Overcoming Mental Health Stigma Within South Asian Communities One Story at a Time

by Sheena Vasani

Growing up, we hear aunties and uncles boast about and compare their children’s grades, looks, and other signs signaling a promising future of social status. And as we get older, everything is up for comparison—the amount of money we make, the career we embark on, the lives we show to the world on social media, and even the ones we love.

The expectations are always rising and our self-worth is always plummeting. Sometimes, it feels like we are never enough.

Undoubtedly, being a young South Asian woman in the U.S. poses unique pressures and challenges. There is the pressure to live up to the usual unhealthy mainstream  standards of female perfection, but then there are also many cultural expectations to uphold to.

Combined, it amounts to a silent understanding that to be an acceptable South Asian young woman in the U.S. often means to value being a somebody over simply oneself.

While all women from all backgrounds do struggle with this internal struggle, this is an issue that is increasingly becoming more and more problematic for our demographic.

According to a report in India West, young South Asian women in the U.S. have a higher suicide rate than the general U.S. population.

As the article delves into, many reasons account for this high figure, from anxiety, cultural stigma, to greater racial and social issues affecting South Asian communities.

As Aruna Rao, associate director of the New Jersey chapter of the National Association on Mental Illness, said, “We are the model minority, so there’s no one to talk to.”

Clearly, mental health is still an unexplored issue, not talked or written about enough. And that’s why I’m happy to launch a new section on Brown Girl, dedicated to promoting mental health among young South Asian women.

I hope to initiate conversation not just about the mental health crisis in our communities, but also, about what it means to be a psychologically healthy, self-compassionate South Asian female.

What does she look like?

How does she live?

What can we do to help our culture nurture and support her emotional growth?

These are important questions to ponder because, at the end of the day, this isn’t just an issue about mental health. This is a South Asian feminist issue as well. We may have achieved a lot of admirable socioeconomic success in the West, but our young women are suffering because of the lack of attention paid to psychological empowerment in our close-knit communities.

[Read Related: What My Bipolar Disorder Taught Me]

Moreover, in the West, female empowerment often equates itself with professional power and success. But how true and healthy is that definition of empowerment for us South Asian women, when the pressure to be perfect and attain social status is one of the things leading us to dehumanize ourselves and end our own lives? There’s clearly more to female empowerment than just the professional aspect of one’s life.

So, let’s start talking about that.

I’ve known many, including myself, who have struggled to maintain positive mental health as a result of many of our unique cultural struggles. From a firsthand, I know that many of my problems deepened and I could have gotten better faster if there was less stigma, education, and women like me openly talking about their lives.

I’m hoping to break this cycle of silence by talking about my own journey towards an emotionally healthy life, what I’ve learned, and what works for me.

For example, I’ll be writing about my own journey replacing unhealthy perfectionist attitudes for a healthier mindset through my creativity–specifically, the designs I create and sell on the Etsy showroom, called HerSoulExpression.

The name is purposefully referring to self-expression, reflecting the healthier values I aspire to embody of authenticity, individuality, and being okay with failing and learning. It’s about the journey of growth rather than outcome–a celebration of taking up new things, trying and failing (because, for me, I neglected my artistic side for years in fear of being mediocre), but getting back up, learning, and trying again has changed my life for the better.

Beyond writing about my own journey, however, I will also promote individuals and initiatives that seek to promote psychologically healthy attitudes and ways of living.

Specifically, I will write about:

  • Resources to help and inspire you. Believe it or not, there is help for South Asians living in the Diaspora—from nonprofits, e-books, community groups/centers, counselors to websites like Brown Girl, HumanologyProject.comMasalamommas.com and India.com.
  • With the unique issues South Asian young females struggle with, we hope to offer tips from professionals, activists, and young women facing mental health stigma in their communities. We will continue to publish more stories that inspire emotionally healthy lives. Feel free to also contribute your own stories, ideas, experiences, and tips.

Here’s to breaking the cycles of suicide and silence. No, you’re not alone.  And yes, it can and it will get better.  Join us as we eliminate the taboo associated with mental health.


