Tag Archives: desidoc

12 Facts About Depression and South Asian Mental Health

South Asia is a broad region that includes close to 2 billion people. Encompassing India, Pakistan, Bangladesh, Nepal, Afghanistan, Sri Lanka, Bhutan, and the Maldives, South Asia is huge.

South Asia is a suicide-dense area but with only a handful of peer-reviewed studies assessing the relationship between depression and suicidal behavior.

South Asia represents approximately one-quarter (over 23%) of the global population. Depression affects close to 90 million people in South Asia. The World Health Organization (WHO) estimates that almost one-third of people suffering from clinical depression worldwide live in South Asia, making the region home to a large majority of the world’s depressed.

Suicide is a global public health issue (World Health Organization, 2021). WHO estimated that suicide isthe fourth-leading cause of death worldwide among 15–30- year-olds. It is the result of a complex interaction between several risk factors which may include biological, personal, social, psychological, cultural, and environmental factors, but psychiatric disorders are one of the most crucial risk factors (WHO, 2014; Arafat and Kabir, 2017). Depression numbers are probably underreported in South Asian communities because of years of stigma about mental disorders.

About 90% of people who die by suicide experience some form of psychiatric illness. Among psychiatric disorders, clinical depression is the most common risk factor for suicides.

Mental illness is taboo in many South Asian communities. Discussing mental health in South Asia has yet to be socially normalized. South Asian religious and cultural influences often do not consider mental health a medical issue, referring to it as shameful and even a “superstitious belief.”

A 2010 study by the mental health campaign Time to Change (www. time-to-change-UK.org) found that South Asians rarely discuss mental health because of the risk the subject poses to their reputation, family, and status.

South Asian languages do not have a word for depression. There is dukkha (universal suffering); pagal (derogatory word, crazy); and shikasta (broken). Many South Asians are unable to express the specific condition of depression in their language. As a result, they often downplay it as part of “life’s ups and downs.” This language limitation and difficulty describing symptoms also makes diagnoses and treatment difficult.

Depression is a major contributor to other global health problems. Medical experts have found a correlation between the symptoms of depression and the perpetuation of chronic illness, such as cardiovascular disease. Depression exacerbates other health conditions.

Postpartum depression in South Asian women is often undiagnosed and unrecognized. The gender of the baby, domestic violence, secrecy, and poverty are all factors that put new mothers at a higher risk for postpartum depression. The stigma surrounding mental health prevents new mothers from receiving mental health care or support during after pregnancy.

Bangladesh, Sri Lanka, and Indonesia are three countries who have recently emphasized mental health as a “top priority” in public health. In 2021, WHO lauded their work and the important step it takes towards normalizing and treating depression and mental illness, as illness.

Non-government organizations (NGOs) have had a positive impact on mental health care. In countries where the government is not willing or able to make mental health a priority, NGOs are providing crucial support to people suffering from mental health issues. NGOs in South Asia have expanded their community-based programs and are providing specialized mental health services. For example, in the Maldives, a number of NGOs are offering rehabilitation, life-skills training, educationsl information, and resilience-building to citizens. These efforts have begun to increase the access South Asians have to mental health care with decreased stigma.

Mental disorders are bad for work and family life. People with major depression struggle to take care of their family, complete self-care tasks, pay bills, and be productive in the work place. Although poverty rates in South Asia are declining, the region accounted for nearly half of the world’s “multidimensionally poor” in 2017. Providing mental health care to South Asians may be a major step in helping to eradicate poverty within the region.

According to the World Bank, strong mental health is a contributing factor to not only the wealth of nations but to increased quality of living and productivity for families and individuals.

Read more about this:  South Asian Mental Health

***Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.
988 Suicide & Crisis Lifeline
Call or text 988; Llame al 988 (para ayuda en español)
Use Lifeline Chat on the web.
The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor.
New: If you are worried about a friend’s social media updates, you can contact safety teams at the social media company. They will reach out to connect the person with the help they need.

