In 2019 my closest friend from college — Arjun, who I have known since our first year at Delhi University — stopped returning my calls for about six weeks.
This was unusual enough that I noticed immediately. We had spoken every few days for seven years. Suddenly nothing. I sent messages that were read but not replied to. I called and it rang out. I assumed at first that he was going through something with his girlfriend, that he would come back when he was ready, that pushing would feel like an intrusion.
After six weeks I drove to his apartment in Lajpat Nagar one Saturday morning without telling him I was coming.
He opened the door in the same clothes he had probably been wearing for two days. The apartment was in a state I had never seen it in before — curtains closed at 11 AM, dishes stacked unwashed in the sink, a general heaviness in the air that I felt before I consciously registered any of the specific details. He looked thinner. He looked like someone who had been somewhere I had not been able to follow.
We sat on his floor for four hours. He told me things he had told nobody — not his parents, not his sister, not the girlfriend I had assumed was the problem. He had been depressed for four months. Not sad. Not stressed. Depressed — in the specific clinical sense of that word that he understood intellectually because he had a psychology minor from college but had been completely unable to apply to himself because he had spent four months telling himself he did not have permission to feel this way given that nothing catastrophic had happened in his life.
His father had not died. He had not lost his job. He had not been through a visible trauma. He had simply, gradually, stopped being able to feel anything except a dense, heavy nothing that sleep did not touch and that he had been carrying alone in that apartment for four months because the alternative — telling someone — felt like a confession of weakness he was not willing to make.
This article is about why Arjun is not unusual. And about what that costs us.
The Silence and Where It Comes From
The National Mental Health Survey conducted by NIMHANS found that approximately 150 million Indians need mental health care at any given time. Fewer than 30 million of them receive any treatment or support. The gap between these two numbers is one of the largest treatment gaps in the world for any medical condition.
Understanding why this gap exists requires being honest about something that most mental health awareness content in India skirts around carefully: the silence is not simply ignorance. Many people who are suffering know what they are experiencing. They have words for it. They have read about it. They choose silence anyway — because in Indian family and social structures, the consequences of speaking can feel genuinely worse than the consequences of staying quiet.
When Arjun finally told his parents — six weeks after our Saturday morning conversation, after he had seen a therapist twice and was beginning to stabilise — his father’s first response was: “What do you have to be depressed about? We gave you everything.” His mother cried and then said she hoped he had not told anyone outside the family because his cousin’s wedding was coming up and she did not want any difficulty with the other family.
Neither of these responses came from cruelty. They came from a framework in which mental health conditions are either moral failures or social embarrassments — and in which love is expressed through the management of perception rather than the acknowledgment of pain.
Arjun had known these responses were likely. That knowledge was part of why he had stayed silent for four months.
The fear of being seen as pagal — crazy — is not paranoia. In Indian family and community contexts it has real consequences: marriage prospects discussed differently, professional reputation quietly affected, family dynamics permanently altered. These are not imagined risks. They are risks that have materialised for enough people that the calculation to stay silent makes a certain rational sense even when it is causing measurable harm.
What the Silence Actually Costs
I want to be specific about what four months of Arjun staying silent cost him — not in abstract terms but in the concrete, traceable consequences that I watched.
He lost approximately six kilograms because eating felt pointless. He stopped going to the gym he had been disciplined about for three years. He missed three important deadlines at work — not because he was incompetent but because the cognitive load of depression had made sustained concentration nearly impossible. He received a performance warning from his manager in month three — his first ever — which compounded the depression with a layer of professional shame that gave it additional reasons to stay.
He lost four months of his friendship with me, with his sister, with the people who would have wanted to help had they known. That lost time cannot be retrieved. The conversations we did not have during those months are simply gone.
And he very nearly made a decision in week eleven — which he told me about three months after the Saturday morning conversation, quietly, while we were walking in Nehru Park — that would have been permanent. He said it matter-of-factly in the way people sometimes describe their lowest points once they have moved sufficiently past them to speak about them. He had been sitting on his terrace at 2 AM and had thought about it seriously and had then gone back inside and sent me a voice note that I had been asleep for and never heard before he deleted it.
I think about that voice note sometimes. I think about what would have happened if I had not driven to Lajpat Nagar that Saturday.
