications of the grave malady of Mental Illness inflicting the nation. It also appeals, on behalf of muted millions, to intellect, erudition and conscience of the Prime Minister. And, there is urgency -seldom do nations get second shot at deliverance after squandering the first - 7th May, 2010 was one such date, on which following two coincidently happened simultaneously:

First, an open letter reached Union Minister of Health, architect of the letter being Hon’ble Justice Ajit Prakash Shah, retired Chief Justice of Delhi High Court. Six page letter is a factual account of state of rightlessness and non-person status of mentally ill in India. One paragraph of the letter is reproduced verbatim here “discrimination against people on the basis of diagnosis of mental illness is common place in India and even in the laws in India. If the multiple laws which sanction the discrimination are not addressed simultaneously then the persons living with mental illness will continue to be incarcerated in institutions”.

Second, latest issue of Tehelka has come out with the headline: “Someone close to you is screaming for help-LISTEN” and the byline “unattended, ignored, millions of families are struggling with someone who is mentally ill. But India has virtually no mechanisms to deal with this”. Its cover story “Mind Snare” traces the tragic debris of destroyed lives in a well-researched and objective manner. You will find the story heart wrenching and as one which brings the Naked-Naked-Truth of the suffering of mentally ill and their equally hapless care-givers. But, I doubt the article will have any lasting impact on our conscience, so deep rooted and exasperatingly imbedded is the stigma against psychiatric illness in our national psyche.

Sir, through most of human existence, 99.99% people, leave the world, having embattled their life as a symbol of inertia and cultural statis, some how managing to keep their life and family together. Dr. Manmohan Singh, over two decades has proved to be one from among that 0.01% people, who disrupt equilibrium and to whom posterity accords the status of world changers. Today the subject of Psychiatric Illness begs your personal attention, if not for the reasons of rights and inclusion as brought out by Justice Shah or for the sheer state of desperation as brought out by Tehelka, then for the sound economic and financial reasons brought out here. I dare say Sir, psychiatric illnesses as a group have turned serious deflators of Indian Economy, and the impact is 2-3% of GDP per annum.

The task of making difference to life and times of sufferers of psychiatric illness is humongous and shall remain non-starter unless championed by you. I do understand your compulsions- governmental resources are finite, and the buck stops at your level to exercise the hard choice between alternative uses of same resource. But Sir, how can the dream of Indian century be actualized if we persistently refuse to or are unable to use Whole Mind of the Nation.

I trust this letter ignites the mind of humane development economist in you and my aim is definitely not to elicit sympathy or empathy quotient for the mentally ill. Assuming we ascribe zero value to human costs of psychiatric illness, the economic costs themselves-both direct and indirect are staggering. Given the famine of even homegrown etiological and epidemiological studies of mental illness in India, for analyzing complex issue of economic and financial implications, I have relied on the external wisdom. Nevertheless, they do provide insight and replicable lessons for informed public policy:

One, during your tenure as Finance Minister, the World Bank in its 1993 World Development Report, highlighted Mental Illness as major contributor to the Global Burden of Disease. Also in 1995, a study by the Massachusetts Institute of Technology found depression costing American industry $43.7 billion annually, including $23.8 billion in lost time due to absenteeism and reduced productivity, $7.5 billion in lost earnings due to depression related suicide and $12.4 billion in direct care costs

Two, Dr. Kathleen Merikangas of NAMI and Ronald Kessler of Harvard Medical School in a study published in Archives of General Psychiatry in 2007, concluded, annual loss of 1.3 billion working days in U.S. due to mental disorders, 50% to all chronic physical conditions combined. Subsequently, in, 2008 the American Journal of Psychiatry, extrapolating from another study by Kessler et. estimated total annual economic cost of serious mental illness in US having doubled from US $ 156 to 317 billion between 1992-2002 excluding costs of comorbidity, incarceration, homelessness, and mortality. By, 2010, this annual loss is, expected to be nearly half of annual GDP of India

Three, WHO in its 2005 Report “Economies of Mental Health’’ concluded that economic costs related to mental illness accounted for 3-4% of GNP in EU nations. Also, Sainsbury Centre for Mental Health in UK estimated this cost to English Economy as Pound Sterling seventy seven billion per annum. Both these numbers are dated today.

BY 2020, the pandemonium of Mental Illness will engulf one member of every family in the country and we need Indian Next Practices and the golden touch of Manmohanomics to combat the scourge. Present dysfunctional paradigm which perpetuates incarceration of sufferers needs speedy burial. The CHOICE program of WHO provides some hope- 300 to 500 million years of healthy life could be gained for every US$ 1 million invested on mental care. The pay back period is nano-low and rate of return exponentially high. You can make tomorrow come today.

Yours Truly,
Akhileshwar Sahay
Principal Instigator
Whole Mind India Foundation

When a Turbulent Mind found its CALLING of LIFE

When I landed at Chennai Airport in early hours of 1st July, 2010, I was unaware, the visit would again alter the course of my five decades of Roller Coaster Life lived with Turbulent Mind. I was greeted on arrival with warm and triumphant smile by the person carrying a placard “The Banyan” and was escorted to a vehicle which said “I Exist Therefore I am”. The normal calling of the vehicle was to ferry rescued wandering Mentally Ill women from Chennai Roads to transit care hospital run by the Banyan. It was befitting that in this extraordinary trip I would have fortune to board the vehicle-It was poetic justice to my Life and Times lived with debilitating Manic Depressive Insanity, secularly called Bipolar Disorder, diagnosed 13 years ago. Unlike my usual corporate journeys to Chennai when I would stay in luxurious star hotels and driven in swanky cars, this special journey for three days was a humbling experience. In my abode for three day stay, Asha Niwas, the room was devoid of luxuries of modern life, except a noisy air-conditioner. Still it was soothing and heartwarming and I had a room companion, the person representing Sir Ratan Tata Trust for the three day event: “National Seminar on Mental Health organized by The Banyan and BALM (The Banyan Academy of Leadership in Mental Health) supported by Navajbai Ratan Tata Trust.


