AYO RE MHARO DHOLNA–RAJASTHANI SONG
February 7, 2011
Laagi Laagi sab kahein, laagi buri bala
Laagi to tab jaaniyo, jab aar paar hoee jaae
Neeki lagat mohe apnay piya ki
(Moray piya ki) Aankh raseeli jaado bhari
Nazar nay nazar mulaqat kar li
Rahay donon khamosh aur baat kat li
Chaen parat naahi mukh daikay bina
Daikh najar bhar jaat bhari ray
Kaahay Turab darre kaahu say
Preet karee, ka mein chori karee ray?!
Exit: the generation of baby boomer parents.
Enter: the Generation X parents.
Being an offspring of a baby boomer parents, I grew up listening to stories from my parents of how different they were from their own parents—concerned and caring and proactively involved in their children’s upbringing. I had always noticed that majority of the parents of my mom-dad’s generation invaded into their children’s privacy and took decisions for them, including which profession to chose, who to marry and so on. (unless one was rarely lucky to have at least a Dad like mine, who was different enough to be called an exception to this the rule).In fact, the term called ‘personal space’ did not exist at least in our generation and especially in our society.
I had always presumed that we the parents of generation X were far more open and appropriately caring generation of parents , only until I came across a research from study by a researcher Neil Montgomery, a psychologist at Keene State College in New Hampshire. And then from a book called Millennials Go to College by authors Neil Howe and William Strauss. The book includes new data from surveys conducted of 1,000 college parents and 500 college students.
Gen X parents,the book claims, the generation after boomers, tend to be more protective and involved with their kids than boomers; 63% parents say they began planning for their kids’ college education in elementary school or earlier. Strauss says parents do this because they want accountability in light of rising tuitions.
“College has become a major investment, and you have to keep close tabs on it like you would any major investment,” says the author. “We tend to be a bit more of a helicopter parent because of it.”
HELICOPTER PARENT? I wondered as I read. So what is this new word? And I research on the net.
The word, helicopter parent, is the advent of early 21st century. It is a self-explanatory term that exemplifies the stock-in-trade of this type of parent:Hovering. Their children cannot move in any direction without the parent correcting, interfering, manipulating, or browbeating both their own children and everyone else who interacts with their children on a regular basis.
Helicopter parents are the bane of every coach’s existence. They hover over and interfere in nearly every aspect of their children’s lives. Teachers hate them, other parents avoid them, babysitters pay them lip-service but otherwise ignore them. Even pediatricians and Sunday school teachers have a hard time tolerating them.
Research reveals that among the gen X ,60% to 70% of parents are involved in some kind of helicoptering behaviour.
Various settings or places acknowledge the existence of this set of parents with a different yet appropriate nomenclature-
In Scandinavia, this phenomenon is known as ”curling parenthood” and describes parents who attempt to sweep all obstacles out of the paths of their children.
Some call it is “overparenting”. Parents try to resolve their child’s problems, and try to stop them coming to harm by keeping them out of dangerous situations.
Another interesting term being ”Lawnmower parents” to describe mothers and fathers who attempt to smooth out and mow down all obstacles, to the extent that they may even attempt to interfere at their children’s workplaces, regarding salaries and promotions, after they have graduated from college and are supposedly living on their own.
As the children of “helicopter parents” graduate and move into the job market, bosses, managers, personnel and human resources departments are becoming acquainted with the phenomenon. Some have reported that parents have even begun intruding on salary negotiations.
An extension of the term, “Black Hawk parents”, has been coined for those who cross the line from a mere excess of zeal to unethical behavior, such as writing their children’s college admission essays.
The rise of the cell phone is often blamed for the explosion of helicopter parenting — it has been called “the world’s longest umbilical cord” . Experts say cellphones and other devices foster strong bonds in today’s smaller families-hence enabling the parents to ‘think’ that they keep tract of every movement of their child. Even the kids get so dependent that they call back to their mom’s cell be it in home or at work place, for slightest of a problem.
A sketch of a typical helicopter parent:The research suggests that most helicoptering is done by mothers who are hyper-involved with (usually) their sons’ lives( fathers are more likely to use strong-arm tactics to get results.).
Providing everything to the child at the bleakest of demands and not letting them learn by falling or making mistakes.
