The topic of mental health is seldom discussed in South Asian communities. Mental health issues are often pushed to the side and ignored. When they are acknowledged, it is often said that the person is being emotional without reason, being lazy, or that kisi ki nazar lag gayi (in Hindi, meaning someone has cast an evil eye on them). This way of thinking creates a lot of stigma around mental health and many people suffer in silence.
I have been one of those people.
Growing up, I was in a constant state of fear and anxiety. My father was an alcoholic. His parents, who lived with us, were both physically and verbally abusive. My mother was working double shifts to try and make enough money to feed her kids. When she would get home, the fights would start. My father would yell. He would smash the pictures on the walls. His parents would start yelling too. My mother would cry, pleading them to stop. I would hide in my room with my siblings, hoping everyone would leave my mother alone.
Once my parents separated, that feeling of fear and anxiety stuck. I was on edge, had frequent mood swings and an overwhelming feeling of hopelessness. I never told my mom because she already had so much on her plate and I didn’t want to burden her further. I hid it from my friends because I was afraid that they would think I was weak or that I was doing this for attention. I was silently suffering.
There was so much going on in my mind and my life, but I had no idea what to do. No one had ever told me what depression was. I didn’t know what mental health meant. I thought that I had a problem. I was never taught to talk about my feelings. In my Punjabi household, feelings were supposed to be private. I thought I was doing this to myself. I felt an overwhelming sense of guilt, hopelessness, and most of all, loneliness.
When I moved away for university, my mental health got worse. It was having a huge impact on my day-to-day life and I was constantly struggling with my thoughts. I couldn’t sleep at night and I would skip my classes the next day. As soon as Friday hit, I would start drinking and would rarely stop until Sunday. I was spiraling. My friends noticed, but I pushed them away. I didn’t want the label of a mental illness. I didn’t want everyone around me to think I was pagal (crazy).
One day in my second year, I attended a presentation with a group of students I was working with. The presentation was all about the university experience. The different presenters spoke about how this had been such a great place for them, how they made friends, and how this place helped them do amazing things. Then the final speaker, a young South Asian male, came to speak. His topic was mental health. He spoke about his own struggles moving away from home and transitioning to university. He spoke about how he, too, had a downward spiral. Then he spoke about how he got help and that he was now alive and thriving.
I was inspired. His presentation gave me the hope and courage to go and seek help for myself. He doesn’t know, but he helped save my life. This is when I learned the true power of storytelling and sharing of experiences.
From then on, I worked on getting better without fear of judgment. I attended counseling sessions. I got medication to help with the chemical imbalance of my neurotransmitters. Another important part of my healing process was sharing my story. I worked with the Mental Health Awareness Committee on my campus. I ran mental health programs in residence. I also joined Jack.org, a Canadian national network of young leaders working to erase stigma around mental health, doing mental health literacy talks at high schools and post-secondary institutions across Canada.
I didn’t want anyone else to suffer in silence as I did.
I was doing a lot of work in the mental health space in my area, but I still felt a big gap in the South Asian community and I wanted to do my part to fill it.
I started The Mental Health Spotlight to help shed light on the topic of mental health in the South Asian community. Through the power of storytelling and fact sharing, I hope to create a safe environment where we can speak openly about mental health.
The Mental Health Spotlight is an Instagram project dedicated to changing the dialogue about mental health in South Asian communities. Every Sunday, we share a story from someone in the South Asian community and their experience with mental health, mental illness, or being a support to someone who is struggling. We are hoping that, by talking openly about mental health, we can normalize the conversation and help erase some of the stigma surrounding the topic.
Our mental health is just as important as our physical health. We would go to the doctor if we had cancer without hesitation. We should not have to feel ashamed when we reach out for help if our mind is hurting.
Chocolate Lover – Bollywood Dancer – Bhangra Enthusiast – Mental Health Advocate.
