This article examines the topics of suicide, mental health conditions, and grief after suicide. Three stories related to mental health issues in families are illuminated through the lens of three women's experiences: a daughter, a wife, and a mother.
In one instance, a sixteen-year-old girl repeats the phrase 'it is you' in front of the mirror with her mother while looking at photographs. The mother, experiencing a psychotic episode related to schizophrenia, insists that the woman next to her husband is someone else, not herself.
In Madurai, a woman grieving her husband cries while the family's golden retriever lies on her lap, wrapping its paws around her neck and licking away her tears. In Mumbai, a 46-year-old woman lives alone, and her life has long been shaped by OCD and anxiety, requiring significant support, especially regarding the future after her parents passed away.
These three cases are presented by Dr. Kavita Arora, a child psychiatrist, member of the Founding Cohort of IMHA, and co-founder of Children First; Dr. Nandini Murali, founder of SPEAK and Project SPEAK; and Dr. Feroza J. Godrej, a philanthropist and art historian who founded the Cymroza Art Gallery. Each of them has walked their own path in family mental health—as a daughter, wife, or mother—and shared their experience in the collection Homecoming: Mental health journeys of resilience, healing and wholeness, which is India's first anthology dedicated to 11 women leaders overcoming mental health challenges.
Their stories often unfold outside the doctor's office. As Kavita notes, 'a lot of life happens between doctor visits.' In these three homes, it was the women who sustained daily life, and very few people asked how they were feeling. This story returns to that question and another: who cared for them?
What a Child Learns to Recognize
When a patient comes to Kavita's consultation room, she does something her training never taught her. She inquires about everyone who did not come. She says, 'I see not just a person or their illness; I try to ask about the family members who are not in the room.' This habit dates back to childhood, which she did not consider unusual then. Her father was a local doctor and the sole provider for the family, her mother handled most of the cooking, and her brother, one and a half years older, was her closest ally. Her mother suffered from schizophrenia, although no one around Kavita named or explained this term.
Kavita recalls, 'When her episodes happened, there could be violence, shouting, and paranoia, but as a child, I didn't know what it was. I thought that's how families lived, and that's what happens behind closed doors in other families.' While her father fulfilled his duties, she and her brother keenly felt the atmosphere in the house as children, simultaneously forming a bond of survival, caring, and supporting each other. Kavita shares that 'March and the end of the financial year were often associated with my mother's relapse, adding stress due to exams for us as children.'
Neighbors often heard fights, but as she says, 'there is no space or forum where this could be safely raised; children do not have direct access to professional care services.' She remembers the scene with the mirror the most because it showed her how far two people can be while looking at the same thing. She says it was difficult for her to cope with this in adulthood: 'How can you even connect with a parent when their perceived reality is completely unreal?'
She was helped by books read by lamplight under the covers, badminton, tennis, and basketball teams, as well as school friends she has known for 38 years. She notes, 'I don't know if they are necessarily coping mechanisms, because it didn't feel like I was using these aspects of my life to deal with what was happening at home. It just felt like wonderful things life offered me, and I felt happy and passionate.'
Although finding joy and immersing oneself in interests can coexist with invisible suffering and mitigation, nothing gave her: an explanation of what was happening at home. The missing element was diagnosis. It wasn't until she was 21 that Kavita learned that her mother's condition was a mental illness called schizophrenia. She was in her third year of medical college, and her compassion and understanding changed profoundly when she understood the diagnosis. She says, 'No one told us what it was. And there was no language for it, and no one asks or initiates a conversation, even when everyone sees it.'
Later, she chose psychiatry because, as she says, 'in many ways, I wanted to provide the care and support that little Kavita lacked.' If her silence revolved around an unnamed illness, Nandini's silence centered on a death no one wanted to discuss.
What Followed the Silence
On the second day after her husband's death in April 2017, Nandini's uncle told her something she wasn't ready to hear. He said, 'When you are ready, you have a book within you.' Her husband, Dr. T.R. Murali, a nationally recognized urologist, died by suicide after the couple lived together in Madurai for over 30 years. She still speaks of him in the present tense and describes him as 'vibrant, brave, and brilliant.'
The ensuing grief arrived, shrouded in silence. She explains, 'It is not something that can be openly discussed due to the stigma, shame, secrecy, and silence surrounding it, so grief also becomes very isolated and alienating.'
Internet searches led her to the word postvention—support offered to people after a suicide loss—and then to Carla Fine's book 'No Time to Say Goodbye.' She wrote Carla an email of thanks and received an immediate reply. She says, 'Today I consider her my sister across the Atlantic.'
