Did you know that one in six people with mental health conditions is aged 10-19 years? According to the World Health Organization (WHO), suicide is the 4th leading cause of death in 15-19-year-olds. Mental health conditions account for 16% of the global burden of disease and injury in people aged 10-19 years. The consequences of not addressing teens mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults (1). For this reason, CandleX places a strong emphasis on supporting teens and has an ongoing project targeted towards helping them: the Teens Empowerment Project. The CandleX Teens Empowerment Project started in 2020 in Beijing, China under Teens Mental Health Program. We target teenagers who are usually third-cultured, international, and multilingual. These are teens who have experience with mental illness, such as depression, bipolar disorder, eating disorder, and so on. Some of them have also experienced self-harm. The goal of the project is to reduce the stigma attached to mental illness and provide a chance for teens to gain knowledge on mental health and tools on how to cope with difficult emotions so that they become resilient. The Teens Empowerment Project has 3 stages. Stage 1 is called “Teen Writers.” The teens write down their own stories with support from a therapist. This process allows teens to find their own voice and explore the struggles and the meaning of their stories. This is like the narrative approach that we take in psychotherapy. Later, the therapist can identify the dominant and problematic story. We also include facts and insight into the editor's notes for professional information. Once we publish that through our own platform and the networks of our media partners, we can help to educate the community and reduce the stigma that teenagers feel is attached to mental illness. Stage 2 is called “Teen Interviewers.” The teens have the chance to interview an influential adult in our community. It might be a startup entrepreneur or the CEO of a well-established company. These are adults who have battled with mental health in the past and are willing to talk to the teens about their experiences. We work with experienced media professionals who volunteer to help the teens structure their interviews, prepare the articles, and write the final pieces. Again, there is a therapist engaged in the process to make sure the whole process is therapeutic and that the final piece serves as a mental health educational purpose. These first two stages allow teenagers to learn how to accept their own struggles and become stronger in dealing with them. They also gain practical skills associated with publishing articles and conducting interviews. For a lot of them, it's also the first time that they publish something on a public platform! Stage 3 is called “Teen Spokesperson.” CandleX gets interviewed by the media every now and then, and as the Teens Empowerment Project develops, we try to create a space for the teenagers to be the people who can talk about their opinions and their experiences as an advocate as well. So far, we've had teens on radio shows, magazines, and now we have an exciting opportunity for them to be on national TV as well! The three-stage empowerment project paints a road map where we can take the teenager on a journey. Not all teenagers will go through all the stages; it depends on their willingness, strength, and preferences. That’s why we take very small steps in this process. We constantly check in with them to see how they're feeling, whether they're learning things and whether things are going according to what they expect. Our role in this process is being the support instead of the supervisor. To empower one teen, we often engage 4 to 5 adults in the process. So far, this is the highest investment project we've had in all our projects. It usually takes about 6 months to 1 year to finish the empowerment project for one teenager. This is also one of the strongest programs we have, where I continue to see changes that teenagers demonstrate throughout the process, as well as after the program has ended. Some of them choose to stay with CandleX and volunteer in other roles, while others continue with their lives and contribute to society in their own ways on mental health afterward. References: 1. Adolescent Mental Health - World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health.

