Rashmi, a 50-year-old first-generation immigrant from India came with her husband to the U.S. in 2000. She lives in San Francisco and her grown-up adult children have moved out of home. Until 2020, Rashmi worked part-time as a clerk in a company while she raised her children. In 2020, her last child moved away; she also lost her job due to the COVID-19 pandemic.
With her children gone and no job, Rashmi felt lonely. She told her husband she felt depressed but did not want to seek help. She views mental illnesses as a character flaw and a sign of weakness. He husband asked us to help.
1. Is Rashmi suffering from mental illness and is it abnormal?
Dr. Sharma: Let us demystify mental illnesses. Mental illnesses are health conditions involving changes in emotions, thoughts or behaviors, or a combination of these. Unfortunately, many people think of mental illness as being permanent. However, most mental illnesses are temporary. A mentally ill person with treatment like most diseases can lead a healthy life. Looking at mental illnesses people think of the person who is to be blamed. This type of thinking needs to be changed. In our society, there is also a stigma toward mental illness. Once again thinking of mental illnesses as similar to diabetes, heart disease or any other ailment helps in this regard. Rashmi may just be passing through a stressful period, or it may be that she is suffering from depression especially if her symptoms have been present for a prolonged period. In any case, this should not be considered abnormal, but she should certainly seek help. The first line of help would be to approach your primary care provider and have her talk to them.
2. Is mental illness a character flaw and can Rashmi just snap out of it?
We need to correct the misperception that mental illnesses are a character flaw. It’s not. Nor can Rashmi simply snap out of it. She needs intervention. There are four kinds of intervention you could consider – medication, counseling or psychotherapy, social support, and spiritual intervention like prayer or meditation. Rashmi would benefit from a combination of two or more of these interventions rather than trying just one – one may be insufficient by itself.
3. How can I help Rashmi?
You, being Rashmi’s spouse, have a very important role to play. You must provide her with unconditional love and support. You must encourage her to seek professional help by starting with a visit to the primary care provider. You both must spend more time together and find creative and recreational activities to do together that you enjoy. Regular communication with your children is also going to help. So is meeting with friends. If you have friends, spending time with them will probably help though Rashmi may be reluctant. At the same time, neither of you should feel guilty for causing this situation to happen.
4. Does Indian philosophy provide any insights that we can apply to our situation?
Indian philosophy has a lot of answers to our daily problems. In Samkhya yoga, the cause of stress is Avidya, or a faulty interpretation of reality. There are four kinds of such faulty interpretations – Asmita or incorrect appraisal of one’s body or mind’s abilities, Raga or incorrect outcome appraisal due to attachment to the objects, Dvesha or incorrect appraisal of how much one dislikes the outcomes, Abhnivesha or fear of death. So, if Rashmi is philosophically inclined then she can identify the sources of her stress this way. Then spiritual approaches that can be used are prayers or bhajans (bhakti yoga), analysis of stressors as described (gyana yoga), selfless service (karma yoga), or meditation (raja yoga). There is a growing body of research on the benefits of meditation in the management of mental illnesses.
5. What are some resources that Rashmi can find?
There are several resources that can help Rashmi. National Alliance on Mental Illness (NAMI) (https://www.nami.org/Home) is a great organization that has a lot of resources and chapters around the country.
Substance Abuse and Mental Health Services Administration (SAMHSA) is a government agency that has a helpline (https://www.samhsa.gov/find-help/national-helpline). An author at WebMD provides 11 tips for natural treatments of depression at https://www.webmd.com/depression/features/natural-treatments.
National Health Service (NHS) in Great Britain, a comprehensive public-health service under government administration shares some tips for depression at https://www.nhs.uk/mental-health/self-help/tips-and-support/cope-with-depression/.
If you have questions, reach out to Dr. Sharma at firstname.lastname@example.org