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I’m in my early 40s and have recently lost someone very dear to me, a close family member. The grief has become this heavy, complex emotion that I find myself wrestling with daily sadness, anger, and an overwhelming sense of emptiness. Simple, everyday activities feel like monumental tasks, and there are moments when waves of sorrow hit me unexpectedly. What can I do to manage this pain?

Answered by Rishav Koirala, researcher and physiatrist

Grief is a complex and deeply personal experience, and the emotions you’re feeling whether it’s the weight of sadness, the intensity of anger, or the overwhelming sense of emptiness are entirely understandable. Facing such a significant loss in your early 40s adds another layer of complexity, as life transitions and responsibilities might already be demanding.

It’s crucial to recognize and embrace the spectrum of emotions that accompany grief. This multifaceted journey often involves navigating through different stages, and it’s entirely normal to feel a mix of emotions at various times. In your mourning process, seeking support is paramount. Whether you turn to friends, family, or a mental health professional, sharing your thoughts and feelings can be therapeutic. It creates a space for understanding and empathy, helping to alleviate some of the emotional burden.

Taking care of your well-being is a vital aspect of coping with grief. The toll that grief can take on your physical and mental health is substantial. Prioritize self-care by ensuring you get sufficient sleep, maintaining a balanced diet, and engaging in activities that bring you comfort or joy, even if they are small or simple.

Recognizing that grieving is a gradual process is important. There’s no set timeline for healing, and every person navigates this journey uniquely. Setting realistic expectations for yourself allows room for the ebb and flow of emotions. Establishing meaningful rituals or routines to honor the memory of your loved one can provide a sense of connection and continuity.

If the weight of grief becomes overwhelming, considering professional help is a valid and beneficial option. Therapists or counselors can offer specialized guidance tailored to your specific needs, providing coping strategies and emotional support. Additionally, joining support groups where individuals share similar experiences can be a source of comfort, understanding, and shared wisdom.

Remember that it’s entirely acceptable to mourn at your own pace, and seeking professional guidance doesn’t diminish your strength but rather enhances your ability to navigate through this challenging period. In your journey through grief, be patient with yourself, allow for moments of reflection, and embrace the support available to you as you work towards healing.

Is it a common experience for individuals to undergo negative emotions in a relationship when apart from their partner, potentially influenced by past relationship issues? Furthermore, can feelings of insecurity and overthinking, stemming from past relationships, contribute to arguments with one’s current partner?

Answered by Rishav Koirala, researcher and physiatrist 

Occasional occurrence of negative emotions when separated from one’s partner may be a common feeling in many people.  But when it’s associated with overthinking even small things leading to anger and argument, we have to explore psychosocial issues.

Everyone’s current experience is influenced by past experiences and in a few it may lead to imprinted emotions which might have a negative influence on current situations. The first step to deal with it is by engaging in a thoughtful exploration of these emotions by yourself. Start by reflecting on the specific aspects of your past relationship that might be impacting your current one. Identify any negative experiences or unresolved issues that could be contributing to these feelings. Self-reflection can be a valuable first step in understanding the root causes of your emotional responses.

Following self-reflection, consider addressing these identified issues. Open communication with your current partner is key. Sharing your concerns and feelings fosters understanding and support. Be transparent about the impact of your past experiences and work together to create an environment of trust. Discussing these matters openly can contribute to a healthier and more empathetic connection.

Recognize the potential role of personality traits, such as attachment styles, in influencing your emotional responses. Individuals with anxious attachment styles, for instance, may experience heightened concerns about separation. Another aspect could be Borderline Personality Traits that have a substantial impact on the relationship of the sufferer. Insecurity, increased emotional sensitivity, and impulsive behaviors may lead to arguments and relationship issues if one has these traits.

Understanding these traits, both in yourself and your partner, provides valuable insights into the dynamics of your relationship. If your past relationships have had a big impact on you, it might have led to anxiety issues. People with anxiety issues tend to misinterpret things and have negative thoughts that can lead to negative emotions such as anger and irritability. This might also be one of the reasons why you jump into arguments by overthinking minor things.

If you are not able to resolve the issues by yourself or with the help of your partner, seeking the guidance of a mental health professional is highly advisable. They can help you to delve deeper into these emotional complexities and develop effective coping strategies. A psychiatrist or therapist can assist in identifying and addressing specific concerns related to your past experiences, attachment styles, and any anxiety you might be experiencing. This professional support can contribute to personal and relational growth, providing tools to manage and overcome these challenges. Simple modalities such as meditation, and relaxing exercises such as yoga can also help you achieve these goals to some extent.