I was listed as one of the speakers on the first day in the inaugural session under the category “User Survivor”. I was humbled and honored at this magnanimity of organizers as a late gate-crasher to the event. This was more so because, instead of being a domain expert on Mental Illness, I thus far was a hapless sufferer of one of the worst forms of insanity known to mankind, an illness where there is only temporary tenuous illusory remission and no permanent recovery and whose etiology and cure has belied the medical and scientific community for more than two millenniums since Hippocrates. The seminar schedule was packed, I was self invited with promise to organizers to finish my presentation within ten minutes. I was there primarily for immersion in the subject which I needed to understand for existential reasons and learn from luminaries, experts and activists working for decades against all odds.

What stuck me most at the Seminar, was presence of an old gentle man of ninety years, intently absorbing full three days of proceedings- he turned out to be one B. Aravind Vellody, India’s past ambassador to world at large, writer of the book “Around the World in Eighty Years” and past-chairperson of the Board of Trustees of the Banyan. Also among delegates was a warrior of rights for disabilities, in wheelchair due to his cerebral palsy, a mental illness cause champion, who sacrificed her marital bliss to be a care giver to a Schizophrenic brother and a petite girl, who had happily assumed arduous role of care giver to the mentally ill sister of her husband.

The seminar turned out to be defining three days for mental health movement with erudite speakers, their zeal, passion and proven track record in preventing, treating, managing, rehabilitating and improving the life and time of mentally ill. The roll-call of speakers was headed by a learned sitting judge of High Court, a doctor Minister from Tamilnadu, relevant government officials, President Elect of Indian Psychiatric Society, leading psychiatrists, other professionals, academia, front line NGOs, advocacy groups, media, caregivers and users. Most impressive were those working with passion at the bottom of the pyramid with destitute and home less mentally ill on the streets of Chennai, Kolkata, Delhi, with tribal’s in Nilgiri range and at beggars home of Mumbai and Delhi. My own contribution was limited setting bizarre process precedence by consuming 90 minutes of proceedings against allotted 10 minutes bringing chaos to Seminar schedule.

The Chennai visit proved chastening, learning, exhilarating, living and extraordinarily humbling journey for me. But what changed the facts of my life for ever, was listening to the wrenching story of the valiant warrior Thiruchelvi who, in last six and half years renewed herself with a miraculous turnaround in life - from the stage of a mental wreck in readiness to sell her two and half year old baby son for a bowl of rice, to the one who was deserted by her husband in her mentally ill state, the one who was rescued from Marina beach and rehabilitated back to normalcy by the Banyan and the one who today gives transformational lectures on bringing new meaning to Life Lived with Madness and Sadness and Mental Wellbeing. Thiruchelvi taught me “There is Life Beyond Madness and Sadness even in extremities of Penury and Hopelessness”. Thank u Thiruchelvi, my teacher, for imparting this one of the greatest learning of life.

I had gone to Chennai with the greed of sharing my own story “Of Madness and Sadness” and the rainbow coalition of my Life, which had given me the status of a relatively successful knowledge worker in the country, despite leading a disrupted undulating life alternating between the abyss of depression and high of Mania. What I came back with, was the indelible impression of gratitude and the lingering memory of a rainbow coalition provided for restoration and giving dignity to the Life to Thiruchelvsi. A sense of I can.

I found new meaning and new calling to my Life midway of the seminar and left Chennai with new found faith – “I would not let my Audacious Dreams for Whole Mind India Foundation (WMIF) die young or unsung, even if it takes my own life prematurely to the grave in the process. The dream of WMIF is to become ultimate rainbow coalition for aggregating all the non-governmental efforts to achieve illusory Total Mental Health Status and to dedicate balance years of my uncertain life to capacity building of all the stakeholders to fight the unequal war of removing stigma, darkness of veil and discrimination from which mentally ill suffer. Chennai enhanced my adrenal to Fight, to envision more than what I was capable of. It also gave me the strength; I found fellow travelers and many of them walking the thorny path for quite a while.

The task assumed by WMIF is daunting and path has blind alleys. Sadly, my own life is fragile, Consensus research, puts my expected life-span ten year lesser than a normal Indian, owing to the complexities of my bipolar disorder & co-morbidities, including substance abuse ( obsessive compulsive smoking) and/or side effects of life and mind saving psychotropic Medication (choice is between life long medication or insanity). This realization of fragility of my life, combined with the constitutional status of a person “with unsound mind” and a non-person status under various statues of the country due to my manic depressive insanity, I have taken a conscious call. And the call is: “I might have been the Principal Instigator of WMIF, but would not hold any position in the governance structure of the Foundation ever. Having been certified as one suffering from serious mental disorder by AIIMS, I, as a responsible citizen, would not take refuse under the legalistic position that I have not been declared of “Unsound Mind” by a court. I accept the reality of my life- my semblance of sanity, is handiwork of medication and other enabling conditions, and will be there is there only till the tenuous Remission lasts. Last, it remains daily battle with violent undulating moods of my SAD (seasonally affective disorder) Bipolar Disorder. My madness can strike back any time with undefined severity.

