Suffering in Silence


It has been known in the psychological community for years that not all cases of depression are the same. Each individual presents different symptoms, and experiences the illness in their own unique way. However, something that is not often considered with regards to depression treatment and therapy is how cultural factors influence the individual’s ability and desire to get help. Values specific to one’s own cultural identity can heavily influence someone’s view of mental illness, and if an individual lives in a culture where mental illness is not really discussed, they could struggle with obtaining the resources they need. There are varying levels of stigmatization across cultures, with increased levels of stigma being present among minority communities. In particular, South Asian Americans experience higher levels of depression, but use mental health services in extremely low numbers.

“I had everything, but life is a double-edged sword. If I tell everything, I will lose everything.”

This is the note Neil Grover, a medical student at the University of Massachusetts, left before committing suicide in 1998. Neil’s death came as a shock to his South Asian family – they never knew that he was suffering from depression. Over the years, there have been all too many similar cases of suicide among high achieving South Asian youth.

Numerous studies have shown that South Asian women do not seek treatment for mental health unless it has become far too much to bear. South Asian immigrants are additionally less likely to stay consistent with medication after a mental health diagnosis. These outcomes are mostly likely due to cultural factors – South Asian families often cling to strict ideals of perfection, and the presence of a mental illness is viewed as completely shattering this illusion. Oftentimes, having a mental illness is viewed not as something to be treated, but as something that is the fault of the individual.  Additionally, South Asian parents tend to push their children to achieve at extremely high levels, and this is not always conducive to good mental health. In many cases, when children express concerns about not liking their job or their studies, they are told that they just need to work harder. These strict standards coupled with shame, silence and stigma often lead to South Asian youth hiding their own struggles until they are too great to bear.

In a community where failure is equated with giving up, pushing through is often the only option. This is especially true when the community in question is a minority in America and is subject to the social pressure of conforming to model stereotypes. Admitting to flaws within the community would take away the comfortable status that South Asian Americans enjoy within mainstream society. As a result of this, there is an enormous amount of pressure for South Asian immigrants and their children to live up to their own ideals of perfection, and for some, these standards are too high. The tendency of South Asian families to tell their children that others always have it worse than they have is extremely damaging. As a result of this, what is often perceived as a crisis point in mental health is not necessarily treated as one.  

Mental health professionals need to keep this in mind when dealing with patients. As it is, depression is stigmatized enough in normal American society, but it is even more deeply hidden among South Asians. The illusion of perfection is just that – an illusion, and until this is realized as a cultural problem, many South Asians will continue to suffer in silence.

References:

Chew-Graham, C., Bashir, C., Chantler, K., Burman, E., & Batsleer, J. (2002). South Asian women, psychological distress and self harm: lessons for primary care trusts. Health and Social Care in the Community, 10 (5), 339-347.

Ahmad F, Shik A, Vanza R, Cheung AM, George U, Stewart DE. Voices of South Asian Women: immigration and mental health. Women Health. 2005;40:113–30.

University of Missouri Health. (2015, July 23). U.S. South Asians more reluctant to seek medication for pain. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2015/07/150723125609.htm

Tabassum R., Macaskill A., Ahmad I. (2000, September 1). Attitudes Towards Mental Health in an Urban Pakistani Community in the United Kingdom. doi: 10.1177/002076400004600303

Sohrabji, S. (2013, July 12). Suicide Amongst Indian Americans We’re Stressed, Depressed, But Who’s Listening?. India — West. pp. A1-A22.

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