In Conversation with a Nepali Psychosocial Counsellor Mr. Saroj Giree: Your Top 10 Mental Health Questions Answered

Have you ever had a question about mental health but didn’t know who to ask?

You're not alone. In Nepal, where conversations about mental health are often shrouded in silence and stigma, having clear, expert answers can make all the difference.

To demystify the process and provide honest answers, we sat down with Mr. Saroj Giree, a respected counselor and psychotherapist based in Kathmandu. He kindly answered the most common questions we hear from our readers.

This Q&A mental health session is designed to provide clarity, reduce fear, and offer a pathway to support for anyone who needs it.

Meet Saroj Bir Bikram Giree—a passionate researcher, academician, author, songwriter, and psychosocial counsellor whose career has been deeply rooted in guiding people through the complexities of life and mental health. Currently a faculty member at the Center Department of Social Work, Tribhuvan University, Mr. Giree brings over a decade of experience in teaching, counselling, and inspiring students and communities alike.

With his expertise spanning psychosocial counselling and social work teaching, Mr. Giree has become a trusted voice in mental health advocacy, blending research-driven insights with real-life compassion. In this special feature, he sits down with us to answer your top 10 mental health questions, offering clarity, guidance, and encouragement for anyone navigating the challenges of emotional well-being.

Your Questions, Answered by an Expert

1. How do I know if I need therapy? Is it only for "serious" problems?

Mr. Giree: "This is one of the most common misconceptions. You don’t need to be in crisis to benefit from therapy. Think of it like this: you don’t only see a doctor when you have a heart attack; you go for a common cold or a regular check-up too. Therapy is for anyone feeling stuck, overwhelmed by emotions, dealing with relationship issues, grief, or simply wanting to understand themselves better. If something is causing you distress and impacting your daily life, it’s reason enough to seek support."

2. What's the difference between a psychiatrist and a psychologist/therapist?

Mr. Giree: "A great and important question. A psychiatrist is a medical doctor (MD) who can prescribe medication, manage the biological aspects of mental health conditions, and often deals with more severe cases. A psychologist or therapist (like myself) typically holds a Master's or PhD in Psychology. We provide talk therapy, counseling, and use evidence-based techniques to help you process emotions and develop coping skills. We often work together for the best outcome."

3. I'm worried about what my family will say. How do I deal with the stigma?

Mr. Giree: "The fear of 'what will people say?' is very real in our culture. My advice is to first prioritize your well-being. You can start the conversation with your family by focusing on how you're feeling, using physical terms if it helps. For example, 'Ma dherai stress ma chu, tauko dukhiraxa, nindra audaina' (I'm very stressed, I have headaches, I can't sleep). This frames it as a health issue, which it is. Remember, seeking help is a sign of self-awareness and strength, not weakness."

4. How do I find a good and affordable therapist in Nepal?

Mr. Giree: "The landscape is improving. Start by asking your general physician for a referral. Organizations like Kanti Children’s Hospital, Patan Hospital, TPO Nepal, and CEHAT offer services at sliding-scale fees. Some private clinics and practitioners also offer lower rates for students or those in need. Don't hesitate to call and ask about their payment options. It's also okay to have a first session to see if you feel comfortable with the therapist this is called a 'goodness of fit'."

5. What actually happens in a therapy session?

Mr. Giree: "Many imagine a couch and someone taking notes silently. It's far from that! The first session is usually about building trust and understanding your story, your history, your challenges, and your goals. It's a confidential, non-judgmental space where you can be completely honest. In follow-up sessions, we work together to identify patterns, challenge unhelpful thoughts, and develop practical coping skills. You are always in control."

6. My friend/family member is struggling. How can I help them?

Mr. Giree: "The best thing you can do is to listen them without judgement. Don't offer solutions immediately. Use phrases like, 'Ma timro laagi chhu' (I am here for you), 'yesto hunchha' (this happens), or 'ke ma kehi garna sakchhu?' (can I do anything to help?). Gently suggest that talking to a professional can be helpful, and offer to help them find one or even accompany them if they're nervous. Your support can be a crucial first step."

7. Can therapy really help with anxiety and depression?

Mr. Giree: "Absolutely. While medication can be essential for some, therapy provides you with the tools to manage your symptoms for the long term. For anxiety, we work on calming the nervous system and challenging catastrophic thoughts. For depression, we focus on behavioral activation (re-engaging with life) and combating negative thought cycles. It's about equipping you to be your own healer."

8. Is everything I say really confidential?

Mr. Giree: "Yes, confidentiality is the cornerstone of therapy. Everything you share is private, with three very important exceptions: if there is an imminent risk of harm to yourself or others, or in cases of abuse of a child or vulnerable adult. This is a standard ethical practice worldwide to ensure everyone's safety."

9. How long does therapy usually take?

Mr. Giree: "There's no one-size-fits-all answer. Some people see significant improvement in 6-8 sessions dealing with a specific issue. For deeper, longer-standing patterns, it might take several months. It's a collaborative process, and we regularly check in on progress and goals."

10. What is your final message for someone hesitant to take the first step?

Mr. Giree: "My final message is one of compassion and encouragement. Taking the first step is often the hardest part. It's okay to be scared, but don't let fear stop you from seeking a happier, healthier life. You deserve support. There is no shame in caring for your mind, just as you care for your body. A better quality of life is possible, and it starts with one conversation."

A huge thank you to Mr. Saroj Giree for his time and invaluable insights.

If you have more questions, feel free to share them in the comments below. Let's keep this important conversation going.