A CRY IN THE DARK

By NEHA KARAMCHANDANI

August 20, 2019. I was driving home from work when I received the biggest shock of my life, one that will stay with me forever: my 29-year-old best friend, Shweta Pardal, had attempted suicide and was on life support in the hospital.

I didn’t know how to react. My hands trembled as I thought to myself if this was a sick joke. I instantly called her phone to confirm that the news was false.

But 11 attempts later, she still hadn’t picked up.

I called members of Shweta’s family and spoke with her maternal aunt. She told me what I heard was indeed true: Shweta had hurt herself and was in critical condition at a Toronto hospital.

As her aunt spoke, I could feel warm tears roll down my cheeks. I was still desperately hoping it was all a bad dream.

According to the Canadian Mental Health Association (CMHA) website, in any given year, one in five people in Canada will personally experience a mental health problem or illness. It also states mental illness indirectly affects all Canadians at some point through a family member, friend or colleague. However, the stigma attached to mental illness presents a serious barrier, not only to diagnosis and treatment but also to acceptance in the community. It comes as no surprise that patients and their families are inclined to incorporate spiritualistic practices in their healing process.

“Religion and spirituality play a vital role in the South Asian community,” said Dr Farooq Naeem, a professor of psychiatry and research scientist at the University of Toronto. “When people from this background have mental health problems, they might turn to religion or spirituality.

“They will seek help from faith healers and spiritual leaders. They turn to religion, go to a mosque or temple. They find peace and solutions to their turmoil. It can be useful. In Sufiism and its practices, people do mindful meditation, yoga and religious pilgrimages and it helps a lot,” added Dr Naeem, who is also a psychiatrist at CAMH.

“There are problems with this approach, too. When people have psychosis or mania, a lot of people from South Asian background first seek help from religious leaders and the problem is we have a term of untreated psychosis. If you leave it untreated for a while, the prognosis gets worse and delays the process of help-seeking and that can have implications.”

Earlier this year, Shweta had mentioned that she was not feeling well. She was always tired. She was losing weight and distancing herself from her loved ones.

As her best friend, I just thought she needed some space to gather her thoughts.

However, as I tried making sense of what she was experiencing, I provided her with sincere advice: seek professional help.

She refused, as many South Asians do. But never would I have imagined that she would attempt to take her own life.

According to the CMHA website, suicide accounts for 24 per cent of all deaths among 15-24-year olds and 16 per cent among 25-44-year olds. It’s one of the leading causes of death in both men and women from adolescence to middle age.

As campaigns such as #BellLet’sTalk reveal, conversations around breaking the silence, helping fight the stigma and offering safe spaces for those suffering from a mental illness and their families to come forward and share their stories can help a great deal.

But the reality is many still don’t come forward or seek help.

According to the 2014 World Health Organization definition, “mental health is a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to her or his community”.

This is different from mental illness, which is a diagnosed condition. Each of them falls on spectrums that are interrelated.

Abraham Verghese wrote, “Spirituality involves belief and obedience to an all-powerful force usually called God, who controls the universe and the destiny of man,” in his report, Spirituality and Mental Health (2008), in The Indian Journal of Psychiatry. “It involves the ways in which people fulfill what they hold to be the purpose of their lives, a search for the meaning of life and a sense of connectedness to the universe.

“The universality of spirituality extends across creed and culture. At the same time, spirituality is very much personal and unique to each person. It is a sacred realm of human experience. Spirituality produces in man qualities such as love, honesty, patience, tolerance, compassion, a sense of detachment, faith, and hope.

“Religion is institutionalized spirituality. Thus, there are several religions having different sets of beliefs, traditions, and doctrines. They have different types of community-based worship programs. Spirituality is the common factor in all these religions.”

Shweta didn’t have a diagnosed condition. She suffered from the stressors in her life, finding it difficult to be happy and live a healthy life. Unfortunately, none of her loved ones including myself have a complete picture of the stressors in her life.

Only she knows.

What we are left with are unanswered questions and a hope for a miracle as we stand beside her while she fights this battle. She is currently on life support.

Dr Naeem says that spirituality can help family members when seeing their loved one struggle with a mental health problem or illness.

“It offers extra coping skills, a simplistic explanation, and inner peace. It helps us with building resilience.”

To cope, I have personally resorted to the benefits of spirituality and religion. I have started meditation and mindfulness living – focusing on living in the present. At the same time, I pray for my best friend daily and have witnessed spiritual healers in her hospital room.

All of this helps me find peace, solace and the calm in a storm.

While spirituality and religion benefit family members, Dr  Naeem encourages patients to also receive a combined treatment.

“I will never say this (medications) or that (spirituality),” he emphasizes. “I’ve learned through my work that it’s a combination. It’s about including spirituality where you can and considering spirituality when you are treating them.

