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I’m a 40-year-old married woman, and I’m not happy with my marriage. I feel sad, lonely, and frustrated. I often find myself yearning for emotional intimacy and connection with my spouse, but it feels like we’ve grown distant over time. We lack communication and understanding. He is always busy, either on his phone or with other things. These days, we fight over small things. I feel emotionally drained. How can I navigate these emotions and work towards rebuilding the bond with my husband? Are there any specific things that we can do to reconnect and strengthen our relationship?—A struggling wife Answered by Tashi Gurung, counseling psychologist, Happy Minds Communicating with your partner and expressing your feelings is the best way to help you cope with the ups and downs in your relationship. But first, let’s start by addressing what those feelings are. For communication to work well, you need to be clear about what you want to say. This self-awareness might help you communicate effectively.  Most of the time, when there is disagreement, anger dominates our feelings and behaviors. Instead of keeping our cool and speaking in a non-confrontational manner, we end up using assertive communication techniques. This might make the process of communicating worse for the both of you.  When that happens, your partner might feel like you are blaming him for everything and might not be open to communicating. Arguments will escalate, and the relationship between you two might worsen. But there are ways in which you can maintain being non-confrontational while also confronting your feelings. You can use phrases like ‘I feel unheard most of the time’ instead of ‘You never listen to me’ because using ‘I’ in phrases prevents accusatory communication. This method will encourage you to communicate your feelings rather than complain about your relationship.  Find an appropriate time to communicate. Remember to create a secure environment where you and your partner can talk about your feelings. It should feel like a safe space for both of you. Make sure that both of you have a positive state of mind and are looking forward to having a conversation. This way, both of you will be ready to keep an open mind while listening to each other. Also, it’s important to pay close attention to what your partner is trying to say. Make eye contact so that your spouse feels that his emotions are being validated. This way, he might reciprocate in the same manner.  Plan distraction-free time without any devices. You should try setting up a regular date night so you can spend time together and engage in real conversations. Plan engaging activities that encourage deep conversations where you can express your views, dreams, expectations, and worries. You can start with simple activities like going for a walk, cozy dates, cooking together, or organizing a trip.  From minor disputes to underlying issues like loneliness, resentment, insecurity, and childhood trauma, there can be many reasons behind you and your partner’s lack of intimacy. So to understand the underlying emotions and needs better, I advise you to seek the help of a marriage counselor. They can offer advice, assist in improving communication, and suggest other methods to strengthen your relationship.

Let’s start with a normal scene in Nepal-India relations. A head of government in Nepal shows commitment to improving Nepal-India relations. But whoever is in the opposition in the Parliament grows suspicious, questioning the very motive of the one in power. Three important interactions have occurred within a year with three visits and three schemas between top government officials of the two countries. They are clean energy (hydropower), infrastructure development and strategic connectivity. After Sher Bahadur Deuba’s visit to Delhi in April 2022, Prime Minister Narendra Modi visited Lumbini in less than a month in May 2022. Prime Minister Pushpa Kamal Dahal awaited a visit reversing his first visit to Beijing in 2008 and concluded the four-day trip to India recently with a focus on clean energy, strategic connectivity—both road and railways infrastructure development—easy monetary system, people-to-people relations and with Nepal’s entry into the India-led International Solar Alliance. This holds six projects and seven agreements with focus on power cooperation and development cooperation. The idea was to re-stress and re-visit the strategic means to achieve the end goals for a harmonious relationship. The latest developments are in keeping with India’s ‘Neighborhood First’ policy and PM Modi’s address to Nepal’s Parliament in August 2014, in which he expressed his country’s intent to ‘HIT’ Nepal by building Highways, I-ways and Transways. Making the most of HIT as well as security diplomacy with defense cooperation, law enforcement coordination and intelligence sharing as integral parts remain formidable challenges.   