Stigma, Silence and Fiction: The Anxious Struggle

Riya has struggled with anxiety since 13, but, despite challenges, she has pulled through. Can others?

Anxiety doesn’t always look like panic attacks and crying fits. Sometimes, it looks like that silence in a classroom after someone asks a question, a message left on read, or a too-loud laugh in the hallway. In India, anxiety is one of the most common mental disorders in teenagers. A cross-sectional study in urban Delhi found that 35.3% of teens aged 10–19 experience anxiety disorders — with social anxiety being the most common subtype [Source -“Prevalence of Anxiety Disorders Among Adolescents,” Maulana Azad Medical College, published via Academia.edu]. An article in The Lancet Psychiatry says that girls are especially affected, with higher rates of disorders consistently reported in national and international research. 

Behind these statistics are teens like Riya. 

Riya (changed name) is a teenager, one who prefers to watch and listen, rather than speak. Long dark hair that falls to her hips frames her face. She wears square glasses; behind the clear lenses, her light grey eyes — rare in her city — seem to notice everything.

“I think everyone sees me as that quiet girl in class, who never speaks up on her own,” she says.

It wasn’t always like that.

“It started when I was thirteen, I think,” she adds.  That’s when she started caring more about other’s opinions, until hers faded into the background.

“Until then, I never really had a problem with presentations in front of the class.” Thirteen was the turning point for her, when her hands started sweating when she had to speak up, when her heartbeat was like gunshots in her chest, fast and loud. She began obsessing over her crooked teeth, how her voice might sound, how others might laugh. “I guess it’s the fear of being judged.”

“I rehearse lines for social interactions," she laughs.

“I literally get into my head and plan what I’ll say if X says this,” she says. She describes conversing with herself “quite easy and actually low-key fun” but feels “well, anxious” when talking to others. “It’s like my breathing quickens, and my heart rate goes up, whenever they say something unexpected, and I have to respond.” 

“I prefer to Google answers instead of asking them in class.” Riya laughs louder. “It’s stupid, I know, but I just get all choked up with the fear that they’ll judge me for asking stupid questions.” She tells me she doesn’t even know who this ‘they’ is. “It could be my teachers, or my classmates. It could even just be my brain, but I don’t really know who it is.”

The Quiet Epidemic

Globally, 10 in 100 teens face Social Anxiety Disorder (SAD). All the symptoms Riya described are characteristic of SAD, and she isn’t alone. There are others who feel as she feels, others who understand her, and who don’t judge. The numbers are even higher in South Asia, but they’re painted with thick silence.

A review published in Cureus (2022) found that 29% of Indian adolescents experience anxiety but only a tiny portion get help. Another study published in BMC Psychiatry in 2021 found that although 1 in 5 adolescents show symptoms of anxiety, only 7.3% of them report it or seek professional help.

That gap is not accidental. It's a result of how mental health is perceived, especially in Indian households.

Stigma and Silence

The Asian Journal of Psychiatry pointed out that cultural beliefs (karma, fate, or the evil eye) are often blamed for distress. This is a factor contributing to the magico-religious interpretations of anxiety and other mental disorders. It pushes away families and individuals from professional help.

“My parents don’t exactly mock me, but they tell me that it’s just a phase. I really hate that word,” she’s laughing now, but there’s no amusement in it. It’s the kind of laugh that’s used to fill silences. “They tell me not to be worried about small things like this,” she finishes. 

And so, like many teenagers, she paints it over with silence.

“I write instead,” she says. “Fictional stories, not like a diary, I feel I’d get a panic attack just by re-reading stuff. And anyone could read it, the thought scares me.” Fiction’s helped her, carving out characters who feel out of place, misunderstood, or trapped inside their own heads. Characters based on real life. “It doesn’t feel as threatening writing fiction, because anyone who reads interprets it in their own way, and don't consider me as the character,” she adds.

The Invisible Barricade - Societal Stigma

Mental health support in schools in India is lacking. Certain urban private schools do employ counselors, but most government and rural schools do not. Even with facilities available, students hesitate to approach the counselor, for fear of being labeled ‘crazy’ or ‘weak’. 

A trial conducted in New Delhi showed improved results with counselor-led interventions in low-income schools — but most students have no access to such resources. 

A 2020 report in The Lancet Child & Adolescent Health pointed out what many teens already feel but can’t always explain — that mental health struggles make up a big part of what hurts during adolescence. Nearly one in six health issues in teens worldwide are linked to mental disorders. But in India, where resources are stretched thin and stigma still runs deep, help often arrives too late — if at all. The report shows what kids like Riya need most: someone to notice them, and support, before the silence turns loud.

But how can you get help when you're taught silence?

“I’m not ‘cured’, not in any sense of the word.”

“But I’ve learnt to live with it,” Riya is smiling, a proper smile that makes her eyes shine, even though the dancing sunlight already lights them up. “I’ve seen through my characters what I can improve, and I’m working on it.”

Not everyone is Riya.

Not everyone can recognise what they’re feeling, or classify their emotions. 

But despite the hurdles, things are changing.

Digital initiatives like iCALL (run by Tata Institute of Social Sciences) are offering free anonymous counselling through phone, email and chat. Since 2012, they’ve helped tens of thousands of callers with confidentiality and empathy. 

One way to combat this is to spread awareness in teens and parents. Hearing from someone who’s been there makes more of an impact than statistics ever could.

Experts recommend some practical steps:

• Start early: Teach children from around age 10 about emotions and mental health in simple, engaging ways.

• Engage parents: Train them to recognise anxiety in their children and respond without judgment.

• Peer-based programs: Encourage mental health clubs, journaling, or creative arts as emotional outlets—approaches shown effective in similar school-based programs in India

Finally, my letter to YOU

Dear teen,

You’re not alone. You’re not numbers or statistics — you’re a real person who deserves empathy and understanding. 

There are other teens out there — teens like Riya and me, who go through the same things you do. We understand you. 

I’m sorry if you can’t get support — I really truly am. I’m sorry if the people around you just don’t get it. 

Whatever anyone says, your feelings are valid. You’re allowed to be scared, overwhelmed, or unsure. That doesn’t make you weak — it makes you human.

There’s strength in small steps. Like asking a question. Like writing something down. Like reaching out — even if it’s just once.

And if you ever feel like no one will understand, I hope you’ll remember Riya. Remember her square glasses, her careful words, and her light grey eyes that notice everything. She's learning to live with it — and maybe, so can you.

With understanding, 

A quiet voice, just like yours.

Written by Ridhi Anish

Ridhi wrote this article as a participant of the Media-Makers Fellowship's May'25 cohort.

This article was adjudged the 'Best Feature Article' created in Week 5 of the program.