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Query

I'm a 35-year-old male who has been a migraine patient for about five years now. I have heard that migraine also brings many mental health problems in its wake including memory-loss. Recently I have been struggling even to recall familiar names. This didn't happen before and I think it is because of migraine. I want to know if it is something I need to worry about. And what can I do to improve things? -KB

Answer by Dr. Rishav Koirala, Psychiatrist at Grande Hospital 

First, for proper diagnosis and treatment, it is important to know the intensity and frequency of headaches. In rare cases migraine is associated with forgetfulness, which is known as transient global amnesia, but it is not as specific as you have mentioned, i.e. only forgetting familiar names. Forgetfulness is common in anxiety disorders as well as in depression. Over 50 percent of migraine patients have depression and anxiety and more than 80 percent of migraine episodes are precipitated by stress. So we need to explore it to properly address migraine as well as to find the cause of forgetfulness you suffer from. This can be done by visiting a psychiatrist who will treat both. 

As you have had migraine for a long time, it is even more important to address it. Migraine is a major cause of disability as it hampers with your work as well as social life. It must also have hampered your life both directly and indirectly. Being aware of what is really going on will help you with the fear and worry you’re experiencing, and you might be reassured once you know you are being treated.

On a personal level, you can try mindfulness meditation. You can find plenty of 10-30 minute meditation guides on YouTube. Taking some time out to meditate will do wonders for your mental health. 

Another thing you can do is maintain a headache diary. After you have a migraine episode, write down what you did in the 24 hours before the episode: list all your activities and events of the day as well as your food intake. After doing this six or seven times, you may observe common activities that trigger your migraine. An empty stomach, disrupted sleep, and high coffee and alcohol intake can also trigger migraine. But most importantly, you need to talk to an expert before jumping to conclusions.

Query

“I am a 27-year-old woman working at one of Nepal’s leading construction companies. I am an engineer by profession. I work hard at my job. But my good work is hardly appreciated. In comparison, my male colleagues get all the praise and credit for their inferior work. Lack of recognition means my promotion has been halted. I have been wrestling with this problem for many years. I can’t quit as I need this job, nor can I put up with this misogynistic work culture. What should I do?” - SS

Answer by Shreeya Giri, Mental health advocate and Founder of Happy Minds

First, I want to acknowledge you for knowing your hard work and the ability that you have contributed to your work ethic. Being self-aware helps you recognize your strengths and weaknesses. Second, the construction and engineering sectors are still by and large male-dominated. Your feelings are thus valid. 

When you’re doing your job well, it is natural to expect appreciation from your coworkers. Since you haven’t been getting the appreciation, it is necessary to clearly communicate your feelings and experience to your seniors. Express your pain points, your effort at work, and the results that have benefitted the team and the company, a clear and direct conversation without being aggressive or passive. Ensure to be assertive and voice your experience, expectations, and needs while staying calm, respectful, and direct. 

On a personal level, you can start by sitting with yourself and putting the problem into words. Be clear and reasonable about what you’re experiencing. You can also ask yourself what is holding you back from communicating your feelings. This will help you see your situation more clearly. A one-on-one conversation with a counselor can also help you become more expressive. 

While taking this to your senior, be sure to keep your emotions in check and present your argument with details of what you’ve experienced. State the fact that it is unfair of the company to push back a responsible, hard-working employee. You could also explore the job market to see what is the expected pay scale for experience and education similar to your profile so you’re confident that it's reasonable.

It is only through assertive communication that your workplace will come to know of gender inequality and take necessary actions. Bring your opinion to the attention which might open ways for other female workers in the company.

Query

"I am a 23-year-old who has been struggling with panic attacks since I was a teenager. I tend to not take situations that are hard on me or upset me very well, and I get easily overwhelmed. I can’t help tearing up and start breathing heavily until I feel dizzy. Sometimes I have very dark thoughts about myself, which I know are wrong but I can’t help myself. Other times, I feel claustrophobic and hyperventilate. I want to take control of my emotions and not be overwhelmed all the time. What should I do?" -A panicky soul

Answer by Dr Rishav Koirala, Psychiatrist at Grande Hospital

What you’re going through points towards the problem of Generalized Anxiety Disorder (GAD). Its common symptoms are the low capacity to handle the stress of daily activities, high emotional sensitivity, anxiety over brooding, negative thoughts, restlessness, low concentration, emotional sensitivity, low confidence, tremors, palpitations, disturbed sleep, and shortness of breath. If many symptoms match, there is the possibility of having GAD. When a person constantly lives in anxiety, it is common to have panic attacks.