Strategic posture  During his recent visit to India, Dahal showed willingness to complement Indian needs, vis-a-vis political, energy and freshwater, with the hope that this will result in economic enhancement for the Nepali people. But Nepal-India ties are not going smoothly, what with ongoing border disputes that can come up as a political whip during elections, thereby impacting the political setups. Of several disputes along the 1,850-km Nepal-India border, disputes over the India-controlled Kalapani-Lipulek-Limpiadhura and the Susta region stand out. There is also the fallout of India’s Agnipath defense recruitment scheme for enlisting Nepali citizens in the Indian Army. Dahal’s reappointment as PM with support from the Nepali Congress after the withdrawal of support from the CPN-UML in the Parliament points toward a joint response from New Delhi and Washington. In this context, recent visits of US Under-secretary of State for Political Affairs Victoria Nuland (in January) and USAID chief Samantha Power (in February) and the visit of India’s Foreign Secretary Vinay Mohan Kwatra (in mid-February) are noteworthy. These trips underscore Nepal’s significance in the geostrategic scheme of things. Also important to note is the fact that the election of NC candidate Ram Chandra Paudel paved the way for the authentication of the Citizenship Amendment Bill that his predecessor, Bidya Devi Bhandari, had nixed. These maneuvers have political-economic-security corollary and a determination for stimulus influence over all countries in South Asia.   Security ties Political interests have changed as technology and geography have become more accessible and reachable than ever. Nepal-India security relations should also be read in this light. They refer to safety measures, or strength against possible detriment or undesirable coercion by nation states and non-state actors preventing the freedom to act. It is the safety from threats and protection of predominantly seven bodies–from economic security, food security, health security, environment security, personal security, community security, human security, physical security to political security. Without peace and stability, sustained economic growth and poverty alleviation are not possible. Peace and stability in Nepal, India and the entire region is possible through security diplomacy. To achieve these ends, law enforcement cooperation and intelligence coordination are necessary between Nepal and India. The new threats to Nepal-India relationship involve obstruction in traditional security ties based on the Treaty of Peace and Friendship (1950), so security diplomacy will be key in coming years. Military-to-military relationship, law enforcement coordination and intelligence community cooperation play an important role in fulfilling foreign policy objectives. While talking about military ties it will be contextual to delve a bit into the Agnipath recruitment scheme. Agnipath is about defense diplomacy that has a distinct setup—domestic, regional and international. The traditional practice of recruiting Nepali Gurkha into the Indian Army remains stalled with political concerns deprived from an understanding of what their absence really means. It is not just about the 75 percent that return after four years adding on to the unemployment list nor is it only about the possibility of unwanted elements misusing them against Nepal. It has strategic bearings garnering political trust, geopolitics, economic, diplomacy, employment opportunities and people-to-people relations. The two nations should move forward acknowledging the trends of defense diplomacy changing its discourse for peace or against peace, diplomacy for development or diplomacy for or against democracy.   The way forward Nepal-India relationship has been primarily viewed through a political lens and PM Dahal’s visit is no exception. The visit has emphasized political-economic-security outlooks of the relationship when world powers are striving for a new world order and Asia for a new normal. Foreign policy, diplomacy amongst different instruments of power and regional connectivity to address the strategic needs of South Asia and beyond—they all are equally important as diplomacy amongst the defenders of national interests. The colonial period, India’s independence, its strides in shaping a favorable security architecture in 1970-1990, its economic growth and global aspirations, Nepal standing out as a sovereign country during the colonial period and China consolidating its territorial gains after 1950 are some of the developments that beget attention. In a changing world, growing interests of China and India are not just in their ‘spheres of influence’, but well beyond as well. For China, it is the Indo-Pacific Region with multi-continental diplomatic engagements. For India, it is beyond its immediate neighborhood to Southeast Asia, East Asia, West Asia or the Persian Gulf. Nepal can play a significant role in addressing challenges facing not only India, but the South Asia region as a whole. These challenges include power shortages, flooding, inundation and shortages of freshwater, which have been impacting comprehensive security. The Joint Vision Statement on Power Sector Cooperation of April 2022 has now entered the sub-region through trilateral power connectivity between Nepal, India and Bangladesh. Being part of the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) will have geopolitical and geoeconomics propositions for Nepal. The transportation connectivity and border crossing arrangements between Bangladesh, Bhutan, India and Nepal (BBIN) should remain an integral part of the international organization and plurality. The joint military exercises envisioned in the BIMSTEC will have a crucial role in addressing the changed dynamics of defense diplomacy, which needs strengthening. In this context, the Association of Southeast Asian Nations (ASEAN)’s decision to conduct the first joint military exercise of 10 member-states in the disputed South China Sea this September is quite significant. Commenting on this development, Admiral Yudo Margono of Indonesia recently said that the exercise is aimed at strengthening “ASEAN centrality” and does not include any combat operations. Nepal and India security relationship is not and cannot remain bilateral; it is regional and international with ‘strategic connectivity’ focusing on power, freshwater, infrastructure, transportations connectivity as well as security connectivity. It has the potential to become an indispensable driver of modernity and progress as well as mutual economic growth in the region, with long-term power trade and management of water boosting reciprocally-beneficial ventures. The author is a Strategic Analyst, Major General (Retd) of the Nepali Army, and is associated with Rangsit University, Thailand

