Severe Mental Illness and South Asian Culture

by Tanvi Patel, LPC-S, NCC

What are severe mental illnesses and what do they look like?  

There can be many types of severe mental illness symptoms, however those illnesses that include psychosis4518942-4x3-340x255 (hallucinations and delusions) and extreme mood related symptoms are typically the most severe, pervasive, and persistent illnesses. Common diagnoses that often include these types of symptoms are:

  • Schizophrenia
  • Schizoaffective Disorder
  • Major Depressive Disorder
  • Bipolar Disorder
  • Schizoid Personality Disorder
  • Paranoid Personality Disorder

Common symptoms include:

Psychosis

  • Hallucinations – seeing things, hearing things, feeling things that are not physically there
  • Delusions – irrational thoughts and beliefs that are untrue
    • Paranoia – beliefs that others are after you, ex) the government, aliens, etc
    • Grandeur – extravagant, extraordinary beliefs, ex) that you are friends with president, that God has chosen you for some mission, that you have some sort of supernatural insight or power

Mood Changes

  • Depressive mood – changes in eating and sleeping patterns, loss of interest in activities, sadness, hopelessness, fatigue, tearfulness
  • Manic mood – decreased sleep, fast/hurried speech, inflated self-esteem, racing thoughts, flight of ideas, increase in pleasurable activities with no regard for consequence (spending sprees, sex, etc)

How can you get severe illness?  Are they preventable?  

Illnesses such as schizophrenia and schizoaffective disorder along with severe mood disorders are known to have a genetic component.  In addition to the genetic predisposition (a genetic environment making it possible for the disorder to present itself), a psychosocial stressor is often needed to precipitate the schizophrenia.  These severe types of disorders are not preventable, nor are they predictable, much like other severe genetic medical conditions.

How are these severe symptoms treated?  

Psychosis and mood symptoms are most effectively treated with a combination of psychotropic medication and psychotherapy.  Intensive psychotherapy and structured medication regimen can help regulate or stabilize severe symptoms.  Once the disorder is stabilized, typical successful maintenance includes continued medication management, outpatient psychotherapy, life skills groups (social skills, coping skills, support groups, etc) and health care workers providing home visits.

Severe Illnesses and South Asian Culture

An important part of treatment and prognosis of such illnesses is having a good support system and community based treatments.  The South Asian culture typically places a great deal of importance on family and community, which improves prognosis for severe symptoms.  Recent studies in India have validated the effectiveness of lay health care workers who work under professional supervision providing services in the home and with the support of family (Chatterjee, et al., 2014).

On the other hand, the discrimination and stigma of severe mental illnesses remains strong in South Asian cultures, regardless of family support and community based interventions.  Some beliefs, or widely believed myths that drive these stigmas are:

  • Mental illness can be cured by free will
  • Mental illness occurs because individuals are too weak to deal with their problems
  • Having a mental illness means the individual is crazy
  • Mental illnesses are caused by ghosts or supernatural forces

In order to increase understanding and compassion for those suffering from severe mental health symptoms, it is important to gain and share knowledge of the illness.

  • Mental illness are biological, medical disorders that cannot be controlled by the individual that suffers from the illness.
  • Having a strong will cannot cure a mental illness, much like a strong will cannot cure a heart attack.
  • Those with mental illness can recover to function across many levels, sometimes a full recovery with the proper treatment and support.
  • Mental illnesses are caused medically, much like any other medical diagnoses, typically a combination of neurotransmitters, genetic predispositions, chemical imbalances and psychosocial stressors.

If you or someone you know suffers from this type of illness, the above points are important to embrace in order to advocate for a change in understanding across the board to reduce stigmas and discrimination. Other tips for caregivers, support systems and family members:

  • Learn about the disorder, including symptoms and treatment options
  • Be patient with the behaviors of the ill individual.  If they could be different they would.  They have an illness that they cannot control.
  • Provide support and compassion even if you do not fully understand the disorder, this will help preserve your relationship with the individual and remove undue stress for both parties.
  • Work with the ill individual’s inter-disciplinary team including doctors, rehab workers, health care workers, support groups and family members to share information about symptoms, progress and goals for the individual.

Resources

National Alliance on Mental Illness (NAMI) → Click on Find Support

  • Local Chapter support
  • Free education
  • Help Line
    • 1-800-950-6264
    • info@nami.org
  • Types of Groups offered include (not limited to)
    • Family to Family
    • Peer to Peer
    • NAMI Support Group
    • In Our Own Voice
    • Discussion Groups
  • Who can benefit from these groups:
    • individuals
    • family members
    • providers
    • general public

Counselors Helping Asian Indians (CHAI) Resources

Sources:  Chatterjee et al, (2014). The Lancet, Volume 383, Issue 9926, Pages 1385 – 1394

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Tanvi Patel is a licensed therapist, trained mediator, trained life & executive coach, and board approved LPC supervisor in private practice serving the Houston area.   She has been writing a series of blogs for CHAI in order to raise awareness about topics related to Mental Health in the South Asian Community.   She is listed in the CHAI South Asian Mental Health Professionals Directory or you can check out her website here,www.counselingandmediation.com, where she also blogs.

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