She buys all of his clothes, cleans his room and does his chores, such as making his bed, arranging his books and even laying the meal on the table and then calling him for it. If the child is really preoccupied in his studies she might even give him bites in his mouth..
She helps the child do all the homeworks perfect and then prepares all the tests in order for him to get the perfect grades. And goes to the extent that revises hsi entire syllabus with him a day before the exam so that he does not miss a mark in the exam.
Drops and drives the child to school or college and back in the car, so that he faces no hardships and delays on the way.
Decides for the child what subjects to choose and what university to go, upto the extent of getting the iniversity brochures and even filling up the forms on his behalf.
If the child sits in an exam—mom waits outside the exam hall all through praying he does well.
Pushing the kids into activities that the parents fancy without bothering to know if he likes it or not..
And at times even when it is time for the cuddly son to go for a work interview and she drives him to the interview and feeds all the way as to what terms and conditions he should demand from his prospective employer.
In a summary, to be constantly hovering 24×7 over their children from preschool to the workplace.
To put it in few words—dreams of the moms to make their kids into SUPERKIDS.
Having said so much about the moms—I still feel there do exist some helicopter dads too.
Why do parents become helicopter parents?
Helicopter parents claim that they indulge into their children’s lives because they want the best for them.
Some parents use overindulgence “as a guilt management tool,” say experts. “(Other) parents just can’t see why you would deprive a child.”
And then there are cases of parents who were not supported or well taken care of as children. As a result, when they become parents, they tend to overindulge in their children. They promise themselves that their children will have better lives than they did. “They don’t want to upset their kids by not giving them the things they want,”
Does helicopter parenting help?
People whose parents are “laissez-faire,” giving their children whatever they want, are the most unhappy.. They tend to have low self-esteem and feel unworthy.
Psychotherapists believe that parents love their children so much they can’t stand to see them in pain, but then that’s not love. A parent’s overindulgence can have other negative effects, as well.
The child of a Helicopter Parent learns that she is not responsible for her own actions. Mom is.
Consequently, the kid will grow up and not be mentally or physically tough enough to survive out in the world,
Students with helicopter parents tended to be less open to new ideas and actions, as well as more vulnerable, anxious and self-consciousness, among other factors, compared with their counterparts with more distant parents.
If parents step in too early in problem or social situations, the children do not have the opportunity to gain necessary social skills and survival skills that are normally acquired during adolescence.
Consequentially such children will not know how to be responsible and will have problems with authority.
The role of the parent is to prepare a child to make it in the world on their own. The research reveals that the children of “authoritative” parents – strong parents who allow children some bargaining power – are the most happy.
A good mom allows her children to make mistakes, to learn how to win and lose gracefully, and to develop constructive problem solving skills.
Parents have to be consistent and strong,” research claims, or else, “ children will never respect boundaries or discipline”.
the researcher recommends that the parents must constantly keep a check on their actions and think about what they are doing as they raise their children, and be aware that there is such a thing as ‘over-parenting’.
The researcher hopes his work leads to more research in the area, including large studies on different populations of children, such as high-school and middle-school students. Future studies will hopefully bring about a clearer picture of helicopter parenting.
A helicopter parent may have good intentions, but her interference could make her child’s life much more difficult in the long run.
All helicopter moms, kindly think….
(PS Baby boomer parents generation: parents born post WWII between 1940s and mid 60s.
Generation X parents: born from late 60 s to early 80 (upto 1982).)
IlmanaFasih
6 December 2010
OH FROM THE LAND OF EGYPT
February 2, 2011
Oh! from the land of the Pyramids
As you come out en masse
To assert your true muscle
And with discipline and sanity
You bring pride to humanity
Tears of joy roll from our eyes
With a clear vision for tomorrow
Oh! from the land of Tutankhamun
As you all march in unison
Chanting slogans of freedom
Eraising all the differences
Neither as Muslims, nor as Coptics
But as one and only Egyptian
Building bridges of unity
Goosebumps are raised
With a new morning for tomorrow
Oh! from the Land of Nefertiti
You send shivers in spines
Of the corridors of power
Force them to come out
With promises, undertakings
To dictate or oppress no more
Our faces glow with great pride
With the brightness from tomorrow.
