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CA therapist talks about: Asian American Mental Health

“there’s a reason sadness in my mother tongue

sounds like a sigh that’s been held a while.

I am the eldest daughter of an eldest daughter

I eat the blame and send back forgiveness.

I turn the day into something worthy.” 

– Kimberly Nguyen

 

This is an excerpt from the beautiful poem “i don’t know the word for depression in vietnamese” by poet Kimberly Nguyen (instagram @knguyenpoetry).  We wanted to share this excerpt because we feel that it really talks to a number of difficult Asian American experiences: the language barrier when it comes to talking about mental health, the intergenerational trauma that can pass from parent to child, the expectation of healing on the child’s part, and the emotional labor of the child (and daughters especially). Asian American mental health is a unique experience and is thankfully gaining more attention in mainstream media. As a practice, we are dedicated to supporting Asian and Asian American mental health and raising awareness about these communities. In this blog, we will be sharing more about Asian American Mental Health – why it’s different, and what factors we should consider. 

1) Cultural barriers

In many Asian American families, emotions are very rarely the topic of conversation, and many individuals are shamed for speaking up about mental health issues or just told to keep quiet. Many are also told that mental health isn’t ‘really’ health, and that their family doesn’t want to have to deal with ‘a crazy person.’ For example, it’s expected of both children and adults to be more emotionally reserved (or stoic) and to work hard without complaint. If they show too much emotion, by crying or externalizing frustration, then they are considered to be making a scene and are ‘losing face’ or ‘embarrassing’ the family.

2) Acculturation

For children, teens, and young adults raised in the U.S., many face the struggle of finding their place in the culture of their family and in the culture of their country of residence. This cultural clash can also cause conflict with their families. Many face the challenge of wanting to honor their family’s culture and traditions while also wanting to fit in with their peers. For example, many face the challenge of using their birth name (in their family’s language) or using a more Anglicized name. Another example, for teens and young adults especially, is dating. Many parents want their children to date someone from the same cultural or ethnic background, but oftentimes, their children don’t feel the same need to limit their dating life.

3) Stigma

Asian Americans face mental health stigma not only from their own families, but from teachers and healthcare professionals as well. They may be judged or shamed for reaching out for mental health support, which will make it more difficult to seek out support in the future. For example, parents may tell their children to stop being lazy when they are actually depressed, or to stop thinking negative thoughts when they are actually experiencing anxiety. In other words, rather than thinking of it as a mental health issue, many parents assume it is a simple problem of needing to do more. Another example is that Asian Americans are underdiagnosed and misdiagnosed for mental health issues because many teachers and healthcare professionals either do not recognize their symptoms or assume their symptoms are due to a physical problem instead.

4) Model Minority Myth

This myth is a stereotype that assumes Asian Americans are naturally smart, wealthy, hard-working, and uncomplaining. This stereotype can create resentment towards Asian Americans, and it can result in other people being reluctant to offer help or to take their requests for help seriously. This myth can also hide academic or workplace struggles. For example, an Asian child is assumed to be naturally intelligent, so if they are struggling in school, then they are thought to be lazy rather than to be in need of support. This stereotype also expects Asian Americans to be quietly obedient, so if they speak up or talk back, then they are thought of as weird or embarrassing.

5) Familial expectations

Many Asian Americans are immigrants or children of immigrants. They are expected to be successful both as an individual and as a part of their family. Thus, they can face significant criticism and pressure from their families, and from themselves. Many families put pressure on their children to succeed academically, do well in extracurricular activities, and achieve financial stability, in order to give back to their family. For example, many parents remind their children of the sacrifices they had to make in order for their children to have the opportunity to succeed. In turn, many children find themselves feeling guilty if they struggle with mental health issues because they feel they owe their family success.

6) Familial duties

As children, many Asian Americans are expected to be responsible and help the family. For example, from a young age, many children are expected to translate in school settings, at doctors’ appointments, or even legal documents. These lifelong responsibilities can make it difficult for them to feel like they have autonomy in their lives. If they try to push back on these responsibilities, then they are scolded and reprimanded for being selfish.. Many young adults begin to assume responsibility for the care of their aging parents, as they are building their own lives. When well-meaning friends or coworkers tell them to be more independent, they feel like they are not being understood because that independence can feel like an impossible desire.

7) Language barriers

Many young Asian Americans are multilingual, but do not have the language to talk to their families about mental health. They may not have the vocabulary to explain to their parents exactly what they’re experiencing, especially if their parents never spoke about emotions and mental health in the first place. The poem above beautifully illustrates the difficulty that many young adults are experiencing in conversation with their parents. Many parents also do not know mental health vocabulary, which makes this language barrier even more difficult to cross.

Written by: Angela Nguyen, MSW