Finding no Indian description of suicide loss written from lived experience, she wrote the book Left Behind: Surviving Suicide Loss, with Carla contributing to the preface. She also joined an eight-week online group, being the only participant from outside the Western world. She says, 'That's when I truly learned to process my grief.'
On the first anniversary of the loss, she founded SPEAK in Madurai, and during the pandemic, the Speak to Us helpline emerged. Project SPEAK now operates in three areas of the Madurai district. She admits that she initially doubted whether the model would work with low literacy levels and immense stigma, but community trust played a decisive role. In her support groups, she starts with her own story because 'when people hear my story, they know I am not making things up.'
A pattern emerges among the women she meets. Many face accusations and shame, and when a husband dies by suicide, 'the ties to the marital side of the family simply break,' she says. When one woman recently described humiliation, other participants responded, 'Why endure all of this? If you need support, call us.'
Nandini notes that such support is rare when it comes to suicide: 'very rarely do you hear people saying: oh god, this happened, how can I support?' Regarding her husband, Dr. Murali, she says, 'people who pass away should be remembered for how they lived their lives and what contribution they made to society, not reduced to the circumstances of their death.'
While Kavita's silence focused on an unnamed illness, and Nandini's silence on a death no one wanted to discuss, Feroza's silence was quieter and lasted longer: years of raising a daughter whose struggles no one in school could see, within an extended family where she had to hold everyone else together.
75% for Family, 25% for Everything Else
Feroza Godrej allocates her day as she learned many years ago: 75% of her time is dedicated to family, and 25% to everything else. She says, 'I needed to make small compartments in my own mind.'
Her daughter Raika, now 46, is a 'strong personality, but very loving.' As a child, 'she tricked me in many ways,' and her mother jokes that she could have been a brilliant lawyer. Raika's academic shortcomings went unnoticed due to the demanding school environment, and later developed into anxiety and OCD. Feroza, herself an educator, says, 'I regret that we weren't taught in undergraduate education what learning disabilities are.'
Although care was provided within a large privileged joint family, Feroza spoke about her daily life: 'You are like a sandwich, squeezed between elders and children.' Compromise often seemed wiser than daily confrontation, though she admits she yielded more often than Raika conceded.
She holds onto the quarter of her time that belongs to her. She remained involved in art, education, and sports because, as she says, 'if I lose 100% of what is demanded of me, I will become a very terrible, difficult, capricious person to live with.'
She also read extensively and consulted therapists, psychologists, and psychiatrists. She asserts, 'you must listen to everything clinicians say because you never know when an illness might be dormant in a person and suddenly flare up.'
Her own mother, who was home every day from 4:00 PM to 6:30 PM, set an example. Feroza says, 'When your child comes home from school, they want to unload everything that happened during the day quickly. They won't tell you at dinner. By then, they will have forgotten.'
A circle of 10 close college friends supported her. She says, 'We chose each other very carefully. Support is very, very necessary.'
Her son, 2.5 years younger than Raika, took a different path. She recalls, 'No matter how outgoing he was, he started to withdraw. Speaking less, quietly,' and today he 'very much protects his sister, and sometimes she listens to him more than me.'
Raika now lives independently, and 'she knows what it is like to provide for her daily needs: her food, her car, whether it needs maintenance,' says her mother. Nevertheless, the question of the future remains. 'Even at 46, her fear of losing us is paramount. What will happen to me later?'
Although their homes differed, each woman came to the same conclusion: to speak up. Nandini wanted a counter-narrative, she says, because 'the main narrative was silence, stigma, shame, and secrecy.' Feroza, when asked to contribute to the book Homecoming, said, 'I will try to contribute. The perspective of caregivers must also find a voice.'
The speaking engagements led to recognition. Readers write to Nandini: 'oh, this gave me hope,' and when Feroza spoke at a recent conference, people told her: 'We have never heard anyone speak so frankly about mental health issues.' Her response was simple: 'I speak because I truly believe what I say, because I went through it. Don't give up.'
The word 'caregiver' applies unevenly to each of them. Nandini, whose work supports women affected by suicide loss, rather than caregivers, distinguishes this clearly, whereas Kavita says, 'My identities as a caregiver, daughter, and psychiatrist do not define me. I am not my role.'
She brings her whole self to Children First and the India Mental Health Alliance (IMHA), and her life experience as a daughter, caregiver, and psychiatrist informs this. She says, 'My life experience informed my approach to care, service design, and systems thinking as much as my clinical expertise.' Nandini's Project SPEAK published stories of 10 women from her support groups, and Feroza continues to send copies of the book Homecoming to people.