One of my earliest jobs in behavioral health was as a counselor in a community clinic in the United States. I remember very clearly walking into the waiting area of the clinic one day to call my next client back for a counseling session. I happened to see a young Indian man waiting with his parents. The family looked distraught, so I gave them a reassuring smile. They did not react, just stared ahead.
Not soon after, I came back to the waiting area to escort my client out. I was told by the office personnel that the family requested specifically not to be seen by the “Indian counselor.” Until that moment, I really did not have a clear understanding of the crippling fear and stigma attached to having a mental illness in our culture.
Years ago, the Indian community in the area was very small, and the family was terrified that word would get out about their son’s issues and he would be labeled “crazy.” The label would take a toll on his standing in the small close-knit community, both in the social circles and within their faith community.
In a culture where arranged marriages are common, they feared for the impact on their son if people thought or said he was not “normal.” They feared their son would be judged harshly in a culture that tends to keep these secrets hidden within families. They were ashamed too, and felt guilty for feeling ashamed.
I was consulted by the counselor assigned to his case because she wanted to get a clear understanding of the cultural issues in order to better help him. The client had just moved to the US from India about a year ago. He had enrolled in a college, but struggled with adjusting to a completely different culture. He also needed to find work to begin helping his family make ends meet.
With every small failure in adjusting to the college or trying to find a job, he became more and more distressed. With every rejection from employers, he began to feel he was letting his family down. He began to feel the walls closing in. He began to worry more and more.
What started as feeling depressed from time to time became a more intense, heavy and deeply painful feeling which would not lift.
His family came to the clinic when things became progressively worse and he started talking about wanting to die.
Despite the overwhelming fears about their privacy, they decided to seek help for fear they would lose their son.
Unlike physical illnesses, his wounds were not visible to their eyes. When his counselor began to work with him, it became evident that he had been depressed for a long time, well before his move to the United States.
His parents did not pick up on the signs at the time. The move and the increased stressors had intensified his symptoms exponentially.
According to the latest data (2012) from the World Health Organisation (WHO), depression affects over 350 million people globally. The data also indicates that a suicide occurs every 40 seconds globally resulting in over 8,00,000 deaths from suicides per year. The number of suicide attempts per year is significantly higher.
Individuals between ages 15-29 are impacted the most, with suicide being the second leading cause of death globally for this age group.
Although depression is a serious issue worldwide, many individuals do not seek help. In some cultures, the stigma related to mental illness can create great barriers to seeking help resulting in grave statistics.
A lack of open dialogue about mental illness can result in symptoms going unrecognised until it’s too late. Individuals with depression can become increasingly withdrawn, isolating from others. A lack of energy or increased fatigue can be present. There can be feelings of overwhelming guilt. It is common for individuals with depression to feel increased anxiety as well. A sense hopelessness and helplessness is commonly expressed by individuals.
Many times, thoughts of suicide may be experienced. Problems with sleep and appetite are often described. Individuals expressing or displaying these symptoms should be encouraged to see a professional.
Counselors can often provide a safe environment to discuss symptoms and place great importance in keeping the confidentiality of their clients. They can work with individuals and families to come up with the best course of action (treatment plan) to address symptoms and concerns. The plan may include ongoing sessions with a counselor, medication if the symptoms indicate such, or a combination of both.
The plan is developed with the input of the individual as well as the family if that is preferred. Seeking help can be a safe, supportive and a positive experience.
– Suja Mathew is a licensed professional counsellor who has been working in the behavioral health field for 20 years. She currently lives in the United States.
Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.