Mental illness is often misunderstood as an issue of individual character or weakness, and the struggles aren’t validated as a medical issue. The stigma that can result from openly discussing mental health issues can therefore prevent some Asian Americans from reaching out for help and lead to a sense of isolation and shame. Within the AAPI experience, there are certain cultural factors that may reinforce that feeling even more, says Dr. Ng.
For example, the idea of shame, or “loss of face,” is one that resonates for many in the AAPI community. The concept of “face” refers to the appearance of one’s social standing, reputation, and respect within a community and is closely intertwined with that of the family. As a result, someone experiencing a mental health issue may avoid seeking care due to the feeling that they’d be shaming not only themselves but their family too. “There’s the double stigma and double barrier,” Dr. Ng says, adding that many may also rely on family to solve issues rather than bring them to people outside the family system. “That concept is called interdependence, and it’s challenging because mental health literacy and awareness of resources may be limited within the family,” says Dr. Ng.
He says the first step in overcoming these barriers is “acknowledgement, curiosity, and openness. And asking, ‘Where do we have our own blinders?’ There’s a lack of understanding that mental illness is an illness, and that, like asthma or like diabetes, there is a treatment.” Breaking the silence also helps to prevent reinforcing the stigma and shame.
To help foster the understanding that mental illness is a health issue, Dr. Ng suggests “medicalizing” the language used when speaking about it. For example, he says, focus on the fact that depression is a disorder of the brain studied in neuroscience, or that it can be treated by medications that “correct” the deficiency of some neurotransmitters like serotonin — similar to the way diabetes is the deficiency of insulin for the body and “correcting that imbalance” helps us remain healthy.
“When I do thyroid hormone tests to rule out that medical cause of depression, some people are so relieved to imagine that what they are experiencing could be a ‘medical’ illness,” he says. “The irony is that it is only stigma that separates those experiences.”