Please note: this project was an initiative by Xiaojie and Megan as individuals, and was not a service provided by CandleX. In Beijing, there has always been an unmet need to support women in the international community who were in abusive relationships. Survivors are usually invisible due to the shame, and affordable professional support almost does not exist due to the scarce resources and high costs. Abusive relationships can exist in the form of domestic violence, intimate partner abuse, or even toxic friendships. Many people who are in abusive relationships may not even realize they are in that situation. But for those who do and manage to get out, there is still a long road of healing ahead which may require work with a therapist. Being aware of that and with the goal to kick start the support on this topic, Xiaojie and Megan provided the much-needed support for women who were in abusive relationships to heal in Oct 2021. Project Organizers Xiaojie Qin Title: Xiaojie is a certified psychotherapist and director at CandleX, who provided the therapy sessions. For this project, Xiaojie provided 4 sessions of group therapy and 4 individual sessions for each participant. Megan Megan is an activist for women and is passionate about supporting victims of intimate partner abuse and domestic violence. She volunteers with Female Health Empowerment Network to help women gain access to healthcare resources in China. For this project, Megan co-organized the sessions and was present to support the therapy sessions when needed. Therapy Details Duration: September 25 - October 24, 2021 Number of participants: 4, from 3 different countries Language: English Group Sessions: Once per week for 4 weeks, 2 hours each week Individual Sessions: 4 per participant Total therapy hours offered: 24 hours Fee: 100rmb for each session, both for group therapy and individual therapy How does the Group Therapy Session Work? We had a screening phase to ensure the eligibility of the participants, as well as ensuring the maximum possible outcome of the project. The purpose of the group therapy was to give women the space and tools necessary to begin or continue healing from their past abusive relationships. Survivors often feel alone in their experiences, and group therapy can provide a space for them to connect with each other. Over the course of 4 weeks (2 hours per weekly session), participants shared and reflected on their stories. Based on their individual experiences and their own needs, group goals were established, and Xiaojie provided everyone with guidance and tools to help them adapt their mindsets and behavior. Each group therapy will vary based on the participants’ experiences, preferences, and established goals as a group. The following structure and content were unique to this group and should only be seen as a reference. Week 1: Unpacking the Past To discover where the dislocation is in your bones, a physician may need to press on the point that causes pain. It’s the same for psychotherapy, and participants felt heavy and overwhelmed after the first session. In our first session, group members shared their past experiences with abuse, which is not easy to express. It did allow the therapist to see the roots of some issues they experience now. After this session, participants were reminded that it is important to schedule something fun and/or relaxing afterwards to recover from intense emotions brought up during the first session. Week 2: Group Goals, Defining Abuse, and How Past Abuse Impacts Us Now Many survivors of abuse have a mentality that leaves them frozen in time, including having difficulty trusting others. Children think concretely, not abstractly. They learn concepts of trust and love through their significant caregivers in life. The absence of such modelling can make it difficult for them to know what those look like. It’s as if “you are trying to describe the color green to someone who’s blind.” Participants need to learn to distinguish abuse from common conflicts or unhealthy interactions. We went through the definition of abuse, relating it to their personal stories. People have different histories of abuse, ranging from emotional and psychological abuse to sexual abuse from family members or their partners, all on different levels of severity. The abuse happened to participants of different ages. It is clear to see how that can create a sense of insecurity within a person, and subsequently lead to hypervigilance and confusion in their world views, and their principles setting in interaction with others. We ended the session by leading the participants to accept that these unfortunate events have happened and to allow those events to stay in the past. Group members started to feel more at ease after this and gained insights that they could apply in current or future relationships. You can learn more about abusive relationships in this article: What is emotional abuse? | Classroom Week 3: Exploring Common Ineffective Thoughts and How to Revise Them Instead of having a therapist to participants conversations, the participants were encouraged to ask questions, give each other feedback, and practice active listening and non-judgment. One common psychological inflexibility all members showed was the fusion with their thoughts, as described in acceptance and commitment therapy. Instead of seeing thoughts in nature as changing, possibly conflicting, and not always reflecting the truth, some participants often have self-loathing thoughts and catastrophizing thoughts. The chess on the board metaphor was used for discussion to understand the new approach of observing these thoughts, instead of acting the negative thoughts. Week 4: New Skills to Move Forward in Life It was interesting to see how participants were on different ends of the spectrum of assertiveness. They were a mixture of passive, ineffectively assertive (defensive), and passive aggressive. Understanding where they are on the scale of assertiveness helps the participant to understand how to create healthier interactions when there’s a conflict. In this session, participants completed a role-play exercise to help them see their own assertive style and work on cultivating healthier interaction patterns. Supplemental Individual Therapy Every participant’s experience with trauma and current state of well-being is different. Individual sessions helped participants to work on specific issues that the group did not address. With some, individual sessions focused on self-awareness of their passions and callings in life, and elevating their mood, in addition to re-constructing their life activities to maintain well-being. With others, its individual sessions focused on managing their current burning issues in life. That included more effective and healthier ways to interact with their current partners, or building their self-sufficiency and self-reliance, and how to balance that in relationships. Overall, the feedback from participants was positive. They felt the sessions provided them with great tools for overcoming negative thoughts and behavior. They also appreciated having a safe space to share their stories and connect with others who had been in similar situations. Not feeling alone was important for them. Participant A stated that having the group to interact with and hear from others made her “realize that others also are struggling” and that they could help learn from each other. Participant B said she “learned so much just in those four sessions” and that sharing the experience with other women provided “comfort and support.” Participants also expressed that they hoped these group therapies would be offered more regularly or on a more permanent basis. Therapy should be an ongoing process, especially when there was trauma in the past. Through continued support and work, we can get closer to living a more fulfilled life. Along the way, we need patience, consistency, and continuing work. As a society, I hope we could create more spaces for that to be possible. To get in touch with Megan, please add her on WeChat: meganpurvis Xiaojie also offers discounted therapy for 200rmb/session for those who experience financial difficulty. Please scan the code below for more information.

