Changing the Mental Health Discussion

Oct/11/2021 / by Pratika Yashaswi
mental health
Image credits: Khushi Mishra Photography

This is the year of Simon Biles. Ben Stokes. Michael Phelps. Naomi Osaka. In a profession where mental health plays a huge role in performance, sports players are speaking up on a world stage for the first time, validating what’s been lingering in the margins but is only now entering world mainstream conversation. As this happens, there’s a demand for more nuance and inclusivity in the conversation. Those who suspect they might be ill but cannot talk about it to loved ones or access therapy in real life are looking for themselves online. Are we truly alone in our struggles? Those who feel that the mental healthcare system is failing them somehow are looking for explanations. Is this really the age of depression and anxiety, or are we just paying attention to it now? What does it really mean to be sane in a world like this? Well, there’s somewhere you can read and learn more about it.

Sanity by Tanmoy began as a couple of LinkedIn posts, Twitter threads and a Substack. It is now a fully-fledged community and a one-man run platform for rigorous mental health reporting combined with the power of sharing lived experiences. With 2,000 readers around the world, it discusses everything from the medical gaslighting of women to cybergrief. It explores things like: the role and relevance of mental health diagnoses, war trauma and Zoom dysmorphia. It has been described as “the most forward-thinking writing on mental health,” and for good reason.

Tanmoy Goswami took on mental health advocacy in the midst of one of the hardest times in his life. He opens up about his own struggles with an openness that draws readers in. He researches rigorously, working closely with mental health professionals to ensure factual accuracy. Writing about his own mental health invites those with shared experiences to do the same, in comments sections, in emails, via direct messages on Twitter — and he responds mindfully to every one of them.

Do you remember the moment you decided to turn your mental health struggle into something more? Would you even term it that?

Yes I do, actually, and I’ve often thought it’s a tad filmy in hindsight! It was the day my son was born, and he was lying in his hospital crib. Some “wellwisher” came to me and whispered in my ears that I should be careful not to pass “it” on to my child. Nothing more was said, but I understood what he was referring to. At that time, I was going through the most challenging time in my life professionally. I had just come out of a self-imposed semi-retirement. In 2016, I had to quit working because of my depression. I was housebound, locked up in my room for about a year. He was born in ’18, I had just come back to work (I was then a senior newsroom leader at a leading business news site) and I realized I could no longer just “dabble” in mental health advocacy. I knew that a few people were reading the Twitter thread I had started in 2017 tweeting my daily experiences of living with depression, and a couple of LinkedIn posts I had written in 2016-17 had also gone viral: all of that was giving me a sense of “OK, I’m speaking up,” and it had a profound impact on my own healing. But that day in the hospital I realized that I couldn’t do this part-time anymore, not because some great sense of purpose had suddenly dawned on me or that “Oh, you know I have to leave a better world for my child,” but primarily because I realized that I needed a lot more of that healing power of sharing than I got via a few tweets, etc. So it was a selfish desire to connect. At the same time, it was becoming increasingly clear to me that what I was up against was not even 2% of what people with far less privilege have to go through. That’s the day that I felt I had to do something in mental health full-time. I had no idea what that would be, but I knew that the only thing I’m good at is writing and editing. Then “The Correspondent” came along, and it was purely that kind of wild moonshot that it sort of worked out.

It’s no secret how heavily the stats are skewed against women when it comes to their diagnosis, stigma, research availability on various cultures, and more. What has your work led you to learn about what the stats don’t tell us about women and mental health?

I have accompanied at least two women to mental health professionals, I was in the room when they were being talked to. In one case, there was a complete refusal on the psychiatrist’s part to even talk to the woman or even address her. The whole conversation was happening as though she wasn’t even sitting in the room. I keep hearing the same thing from women from all kinds of backgrounds, including super-achievers, entrepreneurs, people with a lot of social capital.

Maybe 60 years ago they would have said, “You’re hysterical.” That shadow of hysteria is very much there. Although in psychiatry we don’t use that word anymore, its legacy hasn’t disappeared. We carry that baggage. And the notion that because one is a woman, by default there are certain pains that you have to just endure. “You are a woman, of course you will have these struggles.” Either one is a mother or just someone with PMDD, it’s nothing unique, every woman goes through it, it’s no big deal.

There’s a sort of conspiracy around the identity of a woman. It makes me feel like our baselines are so different in life, and this comes to accessing mental healthcare too. A, if you’re a woman, there’s this baggage of “Are you a reliable narrator?” B, “Is this woman talking sense, or is she just being hysterical?” The fact that someone can say, “Yeah, ok, this is what every woman goes through.” Nobody has ever come to me and said, “Oh yeah, you’re facing financial anxiety, this is what every man goes through. Doesn’t matter.” Sure, there’s the universal gaslighting that tends to happen when anyone lays claim to a mental health condition, but no one comes to me and says “You’re hysterical.”

