Dealing with Mental Health Stigma during a Global Pandemic

The heart race of an anxiety attack always came with an uncomfortable familiarity to me. I knew it so well that the moment it would begin, I expected failure.

Next would be the stomachache, nausea and dizziness until the anxiety collapsed into complete hypersensitivity.

Things would become too loud and pain would feel sharper.

My breathing would become harder to control—it felt like being backed onto the edge of a cliff, until there was no room left—I would just fall and break down.

In the aftermath I would feel extreme embarrassment and shame and the worries of having another anxiety attack would begin looming. I became tormented by the sheer thought that pain is inevitable in life, that the days aren’t certain before they’ve begun—that I could possibly encounter failure and wouldn’t be able to handle it when it came and the cycle would always continue.

However, the hardest thing is when you expect everyone to understand but instead you are received with indifference; a plethora of psychological and emotional invalidation in forms of backhanded advice, subtle disregard, or simple ignorance.

I expected empathy from my Pakistani community but, I was shown the latter.

 

poem:

i remember the sky being so blue and the sun being so bright

 

at 12: i awakened on the floor, a bright light emerged from the darkness.

my science teacher hovering over me: you fainted, it’s going to be okay.

this can’t be happening right now, i hyperventilate.

at the hospital they make me follow a light: you had an anxiety attack.

my parents say: the ambulance, the emergency room, this is going to cost us. eat more and maybe then you’d stop being so weak.

 

at 15: i awakened on the floor, a bright light emerged from the darkness.

my math teacher hovering over me: we heard a loud bang, and you were on the floor. we called the nurse.

this can’t be happening right now, i hear a laugh, i hyperventilate and it happens all over again.

the nurse walks in: do you want me to call your parents?

i say: no, i just need a few minutes to calm down.

i skip class the next day.

 

1 week later: my doctor refers me to a cardiologist; i mentioned how before i fainted my heart was racing.

at the end, an intern at the cardiologist speaks: do you ever feel lonely? or nervous?

i dont know how to reply, no one has ever asked me this before. i don’t feel comfortable speaking with my mom in the room.

the final verdict from dr. cardiologist: nothing is wrong with your heart. things like this happen—maybe it was because your scarf on your head made you feel hot and you fainted from a hot flash? still, nothing is wrong with your heart.

 

at 16: i am in my mosque praying. i shake as i rise from prayer; as i contemplate my existence. i am overwhelmed and i collapse.

a brown woman in black, picks me up and says: where is your mom?

i say:  i don’t know, i just had an anxiety attack and fainted.

she: you are too young for that. no darling, it is because you are so slim, it makes you weak. come on, eat something.

she drags me towards the food table.

 

at 18: in my college elevator, alone. i’m beginning to believe that i am being closed in and imagine images of the elevator falling. no one can hear my screams. i hyperventilate.

it opens, thank God.

i ran to the first floor, onto the field towards the campus bench.

…

i awakened and the sun rays hit my eyes.

 

1 week later: at the community doctor’s office. i admire the Pakistani flag above the height chart. i feel safe.

my mom leaves the room so i can speak to dr. community alone.

i say: i am struggling. i convince myself that i am dying, i know i am not but once the thought emerges, it really feels like it.

my doctor: light chuckle, it’ll be over by your 20’s. by the way, you are missing a few vaccines.

 

***

My community was where I first searched for comfort and validation for my mental health because of the way I saw mosques filled with hugs and kisses, community gatherings filled with the benevolence of strangers who despite not knowing each other, knew each other. We were family as we were bound by the same national roots and all congregated in a foreign land, trying to make a home. We understood each other’s struggles and shared similar stories of Pakistan and immigrating to New York. In times of physical sickness, we would pray for each other, offer aid and support.

For Fatimah Asghar, community felt like “a dance of strangers in my blood,” as describes it best in her poem “If They Should Come for Us,” “my people my people I can’t be lost/when I see you my compass/is brown & gold & blood…for the fire my people my people/the long years we’ve survived.”

My people, I have always thought them strong, for they are—they have endured the pain and suffering of partition, immigration, economic struggle, and loss and still came out of it alive. Still, I feel there is something missing in our conversations of generational struggle, suffering and resilience: the proper awareness, the acknowledgement, or even the conversation of mental health—I’m speaking about the unspoken.

I’m speaking about the countless number of Brown children whose mental health have gone unnoticed or have been neglected, who’ve been left undiagnosed and then, untreated.

I’m speaking about the countless number of Brown women who were abused for years under their own roof, the same ones who were neglected and shamed, who were told to stay quiet because what will people say?

I’m speaking about the countless number of Brown fathers, homesick and lonely in their empty American apartments, counting the days until their wife and children are granted visas, the same ones who were told that tears on a man are a sign of weakness.

I’m speaking about the older generation, the ones who fled during the 1947 British India Partition, the ones who witnessed massacres, rape and famine, the ones who didn’t process trauma in their lifetimes amidst all the fight for their land and freedom, the ones who were forced to live with it and then struggled to explain their sorrow to their children.

I’m speaking about the lack of connection and trust, the unresolved trauma and generational pain, and the ideologies formed from pain that become embedded in our worldviews—that we must be strong.

I’m speaking about this because it is bigger than my own mental health being disregarded: the neglect of our own generational trauma is one of our biggest barriers to speaking about mental health without stigmatization. The second barrier is the structurally racist histories of our wellness systems founded on racial un/conscious biases and lack of inclusivity of BIPOC.

Beyond my community, finding a balance between an affordable therapist who is inclusive of my truths while also validating my mental health is hard because there really aren’t that many people that look like me in mental healthcare fields or therapists that understand where I am coming from culturally. 

Consequently, unaffordable healthcare, the lack of representation, and the stigma within our own communities creates a cyclic situation where individuals feel not only emotionally rejected by their community but also, are combated with cultural rejection and un/consciousness racism by healthcare workers.

The conversation about mental health care is important now more than ever.

Though stress, anxiety, depression and all-around mental deterioration during the COVID-19 pandemic has been a normal response to the isolative effects of quarantine, constant circulation of death tolls, and fearful media headlines, the stress will and has hit harder in BIPOC communities.

This is due to the fact that the COVID-19 pandemic has amplified already existing racial inequalities, causing an increasing mental health crisis among BIPOC communities with a reduced access to inclusive therapy and unrelieved mental health stigma.

The way we handle this trauma from COVID-19—our resilience—is innately impacted by the way mental health stigma and healthcare functioned prior to the pandemic: through inequality and stigma.

Therefore, during this time our focus needs to be retained on our mental well-being as well as how our healthcare systems and communities have been operating in regards to mental health prior and during the COVID-19 pandemic.

For now and the future, our communities need to begin thinking about the formation of wellness resources that are affordable, diverse, and consider the role of local contexts of BIPOC such as family, socio-economic issues, immigration, etc, when approaching healthcare—resources that allow us to collectively share our experiences without stigmatization; that increase our social connectedness in a time of fear, loneliness,  and struggle.

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