Chennai also concretized the idea of commemorating India entering tenth year of Erwadi by observing it as India’s First National Mental Health Awareness Day. The name Re: Mind India and its logo came from the creative mind of Vaishnavi Jaikumar to reminding a nation of the Sacrifice of Erwadi Martyrs and to take a pledge not to let Erwadi happen again. It is a year long inclusive festival to celebrate every step of inclusion and banish every trace of stigma and de-humanization attached to Mental Illness.

Re-mind India starts on 6th August the day we enter 10th year of monumental tragedy of Erwadi. It will ask seminal question “Why people land at Erwadis of India in the very first place and what has changed ten years since Erwadi”. And the only visible answer is, India is increasingly getting disrupted with more and more joining mentally ill bandwagon with psychiatric services for prevention, cure and rehabilitation falling woefully short of requirement. From families, society, government to all other stakeholders, all are lacking in even appreciation of the problem and remain oblivious or turn blind eye to graveness of the situation. While country pays collateral damage in terms of serious psychological, familial, societal, institutional, organizational and national disruptions, including humongous economic and financial costs, the sixty year old festival of denial continues. Leaving all human suffering aside, India is at a cusp where Mental Illness has turned serious deflator of GDP by minimum 2to 3% per annum.

On 6th August, We the People of India take a pledge- “Not to Let Erwadi Happen Again” and we will light CANDLES OF REMEMBRANCE AND HOPE. This 6th August, and every year there after would be observed as National Mental Health Awareness Day, with multi-partisan support of all stakeholders. Broad consensus of stakeholders has decided Re:Mind India will be observed on this 6th August across the country at almost the same time, with symbols of hope and remembrance being CANDLES AND SILENCE. There will be other activities local, regional and national during the year. Re:Mind India Initiative is owned by every Indian, just instigated and powered by Whole Mind India Foundation.

And, here comes the time for some random thoughts and musings of dwelling down the memory lane and why and how Whole Mind India Foundation came into being on 2nd, January, 2010. The cardinal question which often visits my Mind and which repeatedly is asked by friends, family members and well-wishers is, - “What prompted my muddling in the murky Business of Mental Illness, a condition which carries the level of stigma today, worse than that of leprosy in previous century. Further, why I am so fanatically passionate about making difference to the Life of Times of Mentally Ill , when my own life is disrupted beyond repair and needs a daily support system, not only to keep my mood and life even, but also to keep up with the regimen of conformity to mind saving psychotropic medication. And, lastly why and what motivated me to launch Whole Mind India Foundation (WMIF) in the very first place and dream with an unachievable BHAG (Big Hairy Audacious Goal)

These questions are intricate existential questions of my life, and my mis-wired brain does not have any simple answer. One possible explanation (given by my Friend and well wisher Subroto Bagchi, Co-Founder and Gardener of Mind-Tree) is –“probably God sculpted me manic depressive and sent to the Planet Earth with the Bipolar Gift to undertake this mission impossible. The second, probable, explanation is - during my manic high in year 2000, I got a vision to change the world (I then considered myself an incarnation which was a cross between Mahatma Gandhi and J. R. D. “Jeh” Tata, in the hallucination and delusions of manic breakdown) and I indeed set up an umbrella called “Parivartan Foundation” to take forward the vision then. The vision was still born and got lost to my bouts of insanity. Thirdly, it is possible that while asking the fundamental questions “Who I am? And What I want to do in second half of Life”, just before the start of new millennium, thousands of nautical miles away from India, in mentally disrupted state, I got my calling which came to me as “I did not want to be the richest man in cemetery or when I was consigned to flames” .

Of all the possible reasons I can adduce for setting Whole Mind India Foundation, the one which comes closest to Truth is- “When My World Came Crashing Down- I had help readily available at hand”. There came a protective and enabling “rainbow coalition” a canopy of family, friends, well wishers, colleagues, subordinates and passers by who navigated me through troubled water. With five years of past thirteen years spent with severe disability in a vegetative state, I say this with conviction, Whole Mind India Foundation, got instigated by me just because, I turned out to be one lucky Indian despite my devastating “madness and sadness”, in a country where millions of sufferers of Mental Illness either remain incarcerated at asylums, homes, prisons and homes or still worse die often young and unsung and that too due to self inflicted injuries (scientifically called completed suicide). It is the suffering of millions and the great societal debt I carry in perpetuity in Mind, which gave the calling of life, and a new purpose to the meaning of Second Half or balance ten years of life- this is the story of birth of Whole Mind India Foundation on 2nd January, 2010 in cyberspace. It was only on 2nd April, 2010 that A Lamp was Lit by Users and Caregivers with collateral support of stakeholders at India International Centre, New Delhi, which marked the arrival of WMIF in real space, without a home or registration under any valid statute of India. Whole Mind India Foundation could not have asked for a more auspicious place for its birth- India International- the dream project of Dr. Sarvapalli Radhakrishan, India’s second President, actualized with the visionary support of Pandit Jawaharlal Nehru.

