Yousuf Raza – Ask Muhammad Azam AMA
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The speakers discuss the difficulties of measuring success in different roles and the importance of family roles and helping others with mental health issues. They emphasize the need for everyone to play a role in helping others with mental health issues and offer advice on how to deal with their emotions. The speakers also address the consequences of hypnosis and the importance of psychiatrists in helping patients manage their mental health. They stress the importance of addressing symptoms and lifestyle factors for hypersomnia, and discuss the use of medication and the potential side effects of starting two medications together.
AI: Summary ©
Assalamu alaikum everyone.
This is Saeed Baithak, and a lot of
you must have been worried to see me,
and a lot of you must have been
upset to see me, because Yusuf is not
here, and without Yusuf, it seems to me
that there is a void.
Yes, but Yusuf is busy in something, he
might be travelling at this moment, so we
thought that we should do this, so that
we can at least address some of the
questions that have come in, and then we
can go next time with Yusuf.
and then we are also hoping that next
time we will have a guest as well.
So, very quickly, we have some questions, which
you all must be aware of, on our
pages, telepsychiatric.pk, Yusuf and my pages, on
all our pages, there is a question form
available, you can send in your questions.
I will answer them, we still have some
questions, 4 or 5, I think.
and then, in the meantime, if there are
any questions that have come in the chat
along with your comments, I will try to
answer them as well.
but there is a disclaimer, that I would
not be as eloquent and wise as Yusuf
is, so I will try my best to
answer you all, but do not expect me
to answer as Yusuf does.
So, the first question that we have, I
think she is a teacher somewhere, and she
has asked that I am very successful in
my professional life, she has also received the
best teacher awards, teaching at a college level.
But, she thinks, or she says, that at
home, especially with her in-laws, or even
with her parents, or her husband, she is
having a difficult time.
So, before coming to this question, a very
general thing, we generally think that if a
person is successful in one domain of life,
and he is performing well in one domain,
then we generally think that he will be
successful in other domains as well.
And we think that he is such a
good doctor, how can he do such a
good job, he is such a good friend,
such a good teacher, such a good husband,
how can he do such a good job.
So, all the roles that we are talking
about, we all have different roles in our
lives.
It is absolutely true that there are some
skills across those roles that are common among
everyone, but on the other hand, there is
a different skill set that is required in
different roles.
So, I was saying that we have a
different skill set that is required in different
roles, but there are commonalities as well.
So, I am not asking about, I am
not saying about this person particularly, but generally
speaking, there is no guarantee that if you
are performing well in one domain, two domains,
or even in 20 domains, then you will
perform well in the 21st domain as well.
There is no guarantee for this, because we
need a different skill set, first of all,
and apart from that, even if you have
that skill set, we all have an idea
that it is not only about the skill
set, but the circumstances are also important, So,
it is possible that a person has a
very good skill set.
So, it is not wise that he doubts
himself that maybe there is a problem in
me and I need to improve myself.
It might be the case that there is
a problem in others, that there is a
problem in the relationship that is bad, or
it might happen that the relationship that is
going well is not going well.
The other person has such a good skill
set that even with someone having a bad
skill set corresponding to something, the other person
is taking it very well.
So, this will be a very general thing.
But coming to this question, it is very
good that you are performing very well in
your teaching, but you say that you have
some issues with your father, husband, and in
-laws.
So, you would have to look at it
from all the angles that where the issues
are, and it might be the case that
there is an issue on one side and
it can also be that there are issues
on both sides.
So, as always, we can't give you a
very direct answer, and that's the whole point
of these talks, that I can't tell you
one thing, but generally speaking, if we
think that their issues are with others, then
what should we do?
So, we could try to mend those relationships,
we could try to even walk away from
those relationships, but it changes from situation to
situation.
So, I wouldn't answer anything specific in this
question.
So, our next question is, So,
the family should be sharing the responsibility.
Because the reason for that is that she
is a mother, of course, she will have
a spouse, she will also have a father.
This is absolutely correct.
So, as a doctor, I can safely say
that her physical healing has not yet been
completed, let alone her emotional and psychological support,
which is important to her, we can neglect
that.
So, in this, the family will have to
play a role, and in the family, people
will have to divide duties.
At least, if you want the mother of
the newborn to have a good development, good
growth, and heal quickly, physically and psychologically, then
you will have to do something like deviant
of labor.
So, this
should be done at the family level, because,
of course, the child's parents will have to
take care of him.
But the child is also a part of
the family, so the family has a responsibility.
And it is unfortunate that this happens in
many places, but it is unfortunate that most
of the time it happens that people do
not divide it.
And in many places, it is also seen
that the in-laws expect that the female,
who is the mother, has some of her
family, some of her sisters, cousins, and they
live with her and take care of her.
And the in-laws do not have to
play any role, at least when the child
is very young.
So, to all the Dadas and Dadis and
Pupos, if you are not ready to help
the child at that time, and you are
not ready to help the mother, when she
needs it the most, then you may not
deserve to expect from the child that he
should consider you as his uncle, uncle, uncle,
etc.
