Solace

Bismillahirrahmanirrahim
In the name of Allah, The Most Gracious, The Most Merciful

2.31pm
19 Syawal 1438H
T.J Danaraj Library, Faculty of Medicine, UM

Currently in the library, my favourite place so far in the 4 days I've been attached to the Psychological Department in UMMC. Aside from sleeping in this quiet haven, I do study and read an array of books here - currently interested in Karen Miller's Empress and A Treasury from Khalil Gibran. It's Friday today and alhamdulillah it's going to be a weekend tomorrow. I attended 3 seminars in the week, went to talk to one patient in the wards, attended one afternoon clinic, one grand rounds session and one post call forum in the morning. I have yet to get myself exposed to many things in the psychiatric rotation but I have so much to read already. Huhu.

Today, let's talk about anxiety.

What is anxiety?
Anxiety is generally defined as a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.
In psychiatry, the individual is frightened but the source of danger is not known, not organized, or inadequate to account for the symptoms.
This simply means that someone 'over'-reacts towards a certain stimulus that is not even considered to be frightening for normal people.

Anxiety is quite different than other mental disorders as it is an illness that is mainly triggered by stressors --> an event/environment/object/condition that prompts excessive fear in patients.

So basically, once these stressors are removed from the patient, the problem is solved and the patient can live life normally. And usually patients with phobia (which is a subset of anxiety disorders) don't usually present to the clinic unless the stressors are those that are continuously faced everyday causing them to have persistent anxiety symptoms. Such perpetuated events may eventually cause patients to develop other mental illness such as depression and schizophrenia, which explains why some schizophrenic patients might have an underlying anxiety disorder together with the delusions that they are currently facing. However, there is also a Generalized Anxiety Disorder (GAD) that occurs in the absent of any stressful stimulus. This, my friends, is not good at all.

Anxious people are anxious. They have clammy hands, they are tachycardic, sometimes they get short of breath. These are normal responses. But those with a panic disorder, phobias and GAD, all those respiratory and cardiac symptoms are heightened, plus they also feel as though they are about to die and lose their mind.

To help these people facing such illness, doctors would prescribe Cognitive Behavioral Therapy (CBT) which is a talking therapy that can help change the way we think and behave, thus allowing patients to be able to overcome those stressful situations. Pharmacological interventions are also present, given to manage the physical symptoms and also treat the underlying physiological component of the brain that lead to the aberrant reaction.

Ala bi zikrillahi tatma'innalqulub.

Personally, I believe that anxiety is an illness that has its biological and psycho-social component. And as a female, I am prone to develop this condition compared to males - based on the epidemiology of anxiety disorders. (Though I always question, maybe it's just because females tend to seek help in comparison to males so maybe there's an incomplete statistical conclusion on the female gender as a predisposing factor)

Everyone can develop anxiety, depression and schizophrenia because technically we do not know a lot about our future nor are we sure of our capability to endure it. Being a person that has had depressive symptoms for more than 2 weeks (Kak Ejat says I have lots of 'em symptoms last month, and the month before), I know how its like to face those trying times.

Suicidal ideation
Weight loss of more than 5% body weight ( I loss 9% of mine, not too bad la)
Anhedodia
Sadness, hopelessness
Low self-esteem
Sleep problems (unable to sleep at night, wake up feeling lousy)
Low appetite

Reading up the list of depressive symptoms just makes me go, "Heyy, I had all these. Padanlah Kak Ejat risau huhu." Because I never thought I was considered ill, weak maybe, but not ill.

Ala bizikrillahi tatma'innal qulub.

Kekadang kita lupa
The potent remedy is already inscribed in the Quran
But as per usual, we always fail to acknowledge that first
Anxiety and depression
They are true disorders, true diseases, true illnesses
Tapi kan
Sedang kita sibuk dengan anti-depressants dan SSRIs
Pergi talk therapy and support group sessions
Kita lupa nak rapatkan diri kita semula pada Pencipta
Kita lupa nak dekatkan diri kita semula dgn al-Quran
Bahkan kita menjauh
Makin lama, makin menjauh
Adakah kita sudah lupa
bahawa yang memegang pengakhiran segala urusan adalah Allah?
Dan bukankah Dia
Yang membenarkan syifaa' itu hadir
Bahkan Dialah yang memberi syifaa' itu
Buat hati yang sedang kering
Buat jiwa yang sedang gundah

This might be conservative thinking. But you know, all those major depressive disorders began with one event that could be similar as mine. If iman wasn't there, I would have been like them girls running away from home after a relationship breakdown. Would have continued to develop an anxiety disorder, avoidance of men, having trust issues - social phobia. Every penyakit jiwa ada permulaannya, dan kalau dari awalnya kita gagal mengenali fitrah manusia dalam memperoleh ketenangan tu, agak-agak dapat ke tak tenang tu akhirnya?

And kita kat sini nak mempersoalkan lagi tempat Allah, iman dan islam dalam hidup kita. Dah ada bukti kan depan mata? Moga bersama usaha kita memenuhi sunnatullah menyembuhkan jiwa itu, kita iringkan dengan pengembalian kita kepada fitrah manusia, fitrah bertuhan.

Ala bizikrillahi tatma'innalqulub