Voices of Resilience

The Unseen Reality of Meena May

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About the Case Study

Resident’s Profile:

Gender:
Female
Age:
44
Marital Status:
Divorced
Rehab Duration:
1 Year
Illness Duration
5 Years
Patient’s Alias Name:
Meena May
Professional’s Name:
Simal Vinod
Author’s Name:
Shwetha Jois
Depression, Bipolar Affective Disorder, and Obsessive Compulsive Disorder
Medication, Therapy and Rehabilitation

About the Resident

The story of Meena begins like every other modern-day woman. Nurtured with love in a blessed home, she evolved into a powerhouse of excellence and a successful entrepreneur. An inspiration to many and a constant reminder to some, Meena stands tall and proud today as a recovering Bipolar Affective Disorder patient, a volunteer at Cadabams, and a passionate owner of a decade-old BPO business. 

Just as rain and pain may pave the way for a few, it certainly seemed to catch onto Meena, growing up with an older sister in the heart of Calcutta with big dreams. In that pursuit, she enrolled for her Masters in the US. Sometime later, she got married and then divorced in less than a year. Her counsellors regard this moment as an unexpected emotional wound for Meena, especially since she has spoken so little about it. The wounds of her past were triggered when her parents presented a proposal for her to remarry, provoking the onset of her illness.

Upon returning to India, she volunteered at various IT firms in Noida, Gurgaon, Calcutta, and Delhi. She was motivated, determined, and passionate - all qualities that fostered her to begin her own BPO company that caters to multiple renowned international clients. However, this nature of work entailed long nights and lots of pressure. She was more focused on her career than her health at the time.

Case History

She admitted she used to take her health for granted until witnessed her mother trying to recover from multiple fractures while needing the full-time assistance of two nurses. Around this time, she had begun consuming alcohol, smoking, and using cannabis regularly. She resorted to cutting loose and enjoying more than three drinks a day, and occasionally, a little more. Her family did not approve of this behaviour as she had stopped working, talking to people, watching TV, playing the Piano, or listening to music - all of which were her favourites. They sensed that if they left the issue unattended, it could worsen over time.

Meanwhile, experiencing such hardship within the family provoked Meena to question herself with thoughts like “What is happening to me?” and “Why am I like this?”. This was exacerbated when her mother developed depression with the onset of menopause. This, in turn, made Meena realise the severe consequences of neglecting one’s mental health. With the responsibility residing on her shoulders towards her parents, family, business, and employees, she was convinced that it was her duty to heal herself. She knew something was not right and knew that she needed to talk to someone - but who? 

She thought to turn to her family, as any of us would, but with nearly a 15-year age gap between the two sisters, she felt shy and embarrassed to approach her. On the other hand, her parents were quite old and dealing with their own health issues, making her feel like bringing up this issue may not be the best decision. Additionally, with the added stigma attached to mental health problems, she was very confused.

The Role of Cadabams

During the pandemic, everyone felt the burden of isolation, which affected the emotional state of those who were vulnerable with severe repercussions. She spoke with a relative in Calcutta, who was a faculty member at Cadabams, about the need for a change in her environment to cope with her feelings; the relative suggested seeking professional help. Knowing that visiting a regular doctor would not suffice, she thought to herself, “There’s no happiness pill!” and took her first step to recovery.

During Bipolar Affective Disorder (BPAD), a mood disorder, the person alternates between depressive lows and manic highs. They can be extremely euphoric or have a sense of hopelessness. There is no one-size-fits-all answer to the question of what causes BPAD, but it is thought to be caused by a combination of genetic and environmental factors. Some of the risk factors for BPAD include family history and certain medical conditions, such as thyroid problems and substance abuse. Traumatic life events, such as childhood abuse or neglect, can also result in BPAD.

When she arrived at Cadabams, initially she was extremely spiteful towards the place. She found it incredibly difficult to cope with the lack of accessibility, restrictions on mobiles and laptops, and the strict routine that she had no choice but to adapt to. Her IT background and need to oversee communications with the team made it difficult for her to disconnect from technology and let the treatment take its course. 

The treatment plans at Cadabams involve the residential facilities being locked at night to ensure the maximum safety of all patients. Additionally, the residents are only permitted a few privileges, which are approved by the family before they are claimed. For Meena, the point of contact was her sister and brother-in-law; they struggled to deny her requests, whether it was food, access to technology, or excursions outside the facility.

It took about 2 months for her to fall in love with the place, the people, and the cause.  She said to me, “If it wasn’t for Cadabams, I have no clue what I would have done when I was helpless and distraught, weeping in my room, unable to pull myself together to eat or go out, weighing over 100 kilos.”

During her rehabilitation, it struck her that she was pampered right from the start to this point in life. Her parents were busy with work and travel, although she feels like they made up for it with multiple international trips and unique experiences, despite not being around as much. For Meena to acknowledge her blessings, her family insisted that she be put on a basic meal plan. This helped her understand what everyone was eating, the patience it took to stand in the long lines, and the difference in taste before being upgraded to a premium meal plan.

As she began helping other residents, she truly learned how to embody empathy and compassion as she continued to socialise, journal, and practice chanting meditations. She managed to begin to care for her body and mind after a few months of treatment. 

Her mother used to work for Mother Teresa’s ‘missionaries of charity’, and she felt like it was her duty to continue her mother’s journey by leaving her footprint behind. After her mother’s passing earlier in 2023, she started feeling more connected to helping people cope with their struggles. Meena also stated, “Whatever I am is my mother’s gift to me, and if I could help others, then it would be my gift to her.”