So, it might sound harsh, but we all
have to do this, and that is because
without this, we all know how much the
mother can suffer, and she can go into
postpartum depression, postpartum psychosis, because of that stress.
So, the whole family has to play a
role in this, and everything that we have
emphasized on the Dadas does not mean that
the father has no responsibility.
So, to answer this question, of course, I
cannot say that you should leave your child
crying and go to sleep, or that you
should take your pills and go to sleep.
You have to take care of the child,
but if you involve your family in it,
then it will be a problem, and the
family will have to be involved.
Do you know how to hypnotize a patient
and get to the real problem?
No, I do not know how to hypnotize
a patient, but this does not mean that
hypnosis is a bad thing.
Of course, there are good things in hypnosis,
but I am sure that at least in
Pakistan, I do not know anyone, at least
in Lahore, who is a good hypnotist.
And to answer the second part of the
question, how to get to the real problem,
whoever sent this question, there is no real
problem as such that if one thing is
right, then everything will be fine.
The problem is now so widespread that so
many factors have accumulated that we alone are
not able to deal with it.
We all have the capability to deal with
our problems, but the threshold is only crossed
when the person alone is not able to
do it.
So if it is a real problem, then
I am personally, there will be no problem
in my knowledge, which is happening only because
of one person.
So there are different dimensions, but hypnosis is
real, but I do not know if there
is a good hypnotist in Lahore or in
Pakistan.
So the next question is that my parents
want me to marry a boy, but I
do not want to marry him.
He is not a Muslim and I want
him to accept Islam and then I will
marry him.
I know that there will be a lot
of difficulties in this.
So the last sentence of the question is
what should I do?
So in such decisions, especially the decisions that
you have to take all your life and
what are the consequences of it.
I do not think that we should ask
this question, what should I do?
We should ask this question, what are my
options?
Whenever we ask a question to someone else.
Because what should I do is the decision
that I have to make in the future,
this decision should be yours.
And the biggest reason for that is that
it is not a decision that will affect
your life for 2-4 days.
This decision will affect your whole life.
As long as you are alive, you will
not have to bear the consequences of it.
So what anyone can tell you is the
options.
Especially if you are asking a psychologist or
psychiatrist, you should tell them the options.
They should also not cross the line that
you should do this.
Because when you are saying that I should
do this and I should not do this,
then somewhere your personal values are playing a
role.
So you should definitely ask about the options
and even in that, the options you already
know.
You can go to marry the guy that
your family is telling you and you can
go to marry the other person.
But you should have your own decision.
Because if this decision is successful, then you
will get all the credit.
But if the decision is unsuccessful, then you
should not be able to blame anyone else.
Because if we decide on someone else's behalf,
then due to the element of blame, we
try to avoid that responsibility.
So I think you know the options already.
If you want to marry someone and he
is not a Muslim, and you don't want
to get your parents upset and marry him,
then there is only one option that you
will have to talk to your parents and
make them understand.
But considering all this, it would not be
easy.
Because it is not only about converting to
Islam.
It is not only about converting to Islam,
but it is also about converting to other
social beliefs.
So it will not be easy for you
to go and tell your parents and they
will listen to you.
So there is no other option.
If you want your parents to be with
you, then you will have to talk to
your parents.
I wouldn't advise you to get married because
the consequences can be very dire.
Okay.
We do not have any other questions with
me, but there are some questions in the
chat.
I will answer them.
Zain, Abid, not important.
Okay.
There was a question about anti-psychotics.
Yes.
Munazza Aziz next question.
Anti-psychotic medicines are sedatives and have so
many side effects and they need to be
taken for a long time.
How can a person cope with his professional
life while on treatment?
Okay.
So Munazza, as a general rule, anti-psychotics
are sedatives.
But we need high doses of them only
when there is acute illness.
And in that acute illness, there is no
connection to professional life.
You cannot do anything at workplace when someone
has an acute illness like acute mania or
acute psychosis.
So in acute illness, high doses are needed,
which causes sedation.
And in acute illness, we should avoid professional
life anyway.
As far as sedation is concerned in the
long term, when there is no acute illness,
we usually reduce the dose as well.
So there is not much sedation in it.
But other than that, we have some anti
-psychotics, although they are not as effective as
professional life.
But as a general rule, anti-psychotics, which
we consider to be more effective, are those
which have the side effect of sedation.
So when there is no acute illness, we
reduce the dose so that there is less
sedation and side effects.
And the person can return back to his
or her professional life.
So tips to
get rid of anxiety.
Generally speaking, you can find some exercises which
are very simple and you can find them
on YouTube.
You
can
find them on YouTube.
How can one learn holistic approach while practicing
psychiatry?
So you would have to define what is
holistic approach.
So unfortunately, in mainstream psychiatry, there is no
such thing as holistic approach.
There are some grab bag things, but no
one answers that or no one even bothers
to inquire about it.
How can we bridge the gap between psychologists
and psychiatrists?
There is only one thing that I can
say about this.
In different hospital settings, the psychiatrists already exist
side by side.
