Among Asian-American women, a little known battle with depression

When Kristina Wong was struggling with depression as a teenager, she couldn’t turn to her family for help.

“I definitely grew up in a family where it was extremely important not to let anyone know that anything was ever going wrong,” said Wong. “The conversations at my family get-togethers always frustrate me because they always have to do with my work or school, who won what award, and who got a raise.”

A Chinese-American performer, writer and self-described “culture jammer,” Wong just completed a four-year tour of her humorous one-woman show aimed at helping Asian-American women with depression.

The inspiration for the show, “Wong Flew Over the Cuckoo’s Nest,” occurred during a 2005 trip to Wellesley College, an all-woman campus. She was walking around the picturesque campus lake with a group of Asian-American students when the conversation turned to the topic of suicide attempts.

“I had remembered reading that Asian-American women had some of the highest rates of depression and suicide,” said Wong. “It felt so impossible that something so sick could be happening to women so perfect. Yet simultaneously, I think part of me instinctively understood why.”

Depression has taken a quiet toll on the Asian-American community, and particularly women.

According to the Department of Health and Human Services, depression is the second leading cause of death for Asian-American and Pacific Islander (AAPI) women between 15 and 24, who consistently have the highest suicide rates among women in that age group. AAPI women over 65 have the highest rates of suicide among all races in that age group.

Some Asian immigrants have fled violence and turmoil, putting them at risk for posttraumatic stress disorder. China and other Asian countries place a great emphasis on the family unit rather than the individual, and mental illness and depression often reflect poorly on family lineage. The resulting stigma associated with mental illness often prevents these conditions from being addressed within Asian-American communities.

The cultural pressure of homeland values, combined with the feelings of stress and loss common among immigrant communities, has led to what Dr. Shinhee Han, a private practitioner in New York, sees as a mental health crisis facing first- and second-generation AAPI communities.

Han said that first-generation Asian-Americans are often pressured to remove themselves from their family’s struggles and become the image of American success. One of her clients, the youngest of three in a family of first-generation Korean-Americans, had a name that translated into “Last Hope.”

“Often times I have clients whose parents were absent growing up, working nonstop, and telling their kids to study no matter what their family was going through,” said Han. “Many children grew up in a house filled with sadness and too little laughter.”

Girls are more likely to bear the brunt of this pressure.

According to Dr. Dung Ngo, a researcher in the psychology department at University of Wisconsin- La Crosse, Asian-American parents are often stricter with girls than with boys. “The cultural expectations are that Asian women don’t have that kind of freedom to hang out, to go out with friends, to do the kinds of things most teenagers growing up want to do.”

A 2009 study by the University of Washington found that nearly 16 percent of U.S.-born AAPI women have contemplated suicide in their lifetimes. That’s compared with 13 percent of all Americans.

Wong stressed that her experiences do not reflect all Asian-American families. For families like Wong’s, however, the cultural restraint in talking about emotions often results in depression for girls, said Ngo. “For boys, it’s more likely to turn outwards into rebellious behavior and behavioral problems like drinking and fighting,” he said.

Society’s model stereotype of the highly successful, well-educated and upwardly mobile person can also make it difficult for Asian women to accept their “flaws,” according to the National Alliance on Mental Illness (NAMI). In some traditional Asian cultures, women are supposed to be perfect daughters, wives, mothers and nurturers, always putting others before themselves.

Han, who spent 20 years as a mental health counselor at several American universities, believes that the alarming rate of depression-related suicides among college-age Asian-American women is underreported by the media and underserved by mental health professionals.

“Since I began 20 years ago to now, [having] one Asian-American counselor at a university means we are diverse,” said Han. She emphasized that in addition to staff diversity, a curiosity in mental health counselors to go out into the community and learn about the populations they serve is most important.

When Han does outreach specifically geared toward parents of Asian-American students, she characterizes the seminars as ways to help children become more successful. “The goals of the students and parents are the same,” she said, “but the way it’s expressed and the style of achieving these goals are different.” Han tells parents that a mentally healthy child will do better in school and in life.

“Starting earlier is best but college is a great place [to seek professional mental health guidance]” Han says, “because the women are physically away from their parents and making important decisions about their lives.”

While depression is a common and treatable disorder affecting 17 to 20 million Americans annually,  NAMI reported that the pressures AAPI women sometimes feel compound and complicate their ability to get help; only 27 percent seek help or treatment. Han said that most Asian-American students who come to her wait until they are in crisis mode, and they are initially ashamed to discuss their personal problems.

