I was 18 when I started to lose my mind.
Some days it felt as though a giant wrench was clasped around my neck, slowly strangling me, until I was ready to squirt all the air, water, and blood inside. Other days, I bloated and bloated like an overblown balloon, ready to burst.
The sensation in the end was always the same: empty.
I am told I had a grandaunt, Mejo Thakuma, who was possessed by a spirit when she was pregnant with one of her three children (each one named after a Hindu god to ward off the evil eye). She’d eat chunks of dirt and speak in an unearthly voice. Her family chained her up, scared she would wring someone’s neck. One day they called an ojha, who beat her with a broomstick and drove the spirit away.
After hearing the story of what happened to Mejo Thakuma, I became terrified of being possessed. And now, I was.
The thing inside me made me burn the skin of my palms. It made me drink too much vodka and beer and whisky and wake up in the middle of the night, unable to open my eyes because they were coated shut with crusty vomit. It made me repulsive and unrecognisable to myself.
It was 2001, and I had just started college. It was supposed to be fun. I was supposed to be fun. Instead, I was sinking into a bottomless pit of guilt, shame, and self-loathing.
I was in a strange place, among strange people: New Delhi, 1,300 kilometres from my sleepy, provincial hometown of Durgapur in the east of India. Back home, we were all the Bangla-speaking children of industrial labourers. Suddenly, here I was, in a college venerated as “India’s Cambridge”, studying English literature alongside the children of ministers and bureaucrats.
The initial culture shock had been severe, but I did well in exams, even winning an award for my contribution to college life. Then, I went mad.
A shared struggle against madness
The following year, a rare remaining friend, fed up with my freefall, insisted I see the college shrink - an unfamiliar presence on Indian campuses. “Depression” was his diagnosis. So, no nasty spirits … phew.
Relieved as I was to learn I wasn’t possessed, I still had to get my head around this discovery: wasn’t “a depression” just another term for bad weather? What do I do with this new identity?
My fancy new Delhi friends, the nosy uncles and aunties I had left behind in Durgapur, we were all locked in a struggle against madness
The answer came from the work of a man who died a drunken wreck. Urdu writer Saadat Hasan Manto set his 1955 short story, Toba Tek Singh, against the backdrop of our independence from British colonial rule, and the partition that created India and Pakistan.
In Toba Tek Singh, a lunatic exchange on the basis of religion is arranged between the two newly-formed nations: Hindu and Sikh pagal in Pakistani asylums would be sent to India, and Muslim patients in Indian asylums would be sent to Pakistan. The absurdity of this arrangement blurred the lines between the sane and the insane.
“If they were in Hindustan, then where was Pakistan?” Manto writes, describing the torment of the inmates. “If they were in Pakistan, then how could this be, since a while ago, while staying right here, they had been in Hindustan?”
Manto invoked the madness in our origin story which, until then, had remained to me, as it did for many of my generation, too distant to comprehend. His essay also helped in other ways: it made clear that I wasn’t alone in my unraveling. My fancy new friends, their important families, the nosy uncles and aunties I had left behind – we were all locked in a shared struggle against madness.
Mental illness isn’t sexy, but it’s urgent
“Depression affects everyone on the planet, directly or indirectly, in every possible sphere,” writes Canadian journalist Anna Mehler Paperny in Hello I Want to Die Please Fix Me: Depression in the First Person. “Its very ubiquity robs it of sexiness but not urgency.”
According to the World Health Organization (WHO) depression and anxiety cost the global economy US$1 trillion a year in lost productivity. The organisation also reports that suicide, of which mental illness is a major cause, is now the second-leading killer worldwide among 15 to 29-year olds. Every 40 seconds, someone kills themselves. For every successful attempt, there are several failed ones.
A 2016 survey , based on a sample of the population, estimated that over 13% of India’s 1.3 billion people have experienced some form of mental illness at least once during their lifetimes.
There is more. According to estimates by medical journal The Lancet, 230,000 people in my country die by suicide each year (I’ve had two in my family). Official estimates are lower, because the stigma means many cases certainly go unreported.
Reading this in the US? There, for the overall population, suicides are the tenth-biggest killer.
You don’t have to belong to a bereaved family to feel the blow. New research calculates that up to 135 people are affected by a single suicide.
Then there is the connection between mental and physical illness. Again in The Lancet, researchers state the connection with diabetes: “Serious mental health disorders - including schizophrenia, bipolar disorder, anxiety disorders, and major depressive disorder - occur in a larger proportion of patients with diabetes than in the general population. Similarly, development of diabetes is more common in patients with serious mental health disorders.”
The implication of all this is unambiguous: a public health time bomb is hovering above us.
