Asian American Medical Hazard: Somatic Symptom Disorder

When she was 14, Diana Chao began experiencing severe pain in her eyes.  The pressure buildup in her eyes was diagnosed as uveitis, an inflammatory eye disease that caused her to go temporarily blind.  For the next four years, she repeatedly visited doctors to find the cause of her uveitis, which would recur every few months.   When an ophthamologist mentioned that she had seen the same symptoms in patients with mental illness, it dawned on Chao, who had been experienced depression as a child and was also diagnosed with bi-polar disorder as teenager, that her mind might be affecting her body.  This article from the Philadelphia Inquirer talks about Diana Chao and how somatic symptom disorder, a form of mental illness that manifests itself as bodily symptoms, is actually common in Asians and Asian Americans.

How does mental illness manifest physically in Asian Americans?  The article mentions that how chest pain, headaches, and stomach problems with no known physical causes are common in Cambodian refugees, many of whom are suffering from Post Traumatic Stress Disorder.  It also talks about a Filipina American who experienced daily stomach pains which an organic cause could not be found.  This Filipina traced back the source of her problems to being sexually abused as a child.  These kind of stories are very familiar to me.  I have a relative who had persistent stomach pains for which no physical source could be found.  Alleviating anxiety and depression were key to making her pain go away.  One explanation for why somatic symptom disorder occurs in Asians and Asian Americans is that many Asian cultures stigmatize mental illness and tend to repress talk about feelings, causing mental problems and issues to manifest themselves in other ways.

As for Diana Chao, she attributes fewer episodes of uveitis to better mental health treatments.  Her own story is remarkable.  Despite suffering from uveitis symptoms and dealing with bi-polar disorder, she is a photographer who has placed work in prominent places and is currently a sophomore  at Princeton University.   She advocates for mental health treatment, giving a TedxTeen talk on the subject and founding a nonprofit called Letters to Strangers, which aims to destigmatize mental illness and to increase access to mental health care for people aged 13 through 24.   I had previously written about Wendell Tang, who suffered from mental illness but did not receive treatment.  Diana Chao shows that students with mental illness can thrive, even at intense Ivy league institutions, when they receive treatment.

(h/t:  akj)

Asian American Family Sues Harvard, but not for what you might think

Lawsuits against Harvard and well-known selective universities contending discrimination against Asian Americans have happened over the years, with the lawsuit sponsored by Edward Blum still in play and actively opposed by Harvard.  In late 2018, another kind of lawsuit against Harvard was filed. The family of Luke Tang filed a wrongful death lawsuit against Harvard contending that the University was negligent in caring in for Luke, who committed suicide in 2015.

After a suicide attempt his freshman year, Luke Tang was hospitalized.  While he was there, he signed a contract with Harvard saying he could return if he received mental health counseling.  He was able to return for his sophomore year even though, the lawsuit alleges, Harvard personnel knew that he had not received the required mental health counseling.

Since his death, his parents have set up a foundation in his name to raise awareness of signs of depression and other mental health issues, especially as it affects Asian Americans.  In addition, a short documentary called Looking for Luke was produced by the Clay Center for Young Healthy Minds to educate and to destigmatize seeking help for mental health problems.  In the trailer above, the fact that Luke committed suicide is hidden for a long time and only told to one of his friends six months after his death.   My personal experience with the issue of mental health in Asian American families is that any problems are hushed up, considered a shame on the family that is not to be discussed openly, and likely not to be dealt with directly.  In particular, this article on Filipino Americans and mental health really resonated with me and other family members.  Our family, like many others in Silicon Valley, have known Asian American students who have committed suicide.

Harvard was required to respond to the lawsuit by January 9.  I haven’t been able to find the actual lawsuit text or any response since then (if someone has link to any of those, please include it in the comments). At the same time, the Luke Tang foundation is granting scholarships to students who have overcome psychiatric problems and welcomes donations.

September is Suicide Prevention Month; “Together Not Alone” PSA #IFEELALIVE

#IFEELALIVE is a national awareness campaign launched on the Love and Discovery blog in support of Suicide Prevention Month in September.

Suicide was the 8th leading cause of death for Asian-Americans, whereas it was the 11th leading cause of death for all racial groups combined.

This video is aimed at educating and helping Asian American Pacific Islanders with mental health issues.

The following people contributed to this PSA:
Megan Lee, Jason Chu, Elizabeth Sung James Kyson, Sean Michael Afable, Raymond Ma, Grace Su, Only Won, Lina So, Larissa Lam, Emily Wu Truong, Kanika Lal.

