On November 14th, 1998, a young Indian man named Neil Grover killed himself. Neil was bright: He was studying to become a doctor and doing well in medical school. His mother said he had always been happy; she couldn’t understand why he might have felt the urge to take his own life. His suicide note was as cryptic as the act itself: I had everything, but life is a double-edged sword. If I tell everything, I will lose everything.

I repeated the lines to myself over and over, as if I could stumble upon their meaning. But of course I couldn’t. He was like Srinivas Akkaladevi—another young South Asian medical student who also committed suicide. His family also couldn’t imagine a reason. And both Grover and Akkaladevi were as successful as Sarvshreshth Gupta, the Goldman Sachs analyst found dead after working hundred-hour weeks. The cause of Gupta’s death has not yet been determined. His father, Sunil Gupta, wrote of his son:

He started complaining ‘This job is not for me. Too much work and too little time. I want to come back home...’ We counselled him to keep going, as such difficult phases were inevitable in a high pressure job. ‘Sonny, all are of your age, young and ambitious, keep going,’ I would say.

Keep going is the message we hear over and over. Walk it off. There’s a running joke in the movie My Big Fat Greek Wedding: The protagonist’s father is always saying “Put some Windex on it,” as a way to heal whatever ails. It’s a cure-all medicine, and none other is needed. Tough it out is the lesson. It is something you’re used to hearing in South Asian culture, where having a high pain threshold is something to brag about, where only a certain kind of pain is permissible. In the end, we never find out if the Windex works.

A few weeks ago, I sat in the drawing room of a grand house in India, listening to a group of parents talk about their children abroad. “Ravi heard from LSE,” said one mother casually, spooning peanuts into her mouth. “He’s been offered a job at McKinsey, and you can imagine the kind of starting salary they offered him... but he wanted to go to grad school first. He’s just thrilled.”  

Another mother: “Akanksha only just finished med school and now she’s saying ‘Mummy, maybe I’m applying for a Ph.D at Yale.’ They’re never satisfied with what they’re doing: it’s all about how many more degrees they can rack up...”

As they went around the circle, the stories of accomplishment formed a chorus. If you listened, you could pick out certain repeated words: Harvard; doctor; investment banking; award; fellowship; lawyer; $200,000 per year. Though they were careful not to brag outright, all had stories of success—academic, professional, personal—to share. There was only good news. In listening to them, you heard the future of our people, the model minority in America. It was composed of degrees, moving to the big city, raises for their sons, suitable boys for their daughters , moving to the suburbs, retiring at sixty-five in matching woolly jumpers, and raising children who would dream the same.

Snooping for secrets in strange bathroom cabinets is a trope in popular culture; growing up, I remember seeing it in American movies and TV shows and wondering at it with the wide-eyed wonderment of children who have no context for what they see. Our house had no medicine cabinets, no hidden pills for shameful ailments. What was there to snoop for? What would a snoop even find? All we had was a battered tin box on my mother’s desk that held aspirin and bandages.

These were for small pains: cutting your big toe open while playing cricket with the boys, or bruising your knee when you decided to climb the guava tree in the garden. If you had a headache, Mama gave you cough syrup and checked your temperature. If your temperature was above a hundred degrees, you got to stay home from school. If you had a bigger pain, if the bigger pain didn’t go away, you went to the doctor.  Big or little, it was always physical. What other kind of pain could there be? For years, I didn’t know.

There is little data on depression in the South Asian community. According to the Asian and Pacific Islander American Health Forum (APIAHF), South Asian Americans—especially those between the ages of 15-24—were more likely to exhibit depressive symptoms. Another APIAHF report found that there was a higher rate of suicide among young South Asian American women than the general U.S. population. However, the report said, South Asian Americans had the lowest rate of utilization of mental health services—which is a conclusion that should come as no surprise to anyone raised in the desi community.

