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While dealing with substance abuse, I often ponder over how seeking support for my mental health can contribute to understanding and addressing the roots of my addictive behavior. If I seek help from professionals, will I find a treatment plan tailored to my needs and help me in my struggles with addiction?

Answered by Rishav Koirala, researcher and psychiatrist

Collaborating with healthcare professionals becomes a cornerstone in tailoring a comprehensive treatment plan that extends beyond immediate challenges, delving into the deeper, underlying factors influencing struggles and helping the sufferer through the long journey of abstinence and instances of relapses. This collaborative effort involves a detailed methodology encompassing a comprehensive assessment, identification of triggers, exploration of any co-existing mental health issues, and prevention of relapse. 

In addiction, the pursuit of pleasure frequently becomes a driving force, leading to a quest for understanding the reasons behind substance reliance. Acknowledging resulting harmful behaviors and health issues requires a multifaceted approach. Utilizing established psychotherapy techniques such as Cognitive Behavioral Therapy (CBT) and mindfulness is pivotal in reshaping the connection between pleasure and substance use. 

The whole medical treatment process can be divided into two phases. The first phase of detoxification addresses the symptoms of withdrawal such as sleep disturbances, anxiety, physical pain, and related issues. The second phase is relapse prevention. The use of medications helps in the prevention of relapses as well as halts a person’s further deterioration when s/he relapses.

The adoption of a two-phase treatment approach, starting with stabilization and transitioning to maintenance, ensures a thorough strategy addressing both immediate challenges and the deeper roots of addictive behaviors. A huge percentage of people dealing with addiction also have mental health issues both due to the direct effect of the psychoactive substance and due to the life they are living due to addiction. These issues cause problems when one wants to come out of addiction.

Without addressing mental health issues, coming out of addiction is difficult. Mental health professionals help in this regard too.This holistic methodology involves ongoing follow-up and a steadfast commitment to preventing relapse, fostering collaboration between individuals and healthcare professionals throughout the journey of recovery.

The next step is involving and educating family members in the recovery process. Open communication becomes essential, allowing for honest discussions about the challenges and goals of the individual struggling with addiction. Mental health professionals address addiction as a psychosocial issue and address this component with equal importance.

Addressing harmful behavior and illness requires a meticulous examination of the consequences of addictive behavior on physical and mental health. Implementing harm reduction strategies becomes a crucial aspect of mitigating negative impacts during the recovery process. This approach, which goes beyond a focus solely on abstinence, includes education on safer use practices and the provision of resources to promote healthier behaviors.

I’m a 15-year-old girl and I must admit that I’m very lazy. I put things off till the last minute and sometimes don’t even do important tasks. This makes me look bad at school and people don’t trust me when I say I will do something. I want to change but I have no motivation whatsoever. I just want to sleep or watch TV all the time. Please help.

Answered by Kapil Sharma, counseling psychologist, Nepal Institute of Mental Health 

In the journey of cultivating a positive mindset, it’s vital to integrate practices that foster self-compassion and understanding. When reflecting on your emotions, practice self-compassion by acknowledging that facing challenges is a universal part of life; it’s entirely okay to experience them. This approach helps create a space for acceptance and growth, recognizing that emotions, including those tied to demotivation, are natural aspects of the human experience.

As you move forward and seek healing through the process, extend the same kindness to yourself that you would offer to a friend facing similar challenges. Celebrate your strengths and acknowledge the progress you make, emphasizing the positive steps you take on your journey. This self-celebration contributes to building a nurturing environment, fostering resilience and self-love.

When exploring the causes of demotivation, maintain a gentle curiosity. Adopting this approach allows you to understand the factors at play without engaging in self-blame. By focusing on understanding rather than judgment, you pave the way for a constructive analysis that can lead to effective solutions.

Crafting a daily routine is an additional facet of fostering a positive mindset. In your routine, incorporate self-care activities such as mindfulness, exercise, or engaging in hobbies you enjoy. Prioritize your mental and emotional well-being, recognizing that a balanced routine contributes significantly to overall positivity and motivation.

By intertwining these practices of self-compassion, a celebration of progress, curiosity, and a mindful routine into your journey, you lay the groundwork for a positive mindset. Remember, each step you take in this direction contributes not only to personal growth but also to increased resilience and motivation in both academic and personal pursuits.

Balancing work and home responsibilities can be difficult but it’s something I strive for every day. The stress often gets to me. I want to effectively navigate the challenges of balancing work demands while being available for my children. I want to ensure they have a healthy and supportive environment for their overall well-being. What can I do?

 Answered by Rishav Koirala, researcher and physiatrist

 Balancing work and supporting your children at the same time can be a real challenge. A smart strategy is to figure out your priorities and set clear boundaries between work and family time to keep stress in check.