Sheena VasaniSheena Vasani graduated with a degree in International Relations from UC Berkeley.  She is a self-described compassion, gender liberation, and mental health activist, and has worked with various social justice initiatives, including V-Day.  In her free time, she ironically enjoys exploring various religions, cultivating her creativity, and cuddling her kitten. You can follow her on Twitter, and on her personal blog.

By Brown Girl Magazine

Brown Girl Magazine was created by and for South Asian womxn who believe in the power of storytelling as a … Read more ›

‘Uprooted’: A Powerful Short Story of Assimilation, Mental Health and Immigration

BGM literary editor Nimarta Narang is honored to publish this short story by the brilliant writer Ria Mazumdar. This story delves into very deeply important and timely themes of assimilation, family, mental health, and familial obligations.

Trigger warning: Self-harm and suicide.

America just didn’t have the right supply of spices, Neel thought as he scanned the towering aisles of the grocery store for the third time. White fluorescent overhead lights illuminated the vast shelves, which contained over three different brands of ground black pepper. While cardamom, let alone coriander powder, was nowhere to be found. On a daring day, Americans would venture to purchase paprika, which was about as seasoned as their cuisine would get. Although he had spent years in this country, the aroma of his home — an exquisite blend of turmeric, cumin, and freshly monsoon-drenched earth — still haunted Neel’s memory as he sighed into the dry, stale, air-conditioned atmosphere of the American supermarket. The same land that was supposed to grant him more constitutional rights had also robbed him of his sensory joys.

Resigned, he loaded up the metal shopping cart with ground pepper and paprika, wheeling it toward the cash register. A foreboding premonition rose to the front of his mind: without the right spices, his cooking just wouldn’t turn out right, and his wife Rana would break into tears, launching into her routine tirade. Paprika was one of many triggers of homesickness. She would rage against the frigid winters of Massachusetts and lament the absence of her family, telling him how much she regretted ever meeting him. Neel mentally prepared himself for this reaction as he braced himself to exit the store, walking headfirst into the harsh New England chill.

[Read Related: Intersections of Mental Health and South Asian Communities]

The pristine plains outside the supermarket stretched endlessly, as silent flakes cascaded down like sunbeams in the moonlight. As he clenched the thin plastic bags with his gloved hands, Neel proceeded toward his used Toyota Camry. The wind snarled mercilessly, tearing through the night like a whip, bearing no consideration for Neel’s circumstances. It did not recognize that he was a foreigner who had not seen snow until the age of 30, when he was tossed headlong into this abrasive climate, greeted by raging frost on a frigid December dusk. Though the walk was short, Neel trembled to the bone, pulling the diaphanous fabric of his navy blue Big Lots jacket closer to his skin. He was well aware that the flimsy, six-dollar garment was completely inadequate protection, but every penny he earned had to go toward a soft, down jacket for his small daughter.

The thought of his daughter gave him the adrenaline he needed to prevail against the hissing wind. One foot in front of another, he trudged cautiously along the snowy path, seeing nothing but a flat expanse of white before him. In the distance, a streetlamp cast a bluish glow. Finally, he reached the car and opened the door hastily, leaping inside to preserve every drop of heat. Arranging the groceries carefully on the seat beside him, he put the key in the ignition, immediately turning on the cassette player.

Barely any cars had cassette players these days, but Neel had gone out of his way to install one specifically so that he could listen to his old tapes from home. Familiar melodies were his only company on these long, solitary drives, providing stolen moments of tranquility. He emptied his mind, following the undulating roads from muscle memory, erasing any obligations to the outside world. The lyrics of his mother tongue washed over him like lukewarm water.

Sinking into a familiar tune lined with the rising drone of a harmonium, Neel came to a stoplight, drifting in this rare state of mental peace. Suddenly, two loud knocks rammed on the car’s rear window. Neel rolled down the window, seeing two men in the shadows. They were pale-skinned, dressed in extra-large gray hoodies and baggy black sweatpants, rapping at the car rambunctiously — the vapor of their breath emerging in wispy, smoke-like clouds. “Hey, sand n****r!” one yelled. “We don’t need another 9/11, go back to where you came from!” 

