Culture & Mental Health Stigma: An Advocate’s Story of Struggle and Hope
“I wish my son had cancer instead of depression,” an Indian mother told Gayathri Ramprasad.
“If he had cancer, all my friends and family would sympathize with us. How can I tell them about depression? They won’t even understand [what that means]…What kind of future will he have?”
A week doesn’t go by that Ramprasad, founder and president of ASHA International, doesn’t hear from families whose loved ones need help but are terrified to seek it. (The organization promotes mental health awareness, hope and wellness.)
Stigma is rampant in Indian communities all over the world. Ramprasad was born and raised in Bangalore, one of India’s largest metropolitan cities. There, she had access to the best health professionals, and yet, her depression, anxiety and panic attacks went undiagnosed.
In fact, everyone — including the physicians and her parents — insisted that her suffering was all in her head. And, yet, Ramprasad spent days crying, paralyzed with worry and guilt, unable to eat or sleep. Her loving, tight-knit family didn’t grasp the gravity of her suffering. Her parents vacillated between denial and anger. They begged Ramprasad to eat and stop feeling this way. They begged her not to ruin the good life they’d tried to give her.
Ramprasad writes about her harrowing experience with recurrent depression in her powerful memoir Shadows in the Sun: Healing From Depression and Finding the Light Within.
She writes about living in constant fear that others will find out about the “crazy woman” she’s become and she’ll be shunned by her family and ostracized by her community. This fear follows her from Bangalore to Portland, where she moves as a young woman to be with her husband, whom she weds in an arranged marriage.
This fear is overwhelming for people of Indian origin. They fear that disclosing their mental illness will not only bring shame to their entire family but for generations to come, Ramprasad said. They worry they’ll sully their family name, so they suffer in silence.
Many families are like Ramprasad’s family: They love their children and want the best for them — and, they, too, internalize the shame and stigma.
When Ramprasad returns to India, and her depression peaks — all she can think about is killing herself and begs her parents to help her — her parents take her to a psychiatrist.
In the waiting room, her mom tells her, “I pray no one we know sees us here, Gayu. You never know the vicious rumors people can spread.”
“Bangalore has the dubious distinction of being called the suicide capital of India,” Ramprasad said. In her book she cites research that revealed there’s one psychiatrist in India for every 400,000 people, one of the lowest ratios in the world. There are 37 mental health institutions to serve 1.2 billion people.
When she was younger, Ramprasad recalls hearing her mother talking to her friend about her sister. Her friend’s sister, who’d recently given birth, cried for days, displayed erratic behavior, could barely function and experienced mood swings.
While she likely had postpartum depression, “all of this was perceived as being caused by supernatural forces.” The family performed a prayer to their god, and invited a priest to come and exercise the demons inside her.
Ramprasad’s deeply religious mother-in-law also invited a priest to help Ramprasad. (He not only didn’t help her, he molested her.)
Per the instructions of a shaman, Ramprasad’s mother put “halved lemons anointed with vermilion at the intersection of four streets before sunbreak and prayed that the person crossing the lemons be possessed with the evil spirits” that possessed Ramprasad.
“This was happening in the 1980s, and it’s still happening today,” Ramprasad said. The superstitions in Indian culture — such as the belief in demonic spirits — still inform the way mental illness is treated, she said.
Mental illness also is viewed as retribution for a person’s past sins. It’s believed that prayer — praying with a pure heart — is the solution.
The ignorance toward mental illness runs deep. Ramprasad was giving a keynote to physicians of Indian origin in Portland. After she was done, the facilitator sarcastically exclaimed: “I’m so inspired by your story that I now realize I have paranoid schizophrenia.”
Another doctor asked if Ramprasad, a mother to two daughters, had the moral and ethical right to have children knowing she had a mental illness.
Ramprasad responded by asking if he or his family has any chronic conditions. He mentioned diabetes along with other conditions. She asked if they, too, have the same moral and ethical right.
And that’s the problem we face in both Indian and American cultures: Conditions such as diabetes and heart disease are viewed differently than clinical depression and other mental illness. They’re often treated with much more compassion, care and understanding. And people aren’t ashamed to seek help.
In 1989, during her second hospitalization, Ramprasad finally surrendered to the fear and pain, and, with the help of a compassionate nurse, realized that she was a woman who’d traversed a difficult journey — not someone who was possessed or being punished.
She also made a promise to herself: Once she was well enough, she’d take all the days she and her family lived in despair, and she’d refocus on bringing hope and help to others.
And so in 2006 ASHA International was born. ASHA means hope in Sanskrit. In English, it’s an acronym for “a source of hope for all.”
Ramprasad wants readers to know that they’re never alone, and that recovery is possible. She also stressed the importance of reaching out and seeking help.
“You have the power to heal yourself. You have to work for it. But it’s such a worthwhile effort.”
Ramprasad never dreamed that she’d be living a healthy, fulfilling life with her family (she and her husband have been married for 31 years), and even penned a memoir. “And yet here I am.”
Learn more about Gayathri Ramprasad at www.gayathiramprasad.com.
Tartakovsky, M. (2014). Culture & Mental Health Stigma: An Advocate’s Story of Struggle and Hope. Psych Central. Retrieved on October 6, 2015, from http://psychcentral.com/blog/archives/2014/04/04/culture-mental-health-stigma-an-advocates-story-of-struggle-and-hope/