I rarely spoke to my parents about my mental health growing up because I feared that I would be scolded.
For many Asian Americans, talking about mental health issues, especially to their parents or family, is like pulling teeth.
I recall how mental health was deeply stigmatized in the Asian community, even when I was seeking health services. The nurse I met with at the doctor’s office had no idea what I meant when I asked for a referral for a mental health specialist. I remembered that the first character in the Chinese word for psychologist was heart (心) but I didn’t know the second. With my feeble Cantonese, I gestured to her, “Heart… um, feelings. Talk to doctor about feelings.”
She was stumped and a moment of realization came to her.
“You have heart disease? So you want to see a cardiologist then,” she concluded.
They must have rarely encountered someone who requested mental health services. I ended up Google translating it on my phone and she didn’t look thrilled when I presented the Chinese characters to her. When the doctor did see me, he greeted me in an extremely condescending tone, “ah, so you’re the girl who wants to see a therapist huh?”
Why do older Asian generations not “understand” mental health?
The many factors that stigmatize mental health for Asian Americans, also further exacerbates the problem in the community.
Mental health is very much a Western concept with much of its development and theories originating in Western countries. In Asian cultures, it can be a black and white concept. Feeling sadness and hopelessness may not be particularly tied to hormones or biology, but are believed to be one’s own fault or incompetence.
“What we consider ‘mental health issues’ are described in very specific medical model language from a very Eurocentric lens. This means that what we consider ‘depression’ and symptoms of ‘depression’ aren’t described in a way that is recognizable to Asian parents,” said Dr. Yesel Yoon, clinical psychologist based in New York.
“Traditional American psychology has not done a good job of being aware of cultural nuances. There might be a sense of mistrust of the mental health field because of commonly held beliefs about the effectiveness of mental health care and how it works.”
The model minority myth, the misconception that Asians are a monolith of brainy, law-abiding, successful stereotypes, can also contribute to why we do not acknowledge mental health concerns.
“The model minority myth impresses upon us. Even if we don’t fit the mold of how society views Asians as being high achieving, being perfect, there is pressure from others that makes us feel like we should be that way,” Dr. Wang explained.
Cultural differences in parenting can cause lasting impact on one’s mental health
At times it can feel like Asian parents’ are indifferent and even unsympathetic towards their children’s mental health concerns. Infamously known as “tiger parents,” some Asian parents are thought to be abnormally strict and expect their children to be perfect. Asian cultures value strength, resilience, and being self-sufficient. Those values may clash with ones that are treasured in American cultures such as being expressive, loud, and collaborative. Naomi Gleit, VP of Product and Social Impact at Facebook told NextShark about how her own experiences growing up may have affected her mental health.
“My mom was a tiger mom and placed a lot of importance on education,” Gleit recalled. “I tied those to external validation. I was a perfectionist, I tried to earn self-worth through accomplishments and academics. I thought if I accomplished my dream at the time, which was going to Harvard, then maybe I would be worthy.”
Tiger parents may not even realize that their expectations or the way they speak to their children is harsh or harmful. Asian Americans, and many other third culture children, are often spoken to in a way that would shock their White American counterparts.
“A parent might not necessarily see what they are saying or how they are saying their messages as ‘harsh’ and instead they may defend their words as ‘honest’ or ‘truthful,’” said Dr. Yoon.
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“It is important to recognize the role of intergenerational trauma and expectations about behavior. Their own experiences inform how and what they share with their children. Parents often relay similar messages they have heard and do so in the same manner that they experienced.”
The differences between Asian and Western cultures may have a deep lasting impact on a child’s outlook on life. Growing up, I idealized the families portrayed on 90s sitcoms such as “Full House”. No matter what kind of sticky situation the Tanners got into, they would be met with forgiveness, a big hug and a “I love you.” As a child, I interpreted my parent’s lack of verbal affirmations and abundance of criticisms as a message that I wasn’t loved like other children. It wasn’t until I was an adult that I saw the tenderness in my mom peeling oranges for me or staying up late to help me with a school project.
Gleit expressed similar feelings of misunderstanding her Chinese mother’s love languages while growing up.