On MLK Day 2023: With Gratitude to Dr. King, from a Desi Doctor

In February 1959, Dr. Martin Luther King, Jr. arrived in India for a five week trip to learn firsthand the South Asian history and strategies that informed the US battle for Civil Rights. Nine years after Gandhi‘s death, Dr. King wrote that he was deeply struck by direct observation of the Indian caste system and the parallels in American conceptions of race. Over 60 years later, caste-based discrimination continues in India, and, exponentially, in Muslim communities In India.

If you get a chance, read Dr. King’s words about his impressions of India, just profoundly beautiful.

Related: Caste book summary by Isabel Wilkerson

South Asian health professionals in North America need to express gratitude for the activism that has reduced racist structures but also to acknowledge the privilege afforded to us by education and profession. Indian, Pakistani and other South Asian physicians and mental health must lead that charge. Asian physicians make up the second-largest majority of all health professions within the United States. South Asian doctors fall around the 15% range. Of these, for example, greater than 60,000 physicians and approximately 10 to 12 percent of entering medical students are estimated to be of Indian heritage in this country.

Like many of our first and second-generation colleagues, our parents were primarily part of a migration from India, Pakistan, Bangladesh, and Sri Lanka. It began around 1965 and increased through the early nineties, thanks to relaxed immigration legislation and increased employment opportunities, many brought about by the Civil Rights Act of 1964, the Voting Rights Act of 1965, and The Fair Housing Act of 1968. The large number of South Asian immigrants who arrived during those years did so as either recent university graduates, or with the scholarship or family funds to obtain an education here on U.S. soil. As a result, South Asian immigrants have been prominent in fields that require extensive and often expensive training, such as medicine and technology.

We the first and second generation children of immigrants can use our education and position to advocate for change. The first thing to do is speak out against racism within our own communities. Although this statement often angers my South Asian community, it would be dishonest to state that we did not witness growing up with elderly community members, outwardly spewing racist propaganda; particularly condemning engaging in romantic relationships or close friendships with Black women or men. I work with a large number of Desi clients, and many feel they must keep their personal lives secret from family, a practice which is painful and ego-dystonic.

Related, see Dr. Siddique in The Meaning of Difference, McGraw Hill.

As healers, South Asian medical and mental health professionals, must be part of solutions to tackle health inequities for our Black patients. Health disparities in medicine are prevalent in all fields of medical practice. Coronavirus is still claiming the lives of Black Americans at a rate almost 2.5 times greater than Whites or Asians. Black men continue to have a substantially lower life expectancy. As a health community, we must set the goal to help narrow the disproportionate gap in Black Americans’ deaths from coronary artery disease, stroke, diabetes, and cancer. At the least, we should take our skills and funds to contribute to organizations that will help abolish the health inequities that we see daily in our line of work.

South Asians have endured discrimination. Our names are mispronounced, our office lunch mocked, we are stereotyped as doctors or convenience store clerks on many popular shows. We continue to endure micro aggressions from patients, administrators, and supervisors based on who we are. Of the utmost importance now is that we take some of the burden for fighting for persons of color away from our Black colleagues and patients, so they can take a timeout or at least rest.

Additional reading:
Microaggressions are a Publc Health Crisis.
Why Representation Matters: Media and Mental Health

On Thanks-Giving

For many, it is a time to reflect on heritage and family. Kashmir, part of my heritage, has been known as a place of conflict and war since the Partition of India and Pakistan, with tens of thousands of deaths. Before separation from English Colonialism, and Partition, there was a lengthy period of time where Islam, Hinduism, Sufism, Sikhism, and Buddhism coexisted peacefully in one of the most gorgeous areas of the world.

While the timeless male poets Rumi, Gibran, and Hafez have received lots of recognition in the Western World, there are some amazing female poets from my region of the world. South Asian poetry from women often combined spiritual elements with eroticism and everyday life for a potent mix.

Lal Ded was a Kashmiri mystic who lived in the 14th century. She was a yogi and practitioner of erotic (tantric) spirituality. She cast aside traditional values and subsequently became homeless, wandering from village to village.

Centuries later her poetry could not be more timely.