Oh! from the land of Um Kulthum
As you sing into a loud chorus
Of the songs of liberation
And play the drums hard
Of utmost valor and courage
Our hearts throb for you
With the beats of tomorrow.
Oh! from the land of Nasser
As you stay under the open sky
For the sixth day in a row
And as leaders buy time
Dirty deals come into play
Black sheep get bought
By the shrewd hawks high up
And as our brains go numb
To the intense pain for tomorrow.
Oh! from the land of the Nile
As we see you bitterly divided
Its hard to watch you in chaos
Many hungry for the freedom
Others thirsty for your blood
The bright light turns off
Fully blind go our eyes
Seeing the darkness for tomorrow
As a Heaven turns into a Hell
And our joys change into sorrow
I know not what to say
I know not what to expect
I know not what to envision
As I wait with impatience
Evry minute, every hour. each day
To witness events that unfold
Praying that’ SOME’ day
Sanity shall prevail
Order be restored
Freedom be the rule
Democracy be the outcome
And I pray again that,
That SOME day comes VERY SOON.
Yes, SOON, VERY VERY SOON.
EGYPTIANS TUSSI GREAT HO !
February 1, 2011
My love and adulation for this country called Egypt did not remain only on the hearsay of the wonderful memories that my father brought back with him. I too had the full opportunity to know its people during my interaction with them in the Gulf and then some visits to the land of the pyramids.
First thing I noticed about Egyptians was that, like us desis, as they landed in the middle east to earn petrodollars, the whole emphasis was to save as many riyals as possible, to take back home. Like us in the early nineties there was a huge gap between the paypacks in the gulf and back home. We shared pay scales with the Egyptians, which were almost a third of those who came with western passports for doing the same work . So we had common grudges to whine about.
And the gap between the have and the have-nots in Egypt was almost as contrasting if not less than back home, both India and Pakistan. Citadel and the mosque of Mohamed Ali with a chandelier famous for its 10,000 lights overlooking the slums of the City of the Dead made us feel home in Cairo. The simple citizens, enamored by foreign looking faces and then eager to help for the tip was also strikingly similar. But what added to the charm was the name they gave to the tip-the bakhsheesh.
There are all kinds of people in every community, however there are some traits I find common to most Egyptians:
They are fiercely patriotic—calling themselves—“Masr, Umm al Donia” (Egypt the mother of the world) owing perhaps to their glorious past. Though of late, in the past few years when the discontent was brewing, this term has become more of a satirical, mocking jargon.
But I noticed that they never put a blanket blame on their country or ever talked ill about it, en masse. Of course they do indulge in the intellectual debate on lack of democracy and criticise their govt. They even do it with a terrific sense of humor which let them maintain their sanity in these 30 years of oppressive dictatorship. It was this sense of humor which let them face all adversities with grace and a smile.
Political awareness even amongst the farmers in the remote Upper Egypt topped with a great sense of humor made me dote on them. On the issue of Hosni Mubarak being a US ally, they did not give it a religious shade of anti Islam—instead found humor in it too. They equated his regime to be a PCO (public telephone booth) which talks so long as there is coins (US Dollars and Aid for supporting them) coming into it and stops speaking as soon as the money is gone.
Once I even had a friend ask me if I knew who was the president before Hosni Mubarak—and he did not accept my answer of Anwer Sadaat. According to him it was Jesus Christ—hinting at his long regime.
Egyptians are great readers too. The knowledge of their history is at their tips and gives them great pride, owing to their reading habit as a nation. They take immense pride in their glorious past and the culture, music, dramas, their dialect of Arabic and even at their being the ‘poor’ among the Arabs. A study by Alice Scale and Zikry called the Reading Habits of Adults in Egypt which said: they like to read, read newspapers, they read fiction, take course to improve reading ,and retained what they read for long time.