“I would go over to my friend’s house for dinner and there was a lot of verbal affirmation, a lot of hugs and kisses. Compared to what I saw, I felt like my mom didn’t love as much as their parents loved them. She didn’t hug me but would pat me on the shoulder and hand me fruit,” Gleit recalled. “I didn’t realize at that time that’s how she showed love.”
“For those who have immigrated to the U.S. or are refugees, their mindset is around survival. And to survive, you have to be strong and be able to weather the storm. For some parents, being harsh is to help their kids build resiliency, and is done out of love.” Dr. Hall explained.
“In many Asian cultures, mental illness is attributed to a lack of willpower or weakness, a lack of emotional self-control or a lack of harmony of emotions.”
How to heal and grow
It’s not always easy to seek help, especially if you’ve spent years of your life having your concerns ignored or invalidated. You are not alone. Together as a society, progress is being made to fight mental health stigma. Here are steps you take to help you heal and grow.
Build a support system
Seek support from people you trust in a safe, supportive space. Whether it’s friends, siblings, or other family members, speaking up and acknowledging your concerns is the first step to dealing with them.
“Connection is a fundamental human need and feeling supported by those we feel connected with is important for healing,” Dr. Hall reminded us.
Seek professional help
Having a professional mental health provider can help you process your emotions and thoughts, and eventually heal from them.
Sometimes it’s hard to comprehend everything that goes on in our lives. At times, we don’t even know why we feel or react a certain way. Having a trained mental health professional can help you cope with your feelings and provide the tools you need to take charge of them. Dr. Yoon expressed that it helps to have a third-party member, which alleviates stress when talking about family or friends.
Break the cycle with your parents
If you feel safe enough to do so, attempting to talk to your parents about mental health can help break the cycle of misunderstanding. After all, your parents might be struggling with their mental health too but were never given the resources you may have now.
“See if you can get to a place of understanding. Our parents are doing the best with what they’ve got. Many have experienced trauma or other stressors themselves, and when our parents haven’t healed, the trauma gets passed down,” Dr. Yoon explained.
This is something that should be approached very carefully and you should consider if there is enough safety in your relationship to do so. Mental health is a very vulnerable topic and it may be hard for Asian parents to see their children in a vulnerable position.
“When approaching your parents to ask about their mental health, I suggest sharing the struggles as very specific examples or how they are impacting you. When speaking about symptoms broadly like saying ‘I am sad,’ it may be hard to understand,” Dr. Wang suggested.
“If we say ‘I can’t get out of bed, I don’t have any energy, it’s hard for me to focus,’ that might be easier for your parents to understand and empathize with.”
To approach your parents to ask about their mental health, Dr. Wang advised us to come from a place of curiosity rather than one that might be construed as accusatory. This could mean pointing out an observation you made about a parent’s reaction to a situation. Be mindful to use suggestive language rather than definitive.
This could look like:
“I noticed you get a bit upset when you have to do this. Is that how you felt?”
“You always get so anxious when you have to do this. Why?”
“If they have a history of that reaction, they might not realize there’s been a different way to show up in those circumstances,” Dr. Wang added.
After gauging their reaction and if it feels safe to do so, you can continue the conversation with suggestions.
This could look like:
‘I learned about depression in school and what you’re describing could be a symptom of it. The teacher advised us to take deep breaths…”
“You have depression. Why don’t you get help?”
What can we do to help stop the stigma?
Openly discussing mental health in your community and sharing how it has affected you is how we can help normalize it. The more we talk about it, the less taboo it becomes.
“There is nothing more powerful than someone you know telling you that they see a therapist or that they take medication for their symptoms,” said Dr. Wang.
“Normalizing mental health as an important part of our lives and understanding that it is something that we can improve with maintenance and care can be extremely powerful in moving our community forward.”
Author’s note: This article was previously published in 2019 and has been updated in 2021 with advice from Dr. Jenny Wang (@asiansformentalhealth) on how to approach parents about mental health. I have also added personal experiences from myself and Naomi Gleit, VP of Product and Social Impact at Facebook. I hope this article helps you readers, wherever you are in your mental health journey.
If you or someone you know is having a mental health crisis and is contemplating self-harm, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).