In the psychiatry department of Dr L H Hiranandani Hospital in Mumbai, the trickle has already started to swell. A 13-year-old arrives with a persistent headache, well after her parents were rescued from a terrorist-hit hotel. A lady who heard a taxi explode has not slept since. Even a man who just watched south Mumbai fall under siege on television on the night of 26 November complains of excessive fear and insomnia.
Illustration by Jayachandran / Mint
For many of these people, the diagnosis is likely to be post-traumatic stress disorder, or PTSD, a malady that is commonly—and mistakenly— thought to be the sole preserve of war veterans. “But you know, nobody is untouched,” says K. Sekar, a Bangalore-based psychiatrist. “Even a child who saw the Mumbai attacks happen from the street needs to talk to somebody about it.”
Hidden symptoms
In many people, the symptoms may not even be apparent as yet. Following the 1993 blasts in Mumbai, just a loud mention of the word “smoke” alarmed 28 women enough to jump out of their train to their death. After the extensive floods in the city in 2005, fear ignited a stampede in a slum. Both incidents were marked up to the hyper-vigilant state that characterizes PTSD.
Sekar, head of the department of psychiatric social work at the National Institute of Mental Health and Neuro Sciences (Nimhans) in Bangalore, considers such psychological reactions inevitable in witnesses or survivors of severely traumatic events such as the Mumbai attacks. “These are normal reactions to abnormal situations,” he says, “And they need to be vented in a proper manner.”
Medication can help, but if the counselling is good and sustained, doctors insist that drugs are necessary only in a fraction of cases
But Sekar offers a nuanced explanation of what exactly a “proper manner” might be. It does not mean, he insists, that everybody make a beeline for personal therapists and intensive counselling sessions. “We do not have the one-to-one type of infrastructure that’s present in the West, but we also don’t need that,” he says. “There is a resilient support system available in the Indian family. It just needs people who are willing to listen and empathize.”
Support systems
Mumbai-based Harish Shetty, a veteran of counselling disaster survivors in India, has seen PTSD-affected people seeking help from yoga therapists, their family’s spiritual advisers, and “quasi-religious systems”. Many of them, he says, would benefit from just reassurance, support, relaxation exercises, yoga and meditation.