Story of South Asian Mental Health Stigma

three friends talkingIman sat nervously across from her two closest friends. She was so nervous her leg was shaking and her breath was so shallow she thought she might pass out.

“Iman, are you ok?” her friend Shazia asked. “You look really pale. Have some water.”

She knew it was now or never and she had grappled with this decision for over a year so she took a deep breath and said, “This is really hard for me to say but we’re such good friends that I wanted to tell you all. No one else knows.”  Neither of her friends had a single clue as to what Iman was going to share with them.

“I have been seeing a counselor for the last six months. I wasn’t sleeping well and was getting sick all the time. My doctor couldn’t find anything wrong with me so she suggested I see someone to talk to. I think it was the stress of work and balancing that with life and a few other things that had gotten to me.” She quickly glanced up to see her friends’ reactions. Their faces had not moved as if they were made from stone so she continued.

“The counselor helped me to see that I have been depressed for a few years and is helping me figure out how to deal with things better so that I’m not depressed anymore,” she said.

Her friends were quiet for what seemed like an eternity. Finally, Asima broke the silence and said hesitatingly, “Wow I don’t really know what to say.”

Shazia added, “Ya I didn’t know that you were so…fragile. Are you ok?”

Iman became defensive and said, “I’m not fragile. I’m going through some tough things and I realized that I didn’t want to do that alone.”

“Well, we’re here for you,” Asima said. “We’re friends we can talk about anything.”

“I know but as friends you can give me support, love, and empathy. But what I needed was more than that and only a professional can really help me sort things out. That doesn’t mean I still don’t need you but you’re my friends which is different than being my counselor.”

“Oh come on. You’re just being negative. Think positively, focus on the happy things in your life and you’ll feel better,” Shazia said nonchalantly.She appeared to be the most uncomfortable in the conversation and attempted to change the subject. “So has anyone seen any good movies?”

Iman didn’t know what to say and Asima, who was trying to be supportive of Iman, seemed relieved at the change of topic as well.

When Iman left the café, she couldn’t shake off the feeling that her friends had disappointed her. She had hoped they would respond with some empathy and understanding but instead they were judgmental, did not ask about her experience and instead decided to hold on to their misconceptions of what counseling and depression is.

They were her best friends for the last 25 years, having met each other on the playground in 2nd grade. She felt so lonely and betrayed that her closest friends seemed so closed minded and wary of her diagnosis and experience.

Over the next few months, she noticed that Shazia and Asima called her less and when they did talk to her, were very guarded with how they talked to her. They invited her out less and seemed much more distant than they had in the past.

One day, when they all had decided to get together for lunch, Iman became irritated by their superficial conversation. “Ok, what’s going on?” Asima and Shazia looked confused.

“Since I told you that I’m depressed and that I’m seeing a counselor, you both have been acting so weird around me. We barely talk anymore, you don’t tell me what’s going on and we rarely see each other. What’s going on?” she insisted.

They both looked down at their plates, not wanting to say anything.

“This is crazy! We’re best friends! Why can’t you tell me what’s going on?” Iman said angrily.

“Because we don’t know what to say to you anymore,” Asima blurted out. “We don’t want to say anything to upset you.”

“Why would I be upset?” Iman asked, not understanding the connection.

“You’re depressed. You said it yourself. You’re so depressed that you have to go see a counselor,” Shazia added.

“Do you think that means I can’t handle anything?” Iman said becoming upset.

“We don’t know what to think,” Asima said quietly.

“Then ask me!” Iman was frustrated.

“Look this has turned too serious and now we’ve upset you. Let’s talk about something happier,” Shazia interrupted. “Farhad and I are thinking of moving to a new house!”

Iman was shocked. Her best friends had turned into strangers. They didn’t know how to talk to her and they wouldn’t ask her how they could be supportive. They were acting as if she was in a very delicate state of mind, as if she was crazy.

On her drive home, Iman cried. She knew that recovering from depression was not going to happen just by going to therapy. Support from her friends is also a very important aspect of overcoming depression. She felt helpless that her friends did not understand that and would not change their ideas of what depression is to help her.


Asima and Shazia were exhibiting signs of mental health stigma. They minimized the importance or validity of emotional health and mental health care, they changed how they acted toward their friend, and they behaved based on misconceptions instead of accurate knowledge. Because of a lack of understanding, many South Asians misunderstand mental health to mean that a person is weak or dangerous, neither of which is true.

Mental health stigma is a reality for many people and they often feel rejected, isolated and undesirable as friends and partners. People with mental health issues, such as depression, anxiety, schizophrenia etc., who experience being stigmatized also notice a drop in their self-esteem and sometimes an exacerbation of their original symptoms. They tend to lose friends and have a difficult time making new relationships.

Reducing mental health stigma will not only improve the wellbeing of the people being stigmatized but it will increase awareness about what mental health truly is, opening the door for people to seek help sooner so that they don’t suffer in silence.

Read more about what you can do to reduce mental health stigma.

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  1. Excellent article!

  2. Step into a room of 100 people and ask “who has a sore back?” and “who has a cough?” or “sick stomach?” Many hands will go up. Now ask “how many felt paranoid this morning?” No hands and nervous laughter. Hell, how can we respond to that sort of question when we do not have a good definition of what being normal is? To me normal is a range and depending on culture and government response the range can be very narrow. There has to be much more open dialogue everywhere on this issue

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