The light turned green, as though it wanted to let Neel escape, and he stepped firmly on the gas, leaving the men’s laughter trailing in the distance. A small American flag ruffled halfheartedly on the dashboard, just above Neel’s brand new U.S. passport stowed in between the seats.

Neel drove on, feeling more resignation than anger. Such incidents were nothing short of expected for someone coming into this great country, where life, liberty, and the pursuit of happiness were granted to all, as long as they read the fine print. Racism and liberty — it was a package deal. Neel internalized each of these encounters as an exam, an opportunity to prove his stoic nature. He had adapted to his new life. Anyway, with whom could he share such experiences? The last real conversation he had with Rana occurred even before their wedding when he still lived under the euphoric illusion that his parents had discovered the right girl for him. Now, he dreaded seeing his daughter if he knew Rana would be around as well. Maybe someday the little girl could help shoulder some of this burden. Until then, he kept his chin up and moved along, expressionless.

He pulled into the garage, grabbed the groceries and steadied himself before stepping into the doorway. Old photos of his parents greeted him; the only fixtures on the white walls. His daughter, darting through the simply-furnished living room, ran up to hug his calf. He smiled and picked her up, twirling her around a couple of times. 

“Want to help me unpack the groceries?” he asked. She nodded and skipped into the kitchen, her fluffy pink slippers thudding solidly with each landing.

As Neel followed her into the kitchen, he caught sight of Rana watching television, slouched on a couch, wearing her stained purple bathrobe as though she hadn’t moved since the morning.

“Ey,” she called out by way of greeting, her eyes still transfixed on the screen. “Did you bring the fish?”

Neel scanned the items laid out on the kitchen table. “No,” he said with a sigh. “Just chicken — I thought fish was for you to buy next week.”

“I wrote it on your list,” she retorted, her eyes still unmoving. “Why do you never listen to me?” Neel remained silent. As Rana’s tone grew icy, the daughter continued to prance around in the kitchen, unperturbed. Not oblivious, merely accustomed. 

Neel poured the paprika onto a plate with some salt and prepared to turn on the stove. Suddenly, Rana got up from the couch and ambled into the kitchen.

“I want to take her to India next month,” she said, gesturing at her daughter. “We haven’t been back in over two years, it’s time.”

“We barely have enough saved up to get her a proper jacket,” Neel said, continuing to prepare his cooking.

“If she had been brought up in India, she wouldn’t need this ‘down jacket.’” 

Ignoring this counterfactual, Neel smiled dejectedly. “Well, maybe you could bring back some cumin. God knows this house is missing some.” He regretted these words as soon as they left his mouth. His half-hearted jokes these days simply hung suspended in the air, dissipating and leaving quiet trails of resentment lingering in their wake. 

“So, you’re saying we can go? You need cumin. I need my family.”

“No,” Neel said firmly. “We have to wait some more.”

His words seemed to flip a switch in Rana’s eyes. Previously drooping and groggy, her pupils alighted with sparkling embers. 

“I always wait for you!” she shouted. “I don’t want to live in this godforsaken place. We don’t even have a proper store nearby. We can’t even eat proper food. You dragged me here!” 

His ensuing silence only served as an additional provocation. Rana raised both hands to her head, grabbing her hair in tufts. “I HATE you!” she screamed, yanking out hair in chunks while wincing at the pain she was inflicting upon herself. Neel, all too familiar with this show, silently continued to chop tomatoes. Right down the seam in the middle, a clean slice, taking great care not to let them burst and lose juice to the cutting board. He clicked his tongue in exasperation as one lone seed came away from the whole, breaking the fruit’s pristine symmetry. 

Neel’s lack of attention infuriated Rana further, while the daughter continued to sit serenely near her father’s calf. Glancing around the kitchen, Rana seized a small white ceramic plate from the Corelle set her parents had given them for their wedding. Scrunching up her face, she hurled it at the wall in a sudden burst of energy. 