Why talking about the mind is so difficult
The evidence that we need to act now is overwhelming, and yet, attempts to understand the human mind suffer from a glaring lack of global voices. “Our psychology literature is ... based on research [into] a very specific subset of the world population,” says cultural psychologist Jessica Deere, who describes this subset as Weird: western, educated, industrialised, rich, and democratic.
Building a global research base will be slow. In the meantime, another necessary action is possible, but not without its own challenges: talking to each other.
When the media industry trains its eye on mental health, it often makes the problem worse
Mental health conversations can be a minefield. I had to learn, for instance, that saying someone “committed suicide” isn’t ok, because “committed” suggests suicide is a crime – which it still is in many countries. The impulse to describe mental illness as “dark” or “black” is equally problematic.
Even when a language is rich in so many ways, it sometimes provides few avenues into discussing mental health. "Shorir theek achhe?" my parents ask me when we speak. It literally translates as “how is your body?” They have no easy way to ask about the state of my mind.
Media coverage tends to be confined to vacuous self-help advice or part-time projects assigned to busy health reporters. When the industry trains its eye longer on mental health, it often makes the problem worse. As part of an informal advocacy group on Twitter, I routinely confront editors who turn delicate stories on suicide and mental illness into clickbait by disclosing personal details or using triggering graphics with zero regard for ethical boundaries.
Arguably at the heart of the challenge to have more nuanced conversations about mental health is the fact that focusing on issues of the mind is not politically expedient. Other diseases, from Aids to cancer, and a plethora of non-communicable diseases, neglected tropical diseases, and new pandemic scares, are all competing for public attention and private investment.
The ‘sick’ vs ‘healthy’ binary is constrictive, as is the emphasis on treatment over prevention. As Manto taught me, there is a link between the political and the psychological as is evidenced by the disturbing cycle where individuals with mental health issues are lured into dangerous political beliefs, while simultaneously, aggressive nationalism, which requires a strong, homogenous state to succeed, casts off vulnerable people – those different from ‘the norm’ – as inconvenient.
The pursuit of sanity is about regaining agency
In 2017, at the peak of a depression that saw me leave a job, abandon a book deal, and become a hazard for my pregnant wife, I started a public diary of my illness on social networks, Twitter and LinkedIn. The response was immediate – and incredible.
From Indianapolis to Chennai, strangers said my story was also theirs. "I’m sitting in church, by myself," wrote a veteran from Utah. "I’m by myself because I don’t like being in large crowds and I don’t feel like I can relate to most people. Then I saw your article and thought, ‘well, there’s at least one that understands.’"
I now want to join forces with you, The Correspondent’s 50,000+ members in over 130 countries. Together, we can help drag mental health out of the shadows.
This is the ‘sanity’ beat because we need a new direction in our thinking about mental health. It is time to ask the deeper questions about the human condition that traditional, news-driven health reporting rarely has the desire or the bandwidth to.
There are obstacles to progress, but there are also exciting new developments that are resetting the way mental illness is perceived and treated.
Tech-based solutions, ranging from therapy bots to virtual-reality headsets, are being launched by the dozen; the intimidating, monolithic idea of ‘mental illness’ itself is being broken down into more manageable parts - such as burn-out. This will hopefully shift the focus to identifying stressors in our environment that can be fixed before someone gets sick.
As popular culture catches up (Bollywood star Deepika Padukone and Hollywood actor Dwayne Johnson are just two examples of celebrities speaking out about their struggles) new space opens up in the media.
I worry about the shame of ‘weakness’ that makes young people kill themselves rather than speak up
Finally, and perhaps most critically, politicians are taking tentative steps to make mental healthcare a right. India has recently enforced a model law that recognises the parity between mental and physical illness. Ahead of this year’s general elections, two national parties did the unthinkable by adding mental health to their manifestos. Prime Minister Narendra Modi has spoken about depression from public platforms, but India’s budgetary allocation to mental health remains abysmal.
Sanity is the guarantee that if your mind is sick, you’ll get the best possible care. It is knowing that you won’t be fired because crying at work proves that you "can’t handle it".
Sanity is the right of voters to shout: "Give us a better deal, or else!" It is access to the kind of knowledge that helps everyone locate the amygdala in an image of the brain and know that’s where their flight response is manufactured. It is being empowered enough to question every pill you put in your body.
As the father of a 19-month-old boy, who once feared in isolation for my own mind, I worry about the shame of “weakness” that makes young people kill themselves rather than speak up. I am angry at the hierarchy of disability, within which the invisible illnesses of the mind occupy the lowest rung.
The pursuit of sanity is about agency and information, conversation and compassion. Because as Paperny says so eloquently: “Even if you never best it, never loosen its grip on its existence, at least your best attempt at understanding will give you some semblance of agency.”
If any of the issues raised in this piece resonates with you or someone you know, please know you don’t have to suffer in silence. Seek help.
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