Depression in Vietnam

Depression in Vietnam

My struggle with depression began in my teen years, with my junior year in high school being particularly sepia-soaked. I lost all hope that my life would be happy, and since I didn’t feel in control of it, measured every calorie that entered my 69” 120 pound body.  I struggled on with school and violin playing, but was living in the depths of despair, and I didn’t know why.

My parents knew something was wrong on a scale they couldn’t deal with. My father however, was battling his own depression, so was reduced to merely watching me go through mine. My mother probably decided that since I was young, attractive and talented, and “had everything given to me,” that I didn’t need any help from her. Mom and I never did get along very well, but I now realize she was doing the best she could with what she knew at the time. She had had her own struggles that involved losing a husband to World War II and an early life-threatening illness of her second husband, my father.

Going to college at Bloomington, Indiana’s storied I.U. music school certainly helped. I was away from the oppressive blinders that defined my parents’ lives, and was meeting new interesting people. My life was my own, and I loved it. I worked hard at practicing the violin and my course work, and got involved in new groups, expanding my horizons as much as I could at a midwestern campus surrounded by cornfields. I experienced some problems in the form of stage fright, but was mostly emotionally functional.

It wasn’t until much later in life, after my second child was born in 1984, that the depression reemerged with a vengeance in the form of excruciating headaches. Suicidal ideation was what it eventually was labeled, and I landed in a local hospital to be kept for observation. Larry got busy finding me some good help, and came up with Dr. John Markson, a student of Karl Menninger. Three years of therapy and Prozac finally got me back on track, and I felt I had the tools to get through my life, even enjoy it, without further emotional crises.

But, I had to look the demon in the eye before this was possible, and as it turned out, the monster was anger. Then guilt, because of the anger. Then more anger, because why should I feel guilty? I was on a merry-go-round of negative emotions and couldn’t get off. This was mostly because this wonderful pattern began when I was small and didn’t know any better. (My mother always did say I was born angry.) It just whirled around into a tighter and tighter ball until one day, I snapped.

I remember telling Dr. Markson my bunny picture story one day. I was probably around five years old, and had made the Easter Bunny for a school art project. I remember being proud of my picture, and Mom put it on the refrigerator. After regarding it for awhile, I asked her to take it down, and I tore it up, then dissolved into tears. Mom was puzzled, and held me for a bit, asking me why I had destroyed my bunny picture. I always cried when I replayed that story in my head.

“That’s a beautiful story of childhood guilt,” was Dr. Markson’s comment. Guilt, I thought? What would I have had to feel guilty about? The answer was apparently my anger, which I was trying so desperately to hide that it morphed into a bottomless sadness. “Depression is rage spread very thin,” I remember reading somewhere later.

In Vietnam, with so few Dr. Marksons around, most mental illnesses are mishandled, if they’re handled at all. Cultural stigmas, misperceptions, and poor management leave many mental health professionals and their patients in Vietnam fighting an uphill battle. For example, there is currently very little a parent with an autistic child can do to diagnose or help that child; they are usually mainstreamed into public schools, and often abused for their behavior.

A Vietnamese musician friend, a violist who has traveled the world, has an autistic son. She came back to Vietnam to start a school for autistic children, and was able to bring her son back as well. (She is divorced from the boy’s father, who lives in Europe; he blamed her for the autism.) Because of her worldly experience, she is teaching other Vietnamese about autism.

I’ve described our friend Hongky’s father’s struggle with PTSD, a ten year episode that left him bedridden. His only recourse was to trust his family’s ability to care for him, which is often how mental illness is handled in this communal, village-based culture.

This actually isn’t such a bad thing; any experience with depression comes with a desire to hide and not communicate with the outside world at all, for many reasons, fatigue and fear being two big ones. I remember living in terror that I would have to interact with a friend, only to have them realize how out of it I actually was. I know this makes no sense, but that’s what the disease does to perception. To be forced to continue in normal, everyday life in a village environment at least reminds the sick person what life is supposed to feel like, and perhaps hastens recovery if compassion is part of the mix.