“I wish I were dead!” she yelled, her voice breaking and her breathing quickening, growing shallow. Neel kept his gaze on the tomato before him. He mustn’t lose any more seeds. Dice the half down the center, turn and dice again. Rana turned, running out of the kitchen, while her daughter stared confusedly at the shattered ceramic.

***

Indian cooking is a methodical process. In some cuisines, people throw everything in a pot and let their concoctions simmer. Not so here. One must first sauté the onions, and then gently lower the heat. Only then can the spices be added, coating the onions in a thin layer. After hitting a certain level of fragrance, the remaining ingredients are added, one by one. These steps are like a formula, nothing short of mathematical. Neel approached the stove, following these motions, seeking solace in his own muscle memory as he did during those peaceful, solo drives. The daughter skipped happily out of the kitchen.

Once everything had been added to the pot, Neel bent down to pick up the shards of ceramic Rana had left on the floor, sweeping them as far away from his daughter as he could. He felt a distinct lack of loss looking down at the broken pieces, remembering the day her father had presented them with the Corelle set and a pack of gleaming silverware. He really did like his father-in-law. He recalled smiling and laughing, putting his arm around Rana and envisioning the setup of the American home they would call their very own. Although he could replay these memories in sharp focus, he now felt a strange emptiness in his chest. The knifelike pangs of the past seemed to have left him, just as his fury abandoned him when those two men tapped on his rear window. Part of him wished he could muster up that rage. Rage at the men, rage at himself for allowing the societal taboo of divorce to keep him trapped in his crumbling marriage. But instead, numbness enveloped his heart like a thin sheen of ice, simultaneously sheltering him from the polarity of emotion and inhibiting him from release.

Suddenly, he heard a loud thud outside the kitchen. Alarmed, he stepped out, running to the bathroom. The long glass mirror, stained with the debris of the past few weeks, interrupted his reflection as he stood at the door. Three glass dolls that were also once wedding gifts guarded the basin, once pearly white, now discolored in splotchy, uneven patches, grime lining their foreheads in faded streaks. Inside the basin lay twenty sleeping pills, clumped together, just fallen from reach. The open pill bottle lay sideways by the faucet. On top of the toilet lay a razor stained with fresh blood, the scarlet liquid slowly trickling onto the porcelain. Rana lay weeping on the floor, a lone pill in her hand and three long gashes tearing open her shin. The daughter watched.

“I couldn’t do it,” Rana sobbed. “I have to live, for her.” 

Rana knew, but could only admit in her own mind, that she did not want to die. She did not believe in a life after death, only in blankness. But what she wanted was the opposite of blankness. She wanted a release from life as an immigrant. No fresh start can numb the pain of a tree that becomes uprooted from the place it has always stood. Suddenly, it is commanded, not merely to adapt, but assimilate. To shed old leaves and camouflage amid a new, foreign forest. To survive in sub-zero temperatures after being kissed by humid tropics its whole life. To withstand a snowstorm with nothing but a six-dollar Big Lots jacket.

[Read Related: How to Find Mental Health Balance as a South Asian Millennial]

So Rana did not want death. She wanted her hometown, the vibrant island of joy that lay on the opposite end of the planet. She wanted the fragrant monsoon rains that pelted the soil with scent, the same soil from which her own roots sprouted for years before being cut. She wanted a place where English was subservient to her mother tongue, the latter emblazoned everywhere from street signs to soap bottles. She wanted the spices, those long-lost aromas that the “ethnic” food aisle could only dream of capturing. Her body ached to take a dip in the Ganga River. What some, to this day, call the “Third World,” was always her first and only. This place she had landed in was not home. Regardless of what animal inhabited the cover of her passport, it would never be her home. While her body had crossed the circumference of a planet, her heart had stayed back. She knew that her family was a casualty of her pain. Yet it consumed her in clutches so tight, she felt like a puppet of her own longing. Her actions were no longer her own, driven by an unquenchable thirst, the desire for return. So she lay helplessly on the bathroom floor, rocking silently to the rhythm of her sadness. 

