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In the era of networks and technology, human beings are thriving in various ways. However, when it comes to mental health, particularly in Nepali society, everyone either wants to twist the topic or feels too shy to talk about it. And those who talk about it usually delve into the negatives. Why do people hesitate to talk about mental health? Why is stigma attached to the subject? I have been asking people about it for seven years. As a psychologist and founder of the mental health clinic PICS NEPAL, my job is to help people overcome their mental health issues. But the irony is even my own family is hesitant to openly discuss the topic of mental health. There might be various reasons, mainly a lack of education or awareness.

The word education is a process of enlightening people, from darkness to light, zero to everything. In other words, it empowers people with practical skills and knowledge. Imagine villages transformed by roads and airports built by engineers—a testament to the transformative power of education. Similarly, education can illuminate the darkness surrounding mental health. Yet, our current education system fails to prioritize this vital subject. Every family wants to make their child an engineer, a pilot, doctor, or a banker. However, nobody wants to make their child a counselor, psychologist, or psychotherapist. Although people are being educated and have all the facilities from the road to the airport, they still haven’t changed their mindset about mental health.

Changing the public’s mindset is also related to the nation’s education system. If everything has been achieved through education, then why not the perception of individuals? But the primary thing is it should be on the priority list of the government. If a government can change the mindset of voters towards a political party within five years, then why not about mental health? Nothing changes overnight, but if it is in a will list, nothing can stop it. The viewpoint towards mental health, a crazy state, being unconscious, psychosis, loss of control, furious, abnormality, and peculiar behaviors, even if it’s because of sinful activities by their parents or grandparents in some places or a god’s actions against your behavior in some areas, are common in the society. But mental health is quite different than the way people have been assuming. It is a state of well-being in which people can work regularly, help their communities and effectively overcome their daily life stressors. This is a bitter truth, but I found a similar understanding among all the so-called educated people regarding mental health issues. They see it as a state of madness, crazy, and psychosis that cannot be treated. Immediately, questions arise: Do they even have basic knowledge about mental health? What have they studied in their school/ college?

Is education far from the basics of health, or is it simply the ignorance of basic knowledge? A bunch of questions arise when I see the current scenario of our country. In my opinion, it’s not only people’s negligence but also the education system. Our basic education system has to cover health education at its primary level to make people conscious of their health, specifically their mental health. The school curriculum must be reformed. It needs to be practical, useful, and relevant.

Hundreds of thousands of youths are suffering from mental health disorders. According to the national report of government 2077, the burden of mental health among non-communicable diseases is almost one-fifth. People struggle each day to survive, around 20 per day, but can’t; the suicide rate has increased over the last couple of years.

Mental health matters a lot, but the government education system teaches something different in school. To become competent and robust enough to cope with everyday life stressors, one should be informed earlier. School curricula should teach today’s kids about their minds, thoughts, and behavior. Education doesn’t always mean teaching complicated equations and complex word meanings. It should also teach children ways to fight, cope, and overcome the everyday stressors, which could help them lead a happy and healthy life. '

Teaching in school about mental health will help an individual at a greater level and create awareness in the family. The child will talk about mental health and will do homework on mental health; they will be obliged to teach their families about mental health. It will minimize the stigma and prejudice regarding mental health, which will ultimately lead to easy access to mental health as physical health.

Sometimes, we talk about a big topic but miss the small one that has a more significant impact. Let’s initiate a talk about mental health at school, in the workplace, in coffee shops, in the film industry, and in business. Until and unless we talk about it openly in different places, I don’t think we can create awareness regarding mental health.

The role of the media is also crucial to create positive debate about mental health. Media has the power to shape public discourse. Instead of sensationalizing individual cases, it should focus on normalizing mental health conversations. Open discussions and expert opinions disseminated through various media channels can break down existing stigmas and encourage individuals to seek help.

So, let’s all spread positive messages to boost the self-esteem and confidence among those in need—and I believe everybody needs it. We all have a mind (psyche) that controls and regulates our thoughts and imaginations; we might be in trouble at any point, so we all need to take care of our mental health.

The author is counseling psychologist and founder of PICS NEPAL: A place for mental health and psychosocial well-being

I’m in my early 40s and have recently lost someone very dear to me, a close family member. The grief has become this heavy, complex emotion that I find myself wrestling with daily sadness, anger, and an overwhelming sense of emptiness. Simple, everyday activities feel like monumental tasks, and there are moments when waves of sorrow hit me unexpectedly. What can I do to manage this pain?

Answered by Rishav Koirala, researcher and physiatrist

Grief is a complex and deeply personal experience, and the emotions you’re feeling whether it’s the weight of sadness, the intensity of anger, or the overwhelming sense of emptiness are entirely understandable. Facing such a significant loss in your early 40s adds another layer of complexity, as life transitions and responsibilities might already be demanding.

It’s crucial to recognize and embrace the spectrum of emotions that accompany grief. This multifaceted journey often involves navigating through different stages, and it’s entirely normal to feel a mix of emotions at various times. In your mourning process, seeking support is paramount. Whether you turn to friends, family, or a mental health professional, sharing your thoughts and feelings can be therapeutic. It creates a space for understanding and empathy, helping to alleviate some of the emotional burden.

