Book Review | ‘Chemical Khichdi’ is About Changing Mental Health Narrative, Debunking Stigma

One does not read ‘Memoir of Madness and Sadness’ amidst family wedding, but I precisely did that when my friend Partha Mukhopadhay — Senior Fellow, Centre for Policy Research and country’s leading Developmental Economist — slipped ‘Chemical Khichdi’ to me during the cocktail-dinner at Hilton Jaipur on May 10, 2022, night on the eve of my son Anurag’s and daughter-in-law Ishani’s wedding celebrations.

Chemical Khichdi then was 22 days old.

I read ‘Chemical Khichdi’ in one go, finishing it just in time for the wedding celebrations of children at Ashoka Club, Jaipur, next evening.

‘Chemical Khichdi’ left everlasting imprint in my ‘Turbulent Mind’. And I reread umpteen tines, one chapter, one paragraph, one verse and one journal entry at a time, and soaking in its narrative, internalising author’s conversation with self, family, friends and her 60 trusted conscience keepers, her seven therapies and ‘guidance notes’ to sufferers, caregivers, friends, employers and the society at large.

Why I keep revisiting ‘Chemical Khichdi’? Reasons are legion. But I begin with the most important — my existential calling.

To tell readers the truth, I find nothing common between Aparna and me. She was born with the silver-spoon in mouth in a well-known business family — ‘Piramal’s’ and I was born an ordinary lunatic in abject poverty for whom two square meals a day was a luxury.

But Aparna and I have braved the same tsunami, mental illness — I, for 50 years, and Aparna for 20 years; she calls it ‘her bipolarity’, I call it ‘my manic-depressive insanity’, the name Kraepelin, father of the modern psychiatry gave it, in 1899.

‘Bipolar Affective Disorder- I’, the mental health condition of mine and Aparna, is an equal opportunity disease that strikes viciously across race, religion, class, and caste. It is debilitating to live with, and painful in death. Its epidemiology is known for 2,500 years, but etiology remains a mystery — it has not yet yielded secrets of its being to the medical science.

Bipolarity cripples’ lives, destroys marriages, relationships and friendships and is a grand scale career slayer. Worse bipolar proband often die young, earlier than the normative population- ‘reasons are varied but none more pronounced than the death by suicide’.

Aparna says: “Bipolarity and other mental health conditions can be managed with medication, therapy, lifestyle change, family, friends and ally’s support.”

I concur, but with one more item to the survival kit, lots of luck.

Busting the Myth

Amid glowing reviews on Amazon, one isolated review has claimed there is no learning from the mental illness of someone who was born with a silver spoon, and has lived in opulence.

I consider it my duty to first debunk this biggest myth that there is no learning from the life story of a severely mentally ill person just because he or she had a rich pedigree and was born or has lived life in opulence.

I posit whether rich and famous, middle class or poor, homeless or destitute, viciousness with which madness strikes is the same and so are is its crippling collateral damage.

Only benefit that the station of birth provides to the rich is their better access to the treatment. But stigma and denial of the illness is a common theme that runs across all echelons of society. And even with best psychiatrists and therapists at her command, the bipolarity diagnosis of Aparna took 13 years. Also, which lottery of psychotropic medicines will lead to recovery or not is class neutral.

Having debunked the myth let me vouch – ‘madness and sadness is strictly private, it affects rich, famous, poor or destitute’ differently but there are common strands and life learning from the experience of all.

I urge readers to stay fixed at lessons from ‘Chemical Khichdi’, and the pedigree of the author should not be of even peripheral interest.

Life Can Rock on Even with Mental Illness

‘Chemical Khichdi’ has an audacious message, even if in throes of incurable mind-malady, one can still have a fulfilling life. Kernel of the book is its opening paragraph where Aparna says:

“I have lived with bipolarity-classified as a serious mental illness-for over two decades. I believe that you can have a mental health condition and raise a family, be in stable, loving and supportive relationship with close family in friends, study at leading educational institutions, turnaround a company, write a book and a popular column, teach students, give a little back to the society, travel around the world, fail at learning the piano and fall off a horse and get back on it again.”

Aparna is New World Changer

The more I internalise ‘Chemical Khichdi’, more I am reminded of the famous saying of social anthropologist Margret Mead, who said “never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has”.

I submit, Aparna with ‘Chemical Khichdi’, joins the league of the chosen few, who change the world.

The Book Will Emancipate India

I posit ‘Chemical Khichdi’ will emancipate India. This 70,000-word 288-page book written during Covid-19 to me is akin to 30,000-word, 270-page book ‘Hind Swaraj’ written in 10 days by Mahatma Gandhi in return voyage to South Africa. Written at a feverish pace on steamers stationery, partly by right hand, partly by left hand, ‘Hind Swaraj sowed the seed of India’s emancipation from the yoke of British Raj’.

