The provision of mental health care for expats in China is not adequate. In the capital alone, there are over 200,000 (Xinhua Net, 2012) expats. Many are facing the constraints of a limited number of qualified, English speaking psychologists in Beijing. Mental illness in China is heavily stigmatized, and people’s ignorance of depression prevents the majority of Chinese nationals from seeking help.
One of the great fears for those living with mental illness is that in revealing their struggles to others, even close family and friends, it will result in incomprehension at best and severe judgment and social derision at worst. To open up to someone near to you and then be judged as weak, melodramatic, crazy or even worse is certainly a terrifying proposition. But what is so easily forgotten is that discovering the compassion of others is how we truly know friendship, and how we discover who our true family are, both in blood and heart. This fear may also hold us back from an even more amazing experience: the opportunity to show compassion to others.
Welcome back to CandleX Classroom!
In this session, we’ll discuss the important topic of self-care by answering some frequently asked questions: “Should I tell others that I have depression?”, “And if so, who, when, what and how?”
These are common questions people ask themselves during periods of depression. They know they need help but may have concerns about asking for it. Some common concerns people have are as follows:
Will my friends think I am weak?
Am I going to lose my job if tell them? But if I don’t, I am not really performing anyway…
Is this going to make my parents or partner worry about me?
This is our advice; if you have depression, please do tell others. It’s the first step in seeking help. Be aware that not everyone will understand, or know how to respond to that. But some will, and they’ll be your life pillars through the episodes.
Level of Depression is the Primary Factor for Consideration
There are different levels of depression: mild, moderate and major depression (for more details on the symptoms, please refer to Lesson 2.
Regardless of what level you are at, the purpose of telling others should always be helping yourself. Everyone has a different personality, environment and coping mechanisms. And so there isn’t a general yes or no in terms of deciding whether to tell, whom to tell, what to tell and how to tell. Those questions need to be answered by you. You can do it in whichever way feels the most suitable for you. The main question to ask yourself is. “Will the help me to cope with my depression better?” This is the primary principle and is more important that concerns over saving face.
ACTION: Yep, it’s now time to write this question on a sticker and put it on the bedroom wall!
Here are some general guidelines. Remember that you can accept or reject or adapt these guidelines to whatever is easiest for you.
For mild-moderate depression: telling others is not as important as following the doctor’s advice: good night sleep, exercise, nutrition, and mental health counseling, etc. If you can manage to get these done, you are on the way to recovering on your own. Telling is only very much needed if you think you need external supervision/support to get you on a healing track. Focus your energy on getting things on track in life, instead of being stuck with the dilemma of telling or not.
For severe depression: you have to tell others! One symptom of unavoidable symptom is repetitive suicidal thoughts, this is life-threatening. On top of that, severe depression comes with severe cognitive impairment. It has a substantial negative impact on your social life, intimate relationships, work performance and even daily routine functions like getting out of bed or taking a shower. By that, we mean, you need external help to get you through it because you’ve lost the basic functions temporally.
There shouldn’t be any shame in this. Just like any other organ in our body, our brain does get sick, it’s just invisible and less understood by our society. (Go to CandleX Classroom Depression Essentials Series: Lesson 3 Causes of Depression to understand why it happens). So when we are sick, we tell people that need to know so your boss will allow you to take sick leave, and your loved ones will bring your chicken soup, for the soul.
Marco, CandleX’s Representative, shared his story of opening up in the hopes of encouraging you to take this step too.
3 years ago, having suffered a severe breakdown, I responded by opening up to my family and friends, of whom there were many, purely as a matter of survival. If those around me were not aware of what was happening to me during a severe episode, they would have no way to help, and if they weren’t there to help, I might not make it the next time. The effects were lasting. I quite quickly had a support group that I could rely on as my faith in them had not been misplaced.
What’s more, my openness led others to reveal to me that they had similar struggles that they had always been too afraid to share, and it was my honesty and lack of humiliation that allowed them to speak up as well. They knew that I had some sense of what they were going through; I would not be one to judge. And I began to see myself as one among a group of people that formed a special sort of club, one in which we shared a language of adversity that only we could truly understand, but to which those who were willing could also listen to.
In receiving empathy and compassion I found courage, and in giving it, I found meaning. For it is in the light that we can enjoy the company of others, but only in the darkness that we find true friendship.
For Marco’s full story, you can find it in CandleX column: Marco’s Story with Depression.
Do not forget, our peer support group for people with depression in Beijing is a safe and confidential space for you to start the conversation. Take baby steps. We are here to hold your hand.