I did not suddenly contract Bipolar Disorder through viral infection (it is substantially inherited with nurture playing the role in triggering the onset). Similarly, Whole Mind India Foundation was not born in a day. Since the idea first came in a flash in “Sunken Garden” in Manila, Philippines in my dazed state like sudden reawakening in year 1999, it has changed contours many a times and has been a still born baby more than once. Even today WMIF is a pre-maturely born child in incubator, running largely out of meager personal savings of a Manic Depressive, whose financial net worth is perpetually in negative. Mentally Ill Indians, those at the bottom of the pyramid, the destitute and homeless survive by wandering on street, even the one with money normally are not welcome as a neighbor. WMIF has existential similarities with home less mentally ill, as it primarily exists as loose confederation of conscientious Indians, joined together with the passion for the cause, with home-base of WMIF being the squatter in the cyberspace with temporary shelters here and there. The only capital WMIF possesses is that of goodwill and my hope is, it will survive and thrive beyond the troubled birth on voluntarism and hundreds of volunteers across India of Re:Mind India Movement and 1500 plus members of WMIF hyper-connected through super connectivity of social networks-Facebook and Twitter

Leading a difficult disrupted life full “of Madness and Sadness” undulating between mania and depression is not easy in any part of the world. It is excruciatingly difficult for me in our part of the world. It is extremely difficult to explain what goes into the mind of mentally ill even to the nearest and dearest. The Constitution of India brands a seriously mentally ill person (of course once declared by court) as one of “unsound mind”. Statutory frame work of Mental Health Act, 1987 remains one of fear of saving the society from lunatics, something deeply engrained in the preamble of statute itself. The societal construct is one of stigma, veil of darkness and discrimination. Life of a mentally ill is one of seclusion not of inclusion; it is one of fear not of love. Is one of incarceration not of accommodation? This has been my life too, except that I have been lucky, I have a rainbow coalition.

If above is the true state of Life and Times of Mentally Ill in India, and if my life has been saved by my rainbow coalition, if instead of stigmatized by all and sundry, I have received love and affection despite my madness and sadness, if marriages break at the first instance of mental illness in this country, still my wife has been a rock solid single source caregiver and therapist, in the process forgetting her own existence, if my children from childhood have directly landed to adulthood bypassing adolescence, if my employers have not abandoned in mental illness, if my clients wait for my blues to go away to serve them, all I can say. There is Life Beyond Madness and Sadness. There is hope amidst hopelessness. Even mentally ill deserve life of dignity; more over given right umbrella they can propel the annual gross domestic product of economy by minimum additional two percent. Even for mentally ill, if the stigma and discrimination vanishes, life can turn from living hell to heaven on planet earth and they can shine like stars in the sky. Just let them be.

Smoking One-self into the Grave-The Naked Naked Truth

Saturday, May 30, 2010


Smoking One-self into the Grave


"Smoking yourself into the Grave" is the sentence which welcomed me in a swanky private hospital of Delhi yesterday. That turned out to be the hospital's way of deathly reminder to me, of fragility of my own life, the one which has the penchant of digging its own grave. It made me pause. Wrong. It sent shivers deep down to my marrows. And the seminal question came to mind- When will I leave smoking?-. On way to grave or when I rested in grave.



The cardinal question remains unanswered. In few hours from now, the World observes Anti-Tobacco Day. Wrong. It has already started observing at least at the eastern end of the globe and the reminders of ill-effect of substance will reverberate for next forty eight hours in western hemisphere.

I can spend days lecture on harmful effects of smoking use of other forms of tobacco and substance abuse. Like every one else, I know Smoking Kills. And I also know that consumption of tobacco in its totality kills  one person @every eight second. My interest in the damage that smoking and tobacco consumption does, is more than routine. It is an existential dilemma for me and a question of life and death.

Cigarette has been my strange bed-fellow for last three decades. A constant companion taking my life away every nano-second with every puff. I also am a pollutor personified- for every three hundred cigrettes smoked by me, I destroy one tree. Quite a sullied record for a person who champions the cause of public transport for environment friendly sustainable urban mobility. I call it dichotomy of my life. My car seats have holes created by burning splinters and in past my bedsheets have caught fire more than once. The fact that I got saved every time, is n guarantee I will be lucky one more time..


My daily quota of consumption of cancer sticks is twenty Wills Filter Navy Cut. When my love affair with smoking began in 1981, it was the era of "Made for Each Other" the romanticised marketing of the deadly cancer stick by the Great Indian Tobacco Company (ITC). Today, nothing has changed ,except the writing on the pack-t just says plain Naked Naked Truth"Smoking Kills". It does not trouble me.  Vague pictorial warning on the pack of my cigarettes shows how powerful is the tobacco lobby. I just fails to scare me and that is the intent of death merchants. The deadly pictorial warnings in Europe and Singapore, scared me to death and often used to force me to tear off that portion of the cover, but they too never deterred me from being the walking steam engine, such an addicted smoker I am. I have been a valiiant carrier of my own death bomb for decades. Smoking Kills. I smoke. It does not hurt me.



I have been a loyal brand ambassdor for ITC. It has been three decades of Wills Filter Navy Cut. And I will do any thing for the love of it. I will lie at home about the number of cigarettes smoked during the day. I would pickpocket money from my wife's purse or children's wallets which they could decipher instantly. There was an occassion when my desperation made me snatch rupees five, from my previous day offering to God. My quota of Wills has made me break custom laws of the nations I have visited frequently and I have audacity to call  my self an Ethics Counselor in Professional Life. When ever I travelled abroad I would always carry sufficient numbers of packets in my foreign jaunts, which were many and the benevolent customs officials would always heed to my pleadings. Wills filter was central to my survival. Wrong, it was central to acceleration of my death sentence. Even Supreme Court's verdict to Gallows, has a mercy appeal to President of India. There is no such appeal for smokers. They go to grave, directly-Appeal summarily rejected by God. Caregivers suffer, Cancer-stick wins. It is an unequal war.