The daughter looked on, hips akimbo, her head slightly tilted to one side. She was ignorant of her future as a sacrificial hybrid tree, one that grows uncertainly, unsure of its own existence between two lives, two anthems, two tongues, two allegiances, and even two parents. 

As the daughter observed the scene — the glaze of innocence veiling her sight — Neel watched her with a dull sense of regret. He approached the bathroom sink without looking down at Rana, who remained curled up at his feet. He reached in with those hands, worn beyond their years, and picked up the pills one by one. This was one routine he hoped he would never have to teach his daughter.

Taking the little girl by the hand, Neel guided her to his own room, handing her some toys and turning on the DVD player. 

“Just wait for me to finish making dinner, okay?”

She plopped down on the bed, already distracted.

Rana stayed on the floor, bearing the distance of an ocean in her empty chest. The daughter, playing with a Barbie doll in the other room while watching a Bengali cartoon, was already bearing the duality of a world she could not yet understand. And Neel, impassive, carried the weight of a thousand retorts buried deep within his heart. He and Rana had crossed a sea together but failed to cross the impasse that lay impenetrably between them. Neel stood at one end, unwavering, while Rana lay at the other end, drifting amid her own salty tears.

Neel finished cleaning the sink and set the pill bottle back inside the medicine cabinet. He returned to the kitchen, as though the entire incident had been just another task on his to-do list. As he sprinkled more paprika onto the food and resumed his work at the cutting board, his vision clouded. Onions had always made his eyes water. 

When you grow up seeing blood stains on your shampoo bottles, your sense of normalcy shifts as mine did. You don’t cry when you trip and fall on the playground, because you had just seen blood the night before when your mother took a clothespin to her forearms. You watched the blood leak slowly down her clothes and onto the floor, where it left a dark brown shadow for you to see the next day too. You are unfazed when your classmates roughhouse and toss pencils across the room because a pressure cooker was hurled right past your head on your fourth birthday. You rip out pieces of your hair when you get stuck on a math problem because you are following the example of the biological role model that the world assigned to you. You hate this biology for making you what you are: a living reminder of your parent’s suffering, of the hurting of immigrants worldwide. You have escaped that pain simply because of the soil you were born on. And so the burden on your shoulders is inexplicable, as you carry the weight of a parent’s mental health, her suicide threats, the weight of her entire life, day in, day out. Your heart slowly starts to contort inward, its once fiery heat chilling over time like that cold Massachusetts night, for the only love you have ever known is wrapped in tears, sleeping pills, and razor blades.

Artwork: Shutterstock

By Nimarta Narang

Born and raised in Bangkok, Thailand, Nimarta grew up devouring Hindi movies, coming-of-age novels and one too many psychology textbooks. … Read more ›

Men, Mental Health and Vulnerability

And it is beyond the point of “let’s talk about it.”

Time for action. 

Mental health hits close to home for me. As a filmmaker, I will always share my journey with others.
– Jacquile Singh Kambo 

Men, mental health and vulnerability often aren’t talked about enough. “Embrace” is a short film that seeks to change that. It is a short animated film about Arty, a well-dressed man who has no face, gets ready for his date until he meets a younger version of himself. Arty and this younger version of himself delve into a surreal world where he learns to embrace himself. It’s him versus himself.

The façade self; the feeling of wanting to be somebody — are all things people are dealing with especially in adult life. From the dating world to the social media world — it feels like different masks are worn only to make us feel faceless, feel numb or a nobody. Too many masks could make people feel like a lost identity amidst everything that is going on in this crazy world. Out of touch, and out of life — with others and with themselves. The masks are metaphorical, the story is internally about men and mental health. Arty learns to ’embrace’ himself and to overcome his internal struggles.

Not often is it discussed that men should have a safe environment to be vulnerable, amongst others or even other men. Perhaps this is because men are wired to put on a façade when things go wrong, when things get difficult, or when true emotions are not expressed. If these are not dealt with, it can lead to other relationships, including romantic relationships. Further it becomes a cycle: suppression could lead to aggression, substance abuse or self-sabotaging behaviors and could create a toxic environment. Many of these arise from childhood trauma. Quite often childhood is repressed or ignored, and one may take their troubles along with them into adulthood. Perhaps revisiting the roots of the past can help one become successful in a better tomorrow. “Embrace” is an example of how important it is for men to embrace their past.

