Back home for Chhath and does not seem like themselves? What to notice over the four days of the festival, three medical cautions for the week, and how to get help before the return journey.
In this article 17
- Why the festival week shows what phone calls hide
- Four days of Chhath, four chances to notice
- Day 1, Nahay Khay (13 November): watch the plate
- Day 2, Kharna (14 November): watch the evening and the night
- Day 3, Sandhya Arghya (15 November): watch the crowd
- Day 4, Usha Arghya (16 November): watch the talk about going back
- Three medical cautions for the festival week
- 1. Heavy drinkers arriving in a dry state
- 2. The nirjala vrat and psychiatric medicines
- 3. Lost sleep and bipolar disorder
- Quick self-check: ordinary tiredness, or a sign to act on?
- How to start the conversation
- When it cannot wait
- Before the return ticket: seeing a psychiatrist in Patna, Ara or online
- Frequently Asked Questions
- References
- About this article
Quick answer
If someone home for Chhath seems changed, watch for low mood, poor sleep, heavy drinking, unexplained debt and hopelessness. If these last two weeks or more, a psychiatrist in Patna can assess them before they travel back. Shaking or confusion after stopping alcohol, or any talk of death, needs help the same day.
By 4:40 in the morning, Patna Junction is already full. Trains from Delhi, Surat, Mumbai and Bengaluru pull in one after another. The platforms fill with suitcases, sugarcane and people who have not been home since last year.
For four days in November, Bihar gets back the sons, daughters, husbands and fathers who work far away. All year the phone calls said "sab theek hai". Now you see them up close: at the chulha, on the ghat, at 3 a.m. before Usha Arghya. Sometimes what you see does not match what you heard on the phone.
Why the festival week shows what phone calls hide
A ten-minute video call is easy to get through. Anyone can look fine for ten minutes. Four days under one roof are harder. Chhath also brings early mornings, fasting, crowds and long hours standing in cold water, and stress tends to surface under that kind of strain.
Most changes have ordinary causes: a long journey, a hard job, missing home. The aim is to spot the changes that are bigger, last longer or put the person at risk, and to act while they are still here, without rushing to put a label on anyone.
Four days of Chhath, four chances to notice
Chhath Puja 2026 runs from 13 to 16 November.7 Each day of the festival gives the family a different window into how someone is really doing.
Day 1, Nahay Khay (13 November): watch the plate
Nahay Khay is a day of bathing, cleaning and the first sattvik meal of kaddu-bhaat. Notice how your family member eats.
- Has their appetite dropped sharply, or are they eating far more than before?
- Have they visibly lost or gained weight since their last visit?
- Does even home food seem to give them no pleasure?
The World Health Organization lists changes in appetite or weight among the signs of depression, alongside low mood and loss of interest.1
Day 2, Kharna (14 November): watch the evening and the night
After the kheer-roti prasad, the house goes quiet. This is a good time to notice sleep and mood.
- Lying awake until late, or sleeping through most of the day?
- Sitting alone with the phone without really using it?
- Shaking hands, sweating or restlessness in the morning? This can be alcohol withdrawal (see the medical cautions below).
One mother, whom we will call Shanti Devi, noticed that her son, back from a dyeing unit in Surat, had not laughed once since he arrived. He blamed the train. On the second night she found him sitting awake on the roof at 2 a.m., and that was when she asked.
Composite illustration · for education only · not a real person
The story of Shanti Devi is a composite drawn from many families, with details changed for privacy.
Day 3, Sandhya Arghya (15 November): watch the crowd
The ghat is crowded, loud and full of relatives. People who are struggling often show it here.
- Avoiding old friends and relatives, or leaving early.
- Irritability or anger out of proportion to what happened.
- Smelling of alcohol, or taking sleeping or anxiety pills without a prescription to get through the crowd.
- Checking the phone anxiously, borrowing money, or using betting apps. Real-money online games were banned in India in 2025,9 but offshore betting apps still reach phones, and secret debt is a common sign of trouble.
