Bekarar Dil
Anxiety: An everyday trouble maker
Recently I watched and wrote about the movie Door Ka Rahi. Among the many notable songs in the movie one is Bekarar Dil, a duet in the voice of Kishore Kumar and Sulakshana Pandit.
When I gave a thought to the lyrics of this song my attention was drawn to a striking issue I see very frequently in my professional life and relatively infrequently in personal life.
Bekarar Dil….
Dil is mind or heart.
Karar is peace, stability, courage
Bekarar is devoid of karar. A state of disarray, disturbance, restlessness, fearfulness.
Thus Bekarar Dil is referring to an anxious mind.
The poet is addressing his anxiety ridden mind.
Tu gaaye ja
“Please go on singing!”
What is he asking the mind to sing ?
Khushiyon se bhare woh taraane
Jinhe sunke duniya jhoom uthe
Aur jhoom uthe dil, deewane!
“Sing songs filled with happiness. Those songs hearing which the world will rejoice. Not just the world, but you too, my silly mind, will dance with joy.“
We need to understand what anxiety really is. What’s at the root of it? How does it impact us? Why it becomes important to overcome it rather than suffer from it. If we understand the cause, we can find the cure.
Although mind is never in one place for much time, hovering over like a butterfly, it is connected to a sense of wellbeing, a sense of peace and security under what is considered to be normal circumstances. When there is disconnect with this sense of wellbeing there is experience of unease. The unease can be of varying degree, ranging from very minimal to extremely severe. Intrinsically, this is a dysfunction of the lower mind, or mind that is distinct from the faculty of reason, and faculty of understanding and often outside the focus of full awareness. In other words it is largely the subconscious mind that experiences the unease before it eventually reaches the level of consciousness.
Many patients I see in my office say that they experience anxiety when they are ready to retire in bed. Or sitting idly on the couch watching TV. They are fine at other times. Why? Because at other times their conscious brain is engaged in focused activity. Those activities are prioritized during work hours. The restlessness of the subconscious mind becomes perceptible to the conscious brain when it is free or disengaged from activity.
So what creates the restlessness or unease in the subconscious mind? The basic cause is a pattern of negative thoughts and the behaviors they influence. These thoughts usually have gone unnoticed and unchecked for long periods before they begin to impact mental health and wellbeing. The personal deterioration of mental health begins to pour over into relationships and work. That is when most individuals come to seek help. Anxiety, at that point , becomes a symptom of inadequacy. Inadequacy to help oneself and salvage one’s relationships and social obligations.
How do medical professionals treat anxiety in the patients?
Two main modes of treatment from modern medicine are pharmacotherapy( use of medication) and counseling. A third approach is from holistic therapy which may include diverse approaches such as meditation, yoga, pranayama, attending to recreational activities like gardening, music, poetry, painting etc.
I am licensed to prescribe medication to my patients for anxiety. A variety of medications are available for me to offer to them. They have proven benefits as much as they are known to have side effects or risks. As a physician one always considers whether benefits outweigh the risks or vice versa before suggesting medication. I tend to be more cautious and conservative when it comes to prescribing medications for anxiety to my patients. Especially young patients. I do not believe in labeling them with a diagnosis of anxiety and subjecting them to need for medication from an early age. Unless of course the severity of their symptoms at time of presentation calls for quick intervention.
A frequent phenomenon observed in patients with anxiety and other mental illnesses is the tendency to be non compliant or irregular with the prescribed medications. They frequently stop medication prematurely and/or abruptly without proper follow up with the doctor treating them. And thus their mental health doesn’t get a fair chance to be restored.
A better option for treatment of anxiety( and many related mental disorders like depression) is counseling by trained behavioral health professionals like psychologists and psychiatrists. Cognitive behavioral therapy( CBT) is a specialized form of counseling that helps patients first identify the aforementioned negative patterns of thinking, feeling and behaviors. It brings out their faulty beliefs and assumptions and in a controlled setting challenges them. This way essentially it connects irrational thoughts with reasoning, bringing the subconscious mind into awareness and synchronizing it with higher cognitive functions. This in turn helps to shift the prior inadequacy and helplessness to a sense of control. The therapist then gives tools to change the initial patterns of thinking and behavior to ones conducive for achieving the missing sense of wellbeing and purpose. Patients are allowed to apply these tools in their daily lives with specific goals as they progress in their treatment.
While medication may give faster relief of symptoms they fail to reach the root cause of the mental dysfunction. Patients remain theoretically dependent ( not to be confused with addicted) on the external means as opposed to CBT which aims at empowering them without external props. Meditation is a tool that can supplement the role of the therapist to bring insight for the patient. Pranayama is a time tested tool to slow down the agitation of the mind. Recreational activities too serve the purpose of breaking down prolonged or sustained phases of mental agitation with intervals of quietude and happiness. For religious or spiritually inclined minds, prayers, singing hymns/bhajans, studying scriptures, attending church or spiritual discourses work similar to recreational activities.
Anxiety happens to most people at one point or other, yet not all people have access to a medical professional. How does one get to overcoming anxiety at a personal level?
That brings us back to the song we started this discussion with.
Bekarar dil, tu gaaye ja
Khushiyon se bhare woh taraane
Jinhe sunke duniya jhoom uthe
Aur jhoom uthe dil, deewane!
Even in hours of despair and pain, let us learn to dip into a piggy bank of previous or present day things that bring us happiness. Learn to count our blessings and develop gratitude for them. Let us learn to appreciate our strengths and virtues and those of people around us. Let us identify those who are less fortunate than ourselves and make an effort to be of some help to them. Even when we are grappling to find joy in our lives it may surprise us to find that small gestures of kindness from us can give joy to others. Let us make it a habit to do this. Joy is infectious. When someone else feels happy, it reverberates back to us. At least to some extent.
While making others happy has its benefits it does not address the cause of our anxiety. The only way we can get to the root cause is by developing insights. For this we need to cultivate the habit of searching within ourselves. Recognizing our sensitivities, our mental blocks, the assumptions that lie at the bottom of our inferences, is the start of this search. You don’t need any tools for this other than honesty and courage. These two are weak without each other. You can acknowledge the faults only if you have both. You will dare to challenge these faults if you have both honesty and courage. People build muscles by lifting weights, doing resistance training. The same applies to mental strength. You gain strength by accepting and overcoming mental challenges. One of the most formidable challenge for any person is accepting one’s faults and even more challenging is trying to change. The opposite of negative thinking and negative behavior is positive, constructive thinking and meaningful living and productive activities. The transition is called healing. We need to allow ourselves to heal.
Only when you begin to unravel the puzzle of your anxieties do you begin to realize why the discomfort of them was a blessing, and not a curse like you considered earlier. It becomes an opportunity towards health than a sentence for disability. We must learn to seize the opportunity to evolve when anxiety manifests. Recognize that here lies the key to integrating our personality from our subconscious to conscious and from personal consciousness to living beings around us. From our sufferings and triumphs we learn to have empathy for others and facilitate their triumphs.
Vedanta teaches us to reach the position of a witness. The misconception is that witness is an inactive role. When you realize within yourself the power of witness, the power to transform from negative to positive, from despair to hope, others will begin to notice the positivity that this power reflects without a word. Although it took thousands of words for me to explain the process of overcoming anxiety, you will realize that all the work that actually goes into overcoming anxiety happens in silence, in the presence of the witness within you. The witness is in our DNA. We just don’t spare time for it.
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