Mental health in China for expats has been an under supported sector. In the capital alone, there are over 200,000 expats (Xinhua Net, 2012). Many are facing the constrains of limited number of psychologists in Beijing, let alone qualified and English Speaking ones; On top of that, mental illness in China is heavily stigmatised, and the ignorance of depression basic knowledge stops the majority to even seek 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 yourself to someone near to you and 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 know who are true family are, both in blood and heart. And more importantly, that this fear is what may 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 the Frequently Ask Question #1: “Should I tell others that I have depression?” followed by to who, when, what and how.
Lesson 4.1: The Art of Telling- to tell, or not to tell
This is the common question people ask themselves when in times of depression, when they know they need help, but have many concerns:
My friends probably will think that I am weak if I told them, wouldn’t they?
Am I going to lose my job if tell them? But if I don’t, I am not really performing anyway…
I don’t want my parents or spouse to worry about me.
This is our advice, for major depression, please do tell others. It’s the first step in seeking help, and just 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 go to “CandleX Classroom” lesson 2 in classroom)
Regardless of what level you are at, the purpose of telling others should always be helping yourself. Everyone has different personalities, environment and coping mechanisms that might work just for them. So there’s never a general yes or no in terms of deciding whether to tell, whom to tell, what to tell and how to tell. It’s to be reminded that, if the possibility of you doing it or not doing it in a certain only serves the “getting out of your chest but not to help you to get support” or saving face” etc., you are not doing it right, it’s not a good decision. Just always use “would this help me to cope with depression better?” as a primary principle.
ACTION: Yep, it’s now time to write it on a sticker and put it on the bedroom wall!
However, here are general guidelines:
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 on the dilemma of telling or not.
For severe depression: you have to tell others! One symptom of unavoidable symptom is repetitive suicidal thoughts, which 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 organs 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.
You remember Marco, CandleX’s Representative, revealed his story of opening up in hope to encourage you to take the 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 to 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: My 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.