Taking care of your well-being is a vital aspect of coping with grief. The toll that grief can take on your physical and mental health is substantial. Prioritize self-care by ensuring you get sufficient sleep, maintaining a balanced diet, and engaging in activities that bring you comfort or joy, even if they are small or simple.

Recognizing that grieving is a gradual process is important. There’s no set timeline for healing, and every person navigates this journey uniquely. Setting realistic expectations for yourself allows room for the ebb and flow of emotions. Establishing meaningful rituals or routines to honor the memory of your loved one can provide a sense of connection and continuity.

If the weight of grief becomes overwhelming, considering professional help is a valid and beneficial option. Therapists or counselors can offer specialized guidance tailored to your specific needs, providing coping strategies and emotional support. Additionally, joining support groups where individuals share similar experiences can be a source of comfort, understanding, and shared wisdom.

Remember that it’s entirely acceptable to mourn at your own pace, and seeking professional guidance doesn’t diminish your strength but rather enhances your ability to navigate through this challenging period. In your journey through grief, be patient with yourself, allow for moments of reflection, and embrace the support available to you as you work towards healing.

Is it a common experience for individuals to undergo negative emotions in a relationship when apart from their partner, potentially influenced by past relationship issues? Furthermore, can feelings of insecurity and overthinking, stemming from past relationships, contribute to arguments with one’s current partner?

Answered by Rishav Koirala, researcher and physiatrist 

Occasional occurrence of negative emotions when separated from one’s partner may be a common feeling in many people.  But when it’s associated with overthinking even small things leading to anger and argument, we have to explore psychosocial issues.

Everyone’s current experience is influenced by past experiences and in a few it may lead to imprinted emotions which might have a negative influence on current situations. The first step to deal with it is by engaging in a thoughtful exploration of these emotions by yourself. Start by reflecting on the specific aspects of your past relationship that might be impacting your current one. Identify any negative experiences or unresolved issues that could be contributing to these feelings. Self-reflection can be a valuable first step in understanding the root causes of your emotional responses.

Following self-reflection, consider addressing these identified issues. Open communication with your current partner is key. Sharing your concerns and feelings fosters understanding and support. Be transparent about the impact of your past experiences and work together to create an environment of trust. Discussing these matters openly can contribute to a healthier and more empathetic connection.

Recognize the potential role of personality traits, such as attachment styles, in influencing your emotional responses. Individuals with anxious attachment styles, for instance, may experience heightened concerns about separation. Another aspect could be Borderline Personality Traits that have a substantial impact on the relationship of the sufferer. Insecurity, increased emotional sensitivity, and impulsive behaviors may lead to arguments and relationship issues if one has these traits.

Understanding these traits, both in yourself and your partner, provides valuable insights into the dynamics of your relationship. If your past relationships have had a big impact on you, it might have led to anxiety issues. People with anxiety issues tend to misinterpret things and have negative thoughts that can lead to negative emotions such as anger and irritability. This might also be one of the reasons why you jump into arguments by overthinking minor things.

If you are not able to resolve the issues by yourself or with the help of your partner, seeking the guidance of a mental health professional is highly advisable. They can help you to delve deeper into these emotional complexities and develop effective coping strategies. A psychiatrist or therapist can assist in identifying and addressing specific concerns related to your past experiences, attachment styles, and any anxiety you might be experiencing. This professional support can contribute to personal and relational growth, providing tools to manage and overcome these challenges. Simple modalities such as meditation, and relaxing exercises such as yoga can also help you achieve these goals to some extent.

I’m a 35-year-old man and I’m struggling to balance my duties as a son and a husband. My wife doesn’t get along with my mother and my mother isn’t particularly fond of my wife either. They get into arguments very often and both of them expect me to take their side every time. I try to stay out of their issues but I feel like it’s my responsibility to sort things out between them. I feel helpless when I can’t. What can I do?

Answered by Rishav Koirala, psychiatrist and researcher

Balancing the relationship between your mother and your wife can be a formidable challenge. To address this conflict effectively, initiating open and honest conversations with both your wife and your mother is a crucial first step. This allows you to seek their perspectives and express your concerns openly. 

It’s essential to establish clear boundaries that encourage both parties to interact civilly and respectfully, even if they don’t become the best of friends. If conflicts persist and mediating becomes difficult, consider seeking professional help, such as couples counseling or family therapy, which can provide a neutral space for everyone to express their feelings and work towards resolutions.

Moreover, it’s important to encourage your wife and mother to develop their relationship with each other. While they may not become close friends, fostering some understanding and mutual respect can significantly improve the overall family dynamic.

In moments of conflict, strive to be a fair mediator, remaining calm and unbiased. Avoid taking sides and focus on finding common ground and practical solutions. Prioritize your marriage, and your relationship with your mother as well investing time and effort to maintain a strong and healthy relationship with your wife and your mother. This can contribute to an improved family atmosphere.

Most importantly, don’t forget to take care of your well-being, as dealing with family conflicts can be emotionally draining. Seek support from friends, support groups, or a therapist to help you cope with the emotional stress. Keep in mind that resolving family conflicts takes time, so approach the situation with patience and empathy. By focusing on communication, setting boundaries, and being open to positive relationship evolution over time, you can create a more harmonious environment for everyone involved.