Only time, I changed my brand loyalty to Navy Cut, was in favour Charms, the filter version of Charminar, in an era when I found ten rupees for a Wills pack unaffordable. For a year in Manila, Phillipines I was a Marlboro Man. In one year, I consumed the quantum of cigarretes which I would have consumed in ten years.. Marlboro man might have died of cancer, but Marlboro pack of 20, came dirt cheap in Manila in 1999, one rupee for every cancer stick for taking away few seconds of my life, bit by bit. It was a story of blown to bits, blown to smoke.

I have defied the law of gravity so far- I am alive and kicking. The question remains-for how long?.  My smoking has ensured my admittance to the emergency ward of  Escorts Heart Hospital . Lucky again. Let off with a stern warning. I do await a heart attack. My cholestrol level is still manageable and I have Lal Pathological Laboratory's results of yesterday to back it up.. Multiple linear ulcers in my esophagus nearly took my life they were direct result of my being chimney. But at the time of last endoscopy two years back, they had not yet turned malignant. Who knows about tomorrow. Smoking kills. I smoke.


Smoking Kills and before that it makes life hell. Still I smoke and if I donot take a vow for life it will drive me from cell to grave. I did not start smoking because of its romanticised charm nor did I start thinking it would add to my smartness. I casually tasted it in  the State Bank Staff College, Hyderabad in 1981 and before I knew, I had turned an obscessive-compulsive smoker. My journey to grave continues at accelerated pace. On a normal day, I light twenty cancer sticks. I live in a false world of self fulfilling profecy and audacity of hope with a mistaken belief that I take only few puffs per cigarette and that per cancer-stick I consume much lesser nicotine or tar than my soulmates.

My younger son was with me in the hospital yesterday, when the message "Smoking Yourself into the Grave" was doing the break-dance of death, the tandav nritya, before my naked  eyes. His concerned question was- "Dad what Next"?. My usual aunconvicing nswer was "Betu I would think". I am thinking still. Though today I lighting half the number of cigarettes than yesterday-the number is down to 10 from 20. But for how long. I promised my wife and kids a week back-This Anti-Tobacco Day i wouldcall quits to my lady love-the ubiquitous Wills Filter-made for each other. Will tomorrow ever come. Will it come in this life, or after my  passage to grave. The question remains... and I am momentrarily petrified down to my bone-marrows.


Why do I smoke? It is a million dollar question and I keep asking repeatedly. I donot enjoy smoking. Still I long for a cigarrete at pre-determined intervals. I smoke in temples. I have smoked near funeral pyres. Smoking my self into the grave has been a merathon hurdle. My home is declared smoke free and so is my office. I have to come out of home and stand on thethe road to smoke combining the nicotine, tar and mixing it with Delhi's automobile pollution before inhaling it. I do so  in the wilderness of night, in the chilly windy winter, on a hot sun filled day or a day when it incessantly rains. I will get drenched in my car but my car windows shutter down for a puff of cigarrete. So much for my love of smoking. If every husband has the same love for his life, divorce rate in India will dwindle to zero. My marriage survives, I smoke. Smoking Kills, and I smoke. I tell to myself I will not smoke, but I smoke.


I live my roller coaster life dangerously at the edge. I dangle closely to death. I know smoking kills. I still smoke and beauty of my love affair with smoking is I donot want to die. I have unfinished dreams in life-for self, family and society. I am a pathological dreamer and obsessive compulsive smoker. I promise to quit and donot deliver on promise. My first line treatment of bipolar disorder controls me from above, it drives closer to depression and substantially reduces my intellectual prowess. I can not leave psychotropic medication as non-conformity to medication will drive me to madness, a life back to unbridled insanity. My smoking enervates me physically and works as a slow poison. The combination of two is deadly-one eats my mind like a termite. Another kills my body by the second. When will I stop smoking. Smoking Kills.


I have tried to stop smoking several times. I am a strong willed person. I had promised my father in law before marriage, I would come to mandap as a non-smoker. I have given and broken the promises, thousand times to my wife in last twenty three years.  I have tried nicotine patch and chewing-gums which only doubled my smoking.. I have taken professional help. I have gone to faquirs and tantrik s, temples and dargahs of sufi sants,  to pyschiatrists and clinical psychologists. Smoking kills, but I smoke. I know its pitfalls-digging my own grave.


Is there some explanation of my inability to stop my fast-farward march to grave. Probably yes. probably no. In United States of America 45 percent of cigarretes are consumed by those who are mentally ill. In India there is no such statistics avaliable. But co-morbidity of obsessive-compulsive smoking with mental illness is as established a scientific fact as the realization that smkoing kills. The latter is believed. The inability to quit smoking is deemed as character flaw, lack of will, a criminal conspiracy against life. The country works for the benefit of tobacco companies, it has no program of increasing exponentially the outlay for mental health program-and public health programs. Root cause analysis is needed and the causes have to nibbed in the bud.


I long to live. Still I love to kill myself bit by bit. All the scientific evidences point to my early departure to grave. There is a finer point we all miss in India. Smoking in case of most people is a fad, a fashion or a deadly addiction. Obsessive compulsive smoking in case of most suffering from  depression bipolar disorder, schizophrenia  or some other  serious mental disorders is a facts of life and death- thy name is co-morbidity of Substance Abuse. There are studies galore- be it Lancet and Nature the most respected medical journals or studies from the anals of feted Harvard Medical School and others. A case in point, is, the sad part of bipolar disorder - comorbidity with substance abuse is very high-smoking, drug abusing and alcoholisms can be as 60% in manic depressives Smoking kills but I smoke. To me, my more recent explanation is it is co-morbidity.