Many Vietnamese believe that if a child has signs of being “different” it’s a punishment for something you did in the past, or it’s bad luck that you must atone for. Vietnam is a culture that’s had its moments of animism and mysticism and other -isms that make the population less than logical at times. Since gossip, that form of human communication rooted in all the negative emotions, has often been the villager’s best hope of getting news, it’s understandable why these belief systems took root. Many Vietnamese still don’t make any important life decisions without a local fortune teller weighing in as well.

Vietnam, however, appears more rosy than many nations in the suicide department, the only really objective way to measure depression and its effects. The World Health Organization reported in 2012 that it was one hundred twenty-three on the global list, tied with Gambia, whereas the U.S. came in at fifty (South Korea took the number one position. I suspect their northern neighbor is worse, but there’s no current way to measure that). Male and female suicides were roughly equal in Vietnam that year.

Anecdotally, this makes sense to me. For example, Larry and I have seen poverty in Vietnam, but unhappiness is not always a by-product. On the contrary, people we know who have very little seem satisfied with their lots in life, and take pleasure in things we Americans tend to overlook, or don’t consider important. Like American Indians, Vietnamese appreciate and revere Mother Earth and all she has to offer, and this seems universal to the culture. It’s one of the reasons food is so central: it came from Her abundance. Constant reference to ancestors and knowledge and reminders of your family’s roots is also fundamental. There is a lot more to be thankful for than material wealth and well-being, and the numbers on the mental health of the culture bear this out.

Note: the featured image is of Mrs. Van, who was beaten by her husband before divorcing him. She has successfully started a take-out food business in her village using a microloan, and plans on sending her two children to university. After telling us her story, she is congratulated by Mrs. Mai.



Author: Pamela Foard

Teaching and playing professionally since the age of 19, Pamela Foard was appointed a teaching assistant position at her alma mater, Indiana University, while earning a Master’s Degree in Violin Performance. Once graduated, she further honed her teaching skills at the Wisconsin Conservatory of Music in Milwaukee, and opened her private violin and viola studio in 1978 in Brookfield, Wisconsin, which was active until her move to Los Angeles in 2014. While at IU, Pamela studied with Italian violinist Franco Gulli and Polish violinist Tadeusz Wronski. She has also studied with Gerald Horner of The Fine Arts Quartet, University of Wisconsin-Milwaukee; Dr. Gerald Fischbach, Edward Mumm, former Concertmaster of the Milwaukee Symphony Orchestra, Piotr Janowski of the New Arts Trio in Milwaukee, and Vartan Menoogian of the University of Wisconsin-Madison. A transplant from the East coast to Milwaukee, Wisconsin, Pamela was barely out of her teens, when her talents as a freelance musician led rapidly to positions as assistant-concertmaster of the Milwaukee Ballet Orchestra, the Wisconsin Philharmonic, and concertmaster of the Green Lake Festival Orchestra (Sir David Willcocks conducting), violinist with Skylight Opera Theater, and under Music Directors Kenneth Schermerhorn and Lukas Foss, the number one substitute violinist and violist with the Milwaukee Symphony Orchestra from 1970 to 1986. Pamela founded an all string, unconducted orchestra, Sinfonia Concertante, in Milwaukee in 1979, and was the Artistic Director and Administrative Director for four years, where she also served on the board of directors. She was also the Managing Director for Milwaukee’s contemporary music ensemble, Present Music, from 1996-99. In 2006, she and her husband were invited to be artists-in-residence in Hanoi, Vietnam for a three month program, where they collaborated with Vietnamese artists. She commissioned a tuba concerto for her son Aubrey (currently a professional musician in the Charlotte Symphony and head of the low brass department at the UCLA Herb Alpert School of Music) in 2008 from Wisconsin composer Mark Petering. In a series of fundraisers for various levels of sponsorship of the concerto, she solicited from donors over $20,000. Pamela has published two books: "Wedding Music Essentials" and " In Concert: The Freelance Musician's Keys to Financial Success”. Presently, Pamela continues to freelance and resides in Marina del Rey, California with her husband, the fine art photographer Lawrence D’Attilio, and their cat Dasher.

One thought on “Depression in Vietnam”

  1. Pam,
    You always struck me as a very happy person, very gifted, and had a great smile. You also have courage to be open about what affects so many people, and especially musicians or artists. Playing music was the only time life really made sense for me because it is a world apart from the one we live in when we are not playing if that makes any sense. I wish you the best. Playing music is good for the soul.
    Larry Lange


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