Stigmatis-Asian: our inability to talk about mental health struggles is killing us

Photo by Zoe on Unsplash

As a general rule, I don’t like to talk about topics that are divisive, or place broad-sweeping labels on groups. But this one is personal to me, and it’s problematic to a point where it’s affecting me and people I care about, so I think it’s worth talking about, as uncomfortable as it is.

It’s about how we (the Asian community) can’t talk about mental health struggles, and how ongoing stigmatisation means people are too afraid to seek help until their mental health has deteriorated to a point where they’re in crisis, or it’s simply too late. Irreversible actions are taken, people die by suicide, and communities are left broken.

Based on the construct I grew up with, my diagnosis of OCD and my mental breakdown last year, makes me, by definition, within my own community, “crazy.”

What’s even “crazier” is that I’ve chosen to talk publicly about my mental illness, bringing even more shame directly to my family. I still feel momentary waves of guilt about this, and I’ve literally had to devote hours of time with my therapist to address the topic of shame — of being mentally unwell (something I literally couldn’t control), of not being “good enough,” and the “rebound” shame I felt after my story was made public — which, in hindsight, was incredibly important to my healing and not something I regret.

I’m here to say it though, this has gone on for long enough, and to those “aunties” and “uncles” — I don’t care what you think. There are plenty of things I love about my culture and community, but our attitude towards mental health is not one of them.

Collectivism and conformity

I grew up in Lower Hutt, a medium-sized town in New Zealand in the early 90s where most Chinese people knew each other. Chit-chat was rife, often around restaurant tables or the local Saturday markets, and when a person within the community was mentally unwell or displayed behaviour that was considered anything other than “normal”, nothing kind was ever said.

There was the “aunty” with clinical depression who dropped off the scene for a couple of years . I distinctly remember hearing people say, “How can she possibly be sad? She’s got a great husband, and a successful child. How could she be so weak?” There was a man who wandered the streets mumbling, who many ostracised and avoided. It even went so far that unkind words were being said about a neurodivergent young woman — yes, I understand this is not the same as mental illness, but I want to use this example to show the horrendous impact of upholding the impossible collective standard of “normalness.”

This observed behaviour is supported by the 2021 study from the Asian Family Services New Zealand. 44% of Asians showed symptoms of depression, which is horrific enough, but a whopping 98.7% of Asians surveyed believe the public hold negative stereotypes of those with mental illness.

These interactions I had growing up had a profound impact on my perception of mental ill-health and illness. Basically, hold your shit together and conform to being “normal”, or be judged and ostracised. If you’re mentally unwell, you’re weak.

Model minority and filial piety

I had one job in life as the only daughter of two incredibly hard working immigrants — to live the golden narrative. It goes like this: go to school, do well, go to university, get a degree (preferably in accountancy, engineering, medicine or law), make good money, get married (preferably to a man of Chinese descent), have kids and live happily ever after. Anything that deviated from this path caused tension. My parents had sacrificed everything for me, I owed it to them to do life right.

The model minority myth: heads down, tails up — do your part in society and don’t complain.

I partially achieved the narrative. I was very driven academically, got an accountancy degree (quitting law along the way), got into the big-4, hated it, quit after a year and have since changed careers three times and now work as a management consultant. I fell in love with and married my soulmate, a Sri Lankan. I was supporting both my divorced parents financially. From the outside, all was well.

On the inside, I struggled to uphold these prescribed standards of success. I was a horrifically shy and anxious child, desperate to please. While I was never subjected to the stereotypical extreme tiger parenting, other kid’s academic achievements were constantly talked about as the gold standard. So-and-so’s daughter. The dux. The scholars. The doctors. The dentists. The lawyers. I was reminded of the sacrifices my parents made. I was told that not going to university was not an option. Everything I did was to seek validation to be “enough”.