“When Muslims are fasting it’s a bit of a problem because they don’t want to take their medications. Sometimes it’s about educating them – take the medication at a very different time or in a different kind of dose,” he said. “In order to offer such treatment, we need to have a good understanding of their belief system. If we don’t understand this, we won’t be able to respect their choices. It’s a matter of being aware of religion and spiritual practices.”

Understanding religion and spiritual practices also involves assuring people that God isn’t the reason for their mental health problem or illness. This applies universally across all religions, adds Dr. Naeem.

“The misinterpretation of verses in the Quran or Jewish text, for example – if you’re not a good religious person, you will be unhappy – becomes a wrong explanation of depression. That’s not helpful.

“They (those with mental health problems/illnesses) start to feel guilty because they haven’t pleased God. This leads to helplessness. If you believe this happened because of God, you won’t seek help from a doctor. You can become depressed or psychotic regardless of how you religious you are. However, that’s not to say religion or spirituality are blocks on the road to recovery.”

Maneet Chahal, who started SOCH Mental Health, a mental health promotion initiative out of Brampton, shares this opinion.

“In the South Asian community, there’s a misconception that if you don’t pray enough, you can become sick,” she observes. “If you’re not a good religious member of the community, then you’re likely to get a mental illness, which is not true.

“A lot of professionals lack the confidence and training to explore spirituality and faith in someone’s care plan. They feel like it’s too personal to ask those type of questions. For them, it’s about getting the medication, monitoring the medication and side effects. Less time is focused on other types of therapies.”

Chahal, now a full-time care coordinator at Toronto Central Local Health Integration Network (LHIN), developed a wellness program in a clinical setting as a community nurse.

“I started a wellness program when I was on the Assertive Community Treatment (ACT ) team. The reason for that was to look at mental health with a holistic approach – looking at nutrition, hobbies, activities and spirituality. I brought in Kundalini yoga during this time. You see people using spiritual practices, you see evidence of people using positive affirmations and mindfulness.”

Shivi Darubra used spirituality in her self-care plan after experiencing problems with her mental health.

During her fourth year of political science at Wilfred Laurier University in 2014, Darubra had a meltdown in her living room due to the pressures in her life – finances, school and relationships.

She recalls the day vividly. “I couldn’t stop hyperventilating. My vision got blurry and it felt like I was having a heart attack. I couldn’t breathe. I could feel my heart jump out. I heard voices in my head. My roommates saw me and gave me water. I was very cold; my hands were cold. My skin got all dry.”

Her roommates called 911 and were told how to calm her down.

“The call was sent to a triage nurse. They told my friends to make me to do box breathing in increments of three and I did that. Shortly after my breathing normalized, I felt dizzy and passed out,” says Darubra.

This was her first episode. Eventually, she took a year off from school, which helped her find her path in life.

“I identified the sources and changed the pace of my life,” says Darubra. “I moved to Texas, USA, made lifestyle changes, exercised more, changed my diet, volunteered more and engaged in things that I liked. It reminded me of what I was as a human being, as a person.”

She wrote The Little Blue Elephant, a children’s book about mental health published in 2016.

“I found solace in doing Seva – serving the less fortunate – in Houston, Texas; working with homeless people; taking youth out for lunches; helping them out and providing them with care packages. Helping others helped me.”

She returned to Laurier to complete her undergraduate degree and with a master’s degree in Public Administration from the University of Western Ontario she now works in mental health policy development. She is also a member of the SOCH Mental Health initiative. 

“The South Asian community is made up of multiple religions and cultures,” she says. “We all must work together to help each other out and break the stigma. Everyone has their own spiritual journey and it comes down to you and what works best for you.”

In the report, Building Bridges for Inclusive Care, based on the Peel Service Collaborative inaugural breakfast event held on March 3, 2015, faith leaders and service providers discussed the various ways stigma presents itself and the challenges this raises for supporting individuals with mental health issues. Several ways to address stigma were discussed: educating faith communities about mental health, educating service providers about diverse religious beliefs, building trust and rapport between service providers and faith communities; supporting open dialogue; providing faith leaders with the training and tools to address stigma in their communities; and awareness-raising efforts such as events and conferences.

Some spiritual leaders are working closely in their communities with people suffering from mental health issues.

Ravinder Narayan Pandey is a Hindu pandit at the Vishva Shakti Durga Mandir in Ottawa. He has been a priest offering counselling for 22 years.

He strongly condemns the idea that a person experiences challenges with their mental health because they don’t pray to God. He says the stigma around mental health issues stops people from coming and seeing him.

For those who do come to him, he shares recommendations to heal them from the everyday stresses in their lives.

“You can pray to God; you can believe in God. Astrologers believe that the positions of the moon and the planets can affect mental health and cause depression or other mental illness. Meditation and yoga also help.”

While I struggle to fathom what actually happened with my best friend and continue to find solace through spirituality, I pray to God that he helps her find peace – in this world and beyond.