Statistics cited in the video are derived from data from American Psychological Association and American Foundation for Suicide Prevention

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Elisa Lam’s Death and Internet Afterlife

Elisa LamIn early 2013, a young Asian Canadian woman named Elisa Lam was found dead in the water tank of the Cecil Hotel in Los Angeles’s Skid Row. 

After a cryptic video was released of her shortly before she died, the cause of her death became a subject of Internet speculation that continues to this day.  There have even been claims of her ghost being seen at the hotel

What really happened to Elisa Lam? 

In this elegantly written piece on Matter, Josh Dean explains what most likely happened to Lam.  He also discusses how she really does have a kind of afterlife, in a story that is less about conspiracy theories and more about topics you wouldn’t consider in her case, like identify, mental health, and community.  It’s a long read, but in my opinion, worth your time.

(h/t:  This.)

Finding Hope in Support Groups

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Part 3 – Emily’s Story: Finding Hope in Support Groups

By Emily Wu Truong

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In honor of July as National Minority Mental Health Awareness Month, Guest Blogger Emily Wu Truong, who received a fellowship from the Entertainment Industries Council’s Mental Health Journalism Fellowship, created this three-part series on Asian American mental health. This is the third article of the three-part series about perfectionism and mental health. 

While seeking affordable means to help myself, I was privileged to meet Dr. Eliza Noh, Cal State Fullerton Associate Professor specializing in Asian American suicidology.  She reported that having a strong support network was a common theme among her interviews with Asian American women who had attempted suicide. After I opened up to her about my depression, she encouraged I work on building my support network, and I took her advice to heart.

For myself, I found hope when I learned about the world of support groups. The groups I attended were from Recovery International, National Alliance on Mental Illness (NAMI), the Asian Coalition, and Kaiser Permanente’s Depression and Anxiety group therapy.

As I attended these groups, I found myself feeling relieved and far from isolation because I saw that I was not alone. These groups were safe places where I could openly share my experiences of depression without shame. Group members commended me for having the courage to share. We learned techniques to become more cognizant of our own thoughts, feelings, and bodily reactions in response to circumstances that were out of my control. I became more self-aware of my daily thought patterns and began to develop more attitudes of gratitude. To top it all off, fees to attend these meetings were free or nominal! Overall, the more I attended these meetings, the quality of my life improved. They reinforced the messages of hope where helplessness is not hopelessness, and emotional healing is possible.

Continue reading “Finding Hope in Support Groups”

Seeking Help in an Imperfect Mental Health System

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Part 2 – Emily’s Story: Seeking Help in an Imperfect Mental Health System

By Emily Wu Truong

In honor of July as National Minority Mental Health Awareness Month, Guest Blogger Emily Wu Truong, who received a fellowship from the Entertainment Industries Council’s Mental Health Journalism Fellowship, created this three-part series on Asian American mental health. This is the second article of the three-part series about perfectionism and mental health. 

Growing up, I had no idea how to define myself or love myself. I had no concept of understanding my true worth as an individual because I was so critical of myself. I realized that I hardly ever complimented myself and always needed that external validation from others.  However, it was not until my breakdowns in July 2013, that I had breakthrough moments of epiphany, like a spiritual awakening of my true identity.

This awakening began two years ago after dealing with many frustrating circumstances.  I came to a place in my life where I was sick and tired of being sick and tired. I set myself on a mission to learn how to deactivate my emotional triggers. Once I made that decision, a mixture of painful repressed memories came rushing into my conscientiousness.  Emotionally, it was rather overwhelming that I would leave my brain feeling completely mentally exhausted.  These breakdowns then prompted me to seek initial help from the mental health system.

Without anyone to provide me with an orientation to the mental health system, trying to navigate the mental health system was extremely frustrating. 

Continue reading “Seeking Help in an Imperfect Mental Health System”

July: National Minority Mental Health Awareness Month

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Part 1 – Emily’s Story: Living with Perfectionism & Depression

By Emily Wu Truong

In honor of July as National Minority Mental Health Awareness Month, Guest Blogger Emily Wu Truong, who received a fellowship from the Entertainment Industries Council’s Mental Health Journalism Fellowship, created this three-part series on Asian American mental health. This is the first article of the three-part series about perfectionism and mental health. 

I used to believe that perfectionism was real. Because straight A’s were expected of me, I thought perfection was supposed to be the norm. Growing up, my parents would talk about how they attended National Taiwan University, which was considered the Harvard of Taiwan. They were always at the top of their classes, and indirectly, that led me to believe that “I need to make them proud by doing the same.” I thought I was living in a world where adults were to be perfect, and if I couldn’t measure up, I would have nothing to contribute to society. However, it was not until much later in life that I realized that I was shooting myself in the foot by setting up unrealistic expectations for myself.