[Read related: Schism: A Journey to Finding My Own Identity]

Why Animation?

“Embrace” was meant to be a live-action film — until animation was considered. Seven years of re-writing, re-working, and digging down deep with the characters for the story to better fit the message at its core. Animation is an underrated avenue for a universal story that became the key pillar for “Embrace”. What many do not know about animation is that you can create a serious subject matter in a light-hearted way that is universally acceptable. Men and mental health are heavy subjects for some, but animation allows the exploration to become innovative, creative and fun. Animation allows the experimentation of entering surreal worlds.

For example, in “Embrace” Arty enters a surreal world where he has to go up against a younger version of himself — to unmask the root cause of his internal struggles and give himself the “big hug” he needs. This heart-throbbing metaphor is captured in animation that a live-action film couldn’t have captured. The freedom of animation helps tackle tough subject matters about self-love, and how we must embrace the soul, the child, the person within.

 

The Story Behind The Story 

There are many inspirations behind “Embrace”. Film noir, the silent film era, surrealism and the works of Christopher Nolan and David Lynch — the film is able to articulate something far more special. This is more than just a mental health piece for educational purposes. This is a classical narrative from beginning to end; a story of important themes and beloved characters that needed to be shared with the world.

It is not often the words mental health and men and vulnerability are discussed under the same umbrella — especially with growing hypermasculinity, and the likes of social media where facades are put up and the vulnerable parts of ourselves aren’t as expressed. It is here where the film encourages men to look within themselves, and allows them to be vulnerable to themselves. Perhaps this is an important step to better themselves on the journey to have successes (whatever success means to them), and to enlighten and lift those around them. The first step should always begin with “you.”

[Read related: Truth Be Told: Breaking the Silence on a Silent Killer, Mental Illness ]

A Call To Action

It’s tough to find places where men have access in ways of improving their mental health without feeling like a patient or a victim in the institutionalized realm. It’s tough to find places where men can talk to other men about their struggles among peer groups, educational groups, and more.

The “Let’s Talk” phase  and awareness is long overdue; it is indeed time for action. Perhaps creating seminars or group-related events and activities to help create vulnerable environments. Art or art therapy can be a great way of producing something stemming from the inner journey. Or maybe it is time to look at “sick days” as “mental health days” as well. Perhaps more can be done to simply just talk about it. It’s time to give ‘doing’ a chance to start in our close-knit communities.

Maybe if one learns to ’embrace’ themselves, only then, perhaps one can fully understand others and their pain — and have the vision of empathy for others. “Embrace” took seven years to write and a year of animation for a four-and-a-half-minute short film. The film is about self-love, embracing one’s self before one can see empathy for others. It is produced by Raman K Fenty and Jayesh Kodwani and his team, directed and written by Jacquile Singh Kambo, co- written by Sidartha Murjani and stars Jenna Berman. “Embrace” has received numerous international accolades including Best Audience choice at the Emerging Lens Cultural Film Festival of Halifax, Nova Scotia, as well as acceptances in hometown Vancouver, Canada; Goa, India and Chicago, United States.

 If you are struggling with your mental health, please call your regional crisis hotline. These are a few non-crisis mental health resources for men’s mental health. 

Feature Image Courtesy: Jacquile Singh Kambo as Embrace promo

By Jacquile Singh Kambo

Embrace team: Jacquile Singh Kambo, award winning Director and Writer for "Help Wanted" (2016) focusing on South Asian gang violence. … Read more ›

Intersections of Mental Health and South Asian Communities

By: Anise Health

The Covid-19 pandemic and feelings of uncertainty, which have been prevalent across the globe, had lasting effects on all of us. One of the more positive impacts has been on the mental health industry, particularly the normalization of mental health challenges and a more open dialogue about mental health. There have been discussions in the workplace, in schools, and even on Hinge profiles, but what about in South Asian communities? Though some progress has been made, mental health stigma is still widely prevalent among South Asians, impacting individuals’ desire and comfort in seeking help. As a result, the South Asian community reports lower rates of seeking mental health services. And of the individuals who do seek out mental health services, many face challenges in finding therapists who are equipped with a multiculturally competent skill set to understand the South Asian client’s concerns. This is why it’s important to recognize and become aware of the intersections of mental health and South Asian communities.

