Here's why the stigma exists and how the AAPI community can break the silence.
If you’re part of the AAPI (Asian Americans and Pacific Islanders) community, you may remember plenty of things about growing up in the USA, but it probably took you a while to appreciate the clash of cultural differences between Asians and Americans that shaped our conflicting feelings around the topic of mental health.
For example, many Asian cultures view mental health conditions as a “weakness” — something to be ashamed of. This is in stark contrast compared to the USA. In fact, a 2019 poll conducted on behalf of the American Psychological Association (APA) concluded that 87% of American adults believe that mental illness is nothing to be ashamed of.
This cultural contradiction can cause confusion and frustration for the AAPI community, which only further perpetuates the idea that it’s shameful to talk about conditions such as anxiety, depression, and ADHD — and that it’s even worse to personally struggle with them.
Disclaimer: As a Filipina-American myself, I respect and understand the nuances between the terms “Asian American” and “Pacific Islander” - but to make it easier, I’ll generally refer to our community as “Asian American” or “AAPI” in the article.
If you grew up believing you were “weak” or “ungrateful” because of your mental health, you’re not alone. When I started struggling with severe depression and anxiety as a teen, I turned to my mom for help. (Fun fact: it was actually undiagnosed ADHD.)
The way my mom reacted was reflective of the damaging effects of the mental health stigma in Asian culture. Here are some highlights:
Yeah - none of this made me feel better!
*an endearing Tagalog term for sons and daughters in the Philippines
Trigger warning: mentions hospitalization
Eventually, the severity of my symptoms led to me being hospitalized; doctors determined I was a serious risk to myself and I was admitted immediately.
That was the first time my mom took my mental health seriously.
While this is all in the past (I like to joke about it now; because if I don’t laugh, I’ll cry) — I can’t help but wonder what would’ve happened if the stigma didn’t exist.
Would I have gotten support sooner? What if my mom didn’t discourage me from taking medication or seeing a mental health professional? And where did her protests even come from?
My mother’s reaction isn’t all her fault — it stemmed from generations of ethnic cultural values that are seeded in how the elders of the Asian community typically view mental health. Some of these beliefs and values include:
1. You must put family above all else. When you’re struggling with mental health, it’s seen as a sign that you’re unable to fulfill your familial obligations — which is inherently shameful in many Asian cultures.
2. Be grateful. In immigrant families, it’s almost always the case that the adults sacrificed and struggled so their children could have a better life. Any signs of discontent may be taken as ungratefulness — an insult for what they went through.
3. Your illness is a punishment. According to traditional religious beliefs, adverse mental health symptoms serve as a punishment for “something terrible you must have done in a past life.”
4. You can always pray it away. Religious beliefs also claim that if you would just “have more faith” and “pray harder”, you could “fix” whatever “demons” are in your head.
… Emphasis on the quotation marks.
It’s also important to note that the rise in anti-Asian sentiment due to COVID-19 is also taking a toll on AAPI mental health. In fact, 1 in 5 Asian Americans reported one or more experiences with discrimination, harassment, and assault in the past two years because of stereotypes associated with COVID-19.
Odds are, you’ve heard about several Asian stereotypes throughout your life. Whether they’re negative or “positive” (i.e. ‘Asians are smart’), stereotypes are still harmful because they dehumanize us and reduce us to our race. These “positive” stereotypes are collectively known as the model minority myth, which places an unfair amount of pressure on Asian Americans to live up to impossible expectations and standards.
And if we can’t live up to them?
Feelings of failure sneak up on us, adding another layer of shame to our already-compromised mental health.
Professor Gordon Nagayama Hall, a specialist in Asian American psychology, further explained the effects of the model minority myth:
Everything we’ve discussed so far has been heavy, yes — but it’s shown why it’s so important to overcome the barriers and stigma. Too many Asian Americans struggle, and too many of their stories end in tragedy.
The first step is to normalize mental health discussions and treatment for AAPIs, and you can start by simply opening up conversation with your family about it. But for a lot of us, that can be scary.
If you feel safe enough and decide to talk to your family — great! But it’s also totally normal (and expected) to be anxious about what could go wrong in these conversations, such as:
Just start small and keep an open mind. And remember – no matter what their opinion is, your experience is valid!
It can be hard for any of us to understand something until it’s translated into our native language. In fact, many Asian and Pacific Islander cultures have no direct translation of “mental illness” or “mental health.” Most health terms are associated with the physical body or spiritual self.
Luckily, there’s been a big push in the USA to translate more resources into such languages.
Where to start:
There are plenty of professionals across the US who are competent in AAPI treatment or even specialize in that area. Many of them believe that educating your family is an important part of treatment.
Once you find the right fit, they can provide tools for your mental health discussions with your family. You can also bring your parents to an appointment so they can learn straight from the source!
Where to start:
Even when you have the best intentions, things don’t always go according to plan. Brainstorm an exit strategy if the situation becomes toxic so you can excuse yourself and table the discussion for later.
The most important tip of all: take care of yourself! Talking about mental health can be difficult, and if it takes a toll on you, it’s time to practice self-care — exercise, journaling, calling a friend, meditation — anything that helps you cope with stress in the days surrounding your conversation with your family.
Even though talking about mental health can be hard, the good news is that it’s finally becoming normalized in most of the developed world. There’s been an increased push in the USA to educate Asian American and Pacific Islander communities about mental health, which could significantly reduce the stigma.
You can be a big part of the solution! Be open with your family. Create awareness around the topic. Teach them that it’s okay not to be okay.
I promise it’s not impossible. My mother finally came around to the idea of therapy and medicine after decades of being dramatically opposed to it. And as the United States becomes more open with mental health, she’s also grown more comfortable with it.
See?! There’s hope!
Remember: seeking professional help and treatment doesn’t make you weak, and struggling with ADHD, depression, Bipolar Disorder, OCD, etc. is nothing to be ashamed of. You have the power to change the future of the AAPI community and save countless lives … just by being open about mental health with your family.
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