Now moving on I would like to describe three Egyptians who have made me overawed by them one time or more:
The first is my best and the closest friend since past 14 years and she happens to be an Egyptian—who lost her husband in her mid thirties with two junior school kids left to look after. I dreaded how would she survive, but the way she has bounced back as a lioness is worth the mention here, though she happens to be a nobody for all the readers except me. An extremely courageous, smart and intelligent woman that she is—living in the Gulf as a widow and facing the daily gossips and pressures to remarry—she chose not to, to raise her kids with peace. And then carried on with her bubbly personality and fulfilling the life as both mom and dad to her kids with absolutely no support from her inlaws(again striking similiarity to the treatment of widows by her in laws) . And she has carried on her further education doing MRCGP Exam for which she had to come to appear in the Exam in Karachi. Despite a lot of discouraging from friends both Egyptian and Pakistanis to avoid going to Pakistan, especially being a single mom, she insisted to go and with the argument to me that “If you can return back from Pakistan safely why would I not?“
On the day when the incident of Bolton Market fire and suicide attack on Shia procession took place she was in town. She had no acqaintence there, but on calling her she did not even show a grain of fear in her voice.
The second one is none other than the current First lady: Susan Mubarak. Yes she is the gorgeous looking wife of Hosni Mubarak, the corrupt dictator. She may have been misusing her husband’s power or luxuries but it is just one action of hers which made me have great respect for her. In 1990 presiding the The Society of Integrated Care, Mrs. Susan Mubarak started a cultural project in the summer vacations called the READ FOR ALL FESTIVAL. The philosophy behind the project was based on a sound belief in the importance of the role of reading in raising up generations. It also focused on the right of the child for reading. And she regarded reading “as a human right as equal as the rights for education, health and food.”
‘Reading is very essential for confronting the challenges of the age in which possession of knowledge gives power over the possession of wealth’, she believed.
From merely 1856 libraries in 1990 it rose to over 9 500 in 19999. Within the activities of the Reading for All Festival (summer 1999, Susan, adopted the project of establishing 5000 school libraries. Among which 4000 libraries being all over Egyptian villages. The project aimed at providing services to the communities surrounding the libraries. It also targeted the positive utilization of leisure time in order to build up the personal and social identity of the Egyptian individual. Besides, it encouraged self-learning of the adults and youngsters in addition to providing better opportunities for broadening minds and better understanding of problems through direct contact with various information resources.
Last but not the least the contemporary Egyptian I find great is Mohammed al Baradei I do not talk of the newfound greatness in him because he is leading them in the revolution. Not even because he was the head of IAEA for three terms. Not even because he is a Nobel Laureatte. It is due to the stands he took while in that position holding the spirit of a UN Organisation as a as truly neutral and non partisan. And that is what makes him great.
Despite the worries of this chaos going out of hand or turning into the grips of Islamic radicals—I feel world would be such a different place if democracy is restored in Egypt, with Mohammed al Baradei in the lead in a democratic Egypt. He would contribute towards my dream of a world without borders and without wars.
Articles in the newspapers to blogs are all giving reactions to this man’s role in the uprising appropriate to their outlook.
Years ago in 2003, he as a head of IAEA he had warned US and the Bush administration of the non existence of Iraq nuclear program and weapons of mass destruction. But was lashed by the neocons and even the Washington post opposed his stance.
If they had heeded his objective observations, the Americans wouldn’t be in such a soup today.
To the allegations IAEA had said: “Based on thorough analysis, the IAEA has concluded, with the concurrence of outside experts, that these documents – which formed the basis for the reports of recent uranium transactions between Iraq and Niger – are in fact not authentic. We have the therefore concluded that these specific allegations are unfounded. “
This was on the allegation by the US about their allegations on Nuclear negotiations between Niger and Egypt.
Even with Iran he had been very neutral—asking Iran to clarify some important issues but at the same time telling the world community that “the agency has no concrete evidence of ongoing nuclear weapons program or undeclared nuclear facilities in Iran.
Way back in 2007 Bolton had remarked Baradei as an apologist for Iran just because the gentleman had refused to endorse the US backed Israel led attack on Iran.
His neutrality was so neutral that on one hand he criticized Iran for being non cooperative enough and on the other hand also saying it in so many words that attack will be the worst thing that can happen and that robust diplomacy is the ultimate solution to the Iranian standoff.
A Jewish blogger wrote:
“He is a stooge of Iran, and I don’t use the term lightly. When he was the head of the International Atomic Energy Agency, for which he got a Nobel Peace Prize, he fronted for them, he distorted the reports.”