Professional’s Perspective

During my interaction with Meena’s counsellor, I was given a completely different perspective regarding her and her illness. She stated that the patient does not accept that she has a personality disorder but instead justifies it as a sleep disorder. 

This parallax is one of the most pivotal factors in her ability to cope with the disorder, as she is yet to acknowledge it. Thereby,  making therapy and counselling difficult for all mental health professionals. Although challenges may come and go, it is evident that Cadabams is fully equipped to be able to manage difficult situations and sensitive cases with state-of-the-art care. 

She can be easily triggered and offended by a negative comment or feedback, even if it is constructive criticism. On the other hand, she feels like she’s over the moon when she receives a compliment, whether it is for her appearance, behaviour, or work completed. If she likes someone, she will do everything in her power to ensure that they are happy with her, but if she dislikes someone, she is certain to find ways to make their life very complicated. 

Sometimes, she cannot comprehend the negative impact of helping others, which may be counterproductive. For instance, if she has extra snacks, she tends to share her food with all those around her, even if some may be diabetic or dealing with weight gain issues. 

Furthermore, the counsellor mentioned that when she went back home to pay her respects to her mother upon her passing, Meena did not return to a depressive state but instead splurged on clothes, earrings, and shoes, which seemed rather strange under the given circumstances.

Current Scenario

After coping with various conflicting emotions, she emerged with a better perspective on life, free of judgement. She became aware that some people had it better off, while others were in a much worse situation than her. Upon her realization, she started actively working to take better care of herself. She said, “Even though change is very important, I think we are resistant to change. It is definitely one of the pillars of evolution, enabling the next steps to success, but we hold ourselves back from coming out of our comfort zone”. 

When I asked her about who has played a significant role in her road to recovery, she whole-heartedly said, “I’m extremely grateful to Mr. Ramesh Cadabam for his inspirational endeavour that gave birth to a renowned organisation and fostered a revolutionary change in the realm of mental health care.” She gained the confidence to sing, dance, and MC on stage, something she had never done before. The various activities and therapies unveiled her inner strengths and abilities, which were accompanied by a change of mindset. 

Being altruistic, empathetic, and mindful is often arduous for BPAD patients, and truth be told, she is doing remarkably well and managing her business remotely without taking on too much stress. She now lives away from the facility while managing her morning meetings, medication, and follow-ups entirely on her own. She currently volunteers at the facility, helps organise events, and coordinates amongst the other residents. Her experience at Cadabams has provided her with a systematic routine that has enabled her to maintain normal functioning even after being discharged. She says, "It’s not about putting your best foot forward, but instead, your better foot forward.”

Author’s Notes 

During our initial conversation, I was awestruck by Meena’s candour, confidence, and communication style. As she was a volunteer, she was kind enough to take us through a detailed walk-through of the facility. She greeted other residents, staff, and security personnel along the way. While my colleagues and I continued touring the facilities, she shed light on her childhood, her business, and her journey at Cadabams. 

Even though was dressed to perfection with a jovial smile, her makeup began to roll down her neck in the scorching heat. I was tempted to offer a tissue, although I held myself back as I felt that there was a deeper significance to it than what was apparent. It was only when I met Meena’s counsellor that she clarified that Meena was actually coping with BPAD. She further stated that it’s quite common for people to construct their own narratives during such conditions. 

The counsellor also pointed out that she largely identifies with her external appearance, people's views, and thoughts. Additionally, she also expresses a strong desire to dress up, wear makeup, and look thin. She tends to depend on external affirmation to care for her inner desires to be liked and adored by all. And now that I think of it, I’m glad I did not offer her that tissue and accidentally trigger an episode.

Although she seemed to be less bothered by such events since her recovery began at Cadabams. As our conversation came to a near end, she also expressed that she was very happy to have shared her experiences and struggles with us. This process provided her with a sense of catharsis and also gave her the insight to realise how far she’s come. I was very grateful that we were able to provide a safe space for her to be able to communicate without any boundaries. 

Well, that’s the thing - there's a lot that goes on beneath the surface. As Freud says, “The mind is like an iceberg; it floats with one-seventh of its bulk above water.” Similarly, I believe the case of Meena goes beyond what meets the eye and that there may be more factors that we are yet to unravel.

Recognizing the Symptoms: Identifying BPAD and Seeking Help

If you or your loved ones are experiencing any of the symptoms of BPAD, it is important to see a mental health professional for diagnosis and treatment. Treatment for BPAD typically includes a combination of medication and therapy. Medication can help stabilize the mood and reduce the frequency and severity of episodes. Therapy can help people with BPAD understand and manage their condition, develop coping mechanisms, and build resilience.

Signs of Mania

  • Increased energy and activity
  • Euphoria or grandiosity
  • Poor judgment and impulsivity
  • Increased risk-taking behaviour

Signs of Depression

  • Sadness or hopelessness
  • Fatigue and loss of energy
  • Changes in appetite and sleep
  • Difficulty concentrating and making decisions

Living with BPAD can be unpleasant, but it is important to remember that you are not alone. Cadabams can help people with BPAD by providing psychoeducation, support groups, counselling and therapy, and vocational rehabilitation services. By doing so, Cadabams can help people with BPAD manage their symptoms and reach their full potential.

Exploring Voices of Resilience at Cadabams

Bringing out the authentic and personal stories of residents at Cadabams is a delicate challenge. Nevertheless, we hope to highlight the patients' unwavering determination as well as the team's dedication to providing holistic care, fostering resilience and nurturing individuals. To protect their privacy, all names have been altered.

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