Day 4, Usha Arghya (16 November): watch the talk about going back
Before dawn, the vratis stand in the water while the family waits on the ghat for the first light. Conversations turn to the return ticket.
- Dread or panic about going back to the job or the city.
- Lines like "kya fayda", "kuch theek nahi hoga" or "main sab par bojh hoon". Hopelessness and feeling like a burden must always be taken seriously.
- Giving away belongings or saying goodbyes that sound final. This needs action the same day.
Three medical cautions for the festival week
1. Heavy drinkers arriving in a dry state
Bihar has had prohibition since April 2016.8 A person who drank heavily every day in another city may stop suddenly the moment they arrive. Their body may react badly.3
- 6 to 36 hours after the last drinkEarly withdrawal
Tremor, sweating, anxiety, headache, nausea.
- 6 to 48 hoursRisk of withdrawal fits
Seizures can start in this window.
- 48 to 96 hoursRisk of delirium tremens
Confusion, seeing or hearing things, fever and a racing heart.
This is an emergency
Someone who stops drinking on the train can reach the most dangerous window right in the middle of the festival. Delirium tremens is a medical emergency. If they are confused, see things that are not there, or have a fit, take them to a hospital emergency immediately.
Please do not hide them at home out of fear or shame. For a planned, supervised stop, see a de-addiction specialist. Read more about alcohol withdrawal.
2. The nirjala vrat and psychiatric medicines
The 36-hour fast without water begins after Kharna. For anyone taking lithium, losing body water can push blood lithium to harmful levels.2
Warning signs of high lithium
Vomiting, diarrhoea, heavy shaking, drowsiness, confusion and slurred speech. These need emergency care.
If a vrati takes lithium or any regular psychiatric medicine, they should speak to their psychiatrist before Nahay Khay, not after. The psychiatrist can advise on dose timing around the fast and the paran. Do not stop or skip medicines on your own: even a few missed doses can bring symptoms back, and some medicines are risky to restart suddenly after a gap.
3. Lost sleep and bipolar disorder
Overnight trains, late-night thekua making and waking at 3 a.m. all cut sleep. In a large UK study of 3,140 people with bipolar disorder, about one in five said that losing sleep had set off an episode of mania or hypomania.4 Watch for fast talk, little need for sleep, big spending plans and unusual irritability. Protect their sleep, keep medicine times regular, and call the treating doctor early.
Quick self-check: ordinary tiredness, or a sign to act on?
Look at the right-hand column. If the Drinking or Talk about the future row applies, act today. If any two other rows describe your family member, book a consultation before the return journey.
| What you notice | Usually ordinary if... | See a doctor if... |
|---|---|---|
| Low mood, no interest in anything | It lifts after a day or two of rest and family time | It is there most of the day, nearly every day, for two weeks or more |
| Sleep | It settles once the journey is over | Awake most nights, or asleep most of the day, for two weeks or more |
| Drinking | No regular drinking | Drinks daily or hides it, or shakes, sweats or seems confused after stopping. Act today |
| Money | Normal festival spending | Unexplained loans, secret betting apps, calls from lenders |
| Temper | Tired and short-tempered after travel | Outbursts that frighten the family, or behaviour that is out of character |
| Talk about the future | Worries about the job or salary | Hopelessness, feeling a burden, or talk of death. Act today |
How to start the conversation
Choose a quiet moment, away from the ghat and away from an audience. Describe what you saw instead of giving it a name. Listen more than you advise.
Some openers that work in Bihari homes:
- "Is baar tum kaafi chup-chup lag rahe ho. Mujhe fikr ho rahi hai. Kuch baat hai to batao." (You seem very quiet this time. I am worried. Tell me if something is wrong.)
- "Neend aur mann ka bhi ilaaj hota hai, jaise BP aur sugar ka. Isme sharam ki koi baat nahi." (Sleep and mood can be treated, like BP and sugar. There is nothing to be ashamed of.)