While doing some research on perfectionism and its relation to mental health, I found a UCLA research study by Jaimin Yoon and Anna S. Lau on the topic of Maladaptive Perfectionism and Depressive Symptoms Among Asian American College Students: Contributions of Interdependence and Parental Relations. Yoon & Lau stated that “Perfectionism is commonly thought of as a trait that motivates individuals to strive toward important goals and foster excellence. However, a growing literature highlights aspects of perfectionism are linked to negative psychological outcomes, including low self-esteem, depression, and suicidality.” Being able to find research that could validate my personal experiences was eye-opening.

Continue reading “July: National Minority Mental Health Awareness Month”

The “it’s ok” Campaign Counters Stigma of Mental Illness

itsoklogoThe it’s ok Campaign is an effort to battle the stigma of depression and mental illness in Asian American communities.  This project run by the Corporate Asian American Employee Network (CAAEN) will center its efforts around their Facebook page, where they will provide articles and statistics about mental health along with links to mental health providers and community groups.  The message of it’s ok is that is okay to ask for help with mental health issues.  it’s ok has also created an online forum where people can anonymously share their feelings or stories about mental health.

Asian American women 65 and older have the highest suicide rate of any American ethnic group of womenThis New America Media story about the campaign also cites statistics that say Chinese immigrants have a depression rate of 34% compared to 9% in the general population.  Despite these facts, many mental health services that target Asian Americans are underutilized.  “The stigma is so great,” says Sylvia X. Bhatia, one of the campaign’s seven founders.

It’s ok launched on May 10.  The campaign will focus first on the San Francisco Bay Area and then look to expand through the US.

 

An Asian American Journalist Talks about Overcoming Depression

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In this piece from The Fil Am magazine, Asian American journalist Ryan Macasero opens up about his struggle with depression.  He talks about how depression first set in during childhood and how free mental health services in college helped him overcome that depression.  In his story, I see elements common among many stories about Asian American mental health.

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The Oikos University Shooting: Mental Health and Korean American Community

There have been a number of school shootings in the news lately, with the most recent including an elementary school in the Pacific Northwest and a middle school in in Texas in 2012. I can think of few things more heartbreaking, particularly because of my work with youth, I feel deeply invested in the mental and spiritual health of young people.

When it hits close to “home,” for instance, with Korean American Seung-Hui Cho and the massacre at Virginia Tech, I can’t help but feel it cut much deeper. That could have been a brother or a cousin, or someone I knew from church. The most pressing issue to me is the lack of mental health support and resources, and the continued stigma of mental health problems among Asian Americans, and I’d say particularly for Korean Americans.

And now another shooting within the Korean American community by a Korean American has happened this week:

Continue reading “The Oikos University Shooting: Mental Health and Korean American Community”

Wong Flew Over the Cuckoo’s Nest: Depression & Suicide Among Asian American Women

By Kristina Wong

Kristina Wong delves deep into the sky high rates of depression and suicide among Asian American Women to make ‘Wong Flew Over the Cuckoo’s Nest.’

“I’m Definitely Not Crazy. But I Probably am Lying.”

My earliest memories of even thinking I might be depressed were met with warnings by my mother that if I ever dare seek professional help for depression, even as a kid, my employers would one day find out and fire me. It did bother me that being depressed-but-employed versus happy-and-unemployed was the better of the two (and only two) options, but I heeded her advice and never sought professional help. God forbid anyone know I was once a crazy 12-year old kid.

So I hid it for years. And not very well. Even into my college years, I managed to turn club meetings, sleepovers, friendships and intimate relationships into my own impromptu therapy sessions. Anything to avoid the stigma of actually seeking professional help! When I introduced myself to a circle of new friends, somehow unsolicited emotional clutter would always spill out with it. Sometimes my friends were halfway decent at playing Freud, but very often, they were so mired in their own messy lives that my problems just exhausted them.
Continue reading “Wong Flew Over the Cuckoo’s Nest: Depression & Suicide Among Asian American Women”

Depression, Suicide and Asian American Women: My Story

By June

Some questions were raised in a recent interview in NPR about why there is a high percentage of suicide among Asian-American women. There are allusions to the high pressures of Asian parents and the usual stereotypes of submissive or sexualized women.