But we see that the answer of psychiatrists
is always the last answer.
And psychiatrists are the first line of response
when you are in a hospital due to
some psychiatric or psychological issue.
Psychiatrists are the first line of response when
you are in a hospital due to some
psychiatric or psychological issue.
Psychiatrists are the
first
line of response when you
are in a hospital due to some psychiatric
or psychological issue.
In bipolar disorder, there are three phases.
Two phases of active illness and one phase
of normal.
The three phases are mania, baseline and depression.
In these three phases, there will be different
roles of psychotherapy.
In acute mania, there is not much role
of psychotherapy.
Psychotherapy should be more addressed towards the family.
Family should be told how to live and
how to deal with the patient.
When the patient is on the baseline, there
are two important things to tell the patient.
First, how to manage stress.
Second, what are the early signs of depression
and mania.
And what to do if the signs are
there.
It is very important to tell about this.
In depression, it is a different ball game.
You have to address the cognitions of depression.
This is psychotherapy in bipolar.
How does one go about interacting with a
psychiatrist in order to move towards a fruitful
treatment regime for obscure illnesses?
I don't know what you mean by obscure
illnesses.
How does one go about interacting with a
psychiatrist in order to move towards a fruitful
treatment regime for obscure illnesses?
I have only one thing to say.
It is like going to a psychiatrist and
going to a lawyer.
Psychiatry has a psychological life and a lawyer
has a legal or personal life.
You should be as transparent as possible.
That is the key.
We have seen many people.
Even after 6 months, we hear that there
are some things that I cannot tell you
right now.
That's fine.
I understand that people don't feel comfortable discussing
intimate secrets of any person.
We cannot develop a relationship with anyone for
that matter unless and until we are transparent
in it.
What about hypersomnia?
I am suffering from it for almost 3
months.
If it is a COVID thing, that is
normal because we have nothing to do and
we cannot go out.
Many of us are facing hypersomnia which is
irresistible.
You cannot do anything else due to it.
You will have to address it.
I don't want to give a general statement
about it.
If you are suffering from hypersomnia due to
fatigue, that is fine.
That is perfectly normal.
How to live longer?
I would not answer that for you.
Okay.
There is no other question.
As Abid Ali said, if you are suffering
from hypersomnia, get your thyroid levels checked.
If you want to rule out medical illnesses,
you can do that.
That would be very good.
You would need a complete evaluation of the
character of hypersomnia.
I have a lot of work to do.
I think a good doctor will explore what
irresistible means.
When a person says that hypersomnia is irresistible,
the first thing that comes to a doctor's
mind is narcolepsy.
I think a complete evaluation is needed for
this.
You can contact any neurologist or psychiatrist.
If you say that hypersomnia is irresistible, it
might be narcolepsy.
But a large number of cases of narcolepsy
have a genetic predisposition.
I don't think it will be expressed at
this age.
Salma Faiz Usmani asks, how to avoid grinding
teeth during the day and night due to
anxiety?
Salma, a lot of things are used all
over the world at night.
You can use a tooth guard.
You can use chewing gum during the day.
But these are all temporary solutions.
You will have to address your anxiety.
Abdul Haseeb asks, how to deal with elders
who think they always have some kind of
illness and keep checking their BP, wanting to
visit the hospital, get x-rays, but the
tests show up normal?
Haseeb, it might be the case that the
elder you are talking about has some kind
of illness or anxiety disorder.
That is an anxiety disorder in which a
person thinks that he has some kind of
illness.
And because of that, he gets tests done
again and again.
And the patient typically has a big file
in which there are reports of all the
tests, which are mostly normal.
So it might be the case.
But Haseeb, it is also possible that there
is some genuine issue there.
So for that, he will have to look
at it in detail.
But illness, anxiety disorder is a real thing.
So I think that's all.
And because I am alone, I have done
my 30 minutes.
And the 30 minutes that Yusuf had to
speak, we couldn't do that today.
Hopefully next time we can do that.
So folks, whatever your questions are, go to
our page.
There are forms for questions there.
Fill them in.
And every now and then, I think at
least once a month, we have been doing
this Q&A session.
And we will do it again.
Just one last question.
Is it okay to start taking medicines like
Cetanine, Sert, when a psychologist prescribes it in
the first session and not?
Things in detail.
Aren't they addictive?
So Salma, the first thing is that a
psychologist cannot prescribe medicine.
The second thing is that if they have
started Cetanine and Cetanil together, it shows that
they don't even know the alphabet of psychiatric
medicine.
And it is…
It shows how…
I think I should use the word, how
dumb they are.
Even if they are psychiatrists.
Even if they have started both of these
medicines together, it shows how dumb they are.
So you should not start these two medicines
together.
There is absolutely no indication.
And by starting these two medicines, we are
inviting a lot of side effects to come
and hit me.
And if a doctor is listening to us
here, if we start two such medicines that
increase serotonin, then we are increasing the risk
a lot.
I am not saying that it will happen
in this case, but it can be fatal.
So you should not start it.
Okay, I think that's all.
Allah Hafiz.