In February of 2021, Zhen from EmberFlame interviewed CandleX’s director Xiaojie on her story of founding and running CandleX. Thank you to EmberFlame for not only producing the wonderful videos below but also for showing support and interest in mental health. If you live in China, you can watch from our Tencent channel: https://v.qq.com/x/page/w330294a0zo.html In the three-part video series, Xiaojie opens up to us about her personal experience with mental health, as well as the creation and development of CandleX and the community it created. Xiaojie’s own experience with mental illness led to the birth of CandleX. In the past six years, CandleX created a community that provides an open space for talks on mental health. “Through talking, shame dies,” Xiaojie says. Since 2020, CandleX has not only provided help for adults but teens as well. The birth of CandleX only ignited a fire to start discussions, Xiaojie says. The community is doing the rest – it knows its need, and is building the flame to further facilitate space and give strength to those who need it. The Ember Flame is a documentary series showcasing stories of diverse community founders and entrepreneurs pursuing passion projects and building communities in Beijing. (Follow “EmberFlame” on WeChat: WeChat – Discover – Channels – “EmberFlame”)

Xiaojie, psychotherapist and founder of CandleX, was invited to speak about triggers and growth in relationships for Date Night China’s Mind, Body and Soul Workshop on October 23rd, 2021. The event was held at Guoyihui along with speakers Angelo Eugenio, Rachel George, and Juan. Xiaojie talked about healing from past relationships: how trauma or scars in past relationships can affect our current relationships, and how we heal and repair ourselves in our current relationships. YouTube link of full video: https://youtu.be/mR_ewNgAEwU Tencent link of full video: https://v.qq.com/x/page/g3305ahf9uq.html Xiaojie started off by explaining what triggers look like. Triggers stem from the survival brain: the part of the brain that is focused on threat, dislikes ambiguity, and thinks in black and white. When we are in our survival brains due to stress or trauma, we lose the ability to think logically. Texts and replies, opposite gender friendships, communication conflicts, and sex are all examples of triggers. Xiaojie pointed out that what triggers us in relationships could be based on our childhood, past relationships, and culture – everyone’s triggers can vary enormously. Then, she moved on to introduce the learning brain: the part of the brain that is open to new information and comfortable with ambiguity. With our learning brains, we feel calm, connected, confident, and less triggered so that we are ready to learn. Unfortunately, the survival brain often overtakes the learning brain, making it hard for us to think rationally. Image by Jacob Ham This is when we must work on ourselves. Xiaojie ended her presentation by listing out action points for the audience to work on by themselves, with their partners, or through professional support. After Xiaojie, the other speakers presented. Angel from Active Together spoke on physical health and well-being, the environment, and how that impacts the relationships in life. Rachel, a licensed therapist and life coach, presented emotional well-being, values, and boundaries when it comes to relationships and how those values reflect our self-concept. Juan from ComeUnity conducted a mindful meditation session after the three speakers, providing a time for reflection. Afterwards, there was also time for small group discussions and socializing. Although being Date Night China’s first speakers’ workshop, it was a full house. The workshop speakers shared their knowledge with expertise and provided tools to support building healthy relationships between individuals. Xiaojie’s presentation evoked thought upon how the misunderstandings that create discomfort in our lives are linked with our personal backgrounds. Through simple neurology concepts, she explained how the human brain functions, making it easier for us to understand and accept our behavior. People were actively listening and engaging in meaningful discussions with Xiaojie. With a focus on nurturing one’s own mental well-being, Xiaojie’s participation provided the audience with a supportive environment to not only listen, learn, and self-reflect, but also share their mental state. Xiaojie also provides discounted therapy sessions for those with financial restrains for 200rmb/session (4 sessions per person). To know more information on the availability each month, and the criteria, please scan the QR code below for consultation.

