Let’s talk about mental health
During the past year, I have had opportunities to interact with more than a hundred young Nepali people from within and outside the country. After I published an article detailing my experience with depression, many came forward with their own tales of mental illness including anxiety, depression, and post-traumatic stress disorder. Among many stories, a few of them had similar experiences as mine and quite a lot of them had their own encounters.
Through my mental health support group, Paaila, I have had a chance to collaborate with Hamro Palo, an organization that mainly works for empowering and educating adolescent girls.
We are currently doing a digital advocacy with the hashtag #ItsOkayNotToBeOkay through social media platforms. I am not a mental health professional but I launched this campaign in order to create awareness amongst adolescent age group about the importance of addressing mental health issues.
During the campaign, I realized how speaking out about mental health is challenging in our society. There is a stigma even amongst the literate youths about discussing their mental health with their friends and peers. So, it made it very difficult to get youths to open up about their issues during a social media campaign. Most are still unsure as to how their anxiety disorder, obsessive compulsive disorder, phobias, eating disorder and other issues are linked with their mental health and how it can affect their physical health, relationships, education and overall life.
Challenging as it was, a few still came forward with their issues.
A 19 years old girl from western Nepal shares her traumatic experience:
She was in a relationship with a boy for three years. She went into shock when her boyfriend broke up with her and she has not been able to function normally ever since. She is plagued with suicidal thoughts and often thinks of self harm. She is aware that she needs to move on but is having difficulty doing so. She is unable to share her feelings with her family members, not even with the closest ones. She is battling depression which is continuously affecting her studies and relationships with her family members. She is aware that she needs counseling but lacks the courage to do so due to the fear of getting judged by her family and friends.
Here’s a story of a 17 years old girl from eastern Nepal.
She realized that she was suffering from mental health issues and mustered the courage to visit a psychiatrist. During her first session with the doctor, she was prescribed a low-dosage medication and started taking it right away and found it easy not to tell her parents. However, they found out about it after a while and threw all her medicines and further threatened her not to take any medication. Her condition deteriorated after that and she started having panic attacks. Fortunately, she resumed the medication.
The study, ‘Mental health status of adolescents in South-East Asia: Evidence for action’ done by the World Health Organization shows that 5% of adolescents were going through anxiety, 7% were experiencing loneliness and 4% of them didn’t have any close friends. It means that approximately 550,000 youths aged 13-17 had some signs of mental health problems.
The stages of mental health issues vary from person to person from simple to extreme. For some, it can be as subtle as losing interest in daily activities while some suffer from hopelessness and helplessness. Some symptoms of mental health disorder can be loss of appetite, insomnia, anger, and irritation. If diagnosed and addressed at an earlier stage, mental health issues will not take an extreme form which leads to suicidal thoughts, suicide attempts and self harm.
We have seen the amount of deaths due to suicide rise rapidly in the past few years. According to the numbers published by the police, five years ago there were 4680 cases related to suicide, which has increased to 6241 this year. While the official number is disconcerting in itself, many cases still go unreported, which means the real number can be much higher. The number of cases went from serious to gravely dangerous during the COVID-19 pandemic. A total of 1343 people committed suicide during the first four months of the lockdown, where two thirds of them were female.
The aforementioned data clearly shows the state of increasing cases of mental health issues in Nepal, however, very less steps have been taken to address the problem. There is one mental health hospital, which makes it difficult for people outside the Kathmandu valley to access the medical service. Hospitals in rural areas have been lacking special services related to mental health, while the available services like counseling and psychiatric services are overpriced.
Lack of public financing and ignorance from the government has definitely not helped mental health issues in Nepal. Support systems like round-the-clock helpline services are far from being accessible to the mass. In addition to the ignorance of authorities, the general population has not been warm towards patients of mental health. The patients often feel lonely and crave someone to talk to about their issues. People with suicidal thoughts are less likely to harm themselves if they get to speak about their problems to someone they trust.
For people suffering from mental health issues, loneliness can be devastating. A 20 years old boy shared his experience with depression to me last month.
After his breakup, he started feeling lonely. With all his close friends abroad, he had no one to share his feelings. His friends that were still living in the same city think that he is crazy. As a consequence, he took up drinking and smoking. Making matters worse, the pictures posted by his friends having fun abroad make him helpless and hopeless. He often worries that he might end his life.
Illnesses related to mental health such as anxiety and depression are still considered a taboo in Nepal. Even amongst educated families in urban areas, people do not want their family members to get diagnosed and seek help due to the fear of being discriminated against and stigmatized in the community. The abandonment of family and friends makes the survivors and patients of mental health fragile and delicate. What they need is affection and support from their closed ones and encouragement to join counseling and support services.
In our recent session, consultant neuropsychiatrist Dr. Suman Prasad Adhikari said that mental illness is as serious as physical illness and there is no shame in sharing. He has been treating adolescents with mental illness, including anxiety issues, post traumatic stress disorders and depression.
“This is normal, and you will be fine after treatment”
Clinical psychologist Dr. Suraj Shakya explained in a session how social media addiction can affect one’s mental health and how we can control this habit. He said that learning new techniques and technologies with time is good but we should consider maintaining a routine and not overly depending upon it. Maintaining a diary, keeping track of social media usage and limiting your time are some great ways of getting yourself in check. After some queries from the participants of the session, Dr. Shakya said that parental pressure is also a reason adolescents feel anxious. Dr. Shakya counselled the participants on how to handle parental pressure and still be calm and not irritated.
Each and every one of us feel hopeless and depressed at some point of our lives, but if the hopelessness lasts longer than six months, it can get difficult to get back on track. So, it is never late to ask your friends and family about their feelings and well being. It is also extremely important to advocate for mental health issues and let people know you support them.