Last year was a difficult one for Thu Rain. The pandemic left him jobless and isolated, and he started feeling depressed. He clung to hope that 2021 would offer a new beginning. Then the coup happened.
“It almost destroyed me,” said the 25-year-old, who previously worked at a hotel in Yangon. “It’s like losing all your chances. You have a lot of hopes and dreams that are just gone.”
Sharing his feelings with Myanmar friends proved difficult, he said, because he didn’t really feel that he could speak freely with them about his inner struggles.
“I tried to talk to many people, but some were not really helpful,” he said. “I was waving my hands and shouting from my mind, but my voice wasn’t really coming out.”
One major issue, he said, was that many of his peers were uncomfortable talking about feelings or didn’t take mental health seriously.
“People are scared to open up,” he told Myanmar Now. “They feel shy or embarrassed or ashamed, and they also don’t know the importance of mental health.”
But Thu Rain persevered, using dating apps to find social support from people abroad.
“They might never see me in reality. There’s no chance to meet, so we can talk about crazy things. It’s really helpful for mental health, and some people give me good advice,” he said.
He also applied the knowledge he gained during a research internship with a mental health organization, including tools and vocabulary for conceptualizing his feelings.
Among these is self-compassion.
“You have to appreciate what you have done and how you survived,” he said. “[Facing the coup] is a big thing, but before that, you might have had some kind of situation that was very big, maybe even more difficult than this, which you forgot about. You have overcome many things already. Why not this?”
While Thu Rain was able to find informal support and build on his foundation of mental health education, many people are suffering alone through acute distress, worries Vickie Htet, a psychotherapist and Ph.D. candidate in psychology based in Norway.
After spending some time providing emotional support to family and friends in the weeks after the coup, she recognized the urgent need for mental health services for the wider public. This led her to establish Open-Heart Coup Mental Health Support in March, one of a handful of volunteer-based mental health initiatives that have emerged since the coup.
Through social media and word of mouth, Htet connected with around 40 volunteers, including both licensed mental health practitioners and non-professionals willing to attend short training courses to acquire counselling skills.
So far, these volunteers have provided a range of services, including supportive listening, counselling, and psychiatric care, to approximately 170 people. Anyone affected by the coup can sign up for Open-Heart’s services, which are provided through voice calls that protect the anonymity of both volunteers and patients.
Htet said that the program has been successful in reaching people from a wide range of backgrounds, but has had trouble recruiting and training enough volunteers to meet the more intensive psychiatric needs that have emerged.
“The need for help is far greater than the availability of help among the population,” she said. “We don’t have the time to train all our volunteers. Coupled with a lack of training available in the country, this becomes a monumental problem.”
Meanwhile, military-imposed internet restrictions have made it difficult for some segments of the population to access online services. “Our ability to give listening support, online counselling, and psychiatric consultation has been severely affected due to low connectivity,” said Htet.
“I have spoken with people who need to see a psychiatrist, but many of them are unable to do so because they are on the run or hiding somewhere.”
Activists and those participating in the Civil Disobedience Movement are among those who have faced intense pressure since the coup, but are also among the hardest to access.
“I have spoken with people who need to see a psychiatrist, but many of them are unable to do so because they are on the run or hiding somewhere,” said Dr. Wityee Hnin, one of Open-Heart’s volunteer listeners.
Another challenge is that volunteers, like everyone else, have been deeply affected by the coup, often in ways that make it difficult for them to be available for others when needed. “Our struggles remind us of the general struggles our country has as a whole,” said Htet.
But for many, the greatest obstacle is not so much an inability to access support as a lack of awareness about the importance of taking care of one’s mental health, combined with feelings of fear or embarrassment about reaching out for help.
Pannu, a clinical psychologist who is pursuing a Ph.D. in the United States, said that since the coup, some of these barriers have started to lessen.
“Since we have been able to create more dialogues openly to check in with each other or talk about our struggles under the current times, people’s views towards mental health awareness and education appear to be more open and positive,” she said. “These extremely hard times have brought us all together.”
But she said that much work remains to encourage people to feel comfortable reaching out for emotional support, whether through formal services or trusted family, friends, faith groups or like-minded people.
“If someone is struggling with mental health right now, it’s not a sign of weakness at all. It is an understandable, normal reaction to very abnormal situations,” she said. “We just have to live through one day at a time by leaning into our own psychological resilience as well as on each other.”
