Depression has become a common issue among China’s elderly. A 2021 survey in Beijing by the Chinese Academy of Sciences’ Institute of Psychology found that 19% of respondents aged 60 or over displayed mild symptoms of depression, while 12% had moderate to severe symptoms. Yet, experts say their offspring often struggle to notice the warning signs.

Even when they do, convincing a middle-aged or elderly person to seek medical care or professional counseling is not easy. A simple search of the subject on any Chinese social media platform yields countless tales of adult children attempting — and, more often than not, failing — to get their anxious or depressed parents the help they desperately need.

Following are the stories of three people who tried, with mixed results.

A “widow” in distress

One evening during the 2022 Spring Festival holiday, Huang Liling noticed that his mother was struggling to breathe, almost to the point of suffocation. She rushed her to the nearest hospital, where her mother was placed on a ventilator. However, the doctor who examined her found nothing physically wrong and suggested that the attack had been psychosomatic, an internal conflict of mind and body. It was only then that Huang’s mother revealed to her daughter that she was on medication for depression.

Huang was shocked. Living in Guangzhou, the capital of southern Guangdong province, about a five-hour drive from her native Guangxi Zhuang Autonomous Region, the 30-year-old had been completely in the dark about her mother’s condition. Later, she learned from her father that her mother had been diagnosed with menopause-related depression in 2021 after going two weeks with little sleep and struggling to urinate.

Her first reaction was to immediately suggest her mother see a psychologist. But her mother objected, claiming that the cost was too inhibitive. It was not until after her mother retired last year that Huang was able to convince her to visit Guangzhou to see a specialist.

Huang initially tried finding an expert in menopause-related depression, but no doctors mentioned it in their online profiles. Eventually, by searching several key terms, she found a psychiatrist at the Affiliated Brain Hospital of Guangzhou Medical University who specializes in women’s psychological issues.

During the first appointment, Huang says her mother was hesitant to communicate with the doctor, and declined to answer some questions, such as whether she had suicidal ideation or heard voices. However, in the follow-up session, she was more lively and responsive. Huang recalls her saying, “I feel so happy. The medication makes me feel comfortable and relaxed.”

Huang sensed something was off, as if her mother was trying her best to portray her “best self” rather than express how she really felt. The psychiatrist later confirmed privately that this was a symptom of her condition, and prescribed a new course of drugs, which Huang’s mother took as instructed.

In the third session, her mother’s mood had changed again. She said she believed the doctor was starting to become impatient with her and did not want to continue her treatment. As she felt happier in Guangzhou, she also decided to stop taking her medication. Huang did not find this out until a month later.

While spending time together in Guangzhou, mother and daughter had several in-depth conversations. Huang’s mother revealed her feelings about her marriage, saying that, from the start, she had received no support from her husband, who also had a quick temper. After listening to her experience, Huang surmised that “having my father as a partner is the same as being a widow.” Her mother had long tolerated the situation, but it had taken its toll.

After that, whenever her mother came to visit, Huang would accompany her for various activities, allowing her to focus on other things. No matter what her mother said, she would respond, even with a simple “OK,” to let her know that she was listening. Huang would also encourage her often, to make her feel valued.

However, early this year, Huang’s mother began experiencing insomnia again after contracting tuberculosis and was becoming increasingly agitated, unable to sit still for any length of time. Huang did some research and took her mother to another hospital in March, when the doctor confirmed that she was again displaying symptoms of depression.

Her mother felt that all her previous efforts had gone to waste, and Huang was also concerned that taking more medication could affect her health, so she began looking for alternative solutions.

In the meantime, when her mother is home in Guangxi, Huang will call every day to evaluate her mother’s emotional state. She’s also been documenting the experience on social media, noting the moments that left the deepest impression in the hope of encouraging others to pay attention to the mental health of their parents.

Quelling the anxious mind

By the time 35-year-old Yang Kai learned about his father’s insomnia in early 2023, the problem had been going on for two months. It had started shortly after his father had undergone a minimally invasive operation to remove a cancerous tumor from his liver. Although the surgery was a success, he had appeared downcast to family and friends afterward — at family gatherings, he now sat uncharacteristically silently in a corner, and he would pace around his home in anxious concentration.

Yang’s father had quit his job as a technical director in Beijing after his cancer diagnosis, to allow more time for treatment and recovery. This meant he was no longer earning an income. He was also worried about the prospect of further tumors.

His physical health had clearly worsened, Yang says. He started experiencing issues with his bowels, chest pains, and backache, and twice had to be taken by ambulance to the hospital, although no abnormalities were discovered after thorough examinations. In May last year, Yang visited his parents’ home after a month away and found that his father had lost almost 15 kilograms and was still struggling with insomnia, despite taking sleeping pills. Yang began to suspect that his father’s mental health was the real problem.

The sleep deprivation had already caused so much distress that Yang did not need to convince his father to go to the hospital. They scheduled an appointment with a cardiac expert who specializes in insomnia at a top hospital in Beijing. After seeing the pills Yang’s father was already taking, the doctor concluded that he couldn’t offer much help.

In August last year, Yang managed to get his father an appointment at the Peking University No. 6 Hospital’s sleep medicine department. On the day of the appointment, the hospital was packed with people of all ages. Trying to comfort his father, Yang told him, “Look, you aren’t the only one with this problem. It’s very common.”

During the consultation, the doctor diagnosed the patient with a spiralling type of anxiety fueled by thoughts of the cancer returning — this caused his sleep problem, which damaged his health, affecting his liver, and in turn heightened the likelihood of his cancer returning. He recommended Yang’s father be admitted to the hospital for two weeks, saying, “If we can fix the sleep issue, recovery will follow.”