Providing mental health support to teens has been a key part of CandleX’s vision and goals. Teens, unlike other demographics, face unique mental health challenges partly due to the development phase they undergo as well as the social and cultural expectations they receive. According to the U.S.-based organization National Institute of Mental Health, 1 in 5 children ages 13 to 18 have, or will have a serious mental illness. In fact, 50% of all lifetime cases of mental illness begin by age 14.[1] Therefore, the consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults.[2] Since February 2020, CandleX launched a column called Teen’s Opens Letters dedicated to teens to voice their experiences. Whether it’s mental health challenges as a result of moving away from home and beginning university life in a foreign country, battles against eating disorders and depression, unspoken thoughts to parents, Teen’s Open Letters has a place for all these topics. Click here for ThatsBeijing’s recently published article on CandleX’s mental health service and support for teens. Sources: 1. National Institute of Mental Health. www.nimh.nih.gov 2. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

Today is World Trauma Day. Our director and psychotherapist, Xiaojie, talks about emotional abuse, which leads to emotional and psychological trauma. In this video, you will learn how to recognize 14 signs of emotional abuse from One Love Foundation and other factors that differentiate abuse from common unhealthy interactions, as well as social and professional support offered to the English-speaking community in China. Social and professional support currently available Support in Shanghai Thanks to the Inward campaign raising awareness of sexual violence and funds for survivors to receive safe trauma-informed care, Ferguson Women’s Health offers free medical assistance and relevant tests, and Community Center Shanghai offers one free counseling session (with the possibility of extended pro bono or subsidized rate care) for survivors of sexual trauma. For more information, you can see their official WeChat account: CCS-counseling. Support in Beijing Xiaojie and Megan (from Female Health Empowerment Network) teamed up in September 2021 to provide therapy services for women who had past abusive relationships. The services include four 2-hour group therapy sessions for 4-6 participants and discounted counseling individual therapy sessions for 100rmb/session for four sessions. The current round of group therapy is closed. However, if you would like to be informed of future sessions, please contact Megan through WeChat: meganpurvis. For individual therapy sessions with Xiaojie, please contact Emma for intake. Every month, there is a limited number of discounted rates for individuals who have financial difficulties. There are other general support resources available, please check out our article on crisis hotlines.

In November 2021, CandleX launched The Examined Life, an intimate monthly gathering dedicated to self-discovery, emotional growth, and the exploration of topics that most of us can relate to. Greek philosopher Socrates famously stated that “the unexamined life is not worth living.” To Socrates, all philosophical exploration is reduced to one simple commitment: to know ourselves. In our fast-paced society where many social settings require us to mask up and engage in small talk, we don’t always have the time to listen to ourselves and get to know our inner selves better. Many topics that truly deserve our attention are overlooked or pushed to the back of our minds. Some examples: · How do we deal with loneliness? · How do we deal with grief and the ultimate existential concern: death? · What does our parents’ relationship teach or fail to teach us about love? · How do we accept ourselves and why is self-acceptance so hard to come by? · What difficult patterns of behaviour are we prey to in friendships and romantic relationships? Etc. While mental health support group provides a safe space for anyone to open up about their life and mental health struggles, The Examined Life lays tough life questions on the table, and by practicing a culture of vulnerability, candor, and intimacy, helps us better understand ourselves and cope with life’s ebbs and flows. The gathering hopes to bring us deeper self-awareness and more resilience, which are key to leading fulfilling lives. What the Gathering Offers: A safe space to open up, share, and find comfort in each other’s most human, vulnerable side; More lucid understanding of topic discussed; Self-discovery, self-knowledge, and emotional growth; Authentic, meaningful connection with those who likewise crave for and are replenished by such engagement; A non-judgmental support system. Details at a Glance: · Date & Time: The third Tuesday each month, at 7 pm (unless otherwise specified; gathering signup link will be shared in the CandleX group) · Language: English · Fee: ¥50 or donation-based · Gathering size: up to 10 attendees · Location: an apartment near Chaoyangmen station (detail in signup link) · Signup: An event signup will be sent to the CandleX WeChat group the week before. It’s on a first-come, first-served basis. Principles for Gathering: 1. [Not a therapy group] · Our setting is not that of group therapy. We are a casual, friendly gathering. · The host and attendees are not professionals so are not equipped to offer professional mental health advice. 2. [In case of crisis] · Please seek professional help immediately in case of crisis. · Visit our website for more crisis support: https://www.candlex.cn/crisis-support · CandleX is not responsible for the safety of people engaging in self-harm or suicidal ideations. 3. [Non-judgment] · No form of disrespect or verbal/nonverbal violence is tolerated. · We practise active listening and offer personal opinions respectfully. 4. [Participation] · Everyone is encouraged to share. · Everyone can pass any time if they don’t want to share.

