Dear Madam,
I am a 17 years old female, and soon going to sit for my Ordinary Level Examination. Since my exams are near I need to study hard, but the problem is that I cannot concentrate on my studies at all. Whenever I open my books, my concentration seems to fly away somewhere else. Many unnecessary thoughts come in my mind that has no link with the practical life. The thoughts are mainly about my future life. In fact I daydream of my future home, family etc. At same time I know that such thoughts should not come in my mind especially at this age, but I cannot stop them from coming to my mind. I tried a lot, but could not help myself.

Due to such imaginations I cannot study, and thus getting very poor marks in studies. I do get lots of scolding from my parents, but these do not work at all. I am very moody, and cannot keep on with anything for a long time. In other words, I cannot finish a work that I have started. I always have submit myself to my desires. I also want to mention that I am the only child of my parents. I am lonely, and do not have much friends. Therefore, will you please be kind enough, and tell how I can concentrate on my studies, rather than daydreaming? And how will I be able to be control my restless mind?

Hopeless

Ans: You are an O' level examinee and finding it hard to concentrate in your studies. You have identified daydreaming as the main barrier. Fantasy or daydreaming is a playful activity of brain. The proportion of fantasy thinking as opposed to reality thinking gets lesser and lesser with the maturity of the brain; adult brain has lesser amount of fantasy thinking than a child brain. Fantasy thinking can become an automatic response of the brain to protect itself from the stress of real life.

It seems like your reality now is to face the exam and be able to do well in it. Probably this stress feeling is accentuated by parental pressure (“I do get lots of scolding from my parents, but these do not work at all”). You can force yourself to sit in the study table looking at the letters in the book but the mind still rebels by running away to a fantasy land. The contents of your fantasy thoughts are very normal for your age though the proportion seems to be excessive. What else is there in your dream besides home and family? Do you see yourself in any particular career or any kind of activity that requires special knowledge and skill? To create internal motivation, dream a dream that requires you to do well in the exam and then work hard to realize your dream. What else is going on in your current life, are you feeling stable and secure enough in this present life situation? Identify other stressors in life in order to deal with them effectively.

It is natural tendency of the brain to drift away from time to time, particularly so if the stimulus gets monotonous. Sometimes even the brain tends to shut down (how many of us fall asleep in a boring class!). It is a matter of practice to train the brain to stay focused for a long time. Different types of mindfulness exercises help people improve their attention concentration power. Some rituals of organised religions (e.g. Namaz for a practicing Muslim or Puja for a practicing Hindu) can also promote the mindfulness practice by requiring them to focus on a particular doa or mantra. Our body tends to carry the accumulation of past while our mind tends to race after future, it is only breathing that keeps us anchored to the present moment. Different types of breathing exercises help people to learn to live in the present moment. Meditation, yoga etc. are also based on similar principles and are helpful measures in this respect.

You have mentioned that you are the only child and don't have many friends. It seems that you are deprived of adequate human contact that is necessary for emotional health. All work no fun is always more stressful. Studying probably fulfills only the intellectual need; come up with a routine that also takes care of other needs (physical, social, recreational etc.). Doing something to make study time enjoyable (group study, competing with friends, music in the background, using cue cards, alternating between reading, writing and drawing etc.), changing posture or a study corner might help to avoid getting bored. Taking frequent short breaks (bathroom break, snack time etc.) and diverting mind in to something relaxing (going through a comic, doing chores etc.) can be refreshing too. Since an internal distracter mostly interferes with your study attempts, bring yourself back in touch with you surroundings by watching the immediate environment (picture on the wall, color of the book etc.) and sensations in the body (back leaning against the chair, foot touching the floor etc.). Find out what kind of a learner you are- visual, auditory, interactive etc. Some people are book smart, some are street smart- what is your style?

Get bolder in your daydreams; add more excitement and new dimensions to the conventional homemaker role. Give yourself permission to witness the thoughts that run in your head without wrestling to stop them, allow it to happen for a reasonable time (may be 5 to 10 minutes at a time) and then bring yourself back to the reality after putting it in the imaginary mental cabinet, so that you can access it again after you are done with a chapter or exercise or planned amount of study. Visualize the consequences of your choice of action (facing parents/friends on result out day, admission in to the college of choice etc.). Reward yourself for being able to focus for a longer time without submitting to the internal urge. Give yourself the gift of wilder dreams if you can supersede your expectations!!

