MENTAL HEALTH ACROSS BORDERS

By Megan Camlasaran

Stephanie Charitar and her mom Leela Mangroo sit at their dining table every night in the comfort of their quiet apartment made for two. They discuss the events of their day, which often leads to larger discussions about life. One evening, Stephanie recalls, Leela began talking about one of their family members who she believed was suffering with mental health issues but would not seek the “help they clearly needed.”

Stephanie interrupted her mom mid-conversation to remind her that not everyone wants “spiritual help” when it comes to mental health. The two bickered back and forth about whether spirituality is the best approach to mental health like in Guyana, Leela’s home country, or if the medical and therapy approach Stephanie has known growing up in Canada is more effective. Tensions ran high, the frustration boiling up in Stephanie, knowing this was a debate neither of them would win. They both agreed to disagree for the night. It came as no surprise to Stephanie because it’s what she’s known her whole life.

“There’s always going to be that uncomfortable feeling that people get when talking about [mental health],” she said, working to get comfortable enough herself to delve into a conversation about her struggles before her mom comes home from work.

Stephanie describes herself as someone who is passionate, who loves drinking milkshakes, and is always looking forward to the next spontaneous adventure. She is also someone who struggles with depression and anxiety.

These days, she follows a routine, puts in the work in therapy, takes the medication, and is mindful about her personal well-being from day to day.

“People who suffer from depression and anxiety, we want routine, we need stability, need reassurance,” she said.

But talking to her mother and her extended Guyanese family about her health issues is not part of her routine because the cultural differences make such discussions difficult.

It turns out Stephanie’s situation isn’t unique. Though mental health isn’t confined to international borders, different interpretations can be, and multi-generation families can struggle when  a “back-home” mentality is add odds with the experiences of children born or raised in Canada, said Camille Hernandez-Ramdwar, an academic coordinator for Caribbean studies at Ryerson University.

Mental health in Guyana is mostly acknowledged as a spiritual conflict between the mind and body as a whole, with religion and faith believed to elicit healing, she said. After a long-history of colonialism, mental health in the Caribbean also tends to be secretive, because there is shame and stigma attached to what is perceived to be “madness,” according to Hernandez-Ramdwar.

“Colonized peoples were viewed as backward and primitive for maintaining traditional spiritual beliefs in regards to health and other aspects of life,” as colonizers spread the value of scientific thought and knowledge in treating medical symptoms, said Hernandez-Ramdwar.

In Canada, too, the medical establishment is  “very white,” meaning it doesn’t make space for, or welcome different cultural interpretations of health and treatment,” she said. As a result,  some Caribbean immigrants may be hesitant to trust the advice they receive from western medical practitioners.

In Stephanie’s family, there has been a push and pull between the two words. She describes feeling that her grandmother  disregarded mental health all her life, even when she struggled, while her mom finds solace in Guyana’s mental health practices to help her cope. Stephanie recognized and dealt with her own mental health struggles without the support of her family, because an intergenerational silence has existed there and in her broader community for as long as she can remember.

Stephanie’s grandmother, Ellen Macdonald, was among a  wave of Guyanese immigrants who left the fringe of the Caribbean in South America to settle in Canada during the 1980s.

Her mental health has long been a mystery to Stephanie, and she hesitantly tries to unravel it from time to time because she believes she recognizes hints of depression in her “Nani” now that she’s experienced symptoms herself.

“My Grandma is smart and resourceful, but she worries a lot. The Idea of mental health scares her, because she is unknown to it. The idea of depression especially scares her,” she said. 

One weekend not too long ago, her grandmother came over to spend time with Stephanie and Leela at their apartment. The sun was shining through the window that they had to crack open in the crammed kitchen space, which really only accommodates one, so the crisp morning air could overtake the smell of spices mixing together in the pot on the stove. Her grandma’s tired hands worked all morning, but they were as sturdy as Stephanie always remembered them being.

She put on a nostalgic movie that her grandmother used to love in her teenage years in Guyana, and she laughed and clapped along to the music as she re-lived her youth. Given the light-hearted atmosphere, Stephanie took the chance to ask her what life was like for her as a teenager in the slums of Guyana, knowing from past conversation with her mom that her grandmother had struggled at that time of her life. She felt the older woman’s demeanor change as she suddenly asked Stephanie to “take-off” the movie, and then asked how much food she wanted on her plate. Stephanie noticed her grandmother’s hands shake as she served the food.

Afterwards, her grandmother declared that she was going to take a nap, and Stephanie didn’t question it. She was left to wonder if her grandma was “ignorant” about mental health, as she believes most Guyanese people to be, or if it was something her grandma was all too aware of  and just didn’t want to acknowledge.

When Stephanie began to tackle her own mental health challenges, she tried to pin-point the first time she had experienced depression. In the process, she found herself trying to assemble  bits and pieces of her family’s mental health history, a job made difficult by their silence.

“I [thought I] was a very happy child, but I was actually really sad inside. There were moments where I just wanted to die. Moments where I attempted to cut myself, but I didn’t recognize it as mental health.”

-Stephanie Charitar

In late 2019, Stephanie’s mental health was declining because of a strain in her relationship with her brother with whom she is especially close. At the same time, she wasn’t feeling proud of the work she was producing at her job as an analyst for inclusion and diversity at CPP Investments, and she was fighting a lot with her boyfriend.

The first time she realized  she needed professional help was after a fight on the phone with her then-boyfriend. That happened on the heels of a fight with her brother just a few days earlier.

“I remember that I just started feeling super emotional. I didn’t want to talk anymore because I knew I was going to break down… I went into the shower and broke down crying for a while,” she recalled, her hands fidgeting and her head hung low. “I’m not a huge crier, so it was a really big thing. I couldn’t breathe properly, my chest was tightening, and [when] I thought about the issues it would incite more panic every single time.”

She has moved back into her mom’s apartment after living away , and she is finding the courage more and more to press for details about their family history, as best she can. Stephanie has learned her mom won’t offer up specifics about her mental health struggles, but she won’t lie to Stephanie when asked direct questions. It’s from these conversations that Stephanie recently discovered that her mother and grandmother have both lived through periods of depression. It was a breakthrough for the two, and Stephanie was left wondering if there will be more conversations like this now. 

For now, though, Stephanie is choosing not to tell her mom about her personal mental health treatment, which fully embraces North American standards. She isn’t comfortable having that conversation yet.

“I know the way my mom is and how she’d want to approach it. It would frustrate me more. She’s more on the spiritual side and I’m not,” Stephanie said.

Again, their situation doesn’t seem that usual.

Karen Naidoo, a sociology professor at Ryerson University who has studied intergenerational takes on mental health, took a close look at the term “madness” in her dissertation, which focused on Canadian-Caribbean youth. Her research shows that most first-generation Guyanese immigrants living in Canada hold onto their “back-home” religious beliefs when it comes to understanding and treating mental health.

Stephanie’s mom Leela is gradually opening up about her mental health journey, which has involved, at different times,  North American practices and Guyanese beliefs. Leela remembers feeling depressed when she was in her late-twenties in Canada and going through a divorce in 1993.

“When I was getting divorced, I couldn’t sleep, I felt depressed. I had children to raise and work was hard.”

-Leela Mangroo