Stigma

Breaking the Asian American Silence on Mental Health

Tanaya Kollipara

• Publisher: New Degree Press
• Year: 2021
• eBook ISBN: 9781637305461
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Suicide is the leading cause of death among Asian Americans ages fifteen to twenty-four. But most would never guess this due to mainstream representations, which portray Asian American and Pacific Islander groups as "model minorities" in health, wealth, and mannerisms.

Stigma: Breaking the Asian American Silence on Mental Health is both a narrative account and an informative look into the world of AAPI mental health. Exposing harmful narratives, while uplifting their voices and experiences, Tanaya Kollipara sets out to bring to light how the Asian/Pacific Islander identity impacts the stigma experienced and barriers faced by those with mental illness.

Weaving together stories with research and professional advice, Stigma dispels the myths and reveals the truths about mental health and mental illness within the AAPI community. Tanaya shows what happens when fear and cultural stigmas obstruct your ability to care for yourself- and, more importantly, what's waiting on the other side, when you take that step towards mental wellness.

PART 1

CONTENDING WITH REALITY

CHAPTER 3

SARA AHMED

The sun was low, starting to set on the horizon. The street—now bathed in a soft orange light—was packed with bodies, all eager to rush home. Street vendors crowded the edges of the sidewalk, the smell of their cooking—pani puri, samosas, falafel—filling the air. Cars drove by, honking at the vehicles in front of them and at the friendly faces passing by on the street. Women dressed in their cultural finest—shalwar kameez, abayas, saris—scanned the markets for the best produce at the best prices.

Further down the street, right around the corner, were rows of houses. Front doors swung open and shut as kids were called back in. Tan skin, black hair; white skin, brown hair; blue eyes, brown eyes, green too—people of different colors and ethnicities filled these homes. The neighborhood was as diverse as the cuisines served in the nearby restaurants.

Looking closer, in one of these homes was a peculiar sight: a little girl, no more than ten years of age, had her face pressed against the glass of her window. Her thick hair framed her rounded face, the black a stark contrast to the girl’s pale beige skin. She was kneeling on the couch, her arms hooked across the back, waiting anxiously for her mother, who had gone out to get some groceries, to come home. It was just her older sister and her, but instead of doing homework or reading like other kids her age, she was parked by the window, wondering if her mother would ever return. Intrusive thoughts swam through her head: What if she died? What if she never returned? What if something happened to her? Will this be the last time I ever see her?

Suddenly, her mind quieted.

Spotting a familiar tall and wide frame amble across the front yard, the little girl released the breath she had been holding, relief evident on her face. Her mom was now home, safe and sound; there was nothing to worry about—for today, at least. Wordlessly, the girl slipped off the couch, skipping to the front door, ready to greet her mother. When the door opened, she looked up, her smile wide and adoring.

It was the same smile that greeted her newborn child, nearly twenty years later. Sara Ahmed had everything she had dreamed of. She had just given birth to her first child, surrounded by her friends, family, and loved ones. She was safe and healthy, settling down in a community-minded southern town. Her parents were home and with her; her siblings were following their passions. It seemed like everything was falling into place, finally.

So, why did she still feel so unhappy and anxious?

Welcome to Devon, Home of Immigrants

“My story begins in the early 1980s, when I first came to the United States,” Ahmed said.

Born in Pakistan, six-year-old Sara Ahmed, along with her family, had immigrated to the United States from Saudi Arabia (where her father was working as an engineer). They decided to start their brand-new American life in Chicago, Illinois. “We moved to a small neighborhood widely known as ‘Little India,’” Ahmed said. “At that time, there were four or five blocks just filled with brown stores.”

Officially called Devon Avenue, this region of Chicago was known for its rich ethnic and cultural presence, exactly like the scene described previously. Despite being known as “Little India,” Devon was home to people from all over the world—immigrants from Bangladesh, Germany, India, Pakistan, Romania, and more filled Devon’s homes. The neighborhood itself—from its shops and stores to its home decors—was a blend of all these cultures. In a foreign land, this area made its residents feel a little bit more at home, as everyone bonded over their shared journeys across borders.

