Wanted: Suitable girl for mentally disturbed groom. Must be sympathetic, patient and knowledgeable about nature of mental illness. Bride can expect mood swings, bizarre behavior and occasional spells of normalcy. Family will provide full support and emotional backing to the couple.
In a make-believe world, such advertisements could be common and the woman or man married to a mentally disturbed person would know what to expect. But the tragedy is - particularly in the Indian context of arranged marriages - that truth is the first casualty during the search for a partner. Keeping up appearances at all costs and considering marriage as a social necessity - such are the givens in the Indian psyche.
And when the parents of young men and women who are mentally ill are keen on getting their children married, truth is a far, far greater casualty. This is a trend that cuts across economic strata in India. According to Sanju Das, a counselor with Vishwas, an NGO focused on mental health, it is estimated that over 75 per cent of Indians, rich or poor, believe that marriage is a cure for mental illnesses like manic depression, bipolar affective disorders and even schizophrenia. Worse, the history of mental illness is concealed.
The Delhi branch of the Richmond Fellowship Society (India) runs Vishwas, which is based in Gurgaon; it is a halfway home, offering residential and day care for men and women suffering from major mental illnesses. While the Society is an international NGO that manages psychiatric rehabilitation projects in many parts of the world - including one in Bangalore - Vishwas was established in November 2000. Besides offering counseling, residential and day care facilities, Vishwas also has a community outreach program.
According to Siby Sebastian, deputy project manager at Vishwas, and Paresh Shah, senior counselor, marriages involving a mentally ill person are generally doomed from the start. They emphatically advise people that marriage is NOT a solution for people with mental illness. In fact, marriage, with its own inherent stresses, can make such illness worse.
Psychotic disorders - manic depression and schizophrenia, for instance - are manifested in episodes. When an episode ends, or when a person is off oral medication, parents often believe that the problem is over. And then, they promptly get their mentally ill children married. In other cases, having hidden the person's mental illness, parents stop giving the medicines. Medicines need to be taken regularly, and therefore this is a major problem.
When mentally ill people are married, the normal partner is bound to have certain expectations of the other. And when the fact of the illness becomes clear, the wife or husband and the family feel cheated. The ensuing hostility, aggression and name-calling can only devastate the person who is
In India, it has been seen that men married to mentally ill women do not suffer much; they or their families pocket the dowry and go in for a speedy divorce. However, most women married to mentally ill men get little support from their own family; they usually remain stuck in a terrifying marriage.
It is not only the parents who are interested in marrying off their mentally disturbed children; the affected people themselves are very keen on marriage. A sexual drive and the need for companionship are, of course, natural. Shah recalls two schizophrenics in the day care centre who wanted very much to marry each other and have a child. The counselors had to use a great deal of tact and patience to dissuade the hopeful couple.
According to Sebastian, if the psychological environment at home is one of harmony and understanding, the mentally ill have fewer problems. On the whole, recovery to the extent possible is easier, and the intensification of the disorder can be far less. But if the mental illness is not disclosed, as in the case of marriage, the last thing the disturbed person is likely to receive when the fact is revealed, is sympathy and understanding.
In cases of post-partum depression or depression due to the loss of a child, women are likely to get sympathy from the in-laws. In some cases, mental illness does develop after marriage. However, a caring family, regular medication and psychiatric care can help the person lead a fairly normal life. Unfortunately, a married woman whose husband develops schizophrenia or manic depression after marriage is usually blamed by family and society for the husband's disorder.
Mental illness can happen anywhere, and to anyone. It is not an urban phenomenon. Mental illness is a medical condition; instead of fearing it, people should treat it like other physiological but familiar disorders such as cancer or diabetes. In her book, 'Schizophrenia: Straight Talk for Friends and Family', Maryellen Walsh likens schizophrenia to a faulty telephone exchange - "perceptions come in but get routed along the wrong path or get jammed or end up at the wrong destination".
Families of those who have experienced and observed a gradual onset of schizophrenia agree that it is difficult to pinpoint exactly where normalcy ends and illness begins. However, common early warning signals include the inability to sleep, day/night reversal, social withdrawal, isolation, fear and suspicion. Avoiding going out, skipping classes/work, the inability to concentrate, staring, vagueness, hallucinations, repetitive actions, eccentric dress and deterioration in personal hygiene are other signs of mental disturbance.
Vishwas places a lot of emphasis on family counseling - how the family takes care of a mentally ill person is of critical importance to recovery and reintegration into daily life. Counseling as well as proper controlled medication helps to keep an even balance.
The World Health Organization's Division of Mental Health provides several suggestions for coping with mental illness. It recommends avoiding emotional scenes and undue stress, the use of clear and slow speech while giving instructions or asking questions.
Ignoring a disturbed person is inadvisable; and while medicines should be given regularly, unnecessary criticism must be consciously avoided. Trying to reason with someone affected with acute psychosis does not help. When an 'episode' occurs, it is best to decrease other distractions immediately - turn off the TV, or radio, and request anyone present like guests or relatives, to leave.
Overall, the general attitude to mental disorders and the associated stigma needs to change. Although it is still a young organization, Vishwas is trying to create public awareness and to improve people's understanding of themselves and the mentally disabled. With the aid of individual psychotherapy, group therapy and family therapy combined with proper medication, the counselors at Vishwas seek to rehabilitate the mentally ill back into society. The organization is also working in cooperation with other NGOs, and with hospitals such as VIMHANS.
And finally, Indian parents who deliberately hide the fact of mental illness in their family, and try to get their disturbed children married off, need adequate guidance and education. Any marriage based on deceit is risky. But for those with mental illness it is like a ticking time bomb.