I say-‘Chemical Khichdi’ will emancipate India, free the nation from shackles of vices such as stigma, profiling and discrimination of mentally ill.

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It will change the narrative one reader at a time.

The stigma against mental illness runs deep. I often say the mission to change life and times of mentally ill in India is a 100 years’ war but, I dare say, with her heavy lifting work, ‘Chemical Khichdi’, Aparna has brought the victory day forward by 50 years in one go.

Who is Aparna?

A daughter, sibling, spouse, mother, daughter-in-law, friend, business turnaround leader, teacher, columnist, writer and author, Aparna belongs to a prominent Indian business family and was educated in the best of the best — ‘Oxford University and Harvard Business School’.
How can someone with such a pedigree be seriously mentally ill? It is here my hypothesis fits in — ‘mental illness is an equal opportunity disease, which spares none and in lethality of consequences it does not differentiate between haves and have nots’.

What is Bipolarity?

To understand Aparna’s journey, one must familiarise with the beast — bipolarity. It is best articulated by American author John Custance, in his 1952, memoir ‘Madness and Folly: The Philosophy of a Lunatic’.
“The mental disease to which I am subject is… known as manic-depression or more accurately, Manic Depressive Insanity…The manic state is one of elation, pleasurable excitement, sometimes attaining an extreme pitch of ecstasy; depressive state is its precise opposite, one of misery, dejection and at times of appalling Horror”.

And Key Redfield Jamison, the global authority on bipolarity and herself a lifelong sufferer of this illness says: “Manic Depressive Illness distorts moods and thoughts, incites dreadful behaviors, distorts the basis of rational thoughts and too often erodes desire and will to live…

It is an illness that is biological in its origins, yet one feels psychological in experiences of it; an illness that is unique in conferring advantages and pleasure, yet one that brings in its wake almost unendurable suffering and not infrequently suicide.”

Make no mistake, bipolarity is a dreaded mind malady with alternate flameout of splintering mania and an appalling horror of depression and long-term friendship with suicidal ideation. It makes writing a detached and authentic memoir impossible for bipolar sufferers.

‘Chemical Khichdi’ has made the ‘impossible mission possible’.

A Brutally Honest Book

Aparna writes: “In 2014, about 18 months after I was officially diagnosed as being bipolar, I wrote a short note called ‘10 things I’ve learnt about being bipolar’ for my friends, family and medical practitioners, all of whom liked it. I also shared it with my book club who encouraged me to turn it into a book, and I tried writing it back in 2015. But I kept having mood swings at the time and wasn’t sufficiently detached from the material. The lockdown and the pandemic gave me the time, space, and distance to focus on the book. The goal is to tell my story with the intent that it would help others who are facing similar challenges”.

Impact Aparna Wants the Book to Have

Aparna wants her words to have far-reaching impact. She writes to me: “For me, ‘Chemical Khichdi’ represents 20-year journey towards ‘self-realization, self-acceptance and understanding and I know that I am a work-in-progress’. I hope, my ideas resonate with others. ‘It is not so much a manual on mental health, as a template or an invitation for others to think about what might work for them’. I was lucky to have the time and space to think about myself and my condition in great detail, with the support of many others. That is a good starting point for anyone who wishes to achieve a similar outcome”.

Mental Illness Diagnosis is a Zero-Sum Game

Correct diagnosis of a mental illnesses is one of hit and run, even for an expert psychiatrist with astute clinical prowess. It took 13 years for Aparna to get bipolarity diagnosis, I had to wait for 25 years. Aparna writes to me about this —

“My first manic episode was in 2000, when I was 24, and my official diagnosis of being bipolar was in 2013, 13 years later. That’s when I began taking medication. During these 13 years, there was some ambiguity about whether I was a ‘borderline’ case of bipolarity. As a family, we were not keen on taking medication for the side effects. Our psychotherapist at the time was also not keen on the ‘label’ of bipolarity. But then there was an incident of psychosis and mania in 2013 which was so severe that medication became unavoidable, and since then I’ve been taking medication daily”.

The Siamese Twins

Denial and medication — unconformity in mentally ill are Siamese twins. I was in a long haul denial and so was Aparna. Her calling came after a major psychosis filled manic attack in 2013. For life to reboot, accepting the condition and starting medication is a must. When I asked Aparna’s advice for those who get trapped in the medicinal nonconformity trip, she shared pearls of wisdom —

“I am really diligent about medication. I have been in remission for just over four years ago, and medication has progressively reduced over this time. My psychiatrist and I regularly review them at six monthly routine check-ups. I’m keen to reach a stage where I can keep medicines to bare minimum, but I do recognise that I have a very full personal and professional life, with minor oscillations in my moods on a daily basis too, and that I need the meds to support me.”