Immigrant South Asians are particularly prone to depression and related mental health issues. A 2004 study examined the qualitative effects of immigration on the mental health of 24 Hindi-speaking women who had lived less than five years in Canada. Many of the women polled were in agreement on one fact: They had not experienced mental health issues of any kind in India. “You see in India you are always busy with your family members (and) relatives. And here you feel more lonely, feel more loneliness,” said one woman. Another said that she hadn’t known what depression meant until she immigrated to Canada. “The pains and aches here most of them we never even heard of them... Our mothers, grandmothers never even knew or heard about (what) we are getting at a young age.”

The vocabulary of certain aches was inaccessible to them, said the women, but they now had to find words to speak about their pain. This was in part because of particular stressors unique to the immigrant experience—most of all, the absence of the supportive community the women had in India—but part of it was due to the simple fact that Canadians went to the doctor more. “In India, we would only visit the doctor when we are sick,” another woman said. “Here, even if you are healthy, you still go for a check up.”

The women spoke of using Indian home remedies for pain: going to the doctor or taking traditional medication was always a last resort. Although they now needed treatment more than they ever had, they could not afford it and were uncomfortable with the notion of seeking medical help more regularly.

Two doctors at the University of Missouri discussed this strange reluctance to seek medical help in American South Asians and their “minimalistic attitude towards medication” in general. According to Dr. Nidhi Khosla, one of the causes of this trend was that doctors in the South Asian region of the world don’t usually ask patients about their pain, physical or otherwise. “In South Asian culture,” Dr. Khosla said, “it is common for patients not to report their pain to avoid burdening others or being seen as weak.” In a particularly illuminating remark, Dr. Khosla explained that South Asian doctors did not use the same pain scales as doctors in the United States. Health care providers in the U.S. asked patients to rank their pain on a scale from 1 to 10, which is incomprehensible to South Asian patients: There’s no reason for a South Asian patient to go to a doctor, the cultural belief goes, unless she’s experiencing severe pain. Participants in Dr. Khosla’s study said that it was fairly common to be given “low-dose pain medications such as Tylenol after surgeries like Caesarean sections and gallbladder removals.” The study confirmed what I had already learned as a child: Pain management is a priority only for white people.

So many of my conversations with white friends start with the phrase My therapist said. So many of my white friends will tell me “I’m doing terrible, man,” when I ask how they’re doing. My girlfriend dumped me. I can’t find a job. I’m really sad about my granddad dying. They display an emotional honesty that I find equal parts repulsive and endearing. It didn’t seem to matter if I’d known them years or if I’d only just met them in the lunch line: They didn’t mind talking about it to a stranger—it was almost as if they thought it was nothing to be ashamed of. They were eager to provide details of their aches, to enumerate their weak places. I was a witness to events I never consented to see.

As a child, when something bad happened to me, I never wanted to talk about it. Confession was a staple of white culture, I thought: That was why they worked their pain out in therapy and Mead notebooks. Some of them made their pain into art, writing memoirs or confessional television shows. It was the white way.

But that was not the brown way: The brown way preferred silence. In a community that valorizes endurance, stoicism is the lionized mode of existence—especially when the community in question, is in America and subjected to the social pressure of conforming to a model minority stereotype. To admit to cracks within the community would be to question the status that Indian Americans enjoy within mainstream society. The pressure to live up to this perceived social position has been directly cited as one of the reasons that young South Asian women do not call for police assistance or social services in cases of domestic violence.

I spoke to a friend recently, a young Indian man, who told me definitively that he didn’t experience any racism in the United States. I think he sensed my skepticism. “I mean, people give you looks and say things... but I haven’t experienced actual racism,” he added. I remember my brother telling me that he’d been called a Paki plenty of times in London, but that it wasn’t racism like “other people experienced.”

This tendency to underestimate, smooth over, and finally deny pain is what keeps young brown people from calling things by their true names. We live in a world where the only metric is other people. Other people, we are told, have it so much worse than we do—so shut up. And so, what other people might perceive as a crisis point is not treated as one.