I’m a 35-year-old man and I’m struggling to balance my duties as a son and a husband. My wife doesn’t get along with my mother and my mother isn’t particularly fond of my wife either. They get into arguments very often and both of them expect me to take their side every time. I try to stay out of their issues but I feel like it’s my responsibility to sort things out between them. I feel helpless when I can’t. What can I do?

Answered by Rishav Koirala, psychiatrist and researcher

Balancing the relationship between your mother and your wife can be a formidable challenge. To address this conflict effectively, initiating open and honest conversations with both your wife and your mother is a crucial first step. This allows you to seek their perspectives and express your concerns openly. 

It’s essential to establish clear boundaries that encourage both parties to interact civilly and respectfully, even if they don’t become the best of friends. If conflicts persist and mediating becomes difficult, consider seeking professional help, such as couples counseling or family therapy, which can provide a neutral space for everyone to express their feelings and work towards resolutions.

Moreover, it’s important to encourage your wife and mother to develop their relationship with each other. While they may not become close friends, fostering some understanding and mutual respect can significantly improve the overall family dynamic.

In moments of conflict, strive to be a fair mediator, remaining calm and unbiased. Avoid taking sides and focus on finding common ground and practical solutions. Prioritize your marriage, and your relationship with your mother as well investing time and effort to maintain a strong and healthy relationship with your wife and your mother. This can contribute to an improved family atmosphere.

Most importantly, don’t forget to take care of your well-being, as dealing with family conflicts can be emotionally draining. Seek support from friends, support groups, or a therapist to help you cope with the emotional stress. Keep in mind that resolving family conflicts takes time, so approach the situation with patience and empathy. By focusing on communication, setting boundaries, and being open to positive relationship evolution over time, you can create a more harmonious environment for everyone involved.

My grandmother is a 65-year-old retired teacher. Lately, she has been experiencing memory problems, such as forgetting appointments, misplacing keys, and struggling to recall the names of familiar people. What could it be and is there anything that could be done

Answered by Rishav Koirala, psychiatrist and researcher

Age-related cognitive changes are common, and some degree of forgetfulness is considered a normal part of aging. Chronic stress can lead to cognitive difficulties, and addressing stress management techniques may help improve memory. Sleep disturbances, such as sleep apnea or insomnia, can also impair cognitive function, and optimizing sleep quality can have a positive impact. 

If your grandmother is on some medication regimen, there are some drugs that may be affecting her memory. So a review of her medication is essential. Additionally, addressing any underlying medical conditions and ensuring proper nutrition can play a crucial role in memory improvement.

With the aging population in Nepal, the prevalence of cognitive disorders, including dementia, has been on the rise. In the context of dementia, individuals may experience a distorted sense of temporal orientation, emphasizing past memories while struggling to remember or anticipate the future. This temporal disorientation can lead to a sense of ‘wandering’ through time, where past experiences become more accessible, while future events and plans become increasingly elusive. 

As a result of this temporal disorientation, individuals experiencing memory problems may also find it challenging to remember tasks or work that was in progress, which can be disruptive and disorienting. This issue can further compound the difficulties associated with dementia, as individuals may ‘lose track’ of their ongoing tasks, adding to their sense of temporal disorientation and causing frustration and confusion. Understanding and addressing these challenges are essential in providing appropriate care and support to individuals with dementia.

Moreover, it’s crucial to recognize that the person looking after the patient, such as family members or caregivers, may experience significant emotional and psychological challenges. The constant adjustments and uncertainties brought about by dementia can lead to caregiver anxiety, stress, and burnout. Caregivers often grapple with the demanding responsibilities of ensuring the patient’s safety, providing emotional support, and managing the daily care routine, all while witnessing the progressive decline of their loved one's cognitive function. Recognizing and addressing the caregiver’s well-being is a vital aspect of holistic care for individuals with dementia, as it helps ensure the patient receives the best possible support while also maintaining the caregiver’s own mental and emotional health.

To determine the exact cause and appropriate interventions, it is crucial for your grandmother to seek a comprehensive evaluation from a healthcare professional, be it a psychiatrist, neurologist, or geriatrician, who can provide a tailored assessment and guidance for her specific situation. Early intervention and support can significantly affect the management of memory issues, irrespective of their underlying cause, and may involve addressing temporal disorientation and providing a supportive environment for individuals with dementia.