Jessie Brar studied psychology at Queen’s University and is currently working at a boutique recruitment firm in Toronto, Canada. Her spare time is dedicated to raising awareness about mental health through volunteering with organizations such as Jack.Org and running The Mental Health Spotlight (@TheMHSpotlight), an Instagram project dedicated to erasing stigma around mental health and mental illness in South Asian communities through the power of storytelling. In her downtime she can be found cuddled up watching/reading Harry Potter, eating Reese’s Cups, or dancing to Bollywood and Bhangra tunes in front of a mirror.
February 28, 2023February 28, 2023 4min readBy Sara Qadeer
Hi! I am Sara and I am a mom to a beautiful, neurodivergent child. This piece explores some challenges of parenting an atypical child in a typical world.
It is a sunny day in the summer of 2020 and I am trying to enjoy the only entertainment that has finally been “allowed” by our province. Parks. Sunshine was always free; scarce but free. I have eyes on my daughter, running and somersaulting, with that untethered quality they say she gets from me, while socializing with two girls her age from a distance.
All of a sudden, the distance called ‘social’ gets smaller and as I run and call out in vain my child has the kid in a tight and loving but forbidden hug. I understand that pandemic or no pandemic, physical space is a basic right but for my daughter, it falls under the ‘but why?’ category.
The next 15 minutes are spent apologizing to an exasperated mother asking me why my kid was not taught the dangers of COVID-19 and personal space. She is four, I tell her, she just got excited. At some point, I zone out and just let her say her piece. Some of it is in a language I have never heard before, complete with hand gestures and melodrama as if it was not a preschooler but Bigfoot.
Maybe later I will do the thing we all do; oh, I should have said that. Maybe I won’t. This is not the first time my kid has drawn public attention and it is not the last.
Six months later, we received a diagnosis for Autism Spectrum Disorder (ASD). After the reaction time (read stress eating and ugly crying) ended, we began our journey of raising an atypical child in a world that insists on the typical.
Textbook wise, neurodivergence includes Autism, ADHD, Asperger’s Syndrome, Dyslexia, Dyscalculia, OCD, hyperlexia and Tourette Syndrome.
I could write a book on my journey as a mom raising a child who is neurodivergent (ND). I will in due time and the first chapter would be, “Fighting for inclusion in a world insisting on exclusion.” If you ask any parent with a neurodivergent kid, they will tell you that it is not finances or the fear of the future bringing them down, it is just people. But that’s been the case since the dawn of time anyway.
If you are someone who is kind and inclusive but are confused by the jargon, read on for some guidance that will make you an ever-favorite ally and, well basically, just decent. It is just basic decency after all to be inclusive and kind.
If you have a kid on the spectrum for ASD or ADHD or any other neurodivergence in your social circle, the first step is to not stop being friends with their parents. Yes, that happens. Parents can get super isolated and alienated because their kid is a certain way. Give ND families a chance to breathe. Invite them to BBQs, ask them what their kid will eat, encourage your kids to include them — the whole nine yards.
There will be meltdowns, at birthday parties, at the mall, in restaurants. Sometimes the best thing to do is to look the other way. Ask the right questions. Rather than asking “what happened?” or “why are they doing this?”simply say “how can I help?” Maybe you can help with another sibling or give the child some space.
Do not equate a sensory meltdown or otherwise to a parenting failure or a lack of discipline. ND parents face a lot of judgment on those grounds. That is one of the top reasons they scoop up their kids and leave before dinner is even served.
The biggest challenge in our community is acceptance. There is a dire need to accept that around 30 percent of our population is neurodivergent. This includes adults and undiagnosed individuals. You and I might not even know if we are atypical, the world is just getting to know this word and what it entails. As for the South Asian community, neurodivergence is practically stigmatized and seen as ‘spoilt’ child behavior or ‘mom spending too much time at work, on social media, Netflix, sewing, knitting, kayaking…’ The list goes on.
It is 2022 and we are all trying to make space for people at our tables. This includes people who might not look or act or perceive the world like us. As a parent I have fears that all parents have, but somehow those fears have been heightened to exponential limits ever since my kid’s diagnosis came through.