The silence has a cost. It is not abstract. It is sitting on a terrace at 2 AM alone with a thought that has nowhere to go.
Depression Is Not Sadness — This Distinction Matters
The most important thing I understood from watching Arjun’s experience closely is the one thing that most mental health content in India fails to communicate clearly: depression is not sadness and it does not require a visible reason.
Arjun’s father’s response — “what do you have to be depressed about” — is the natural response of someone who understands depression as an emotion provoked by circumstances. Under this framework, depression without obvious cause is either exaggeration or weakness. Under either interpretation, the correct response is to try harder.
Clinical depression is not an emotion. It is a medical condition that disrupts the brain’s ability to regulate mood, motivation, cognition, and basic functioning regardless of external circumstances. A person with depression may have objectively good circumstances — a stable job, people who love them, no recent loss or trauma — and still be genuinely unable to feel pleasure, sustain concentration, maintain normal sleep patterns, or generate motivation for basic self-care.
This is not because they are not trying. It is because the machinery that allows those things to happen is not functioning correctly.
The treatment gap in India is partly a resources problem. But it is substantially a comprehension problem — a widespread misunderstanding of what these conditions actually are that causes suffering people to believe they do not deserve help because nothing bad enough has happened to justify it.
Arjun spent four months telling himself he was being weak. He was not being weak. He was ill.
Anxiety — The Condition Most Visible in Indian Life and Most Rarely Named
If depression is underrecognised in India, anxiety disorders are almost completely invisible despite being extraordinarily common.
The academic pressure that begins in Class 10 and intensifies through Class 12 and competitive entrance exams creates conditions of sustained, severe anxiety in millions of Indian teenagers. The pressure of competitive job markets, the financial stress of supporting families on salaries that do not stretch as far as they once did, the social pressure of marriage timelines and family expectations — Indian adult life contains an unusual density of anxiety-producing conditions.
What is almost universally absent is the recognition that the racing heart before an exam or presentation, the dread of family gatherings where certain questions will be asked, the inability to sleep the night before anything important, the constant low-level scanning for things that might go wrong — when these patterns are persistent and begin to limit your ability to function or enjoy your life, they constitute a clinical condition that has a name and for which effective treatment exists.
My younger cousin Meera — 24, working at an IT company in Pune — described to me last year what her mornings look like. She wakes up already anxious before she has checked her phone. She catalogues potential problems for the day before she has had chai. Her heart rate is elevated by the time she gets to her laptop and she is not sure she has been genuinely relaxed, in the way you can feel your body relax, for about two years.
She has never seen a therapist. She has never told her parents. She has read enough online to know that what she is describing probably has a clinical name but she has concluded that what she has is not bad enough to warrant professional attention because she is still functioning — she goes to work, she delivers her assignments, she attends family events and manages to be present enough.
This is one of the most common and most damaging mental health misconceptions in India: that you have to be unable to function to deserve treatment. Meera is functioning. She is also suffering unnecessarily for two years from a condition that responds well to therapy and in some cases medication.
The threshold for seeking help is not whether you can still get through the day. It is whether you are getting through the day in the way you want to live.
Why the Next Generation Is Not Fine
One thing I want to say directly, drawing on what I see among people in their 20s and early 30s in Delhi and through conversations with people across Indian cities: the generation growing up with social media alongside the pressures specific to being Indian and young in 2026 is not fine in aggregate.
The comparison that social media enables — continuous, involuntary, and calibrated to show the best of everyone else’s life against your private experience of your own — is genuinely new in human history and its effects on how young Indians feel about their own trajectories are significant and largely unacknowledged.
The young man in a tier-2 city watching his batchmates from college posting about their Bengaluru or Gurugram salaries and lifestyles while his own career path feels slower is experiencing something that does not have a name in most Indian family vocabularies. The young woman managing family expectations about marriage while navigating a career she cares about is carrying something that her mother’s generation did not carry in the same form even if they faced their own pressures.
These are not individual failures of resilience. They are structural pressures that have increased faster than the social and psychological infrastructure to process them has developed.
What Getting Help Looks Like in India Today
The mental health landscape in India has changed more in the past five years than in the previous twenty. It is still inadequate. But more options exist than most people know.