Pannu is well aware of the lasting impact of the sort of violence that the Tatmadaw has inflicted on the country’s people.
“Having grown up in Myanmar, I understand the effects of systemic trauma and violence on mental health,” she said. “I have also witnessed the incredible resilience of our communities, individually and collectively, in the face of these decades-long adversities.”
“If someone is struggling with mental health right now, it’s not a sign of weakness at all. It is an understandable, normal reaction to very abnormal situations.”
It is this resilience that she says she hopes to help build by developing informational resources and running online workshops for the general public.
“I want to do my best to strengthen the resilience of our Myanmar people as they live through deeply traumatic experiences,” she said.
Pannu has developed resources on coping skills, managing trauma reactions and processing collective grief. More recently, after learning that at least four refugees from Myanmar had taken their lives since the coup, she turned her attention to suicide prevention and safety planning.
Salai Laizo, a Chin refugee in Kuala Lumpur who until March worked as a community mental health volunteer with a local non-profit, said that the coup has severely exacerbated an already stressful situation for refugees and asylum-seekers in Malaysia, where three of the recent suicides happened.
“People worry about their families back home. Some people’s hope of going back to Myanmar has been destroyed. People want to help those in Myanmar who are struggling due to the coup, but cannot help much due to losing their jobs because of the Covid pandemic,” he said.
“Some people [in Malaysia] are struggling to survive day to day. When these feelings collide, people feel stressed, anxious and angry.”
With limited formal mental health services available to refugee and migrant populations in Malaysia, Salai Laizo said he hopes people will increasingly come together in solidarity and be open to talking about mental health with their families and communities, especially after the recent suicides.
“If people help each other emotionally, in religious ways or any way available, it can help prevent the tragedies that are occurring in our community,” he said.
‘It’s OK not to be OK’
Chris Lwin, a Kachin refugee and university student in Melbourne, Australia, began speaking out on social media about mental health and trying to be a more supportive friend and listener after a friend committed suicide in 2020.
But until the coup, he didn’t imagine he might find himself on the receiving end of this support.
“When you see really egregious things that you should never see in your lifetime, and you see it literally every day for months, it psychologically affects you in all sorts of ways,” he said.
He began having headaches and difficulty breathing. When doctors suggested it might be anxiety-induced, he struggled with self-doubt and insecurity about showing his vulnerable side, even to his closest friends and family.
“When you see really egregious things that you should never see in your lifetime, and you see it literally every day for months, it psychologically affects you in all sorts of ways.”
“It really hit me and made me confused,” he said. “I always have expectations of myself to be strong, to just get over it, not complain about it, not talk about it [for fear of] seeming weak. It’s [been] really challenging to come out of that mentality and to say, ‘It’s OK not to be OK.’”
When he finally reached out, his friends supported him in much the way that he had for them, and it has helped him to cope.
“The truth is that you’ll be a different person in certain times, when you’re really stressed or really feeling down. You’re not constantly an energetic and enthusiastic person. Your friends should also know that,” he said.
“I’ve learned to accept that it’s best to be myself. [When] I’m not feeling well, I’ll be different, but so be it. It’s not like I’m going to be like this forever.”
He hopes that shared experiences of fear, pain and loss will encourage more people to feel comfortable about reaching out to their friends, and also to be supportive when their friends reach out to them.
“If you want support from someone, be that support for other people,” he said.
Mental health resources:
Serenity Counseling Service – Burmese-language free weekly online emotional support groups; online sessions on topics such as psychological first aid, trauma care and support
Myanmar Mental Health Support Group – Peer-to-peer support network over Facebook
MindToMindMyanmar – Burmese-language Telegram channel
G-Taw Zagar Wyne – Burmese-language mental health podcast
Citta Consultancy – Social enterprise providing counseling, consulting, psychoeducation workshops, and capacity-building training in Burmese
Resources in Burmese on basic coping skills and managing trauma reactions, safety planning to prevent suicide and self harm, and processing grief by Phyu Pannu Khin, Ph.D. candidate in clinical psychology
Suicide prevention webinar in Burmese by Dr. Su Su Maung, licensed therapist, and Phyu Pannu Khin, Ph.D. candidate in clinical psychology
Psychological Support for All – Burmese-language Telegram channel
Free mental health consultations with psychologists from Brazil focused on people from Myanmar or expatriates in Myanmar or who have recently left, available in English, Portuguese, Italian and French. Appointment link available here.