I once knew a girl in college named Shirley. Though we weren’t that close, I chatted with her each time I saw her in the hallway or on campus. One afternoon, I was sitting at my desk in my dorm room when I heard the news. Shirley was found dead after falling from her dorm room window. She had committed suicide. Several other suicides had taken place on campus, and it was perhaps an eerie coincidence that a few of the victims were also Asian American women. I began to wonder, was it all just a coincidence? Or was something larger at play? If so, what made Asian American women more susceptible to suicide than the general population? Or was it that they were less inclined to seek treatment for depression?
Some Asian American women felt they were unable to pursue academics or activities of interest to them and were instead pressured to pursue more “secure” careers, such as medicine.
I wondered.
Depression is defined as a mood disorder that causes one to feel sad or hopeless for a long period of time. It is more than the normal temporary feelings of sadness and hopelessness that accompany difficult life events. Symptoms can include depressed mood, problems concentrating, lack of interest in activities, significant weight loss or gain, or thoughts of death or suicide. By the year 2020, depression will be the second largest disease in the world. At present it ranks third in mortality and lost workdays.
So how are Asian American women affected? In 2001 the Center for Disease Control and Prevention reported that Asian American women ages 15 to 24 have the highest rate of suicide across all racial groups in that age group. Asian American women over the age of 65 have the highest suicide rate among all women. And among all ethnic populations, Asian Americans utilize mental health services the least.
There seem to be two explanations for the phenomenon. First, the conflict between Asian culture and American culture can be a source of anxiety for the Asian American woman. Second, certain aspects of Asian culture discourage seeking treatment.
Cultural Barriers
Asian Americans face stressors specific to their ethnicity. One’s immigration status can be a source of stress. Moving to a new country and adapting to a new culture, lifestyle, and language are enormous adjustments. Eighty-nine percent of the Asian American women who have committed suicide have been immigrants. And suicide rates are higher for foreign-born Asian Americans than for American-born Asian Americans.
Asians may also face discrimination and stereotypes. In addition to “traditional” outright racism, there is the stereotype of Asians being the “model minority,” that is, the stereotype that all Asians are smart, hard-working, and successful. Those who feel they “should be smart” yet fall short of the stereotype may feel isolated and inferior.
Additionally, Asian Americans may grapple with their ethnic identity. They may embrace certain Asian values that conflict with American culture and even their own personal aspirations. There are familial expectations and standards of success. Immigrant parents move to America and toil so that their children can succeed. Any deviation from one’s parents’ dreams would be a betrayal. In a study conducted by the National Asian Women’s Health Organization (NAWHO), some Asian American women felt they were unable to pursue academics or activities of interest to them and were instead pressured to pursue more “secure” careers, such as medicine. The women thus felt they were not in control over their life.
There are gender-specific cultural expectations. A woman has a very particular role in the family. There is the pressure to marry and have children, yet at the same time, balance the family with a successful career. Asian American women in domestic violence situations face an even heavier burden. NAWHO reports that “intimate partner violence is believed to be the single most important precipitant for female suicide attempts in the country.”
What made Asian American women more susceptible to suicide than the general population?
NAWHO further observed that the lower one’s self-esteem, self-confidence, and sense of control over one’s life, the more at risk the woman was for depression.
Treatment Barriers
Asian American women also face barriers to treatment. Cultural customs and stereotypes can limit access to proper healthcare. Without treatment or counseling, the depressed Asian American suffers even more in silence.
A significant number of Asian Americans are immigrants or refugees. This population may be particularly susceptible to advanced depression because of economic circumstances and language barriers. Being unable to afford or communicate with healthcare providers prevents this population from accessing healthcare.
The model minority stereotype can again play a role. NAWHO notes how some providers perceive Asians to be well-adjusted. These providers mistakenly believe that there is less of a need among Asian Americans. This false thinking limits education, prevention, and treatment efforts for this community.
In 2003 Bryan S. K. Kim from the University of California, Santa Barbara and Michael M. Omizo from the University of Hawaii at Manoa conducted a study on Asian American college students who ranged from first generation to sixth generation Asian Americans.¹ The study revealed that Asian Americans who adhered to traditional Asian cultural values the most were less inclined to seek treatment or counseling.
Certain Asian values emphasize internalizing problems, restraining strong emotions, and conforming to social norms. “Deviating from the norms by admitting psychological problems can be easily perceived as a violation of Asian cultural values, resulting in shame to the family,” say Kim and Omizo. Problems must therefore be kept secret and private. The social stigma associated with mental illness deters treatment-seeking even more.
Another valued trait is self-sufficiency. People should resolve problems on their own rather than seeking outside help.
