Three days ago, I decided to tell my younger girl cousin, who lives in China like all my other relatives, that I have bipolar, autism, and ADHD. She is nineteen years old, which is the age at which I developed bipolar, so I believed that she ought to know that a relative has a mental health condition in order to recognize it in herself if she happened to experience something similar. But my mother did not want to tell any of my relatives about my mental health or neurodivergence. She believed that they would not understand due to the cultural gap.
Yet months ago I told my one older cousin about my bipolar, and she was very understanding, agreeing not to tell anyone what I told her and even offering to let me talk to her about my struggles if I needed. So I thought that my younger cousin, who is in college and thus, I believed, would be exposed to new perspectives that open her mind, would be just as understanding.
But unfortunately, she was not. Firstly, when she read what I shared with her on WeChat, she responded with shock and immediately started asking me how someone would develop such conditions. Was I bullied in school perhaps? Apparently she once had some curiosity about psychology herself, but her questions to me showed that she was quite clueless about the subject. I tried to explain, as best I could with my not completely fluent Chinese, that these conditions did not have singular causes and that genes were likely involved. But unlike my older cousin, she did not offer any support, only ask me these questions that felt oddly intrusive (although I do appreciate her willingness to learn about these things).
The next day, my mother told me that my cousin told her mother, who is my mother’s sister, about what I told her. I was shocked that she blabbed despite my instructions to her not to share. Apparently immediately after she told her mother, she said that she felt guilty for sharing because I told her not to. But what use is such guilt? She has not confessed or apologized to me herself; I only know because her mother told my mother. I thought that even if my cousin did not understand psychology, I could trust a nineteen-year-old to keep a secret from her parents.
My mother was angry at me. She did not agree with me about the importance of sharing mental health history with one’s family members. She had always assumed that I was unique among our family members in my intensity, despite my brother also having experienced depression and my father being clearly autistic (autism is genetically related to bipolar and schizophrenia, both conditions that most frequently emerge in late adolescence or early adulthood). But if my mother was unwilling to talk to our relatives about mental health, then our relatives might also hide their children’s mental health information. So at the very least, I thought that my cousins ought to know for their own benefit.
My mother was upset that I potentially caused her whole side of the family to know about my differences, as according to her, her family members all have a tendency to blab. And in hindsight, I do think I told my cousin more than I needed to, detailing my experiences in such a way that she might have gotten scared somehow. I have a tendency to overly trust people, and I also was feeling enthusiastic in my attempts to figure out how to explain psychological phenomena in Chinese.
Unfortunately, the language used in Chinese in relation to mental health sounds much more severe than its equivalent in English. As my mother explained to me, Chinese people understand mental health troubles in a sort of binary: either you get a little stressed out because you were bullied in school or some other external thing happened to you, or you’re absolutely “crazy” and “can’t live in normal society.” My cousin’s mother reacted to learning about my conditions in the same way as my cousin did, assuming that I must have been bullied in school. This fascinates me, as it suggests that Chinese people tend to assume that, at least for most people, nurture is what shapes a personality. Which makes a lot of sense. I’m sure that plenty of Chinese people could be diagnosed with ADHD, but with just how strict school in China is, even children with ADHD have to become extremely disciplined through daily conditioning. Confucian culture puts a lot of emphasis on cultivating character, and the assumption is that the majority of people — those who are not absolutely “crazy” — are capable of balanced character development according to societal standards.
My cousin’s mother apparently worried about me for the whole day after being told about my mental health difference and said to my mother that it would be better if I lived in China and could interact with my cousin more. Which doesn’t make much sense. It is not helpful advice, and it seems to rather express my aunt’s desire for our family members to all be physically and emotionally close to one another. My mother attempted to calm her down by explaining that I am simply a more sensitive person and that my mental health is currently fine, but it’s unclear if that did anything.
Clearly I caused a bit of a mess by telling my cousin about my diagnoses, but I am still glad that I told. I believe that mental health is important to talk about, and if Chinese culture currently does not often permit these conversations to happen, then it is good that I have initiated such conversation. Perhaps my cousin, if she continues to be interested in psychology, looks up these diagnoses on the internet and educates herself. If she doesn’t connect with these experiences herself, she might still recognize them in people around her and perhaps be able to help a friend.
One thing I am worried about though is that I might be imposing a Westernized perspective on mental health. Chinese medicine treats mental health as an aspect of physical health rather than as something separate. Someone who experiences what could be called bipolar in a Western context might be diagnosed as, for example, having too much fire either in the heart or in the liver, and then be given herbal medicine to treat specifically heart-fire or liver-fire. My impression, however, is that most Chinese people do not know much about Chinese medicine’s view of mental health, and the increasing popularization of psychology in China is mostly centered on Western psychology. Perhaps some awareness through one model is better than no awareness through any model.
In the fight against stigma, my habit has often been to act as if the stigma does not exist. Thus I tend to be very honest about my experiences, perhaps too honest sometimes, in order to educate others and to inform them about my needs. My assumption is that dialogue about mental health is important even if it is difficult or uncomfortable. But my mother certainly understands her family’s dynamics better than I, and I’ve agreed to not discuss mental health with my relatives — at least on her side — in the future. We certainly do not need family members uselessly worrying about me and repeatedly lamenting that we live so far away from each other.
Have you ever had to navigate difficult topics with extended family, especially family members separated by distance or culture? Share your story in the comments.