Covid-19 is often measured by the number of people infected and the deaths associated with it. But the impact of the virus has extended beyond the direct effects of the coronavirus. Covid-19 is no longer a global public health emergency, but its effects still run wider and deeper. Urmila Sharma (38) of Koteshwor feels fatigued and tired. She experiences shortness of breath when walking for a little distance and also while climbing stairs. She feels that her health has not been the same after she got infected with the coronavirus a year ago. There are many people across the world who have a similar plight to that of Sharma, experiencing similar kinds of symptoms such as fatigue and tiredness. Many are suffering from heart diseases and diabetes. Such patients are visiting hospitals for a regular check-up concerning the long effects of coronavirus. Their main concern is their current health status, as they had recovered from the coronavirus infection after receiving intensive care. As per Dr Bidesh Bista, clinical pulmonologist at Civil Hospital, many of the patients who were infected from the coronavirus in the past have recovered. The lungs infected by the coronavirus have become normal, but 10-15 percent of the patients who had Covid-19 in the past still have lung fibrosis, a condition where patches are seen in the lungs. According to the Ministry of Health and Population, a total of 1,157,414 people have been infected from the virus in the country. Meanwhile 12,031 people have succumbed to the infection as of June 18. According to the World Health Organization, common symptoms of post-Covid-19 can include fatigue, shortness of breath and cognitive dysfunction. Over 200 different symptoms have been reported that can have an impact on everyday functioning. Long covid symptoms Long Covid symptoms include chest pain, fatigue or muscle weakness, palpitations, cough, diabetes, pancreas injury, abdominal pain, nausea, cognitive impairment, brain fog, disordered sleep, memory loss et cetera. In a study conducted by Jin Yin-tan Hospital in Wuhan China published in the Lancet in August 2021, in which the authors reported on one-year outcomes from the largest cohort of hospitalized adult Covid-19 survivors, it showed that fatigue or muscle weakness (63 percent, 1,038 of 1,655) and sleep difficulties (26 percent, 437 of 1,655) were the most common symptoms. Anxiety or depression was reported among 23 percent (367 of 1617) of patients. Fatigue A research conducted by Sangam Shah and others showed the post-Covid status of 300 patients admitted to the Tribhuvan University Teaching Hospital. The study revealed that most of the patients had fever (81.7), followed by fatigue (81.3) and cough (78.3). The research revealed that fatigue was the most common persistent symptom. “People have been experiencing fear, anxiety, feeling short of breath, trouble concentrating. Such complications are more in elderly people and in diabetics. These symptoms also differ how much degree of severity one had due to Covid-19,” said Dr Bista. Dr Prabhat Adhikari, internal medicine, infectious disease and critical care at Center for American Medical Specialists (CAMS), said: “Patients who were more severely ill because of the coronavirus, who were admitted in the intensive care unit have experienced comparatively higher long term effects.” To prevent the long effects of Covid-19, doctors suggest preventing oneselves from catching infection and maintaining body weight. Psychological disorders People who had Covid-19 have been experiencing psychological disorders such as anxiety, depression or other mood changes, concentration or memory problems—brain fog and sleep disturbance—as well. Though the exact causes for these symptoms are unknown, they could be because of the effects of the infection on the brain, immune system or the other organ, say doctors. They could be the result of traumatic aspects of the experience of having Covid-19. Long-term hospitalization, in intensive care units, can lead to post-intensive care syndrome, which often includes severe weakness, cognitive problems (including poor concentration), and even post-traumatic stress disorder. “If one has psychological issues one can practice yoga and meditation. Psychological consultation is necessary for depression,” said Dr Adhikari. According to a research paper published in Nature Journal, entitled Long COVID: Major findings, mechanisms and recommendations, long Covid is an often debilitating illness that occurs in at least 10 percent of severe acute respiratory syndrome coronavirus 2 infections.  