Deborah S. Lee, director of Asian American Mental Health Services in New York City, notes that certain Asian cultures interpret symptoms of mental illness as spiritual signs. For example, her Chinese clients have interpreted mental illness as punishment for wrongdoing carried out by their family or ancestors. Consequently, they feel ashamed to seek treatment.
Healthcare facilities should therefore be culturally competent and sensitive to different ethnicities. Dr. Stanley Sue, director of the National Research Center on Asian American Mental Health in Davis, California, advocates training mental health workers on aspects of Asian culture, using Asian consultants in mainstream facilities, and targeting Asians through community education.
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There certainly are barriers other than those mentioned that contribute to depression among Asian American women. However it is important to note how culture intersects with depression and lack of treatment. With education and cultural sensitivity, healthcare facilities will hopefully better serve the Asian American community. And perhaps in the end, we can save just one more woman from the deafening silence of depression.
Where to go for help
NAWHO is launching TAKE A CHANCE. TAKE CHARGE, a public awareness campaign for Asian American women and mental health. The campaign's brochure recognizes depression as a problem and suggests where Asian American women can go for help. To hear more about the campaign or to order materials, contact Jennifer Stoll-Hadayia at 415-989-9747 or visit the Web site at http://www.nawho.org.
Pick Your Path to Health is a national public health education campaign sponsored by the Office on Women's Health within the U.S. Department of Health and Human Services. For more information about the campaign, please call 1-800-994-WOMAN or 1-888-220-5446 (TDD), or visit the National Women's Health Information Center at http://www.womenshealth.gov/
¹ Bryan S. K. Kim, Michael M. Omizo, Asian Cultural Values, Attitudes Toward Seeking Professional Psychological Help, and Willingness To See a Counselor, THE COUNSELING PSYCHOLOGIST, Vol. 31 No. 3, May 2003, 343-361.
Kristine Chung is Korean American. She studied Psychology at Barnard in New York City and enjoys writing about Asian American issues in her spare time.
8 thoughts on “The Deafening Silence: Depression Among Asian American Women”
I can surely relate to this article with first hand experience as myself an American who is married to Asian woman. If anyone wants an interview, I can give you one heck of story. The story, which is true dealth with how an Asian family denied medical treatment for a daughter so not to bring shame upon the family and how the husband was ostracized for his attempts to help his wife.
If you read the complete story of “Push to achieve tied to suicide in Asian-American women” on the CNN website (http://www.cnn.com/2007/HEALTH/05/16/asian.suicides/index.html) of how one asian women took her own life, you will realize that it is not just the fact that she felt the societal pressures of the “model minority” that caused her to take her own life. Frankly, I believe that many asian women are “Weak Minded” and have “Low Self-esteem” and have “A Lack of Faith” in her own race and identity. Remember, depression is a mental state and all three of the factors that I mentioned above are “Mental”. If you read that article carefully, you will find the following quotes from the sister of the victim.
“It’s become a U.S.-based ideology, popular from the 1960s onward, that Asian-Americans are smarter, and should be doing well whether at school or work.”
And ….
“My sister had a really low self-image. She thought of herself as ugly,” she says. “We grew up in Houston in the ’70s and ’80s, and at that time in school there were very few Asian faces. The standard of beauty she wanted to emulate was white women.” In college, Noh’s sister had plastic surgery to make her eyes and nose appear more European-looking.
I understand that it is not funny when someone suffers from depression and commits suicide. However, we cannot simply ignore the root causes of the problem if we truly want to help the victims who are suffering. Of course there are many different reasons why a person maybe depressed. But we must face the truth that the biggest problem with Asian Women in America is the fact that most of them suffer from “Low Self-esteem” because they are “Weak Minded” and have a “Lack of Faith in their own identity”.
The problem that I noticed with Asian Women in this country as well as over in Asia is that they are too focused on the material world and the phycial features of people and things instead of focusing more on the spiritual side. They lack the resiliency to step away from the temptations of the physical world and what society and the media feeds them. The other problem is that the Media constantly pushes on us the images that define “Beauty”, “Power”, and “Wealth”. Asian Women need to learn to focus less on the material world and the physical features of people and things if they want to avoid putting themselves into a state of “Low Self-esteem” and thus risk being depressed.
If you read the complete story of “Push to achieve tied to suicide in Asian-American women” on the CNN website (http://www.cnn.com/2007/HEALTH/05/16/asian.suicides/index.html) of how one asian women took her own life, you will realize that it is not just the fact that she felt the societal pressures of the “model minority” that caused her to take her own life. Frankly, I believe that many asian women are “Weak Minded” and have “Low Self-esteem” and have “A Lack of Faith” in her own race and identity. Remember, depression is a mental state and all three of the factors that I mentioned above are “Mental”. If you read that article carefully, you will find the following quotes from the sister of the victim.