Quality time with your kids matters more than just quantity. Doing activities together that build a strong connection and help your kids grow emotionally is important. Take care of yourself too. Make sure you exercise, do things that relax your mind, and get enough sleep too. A happy and healthy parent can provide better support than a stressed and irritated one.

Open communication with your children about your work schedule is key. Being flexible in how you handle work and family is important. Share responsibilities at home and work, and build a support system of friends and family who can lend a hand when things get overwhelming. Look for new ways to blend work and family life when possible.

If things get tough and you are unable to deal with it, family therapy can be a helpful option. When things seem to be going out of control, seeking advice from a professional shows your commitment to personal growth and your family’s well-being.

It’s not just about managing time but understanding what matters to you. Good communication, flexibility, and having a strong support system are the keys to finding a balance between work and supporting your children.

In the era of networks and technology, human beings are thriving in various ways. However, when it comes to mental health, particularly in Nepali society, everyone either wants to twist the topic or feels too shy to talk about it. And those who talk about it usually delve into the negatives. Why do people hesitate to talk about mental health? Why is stigma attached to the subject? I have been asking people about it for seven years. As a psychologist and founder of the mental health clinic PICS NEPAL, my job is to help people overcome their mental health issues. But the irony is even my own family is hesitant to openly discuss the topic of mental health. There might be various reasons, mainly a lack of education or awareness.

The word education is a process of enlightening people, from darkness to light, zero to everything. In other words, it empowers people with practical skills and knowledge. Imagine villages transformed by roads and airports built by engineers—a testament to the transformative power of education. Similarly, education can illuminate the darkness surrounding mental health. Yet, our current education system fails to prioritize this vital subject. Every family wants to make their child an engineer, a pilot, doctor, or a banker. However, nobody wants to make their child a counselor, psychologist, or psychotherapist. Although people are being educated and have all the facilities from the road to the airport, they still haven’t changed their mindset about mental health.

Changing the public’s mindset is also related to the nation’s education system. If everything has been achieved through education, then why not the perception of individuals? But the primary thing is it should be on the priority list of the government. If a government can change the mindset of voters towards a political party within five years, then why not about mental health? Nothing changes overnight, but if it is in a will list, nothing can stop it. The viewpoint towards mental health, a crazy state, being unconscious, psychosis, loss of control, furious, abnormality, and peculiar behaviors, even if it’s because of sinful activities by their parents or grandparents in some places or a god’s actions against your behavior in some areas, are common in the society. But mental health is quite different than the way people have been assuming. It is a state of well-being in which people can work regularly, help their communities and effectively overcome their daily life stressors. This is a bitter truth, but I found a similar understanding among all the so-called educated people regarding mental health issues. They see it as a state of madness, crazy, and psychosis that cannot be treated. Immediately, questions arise: Do they even have basic knowledge about mental health? What have they studied in their school/ college?

Is education far from the basics of health, or is it simply the ignorance of basic knowledge? A bunch of questions arise when I see the current scenario of our country. In my opinion, it’s not only people’s negligence but also the education system. Our basic education system has to cover health education at its primary level to make people conscious of their health, specifically their mental health. The school curriculum must be reformed. It needs to be practical, useful, and relevant.

Hundreds of thousands of youths are suffering from mental health disorders. According to the national report of government 2077, the burden of mental health among non-communicable diseases is almost one-fifth. People struggle each day to survive, around 20 per day, but can’t; the suicide rate has increased over the last couple of years.

Mental health matters a lot, but the government education system teaches something different in school. To become competent and robust enough to cope with everyday life stressors, one should be informed earlier. School curricula should teach today’s kids about their minds, thoughts, and behavior. Education doesn’t always mean teaching complicated equations and complex word meanings. It should also teach children ways to fight, cope, and overcome the everyday stressors, which could help them lead a happy and healthy life. '

Teaching in school about mental health will help an individual at a greater level and create awareness in the family. The child will talk about mental health and will do homework on mental health; they will be obliged to teach their families about mental health. It will minimize the stigma and prejudice regarding mental health, which will ultimately lead to easy access to mental health as physical health.

Sometimes, we talk about a big topic but miss the small one that has a more significant impact. Let’s initiate a talk about mental health at school, in the workplace, in coffee shops, in the film industry, and in business. Until and unless we talk about it openly in different places, I don’t think we can create awareness regarding mental health.

The role of the media is also crucial to create positive debate about mental health. Media has the power to shape public discourse. Instead of sensationalizing individual cases, it should focus on normalizing mental health conversations. Open discussions and expert opinions disseminated through various media channels can break down existing stigmas and encourage individuals to seek help.

So, let’s all spread positive messages to boost the self-esteem and confidence among those in need—and I believe everybody needs it. We all have a mind (psyche) that controls and regulates our thoughts and imaginations; we might be in trouble at any point, so we all need to take care of our mental health.

The author is counseling psychologist and founder of PICS NEPAL: A place for mental health and psychosocial well-being