The Silent Struggle: Assam’s Dr Deepanjali Medhi, Dr Kamal Nath & Dr Suman Baidya Address Mental Health Crisis Among India's Youth

In the bustling halls of academic institutions across India, a silent struggle unfolds every day, often hidden behind the facade of success and achievement. Behind the bright smiles and academic accolades lies a harsh reality – a growing epidemic of mental health issues among the youth.

A WHO study published on April 28, 2023, says the highest number of deaths among young adults and teenagers happens first due to accidents and second “sucide”. Within the age group 10–24 years, mortality rates are lowest among adolescents aged 10–14, and highest among young adults aged 20–24 years. That is the age when most young adults fall victim to often-ignored mental health issues. Depression and anxiety are among the leading causes of illness and disability among adolescents, and suicide is among the leading causes of death in people aged 15–19 years. Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated. India has one of the world’s highest youth suicide rates. One student took their own life every 40 minutes in 2022, according to the National Crime Records Bureau (NCRB). A total of 13,044 students died that year. In a country like India, where the pursuit of academic excellence often comes at a steep cost, the pressures imposed by societal expectations, familial aspirations, and the relentless pursuit of success have created a breeding ground for mental health crises.

Mental health experts say suicide is a “failure of the society”. Suicide prevention is urgent owing to its repercussions for mortality and means of preventing self-harm. The recent death of an NIT Silchar student has shown the mirror to society and showed how we failed collectively to give space to a young and bright mind. Various sources told Barak Bulletin that the departed young soul didn’t want to continue his engineering but his parents thought otherwise. Police also confirmed that he was “acutely depressed”. The word might be in vogue but to what extent are you aware of depression, how is it different from “just a phase” of feeling low or sad?

Barak Bulletin reached out to three expert doctors, Dr Deepanjali Medhi and Dr Kamal Nath, the Heads of the Department of Psychiatry at Guwahati Medical College and Hospital and Silchar Medical College and Hospital respectively, along with Dr Suman Baidya, a consultant Neuro-Psychiatrist at SMCH. The mental health professionals delved into various dimensions to answer the questions, how to deal with parental pressure, what are the early signs and symptoms of depression, and how can we reach out for help.

Dr Kamal Nath believes it came to the news because the student was from NIT Silchar. Still, many adolescents are today facing mental health issues who fail to address them due to the stigma associated with seeing a psychiatrist. Dr Deepanjali Medhi delves into the root causes of this crisis. Parental pressure, she explains, often stems from a misguided desire to fulfill their dreams through their children, leading to a toxic cycle. But amidst the darkness, there are glimmers of hope. Dr. Suman Baidya emphasizes the importance of open communication between parents and children, urging families to prioritize understanding their children’s interests and aspirations rather than imposing their expectations.

Following are the edited excerpts from the conversations and some useful tips and solutions:

On Parental Expectations: The Good, The Bad, The Ugly

Guwahati Medical College’s Dr Deepanjali Medhi said, “Parental psychology is different. In my understanding, they want to fulfil their dreams through their children this sets a very wrong kind of cognitive error. But again there is another side that the parents pressurise or impose their decisions as they want their children to do well in this competitive world. But if a child has reservations, it leads to negative cognition”.

Dr Kamal Nath believes, “Parental pressure can’t be generalised to say it’s wrong. If you just let one student leave their studies because they don’t like it, then 80% of them will leave because of the competition. Leaving the course is not the solution. He should be properly counselled, and properly guided through systems of relaxation and developing positive mental health. Today the world has become so competitive, there is competition in everything. Parents sometimes just innocently want the best for their kids, which at times comes out to be pressurising. Due to this competition, students are always in stress and anxiety. Different students have different mechanisms to cope with that, some suffer and somehow continue with it and a few make some drastic decisions. This can’t be blamed just on the parents. Parents have different kinds of responsibilities. They need to be aware of the whole situation of their children. They must learn, how their child is coping up”.