Honourble, Chief Justice of India, are you listening my Lord. I long to live, still I kill my self daily. Your judical pronouncement of banning smoking in  in public place  is laudable. But where I go.. Your judgements have made my life more miserable but it has not made me quit smokingmakes my life more miserable. It does not help me. It has made my work life a living hell. Do I have a right to live Sir freely. Your prouncements are noble, but they infringe on my fundamental rights under Article 21 and Artile 22 of constitution. And as a responsible citizen I try to follow your judgement to the core when others flaunt it by day. Your honour, I am yet to find a definition of public place.

 I suffer from debilitating manic depressive insanity. My smoking gets classified as  obsessive ompulsve comorbidity. Your laws give me the status of a non-person  with no-rights. That has made me be Pappu by choice. As aresponsible citizen who suffers the double whammy of rightlessness and non-person status, I still travel down fifteen floors of my swanky office to smoke one cigarrete. Your judicial pronouncements are profound your Honour, except that they are killing the messenger not the  culpprit-the government which plays in the hands of smoking lobby on one side and does not change the paradigm of managing mental illness. The omillion of such smokers in India who smoke due to their comorbidity of mental  mental illness are not on radar- they reresent a non-subject to Indian pysche, to policy makers and other stakeholders


But here is my resolve. And public made on this Anti-tobacco day. I will quit smoking . I will do it for the love of my wife and sons who have been pivots of sanity in my insane life. I will quit because I want to fight to finish- for making difference to life and time of mentally ill, with the vehicle of Whole Mind India Foundation (WMIF) still a baby in the incubator. My vow is, I will not smoke myself into grave.
 
I will stop my silent march to grave before it becomes a violent departure to pit. I believe can. I give life to me. I will quit smoking. Smoking kills. I still smoke. The silver-lining is- I have driven my debilitating Bipolar Disorder to slumber called remission. That was more difficult thing to do. I will quit smoking, sooner rather than later. I want to embrace life. Want to say yes to Life and no to Grave. God help me if u are there, and I know u are there. My rainbow coalition is intact. Hope I will soon get the steely resolve. Else, it will be too late in the day.
 
My fellow smokers call it quits. Do it now. Tomorrow never comes

Smoking One-self into the Grave

 "Smoking yourself into the Grave" is the sentence which welcomed me in a swanky private hospital of Delhi today. That turned out to be the hospital's way of deathly reminder  to me, of fragility of my own life, the one which has the penchant of digging its own grave. It made me pause. Wrong. It sent shivers deep down to my marrows. And the seminal question which came to mind- When will I leave smoking?-. On way to grave or when I rest in grave.

The cardinal question remains unanswered. In few hours from now, the World observes Anti-Tobacco Day. I can give a day lecture on harmful effects of smoking. Like every one else, I know Smoking Kills. And I also know that it kills  @ one person every eight second.  My interest in the damage that smoking does, is more than perfunctionarly. It has been my strange bed-fellow for last three decades. A constant companion taking my life away every nano-second with every puff.  I  also am a pollutor personified- for every three hundred cigrettes smoked by me, I destroy one tree. Quite a sullied record for a person who champions the cause of public transport for environment friendly sustainable urban mobility. I call it dichotomy of my life.

My daily quota of consumption of cancer sticks is 20 Wills Filter Navy Cut. When my love affair with smoking began in 1981, it was the era of "Made for Each Other" the romanticised marketing of the deadly cancer stick. Today nothing has changed ,except the writing on the pack. It just says "Smoking Kills". Its vague pictorial warning does not scare me. The deadly picotrial warnings in Europe and Singapore, used to force me to tear off that portion of the cover but they never deterred me from being the walking steam engine. I have been a valiiant carrier of my own death bomb.

I have been a loyal brand ambassdor for ITC. It has been three decades of Wills Filter Navy Cut. And I will do any thing for the love of it.. I will lie at home. Pickpocket money from my wife's purse or children's wallets
which they could decipher instantly. My quota of Wills has made me break custom laws of the nations I have visited-I call my self as Ethics Counselor in Professional Life. I would always carry sufficient numbers of packets  in my foreign jaunts, which were many. Only time, I changed the brand loyalty was in favour Charms, the filter version of  Charminar, in an era when I found ten rupees for a Wills pack costly. For a year in Manila I was a Marlboro Man. In one year, I consumed what I would have consumed in ten years.. Marlboro man might have died of cancer, but Marlboro pack of 20, came dirt cheap in Manila in 1999,  one rupee for every  cancer stick for taking few seconds of my life. It was a story of blown to bits, blown to smoke.

I have defied the law of gravity so far.. my smoking has ensured that I am admitted in the Escorts Heart Hospital in the emergency. I do await a heart attack. My cholestrol level is still manageable. Multiple linear ulcers in my esophagus nearly took my life. But at the time of last endoscopy two years back, they had not yet turned malignant. Who knows about tomorrow. Smoking kills. I smoke.

Smoking Kills and before that it makes life hell. Still i smoke. I did not start smoking because of its romanticised charm nor did I start thinking it would add to my smartness. I casually tasted it in State Bank Staff College, Hyderabad in 1981 and before I knew I became an obscessive-compulsive smoker. My journey to grave continues at accelerated pace. On a normal day, I light twenty cancer sticks. I live in a false world- my mistaken belief that I take only few puffs and that per cancer-stick I consume  much lesser nicotine or tar than my soulmates.