He’s been highly critical of Arab autocrats and the Western governments that prop them up.
“Western policy towards this part of the world has been a total failure, in my view,” he told the Guardian, in March 2010. “It has not been based on dialogue, understanding, supporting civil society and empowering people, but rather it’s been based on supporting authoritarian systems as long as the oil keeps pumping.”
Once talking to Hard Talk he had remarked that he could have earned a great deal being some one’s voice in this coveted position of IAEA Head but wished to have better sleep at night than more money. That was the day I started to revere this man, who I had taken for granted as a CIA agent earlier on.
Although many Egyptians might not fully want a person regarded as an expatriate coming in to take over the opposition to Mubarak’s police state, others regard him, as a man who gave their country a very high and positive international profile in a world that was rapidly becoming Islamophobic and racist toward Arabs.
We can relate to that by our dismay at expats like Sonia Gandhi or Shaukat Aziz getting into power.
As the Egyptians gather in the Tahrir Square and prepare to start the million march, the whole world has its eyes on how this man will steer the direction of the revolution which is till now a ‘leaderless’ one. They will need someone to lead and who could be more suitable than a moderate, educated, conscientious Al Baradei.
He is a man who is not even at odds with the Muslim Brotherhood and is at the moment a member of ‘movement for change’ of which even Muslim Brotherhood is a member.
Impatiently we all await how the things will unfold.
THE EGYPT OF MY LIFE
January 28, 2011
Yet another progressive Arab country bounces back to restore back it’s lost glory.
Indeed, none other than Egypt and the way it is adjacent to Tunisia, it looks like a domino effect has started not just in the metaphorical but the literal sense.
But to say that Egypt bounces back because of a common border with the Tunisia would a shameful underestimation of Egypt’s potential.
Along with Tunisia, it is one of the few Arab countires with a strong, ancient history and a history of cultural and liberal values far detached from the religious tag . Yes, Egypt probabaly would stand even ahead of Tunisia in that respect.
The situatuion gives me jitters and also butterflies in the stomach. Not because I have this appetite for international politics but because I have a special attachment to Egypt.
After India, Egypt has been living in my life, even more than Pakistan. Strangely though I have never lived in Egypt except for two visits for a fortnight each.
I woke up to this world with a name given to me by my Dad after being inspired by Egyptian names. His special love for Egypt was still fresh and alive in him when I was born. Just a couple of years ago had he returned from Egypt, after earning a PhD in Egyptian Liberal Nationalism and with Jamal Abdul Nasser his hero.
I grew up hearing his stories about Jamal Abdul Nasser, Egypt ‘s rich culture, their progressive intelligentsia, their sense of humour, the plays and most of all their music which was represented by none other than Umm Kulthum.
My dad who went to Egypt in the early sixties for a Phd, had gone there as a son of a maulvi (though he had been a rebellious communist too, in his early student life), but returned back some years later as a very progressive man with a wide horizon. He was in love with this place till the last moment of his life.
However when he returned to Egypt once again, in late eighties two things disappointed him terribly. He did get connected with all his old friends some of whom had gone ‘BIG’ in Egypt by then, one of them being the ex Secretay General of UN Boutros Boutros Ghali and Amr Moussa, the foreign Minister then. They all gathered together bringing back the youthful memories. Despite the 60’s era, he used to tell us that, he had a couple of girls too in his group of friends who hung around in the university together.
One of the two things that had disappointed him was the rise of Radicalism and that there were so many women now sporting Hijab and Niqab in the Cairo University. Though in the early sixties they could hardly see any.
And the second , which was no less disappointing to him, was that one of his extremely petite and pretty girl friends from the old group at that time, who was now the Head of the Political Science Department in the University, had gone at least four times as fat. They all joked about her and she too joined the hearty laugh without getting offended.
He was a very hurt man.
Egyptians have a terrific sense of humour, and if they don’t have any joke on politics, they laugh on themselves. But they make it a point to crack one joke a day –calling it a NUKTA. If anything it was their sense of humour my Dad carried back along with him on his return.
Anyhow coming to the point I wish to tell here that women have alwasy been very liberated and strong in Egypt since long. Not just in the few centuries but in the ancient Egypt 3000 years ago, too. The woman, in the pharoanic times some 2000-3000 years ago, was far more liberated than many women in the current world in 2011.
