A Journey of Bipolar Disorder in a South Asian Family
How stigma can impact the diagnosis and treatment of mental health.
Posted July 14, 2022 | Reviewed by Michelle Quirk
- In the South Asian community, mental illness is still seen by many as a spiritual imbalance, not as a biochemical issue.
- "The Shelly Story" is about empowering individuals to take an active role in their own health care.
- South Asian culture offers spiritual wisdom that includes Ayurvedic medicine, yoga, and meditation, which can benefit mainstream treatment.
The stigma of mental health in the South Asian family can be a very complex situation. Not only can parents or loved ones deny or minimize issues, but they may even mismanage them to the detriment of their family member, contributing to a spiraling situation. I had the wonderful opportunity to interview Shelly Sood and Nikhil Torsekar, a South Asian husband–wife duo who host a podcast called "The Shelly Story," which aims to uncover the bipolar reality, offer hope to those suffering from this cruel illness, and ultimately create change. Shelly is also the author of an upcoming book entitled, Untethered, which discusses their arduous journey with Nikhil’s bipolar disorder.
Jyothsna Bhat: What is "The Shelly Story" about?
Shelly: "The Shelly Story" is about owning your own health. We believe that while we need our doctors, nurses, and therapists, it is imperative that we avoid taking their statements as gospel. That can be highly detrimental to a family and marriage. For example, over 20 years, Nikhil would cycle between depression and mania and be continuously misdiagnosed with depression. Even after hearing about Nikhil's 18-month manic episode, and our turmoil-filled separation, the treating psychiatrist, at the time still initially diagnosed him with depression.
By the time Nikhil sought proper treatment, he was suicidal. But what really saved him at that moment is that Nikhil told the doctor to take a clinical history from [me], “because she can give you a full 360-degree picture.”
Fortunately, Nikhil then got a proper diagnosis and the appropriate treatment, which helped to stabilize his mood. He had been prescribed antidepressants in the past—which, we learned, if you give a patient with bipolar disorder an antidepressant and not pair it with a mood stabilizer, it can result in cycling manic episodes and can potentially trigger suicidal tendencies, which is what happened to Nikhil.
Nikhil: Yes, so "The Shelly Story" extends beyond the podcast, to the blog, the book, and eventually a movie. Shelly began the project while we were in the midst of a separation. She had been writing about a lot of the turmoil unfolding at the time as documentation for her lawyers, but also as a cathartic exercise. This formed the first draft of the book. I started out editing the content, and then it evolved into a shared story written from our dual perspectives.
In addition to telling our story, it’s about giving people in the South Asian community a platform to tell their stories and hear from other voices. I think it'll propel people to come forward and say, “I'm suffering from this” or “I know someone who needs help.”
Shelly: The platform is largely about educating people on alternative treatment approaches they can use to supplement traditional modalities (i.e., medication, talk therapy) to optimize their mental health.
Nikhil: As South Asians, there's so much wisdom in our culture at our fingertips, including Ayurveda, mediation, and yoga. We’re trying to bring that back into our collective toolkit for managing mental health.
JB: This sounds like an incredible platform. I mean, it’s amazing that your story was the catalyst to all of this. The idea of owning your health is so important. Just to get a little deeper about your own journey, Nikhil, with bipolar disorder, what was that like, and what were the family dynamics around this?
Nikhil: As a kid, I exhibited a lot of hyperactivity, and teachers would ask, “Is everything OK at home?” I feel bad for my parents looking back because I don't think they got it. They were more concerned about appearances and always asking me, “How do you think this makes us look?” I'm not saying this as an indictment on my parents; it’s just that these were the times. Unfortunately, anytime I had to talk to a therapist, it was because I was acting up in class, so therapy was seen as punitive to me.
Fast forward to college at Washington University in Saint Louis, when I had to take a leave of absence from my intense premed program due to experiencing my first manic episode. The way it was handled was not the best. For my parents, the primary concern seemed to be keeping it under wraps and throwing meds at it in the hopes it would resolve itself. My father, who’s retired now, was a psychiatrist. People are shocked when they hear this, as they wonder how he missed the signs. I chalk it up to clinical detachment: After talking to patients all day, the last thing he wanted to do was come home and think that a problem existed under his own roof.
After college, I found my passion in “FinTech” (financial services and technology), which (much like my undergrad experience) had a very Type-A, cutthroat culture. Lack of sleep was not seen as a problem, but as something to be rewarded. I’d be firing on all cylinders for months at a time. And then, when I would hit a depressive patch, it would be mismanaged again.
JB: Shelly, how was this for you at the time?
Shelly: Nikhil was consulting and traveling for so many years. And there was a kind of disconnect to what was happening with him internally—going between manic and depressive episodes. I excused his irritability and destructive behavior as the expected toll of a stressful job. What made matters worse was that I relied entirely on Nikhil’s father because he was a psychiatrist. I turned a blind eye and trusted him completely. And that was kind of mistake number one. Throughout the years, I was very close with my in-laws and treated them with the utmost respect, and tried to be a traditional good daughter-in-law. However, there were family disputes, drama, and dysfunction throughout the years—not uncommon in the collectivist South Asian culture. I didn’t even know what was going on. I was just a busy wife with three children, trying to keep everything afloat and support my husband as much as I could.
JB: That’s quite a lot you both had to deal with. Nikhil, you spoke of how therapy felt like a punishment. I've certainly seen that with some of my younger clients. And, Shelly, yes, what you did was very natural and probably what a lot of people would do in your circumstances.
Nikhil: It’s also the centuries-old stigmatization of mental health in India. Even in this day and age, mental illness is often seen as a spiritual imbalance—not as a biochemical issue.
Shelly: One of the other big elements that came into play was family dynamics. When this whole thing blew up, I begged his parents for an intervention and to be more involved, because I knew he needed emotional support in order for treatment to be effective. I was very desperate, as my children weren’t doing well. I also feared that Nikhil, while suffering from mania, couldn’t be trusted with our then-15-month-old baby. They knew the situation and how I had suffered for so many months, but they remained in denial of everything going on.
JB: Unfortunately, this is not an uncommon response in the South Asian community, especially when it comes to mental health. Nikhil, how were you dealing with all of this?
Nikhil: At that point, I had lost my job. It was in the middle of this really contentious divorce; my health was in shambles. And so that was really my rock bottom. For months I’d laughed at Shelly whenever she said that I had issues to deal with. Finally, I waved the white flag and agreed to try treatment.
Shelly: We didn’t end up getting the divorce, but put our marriage “on hold” so he could focus on getting better. At the time, I no longer cared what happened to our marriage. It was all about Nikhil and his treatment. Of course, I helped him recover, but he had to do a lot of the initial pushing himself to actually get better. But, if he didn't have me or the children and anything that was important to him in his life, we may not be here today.
Nikhil: I learned the importance of relationships: embracing the ones that were nourishing and walking away from the ones that were toxic. I feel very fortunate to be of South Asian descent at this moment because there's a lot more dialogue and awareness about mental health. Our predecessors have forged a great path for us. I'm glad that, in addition to just acquiring material wealth, we're also looking at what I would call "mental wealth," and, as Shelly talks, of owning our health and using tools beyond medication when approaching psychological issues.
JB: And that is what's so important about the work that you’re doing because this can sort of break up families if it's not handled well. It continues the cycle of intergenerational trauma. And, so, I am truly thankful you both pulled through this difficult time together. Thank you so much for sharing your story and for the work you are doing for the community.