“It’s become a U.S.-based ideology, popular from the 1960s onward, that Asian-Americans are smarter, and should be doing well whether at school or work.”
And ….
“My sister had a really low self-image. She thought of herself as ugly,” she says. “We grew up in Houston in the ’70s and ’80s, and at that time in school there were very few Asian faces. The standard of beauty she wanted to emulate was white women.” In college, Noh’s sister had plastic surgery to make her eyes and nose appear more European-looking.
I understand that it is not funny when someone suffers from depression and commits suicide. However, we cannot simply ignore the root causes of the problem if we truly want to help the victims who are suffering. Of course there are many different reasons why a person maybe depressed. But we must face the truth that the biggest problem with Asian Women in America is the fact that most of them suffer from “Low Self-esteem” because they are “Weak Minded” and have a “Lack of Faith in their own identity”.
The problem that I noticed with Asian Women in this country as well as over in Asia is that they are too focused on the material world and the physical features of people and things instead of focusing more on the spiritual side. They lack the resiliency to step away from the temptations of the physical world and what society and the media feeds them. The other problem is that the Media constantly pushes on us the images that define “Beauty”, “Power”, and “Wealth”. Asian Women need to learn to focus less on the material world and the physical features of people and things if they want to avoid putting themselves into a state of “Low Self-esteem” and thus risk being depressed.
But seriously, you ain’t that bright are ya? Weak minded? I believe that can be applied to any race, any gender. White women (example here, not pointing fingers) see themselves everywhere, and have all different kinds of representations. How about Asian women? Almost slim to none. I could elaborate but I’ve got things to do. So please, think before you type. Friends shouldn’t let friends type stupid. =]
I discovered something that made an amazing difference in my mood quite by accident. I had always eaten chocolate regularly and one day went to my local health food store to get a big bar and the clerk told me casually that she no longer ate chocolate because it made her depressed. A giant light bulb went off ( I have been a MAJOR chocoholic my entire life) and I vowed to notice what effects I felt after eating the bar I had just purchased.
Of course, it was sooo deliscious but the next day I was unmistakably *down*. And as per usual, it was very very down. Like, thoughts of death sounding reasonable kind of down. This was the state of my old depression, but I had always resisted taking anti-depressants because it did not seem like the right thing to do for me. It took three days of pure agony – the usual state of being that I ate chocolate to alleviate in the first place – to return to a normal, non-depressed state of mind. This time though, thanks to that shop girl, I was made Very aware that it was simply a very bad- and so trajic!- reaction to eating chocolate. I now share this whenever appropriate to help people realize that chocolate may be a factor they should look at – before they ingest dubious pharaceuticals for no reason. Thank you for writing this article!
I do not think Asian girls suffer from depression anymore than another race. Remember that suicide has always been commonplace in the far east. I do know that Asian parents put alot of pressure on their children to succeed but I do not see that as a negative. Asian women have many positives and in my experience are generally more happier with life than other ethnic groups. Asian women are usually naturally pretty aswell and keep a great figure with ease. I am sure there is more depression amongst African American women as they have a weak cultural identity and many are not very intelligent or good looking.
Based on your last sentence I am assuming that your perceptions of African American women are very limited. In my experience, African american women actually express more pride in their culturally identity and are beautiful and have a natural intelligence. Let’s not blame the whole race for those from low socio-economic status with low test scores and “sub-standard” representations of beauty. Our society denies them appropriate access to good nutrition and suficiently funded school systems. African americans with less access to basic needs struggle more to survive and deal with the everyday pressures and issues of their identity. Let’s show more compassion and love to those that we don’t understand before reiterating degrading comments cranked out by mainstream media and myopic opinions.
First, I applaud the writer for writing about this topic. There is a lot of stigma around mental health, especially for being a minority AND being a woman. Especially in most Asian American cultures, it’s discouraged to talk about disorders or health problems – especially mental health problems.
Secondly, the term Asian American is a problem. It covers so many types of Asian Americans. There are different cultural factors and expectations that go into play. Southeast Asia is so different from Eastern Asia, et cetera. This umbrella term makes it difficult to figure out the factors that go into the statistics.
Ken, your answer “blame the victim for being weak” is not helpful for those in depression. Instead of generalizing an entire group (made of many different types of subgroups) for being shallow and superficial. Obsession with beauty is a worldwide trend and affects both men and women equally (see rising rates of anorexia for men in South America).
Junglegirl, you made a good point that diet affects one’s health and mood – however, when medications are prescribed correctly in addition to therapy, they can help many individuals heal and focus on making themselves into stronger people. Medications on the market are not simply “dubious” and they do have good purposes when used appropriately.
Kevos, parental unrealistic expectations have been linked to depression in Asian American students. The drive forces them to perfection and puts them in a vulnerable place where they can’t confront their parents or shame their family because of cultural expectations.