Before We Had Words for It

I’m sharing this story in series of posts for mental health awareness and for caregivers who are walking a path they never expected. #1

Mental illness rarely announces itself loudly at the beginning. For us, it arrived quietly; disguised as anxiety, depression, fleeting psychosis that felt like a vivid nightmare, and heightened sensitivity. Like many families, we believed we were dealing with something temporary like school stress, puberty or a phase. She was bright, thoughtful, and deeply sensitive.

Early Signs We Didn’t Understand

She was born with separation anxiety and had scarlet fever at age eleven, something that may have triggered underlying vulnerabilities, though nothing became obvious at the time.

Faith, Fear, and Missed Language

The real shift came years later, when I took a job 400 miles away and she was left to manage her daily life on her own at sixteen. I couldn’t hear what wasn’t being said. She couldn’t make sense of the conflicting thoughts she was having; thoughts that didn’t align with how she was being raised in Sikh faith. She called them “bad thoughts,” and our response was to lean into spirituality; focus on Waheguru ji, stay positive. Faith over fear. I wish I had taken her into intensive therapy then and learned the name for those thoughts. They weren’t moral failings or weakness; they were irrational thoughts. They were depression.

When anxiety and depression emerged during adolescence, medication was offered. What I didn’t understand then was that medication alone wasn’t enough. Family therapy mattered just as much; not only for her, but for us as caregivers. She was still a child, and we had the responsibility and opportunity to guide her and protect her. Because my husband and I were not aligned on the use of medication, it was equally important that she not be left with confusion or mixed messages about it. Consistency and clarity could have provided her a greater sense of safety and trust during an already uncertain time.

When Medication Entered the Picture

In the first two years while she was still living at home, in my uncertainty about the use of allopathic medication, I turned to herbal medicine for anxiety treatments I found online. When her symptoms eased, we assumed she was healed. Looking back, I understand that symptom relief is not the same as recovery.

Then she graduated from high school with flying colors, earning acceptance to several of the top UC universities. Knowing how sensitive she was and recognizing that our home environment wasn’t ideal for her at that time I encouraged her to attend the nearest university. Before making that decision, I spoke directly with the dean to understand the behavioral health services available on campus, believing that proximity and access to support would help her succeed.

At university, shortly after the first quarter, her anxiety intensified. She took that quarter off, and during that time I decided to consult a psychiatrist. Medication was recommended. By then she was an adult and chose not to pursue therapy, but she did stabilize on the medication. She returned to the university, completed her first year with good grades, and took summer classes to make up for the missed quarter.

After the summer, during a follow-up appointment with the psychiatrist, her medication dosage was adjusted. That was when we began to notice sudden and unsettling changes in her personality.

Stability Is Not the Same as Recovery

I noticed troubling changes; sudden insomnia after medication adjustments, heightened agitation instead of calm, and emotional intensity that felt disproportionate through what she was sharing on social media. She ended up taking that semester off. I took family leave from work and stayed home with her. In my uncertainty about the medication, compounded by the misalignment between my husband and me, I made the decision to taper her medication on our own. She began to do Nitnem with me and stopped arguing about everything. What I thought was her “old self” returning was, in fact, a manifestation of deepening depression. It lead to her first hospitalization.

I learnt it hard way that mental illness often evolves. What looks like anxiety at sixteen can look very different at twenty. Stability does not always mean resolution; sometimes it means remission. How a child reacts to medication can be a signal, not just a side effect.

Key lessons learned:
• Alignment matters. When caregivers are not unified, children absorb the uncertainty. Clarity and consistency are part of treatment.
• Medication may help initially, but it is only one part of care. Family therapy and close observation are equally important.
• Medical or infectious events (such as childhood illness) can sometimes precede mental health changes, even if symptoms appear years later.
• Major transitions; distance from family, increased independence, or stress can unmask underlying conditions.
• Conflicting or intrusive thoughts are often misunderstood as moral or spiritual struggles. These thoughts are symptoms, not personal failures.
• Reactions such as insomnia, agitation, or emotional intensity may be signals; not just side effects. Reassurance should never replace careful monitoring.
• Symptoms change over time. Stability does not always mean recovery; it may indicate remission that still requires support.

Caregiver Guidance:

• Delay independence if emotional stability is fragile.
• Question extreme medication responses.
• Remember that improvement does not eliminate vulnerability.
• Keep detailed records of symptoms, changes, and concerns.
• Trust patterns and instincts; they are valuable clinical information.

If you are a caregiver reading this and feeling uncertain, trust that your attention matters. You are not overreacting. You are advocating.