What has your experience been, writing daily, publicly, and working so closely with your own trauma of living with depression?

When I first started tweeting out those snippets from my daily life, that was my first experience writing about mental health without a filter. My tweets were my window into this world, and it was also a way to check how much I was comfortable sharing with this completely nameless, faceless crowd. What I discovered quickly was that I was very lucky to have found an extremely non-judgmental space, which a lot of people don’t get. Twitter can be a very toxic space, especially for women and marginalized people, but mental health Twitter has been a wonderful little nook of the internet for me. Even when I shared my story on LinkedIn, I got hundreds of replies, including some that I could not believe. A young guy sitting in a church, ready to give up on life, read my Linkedin article of all things and messaged me saying, “Nobody understands what I feel, my wife doesn’t understand it, and I read your article and I felt like at least one person in this world knows, and now I want to give life another chance.” I was, like, ‘What?! Is there really so much loneliness in the world?

I could never imagine over my 16-year career that this kind of bond between the reader and the writer could be possible. This bond is based on shared trauma and shared agony, but also on unconditional mutual respect. They realize that it takes a lot for a journalist to literally put their name to a platform. When I call my platform Sanity by Tanmoy, it’s a conscious choice, because this is my story and I don’t claim to speak for anybody else. When people choose to trust me with their stories, I try to give my utmost respect to that gesture. I also look at my readers as bona fide experts: that has been a complete game changer for me.

Does it ever get really overwhelming?

I’m very intentional in the way that I tap into my readers’ wisdom and expertise. It’s not merely an “engagement” metric to me. When I have a person sitting somewhere in Arizona telling me about their family’s most vulnerable experiences, how can I not feel connected to that at a human level? I have been that person who has wanted to reach out to someone in desperation. As I continued to struggle with some of my worst episodes, it wasn’t always easy to find someone who would listen to me and say, “Here, let me help you understand how what you’re going through is part of this giant mess called the human condition.” My readers send me story ideas, pdfs and book recommendations nearly every day. The other day, somebody sent me some news clips about the psychedelic drugs boom in the US, asking “Are you interested in exploring this?” So yeah, writing about distress and suffering every week can get overwhelming sometimes, but my readers hold me and make it easier.

Livestreaming your panic attack: You talk of it being like a floundering mess of a persona that’s a marketing necessity. You write, “People told me this persona helped them feel seen and heard, so I kept nurturing it, and it grew into what I learned was ‘advocacy.’ I had no expectations of it except to feel connected with you.” Do you ever wish you didn’t have to do it?

Yes. I do wish that sometimes. Let me share my thoughts on the marketing point. In mental health writing, I have noticed an unspoken hierarchy. If you look at the classics of mental health literature, lived experience literature, many of them tend to have two things in common: one is forced institutionalization, and the other is suicide attempts or severe self harming behavior. These books are very important, and their authors have illuminated the path for so many of us. But you also have to ask, will publishers be interested in telling stories about “garden variety” anxiety? Your experiences may not make the cut, they may not be considered bestseller material. That’s the reality of any “market.” I’m lucky that my readers are not interested in trauma porn. Sure, people do gravitate naturally towards lived experience, but what they value is authenticity. How much should I share? How much of my scab should I expose? These are not “calculations” you can make. You start unspooling, and you get to a very raw place sometimes, and people appreciate that because it connects, it speaks to their most vulnerable experiences and a lot of people are not able to say these things out aloud. Ultimately, it can be draining — this balancing act between a writer who has to produce an authentic, well-written piece that people will be interested in reading, and a person who just wants to close the laptop and curl up in bed. It’s nobody’s idea of a strategically planned career. It just happened to me and I just try to make the best of it. But that said, I love my work. Even on the hardest days, I can’t think of something else I’d rather do.

Do you have any parting words for our readers?

Two things: One, if you’re accessing mental healthcare online, please be aware of what technology your therapist is using. Are they storing your data somewhere? Are they making paper notes or saving it on the cloud somewhere? This question matters, because we’re moving to online therapy en masse, and we have no idea what is happening with our records. And already there have been cases. In Finland there was a massive hack in February — and Finland is one of the most tech-savvy countries in the world. A therapy chain was hacked, and all records made public. Lots of ransom was extracted. Please talk to your therapist about the nuts and bolts of online therapy.

Mental health professionals, please do this on your own, even if nobody asks you this question. Please tell your clients what you do with their data. If you’re using Whatsapp calls, Zoom or Skype, please reassure your clients that you’re taking maximum care to ensure their privacy. If possible, please encourage the use of safer platforms like Signal, because we don’t even have a conception of what might go wrong.

There are so many apps and bots and everything now, there has been a glut of online therapy solutions during the pandemic. People are unloading their entire life stories on these platforms. Do we even read their privacy policies? Do we ever go into a room full of strangers and start talking about our deepest vulnerabilities (unless that’s your work, like it is for me!)? Then why won’t we exercise the same discretion online?


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