Dear Doctor,
I am 24 years old and have white patches on my chin, forehead and parts of my neck. I was taken to a lot of doctors by my parents and they diagnosed it as vitiligo. I have used many kinds of medication but have not had much help. Please help.

Well if it is vitiligo you need to know that it is very hard to treat but still in some cases where the lesion has stopped growing the areas can be treated by Melanocyte transplant. Also sometimes if it is a small area it can be excised. You need to come for a consultation to see the condition of the lesion and then decide what to do about it.

Dear Doctor,
I have a blocked nose and cannot breathe through the nose comfortably. I think the problem is in both sides of the nose also I have a hump on the upper part of my nose. It gives me a 'witchy' look. Can both problems be treated at the same time?

Yes, of course. You probably have some hypertrophied tissues on the sides of your nasal cavity that gives you the blocked feeling. This can be treated by either cautery that is shrinking the tissue by electric heat or by excising it. If its still small then only sprays may also help. As for the hump you will need a reduction rhinoplasty where the hump is reduced. Both procedures can be done in the same sitting and will require general anesthesia.

Dear Doctor,
I have a baby aged 3 months and she has a black hairy growth on her right cheek. It looks awful and I would like to get it treated but my parents won't let me due to some superstitions. Will this be harmful for my child or will it remain the same?

Well it sounds like the baby has a congenital melanocytic neavus. Usually they are treated by excision. Given the tender age of your child, it is best if you consult a doctor in person. If untreated it will possibly grow big

…not my child
Oyeshi was in her early twenties when it happened but the seed was sown much earlier. As a teenager she was introduced to drugs, pornography and promiscuity. It was not until one day when her parents brought her home from a high-end entertainment party in a club, drunk and unconscious, did they realise the depth of their daughter's despair. A psychiatrist was consulted and she was soon diagnosed with borderline personality disorder, a disease characterized by a pervasive pattern of instability in interpersonal relationships, self-image and emotions. Her doctor father totally disregarded the specialist opinion, and outlandishly put a bar on meeting all her university friends. She was soon transferred to a foreign university, where she has re-engaged in marijuana and free sex.

Nayeem, her friend, tells us- “Oyeshi was a nice girl. Everyone in the university was aware of her eccentric attitude and the drugs but we never encouraged it to her. Oyeshi was the only person doing drugs in our gang. We asked her a few times to quit but she paid no heed. We learnt to live through it as long as she was not taking drugs in front of us. Her parents had the idea that we introduced her to narcotics. But I, as a school friend, know well that she was into drugs long before that.”

It's not my fault or is it…
Ipshita was a young child when it first happened; she realised that her paternal uncle was fonder of her than her siblings or cousins…and a bit too physical. It was not until a few more years that she realised she was being abused. Her entire puberty passed by with guilty conscience. She confided in her mother only to be faced with mistrust. Now standing seventeen, she does not know what she should do.

Tales from room 103
“Raheid was a shy boy”, says Pinu Haq, “but he grew quieter after the death of his father”. “Initially we thought of it as a blessing. Raheid was a stark contrast of his brother- quiet, good in school, well spoken and as it seemed, and mature beyond his age. I first realised he was facing problems in 1999. He was studying for his Advanced Level examinations back then, and I was worried sick about his future prospects, having a bad school record. He was a good student, always. And we expected he would outshine everyone in the family. It was in late 1999 that Raheid came asking for psychiatric help. Initially what seemed as shyness turned out to be suppressed depression.

By early 2002, Raheid was almost out from medication. He overcame his bout of depression and joined a local university. But what seemed like the end was only the beginning of a long and turbulent journey. He slit his wrist a few times, but we took it as a mere sign of frustration until the day he was admitted in the hospital. He was in comma and the doctors gave up all hope of his survival. But he regained consciousness. Electro-convulsive therapy was suggested.

“I saw my son undergo it all. I don't know where I went wrong but I must erred somewhere; his brother faced a similar situation, they battled the same odds, but while his brother could take it boldly, Raheid could not” says Pinu Haq, Raheid's mother.

Parenting is not easy, it never has been. Living in a society where the concept of nuclear family has gained popularity, we understand our needs. But sometimes, we fail to understand the child's need! We shower them with expensive gifts, pamper them and fail to be strict when we should. Sometimes, parents are stricter than they ought to be. We try to relive our dreams through our children, giving no thought to the dreams of the child. Parenting is supposed to be a well-balanced act, but sometimes we just fail to find the balance.

By Mannan Mashhur Zarif