In fact, in the last eight years, I have spent hours and hours listening to the experiences of people living and struggling with a range of mental health problems. Mostly, these experiences have been linked to loss, tragedy, hopelessness, and failure. As such, I was expecting her story to be akin to the stories I’d heard in the past.

For a good few minutes, I was watching silently, slightly nervously, as the steam from my coffee cup rose and vanished into the air, without once bringing my head up to meet her gaze. She finally broke the silence, “See, I am now in my early 60s. Do I look like a woman suffering from mental illness?”

My head finally came up. “I am not qualified to judge mental illness. The images and public perceptions of mental illness are largely built on misconceptions and misunderstandings anyway,” I said. She nodded in agreement.

Silence again.

“I’m from a well-off family from Kathmandu actually,” she started again. This time, she kept going. She said she had been fortunate enough to go to the best school of her time, that she was a great student, active in sports, and had lots of friends as a youngster. “I had dreamt of being a medical doctor when I was 12 or 13,” she explained. She dreamt of travelling the countryside and serving those in need. Like most other children, her childhood days were full of idealism, motivating her to take up biology at the Amrit Science College in Kathmandu after grade 10. In the midst of studying ISc, she got a scholarship to study abroad, but in the social sciences. That marked a major change in the course of her life.

Unknown symptoms

It was when she was studying for a BA abroad that she first started to experience the symptoms of a mental health problem. “I didn’t know what it was,” she said and it took her several years to associate her illness with bipolar disorder. Without any diagnosis or knowledge about what was going on inside of her, she completed her Master’s degree. She recalled, “During those college years, I suffered periods of inactivity, social withdrawal as well as hyperactivity. To some extent, it negatively affected my social network and friendship circle too. More than anything, it hampered my education as well as work output. As these symptoms were foreign to my family members and I, we never discussed them, assuming they were normal. I survived as a lonely sufferer for over a decade. ”

After completing a Master’s degree, she was very lucky to find a job with an international agency and was posted to different countries in Africa, Asia, and Europe. “I often suffered a lot in my work. I used to be absent from work during the low times. It was hard for me to concentrate on work and I used to find myself lost in emptiness. I didn’t feel or express any emotion in times of joy or sadness. From the onset of mental illness, it took me over a decade to seek professional help. It was a painful journey,” she remembered.

Seeking help

But after a period of long suffering came help at last. She said, “I sought professional help, accepted the diagnosis, and took prescribed medicines regularly without fail and it gradually worked.” The other important thing for her was that she did not lose herself to self-stigmatisation. She proudly said to me, “I accepted my condition once I knew it was a mental problem and constantly sought professional and family help to improve it.”

She continued, “I was fortunate as my employer never judged me on the basis of my diagnosis as long as I could perform my work properly. After six years of diagnosis, my employer found out about my condition, but took it as a very normal human condition and remained always supportive. ”

She recalled her past, “Since the onset of the first symptoms 40 years ago, I have suffered a lot. It has affected my family and social relationships.” During those years, she said that she was even hospitalised a couple of times. She received Electro Convulsive Therapy (ECT), which did not work, aside from leaving damaging side effects in temporary loss of immediate memory. There were periods, in the later years, when she thought about suicide not infrequently.

“In the last five years, I have also sought help from a psychotherapist while continuing psychiatric care. Psychotherapy has an important role in boosting self-confidence, motivation, and natural healing, but I have found that the medication provided by psychiatry crucial.”

Lessons learnt

In the end, she said that reliable medical support is vital, “which includes both clinical and psychological support.” More importantly that, “one should not be afraid to seek help and trust medical caregivers.” With a sly smile on her face, she said, “Throughout my life, I have learnt closely that there is no health without mental health.”

I asked her if there was any message she feels that people ought to hear. Her face lightened up. She put her cup of coffee on the table, looked straight at me, and said, “There is no reason to be ashamed about mental illness. Be honest and open to your close family members and friends. There is always hope and help if we seek it.”

As we finished up our third round of coffee, I asked her at last, “Any regrets?” “Nope, none at all,” she said. “I have no regrets.”

Lamichhane is principal coordinator for the Movement for Global Mental Health