When I heard about this, I wasn’t surprised, because this has happened in my own family. But I can’t say I relate to the women stereotypes, because I was still just a kid when I first became depressed. Maybe I relate to some of the stereotypical parental pressures, but there were other problems.

I was born in Taiwan but raised in the U.S. from babyhood. I started out as a happy kid, but I became very depressed at the age of eleven. I felt helpless about finding help for this, because I didn’t feel I could relate to or communicate well with my own family, even my older brothers, who were essentially raised in a different culture. I felt I couldn’t talk to my American friends or teachers about it because I felt that they wouldn’t understand the kind of difficulty I was experiencing. Also having been raised in an affluent background, I sometimes questioned the validity of my own depression.

All this on top of the fact that seeking therapy or admitting to mental disorder seemed completely taboo (I’m sure this is true for many non-immigrant Americans as well), and one of my brothers probably had Asperger’s Syndrome when we had no idea what it was. I started to resent my own family for not addressing my brother’s Aspergian issues. It was a dysfunctional family without a lot of hope.

Like Ms. Wang experienced in her therapy, I was also skeptical of finding an American therapist or teacher who understood what I was going through. There were other Asian-American kids at school, but somehow they all seemed much more assimilated into American society and didn’t outwardly reflect the problems I was feeling. (My Chinese piano teacher seemed horrified that I was unfamiliar with all the standard Christmas songs, for example. Was I supposed to be mad at my teacher or my parents?)

But I was incredibly fortunate that I had a very functional and inspirational older brother who detected signs of my depression, and even though he had moved thousands of miles away to college, he recognized my feelings and my pain and kept reminding me that eventually there would be a way out. He helped me focus on what I could do later in life, when I could escape the confines of a dysfunctional family. I am not sure I would be here if he didn’t reach out to me that way.

When I was in my teens, my mother died, suddenly. I was told that she died of a heart attack. I was so stunned and numbed by this news, that I didn’t even have the impulse to hug my father like I wish I could have. It wasn’t until my father died many years later of cancer that I learned that my mother had actually committed suicide. But I wasn’t surprised. I knew she was depressed. But I didn’t know that she had also suffered from delusions.

I’m sure my whole family felt the guilt of not reaching out to her… and probably still do feel that guilt. Aside from the stereotypes of Asian culture, we had communication problems, we had cultural misunderstandings, and conflicts of values having grown up in differing cultures. I couldn’t comfortably express my feelings or thoughts at home, or if I did, I didn’t believe that anyone would listen or do anything about it. There was a huge sense of betrayal and isolation that grew from all of that. I also felt that my father was domineering and verbally abusive.

But looking back on it, my father likely had Asperger’s Syndrome as well. I believe my mother felt trapped (like I did) and tried to survive long enough to take care of us. When she became depressed and delusional, my family hid her mental illness from me (being the youngest) and anyone else. I understand that they wanted to protect us, but it ended up being very damaging, as my mother didn’t get the help that she needed.

There is a lack of education and awareness about mental disease in general, and any time there are unknowns, people become very afraid of it. I am still learning about it and dealing with it. I think there needs to be a heightened awareness especially for immigrant families, who fear mental illness and don’t know how to address it.

My parents also were very socially isolated, so that only diminished any hope of healthy-minded friends who could have reached out to them. As a result, I’ve made a point of broadening my social circle as a kind of extended family and support group. And even though my parents are gone, I have grown closer to my cousins and visit my extended family during the holidays to maintain a sense of family.

People who know me now recognize me as one of the happiest people they know. I’ve even been asked if I am ever sad, which is a little ridiculous. I am not a happy robot. I survived a very dark time, and so everyday I feel very fortunate to live a functional life now. I feel that I owe it to my parents to do what I can to be happy, because they weren’t as lucky to enjoy that. I had a lot of fears growing up, and along the way I’ve assured myself that I am capable and have found people who will support me. So now when times are difficult, I believe there is a way out of it, and I just need to be patient in finding it. And while I still try to be a very independent adult, I know that I can ask for help if I need it.

I should also point out that therapy is often not covered by insurance, so I am sure the financial burden of seeking therapy is a huge part of the problem. My father was self-employed, so I grew up without health coverage. My parents ultimately sacrificed their lives for us, and probably didn’t know any other way to deal with it, under the circumstances. I hope that any health reform that happens will address the complications of mental illness.

I hope that by sharing my story, it might help others understand the issues that lead to such tragedies and might prevent it from happening in your family.

ABOUT JUNE: June Shieh is a freelance Toy and Web Designer and a Californian transplant, now living in New York (soon to reside in Greenwich Village).

(Flickr photo credit: Paul J Everett)