30 May 2018

Having lived in a hostel far away from home he had developed a complicated relationship with his parents. But it was perhaps the death of cousin that really put Vinayak out of his place. The day the news of the crash broke in, Vinayak had his first anxiety attack. His chest constricted, his vision blurred, a deep desire to retch soon followed as he turned red and passed out eventually. He was discovered by his mother. After a couple of sleepless nights and constant grim ambience at his home, he decided to head to college. Everything was the same yet everything had changed. He no longer felt the need to be around a large group of people, the constant chattering annoyed him, and the bickering reminded him of his cousin. He completed his assignments just to get away from his friends and family. Even basketball couldn’t keep him interested. He knew he needed to get help. But the fact remained that society called people who sought advice of a therapist as “psychos” so he decided to sort it on his own. He tried meditation. He tried music. He tried writing. Nothing helped. There was a vacuum inside him. A sense of impending doom that he just couldn’t shake off.

Slowly Vinayak lost the exuberance of his nature, his parents were reluctant to inquire. He maintained a façade around his friends but he couldn’t be the same towards his girlfriend. His absence, dodging of any kind of personal conversation and lack of attention furthered the distance between them. He loved her truly but even that couldn’t salvage the relationship. A breakup was inevitable. After his recent behaviour Vinayak anticipated the break up but when it was delivered to him personally in his favorite restaurant, it broke his heart.  Hurt and feeling rejected Vinayak drank his heart out. Against his better judgment he decided to drive. That’s when his anxiety attack hit. Hyperventilating, he lost control of his car and crashed against a pole.

Arati was grossly under prepared to welcome her unborn child when her water broke a moth before her due date. The room needed painting, clothes were yet to be bought, the cot needed to be assembled, so much was left yet there she was bringing a child into this world. As his cries were heard for the first time, she couldn’t even heave a sigh of relief for he was immediately taken to the NICU. 14 hours later she saw her baby, entangled in a mess of IV drips. Her heart broke. Even a week later when she was handed over the baby, she felt responsible for his condition. She panicked when he didn’t take his milk, she panicked when he wouldn’t pee, what was supposed to be a blissful experience had slowly turned into a nightmare. “I cannot do this” she heard herself say that repeatedly as she held the baby and cried herself to sleep.

Nina couldn’t bear to see her things out of order. Everything in her life was in order and had to follow a certain pattern. Newly married her husband brushed off her quirk as a joke for a couple of days. Soon Aviansh got tired of having his life so organized and boring. After just 6 months of marriage Avinash moved out of their house and moved in with his parents. “She suffocates me” he told them.

All these stories and instances are examples of how the debilitating form of mental health issue ruined each of their lives.

Mental illness is the illness of the brain wherein disturbances are caused in thinking, behavior, energy or emotion that make it difficult to cope with the ordinary demands of life. The two most common mental illness are:

Anxiety Disorders: such as Post traumatic Stress Disorder, obsessive compulsive disorder, panic disorder, or phobias

Mood disorders: such as depression, bipolar depression.

So much stigma and prejudice is associated with the mental health that it makes it difficult for the already vulnerable to come out in the open and seek help. Mental Health is and should be treated like we would treat any physical disease. Just because the symptoms aren’t visible, the pain isn’t less nor is the outcome less fatal.

In 1999 the U.S. Surgeon General labeled stigma as perhaps the biggest barrier to mental health care; this stigma manifests particularly in a phenomenon known as social distancing, whereby people with mental issues are more isolated from others.

Here are some astonishing facts about mental health-

According to the World Health Organization (WHO) and the World Economic Forum (WEF) (link is external), mental illness represents the biggest economic burden of any health issue in the world, costing $2.5 trillion in 2010; this burden is projected to cost $6 trillion by 2030 with two-thirds of these costs attributed to disability and loss of work. And yet shockingly, of the 450 million people worldwide who suffer from mental health conditions, the majority (60 percent (link is external)) do not receive any form of care, with 90 percent (link is external) of people in developing countries receiving no form of care.

Awareness and acceptance of the diseases allows people like Vinayak, Arati and Nina to step forward seek help. While May is the Mental Health awareness month, many of the cases are trivialized saying “get over it” “everyone deals with them, so can you”. The solution to all their problem is so much more complex than a one line advice.

Stigma in society

From a young age children will refer to others as “crazy” or “weird” or “psycho” when they find others different than themselves. These terms are used by adults as well. This leads to creation of the negative stereotypes involving perceptions that people with mental illness are dangerous. This bias is not limited to people who are either uninformed or disconnected from people with mental illness; in fact health care and even some mental health professionals stick to these very same stereotypes.

When people feel that an individual with mental illness is dangerous, that results in fear and increased social distance. This social distancing may result in the experience of social isolation or loneliness on the part of people with mental illness..

With stigma, prejudice and hate in sight people with mental health issues internalize this stigma to develop a strong “self-stigma .This self-stigma will often undermine self-efficacy, resulting in a “why try” attitude that can worsen prospects of recovery. Further, as people begin to experience symptoms of their mental health conditions such as anxiety or depression, stigma may cause (link is external) some people to try to avoid, separate from or suppress these feelings, all of which have been linked to the worsening of well-being.

How to help?

In a case like Vinayak which clearly states depression and panic attack,  or Arati who is unmistakably suffering from Postpartum depression or Nina who has OCD, dire circumstances could have been avoided if only someone was sensitive enough to talk to them about the changes they experienced.

  • There needs to be an environment safe for a person to seek help without being belittled and ridiculed. The society’s obsession with masculinity has resulted in fewer males seeking help. Open dialogue and acceptance are the key to helping people with mental health issues


  • Change strategies for public stigma have been grouped into three approaches: protest, education, and contact. These efforts send two messages. To the media: STOP reporting inaccurate representations of mental illness. To the public: STOP believing negative views about mental illness.
  • Educate Yourself And Others. Only knowledge and experience can change people’s view.
  • Encourage Equality Between Physical And Mental Illness
  • Show Compassion For Those With Mental Illness
  • Choose Empowerment Over Shame
  • Be Honest About Treatment

Mental Health Care in Nepal

  • Matrika Devkota is a mental health advocate who lives in Kathmandu, Nepal. After experiencing the discriminatory attitudes toward mental illness and the lack of mental health resources in his country, Matrika founded Koshish as a “self help” organization where those with mental disorders are given a voice and an opportunity to advocate on their own behalf.
  • The Centre for Mental Health and Counselling –Nepal (CMC-Nepal) is a non-governmental organization working in mental health and development by providing mental health & psychosocial services and by imparting training for developing human resources in mental health and psychosocial counselling.
  • Transcultural Psychosocial Organization Nepal (TPO Nepal) is one of Nepal’s leading psychosocial organization.


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