Last month the Journal of the American Medical Association (JAMA) published a commentary by federal policy medical consultant Dr. Chandak Ghosh that pointed to a lack of federal resources and information specific to the health of Asian Americans and Pacific Islanders. Ghosh recommended a national AAPI health agenda to address health disparities relative to the rest of the U.S. population; one area identified was mental health.

After each show of “Wong Flew Over the Cuckoo’s Nest,” Wong, whose tour reached many college campuses and has been released on DVD to educators, opened the floor for questions and answers. She wanted to provide a platform for young women to talk about depression in a natural setting.

“It feels at times that you have to ‘prove your craziness’ to get free help immediately,” said Wong. “There needs to be more mental health services, not just for people in high crisis but for those who just want to talk to someone.”

 
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Comments

  • http://www.meetingwomensecrets.com/members/category/approaching-women/pick-up-lines-openers/ Tips on How to Approach Women

    Depression is a state of low mood and aversion to activity. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable or restless. They may lose interest in activities that once were pleasurable, experience loss of appetite or overeating, or problems concentrating, remembering details or making decisions; and may contemplate or attempt suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains or digestive problems that are resistant to treatment may be present

  • BarkingBackAtTheBlackDog

    I often feel that depression for women is sadness and powerlessness not being able to be released in a ‘heard’ way. Women have always been told to be strong for the sake of family. The expectation is that women can do it all. Well, we can’t. The stupid idea of the career woman who is also a mum and takes care of her family at the end of the day is totally ridiculous. Feminists told women they could do it all and be happy. Sorry but it is a fallacy. Something eventually has to give, and the women start to feel they HAVE to live up to the expectations of society, their own culture (AAPI in particular it would seem) and their own families.
    Even without being a career woman and/or a mother, life is fast paced and stressful. Jobs seem to disappear overnight. Everyone is supposed to look beautiful. Etc. Depression on top of that becomes a nightmare of ping ponging from doing the right thing, to feeling overwhelmed, and back again, becoming worse in feelings each time.
    Kristina Wong, I am an Australian and a Caucasian, and I take my hat off to you for getting the message of depression out there. I feel for your race, it is hard enough being a ‘normal white woman’ with depression let alone what you and your ‘sisters’ go through.
    PBS thanks for allowing me to learn about my world in a new light!

  • http://www.facebook.com/profile.php?id=546018882 Karen Colburn

    hm. sorry to need to address topics of depression and suicide and race relations.
    I’m never sure with numbers, but I’m not sure I agree with the claim that AAPI population suffers in greater number than the Native American population.

    Preventing adolescent suicide
    By Dave Capuzzi, Larry B. Golden

    http://books.google.com/books?id=PIAtCbIRHyMC&pg=PA302&lpg=PA302&dq=suicide+rates+native+american+women&source=bl&ots=oiCVKStkYz&sig=qf-F-4p9MhmDaOAOcexgMpI4Lyg&hl=en&ei=cqu1TKmxPMP78Aamou2EDA&sa=X&oi=book_result&ct=result&resnum=5&ved=0CCsQ6AEwBA#v=onepage&q=suicide%20rates%20native%20american%20women&f=false

  • http://www.facebook.com/profile.php?id=546018882 Karen Colburn

    tough topics: depression. suicide. suicide attempts. women’s issues. men’s issues. race issues.

  • Stevegpace

    I understand the study is on all Asian families, are the statistics any better for mixed families children, like you know white guy with Asian girl.

  • Fred Johnson, Virginia Beach

    This was an excellent, well-written article, but I was disappointed that the author limited her focus to external/situational causes of clinical depression – and did not address the equally significant genetic components of clinical depression. Further, the author placed all of her emphasis on women’s problems with clinical depression, and did not use the word “men” even once in her article. (Hint: Ctrl+F)

    IMHO, the book “I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression” (1998) by Terrence Real should be required reading in every high school – for students, teachers – and parents. Men not only can’t discuss problems with clinical depression, our society will not tolerate it!

    This is what Amazon (dot com) says about the book… “When Terrence Real was studying to be a therapist, he accepted the notion that women suffered depression at rates several times that of men. Now he believes that conventional wisdom is wrong, that there has been a great cultural cover-up of depression in men. Real is convinced of the existence of a mental illness that is passed from fathers to sons in the form of rage, workaholism, distanced relationships from loved ones, and self-destructive behaviors ranging from stupid choices at work and in love to drug and alcohol abuse. Men reading “I Don’t Want to Talk About It” will probably recognize themselves in every chapter, while women will recognize their partners — and, of course, both sexes will see their fathers in a new light.”

