For Mental Health Awareness Month I’ll explore mental health in the media beginning with Never Have I Ever, a coming-of-age comedy that delves into the life of “Devi Vishwakumar” a spunky fifteen-year-old Indian-American girl who struggles to find herself following a tragedy.

As a therapist I’ll explore identity, grief, PTSD, therapy, and more!

Spoiler Alert: I’ll comment on the show without giving away too much!

Coping with PTSD

Never Have I Ever begins with a tragedy as Devi’s father abruptly dies and her legs become paralyzed soon after. While she tries to make sense of life with her new disability and without her father, one day the use of her legs curiously returns. Devi presents with PTSD (posttraumatic stress disorder) a mental health disorder that can occur after experiencing or witnessing a traumatic event. Side note: The diagnosis of “acute stress disorder” transitions PTSD if symptoms persist after one month following a traumatic event. Devi meets the following diagnostic criteria for PTSD that cause distress in her life:

Intrusion symptoms associated with the traumatic event(s)

Devi experiences a variety of intrusion symptoms like recurrent distressing dreams, intrusive distressing memories, and intense flashbacks that border on hallucinations.

Avoidance of stimuli associated with the traumatic event(s):

Devi desperately tries to avoid painful memories of her father’s death and the events leading up to it. She also avoids external reminders that trigger these memories, thoughts, or feelings, such her harp.

Changes in reactivity associated with the traumatic event(s):

Struggling to cope with her trauma, Devi engages in reckless behavior as she radically tries to change herself and find a sense of belonging as a teenage girl. Additionally, she’s more irritable and has angry outbursts with little provocation.

Mental Health Stigma in Indian Communities

Mental health issues are often stigmatized in Indian and other South Asian communities as mental illness may be seen as a weakness or moral flaw. Fortunately, stigma seems to be decreasing in Indian-American communities as mental health issues become more normalized in American society. Though Devi meets with a therapist, she isn’t ready to process her grief and trauma, and deflects most of her therapist’s questions. As she and her mother have a strained relationship, they don’t talk about their grief with each other. It’s heartbreaking to watch them silently suffer, feeling the same pain yet emotionally distant from each other.

Conversion Disorder

Devi’s mysterious paralysis following her father’s death can be explained by conversion disorder, also known as functional neurological symptom disorder. Conversion disorder involves an unexplained alteration in motor or sensory function, such as paralysis. The neurological symptoms are real and may be triggered by stress or traumatic events, such as Devi’s paralysis being triggered by witnessing her father’s death. Symptoms may come and go, and one can’t control them. Devi’s psychosomatic response to the trauma of her father’s death becomes a traumatic event in and of itself.

Indian-American Identity

Balancing both her Indian and American cultures, Devi wrestles with her identity. She doesn’t view being Indian as “cool,” and feels embarrassed by her cultural differences. Living with Kamala, her cousin visiting from India, she sees how different her Indian-American culture is from traditional Indian culture. She ventures on nontraditional paths and experiments with what parts of Indian culture she chooses to identify with. Culture can be a huge part of a person’s identity, which is why culturally-sensitive therapy is so important. If a therapist ignores a person’s culture, they may inadvertently also ignore their beliefs, values, and worldview.

Grief Response

Devi denies the need to process her grief and instead focuses her energy on her social life, a convenient distraction. We can experience sadness and grief in reaction to painful events in our lives, such as the death of a loved one, loss of a job, or the ending of a relationship. Additionally, the process of grieving can look different in each person.

While grief and depression share traits, they are not the same:

• In grief, self-esteem is usually unaffected. In depression, it’s common to feel worthless.
• In grief, painful emotions tend to come in waves, often mixed with positive memories. In depression, mood and/or pleasure are decreased for most of two weeks.
• For some, traumatic events can lead to the combination of grief and depression, and grief can be exacerbated when coupled with depression.

Step Into My Office…

Following the death of her father, Devi and her mother struggle to get along with each other and adapt to their new family structure. While they individually cope with his death, they take their anger out on each other instead of addressing their grief as a family unit. In addition to individual therapy, I’d recommend that Devi and her mother engage in family therapy. Families can benefit from therapy especially when they experience a stressful event that may strain family relationships. Therapy can also improve understanding and collaboration between family members. If I were Devi and Nalini’s family therapist, I would use some theoretical techniques such as:

• Enactments: Family members act out their dysfunctional interactions instead of talking about them. As Devi and Nalini are both very passionate in their verbal arguments, this may help them gain insight on their communication styles while allowing me an opportunity to intervene on the spot. I’d be cautious to not let the role-playing turn into an actual fight!
• Reframing: This allows problematic behaviors to be viewed with a new perspective. Reframing a behavior with a more positive meaning can promote empathy between family members and tap into deeply-embedded issues. I suspect Devi and Nalini would be stubborn to do this at first, but may be more open to it over time.
• The Miracle Question: “Suppose tonight, while you sleep, a miracle happens. When you wake up tomorrow, what would be some of the things you’d notice that would tell you life had suddenly gotten better?” This exercise can help people look beyond the difficulties of their current situations and envision a positive future that they can work towards.

Conclusion

As an Indian-American woman, I was thrilled to see Never Have I Ever feature an Indian-American female lead. As a child I didn’t see people in the media who looked like me or that I could culturally relate to. Watching Devi felt restorative as her life touched on many familiar facets of Indian-American culture. As a therapist, I was impressed that its depictions of PTSD, conversion disorder, and grief were well-formed and thought-provoking. Never Have I Ever highlighted the importance of talking about our mental health and relying on our communities for support.

So… when’s season two?!

Interested in the psychology behind other TV shows? Check out my reviews of Tiger King, Love is Blind, Too Hot to Handle, and You.