- "Wapas jaane se pehle ek baar doctor se baat kar lete hain? Online bhi ho jaata hai." (Shall we talk to a doctor once before you go back? It can be done online too.)
Phrases that usually shut the door: "Sab dimaag ka vehem hai", "Itna kamaate ho, kis baat ka dukh?", and comparisons with a cousin who is "doing well". Faith and treatment can go together. Prayer and Chhath maiyya's blessings can sit alongside a doctor's help.
When it cannot wait
If your family member talks about ending their life, has made a plan, or you are frightened for their safety
- Stay with them. Do not leave them alone.
- Keep medicines, pesticides and anything they could use to harm themselves out of easy reach.
- Call 112 for emergency help, or Tele-MANAS 14416 (free, 24x7, available in Hindi).6
- Go to the nearest hospital emergency.
Asking directly, "Kya kabhi khud ki jaan lene ka khayal aata hai?", does not put the idea in their head. Research shows that asking about suicide does not increase suicidal thoughts.5 Read our guide on suicide prevention.
Before the return ticket: seeing a psychiatrist in Patna, Ara or online
The festival gives you a few days with them in Bihar. Use one of those days for an assessment.
- Healthy Minds India, Patna: a mental health clinic in Patna at House No. 46/B, Sahdeo Mahto Marg, near Sri Krishna Puri Park, Patna 800001. Open Monday, Tuesday, Wednesday, Friday and Sunday, 9 a.m. to 7 p.m. Closed Thursday and Saturday.
- Ara OPD: Alok Medical & Surgical Agency, S Gali, Sadar Hospital Road, Nawada, Arrah 802301. Please call to confirm the OPD days.
- Online consultation: if they must leave before an appointment, or for follow-ups from Delhi, Surat or Bengaluru, an online consultation keeps treatment going.
A first visit includes a detailed conversation, a check for physical causes, and a plan the person agrees to. Depression treatment in Patna today combines talking therapy, medicines when needed, and for some people non-invasive brain stimulation. Families from across Bihar also come for de-addiction in Patna. Read what to expect at a first visit to a psychiatrist.
Book a consultation before the return journey
If someone in your family came home for Chhath and does not seem like themselves, do not wait for the next festival. Talk to Dr. Saurabh Kumar, psychiatrist in Patna, at Healthy Minds India.
Call or WhatsApp: 70500 24223 / 90604 84416 · Book an appointment · In person in Patna and Ara, online across India
Frequently Asked Questions
How do I know if it is depression or just tiredness from travel and work?
Tiredness from a journey usually lifts after a few days of rest and home food. Depression stays. Low mood or loss of interest is present most of the day, nearly every day, for at least two weeks, often with poor sleep, appetite change and hopelessness. If unsure, a psychiatrist in Patna or online can tell the difference.
My son drinks heavily outside Bihar. Is it dangerous if he suddenly stops when he comes home?
Yes, it can be dangerous. In a daily heavy drinker, stopping suddenly can cause shaking and sweating within hours, fits within two days, and delirium tremens within two to four days. Delirium tremens is an emergency. Supervised detox with proper medicines is the safe way to stop. Please do not wait for fits to start.
Can someone taking psychiatric medicines keep the Chhath nirjala vrat?
Often yes, with planning. Anyone on psychiatric medicines should plan the vrat with their psychiatrist before Nahay Khay. The 36-hour waterless fast is riskiest for people on lithium, because losing body water can raise lithium to toxic levels. Never stop or skip medicines for the vrat without medical advice.
He goes back to Delhi after Chhath. Can treatment continue from another city?
Yes. The first assessment can be done in Patna or Ara during the festival week, and follow-ups can continue online from wherever he works. A few controlled medicines cannot be prescribed online under India's telemedicine rules, so an occasional in-person visit may still be needed.