[Read Related: How to Find Mental Health Balance as a South Asian Millennial]

Although there is an overlap between the mental health concerns of South Asians and other communities of color, there are also unique intersections between culture and mental health that I want to bring to the forefront of this conversation. As a South Asian psychologist, who is both a researcher and clinician, I have firsthand experience examining how our individual cultural context impacts our emotional experience. If we can understand, or at least consider, how the cultural context impacts us, we can better understand ourselves and feel seen by others too. We, South Asians, are a diverse group in terms of ethnicity, language, food, religion, traditions, and so much more. So, while learning about the “state of mental health in South Asian communities” is much more complex and nuanced than what I can cover in just one editorial, I believe starting the conversation about issues that don’t get talked about nearly enough is an important first step towards destigmatization. 

What is the state of mental health in the South Asian community? 

Here are some numbers to set the stage, based on research done on South Asian communities. One in 5 South Asians currently reports experiencing mood or anxiety disorders. South Asian youth and young women, in particular, are at greater risk of having suicidal thoughts and behaviors compared to other groups. Only 24 percent of South Asians diagnosed with a substance abuse problem sought treatment. And South Asian Americans express greater stigma toward mental illness than other ethnic groups. How often are facts like these discussed? Not often. Since South Asians are often mixed in with the larger Asian American population, these issues and their nuances are rarely discussed within mental health communities. This underrepresentation can make the reality of our emotional experiences easily misunderstood and make our needs feel invisible. Relatedly, concepts like “model minority” lead outsiders to often assume that South Asians are well-adjusted. And even within the South Asian community, stigma and beliefs about the causes of mental health issues (e.g., mental illness indicates problems within the family, a sign of weakness, etc.) lead all these facts to continue being ignored.

 

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How do mental health concerns intersect with South Asian culture?

While mental health concerns are prevalent among my clients from all backgrounds, these common concerns intersect with culture to create an individualized version of the issue that requires specialized attention and care.  

Substance abuse

Within the South Asian community, there are cultural differences in alcohol and drug use and the discussion of these topics. Alcohol is prohibited in Muslim and Jain faiths which makes open dialogue about substance abuse and its prevalence even more of a challenge within these communities. Admitting you have a problem can be hard and adding the cultural taboo can make it more difficult. 

Career stress

There is a tendency in the South Asian community to highlight that only linear careers in financially stable or ‘reputable’ fields — such as medicine, engineering or finance — will lead to success. This expectation not only impacts career decisions but also mental health, self-esteem, and self-confidence. Even if we think we are not influenced by outside factors in our career choices, how do we know that subconscious messaging is not impacting our decisions? I personally was pre-med for as long as I can remember and was apprehensive if my parents were going to accept my desire to go into psychology and mental health instead of medicine.

Caretaker stress

Caring for loved ones, who are aging or ill, is emotionally challenging for most people. What makes this stress unique for the South Asian community? South Asian communities are collectivistic and therefore rely strongly on interdependence well into adulthood. Therefore, caretaking and providing for elders is an integrated part of our lifestyles. Pursuing personal goals can sometimes be seen as selfish and therefore South Asians feel the need to sacrifice personal desires. This can make setting boundaries in relationships or making decisions focused on one’s own needs especially difficult and not as straightforward as may be suggested by Western psychotherapy interventions. 