For Ahmed, it blessed her with an opportunity to feel not so much of an “other” in a country that was filled with those who didn’t quite look like her. From her best friend, whose house was filled with the sounds of Greek, to her neighbors, who never failed to invite them over for Eid, Ahmed was surrounded by a strong sense of community. “I was blessed to not have the typical immigrant experience,” Ahmed said. “I never really had a truly ‘American’ friend. Everyone was a first-generation immigrant like me, whose moms wore traditional clothing and spoke in their mother tongue. There was no real sense of embarrassment because that was how all of our lives were.”

Although the ethnic diversity lent itself to a childhood free of shame, it also introduced, and perpetuated, many of the cultural stigmas from the homeland. One such stigma was that of mental health. In many of the countries these residents hailed from, mental health was never truly seen as legitimate and important. Rather, it was considered an over exaggeration, a reflection of one’s lack of piousness, a testament to one’s mental weakness. As such, it was never spoken about. “It was like it [mental health] didn’t even exist,” Ahmed revealed. “I don’t think I remember ever—ever—anyone talking about it, being diagnosed with it, or suffering from it.” These attitudes silenced the possibility of conversation, preventing Devon and its residents from understanding mental health.

They also ended up molding Ahmed’s childhood environment into one that ignored, rather than recognized, her mental health symptoms.

Facing Childhood Anxiety and the Mental Health Stigma

“For the most part, I had grown up as a bit of an anxious child,” Ahmed said.

Her anxiousness stemmed primarily from one place: the possibility of her loved ones dying. Like in the scene described above, whenever her parents would leave the house, Ahmed’s mind would be filled with uncontrollable, anxious thoughts. She would hold vigil by the window, nervously waiting for their return—or news of their sudden death.

Now, many kids do feel this sense of anxiety as they grapple with their parents’ mortality, imagining scenarios in which their parents do not return home. However, there is a fine line between what is considered typical behavior and what is not. “When it comes to mental health,” says board-certified psychiatrist Dr. Ramesh Reddy in our interview, “it’s easy to believe what might just be a case of nervousness before a big speech is anxiety. In order to differentiate between a relatively ‘normal’ feeling and a mental health disorder, we look for evidence of a certain characteristic.” That defining characteristic being: The behavior interferes with daily function or causes distress for the individual.

In Ahmed’s case, her anxious thoughts were accompanied by an inability to complete her current task, as she would immediately station herself by the window to wait for her parents’ return. Her anxiousness interrupted her ability to function while simultaneously causing her feelings of distress. In light of this, it’s clear that Ahmed’s actions served as evidence of that “defining characteristic,” indicating a high likelihood of a mental health disorder when she was younger.

Ahmed’s family, however, didn’t believe these behaviors warranted a visit to the local physician. “At that point, my parents didn’t have quite enough of an understanding to ever think it was a problem,” Ahmed said. “It was something you found a hundred different explanations for, but not one of them was mental illness.” In effect, all proposed “solutions” centered around everything but mental health or medication. Ahmed’s parents would advise their daughter to pray more to alleviate those anxious thoughts. They reminded her to be grateful to God more, parroting the same advice they themselves had received growing up. To Ahmed and her family, her anxiousness wasn’t a mental health issue—it was just a mind not as connected to God. As such, Ahmed didn’t receive the help she needed for those anxious thoughts as a child. In fact, it was only decades later that she recognized them for what they actually were: a symptom of childhood anxiety.

Despite the lack of treatment for her unusual preoccupation with her parents’ impending deaths, Ahmed had an otherwise warm and loving childhood. It was filled with positive experiences, from laughing to her heart’s content around the kitchen table to trying her best friend’s cultural cuisine. Ahmed, along with her two other sisters, were always encouraged to fearlessly pursue their career goals by their father. “In a time when woman empowerment wasn’t really a thing,” Ahmed said, “my father pushed us to be independent. Even with my mother, he made sure she knew how to drive and that she had her own car. He wanted his girls to be independent and empowered.” In turn, Ahmed dove into her education, working hard to maintain near-perfect grades. Surrounded by friends who were equally studious, Ahmed would spend much of her time with her nose in a book. It was her superpower—it was where she shined. Even after her family’s move to Atlanta, Georgia, the summer before high school, Ahmed kept to her brainy identity, pushing herself to do well. Midway into her high school career, Ahmed’s family moved once more, this time to Minnesota. Although the winters were harsh there, it just turned into an opportunity for Ahmed to hole up inside and immerse herself in her work. “As you can see, I was a bit of a nerd,” she said with a laugh.