    Think you don’t know any men who have secretly struggled with clinical depression every day of their lives since adolescence? Guess again.

  • http://twitter.com/christinelu Christine Lu

    Thanks for raising awareness of this. There isn’t a lot of information out there about depression and suicide …let alone within the Asian-American community. My sister took her life in ’04 at the age of 30. She was the poster child of “success” according to any Asian immigrant parent. She hid her depression almost right up until her death. As a survivor of someone who has committed suicide I can tell you it’s not a group you want to be part of and it’s something you never really “get over”

  • Astha

    forget the American part…it can be generalized to Asian/Pacific Islander Women anywhere….and when it comes to kids, its both sons and daughters….the difference being sons have a choice of expression and even rebel …but not so common among daughters. Nice article.

  • Guest

    Depression is a huge problem in many aspects of life. We need to treat the root of the problem, however. This necessarily mean medication. It means getting to the bottom of the issues that are underlying. Many of these are hidden, masked, or not talked about. If one does not feel loved, or that they have done something wrong, it weighs on them. Possibly, one of the least talked about issues is the link between those that have had abortions and depression.

  • Guest

    Correction in previous message – “This does NOT necessarily mean medication”.

  • george

    I am a man, and I am going through all you have described. I lost my job, exhausted unemployment benefits, had to go through the demeaning and belittling process of public assistance. I am a single Dad who has been the sole caregiver for a teenager since her birth, and if not for the love of my kid I do not know what I would do. I try to keep an upbeat attitude because I do not want to pass on what I am feeling to her, but there are days when I can barely get out of bed. I am caring for a mother who is elderly with little mobility, and my father is in a hospital dying, and I can’t even afford to see him. I never saw myself ever getting to this point. I wasn’t rich but I was able to keep a roof over our heads, put food on the table, pay the bills, and have a life. As the holidays approach I am feeling worse.

  • nolu

    You are going through a lot of things right now but don’t give up!!! You are a strong person for having to take on so much responsibility. Be proud of yourself that you have been able to care for your daughter and your mother thus far :) . And as the holidays approach, just remember that your child needs you!! And as cheesy as this sounds, you have each other :) I’m sure your daughter may be feeling a little bit of the stresses that you are feeling as well and may not show it. Keep your head up. Times can get tough and when they do, just remember to breathe. Maybe go talk to someone. It feels good to just vent sometimes to someone.

    I may not be the best advice giver but all I know is when my family was going through really tough times, I don’t know what I would have done if my mother hadn’t tried to keep herself together. She at one point was the sole caregiver of the family and she has told me several times that if it were not for the love of my brother and I, she doesn’t know what she would have done.

    I hope you feel better soon :)

  • charles

    You might think minorities in general have higher rates of depression in our racist society. This is especially true for Asians who are generally less represented in the general culture but over represented in the professions and universities- thanks to past and present restrictive immigration policies and our racist history (though we always seem to be getting better on this score). Added to that, the cultural background of many Asian families place more restrictions and domestic responsibilities on women so it’s not surprising Asian Women may have more depression. That said, depression is a common sickness that anybody anywhere is vulnerable to – from New York to Tanzania. Many things in our society and attitudes can change to make everybody feel happier.

  • http://pulse.yahoo.com/_W5VBSFOOGRURMU32C4CLGWVRKI bob

    I am the only boy in a family of mostly asian women, so I’ve gotten a pretty good bird’s eye view of this whole phenomenon.

    I think, asian men have it FAR WORSE. Women, we all know can cry, pout, and for the most part, society will “give em a break’ the first few times.

    By the 3rd cry, okay, we will slap them upside the head. But, they get a few shots at being sadly dramatic with our sympathy.

    Asian guys get ZERO. One moment of whine, cry, sadness.. it’s that instant, instant, instant “Asian guy weak non manly thing”

    And here were are, living among the Blacks, Hispanics, you think the men can show that?? They are trying too hard to look hard.

    Ever since the days of the early 90′s when Asian men were trying to sound Black.

    The problem, Asian men/women have NO AMERICAN CULTURE TO TURN TO.

    Think about it. Whites, they have the “rock and roll” and pretty much all american pop culture to turn to. Hispanics can proudly sport their LA Dodgers hat and talk about Viva La Raza and go hang out in LA all day. Blacks.. they just about own all sports and music in the USA.

    Asians… we must PICK one of the other cultures to fit into: either white, latino, or black.

