Mental Healthcare for Young Women in Indian Family Settings

This is the second part in a four part series by Vatsala Joshi that examines Mental Healthcare for Young Women in India. You can read Part 1 of the series here.

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We are nearly done with Sunday brunch. The bill has been paid and we’ve both booked cabs back home. Sada is still sitting though; she seems lost in thought and shows no sign of moving any time soon.

I look down at her with concern. My cab is already at the door.

“You okay?” I finally ask. “Your cab’s probably here; we need to get going.”

She starts, “yes… yes, we need to get going,” almost muttering a little shamefacedly, and gathers her things up quickly. “I just… need to compose my face a little bit before I go home.”

“Compose…your face?”

“And my head, a little bit,” she says grimly. “I’ve been venting away all morning, and it felt good, but I can’t let my parents see this.” She gestures to herself. “I can’t let them know how bad things are inside my head.”

Like 80 per cent of India’s young urban population, Sada lives with her family. In my last article, I wrote about how moving away from one’s family and the family home and living alone in anonymous big cities triggered depression and anxiety in many young women. In this article, I want to turn the lens the other way round. I will focus on the substantially larger percentage of young women who stay with family, and how it impacts the way they deal with mental health challenges.

On one hand, it provides a vital cushion against isolation. “I complain relentlessly about how hard it is to live with my family while dealing with clinical depression, but I have to admit, in some ways, living at home is a lifesaver,” Sada admits. “When I lived on my own, on bad days, I would retreat into a shell. I wouldn’t eat, bathe, or ever get out of bed. I wouldn’t talk to a single soul for days. Here, I have to force myself to not lock myself up in my room all day; I have to make myself presentable and exchange a few words with my mother every day. On most days, having this routine; just getting started with the first step, pretence or not, gets me through. It also keeps me from acting on thoughts of self harm and suicide, because my parents’ close presence is a near constant reminder that I do matter, at least to these two people.”

“a uniquely South Asian problem is families’ reluctance to acknowledge mental illness and seek help.”

Archana, a 25-year-old Chartered Accountant (CA) aspirant who lives in Bengaluru with her parents, reiterates the immense benefits of the structure which comes automatically with living with one’s parents. “Getting qualified to be a CA is one of the loneliest, hardest academic journeys one can make. It had been my childhood dream to be a CA, but when I failed to clear my qualifying exam for the fourth time in a row, my mind began to take me to some dark places. The self doubt and the sense of having my dream crushed was terrible. I hadn’t kept in touch with friends because I had been so busy preparing for the exam. It was my parents who kept me from total isolation. Even though I hated it at the time, their constant nagging to leave my room and participate in activities helped drag me out of my shell.”

Despite this, a uniquely South Asian problem is families’ reluctance to acknowledge mental illness and seek help. Deeply entrenched patriarchal attitudes further compound the problem. “Indian women are raised to put their own emotions last,” Sada muses. “Our mothers and grandmothers may have seen great suffering and pain, but they were conditioned to ignore it and keep on going, because God forbid the men in the house were inconvenienced!”

Families may be kinder to young women today, but even apparently those urban families that appear to be progressive find it hard to accept and support a woman who takes up too much space, metaphorically. And mental illness often requires a stretching of family resources—time, money, patience—which parents are still askance to do. I reached out to several parents for this article, but nearly all of them were reluctant to discuss their daughters’ struggles with mental health. Many were in wilful denial, refusing to acknowledge there was a problem to begin with, even as their children went days in depressive hazes or experienced panic attacks on the regular. One middle-aged father dismissed this as a “young people” problem, caused by the ease of access to media and the internet. Other parents echoed this sentiment, with several parents claiming their daughters were merely exaggerating “sadness” or “nervousness” or “laziness”. All of them refused to be probed further with regard to family histories or triggers.

Some parents did acknowledge that their daughters were suffering from mental illness, but were reluctant to get professional help. An overwhelming fear was of their daughters’ marital prospects. 

In Archana’s case, her parents came to acknowledge that what she was undergoing might be clinical depression, and not merely sadness over her CA results or self-pitying laziness. However, they refused to allow her to seek professional help, because they were afraid that their social standing may take a hit if the news got out; which would ultimately lead to ‘substandard’ marriage prospects. “It was incredibly frustrating,” Archana shares, the quiver in her voice apparent even nearly four years after her depressive episode. “It hurt so much, because they could see how bad I was, and how much I needed professional attention. But they kept saying that I couldn’t go to a psychologist, I couldn’t seek help, because no one would marry me. It hurt so much, because they would rather let me suffer than risk facing gossip; that marriage was more important than my career, my health—everything.”

“Indian women are raised to put their own emotions last”

Even when young women were financially independent, parents stopped them from seeking professional help, because of the same fears. “I thought the battle was won after my mother began to see I was legitimately suffering and not just making things up, after nearly five years of panic attacks and insomnia,” Shefali, a Bengaluru-based software engineer says. “Because my mother appeared to be more understanding lately. I told her I was planning to go to a psychiatric clinic I had found online. And then all hell broke loose. She screamed, yelled, cried, emotionally blackmailed me until I gave in and agreed to never see a doctor for my mental health. Why? Because no one would marry me if I did so.”

“I was sleeping less than 2 hours every night, I had bags under my eyes, I was unable to have proper, functioning relationships with my friends or family because of my constant anxiety, and I had a constant fear that this would somehow end up costing me my job. Yet, none of it was deemed as important as getting married. And I don’t think I’ll ever be able to explain how much it hurts when the one person who should be in your corner, your mother, chooses to do something like that,” she adds bitterly.

“It’s not that Indian parents don’t care,” Sada says, reflectively. “But the parent–child relationship needs some serious re-examination. Many of our parents were raised in community-focused families, where you had to be cognisant of what people around you thought of you, with the understanding then these very same people would also reach out and lend a helping hand if and when required. In our increasingly individualised urban lives, this no longer holds true. Parents need to let go of the baggage of societal expectations, and show up for their child, and their child alone.”

Wise words, indeed. When children no longer have a village to raise them, and crumble under the burden of isolating modern urban life, parents need to reevaluate their roles and expectations. If a village cannot be prepared, at least a welcoming home can.

Vatsala is a writer and editor currently based out of Hyderabad. She received her first diagnosis of clinical depression in 2017, and since then, has had myriad (mis)adventures with psychiatry, psychotherapy and alternative healing. She is presently working towards accepting her states of mind as part of who she is, instead of pathologising it as “illness”. To this end, she is opening herself up by using her pain to fuel her art, writing, and conversations with other people.

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