I have seen an educated man starve,
a leaf blown off by bitter wind.
Once I saw a thoughtless fool
beat his cook.
I have been waiting for the allure of the world to fall away.

I might scatter the southern clouds,
drain the sea, or cure someone
hopelessly ill.
But to change the mind
of a fool
is beyond me.

I came by the public road
but won’t return on it.
On the embankment I stand, halfway
through the journey.
Day is gone. Night has fallen.
I dig in my pockets but can’t find
a cowry shell.
What can I pay for the ferry?
Wander, my poor soul, you’re not going home anytime soon.

See also my post on heritage and ancestry.
In peace. 🙏🏽

Summer reading rocks

Her: I have to read three books for AP English this summer. Ugh.
Me: Do you get to decide what you read?
Her: Yeah, and we have to write about it when classes start.
Me: Let’s make it four.

What are you studying this summer? It’s a great time to explore something you have been interested in, or to discover the new.

I’m learning more about my Desi ancestry and Partition.

Below: Lady Dufferin Hospital for women, Karachi. The hospital where I was born was built in the 1890s by the wife of the British Viceroy, after whom it is named. Women were dying giving birth at home. It became known for state of the art maternity care in India. Today, it is known for exemplary medical services, combined with inclusion.

Hurts so good: Neuropsychology and Chili Peppers

Ghost peppers
The world’s hottest peppers, originally grown in Assam Province, Northeast India, epitomize the lure of pain and pleasure. Also known as raja mircha (king chili), ghost peppers or bhut jolokia originated in a region of the country where the cooler temperatures, heavy rains/monsoons, and soil quality made them grow naturally.

Currently, they are served most delectably as a condiment with mounds of rice ladled with curry, lentils, salad, and vegetables. They also pack a punch served with Maggi noodles, a South Asian comfort food, leaving you with a runny nose, sweating face, and a slow burn of volcanic heat.

The neural science
Brain pain receptors are proteins that have a certain shape that only fit specific molecules. Some pain receptors have the correct shape for capsaicin, the heat component of all peppers to fit into, like a lock and a key. When a capsaicin molecule binds to one of these pain receptors, there is a release of neurotransmitters that send a message to the brain. All neurotransmitters are chemicals that are transmitted from one neuron to the next, instant messaging, saying this is HOT. There is a quick burst of endorphins, the pain alleviating neurochemicals. Capsaicin also stimulates the thermo receptors that perceive heat, stimulating sweating and flushing. This actually has a cooling down effect, crucial in hotter climates. Not surprisingly, many countries with extremely hot menus are found in Africa, South Asia, the Caribbean (the Trini Scorpion chili pepper will make you gasp), and South America, where the temperatures are often steamy.

Why yearn for the burn? A sample of the research.
-Longevity: All chili peppers have anti-inflammatory, antioxidant, anticancer (free radical), and blood-glucose regulating effects. Many of the health benefits have specifically been attributed to capsaicin molecules. Additional benefits include lower levels of bad cholesterol, increased metabolism, better gut health, analgesia (increased pain tolerance), and a general boost in immunity.

-Personality: A number of studies have found that more adventurous people are drawn to spicier and more stimulating foods. Chili 🌶 lovers are eager to try new things; willing to take risks; have a higher level of mental flexibility; and may be hungry for a variety of strong emotions, visceral experience, and adventures. This means they have a high degree of curiosity; or in other terms, they may be easily bored.

-Mood: Spicy foods create a safe high. The burst of endorphins produced by biting into a searingly hot pepper creates a burning sensation and then a sense of euphoria.

-Social Interaction:  Sharing hot food creates a sense of connection or similarity. Couples and family research shows that arguing over ‘what to eat for dinner’ is a common source of potential conflict or compromise.  “Because what I eat, what I drink, is in itself the ‘second self’ of my being,” wrote the philosopher Ludwig Feuerbach. Figuring out what each person would like to eat, or not, is part of relational negotiation: do we fit together?

Also see: On nutraceuticals and mental health – Turmeric and Mental Health.

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