How is she doing? Did someone bully her? Does she have friends? Is she included in activities? What if she says something silly and they laugh at her? What happens when she is older? Will she go to college? I should not be thinking that. I want to think about how much she is learning at school, what game they played today, what she and her friends talk about and all other typical mom things.
Except I am not a typical mom. And that is okay.
My child has wonder; she has innocence. I see things from her lens and her computation of the world is unique. The biggest misconception people have is of intelligence. A child with autism finds difficulty in processing social cues (like sarcasm) but otherwise they are as smart as you and me, if not more. Probably more.
Some days are hard but not all days are hard, and not every moment of that rough day is difficult. We, parents of ND children, do not keep obsessing over the fact that our kids are atypical; we binge watch the same shows, we have hobbies and interests and date nights and ‘me-time.’ Some days are magical and the most important thing for people to know is that Autism families are not looking for pity parties, just kindness and inclusion with a healthy sprinkle of understanding— an understanding of the atypical in a world only rooting for the typical.
Ten to 28% of the world’s population of women experience painful sex. Keep in mind, that this is just what is reported. As embarrassing and as vulnerable as you may feel, you are absolutely not alone. The good news is that in addition to your traditional medical care to treat painful sex (also known as dyspareunia) such as medication, injections and surgery — a conservative approach is effective and long-lasting. Conservative care ranges from pelvic floor physical therapy, chiropractic care and acupuncture which are beneficial in treating the root cause of painful sex, as well as symptoms, for long-term healing.
Some of the signs to look out for if you experience pain are:
Treatment options for painful sex such as pelvic floor physical therapy, chiropractic care and acupuncture provide a long-lasting and profound effect on the pelvic floor and address your entire physical well-being.
The pelvic floor is a layer of muscles that range from the pubic bone to the tailbone. The purpose of these muscles is to assist in bowel and bladder control, support a baby during pregnancy and contribute to sexual sensations. Just like any other muscle in your body, these pelvic floor muscles can become tight or weak which can be a contributing factor to pain.
Pelvic Floor Physical Therapy
Pelvic floor therapy can assist by strengthening and relaxing the muscles which is necessary to relieve pain during sex.
Chiropractors can be extremely beneficial with assisting in helping relieve pain. Associated pain and discomfort can originate from the lower back and buttock muscles. Chiropractors are trained in taking a history and performing a neurological, orthopedic and soft tissue examination to identify treatment options. Deep tissue massage, skin rolling, Active Release Technique, muscle energy technique, ice, heat and electrical stimulation are just to name a few.
Acupuncture
Acupuncture can activate the human dopamine system which helps regulate hormone levels and can assist in psychological factors. Acupuncture can improve mood, decrease pain and can be vastly beneficial in managing pain and mental health symptoms.
Ask for help
“Everyone is having pelvic pain and no one is talking about it”
Start with seeing your gynecologist who you trust for a history and examination of current symptoms to rule out any other medical conditions that could be a contributing factor to symptoms.
How to talk to your partner about this in a safe/healthy way
Being open with your partner about your symptoms and painful sex may seem like a difficult conversation. Intercourse should never be painful and learning when to stay ‘stop’ is important in communication. Talking about pain before, during and after sex is important also in your own health diagnosis to see if pain symptoms are improving or becoming worse. Having open communication does not only benefit your relationship but most importantly, your own health.
To experience these symptoms may seem taboo or unheard of but quite frankly, they are common in many women. Women deserve to be directed to proper healthcare.
Disclaimer: These are based on recommendations from a board-certified chiropractic physician and licensed acupuncturist. If symptoms become new or worse, consult with a primary care physician and or OBGYN to co-manage symptoms.