It is advised that you should visit a psychiatrist, any that you trust, and they can help you evaluate what problems you’re going through and find a solution for you accordingly. Meeting a psychiatrist doesn’t mean starting medicine! As you have a long history of suffering, it is necessary to consult a psychiatrist.

On a personal level, there are a lot of non-pharmacological ways to deal with anxiety, starting with your diet. For instance, avoid things like coffee or alcohal as they can increase anxiety,

Similarly, taking some time to calm yourself and deal with the emotions you are trying to control can also help by meditating. There are tons of guided meditation tutorials you can find on YouTube. Try exploring and following one that resonates with you. Take 20 minutes out of your daily life for mediation.

Physical exercise can also help. Maybe you can set aside 30 minutes a day to follow a small at-home workout routine (aerobics or cardio) or go running every morning or evening. You can even do stretching or try Yoga. These physical activities can do wonders.

Since you struggle emotionally, observing your feelings is also necessary. Ask yourself: Why is this making me cry? Why am I overreacting? It can help you understand your situation better and to figure out how you can deal with it logically. 

Keeping your struggles to yourself can be harmful and can have long-term consequences. So, sharing with someone you're comfortable with can help you emotionally. You can also visit a therapist to help you understand your feelings and your emotional reactions to events. 

And in the end, I would like to assure you that there is a solution to the suffering that you have been experiencing for long.

Query

I am a 33-year-old working male. With the arrival of another wave of Covid-19, I feel anxious all the time. As I and my family have already been through the agony of covid infection, I fear it could happen all over again. It reaches a point where the smallest of things like a dry throat in the morning or a light headache in the evening makes me fear covid and I get anxious all over again. I start to worry about my family: how will they cope if something happens to me? So much so that I cannot even do routine work. How do I overcome my fear? – An anxious breadwinner

Answer by Kapil Sharma, Counseling Psychologist, Hudec Nepal 

I want to say that it is okay to be scared right now. The fear of catching Covid helps you be more alert and cautious. But that fear is a matter of concern if it scares you beyond reason. First things first, having gone through the experience before, you have a better idea of what it is like and what can be done when you or someone in your family is infected. You have the experience of taking care of your family and that in itself is a reassurance that no matter what happens, you know you will get through it and will help your family do the same.

Second, validation on a personal level, with family members, or with an expert can do wonders. Sit with yourself, check in with your feelings, and maybe write down what you are scared of. Why did this particular instance or feeling trigger your fear? How can you solve or get over it? Write down your thoughts and then go through them to differentiate which are true and which are not. 

You can also communicate with your family and share your feelings. A simple conversation can help you realize that you have no reason to be scared. 

That leads us to a logical validation. Try to validate your fears with logical reasoning. For example, if a dry throat in the morning triggers your fear of covid, try drinking warm water. Maybe it is just dehydration, and if that helps, you will calm down. If your throat still feels dry and the fear is still there, talk to your physician and share your feelings. Nowadays, we do have an option of telehealth services where you can cross-check and validate your symptoms with physicians and experts from your own home, so just dial and get your worries validated you are just a call away from winning your worries.  It will help you understand what is going on and what can be done for the safety of you and your family. 

Fear of uncertainty can be crippling. Of course, there is no way of knowing what is going to happen next, which can make you so fearful you can’t even do routine work. But then you can also take your fear as a window of opportunity. Make it a reason to be more cautious in any way you can. This can help you become more grounded and figure out how to stay safe rather than what is keeping you in danger. For instance, if stepping out for grocery shopping is nerve-racking, get a face shield and glasses besides other recommended safety measures before leaving home. That way, you are taking precautions, thereby reducing the chances of infection. 

If the issue persists, you can visit helping professionals like psychiatrists, counseling psychologists, or psychosocial counselors in person or online and help yourself to be resilient and be in an optimal state of wellbeing.