Nostrum of Seven Therapies

Aparna says to survive severe mental illnesses, medication is a must, but it can take one only this far-Medication seldom returns one to a high level of functioning. Nobel Laureate John Nash says it so beautifully in the book, ‘A Beautiful Mind’ – “Getting a Nobel Prize after a long time of mental illness was not impressive; what would have been impressive is persons who after a time of mental illness achieve a high level of mental functioning and not just a high level of social respectability”.

  जानें क्यो होता रहता है महिलाओं के तलवों में दर्द, ये हैं कारण और वो उपाय जिससे समस्या हो जाएगी

Aparna says rightly; attaining a high level of mental functioning after severe mental illness is difficult but not impossible. Her seven therapies provide the pathway to move up the value chain from ‘coping and surviving with mental illnesses’ to ‘healing and thriving despite mental illnesses. Her seven therapies are her nostrum, and it is my informed opinion, they will work for others too with some person centric refinements.

What are Aparna’s seven therapies? They aim at a holistic 360-degree approach – ‘medical therapy (both medicines and therapy), love therapy (mental health a team sport,) her sixty non-judgemental allies (therapy by empathy), work-therapy, self-therapy lifestyle therapy and spiritual therapy.

To deep dive in her seven therapies, I asked Aparna about the role Self Therapy and Spiritual Therapy have played in her journey. She writes —

Self-Therapy

‘Self-therapy is heart of the book. It has enabled me to get understanding of the psychological triggers behind my mood swings. Philosophers for centuries have talked about success, happiness, fulfilment, identity, purpose, meaning and dharma — these are some of the subjects that came up repeatedly in my conversation with myself, mostly through journaling. I do not think I am fully resolved or ‘enlightened’ in anyway, but I am definitely in a much better place now than 10 years ago when I first began writing the journal in order to document my thoughts and emotions and have this conversation with myself.

Spiritual Therapy

Spiritual therapy is another tool to understand and cope with my triggers better, by learning from spiritual masters. I believe that many ideas I have discussed such as mindfulness, detachment, and gratitude are universal in nature. They can help anyone, whether or not they happen to be a person of faith, to find the equanimity that is so often elusive to individuals with a mental health condition.

Bipolar is a Life Slayer

Aparna has experienced mania with psychosis. She knows Bipolar-I is a life slayer.

I inject here personal note again; in manic high, my extravagance ruined our family finances and goal directed behaviours almost ruined my marriage.

Aparna turned lucky, but she knows goal directed behaviour is a key predictor of mania. She gives loud message to bipolar proband and their caregivers.

“To individuals who are bipolar, I think the message is resilience is the only way out, in my experience. One has to want to live a normal life, and not in an ‘unreal’ or ‘fantasy’ world of spending sprees, or in any of the other extremes that define mania. Unless one makes it a personal mission to seek a normal life and find joy in that existence, the ‘highs’ of mania will continue to be attractive. It takes resilience to fight one’s DNA which pulls one towards mania, but it is possible.”

A Message for Carers

Aparna adds, “To caregivers, one can only prescribe patience and I know my family, especially my husband, have drawn on that a lot! It takes patience, compassion and understanding not to be judgmental when your loved ones are behaving in this way. The other advice is to include other allies, members of the extended family, mentors, friends, anyone whom the patient is willing to listen to, who can counsel them in telling — “Happiness does not lie in the highs”, however, much it might seem that it does.

Mental Illness Not a Career Slayer

Despite bipolarity, Aparna graduated with flying colours from the Oxford University and Harvard, turned around a sick family business, became a prolific writer, columnist, teacher and author.

Like her, God has helped me rise from the ashes and thrive as – “social scientist with action bias”. But possibly, Aparna and I are outliners, lucky at workplace. A lot needs to be done at workplaces to ensure mental illness does not remain a career slayer.

When I asked what must be done to make Indian workplaces less toxic and more inclusive, Aparna wrote —

“This is a huge question! For me, conversations with bosses were game changer because they gave me confidence to be myself, and my productivity and professional relationships actually improved after I told them. But I do realise that is not the case with everyone. So, I think an enormous amount of work needs to be done to create awareness and sensitisation in the workplace, and the work therapy chapter outlines some of the ways in which this can take place. Workplaces are some of the biggest obstacles, but also the most important change-agents, towards mental wellness and well-being, in my opinion.”

Changing India One Reader at a Time

Above are the reasons enough to say ‘Chemical Khichdi’ will change India. But here are five more reasons for why I say so.

Radical Transparency: The Naked Truth

First, it is easy to conjure a story around madness and sadness and depict it as compelling or sizzling novel depending upon writer’s predisposition but portraying first-person account of decades lived with bipolarity, characterised by alternating frenzied burst of energy and catatonic low, must have sent chills down Aparna’s marrows.