Teenagers who are in the process of applying to universities in the US are often stressed, anxious and report having a low mood. It is not uncommon for the consultants that assist these teens to see depression, eating disorders, and maybe self-harming. The biggest question among the consultants is, “what do I do when I am dealing with a troubled teenager?” On August 13th, 2021, CandleX’s mental health consultant, Melena Slaven, presented by Zoom Meeting to a group of Elite Scholars of China (ESC) consultants from all over the world that work directly with the students from the ESC program.  ESC has successfully helped over 1000 students gain admission to the most selective colleges in the United States. The consultants were looking for ways that they can support their students both directly and indirectly.  The consultants want to be equipped with the tools they need to provide empathetic emotional support and maintain positive relationships with the students.  They also need to know when the situation is too much for them to manage and where they can send their students for help. CandleX provided them with the resources they needed to be able to connect with their students in a non-judgmental way and offered them the resources they needed to be able to refer their students to counselors, doctors, and hospitals that acknowledge and support those with mental health needs.  Crisis hotline information was also provided. Consultants were given information about some of the risk factors their students have as well as an overview of depression and anxiety.  They were taught about the warning signs of suicide and how to talk about it without being timid. Most importantly, Melena talked about how to prevent some mental health problems by building relationships. She shared her favorite apps for mental health such as Clear Fear, Calm Halm, and Dare. These apps are free and provide amazing tools for people suffering from anxiety, self-harm and depression, respectively. Other resources given to the consultants for them to use with their students were a self-care assessment and mindfulness coloring pages. The self-care assessment can be used to prompt discussions and to rate their students’ strengths and weaknesses in all aspects of good health and well-being (physical, psychological/emotional, social, spiritual, and professional). The mindfulness coloring pages are great for relaxation. CandleX has been providing workshops to the students of the ESC program since 2015 and they are very proud of the ESC consultants for taking this new step this year to learn more about mental health and ways they can help their students in a proactive way.  ESC knows that it takes a village to raise a healthy child.

Mental illnesses are often seen as short-lived, singular events, from which we move on as soon as we see signs of recovery. In fact, healing takes time and support is needed. Like any major life event, mental illness leaves a mark and becomes a part of us. There have been increasing discussions around the diagnoses of mental illnesses; however, what remains after the initial stages of the battle is not discussed enough. How does one continue to support a mental illness survivor? What does the healing process look like? Katelyn bravely and openly shares with us her story. To understand the life events that contributed to this story, please read the previous three chapters: Chapter 1: “Crushed and Misunderstood” on the author’s arrival to Canada again at the age of 13, Chapter 2: “Depression is Treatable, Doctor Said” on her hospitalization, and Chapter 3: “Stuck in the Purgatory” on a continual journey after leaving the hospital. Author: Katelyn (pseudo name) Written in 2020 Now if this was a movie, this would be the part where I learned a bunch of life lessons and found my happily ever after. I landed in Beijing with so much excitement and hope, enrolled in an international school with the thought of forgetting everything that had happened, as if it was all just a bad dream. I would start clean and fresh, make new friends, get good grades, graduate from high school and move on to college. This illusion was soon shattered as I learned that depression is deeply ingrained in my brain. It is always creeping around, every thought and every action shadowed by this growing and immovable force. Depression feasted on my pursuit of perfectionism and on my fear of failure. With every passing day, I grew more paranoid, more insecure. After four months as a junior in high school, the new environment completely burned me out. I began to lose all sense of time. I dropped out of school and lived every day like a zombie. I wasn’t entirely alive but wasn’t dead either. I was losing the war with depression, so I tried my best to conceal and numb my feelings. As I lay hopeless on my bed, in the darkness of my room full of laundry and litter, I saw no possible future in which I could live a happy and meaningful life. “Breathe in, two, three, four, breathe out, two, three, four.” My stomach rose and fell in sync with the soothing voice of the guided meditation. As I meditated deeper, I could feel the fogginess in my brain disappear, unveiling a serene and peaceful sensation that I rarely feel. As someone who’s been in countless therapy sessions, I am familiar with CBT, DBT and meditation. I never gave the latter a try though, until recently when a long-time family friend passionately introduced me to it, believing it would benefit me. She said it helped her recover from her brain injury after a car crash. And she was right. Before I never dared to take a deep look at my thoughts and my feelings, afraid I would give in to depression. Meditation is merely a form of guidance, gently casting a beacon of light, scaring the shadows and darkness away to reveal the scared little lone girl. She only begs for forgiveness and love, and I vowed to take care of her. “HAPPY 18TH BIRTHDAY!” My family shouted in glee, the warm candlelight on the birthday cake giving their faces a soft glow in the dark. I smiled, thanking them for their support, and blew out the candles. It’s been two years since I last went to regular school. I’m homeschooled and do online classes now. I’ve been going to therapy every week, taking my