While most women, in the ancient Egypt, played traditional roles of wife and homemaker, they had many liberties and freedoms that were denied to women of other cultures in the ancient world. Married women were the complete governors of their household, husband seldom interfered in the domestic matters. Though they did all the domestic chores themselves.
Legally too they were equal to men in terms of rights and could take a loan of her own, ask for divorce, buy property in her name and even free slaves at her will. She was given third of her husband’s property on his demise. And could even remarry without any stigma. Divorce was not seen as stigma either.
There are records of women holding positions of Ministers to Pharoahs. Out of many, one most important name is Queen Hatshepsut :18th dynasty1473-1458 BC . She ruled in the early part of the ‘golden age of Egypt’ which includes other Pharoahs like Tutankhamoun, Nefertiti , Akhenton.
Needless to mention Queen Cleopatra and her stories of power not only on her Kingdom but also her control on her sweetheart–Mark Antonius was also an Egyptian Queen. Narrating about their story would need several blogs.
Women in ancient Egypt, rightly or wrongly, took great pains to ensure their physical attractiveness and even women among the poorer classes relied heavily on cosmetics and lotions to retain their youth and beauty.
After all this glory of women did spill over in the contemporary world too. Although the impact of religion did lead to segregation in schools. veiling etc. And with rise of Radicalism in the eighties it has gone worse.
I am not an expert on religion but have been told by my Egyptian friends that The MALKI SCHOOL which the Egyptian Muslims follow is pretty liberal. And they are far more progressive towards giving rights to women.The 1956 Constitution of Egypt was one of the most liberal on women’s right among the Arab and the Muslim World.
To be continued in next blog…..
Pardon me–got to leave.
Ilmana Fasih.
This excerpt is taken from an article ”
EMERGING WOMAN HAS A LOFTY AND KNOWLEDGE BASED PRIDE – Dr. A.P.J. Kalam” on four Indian Women Scientist published in India Current Affairs on September 3, 2010.
Madam Curie was a co-worker of Henri Becquerel during research, who discovered the properties of the element uranium. Curie came to know about those properties and set about investigating the effect, which she named “radio-activity” for her Doctorate research.
Madam Curie’s life has full of challenges. She was not afraid of the problems, she defeated the problem and succeeded. This experience of Madam Curie will definitely be an inspiration for all students of the present and future generations.
Marie Curie checked many other elements to determine whether they too were radioactive. She found one, thorium, and also came across a source of radiation in a mixture called “pitch-blend,” which was much more powerful than either thorium or uranium.
Working together, it took Marie and her husband Pierre four years to isolate the radioactive source in the pitch-blend. Madam Curie used to carry large quantity of pitch-blend on her head for extracting few grams of material in the laboratory which needed tons of ‘pitch-blend’. That few grams of the material was her discovery. Marie named it as radium. For the discovery of radium, Marie and Pierre won a Nobel Prize in Physics in 1903, which they shared with their friend A Henri Becquerel. Shortly, Marie found that what she had discovered was not pure radium, but she was able to isolate the element itself after quite a struggle. For this work, she was given the Nobel Prize for Chemistry in 1911.
During her work, Marie discovered radiation could kill human cells. She reasoned that if it could kill healthy human cells, it could kill diseased human cells also and went about isolating radium for use in killing tumors.
In 1906 Pierre Curie was offered the position of director of the Physics Laboratory at the Sorbonne. Before he could take the position, however, he was run over by a carriage and killed. After her husband died, Marie was offered and took the position, the first woman to become director of a research laboratory. In our country time has come for talented women scientists to take up the position of directors of major scientific laboratories.
During the first World War, Marie Curie went to work for the French designing and building X-ray machines. Knowing that moving soldiers to a hospital before they needed surgery was not always possible, she designed the first mobile X-ray machine and traveled with it along the front lines during the war.