Relationship stress

Romantic relationships can be especially stressful for South Asians because of the need to navigate between one’s own desires and family expectations. Older generations pass down messages that people should focus on their careers instead of dating, which can lead to not dating or secret dating and youth navigating romantic relationships on their own. Then, suddenly, the conversation shifts to the need to get married by a certain age, which seems especially difficult when you have not been allowed to date or when it is not something you want in your 20s. South Asians may also experience family expectations about their partner being from the same ethnic/religious background, working in a specific industry, or having a specific family background. These family or cultural expectations and issues also impact the LGBTQI+ South Asian community and South Asians often feel the need to sacrifice personal desires for the expectations that their families or deep-rooted social norms have set for them. 

Emotional Awareness 

Being able to communicate the complexity of our emotional experience is especially challenging when being emotional is considered a weakness. This cultural sentiment further perpetuates emotional suppression and increases the barrier to seeking support. Also, South Asian languages have limited vocabulary to describe mental health and the emotions involved. It is not only challenging to identify our emotions, but it is difficult to communicate the complexity due to the lack of words in South Asian languages to describe those emotions. Let’s take the word, “gussa,” which means “angry” in Hindi. The only way to explain the level of anger you are feeling is to describe the full situation. While in English, you can use variations of the word “anger,” such as “annoyed” or “furious” to describe the emotions with more nuance. 

Body image

Culture is integrated in small and big ways into how South Asians experience their body. It can be common for family members, especially older women or “aunties,” to comment on one’s body weight in direct ways like telling someone they have gotten fat or thin. There are also unspoken rules about food that impact one’s relationship with food and potentially overeating, including “it is rude to not finish all the food on your plate,” or if you don’t go up for seconds that means you didn’t like the food. Research has also found South Asian women in particular often struggle with the pressure to conform to Western beauty norms (e.g. removing dark hair, and lightening skin color). 

Identity development

We all are constantly evolving and understanding who we are and what we value. What makes this unique for South Asians? Culture intersects with other parts of our identity, including generational status (1st, 2nd, or 3+ generation), religious beliefs, gender identity, and age which impact the way we make sense of who we are. Being born in the US makes one American, but are you still American if you primarily connect with your South Asian ethnic identity or maybe your religious identity? Or what messages does culture pass down about what it means to be female? Are you supposed to do all the cooking and cleaning? Do you have to have children? Culture intersects with identity development in complex ways.

How can you get support with what you may be feeling and experiencing?

I believe the first step in breaking the barriers, is shifting your mindset about seeking mental health support from something that means you have a “character flaw” to something that you do for your overall well-being. Taking care of your emotions and processing your emotional experiences is as important as your weekly workouts, annual physicals, or that apple a day. One way to start this process on your own is to spend 10 minutes a day engaging in mental hygiene practices (meditation, gratitude journal, positive experience journaling, writing a thought log, prayer, or deliberate time in nature). 

 

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Alternatively, if you feel ready and have the means, try searching for a mental healthcare provider who actually understands and is aware of your cultural background and belief system. As we think of all the ways mental health can intersect with cultural context, it is helpful when your provider can hold cultural identity as being critical to your treatment. There is a clear and urgent need for therapists and interventions that use culturally-relevant treatments to drive clinical outcomes. One such resource is Anise Health, which is the first culturally-responsive digital mental health platform built by and for the Asian American community. Anise Health, co-founded by Nisha Desai and Alice Zhang, incorporates culture and intersectionality into clinician training and offers a wide range of evidence-based online services (therapy, coaching, self-guided resources) that are tailored to meet your unique needs. 

[Read Related: Truth Be Told: Breaking the Silence on a Silent Killer, Mental Illness]

If any of the concerns I discussed earlier resonated with you, consider signing up for Anise Health by filling out this short intake form; you’ll get matched to a culturally-responsive clinician within two business days. I’ve also listed a few additional resources below that aim to address mental health needs in South Asian communities.

I hope we can continue to bring the ways our South Asian culture impacts our well-being into the forefront of the conversation around mental health. By highlighting the South Asian community’s experiences, we can feel more seen and create a more accepting environment that allows us to get the help that we all deserve.

If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

Feature Image Courtesy: Author

By Anise Health

Dr. Ummul-Kiram Kathawalla is the writer for this article. She advises Anise’s clinical and scientific research programs, as well as … Read more ›