My younger son was with me in the hospital today, when the message "Smoking Yourself into the Grave" was doing the break-dance of death before my eyes. His concerned question was- Dad what Next?. My usual answer was "Betu I would think". I promised my wife and kids a week back. This Anti-Tobacco Day i will call quits to my lady love-the ubiquitous Wills Filter-made for each other. Will tomorrow ever come. Will it come in this life, or after my accelerated passage to grave. The question remains... and I am momentrarily petrified.

Why do I smoke? It is a million dollar question. Smoking my self into the grave has been a merathon hurdle. My home is smoke free. I have to visit the road to smoke- in the wilderness of night, in the chilly winder, on a hot sun filled day or a day when incessantly rains. I will get drenched in my car but my winter shutter will be down for a puff of cigarrete.

I live life dangerously. I dangle closely to death. I know smoking kills. I still smoke. I donot want to die. I have  unfinished dreams in life-for self, family and society. I am a pathological dreamer and obsessive compulsive smoker. I promise to quit and donot deliver on promise. My first line treatment of bipolar disorder controls me from above, it drives closer to depression and substantially reduces my intellectual prowess. I can not leave medication as non-conformity to medication will drive me to madness. My smoking enervates me physically. The combination of two is deadly-one eats my mind like a termite. Another kills my body by the second. When will I stop smoking. Smoking Kills.

I have tried to stop smoking several times. I am a strong willed person. I had promised my father in law before marriage, I would come to mandap as a non-smoker. I have given and broken the promises thousand times to my wife in last twenty three years. Have tried nicotine patch and chewing-gums which only doubled my smoking.. Have taken professional help. Has gone to faquir and tantrik and doctors.  Smoking kills but I smoke. I know its pitfalls-digging my own grave.

Is there some explanation of my inability to stop my fast-farward march to grave. Probably yes. probably no. In United States of America 45 percent of cigarretes are consumed by those who are mentally ill. In India there is no such statistics avaliable. But co-morbidity  of obsessive-compulsive smoking with mental illness is as established a scientific fact as the realization that smkoing kills. The latter is believed. The inability to quit smoking is deemed as character  flaw, lack of will, a criminal conspiracy against life.

I want to live. Still I kill myself bit by bit. All the scientific evidences point to my early departure to grave. There is a finer point we all miss in India. Smoking in case of most people is a fad, a fashion or a deadly addition. Obsessive compulsive smoking for a bipolar or some other suffering from serious mental disorders is a facts of life and eath. There are studies galore- be it Lancet and Nature the most respected medical journals or studies for Harvard Medical School or others. The sad part of bipolar disorder is that comorbidity with  substance abuse is very high-smoking, drug abusing and alcoholisms. It can be as high as 60%. Smoking kills but i smoke.  To me it is co-morbidity. Honourble, Chief Justice of India, Are you listening my Lord. i want to live, still I kill. Your statute of ban in public place makes my life more miserable. It does not help me. It has made my work life a living hell. I am not allowed to smoke even in the compund. Do I have a right to live sir. Your statute gets disobeyed. I am mentally ill, comorbidity is my obsessive ompulsve smoking. As aresponsible citizen who suffers the double whammy of rightlessness and non-person status, I still travel down fifteen floors to take one cigarrete. Your judicial pronouncements are profound your Honour, except that it is killing the messenger. Not the culprit-in case of million smokers in India their mental illness-a non-subject to Indian pysche, to policy makers and other stakeholders

But here is my resolve. A public one. I will not  smoke myself into grave. I will stop my silent march to grave before it becomes a violent departure to pit. I believe  can. I give life to me. I will quit smoking. Smoking kills. I still smoke. The  silver-lining is- I have driven my debilitating Bipolar Disorder to slumber called remission that was more difficult thing to do. I will quit smoking, sooner rather than later. I want to embrace life. Want to say yes to Life and No to Grave. God help me if u are there, and I know u are there. My rainbow coalition is intact. Hope I will soon get steely resolve. Else, it will be too late in the day



I

Travesty of Life: When Youth Died Young and Unsung

Good Bye Suresh,


Suresh is no more. He died in prime of his youth- both young and unsung. He remains in my heart. Suresh left for heavenly abode five days back but I came to knew only an hour back and yet to recover. In shock is the right expression. Death of Suresh was not worthy of front page, Page 3 or inner page of any local news paper, not even vernacular Marathi one, he was a native of Konkan village.
This obituary is to lessen my grief and guilt. I am not sure what killed Suresh. Doctors say it was brain tumor. Alas! He was here taking care of me and taking care of his family. I wonder did abject poverty killed him or lack of Medicare facility for the poor. He was to be here in Mumbai this week for treatment, which any case he or his family could not afford.

Suresh was unemployed for few months. And I feel guilt for that. He was not able to manage his family with his meager salary in any case and had not got customary wage increase last year. His health was deteriorating and stress level at work was increasing. He needed another helping hand in guest house, we were not able to provide, because we were on genuine serious cost optimization spree.

Due to double whammy of uncertainty of election last year and looming depression, all of us had gone for a salary freeze. Suresh too also was in the same boat except that his basic needs were more than his meager means. I carry the guilt- had promised to put forward his case for raise but in between he fell sick and went home. My last remembrance of him was crying with pain, in the guest house, he did not know his ailment then.

Suresh leaves behind in this world an ailing physically dependent mother who is very old, a young illiterate wife with no earning capacity and a four year old son. The bereaving family does not even know how to express its grief.

