Neha was feeling out of sorts. Exams were looming and the pressure was
intensifying. The Iron Gate of the SLC (final school exams) seemed to get
taller every day. Her will to go on had disappeared. I hated seeing her under
this amount of pressure, wished I could do something. The Nepalis I spoke to said
it was simply exam pressure and everyone had to go through it. But it was more
than that. Her appetite had gone, she couldn’t sleep. She had started talking
about suicide. Her soul was giving up. I sought advice in Australia. I was told
she needed counselling and to be put on anti-depressants, that she was
clinically depressed.
I returned to the psychiatrist in Kathmandu to ask his advice. “It’s normal
exam pressure, but if you think it’s more, then here are some anti-depressants
and sleeping tablets.” Um, no thanks. Sleeping tablets for a suicidal teenager didn’t
seem logical. And counselling in Nepal generally consists of telling them to
get over it and study harder.
All options seemed counterintuitive. Talking about what was making her
stressed and drumming it further into her mind; medicating her so she wasn’t able
to feel the stress; telling her to get over it; removing the stress entirely by
telling her not to sit her final SLC exams, effectively limiting her future
options. There had to be a better way; one which was more positive, which would
build her resilience against future stress as well. Not one which seemed to
compound the problem.
Then I came across this quote about the Rwandan approach to dealing with
depression. It was an aha moment for me.
"We had a lot of trouble with
western mental health workers who came here immediately after the genocide and
we had to ask some of them to leave. They came and their practice did not
involve being outside in the sun where you begin to feel better. There was no
music or drumming to get your blood flowing again. There was no sense that
everyone had taken the day off so that the entire community could come together
to try to lift you up and bring you back to joy. There was no acknowledgement
of the depression as something invasive and external that could actually be
cast out again. Instead they would take people one at a time into these dingy
little rooms and have them sit around for an hour or so and talk about bad
things that had happened to them. We had to ask them to leave."
As I reflected on this as well as the elements of wellbeing and the
research surrounding resilience, I felt like we needed to inject some fun into Neha’s
routine, some laughter and positive experiences. So we started with a “Love
Bomb” – a burst of one on one attention doing something she enjoys. Often these
have the effect of giving a boost of energy which enables the person to grab
onto the first rung of the ladder to help them climb out of the pit of
depression. We combined this with a number of other strategies – spending time
in nature, allowing our bare feet to connect with the earth; hanging out with
the kindergarten kids (there is something uplifting about enjoying the company
of young children with few inhibitions and a wonderful curiosity for life); a
crazy hour of dancing to all her favourite songs. We also taught Neha the
impact that stress was having on her body, allowing her to identify the
symptoms and giving her some tools (breathing exercises, mindfulness
techniques) to minimise these. Then we added some memory boosting foods such as
almonds and tuna.
Of course, the tension and pressure of exams continued. We can’t remove
this. But by adopting the Rwandan way, giving her a package of positive
boosters, we hoped to allow her to climb out of the depressive pit and to allow
her to feel confident she could handle things herself in future.
As Neha’s final exams near, she is in a great place. Stressed and terrified,
understandably yes; but no longer feeling hopeless and sad. Now she sees the
opportunities to learn from the experience and is excited about her future. And
her cheer squad is right here to give her boosts of fun and love along the way.
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