He was immediately admitted to a sleep ward, with treatment costing the family 4,000 yuan a day. “Think of it as a vacation in a fancy hotel,” Yang recalls joking with his father. “It’s better to fix it once and for all than to keep suffering like this.”

Cut off from the outside world, Yang’s father underwent mindfulness therapy and electroconvulsive therapy, and ingested various medications. During one visit, Yang says his father told him he had started sleeping at least five hours a night. And he found his mood much improved after he was discharged from the hospital; his father no longer anxiously paced the house.

In March, Yang’s father felt healthy enough to return to the workforce, landing a job in construction and renovation. In addition to helping with his father’s condition, Yang also feels the treatment process brought them closer together. “If you’d asked me to go through the same thing,” he says, “I don’t think I’d have dealt with it as well as him.”

Sharing about caring

Tensions were high from the moment Song Wendie’s mother arrived at her apartment. She stepped through the front door and instantly described the place as “looking like a dog’s den.” The 34-year-old Song had invited her mother to stay with her in Shanghai for a month, giving them a chance to spend some quality time together. However, she’d failed to adequately prepare herself for the constant barrage of instructions and criticism.

The duo had not lived in such close quarters since Song left the family home in the southwestern city of Chongqing for university in 2008. Since moving to Shanghai, she’d developed a habit of calling her parents only every so often, merely to check in and ask about their health.

On that first evening, Song said she was going out to feed the stray cats that wandered through her community, something she often does, but her mother stopped her and demanded she go to bed instead. It was a level of interference Song wasn’t used to anymore, and it made her feel uncomfortable.

Things reached a peak on the third night, at 3 a.m., when Song was startled awake by her mother attempting to forcibly push her onto her back, “because apparently sleeping on my side is bad for my posture.” Song hit the roof, and they argued for an hour, resulting in a tense, sleepless night. They went on to have more fights over that monthlong visit than in the entire previous decade.

However, Song began to notice oddities in her mother’s behavior, one being that she became defensive in the face of even innocuous comments, often complaining that she felt “under attack,” which reminded Song of a friend who had been diagnosed with depression. She’d learned that people with that condition tend to “interpret neutral things people say in negative ways.” This made Song think that maybe her mother could be experiencing a psychological issue.

Song knew that her mother would never entertain the idea of seeing a therapist, so she came up with a subtle plan. She told her mother she’d seen a promotion online for relationship advice that cost just 100 yuan ($13), saying, “We always argue, and it seems I have a bad temper. Why don’t we take this opportunity to see what’s making me irritable?” Framing it as solely Song’s problem worked, and in mid-January, her mother agreed to visit a counseling center in Shanghai that offered group sessions. However, things didn’t go as Song hoped.

Both women were given 30 minutes to share their thoughts. During the session, when Song’s mother was asked by the counselor to rate herself, she gave herself a failing grade, saying that she had a poor relationship with her husband and daughter. Crying, she described how she came from a strict, traditional background and grew up in a privileged environment. Song didn’t buy it; she believed her mother was just trying to show off. “I felt she wanted to give a good impression,” she recalls.

The counselor concluded the session by suggesting Song’s mother should let her educated, grownup daughter find her own way in life, and not be so overbearing. Afterward, Song felt she’d gained a fresh perspective, but when she asked her mother for her feedback, she remembers her saying, “That person is talking nonsense! She says I should not care about you anymore — how can a mother not care about her child?” Song realized that her first attempt to help her mother had failed.

Song feels that her mother’s sadness probably manifested a few years ago. Her mother had long taken care of her own parents, but when she retired at age 56, and then Song’s grandfather passed away, her life started to lack direction. To improve her mood, Song initially encouraged her to socialize more with friends. Her mother followed her advice, but this led to unexpected conflicts with her mother’s siblings, causing further emotional strain.

After Song shared her experience on social media, some netizens commented that it was in fact her who needed to change or be more understanding toward her mother. Yet, she became concerned that if she didn’t intervene, their relationship would only deteriorate further. In February, she tried again, this time contacting a therapist offering online consultations, which would allow her mother to chat one on one.

Surprisingly, Song’s mother did not reject the idea. She went on to meet the therapist three times, although she still didn’t appear comfortable sharing her feelings with her daughter. “She always maintains this sense of being above me, and as a parent feels she can’t reveal her vulnerabilities in front of her daughter. She cares about having a sense of authority,” Song says. The therapist also advised Song to acknowledge her mother’s sacrifices and views, “to praise loudly and criticize softly,” and to guide her in adopting more empathy.

In Song’s opinion, her mother has always accepted social norms, such as being punctual and frugal. However, she imposes these exacting standards on those around her, too. So, Song says she has learned to “pretend” over time. Her mother likes cleanliness, so she cleans up whenever she’s around; she cares about posture, so Song avoids slouching when using her phone; when her mother asks her to do something, she complies immediately. Song adds that, more importantly, she has learned to provide her with emotional support. For example, if her mother posts a video of herself in the family’s online chat group, Song will praise her, such as with “You dance great” or “You organized this so well.”

Lately, their relationship has been moving in a positive direction. When her mother came to visit in October, Song noticed that she no longer criticized her or issued a litany of instructions; instead, often showering her with compliments. Yet, when she attempted to acknowledge her mother’s progress, the older woman protested, saying it was in fact her daughter who had changed for the better.

(Huang Liling, Yang Kai, and Song Wendie are pseudonyms.)

Reported by Yang Xiaotong.

A version of this article originally appeared in Oh Youth! (36Kr). It has been translated and edited for brevity and clarity, and is republished here with permission.

Translator: Vincent Chow; editors: Wang Juyi and Hao Qibao.

(Header image: Visuals from IMAGEMORE/VCG, reedited by Sixth Tone)