My bonding with Suresh was without bound- he was not the caretaker of our Mumbai guest house. For me he was my carer, it was his responsibility that I got my psychiatric medicines for Bipolar disorder in time, he knew my medicines and its exact dosage. When I would lie low (Mumbai had that effect on me) in frequent visits to Mumbai he would provide me relaxation by massaging. His countless cups of tea. His attuning his sleep to my erratic bipolar sleep deprivation, they r all missed. We will miss him as a family too, when we came for few days for a family wedding in 2008, Suresh became a part of family.
Before we started our guest house few years back Suresh was an office boy in our Mumbai office. The occasion I remember most  is when he worked by my side for 100 hours without break on a very important assignment that was the level of his devotion.
Suresh was loving and caring beyond his normal call of duty. He was a true service professional par excellence in a service company which prides on excellence> Suresh was a true Feedbacker. For me he was many things, am not finding words to express.

U will be missed Suresh for ever. But also will be in the heart. May God give Rest to the noble soul.


Love , peace and Amen

India's Defining Decade-Your Mind needed for an Idea whose Time has come

Good Bye 2009- Welcome New New Decade of Hope
First decade of the new mellinium has gone by. It's  farewell for me was significant, maddening, saddenning but beautiful like the following rememberances from a Verginia Woolf Quote:

"I can only note that the past is beautiful because one never realises an emotion at the time. It expands later, and thus we don't have complete emotions about the present, only about the past.
Virginia Woolf "

The new mellinium had started for me in a devastating and debilitating manner thousands of miles away from India. In  was in year 2000, when I was stuck by "Madness"  in full bloom outof no where. Thereafter, it has been an intense and often losing but dogged battle with "Madness and Sadness" with  diurnal abrupt variation of moods of my daily and seaonally affective disorder-Manic Depressive Insanity . In recent years, the winter has meant  horrifying Depression and summer often brought unknown pleasures, extraordinary abilities and unrealistic exuberance of Mania- it also gave eminently forgettable periods of complete psychotic breakdowns.

The decade tested my "rainbow coalition" of family, friends and wellwishers to extreme. It was resolute doggeedness of my wife annd kids which has seen me survive the daily and seasonal battles and few close calls of deadend- The Death from Self Inflicted Injury.


Circa 2009 began एंड ended in  contrast- at the beginning of the year, like global economy, my mind and life was in debilitating Depression - a carry forward from last three months of 2008. My extreme sorrow  went away very painfully and excruciatingly slowly with the help of my psychiatrist, care of my wife and kids and very strong support from my employers, colleagues, friends, subordinates and clients. Yet, final lifting of mood was like magic and it came while listening live to Anouska Shankar live in a South Delhi Mall open space. Music has always helped me fight the "Black Dog"

Decade and the year which just got over, instilled a new purpose to my life, profession and turned out to be defining one, as it provided me with the "New New Calling in Life".

I had many failures and missed targets during the year, none of them more important than non-completion of  the book "Of Madness and Sadness: Life and Times of an Ordinary Indian". The book is a clarion call of my life and it was scheduled to be published in 2009. It has been a conscious decision to go slow- to save me from burnout and to make it more meaningful. It is one of my ways of fighting the 100 Year War against Stigma and Lack of Awareness in India against mental and brain disorders of all types.

Given the fact that Valproate my first line medication, controls me from above, leaving me to perform at sub-normal and sub-optimal level (against my old  untreated exuberant self), with all humility I did have few satisfactions in both personal and professional life during the year. I definitely grew as a knowledge worker, as a knowledge sharing teacher, as a very hestitant member of the commentrariat and lastly I took baby steps in my foray of "Working as a Life Coach". I also took conviction and fight for resoration of values and ethics in a disrupted nation to the next level- learning to differentiate between right and more right.

On 5th November, 2009 my life was turned upside down when the trailler on my fights with Manic Depressive Disorder was croniclled by Mint (A Hindustant Times- Wall Street Journal Business Daily in India) as a front page story. Its effect has been electrifying- at personal level it has further strengthened my "rainbow coallition" and at a humane level, it has given me the New New Calling for balance period of my life. I have rededicated my life in the New New decade to making difference to those suffering from mental disorders in India.

A humble beginning has been made by reactivating my blogsite (akhileshwarsahay.blogpost.com), which I have primarily devoted to topical issues pertaining to mental illnesses in general and Manic Depressive Disorder (Bipolar Disorder) in particular But the more significant activities lined up for 2010 are two fold:

One,  completion of my Memoirs of Madness and Sadness during the first year of the decade. The sole purpose of the book is to desimminate the hope in a hopeless situation. I also believe that it will help other sufferers in coming out with  their own sufferings and coping strategies.Even a mentally ill can live a productive life and the cost of inaction is very heavy.

Two, In December some leading minds joined me when I conceived the idea of Whole Mind India Foundations (WMIF) as its Instigator. The year will see getting it formalised. The process of registration as a Society and development of its website (http://www.wholemindindia.org/) is a work in proress. The organization is being set up with a big hairy audacious goal (BHAG)- to become national aggregator of all the efforts of improvement in the lot of those suffering from mental disorders. In the first month it has a aim of having 50 members and 1000 Friends. It is going to work in the areas of education, destigmatisation, awareness generation, policy change advocacy, working with and recognising the effort of front line NGOS in the field.

The responsibilities assumed are onerous but the battle has begun. I might be one of the early bird fighters but I have this humbling realisation- I canot win the war. It needs all of you and millions more. Urge you to rise for the cause- some where some one whom you know  needs your support. After all, 120 million Indians suffer from one or other mental disorder today and at least one in four will be afflicted by the same at least once in their life time