Understanding mental illness: The balance between community support and personal growth

Editor’s note: What does it mean to be ‘mentally ill’? In this weekly column, Sneha Rajaram writes about navigating through a ‘mentally ill’ life — encompassing aspects that are both everyday (medications, rights) and contemplative (the universality of suffering) This story contains a reference to suicide. Reader discretion is advised. After my first suicide attempt at 19, the way in which I related to people changed completely. Before, my friends and I needed each other equally. After, I became a black hole of need — one that probably couldn’t have been filled even if someone had tried. (Eventually one friend did try — a Herculean effort — and it saved my life, at what cost to her I do not know. But that was later.) In the bitter months and years that followed my attempt, as my childhood friends understandably stepped away after witnessing the horrifying momentum of my downward spiral, I thought of every single person who would hop on a train to attend the funeral if I actually killed myself. Why couldn’t they come visit me now? I made a grudge list. I repeated the list to myself, sort of like Arya Stark from Game of Thrones, seething. I was caught in a life-and-death binary that increased my sense of entitlement every day – and with it, my suffering. And I didn’t know how to back down. That was my introduction to some facts about relating to people as a mentally ill person: Life goes on for other people, the planets they live on are just as real to them as yours is to you. And sometimes, your community fails you when you need it, because you need it. [caption id="" align=“alignnone” width=“825”]  Community is everything for those of us who can and cannot afford therapy. Illustration by Satwick Gade[/caption] At that time I didn’t think of therapy or the internet, not because of money, but circumstances and my own attitude (I’m “ uniquely f*cked”). I failed myself because I failed to Google my issues or find mental illness communities online (they must have existed by the mid-2000s). I relied heavily on my sister and one friend, resulting in emotional “dumping”. Most people in this country don’t have access to therapy or support groups or online communities. They suffer alone and face stigma and violence from family and social circles. And the ones who need therapy the most, i.e. the ones who face systemic oppression, are the least likely to be able to access it or afford it. Therapy is horribly expensive in this country (except for a few affordable therapists who are heroes), and while this is to some extent understandable because therapists sacrifice their mental health for ours, some of the higher rates seem preposterously inflated. When I see debates online about whether one should go to therapy or make one’s community do all the work of support, one of the points being made is that most people don’t have access to therapy. But for a moment I must pause nevertheless and ask, what about the few of us who do?

Are we obliged to get help to relieve our family and friends of some of their emotional burden?

My answer is yes, for those of us who have access. I believe in people’s absolute right to choose medication or reject it without facing judgement, but for myself, I believe that I am obliged to take medication too, in addition to therapy, to relieve my family of some emotional labour. (For now, anyway.) I’ve noticed a pattern among urban people who are aware of and can afford therapy, especially depressed men, where they implicitly or explicitly feel entitled to women’s emotional labour to keep them going. These men are floundering to an extraordinary degree, at risk of suicide, and asking for help has been drilled out of them at a young age. So they ask for help without asking for help, assuming the women around them will take up their cues. I’ve also noticed they are much less capable than depressed women of asking, after talking about themselves for hours, weeks or months: “How are you? How’s your mental health?” and truly listening to the answer the way they’ve been listened to. This was probably me at 19 too, and I still have to keep working on it. If the other person senses you don’t care enough, they may not even tell you the truth about how they are. This ability to care deeply about our friends and caregivers despite the magnitude of what’s happening to us, to create unconditional space for their feelings (including their feelings about us) without comparing their pain to ours (rule of thumb for interpersonal, though not sociopolitical, comparisons: apples and oranges) or deciding that because they’re functional they can deal with us – this ability is a worthy aspiration for the mentally ill. That’s what we can strive for from our end. But, at the other end of things, as one Twitter user pointed out, “Therapy is not a substitute for a community that cares for you, and was never supposed to be.”

Community is everything for those of us who can and cannot afford therapy.

If we don’t have a supportive and empathic community, therapy can only take us so far. For some people, the danger lies in being stigmatised by their close-knit community, or even simply in being loved but not in the way they need. For others, it lies in the fragmentation of our communities under the stresses of modern life and the internet. Some of us are screaming at a barricade made of the backs of smartphones and laptops. Isolation and individualism are taking over some social spaces and it’s becoming harder than ever to reach out and ask for help. And for the oppressed, the danger is a thousandfold, because they’ve already been violently ripped out of the fabric of society. This is why, in my view, one of the most cruel, hollow, if-they-don’t-have-bread-let-them-eat-cake gestures by the Indian government has been to offer Art of Living or vipassana courses in response to farmer suicides. Sri Sri Ravishankar is supposed to have told farmers: “Committing suicide is foolishness. It offers no solutions to any trouble,” and “I want a Gurudakshina from you. Take a pledge to banish the very thought of suicide.” Don’t get me wrong. I don’t evangelise vipassana but personally I am a big fan (though I am not a fan of Art of Living). Vipassana prevented my suicide, but only because I was under no external socioeconomic pressures. Vipassana, in its current Indian institutional form founded by SN Goenka, is free of cost (though dependent on donations) and can give a socially oppressed person some tools to deal with the trauma of oppression better in their personal life. But it cannot change social oppression on a large scale except in the most hypothetical of fantasies. It does not acknowledge the pervasive sociopolitical darkness in our world. And it definitely runs the risk of victim blaming and gaslighting by putting the onus of dealing with oppression squarely on the oppressed: “If you face caste discrimination you should remember that it is impermanent as all phenomena are,” is how its message could be interpreted. Vipassana is not a solution to farmer suicides, even if it happens to help a few farmers a little bit with internal turmoil, which is a very tiny fraction of their problem. Economic support from the government is an actual solution to the mental pressures of crippling debt. And that is why community support must complement the work we need to do on ourselves and vice versa – but in the right proportions, appropriate to the situation. Read more from this series  here