Agreeing with this notion by the two doctors in the same field, Dr Suman Baidya said, “My takeaway from Farhan’s character in “Three Idiots” is that parents should try to find their kid’s interests and help them develop skills related to their interests. Everyone is different. It is better for the parents and to some extent the teachers to find out what the child finds interesting as a subject and guide them towards that stream or subject for higher education”.

The doctors said, that forcing a child against their decision without understanding their side of the story can lead to mental illness, starting with negative emotions and thoughts, leading to depression and anxiety. “What we need to understand about depression is that it is not natural and it should be treated just like any other illness of the body.”, further said Dr Medi, “ When a person has depression, they will feel low, and their self-esteem and confidence will be low. Such mental illness should be detected early and taken care of. Unfortunately, our society is still not psychologically oriented to identify anything other than physical illness”.

Awareness: The Dos and Donts

Dr Kamal Nath weighed in on this to say, “Awareness and early detection is missing. We must know what are the warning signs of mental illness, depression and psychotic illness. A common man might not know them and that is where the collective responsibility lies, we must all work together to spread this message and be aware of everyone. It is not just for the students, it is for everyone”.

Dr Medhi emphasized that teachers, classmates and friends are the people who can better identify symptoms of depression these days because a child spend the most amount of time with them compared to their parents. Dr Kamal Nath also agreed to this specification and added that if one does, they should inform a competent healthcare provider.

Coping Mechanism

When asked, why are students failing to cope with stress these days, Dr Medhi replied, “Parents are also responsible for this to some extent. If one is too coddled, they fail to make decisions in life. You have to let them learn how to fly. If they are overprotected then there is a problem. These days children don’t have friends. They run from one academy to another. After school, there is no time for a kid to play and even if they do, they go to an academy where there is again competition”. On this Dr Suman Baidya added, “When we were children, we would go out to play with friends after school, we would fight and resolve on our own. In some way, it helped me to develop a kind of stress-coping capacity. Up to Class 12, parents now are taking away all the problems from their child and suddenly when they end up at a hostel far away from home, there will be some adjustment issues with peer groups and college and they feel like they are in an ocean with a radarless boat. That can lead to getting into self-destructive mode. At this stage, they can’t even share these difficulties with their parents”.

On this, Dr Nath added, “Primarily the coping capacity demands the personality of the individual, childhood experiences and training, and whether the individual is already suffering from any mental illness.

Should the student facing parental pressure at home go for counselling or should the parents see a doctor?

To this, Dr Medhi said, “Both parents and children need to get counselled and the stigma around mental health should be removed, they should be open to solving the interpersonal conflict. There should be open communication. In cases of no communication, they should see a competent authority, a qualified counsellor. Mental health is about brain health, which develops at every stage of life. You learn about coping skills and mechanisms and you grow older”.

Taking a hit at the teachers at institutes of Higher Education, the top mental health expert of the state said, “I don’t understand their ego. It just shows their pent-up passive aggression coming out on the students. Just because you are a faculty of NITs or IITs or Medical College doesn’t mean you can’t be lenient on your students. A student is leaving their parents and family and home at such a tender age for a hostel, so why be harsh and cruel towards them? Communication should be without any prejudice. PhD guides in such institutes should be careful. I remember a case from one IIT, where a girl was doing her PhD and the guide made her life hell. She was a little introverted which resulted in her psychotic illness and she developed schizophrenia”.

Open your hearts: Both Parents and Children

On establishing communication with parents, the HoD of SMCH said, “Depends on childhood experiences and relationship. Right from an early age, warm relationships and open communication should be developed with a kid and maintain that environment. At the age of 21 or 22, it is difficult to change the relationship between the parents and their children”. Dr Medhi on the other hand opined, “Those who can’t communicate openly with their parents can write to their parents or send messages or make them alert through a third person if they are facing any such issues that needs attention”.