    So, we are ALWAYS in someone else’s culture. Never our own. Unless we stick to doing kung fu and tai chi all day, while listening to the soundtrack of crouching tiger.

    But C’mon, if that’s the case, I SEE WHY we’re so depressed. That IS depressing, as an American Asian, to know all we have that is truely, OUR OWN, is danm kung fu and other retarded things that has been proven to not be quite as cool as say,. basketball, gangs, musicians, etc.

    Asians simply ain’t really making it in this modern day, liberalized world of America.

    Don’t believe the external smiles.. it’s all fake.

    I’m not happy about it. I know we aren’t. We just don’t admit it.

  • http://pulse.yahoo.com/_7DM2IX5PATYOJAJTSSYGTHNC5U Set

    This article makes me sick. Another bitch and cry from Asian women. Asian men have it 100X worse. Asian women can just open their legs and date a white guy to move up the ladder. And they are depressed? It’s articles like this, and movies like The Joy Luck Club that’s filling Asian women’s mind like their are some oppressed minority. Give me a break.

  • http://pulse.yahoo.com/_7DM2IX5PATYOJAJTSSYGTHNC5U Set

    That’s is some useless advice. Expected from a WOMAN. Listen George, go out, get a job. If you can’t, work under to table. Anything. Hustle. Smiling and thinking good thoughts will not put food on the table. Don’t listen to nolu and her useless banter.

    There are many ways to make money. Usually, your state will have a department of labor and training that will help you find a new job. They will even help you write a resume for you if you don’t have one.

  • Ravi

    Props to Kristina Wong for highlighting this important issue!

  • Anonymous

    not all white Americans are like that..
    as far as “danm kung fu and other retarded things that has been proven to not be quite as cool as say,. basketball, gangs, musicians, etc.”
    2 words Bruce Lee..
    rent Dragon..
    http://www.imdb.com/title/tt0106770/

  • Anonymous

    george !!
    hang in there pal!
    don’t worry about the holidays.. just be with your family!.
    no need for preseants or any fancy meals, just be with the ones that love you.
    and seek out support, your church, friends, scocial groups…
    the best for you my friend!

  • Dove173

    Ms. Lu I agree 100% I lost my only child/son Oct.25 ,07 He smiled everyday we went to the mall eevery weekend I do not like the suicide but evil got. My Baby and I have not had 1 good since. Straight A student , just bought him a SUV NO SIGNS NO CLUE .MY BABY WAS DEPRESS. NOW ALL HIS PAIN I HAVE. IT’S NOT ABOUT THE RACE. IT’S HOW WELL SOME CAN HIDE IT . YOUNG SUCCESSFUL BLACK MALE. JUST PRAY IT NEVER HIT YOU ALL THAT READ THE COMMENTS. GOD BLESS ALL YOU .

  • dove173@gamil.com

    To add to my comment My Baby was only 17 yrs old well liked student

  • Mei D.

    Depends on how you raise your children. Make sure you expose her/him to positive Asian and White role models so that she/he will be proud of both heritage. The whole family should spend quality time together by planning board games, taking bike rides in the park on the weekends, traveling, spend time laughing and doing thoughful things for each other. Asian parents tend to be too serious with their kids, lighten up and allow them to make mistakes, allow them to grow and trust them if they haven’t given you any real evidence not to. Best of luck :)

  • Mei D.

    oops playing board games (I should really read before posting)

  • Christinajvue

    great article… i do think its harder for a guy to get help than a girl, no matter what race he is…. hwoever, i think its important to bring this issue to light. suicide and attempted suicide among asian american women is higher than reported. i remember going to school and knew five asian girls who were suicidal, i knew seven cousins who were female suicidal (3 male cousins i knew were suicidal. depression didnt hit me until college, when i felt life was pointless and whatever i do or become, i would never be fully happy b/c of all the limitations i felt were placed on me (most of it had to do w/ self esteem, some w/ parent issues). i think when my aunt committed suicide and i saw the reactions she left, i didnt want to do that…. its hard to be a strong, quiet girl like your mother, or your grandmother or all the other older women you know in your family when u got this storm inside you…. ive seen the consequences of what stigmas have done to my family and frens…. usually it’s either suicide or they start to emotionally and psychologically downspiral….

  • http://twitter.com/anbmsource The ANBM Source

    Seems to be all too much with blaming culture as the cause.

    Has anyone looked at other possibilities?
    perhaps it’s more to do with the suicide victims interpretation of their culture and expectations.