meds as prescribed and trying to maintain a healthy diet and sleep schedule. My pondering nature often blurs the line between sadness and depression, but I’ve started to appreciate my unique view of the world. I still have a long way to go in my recovery, and I have yet to know my place and meaning in the universe. But this will be a colorful journey that I’ll cherish dear to my heart, because I know I will always have the love of my family, my friends and myself. Right now, the tranquil night is transforming into a dreamy blanket for the city. The moon so shyly shimmers in the dark as I hear my pet hamster excitedly run on his wheel, and I’m grateful for all of these things. As I write these last words, I thank you, dear reader, for reading my story. According to the U.S. National Institute on Mental Health, nearly one-in-five adults live with a mental illness[1]. When it comes to depression, specifically, every person’s path to recovery differs. Some take a few weeks or months. But for others, depression is a long-term companion. In about 20% to 30% of people who have an episode of depression, the symptoms don't entirely go away[2]. However, many are rushed in the process of healing. It is understandable that all involving parties long for a swift recovery. But those who suffer may find it not only a difficult goal to achieve, but also a lonely battle they must fight alone. Looking on the bright side, it isn’t rare that many living with depression still find deep joy and meaning in between and sometimes during episodes of suffering. As Katelyn described, these journeys are indeed war-like; nonetheless, we must also acknowledge that there are victories despite the casualties. We recommend you to check out stories under #Emotions&Stories in the CandleX official account to further read about adults who manage to both live with depression and appreciate life for its beauty. “An Overview of Depression Recovery.” WebMD, WebMD, www.webmd.com/depression/recovery-overview. “Living Well with Serious Mental Illness.” SAMHSA, www.samhsa.gov/serious-mental-illness.

The recent decades have remarkably changed how people view mental illness, particularly depression and anxiety. However, there is still stigma around it. Comes with it is the battle many of us fight alone, in silos. After her discharge from the psychiatric department, she then was faced with the battle of living with a condition but having to cover it up. To understand the life events that contributed to this story, please read Chapter 1: “Crushed and Misunderstood” on the author’s arrival to Canada again at the age of 13, and ‘Chapter 2: Depression is Treatable, Doctor Said’ on her hospitalization. Author: Katelyn (pseudo name) Written in 2020 “You’ve been gone for so long! What happened to you! Cancer?” Brooke’s eyes lit up when she saw me, as she practically flew across the hallway. Her tone was accusative but I could see the corners of her mouth curling up. “Ha, something like that,” I tried to brush it off. I never told people about my depression. I was afraid they would misunderstand me and see me as weak or crazy. It’s not as straightforward as breaking a bone, after all. Almost no one knew about my mental illness in the new English school I’d been attending for grade 10. The school agreed to let me skip grade 9 after I was assessed. I was no longer a year behind my peers. Even then, I was well aware of the stigmatization around mental illness, probably because so much of what I’d experienced was internalized. I did tell one girl there about my depression, but that’s because she was depressed too. “Someone so bubbly and outgoing like Brooke wouldn’t understand,” I thought bitterly, determined to not let anyone find out about why I was away for a month. I became a regular at the mental health department for teenagers in my local hospital. I’d just been discharged from my longest period of hospitalization. We had established very clearly that suicide was off the table, but I just felt like I was stuck in a never-ending hellish purgatory. I would go to school for a week then stop for a few days, and the cycle would repeat. Needless to say, I didn’t get good grades, which made me feel ashamed and worthless. By the end of grade 10, I lived every day drowning in hatred, directed both towards myself and to the world I lived in. Every breath I took felt like a reminder of how much of a failure I was, and I wanted to end everything. “Why don’t you come with me to China, where you can start afresh and have a change of scenery?” my dad suggested, glancing at me surreptitiously, searching for signs of agreement on my face. I was a bit taken aback by the suggestion. I turned my head and saw my reflection through the glass window: greasy hair from not taking a shower for weeks, a scrawny silhouette from microwaved ramen at midnight, her stare weary and spiteful. I resented this image of her, and I wanted desperately to be that happy and carefree girl again. In Acceptance and Commitment Therapy, it is believed that the avoidance of experiences distracts us from living a fulfilled life. That means, our pursuit of happiness as a goal to avoid all other normal feelings including sadness, frustration, disappointment, anger in life could hinder our mental wellbeing, quite counter-intuitively.[1] That being said, as a parent, your attitude towards feelings is ultimately important. Are you able to accept the whole range of emotions as they arise, and not just happiness? Your children are the most imminent people that are influenced by your attitudes. As a society, we have co-created the compelling concept through advertisement, social media illusions that lasting happiness is the goal of life. What’s your experience in pursuing that goal? Fortunately, we have also seen an exploding trend of mindfulness practice, which helps us stay intuitive and embrace our feelings regardless. Whether you are a parent, a teenager, a teacher, or someone who builds a community, it is important to ask the question: what attitude do I have towards emotions, and how does that attitude unfold in my daily operation as an individual? References: 1. Hays, S. C. & Strosahl. K. D., (2004). A Practical Guide to Acceptance and Commitment Therapy. Springer.