Reference: Tayyeb M, Gupta V. Dyspareunia. [Updated 2022 Jun 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/
Photo by anushkaniroshan stock photo ID: 2071991336
The Covid-19 pandemic and feelings of uncertainty, which have been prevalent across the globe, had lasting effects on all of us. One of the more positive impacts has been on the mental health industry, particularly the normalization of mental health challenges and a more open dialogue about mental health. There have been discussions in the workplace, in schools, and even on Hinge profiles, but what about in South Asian communities? Though some progress has been made, mental health stigma is still widely prevalent among South Asians, impacting individuals’ desire and comfort in seeking help. As a result, the South Asian community reports lower rates of seeking mental health services. And of the individuals who do seek out mental health services, many face challenges in finding therapists who are equipped with a multiculturally competent skill set to understand the South Asian client’s concerns. This is why it’s important to recognize and become aware of the intersections of mental health and South Asian communities.
Although there is an overlap between the mental health concerns of South Asians and other communities of color, there are also unique intersections between culture and mental healththat I want to bring to the forefront of this conversation. As a South Asian psychologist, who is both a researcher and clinician, I have firsthand experience examining how our individual cultural context impacts our emotional experience. If we can understand, or at least consider, how the cultural context impacts us, we can better understand ourselves and feel seen by others too. We, South Asians, are a diverse group in terms of ethnicity, language, food, religion, traditions, and so much more. So, while learning about the “state of mental health in South Asian communities” is much more complex and nuanced than what I can cover in just one editorial, I believe starting the conversation about issues that don’t get talked about nearly enough is an important first step towards destigmatization.
What is the state of mental health in the South Asian community?
Here are some numbers to set the stage, based on research done on South Asian communities. One in 5 South Asians currently reports experiencing mood or anxiety disorders. South Asian youth and young women, in particular, are at greater risk of having suicidal thoughts and behaviors compared to other groups. Only 24 percent of South Asians diagnosed with a substance abuse problem sought treatment. And South Asian Americans express greater stigma toward mental illness than other ethnic groups. How often are facts like these discussed? Not often. Since South Asians are often mixed in with the larger Asian American population, these issues and their nuances are rarely discussed within mental health communities. This underrepresentation can make the reality of our emotional experiences easily misunderstood and make our needs feel invisible. Relatedly, concepts like “model minority” lead outsiders to often assume that South Asians are well-adjusted. And even within the South Asian community, stigma and beliefs about the causes of mental health issues (e.g., mental illness indicates problems within the family, a sign of weakness, etc.) lead all these facts to continue being ignored.
How do mental health concerns intersect with South Asian culture?
While mental health concerns are prevalent among my clients from all backgrounds, these common concerns intersect with culture to create an individualized version of the issue that requires specialized attention and care.
Substance abuse
Within the South Asian community, there are cultural differences in alcohol and drug use and the discussion of these topics. Alcohol is prohibited in Muslim and Jain faiths which makes open dialogue about substance abuse and its prevalence even more of a challenge within these communities. Admitting you have a problem can be hard and adding the cultural taboo can make it more difficult.
Career stress
There is a tendency in the South Asian community to highlight that only linear careers in financially stable or ‘reputable’ fields — such as medicine, engineering or finance — will lead to success. This expectation not only impacts career decisions but also mental health, self-esteem, and self-confidence. Even if we think we are not influenced by outside factors in our career choices, how do we know that subconscious messaging is not impacting our decisions? I personally was pre-med for as long as I can remember and was apprehensive if my parents were going to accept my desire to go into psychology and mental health instead of medicine.
Caretaker stress
Caring for loved ones, who are aging or ill, is emotionally challenging for most people. What makes this stress unique for the South Asian community? South Asian communities are collectivistic and therefore rely strongly on interdependence well into adulthood. Therefore, caretaking and providing for elders is an integrated part of our lifestyles. Pursuing personal goals can sometimes be seen as selfish and therefore South Asians feel the need to sacrifice personal desires. This can make setting boundaries in relationships or making decisions focused on one’s own needs especially difficult and not as straightforward as may be suggested by Western psychotherapy interventions.
