From “what will people say?” to “this is all modern day hullabaloo”- in most South Asian households, mental health remains a taboo topic, even in the 21st century. In my 9 years of psychotherapy experience, where I have largely worked with young adults from the Indian diaspora, living across India and abroad, the most common complaint which these clients have about their families, is that, “sharing struggles with our family is not a possibility, they just won’t get it”.

Understandably so, most young adults from South Asian families who are seeing a therapist feel the need to hide this part of their life from their parents for the fear of being judged, or from the fear that they will be forced to stop therapy. Many South Asian households still believe that talking about mental health openly is shameful--they view it as separate from medical health, and sometimes believe that there is an evil power being the troublemaker instead of confronting what is really going on.

Mental health concerns are very common among South Asians; for instance, a recent study published in The Lancet (Psychiatry), in February 2020, has reported that there are 44.9 million people in India with a diagnosis of an Anxiety Disorder.

So, how does anxiety manifest in South Asian households? Based on my clinical experience and readings, here are the most common ways:

1. Anxiety manifests somatically: What does this mean? Well, a lot of people with anxiety present with unexplained bodily complaints, also known as psychosomatic complaints. Some common ways in which this manifests is, aches and pains in unrelated parts of the body, frequent respiratory issues like cough, cold, & flu like symptoms and gastrointestinal issues like irritable bowel syndrome, constipation, indigestion, etc. These somatic complaints are recurrent and often have no strong explainable biological reason.

2. Performance Anxiety: South Asian households often emphasise a significant amount on academic and career performance, from a very young age. This often leads to a major chunk of young adults, growing up with unaddressed performance anxiety. People also start basing their overall self-worth on their academic or professional performances.

3. Social Anxiety: Since many South Asian families place a lot of importance on social approval and people’s opinions, children in these households grow up with the same anxieties as their parents, about people’s judgments on their actions. This manifests in different ways for different people, but the most common manifestation includes panic attacks before entering social situations, excessive preoccupation with being negatively judged and sometimes, even complete social withdrawal.

4. Health Anxiety: In my clinical work, I see about 5-6 clients every single week with health anxiety. These are young adults in the prime of their physical health. Most often the trigger is an unexpected illness in the family which is often talked about obsessively, by the rest of the family members. Clients with health anxiety are usually preoccupied with imagined health concerns and go to any lengths to seek reassurance that they are physically healthy; unfortunately, the impact of these reassurances is temporary.

5. Substance Usage: A lot of young adults are increasingly resorting to consumption of alcohol, smoking and other substances in order to cope with their anxieties. Substance usage is a common sign of the underlying anxiety and fuels a negative behavioural – cognitive loop.

If you or someone you know is displaying any of the above manifestations of anxiety, do get in touch with a psycho-therapist, and ensure that they know they are not alone and there is professional help they can seek.