Self-harm or suicide attempts are attempts taken to ease the pain and to respond to extreme despair, symptoms often experienced by people with major depression. This story could be triggering to some, and reader’s discretion is advised. To understand the life events that contributed to this story, please read Chapter 1: “Crushed and Misunderstood” on the author’s arrival to Canada again at the age of 13. Author: Katelyn (pseudo name) Written in 2020 I didn’t dare open my eyes. I thought to myself, so this is it. I was covered with a blanket, and the ambulance worker beside me took my blood pressure. I was rushed to the hospital, the doctor shined a light into my pupils to check if I was still conscious. They attempted to wake me up by performing a series of physical stimulations. I was fully aware of my surroundings and felt the sharp pain that everything had caused me. The simple act of lifting my eyelids and letting light in was the last thing I could do. The nurse then forced open my mouth. One hand pinched my cheeks while the other hand pressed a tongue depressor so hard until I gagged. I felt blinded by the beaming surgical lights. “Wow, where did you learn that trick?” The nurse beside her was impressed. That night, I had what would be the first of my many therapy sessions. I anxiously waited in the room, until one man walked in with a calm and serene presence. He sat down and we stared at each other in silence. “My dear, you look really, really sad.” The words gently echoed in the room. The last tight nerve that I was holding onto finally broke. All the emotions that I’d been bottling up over the last few months erupted at the same time. The sadness, the guilt, the shame, the hate and the hopelessness all turned into uncontrollable streams of tears. I lowered my head, shivering and sobbing, wanting to curl into a ball, unable to speak. Finally, I thought. The world that expects so much of me will have an answer. I can rest now. When I woke up the next morning, I found myself alone on a hospital bed. I turned my head and saw sunlight for the first time in months. I quietly observed the room I was in. It was cleaned spotless, and a giant window overlooked me where I could see the busy hospital staff. The bathroom was covered in steel and metal, and so was the toilet. Just like in prison, I noted to myself. Even the mirror wasn’t made of glass but some sort of shiny reflective material – unbreakable, of course. I soon learned that even plastic knives were locked away. Every morning, we used spoons to spread jam on our toast. Over my week-long stay, I had countless appointments with psychologists and psychiatrists. “You have depression. Major depressive disorder, to be more exact,” Dr. Elizabeth said. This was not the first time I’d heard the term, though it was the first time I’d been diagnosed with it. I learned that my school was wrong, and that I’d been suffering from depression for a long time. “Don’t worry, depression is treatable,” Dr. Elizabeth assured me. The psychiatrists then prescribed me SSRIs, a type of antidepressant, though to this day I have yet to find one that works for me. Experiences of being discriminated and marginalized can cause intense emotional pain for children. In a state of major depression, children sometimes resort to self-harm or suicide to ease or end the emotional pain. According to WHO (2020), Suicide is the second leading cause of death in 15-29-year-olds (1). This type of behavior is sometimes hidden. Therefore, it is important to recognize symptoms of depression and seek professional help. If the child resents going to school, becomes irritable, depressed, loses interest in the things they usually like, changes in appetite, experiences sleep problems or significant fatigue, these symptoms may be related to depression. Although Katelyn has not found the right mix of medication, it’s worth being noted that many do respond to anti-depressants, which gives patients the space and energy to work effectively on their fundamental underlying psychological problems, usually through counselling. According to WHO (2020), for major depression, Antidepressants can be an effective form of treatment for moderate-severe depression, however, they are not the first line of treatment in adolescents, among whom they should be used with extra caution (1). References: 1. World Health Organization, 2020, https://www.who.int/news-room/fact-sheets/detail/depression CandleX’s Resources Are you or a friend in a Crisis? Crisis Support Your questions on mental health | CandleX Classroom https://www.candlex.cn/classroom Depression stories from our community members (both adults and teens) CandleX Column | Community Writing https://www.candlex.cn/community-writing Pretreatment CandleX Wechat Groups all ages, add our admin: niama_elazzab for 15-22 year old, add our admin: amaraprenderyya Peer Support Group biweekly meetings and biweekly hangout