Relationship stress
Romantic relationships can be especially stressful for South Asians because of the need to navigate between one’s own desires and family expectations. Older generations pass down messages that people should focus on their careers instead of dating, which can lead to not dating or secret dating and youth navigating romantic relationships on their own. Then, suddenly, the conversation shifts to the need to get married by a certain age, which seems especially difficult when you have not been allowed to date or when it is not something you want in your 20s. South Asians may also experience family expectations about their partner being from the same ethnic/religious background, working in a specific industry, or having a specific family background. These family or cultural expectations and issues also impact the LGBTQI+ South Asian community and South Asians often feel the need to sacrifice personal desires for the expectations that their families or deep-rooted social norms have set for them.
Emotional Awareness
Being able to communicate the complexity of our emotional experience is especially challenging when being emotional is considered a weakness. This cultural sentiment further perpetuates emotional suppression and increases the barrier to seeking support. Also, South Asian languages have limited vocabulary to describe mental health and the emotions involved. It is not only challenging to identify our emotions, but it is difficult to communicate the complexity due to the lack of words in South Asian languages to describe those emotions. Let’s take the word, “gussa,” which means “angry” in Hindi. The only way to explain the level of anger you are feeling is to describe the full situation. While in English, you can use variations of the word “anger,” such as “annoyed” or “furious” to describe the emotions with more nuance.
Body image
Culture is integrated in small and big ways into how South Asians experience their body. It can be common for family members, especially older women or “aunties,” to comment on one’s body weight in direct ways like telling someone they have gotten fat or thin. There are also unspoken rules about food that impact one’s relationship with food and potentially overeating, including “it is rude to not finish all the food on your plate,” or if you don’t go up for seconds that means you didn’t like the food. Research has also found South Asian women in particular often struggle with the pressure to conform to Western beauty norms (e.g. removing dark hair, and lightening skin color).
Identity development
We all are constantly evolving and understanding who we are and what we value. What makes this unique for South Asians? Culture intersects with other parts of our identity, including generational status (1st, 2nd, or 3+ generation), religious beliefs, gender identity, and age which impact the way we make sense of who we are. Being born in the US makes one American, but are you still American if you primarily connect with your South Asian ethnic identity or maybe your religious identity? Or what messages does culture pass down about what it means to be female? Are you supposed to do all the cooking and cleaning? Do you have to have children? Culture intersects with identity development in complex ways.
How can you get support with what you may be feeling and experiencing?
I believe the first step in breaking the barriers, is shifting your mindset about seeking mental health support from something that means you have a “character flaw” to something that you do for your overall well-being. Taking care of your emotions and processing your emotional experiences is as important as your weekly workouts, annual physicals, or that apple a day. One way to start this process on your own is to spend 10 minutes a day engaging in mental hygiene practices (meditation, gratitude journal, positive experience journaling, writing a thought log, prayer, or deliberate time in nature).
Alternatively, if you feel ready and have the means, try searching for a mental healthcare provider who actually understands and is aware of your cultural background and belief system. As we think of all the ways mental health can intersect with cultural context, it is helpful when your provider can hold cultural identity as being critical to your treatment. There is a clear and urgent need for therapists and interventions that use culturally-relevant treatments to drive clinical outcomes. One such resource is Anise Health, which is the first culturally-responsive digital mental health platform built by and for the Asian American community. Anise Health, co-founded by Nisha Desai and Alice Zhang, incorporates culture and intersectionality into clinician training and offers a wide range of evidence-based online services (therapy, coaching, self-guided resources) that are tailored to meet your unique needs.
If any of the concerns I discussed earlier resonated with you, consider signing up for Anise Health by filling out this short intake form; you’ll get matched to a culturally-responsive clinician within two business days. I’ve also listed a few additional resources below that aim to address mental health needs in South Asian communities.
I hope we can continue to bring the ways our South Asian culture impacts our well-being into the forefront of the conversation around mental health. By highlighting the South Asian community’s experiences,we can feel more seen and create a more accepting environment that allows us to get the help that we all deserve.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.
Chocolate Lover – Bollywood Dancer – Bhangra Enthusiast – Mental Health Advocate.