An investigation of psychological distress in South Asian women in the UK revealed that crucial mental health services were routinely accessed at a point of desperation, when it is often too late. The stigma surrounding the breaking of silence in desi communities means that people within them have a higher risk of resorting to self-harm and suicide. A similar experiment conducted in Toronto concluded that there was a pattern of “delayed help-seeking” with South Asian women in abusive marriages. In that experiment, women said that they would wait to seek help until the point when “pani sar se guzar jata he”—translated literally, it means “the point when water crosses over your head”. Although there were a variety of complex reasons for this delayed help-seeking (for instance, the lack of social support abroad, as well as marriage obligations), the women cited the culture of enforced silence as an important cause.

And more important than other people always having it worse than we do, other people in our desi communities are always watching. South Asian culture is, above all, community culture. The concept of izzat, or honor, is paramount to those raised in traditional South Asian families. It’s linked to the concept of sharam, or shame. The two are so inseparable that the Hindi word lajja counts both ‘shame’ and ‘dishonor’ in its list of meanings.

To admit to mental health issues would be to threaten the izzat of one’s family, since depression is so deeply stigmatized in our communities. As a consequence, we live performatively. We maintain izzat at the expense of individual health. When we tell each other stories about how we’re doing, we gloss over the weak parts—they are believed to be private matters. “Dev was just made partner at his firm,” we’ll say, and we won’t tell each other that Dev drinks too much, even if we know. And maybe we don’t, because Dev has been taught to hide his drinking. We think what we see is all there is. I had everything, but life is a double-edged sword.

The ancient Indian epic Mahabharata tells the story of a young man named Karna, who seeks a teacher. He approaches a revered guru, Parasurama, who agrees to take him on as a pupil. However, Parasurama has one condition: he will not teach Kshatriyas, members of the warrior clan. Karna—a Kshatriya—lies, telling Parasurama he is no warrior.

One day, Parasurama is sleeping in his student’s lap, when a scorpion crawls up Karna’s leg and bites him. The pain is unbearable, but Karna does not flinch nor cry for fear of waking his master. It is only when the blood from the bite drips on Parasurama that he awakens. Furious, he shouts at his disciple: “No Brahmin boy alive could withstand such pain in silence. You must be a warrior. You must be a Kshatriya,” he says. He curses Karna, saying that the latter will forget the teachings of the guru when he has most need of them.  It is this curse that will prove to be the latter’s undoing when he fights in the climactic battle of the Mahabharata, in which the Pandavas seek to end the tyrannical rule of their cousins, the Kauravas.

It is a story that calls to mind the fable of the young Spartan boy who, having concealed a stolen fox under his cloak, let it bite through his flesh rather than betray pain. These are stories of extraordinary human endurance. And yet—a fact that struck me as shocking when I first read it—there is no reward for stoicism. Karna’s tragedy is that an act done out of love, a seemingly selfless act, is repaid with a curse. It suggests that enduring pain silently is not, after all, a quality to be prized. Even in our culture.

Knowing what I know about the very real consequences of denying my own pain, I feel the urge to censor myself, to qualify any confessional writing about pain with “I know other people have it much worse,” as I’ve been taught. The culture of silence is so deeply rooted in me, in we desis, that some of us may never overcome it in our lifetimes. If I tell everything, I will lose everything. We are careful with our stories. We edit them compulsively so they seem less raw, less painful. The first time I described a difficult time two years ago to a friend, I tried to do it nonchalantly, since I felt anything else would be embarrassing.

“I was sad a lot that year. Sometimes I would open the fridge door at 9:00 AM and stare at a carton of orange juice,” I told him.

“Why orange juice?”

“Because it was right next to the handle of whiskey.”

“So you were depressed.”

I negated that immediately. “I wasn’t depressed. I was just sad. Sometimes. They’re not the same thing.”

“True,” he said agreeably. “But, you know, it’s okay if you were depressed.”

“I wasn’t,” I repeated. “What are you trying to say?”

He shrugged.

“Nothing,” he said. “I’m trying to tell you it’s okay. That’s all.” 

Here’s what I believe: There’s no inherent value in silence. There’s no value in pretending that we’re never hurt. There’s no shame in needing medicine; there’s none in confession either. We don’t have to cling to the illusion of perfection. We have everything, but life is a double-edged sword. When we tell each other this, we might risk our reputation. But this is the only way we can survive.