Katelyn (pseudo name) was born in 2002 to a Chinese family in Beijing. She first moved to Canada with her family when she was 3, and since then moved back and forth between China and Canada a few times. She now lives in Beijing and has participated in our teens program since 2020. She bravely shared her story of a time that she moved to Canada again at the age of 13, where she attended a French boarding high school. Author: Katelyn (pseudo name) Written in 2020 “You cannot have depression, as it would take a minimum of three months before one develops it.” Those were the words of the woman in front of me, as I was going through half a box of tissues to wipe away my tears. It had been three weeks since I started grade 8 in a French catholic boarding school. I was 14, and one year had passed since I returned to Canada. I had already been held back a year, as I was forced to complete an immigration program in French. I was determined to make up for this lost year and do my best to fit in. I remember how I first walked into the school cafeteria, subconsciously searching the crowd for faces like mine, but I failed to recognize any people of Asian heritage. I was the only person of color in my grade of 300 students who was actually an immigrant. The three other POCs were all adopted by white families. I felt intimidated but strangely excited about the challenge of introducing all these people to my culture. “But… but what could possibly be wrong with me?” I cried, struggling to get the sentence out. I don’t remember much from the school counseling session other than feeling crushed and misunderstood. I specifically requested it to be in English, so I would at least have some sense of comfort and familiarity. Ever since arriving, I had tried my best to maintain perfect grades and a positive attitude towards my new classmates despite feeling isolated and sometimes being mocked. Every Friday when I went back home, I would cry and beg my mom to not drive me back to school the following week. I didn’t get physically bullied and I could sense there wasn’t much malicious intent behind the teasing. It was just extremely ignorant and dumb. One time, I remember teaching some other students Chinese. A teacher overheard me and commented it sounded like “zoo animal language.” A few more weeks passed by, and I began to suffer academically. Focusing in class became much harder. My mind was preoccupied with thoughts like, “No one likes you here” or “Nothing will make up for the fact that you’re not white, rich and pretty”. I always held myself up to next to impossible standards when it came to grades, and I couldn’t imagine what I’d lose if I wasn’t at least a good student. Unfortunately, all of that was now slipping away, too. I wasn’t myself anymore. People no longer saw me as extroverted, witty and competent. Instead, I did every assignment half-heartedly and spent my breaks alone, crying in the bathroom. The hope that I would eventually be accepted as one of them but still somehow stand out had long vanished. My 14-year-old brain couldn’t understand the inequality and injustice I experienced, but it became clear to me that either I had to completely change or the environment had to. I stopped going to school altogether. “You’re so weak-minded! How can you face me like this! You’ve become a disgrace.” The words of my father ringed in my head. It had been months since I last went to school, or ate with my family, or woke up during the day, or felt like a decent human being. I thought I would only be taking a short break, but I’d never felt this exhausted in my whole life. I told my mom I wanted to go back to my old school, where it was culturally diverse and I still had friends, and I did. This is a story of an international family, which is characterized by the family moving countries every few years. Often times, the moving decisions are decided by the parents, where the children in the family just tag-along. Although children have to move with their parents, it’s important to have a discussion with your children and let them participate in choosing the new school environment that they are going to be in. The decision process should be a collaborative one. Teenagers are at the developmental age where their relationships with their peers are of crucial importance. Culture shock can happen at different levels, but when there’s strong cultural discrimination at a new school both amongst students and faculty, it could put your children at a high risk of depression and anxiety. It is vital to monitor their adjustment to the new environment based on their emotional wellbeing. This can be done by having regular conversations about their concerns, fears, as well as new learning and achievements in school. We would like to remind parents who have always had high expectations for their children that communicating to your children the following information would make your communication with your children more open, honest, and effective. It would also provide them a space where they can go to get support if they do need it. First, everyone fails and it’s normal. Embrace all the feelings that come along with the failure, such as insecurities, frustration, sadness, disappointment, or even anger. Second, when you fail, I am here to support you, I still believe in you and I love you nonetheless. Lessons we take from failures that are valuable, and we can learn from them together. CandleX’s Resources Are you or a friend in a Crisis? Crisis Support Your questions on mental health | CandleX Classroom https://www.candlex.cn/classroom Depression stories from our community members (both adults and teens) CandleX Column | Community Writing https://www.candlex.cn/community-writing A CandleX production on Depression The Tiny Little Box | A Documentary on Depression CandleX Wechat Groups all ages, add our admin: Zingyzinger for 15-22 year old, add our admin: amaraprenderyya Peer Support Group biweekly meetings