More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65m individuals around the world have long Covid, based on a conservative estimated incidence of 10 percent of infected people and more than 651m documented Covid-19 cases worldwide. The number is likely much higher due to many undocumented cases. The incidence is estimated at 10–30 percent of non-hospitalized cases, 50–70 percent of hospitalized cases and 10–12 percent of vaccinated cases. Long Covid is associated with all ages and acute phase disease severities, with the highest percentage of diagnoses between the ages of 36 and 50 years, and most long Covid cases are in non-hospitalized patients with a mild acute illness, the research reveals. More research necessary Though people are experiencing long Covid symptoms no proper study has been done in Nepal to conclude the long effects of the infection and its symptoms in people across the country. “The virus can trigger the immune system. No research has been done in the country regarding whether the virus in the cells have been completely damaged or not. Is the virus still overactive in the body and weak? It needs to be studied. Also there is no specific test to find out whether the above symptoms are of long Covid or not,” said Dr Anup Subedee. There have been more than 200 symptoms that actually have been reported in patients, according to the WHO. However, there are no exact number of people suffering from long Covid in the country. Protecting yourself from long Covid Some of the effects of the virus can be seen even after decades. Health practitioners recommend a number of measures to help prevent long covid. They recommend people to:

•         Take Covid -19 vaccines/boosters
•         Take vaccines against influenzas
•         Wear well-fitting masks
•         Wash hands regularly
•         Ensure well ventilation in indoor spaces
•         Prevent catching Covid
•         Increase the number of Covid tests

Youth suicide is a tragic global issue that continues to affect communities worldwide. A rising prevalence of mental health disorders, particularly depression, among young individuals has become a significant concern. This article aims to shed light on the profound relationship between mental health, depression, and youth suicide. By understanding the factors contributing to this distressing phenomenon, we can work toward effective prevention strategies and support systems for vulnerable young people. Mental health issues have reached alarming levels among today's youth. The pressure of academic performance, societal expectations, peer relationships, and the pervasive influence of social media have contributed to increased stress and anxiety. According to studies, approximately 20 percent of adolescents experience a mental health disorder at some point in their lives. Depression, in particular, is a leading cause of disability among young people globally. Depression plays a critical role in youth suicide, as it often serves as a significant precursor to suicidal thoughts and actions. Many young individuals who take their own lives have experienced prolonged feelings of hopelessness, helplessness, and despair. The symptoms of depression, such as persistent sadness, loss of interest, changes in appetite and sleep patterns, and low self-esteem, can intensify these negative emotions, pushing vulnerable individuals toward contemplating suicide as a perceived escape from their suffering. Recognizing the risk factors and warning signs associated with youth suicide is crucial in identifying those who may be at risk. Some common risk factors include a history of mental health disorders, previous suicide attempts, family history of suicide or mental illness, substance abuse, bullying, and social isolation. Warning signs may include sudden changes in behavior, withdrawal from social activities, giving away possessions, expressing feelings of hopelessness or worthlessness, and talking about death or suicide. Recently, a young content creator committed suicide. This incident, one among many cases of youth suicides, should be looked into in the light of factors mentioned above. Creating supportive environments and providing adequate interventions are key to preventing youth suicide. Educational institutions, families, communities, and healthcare providers play critical roles in identifying at-risk individuals and offering timely assistance. Promoting mental health awareness, destigmatizing seeking help, and providing accessible mental health services are essential steps toward addressing this issue. Early intervention and proper mental health support are crucial for young people struggling with depression and suicidal thoughts. Establishing school-based mental health programs, counseling services, and helplines can provide accessible avenues for seeking help. Collaborative efforts between mental health professionals, educators, and parents can facilitate early identification and intervention, offering necessary support and treatment options tailored to the needs of each individual: Building resilience and promoting emotional well-being are key factors in preventing youth suicide. Empowering young individuals with coping mechanisms, stress management techniques, and social-emotional skills can equip them with the tools needed to navigate life's challenges. Encouraging open conversations about mental health, fostering supportive relationships, and promoting self-care practices can create a nurturing environment that reduces the risk of suicide and supports overall well-being. Summing up, addressing the impact of mental health and depression on youth suicide requires a multifaceted approach that involves individuals, families, communities, and policymakers. By prioritizing mental health education, early intervention, destigmatization, and providing accessible support systems, we can work toward preventing youth suicide. Together, we can create a society that values and protects the mental well-being of our youth, offering them hope, support, and the opportunity to thrive.