Free helplines available right now:
- iCall: 9152987821 — run by TISS (Tata Institute of Social Sciences), staffed by trained counsellors, available Monday to Saturday 8 AM to 10 PM
- Vandrevala Foundation: 1860-2662-345 — 24 hours a day, seven days a week, available in multiple Indian languages including Hindi
Affordable online therapy:
iNnerHour, YourDOST, MindPeers, and the therapy section on Practo offer sessions with registered psychologists starting at ₹400 to ₹700 per session — substantially below private clinic rates in most Indian cities. The online format also removes the barrier of being seen entering a psychiatrist’s clinic, which matters in contexts where discretion is important.
Employee Assistance Programmes:
Many Indian companies now offer EAP services — typically three to six free confidential counselling sessions per employee per year. The sessions are with external providers and your employer does not receive any information about what you discuss. If you work at a company with more than 200 employees it is worth emailing HR to ask whether an EAP is available. Arjun used his company’s EAP for his first two sessions — it cost him nothing and the confidentiality was complete.
Government services:
NIMHANS in Bengaluru and government medical college psychiatry departments in most Indian states provide free or heavily subsidised psychiatric and psychological care. Waiting times can be long but the services exist and are staffed by qualified professionals.
What to Say When Someone You Care About Is Struggling
The most common question I have been asked since Arjun went through what he went through — and since I have talked about it with some openness in the years since — is what to actually say to someone you are worried about.
I drove to Lajpat Nagar that Saturday without a plan. I did not know what I was going to say. What I actually said when he opened the door was: “I have not heard from you in six weeks and I am worried about you. I am not going anywhere.”
That was it. I did not have therapeutic training. I did not know the right words. I just showed up and said I had noticed and I was not leaving.
You do not need to have answers. You do not need to fix anything. You need to ask directly — “are you okay, because I have been worried” — and then stay present with whatever they say. Do not rush to comfort or silver linings. Do not compare their situation to others. Do not tell them that others have it worse. Just listen and stay.
If you are worried someone is in crisis — if they have said anything that sounds like they are thinking about harming themselves — ask them directly. “Are you having thoughts of hurting yourself?” Asking does not plant the idea. It gives the person permission to answer honestly and opens the door to getting them help.
Then help them find that help. Offer to look up a therapist. Offer to go with them to a first appointment. Offer to sit with them while they call iCall. The practical offer of accompaniment — not just “you should talk to someone” but “I will help you find someone and I will come with you” — is often the difference between someone taking action and continuing to sit alone with something unbearable.
A Final Word
Arjun is well now. He has been in therapy on and off for three years — he paused when things stabilised and returned when he needed to, which is how it tends to work. He talks about what he went through with more openness than I expected — not with everyone, but with people he trusts and occasionally with people who seem to need to hear that someone they respect went through it and came through it.
His parents have never discussed it again after that first conversation. His mother occasionally asks whether he is “still going to that doctor” in a tone that mixes concern and residual discomfort. He tells her yes. She does not ask more. That is, for now, enough.
The conversation about mental health in India is changing. It is uneven and slow and the gap between what needs to exist and what does exist is still enormous. But it is changing.
It changes when one person drives across the city on a Saturday morning without knowing what they are going to say. It changes when someone who went through something speaks about it to one person who needed to hear it. It changes when a young woman in Pune tells her cousin that what she is experiencing has a name and that help exists.
One conversation at a time. That is how it changes.
If you are carrying something right now that you have not told anyone — you do not have to be at your worst to reach out. You do not have to justify the weight of what you are carrying to anyone. You just have to tell one person.
Start there.
Disclaimer: This article discusses mental health topics for educational purposes. It does not constitute professional psychological or psychiatric advice. If you are experiencing mental health difficulties, please reach out to a qualified mental health professional. Crisis helplines: iCall 9152987821, Vandrevala Foundation 1860-2662-345.
Alen is a Delhi-based writer covering health, personal finance, and career topics for Indian audiences since 2020. A conversation with his closest friend about depression — and the years of watching what recovery looked like — formed the foundation of everything in this article.
Alen is a Delhi-based writer covering personal finance, health, and career topics for Indian audiences. He has been writing about practical financial and lifestyle topics since 2020 and believes that clear, honest information should be accessible to every Indian regardless of background