But that “nerdy” nature brought Ahmed to the University of Houston in Houston, Texas. There, Ahmed created lifelong friendships and explored her community. The longer she stayed, the more she found herself loving the city. “I knew I didn’t want to leave this place ever,” Ahmed said. And so, she never did. She continued on in her college career, ultimately teaching at her alma mater. Later on, she would enter into the field of freelance writing, publishing numerous papers, articles, and even a book—all while deepening her roots in Texas.

Now, although Ahmed was having an extremely enjoyable time in Houston, she was still experiencing the anxious thoughts of her childhood, still centered around her parents’ potential deaths. However, in spite of its continued presence, Ahmed didn’t consider it as anything more than just a facet of who she was: a worrier. Even with increasing conversations around mental health in the early 2000s and a greater availability of counselors and psychiatrists on college campuses (Kraft, 2011), it didn’t register in Ahmed’s mind that perhaps those services could be of use to her. “I believed it just didn’t happen to Asians,” Ahmed said. “I didn’t want it to happen to me.” So, Ahmed made her way through college, unaware and unwilling to learn about the world of mental health. She tucked away her anxious thoughts to the back of her mind, never taking a deep look at whether they were causing issues in her life. After all, she had much better things to look forward to.

One of them was her future husband. During this time of collegiate self-discovery, Ahmed met the man with whom she would end up tying the knot with. “He always made me laugh,” Ahmed said, her voice soft as she spoke about her now-husband. “He was the type of man you could never get bored talking with.” Their romance blossomed, leading up to marriage shortly after the pair graduated from college. A couple of years later, Ahmed gave birth to their eldest son, beginning their journey as parents. After a lifetime of working hard, achieving her goals, and reaching for success, Ahmed had everything she wanted—a budding career doing what she loved, a doting husband who supported her in all her endeavors, a gorgeous baby boy, and a forever home in family-centered Houston. It was the culmination of her life’s work; it was Ahmed finally living her dreams.

Before long, however, these dreams turned into a nightmare.

The Onslaught of the “Baby Blues”

“It was after the birth of my first child, I started really experiencing mental health symptoms,” Ahmed said. “I wanted to believe that this [my life] was so amazing, that everything was so great...but it wasn’t. It was the most difficult time I ever had.”

At thirty years old, with a newborn in hand, Ahmed had quit her job teaching at the university. After two weeks, Ahmed’s husband returned to work, leaving her at home with their child. “I could not find peace of mind,” Ahmed said, explaining. “I developed this obsessiveness of something happening to my son, that I would accidentally kill him while on the job, which was twenty-four/seven. It was so overwhelming.” It was similar to the anxious thoughts Ahmed had all throughout her life—this time, directed toward her son’s mortality. Similar to how it was when she was younger, Ahmed started exhibiting certain unhealthy habits. “I would constantly—and I mean, constantly—go and check on his breathing.” Whether it was nap time or feeding time, Ahmed would hold her finger under her son...

Table of contents

• NOTE FROM AUTHOR
• CONTENT WARNING
• INTRODUCTION
• PART 0. HOW WE GOT HERE
• PART 1. CONTENDING WITH REALITY
• PART 2. SUPPORT SYSTEM AND RESOURCES
• PART 3. PARENTS ARE ALLIES (AND WHY SOMETIMES THEY’RE NOT)
• PART 4. NORMALIZE THERAPY (AND OTHER MENTAL HEALTH SERVICES)
• CONCLUSION: LET’S TALK
• RESOURCES FOR FURTHER EXPLORATION
• ACKNOWLEDGEMENTS
• APPENDIX