Some nights I scroll too far.
The algorithm offers up tears from Tokyo, panic attacks in Nairobi, therapy memes from Buenos Aires. I watch a woman in Jakarta describe her “undiagnosed ADHD,” a teenager in Toronto wondering if he’s “autistic-coded,” a pastor in Atlanta explaining trauma to his congregation like a TED Talk.
It’s as if mental health has become the world’s newest export — not just language and frameworks, but an entire map of what it means to suffer, to survive, to be “okay.”
We are globalizing the mind.
And in doing so, we are redrawing the borders of sanity.
We’ve done this before.
🧵 One: A History of Tangled Nets
Globalization isn’t new. We’ve had many waves: ships, spice routes, telegraphs, Instagram servers. Each wave brought goods, yes — but also ideas. And tucked into those ideas was always some whispered standard about what it meant to be rational, civilized, sane.
In the late 1800s, asylums rose like monuments across colonized lands. In British India, trance states were called “religious mania.” In Sudan, spirit possession became “hysteria.” French psychiatrists diagnosed Haitians with “tropical neurasthenia.” Missionaries and doctors joined forces to “cure” spiritual distress by replacing ritual with restraint, elders with electroshock.
Madness became measurable.
And once it was measured, it could be managed.
🪝 Two: Whose Normal Is It, Anyway?
Michel Foucault once wrote that madness is defined by its distance from power — that those who control the discourse draw the lines between the sane and the unwell.
And during the colonial period, those lines were not just drawn, but shipped.
To be colonized was to be dismembered — land, language, and mind. Local expressions of grief, rage, spiritual crisis, or resistance were pathologized. Entire cosmologies were rewritten. A woman dancing in trance for her ancestors became a clinical subject. A boy hearing voices became a broken brain in need of fixing.
Later, as the empires collapsed, a different empire rose.
This one sold pills.
And it sold them in the name of “mental health.”
🌍 Three: The Chemical Romance
In the second half of the 20th century, psychiatry became more pharmacological, and pharmaceuticals became global. Depression, anxiety, schizophrenia — these diagnoses went worldwide, translated into dozens of languages, marketed in the pages of Vogue India and Nigerian newspapers.
This was not all bad. For many, medication brought relief.
But it also brought a kind of monoculture — one that assumed distress lived solely in the brain, not in poverty or politics, not in family systems or ancestral wounds.
Today, WHO’s “mhGAP” programs export Western screening tools to countries like Uganda and Nepal. These tools often reduce complex communal distress into checkbox symptoms. They offer Prozac, but not ritual. A DSM label, but not a drum circle. A hotline, but no grandmother to hold your face and remind you who you are.
📱 Four: TikTok and the New Empire
Now we’re in a new wave: digital globalization.
Madness moves through memes.
The DSM is recited in voiceovers.
Kids in Accra and kids in Oakland self-diagnose with the same hashtags.
Trauma is trending.
This, too, is a double-edged sword.
There is something beautiful here — global solidarity, the normalization of suffering, language for invisible pain.
But there is danger in flattening every ache into a diagnosis.
In assuming everyone’s sadness is “depression.”
In teaching a young girl in Manila to doubt her own body’s wisdom in favor of a clinical checklist designed in a Boston boardroom.
The internet doesn’t just connect.
It colonizes.
And it doesn’t ask first.
🌊 Five: What We Lost — And Might Still Reclaim
In many cultures, madness was not a disorder.
It was a threshold.
A spiritual calling.
A rupture that made space for transformation.
The Dagara people of Burkina Faso have long believed that those who “see things others do not” are often being called by the ancestors to become healers. In the Philippines, trance mediums were once the keepers of balance between the seen and unseen. In Lakota tradition, the person who struggled with overwhelming visions was held by the tribe — not cast out.
What would it mean to remember that?
To hold madness with reverence instead of restraint?
To ask: what if the mind is not broken, but breaking open?
✨ Six: May the Net Catch Us, Gently
This tangled net — this globalization of mental health — is not inherently bad.
But it is incomplete.
The West does not own suffering.
It does not own healing.
There are many ways to be human, many ways to hurt, many ways to come back from the edge.
Let us not mistake mass adoption for universal truth.
Let us listen for what we’ve forgotten: songs, sweat lodges, soliloquies, spirit dances.
And if we are to globalize anything — let it be compassion, pluralism, and the courage to say:
you are not broken, even if the world is.
✨ The next edition of The Tangled Net arrives next Friday.
May you carry yourself through this week with kindness toward your body, space for your thoughts, and softness for every aching part of your heart. And if you find yourself a bit knotted — may it reveal something honest and healing.
💛 If your own net feels too heavy to hold alone, we’re here.
The California Grief Center offers support for individuals, couples, families, and organizations — across California and virtually nationwide.
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You can sign up here for The Grief Wave, our twice-weekly newsletter, and receive reflections, grief resources, and upcoming events delivered straight to your inbox.
📚 Endnotes & Suggested Readings
1. Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason (Vintage, 1988)
2. Frantz Fanon, Black Skin, White Masks (Grove Press, 2008)
3. Arthur Kleinman, The Illness Narratives: Suffering, Healing, and the Human Condition (Basic Books, 1988)
4. Vikram Patel et al., Global Mental Health: Principles and Practice (Oxford University Press, 2013)
5. Derek Summerfield, “How Scientifically Valid is the Knowledge Base of Global Mental Health?” BMJ, 2008
6. Megan Vaughan, Curing Their Ills: Colonial Power and African Illness (Stanford University Press, 1991)
7. Ethan Watters, Crazy Like Us: The Globalization of the American Psyche (Free Press, 2010)
8. Bessel van der Kolk, The Body Keeps the Score (Penguin Books, 2014)
9. Ngũgĩ wa Thiong’o, Decolonising the Mind (Heinemann, 1986)
10. Mikkel Borch-Jacobsen, Making Minds and Madness: From Hysteria to Depression (Cambridge University Press, 2009)