I was also witnessing an unstable marriage deteriorate over my childhood. My parents themselves did not seek help, because if people found out they needed therapy, it would be considered a “shame.” So we dealt with it, like many, behind closed doors. And when their relationship did eventuate in a divorce, I was not allowed to breathe a word to anyone about it, out of love and respect for them.

In hindsight, this “brush-it-under-the-rug” attitude took a massive psychological toll on me. I had terrible mental health as a child and young adult. I started experiencing what I now know as intrusive thoughts at a young age and had the beginnings of what would eventually manifest itself as OCD at age 29. On more than one occasion, my doctor quietly asked if I wanted antidepressants and if I’d considered therapy. I said no, I didn’t want to be seen as weak.

To love was to serve, but it came at an enormous cost.

The fall out

Of course, all this bottled up anxiety came to a head in 2020, when I had a mental breakdown of my own. It came after a prolonged period of stress — moving cities, a global pandemic, possible redundancy, a dying family member, and being accountable for major financial decisions on behalf of family members all while maintaining the “dutiful daughter” mirage, which was just that — a mirage.

My story is well documented elsewhere, but in short: OCD made me go to the darkest depths of my brain, and there was a point when I didn’t think I could come out. It was the most profoundly human (and horrific) experience I’ve ever had.

During this time, it was safe to say that my immediate family members didn’t know how to cope. A mental breakdown is not part of the golden narrative. I was told to check for a brain tumour, because that seemed to be a more plausible reason for my distress than mental illness. (I wish I was kidding).

I find this widely-held cultural belief that “brains can’t break” really difficult to stomach. Because ironically, our community is consumed by health anxiety and fixated on remedies — but only if the illness is physical. What we’ve struggled to grasp is that mental illness is a biological illness. Your brain is as susceptible to failing as much as your liver is, so the more we can come around to this, the better off we’ll all be.

The harm

In ‘Mental Distress and Discrimination in Aotearoa New Zealand’ report published by the Health Promotion Agency, Asian people reported lower rates of mental distress. It is unclear whether this reflects actual rates or cultural differences relating to disclosure, but based on personal experience, I’d say the latter definitely has something to do with it.

It was reported in this heartbreaking New Zealand Herald article that a family watched for years as an elderly woman’s mental state declined because “it was frowned upon to think there was something wrong with your parent.” Because they waited so long to seek help, she never recovered fully from her illness. Our inability to acknowledge and talk about mental illness has horrific and long-lasting consequences.

So it wasn’t surprising that when I came flying out of the mental health closet, I wasn’t immune from the whispers. What is a relief is that I’m over 600km from my hometown now, but, yes “aunty,” you did read about my mental breakdown in the papers, what you said came back to me. But guess what? Unbeknownst to you, there are kids now reaching out to me to seek help now — because they have no where else to turn. People all over New Zealand are getting diagnosed with OCD early and getting treatment because of that story. So it’s been worth it.

I reflect on the prevalence of suicide in our community. Two in particular had a profound impact on me. A family friend/“uncle” who died in my early teens, and the other in more recent years, a teenager. Our community was left reeling, their families devastated. Of course, words were still spoken around the restaurant tables and local Saturday markets, but this time, it was everyone wondering “why they never spoke out and got help.”

It’s this drastic switch from stigmatisation to “why didn’t they just say something” that I continue to struggle to reconcile.

The solution

We have to start changing the narrative around mental health and illness among the Asian community. Doing so will save lives, and early intervention is key to prevent further mental distress.

But it starts with learning about mental ill-health and illness. Knowledge trumps fear. And the reality is many people who experience mental distress can manage their symptoms, and often make a full recovery.

It starts by dropping the dehumanising terms used to describe someone living with a diagnosis, and not lumping them into buckets of “crazy” and “weak.” A little bit of kindness will go a long way.

It starts with challenging the status quo and cultural norms. By saying enough is enough with collectivism and recognising that selective ignorance is literally killing us.

It starts by normalising conversation, getting therapy, and taking medication.

It starts with stories.

It starts with us.