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Nonetheless, she narrates the truth of her bipolarity filled life with radical transparency with critical intimacy with her true self with readiness to suffer the consequential damage. I call it naked-naked truth narrated truthfully.

Aparna writes with empathy and detachment about break-ups before marriage, coming to terms with parents’ divorce, persistent suicidal ideation, delusions, and hallucinations where she is traumatised by “scenes of sexual trauma” playing out in mind even though she was never sexually abused herself.

I, as one who has lived life accursed with mind maladies for decades and was first in India to openly say ‘I am a mad man’, know how gut-wrenching it must have been for Aparna to revisit her traumatic past. But she has made it therapeutic and a self-realisation journey.

I humbly posit – Aparna is that new change agent who is illuminating the world burning the candle of her life from both ends.

Debunking Stigma

Second, The New York Times wrote on June 23, 2011: The enduring stigma of mental illness teaches people with such a diagnosis to think of themselves as victims, snuffing out one thing that can motivate them to find treatment: “Hope”

‘Chemical Khichdi’ gives hope and debunks stigma.

Stigma against mental illness is deeply engrained in the Indian society. Ignorance, prejudice, and discrimination get internalised at an individual level as self-stigma, between individuals through interpersonal stigma, and at institutionally through structural stigma.

Aparna makes a frontal attack on the stigma and inspires one to find a pathway of living a meaningful life despite having severe mental health condition.

Be-friending Emotions

Third, Aparna gets salvation befriending her emotions — joy, anger, ecstasy, high, low, mania and sadness, and she exhorts sufferers to neither repress feelings nor get consumed by them, but to acknowledge them as one would attend to a friend, and respond to them by recognising — ‘I am not my emotions’.

Aparna lets readers enter sanctum sanctorum of her deepest and most private vulnerability from where begins a powerful conversation about “vulnerability without becoming its victim”.

It is this candidness that sets Aparna and ‘Chemical Khichdi’ apart from hundreds of memoirs of ‘Madness and Sadness’ that I have read busting lakhs of rupees on Amazon. What a powerful one-line wisdom just changed my life in a book priced Rs 399 – “You can live your life on your terms, even if you’ve been dealt a tough hand”.

Embracing Bipolarity as Family

Fourth, Aparna says, “There is no doubt, we are an unusual family! My parents Dilip and Gita are divorced. My father is remarried to Shalini, and they have a young daughter, Priyadarshini. My sister Radhika is openly gay and has a wife, Amanda. And I am bipolar, married to Amit who, is from a different background.”

And Aparna adds, “This is not what makes us unusual, in my opinion. What makes us — and our extended family — unusual is how we have embraced mental illness as a family. We have accepted it, evolved practices to negotiate it and learnt to not just live with it but to thrive with it, just like in the case of any other disease”.
This is what Aparna calls ‘love therapy’, which every mentally-ill person needs in India.

Self-Realisation

Fifth, Aparna realises time is never linear in her world and amplitude and frequency of highs and lows might have flattened but they will never disappear. Learning to survive and thrive with bipolarity has brought her self-realisation after continued self-examination, which might otherwise not have happened.

It is this self-realisation, which Mahatma Gandhi sought in ‘My Experiments with Truth’ and which Lord Krishna imparted to Arjuna when at the end of chapter-one of Bhagavad-Gita: “Arjuna sank down in field of Kurukshetra on the seat of his chariot, after speaking out his hesitation and despondency, casting away his bow and arrow, his spirit overwhelmed by sorrow with eyes troubled and filled with tears and much depressed mind”.

Arjuna needed his Madhusudana, Lord Krishna, to show the path ahead. Aparna had her doctor, therapist, family, friends, 60 allies and spiritual healers to help attain self-realisation, a goal which is extremely difficult to reach but which every human mentally ill or otherwise must seek to actualise.

As I end this review, I am wondering what should I compare Aparna’s ‘Chemical Khichdi’ with. As I find no template, no Indian canvas, I end up likening it to ‘Confessions (1782) of Jean-Jacques Rousseau’ where he wrote –

“I have resolved on an enterprise which has no precedent, and which, once complete, will have no imitator. My purpose is to display to my kind a portrait in every way true to nature, and the man I shall portray will be myself”.

‘Chemical Khichdi’ will slowly but surely bring evolutionary revolution to change life and times of mentally ill in India.

Akhileshwar Sahay is the Principal Instigator of Whole Mind India Foundation (WMIF). He is also the Principal Instigator of Mission Zero Suicide India. He is the past member of Government of India Mental Health Policy Group and a past non-official member of Central Mental Health Authority (CMHA). The views expressed in this article are those of the author and do not represent the stand of this publication.

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