A collective responsibility 

Whose responsibility is it to prevent a person from escalating into a situation where they take any drastic step? Answering this question, Dr Nath said, “There are a lot of people on whose shoulders the responsibility lies, starting from the individual himself, friend circle, peer group, and roommates if they are staying in a hostel. If a person is feeling low or anxious if they are sleep deprived, their appetite is low behavioural changes, loss of concentration and weak memory, these are the early signs of someone succumbing to stress. We need to circulate this awareness in the institutes. Those who feel these changes and come out seeking help on their own, there we can do something. But if someone doesn’t understand the need to seek help, that is where the need for awareness comes in. People must be aware that if they see anyone facing any mental illness they should accompany them to a caregiver, a counsellor or a psychiatrist.  Otherwise, the matter can escalate into an emergency with the individual developing serious mental illness or depressive disorder. Depression and anxiety are treatable problems and we are failing to communicate this message”.

What to do if you are suffering from mental health issues, where to go? Dr Nath replied, “Our Psychiatry OPD is open 24×7 for any emergency and routine problem. Doctors are available round the clock. My advice to any patient visiting us, come with a person of trust as the attendant. You can come alone but it is important for comprehensive, better treatment and management If a person comes to the hospital and is diagnosed as having suicidal tendencies, we can at least inform the attendant to take care of them give them the medicines on time and take care of the follow-up checkups”.

The Grim Reality

Dr Suman Baidya also talked about the Kota Coaching Industry situation and said, “Many students are committing suicide, and many are going missing because of this pressure. They are being sent at such a young age. Along with the pressure from parents for IIT JEE and NEET and then the coaching institutes who are just after ranks and number of selections. Comparing their children, mostly with the toppers is another mistake parents make. Pressure is the same for everyone at a coaching centre, but different people have different coping capabilities. If s/he is stressed out, s/he might be weak from the inside ultimately leading to high suicide rates in Kota. I request the parents to spend that time discovering what their child is good at and find their skill set. Academic prosperity is not everything”.

• About the reason why GenZ suicide rates have spiked, Dr Baidya said, “ With urbanisation, our familial structure has also changed. From joint to nuclear families where both the parents are working. So they spend less time with their parents, plus don’t even have cousins or the chance to interact with other children in the same colony. This culture is diminishing in most urban sprawls”. According to the doctor’s estimate, 70-80% of suicide cases happen due to depression and anxiety and it is increasing day by day.

What are the early signs of a person’s depression?

Answering that question, Dr Baidya said, “It is a psychological matter and we diagnose through various observations and tests. Depression is different from feeling low, you might feel low for two hours to even two days, then wake up the next day feeling everything is okay, we can’t call it depression. But for general understanding, I can say that, if a person has a low mood, doesn’t find interest in anything, they can’t derive pleasure from the earlier enjoyed things, feeling lethargic and easily tired. If this continues for more than two weeks, along with feeling helpless and that every bad thing is happening to them, then it can be said the person is depressed”.

“What parents or teachers and friends can observe is that, if they are not communicating with their friends, interacting with the teacher like they used to, or they are unable to concentrate in the class they’re not present in the situation mentally, these are the early signs of depression. Another major change will be disturbance of sleep, not getting proper sleep. If earlier they used to wake up at 7 in the morning and now they are waking up at 4 or 5, then they should seek help”, further said Dr Baidya.

The good side:

Seeking help is visibly increasing said Dr Baidya. The stigma associated with mental health issues and madness is reducing. In some cases, you need counselling and in others you need medicine. If parents can understand these issues and send their children to the counsellor then only our society can change because society starts from the families.

When we move away from a very result-oriented education system, we can expect things to change. Especially in higher education only pass and fail should matter, said Dr Medhi.

As a civilisation, we consider ourselves advanced and in such a civilisation, mental health should not be a taboo and be considered just like physical health. Today only worst-case scenarios are addressed. Early detection of mental imbalance and illness can be treated easily with the onset of symptoms. Then the person will not escalate into mental instability. We should create an environment of positive mental health, not just treat the negative aspects concluded Dr Nath.