On July 4, 1934, Marie Curie died in Paris, killed by her own experiments. She died of radiation poisoning and may have been the first person to do so. Marie Curie had brought herself up from poverty, struggling to get her education and succeeding brilliantly. The work she did, she did with patience, often getting results only after years of careful experimentation, while struggling for money to support her work. For her struggles, she received two Nobel Prizes – the first woman to win even one. Through the knowledge she gained, thousands of lives have been saved. The courage and perseverance shown by Madame Curie in her pursuit of scientific mission and achieving successes are indeed remarkable and stimulating.
Speaking in a forum of front-line service providers and the community members
Good evening everybody,
Depression has been shown to be a risk factor for mortality during the 12 months following acute myocardial infestion and stroke.Research of good quality namely the metaanylyses of various studies confirms that acute myocardial infarction(heart attack) and strokeare often accompahied by depression and anxiety. This may be either during the attack and hence being a contributory factor to it, or following later during the recovery phase.
About 40% of the patients within 6 months of heart attack or stroke have depression and a lot ( stats not available) more have anxiety or anxious personality. In fact we know that most of the people who suffer from the two ailments have the Type A personality , which is itself associated with anxiety.
The depression may be clinical i.e. with obvious signs and symptoms, or sub-clinical i.e. the symptoms are not obvious and hence often get missed by the treating cardiologist or neurologist unless they maintain a high index of suspicion.
Depression among these two group of patients is associated with broad range of adverse outcomes including mortality , prolonged hospitalisation, worse health status and a repeat event of heart attack or stroke.
One interesting study showed that the younger women (<60 yrs) are the most vulnerable group to be depressed and they are more likely to be–dark skinned, with low household income, single status, less than University education and a smoker. They are also more likely to be having other co morbid conditions like Diabetes, obesity, raised Cholesterol, CCF. But they are unlikely to be on b-blockers.
Amongst the men they are likely to be Hypertensive, have had revascularization procedure and lower ejection fraction i.e. lower pumping ability of the heart.
23% of the patients discharged from the hospital post MI or Stroke treatment have clinical depression.
Out of those depressed only 27% ( 31% of women and 24% of men) had previous history of depression prior to the event. This implies that about 73% had the depression, triggerd by the event.
Unfortunately only 18% are discharged with a prescription medication for depression or referred for psychotherapy.
So it is important to clinically recognise depression in patients associated with MI or Stroke. Not only is depression an important illness in its own right, it confers 3-5 times higher risk of mortality within 6 months of the event. The mortality is high even in the absence of clinical diagnosis of major depression-with clear dose response relationship i.e.the more severe the depression, the more are the chances of dying in the next 6 months, and then also more chances of longer hospitalisation, worse symptomatology, psychological and social outcome in the next 3 and 12 months.
And patients with moderate to severe depressive symptoms require treatment and close followup with monitoring of their mood and compliance to the treatment
Aggressive screening of the patient for depression and anxiety at the time of admission, during hospital stay, at discharge and then followup with the Cardiologist or the Neurologist or the Family Physician.
About 25 % patients on treatment for depression after MI or Stroke do not respond to the medication and the depressive symptoms persist. Such patients need more stepped up care, even closer monitoring along with polytherapy and even Electroconvulsive therapy.
It is important for the post MI or Stroke patient to join a Cardiac or Stroke Rehabilitation Program. The programs with the help of the Rehab Team tailor the services to the patient.
You all can help find a rehab program for your clients in your community through Family Physicians, hospital where patient was treated, Public Health Department otr the local office of the Heart and Stroke Foundation.
Information about Cardiac/ Stroke Rehab is available at the HSFO website.
Take home message friends:
1. There is high ( 40%) incident of depression in post MI/Stroke patients
2 .Keep high index of suspicion to identify the depressed patients.
3. Its a viscious cirlce with MI/Stoke and Depression exacerbating each other.
4. Most vulnerable group ios the women below 60 yrs of age.
5. Timely diagnosis, treatment and foillowup can improve the physical as wel as the mental outcome of the patient post MI/Stroke.
Thank You
Ilmana Fasih
Lead, South Asian Health Ambassador
Heart and Stroke Foundation of Ontario | Finding answers. For life.
Tel: 905.451.0021 905.451.0021 | Cell: 416-629-1689 416-629-1689 e Fax: 905.452.0503 | Address: 201 County Court Blvd., Suite 306 , Brampton , Ontario , L6W 4
Blind to Bounds 
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