Will seeing a psychiatrist mean taking medicines for life?
Not usually. Many people need medicines for months, not for life, and some need none at all. Some conditions, such as bipolar disorder, need longer treatment. The plan depends on the diagnosis, its severity and the person's own choice. A good psychiatrist explains every option, including talking therapy, and reviews the plan regularly.
References
Every source below was opened and checked; each supports the claims cited to it in the text.
- World Health Organization. Depressive disorder (depression), fact sheet. Geneva: WHO; updated September 2026. who.int
- NHS. Side effects of lithium. nhs.uk
- Mark N, Ramzy M. Alcohol withdrawal, ICU one-pager. OpenAnesthesia (CC BY-SA).
- Lewis KS, Gordon-Smith K, Forty L, et al. Sleep loss as a trigger of mood episodes in bipolar disorder: individual differences based on diagnostic subtype and gender. British Journal of Psychiatry. 2017;211(3):169-174. doi:10.1192/bjp.bp.117.202259
- Dazzi T, Gribble R, Wessely S, Fear NT. Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine. 2014;44(16):3361-3363. PMID: 24998511.
- Ministry of Health and Family Welfare, Government of India. Tele-MANAS, national tele mental health helpline 14416 (Vikaspedia). telemanas.mohfw.gov.in
- SmartPuja. Chhath Puja 2026: date, arghya timings, Nahay Khay and vidhi. Cross-checked with Shubh Panchang.
- ETV Bharat. A decade of liquor prohibition in Bihar. February 2026.
- Vision IAS. The Promotion and Regulation of Online Gaming Act, 2025.
About this article
Written and medically reviewed by
- MD (Psychiatry) AIIMS New Delhi
- Associate Professor & HOD, Dept. of Psychiatry, RDJM Medical College, Muzaffarpur
- Ex-Assistant Professor, PMCH Patna
- Consultant, Healthy Minds India, Patna
- Former Senior Registrar, NDDTC, AIIMS New Delhi
- Published
- 16 October 2026
- Format
- Patient guide
- Focus
- Noticing mental health changes in family members during Chhath
- Last medically reviewed
- 12 October 2026
- Sources
- 9 references
- The story of Shanti Devi is a composite drawn from many families, with details changed for privacy.
- Chhath Puja 2026 dates (13 to 16 November) are taken from published panchang listings. Local arghya times vary, so please check a Patna panchang.
- Written for general education. It does not replace an individual assessment by a qualified clinician and does not diagnose any condition. Diagrams are original illustrations prepared for this article.
© 2026 Healthy Minds India, Patna · Blog edition 1.0, October 2026
If you or someone close to you needs help right now
Emergency: 112 · Ambulance: 108 · Tele-MANAS (free, 24×7, Government of India): 14416 or 1-800-891-4416
If there is any immediate risk to life, do not wait for an appointment: call 112 or go to the nearest hospital emergency department.
Healthy Minds India, Patna
House No. 46/B, Sahdeo Mahto Marg, Near Sri Krishna Puri Park (Children's Park), Patna 800001
In person in Patna, online across India · Mon-Wed, Fri & Sun, 9 AM-7 PM (Thu & Sat closed)
Appointments
Non-emergency: 7050024223 / 9060484416 · book a consultation
Services: Adult psychiatry · Depression and anxiety care · De-addiction · Online consultation across India · Ara OPD (call to confirm days)
For general education; not a substitute for a personal consultation. If you or someone close to you is in distress, please speak to a qualified mental health professional.
Medically reviewed by Dr. Saurabh Kumar, Consultant Neuropsychiatrist, Healthy Minds India, Patna. This article is for general education and is not a substitute for a personal consultation. To discuss your situation, book an appointment or contact the clinic.
Disclaimer: all characters and events depicted in this blog are entirely fictional. Any resemblance to actual persons, living or dead, is purely coincidental. The content is intended for informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for medical concerns.