    Asian culture does not tell anyone to remain silent. Because it is not just Asian suicide victims that are quite before attempting it.

    I think it’s better to focus on the current state of the victim and the society they are raised in.

    The problem may not be within the family culture but perhaps the dominant culture disconnecting them as individuals from the family.

    You have to investigate the external material factors surrounding that individual and how they respond to it.

  • Bekind

    serious props to all those who are and have been bringing this issue of depression in the AAPI community (specifically 15-24 yo age group) to light…definitely need a platform/forum in which to discuss this issue openly to help reduce stigma, identify the incidence, encourage more discussion, and foster community…

    i am a 35 yo asian-american who has suffered severe clinical depression. born and raised in pacific asia until i moved to NY when i was 9. i have a masters from an ivy league school, grew up upper-middle class. i’ve suffered depression my whole life. progressive since i was a child and no one detected it. by the time i was 23, i was immobilized by depression. unable to eat, sleep, get up, button my own shirt, to say the least. i couldn’t stop crying for days at a time.

    i’ve seen over 30 therapists since i was 19. none of them identified/made the connections re: the probable cause(s) until i was 32. and that was mostly due to my own vigilance about finding the truth about what was going on with me.

    the origins are rooted in sexual, physical, and emotional abuse by family members and parents. i was in denial, totally disconnected that my parents or my family could have been harming me. that belief meant my survival. i was denied the truth about my sexual abuse, told it didn’t really happen. told i must have imagined it.

    societal, cultural, economic and religious beliefs and traditions planted, perpetuated, and enforced the abuses. no one acknowledged it. even when i was spelling it out loud because i was near suicide. ALL ARE REASONS. It is not one or the other. It is at least one of the many. And it is individual as well as societal.

  • Anonymous
  • anonymous

    As an Asian American woman, try finding an Asian therapist! I’ve had the typical jewish, caucasian therapist for years, and really did not feel like they or I really connected. So by the grace of God, I now have an Asian American therapist who grew up in L.A. like I did, don’t get me wrong, there are Asian Americans therapist who have just graduated from school, but they’re so young! Issues with racism, cultural differences, shame, identity, competition with society and each other-we are the MODEL MINORITIES-who are basically not to have feelings.

  • guest

    I’m 14 and asian, and i feel so depressed. and i have no one to turn to because me family doesn’t care about anything but education and money, and they push me everyday, and all I could do is sit in the car and weep and talk to myself. 

  • http://www.thebestyouare.com/relationships/relationship-advice/relationship-problems-the-reasons-part-1.html relationship problems

    I do agree that the cultural difference can harm and cause a deep depression, but what i really think is that there is the cultural shock which is not taken down by the state. I think that a basic formation and education can reduce this depression state if not eradicate it. Very sensible post and i am going to share it.

    Hope that you will feel really better and if i am here if you need help.

  • http://profile.yahoo.com/FZBL73M46MSA66K2QWFPM4WERI Ian

    Is that why most of you guys act all bitchy rude and stuck up?

  • http://profile.yahoo.com/FZBL73M46MSA66K2QWFPM4WERI Ian

    Do what most of you guys do to cheer up, blame a black person for your problems.

  • Kristinyc

    You also miss a very important point. In general, girls and women are not viewed equally as important as boys and men in asian culture, in the eyes of their own families.

  • Kristinyc

    I’m so sorry for what happened to you. I went through the same things you mentioned. To this day, I want to put my parents through the worse torture possible. What’s sad is that I still provide care for my elderly mother cuz she doesn’t have anyone else to help her. I will keep you in my prayers. Remember, there are ALOT of people who went through what we did. You’re not alone in this.

  • Kristinyc

    I know what you’re saying but the article is specifically about depression in asian Women.

  • Kristinyc

    I just came across this article, but hopefully some of you are still following up on this topic, and this article. Parents should be held accountable for their children’s emotional well-being. Having to work all day – or being a “hard worker” – is not an excuse. And all parents need to recognize that. Frankly, based on the expereinces of some of these commentors, their parents should have been arrested for neglect and/or abuse.

  • Denise

    I’m really struggling as I came upon this article. It’s hard to rely on my family for help

  • Anonymous

    So happy to see that researchers like Dr. Chandak Ghosh mentioned in the article are studying the lack federal resources are focused on Asian American health!

  • Robert Roberts

    This is total BS. It’s a negative stereotype to make Asian men look evil. But of course, we can’t let something like the “truth” get in the way of needing a convenient subgroup to hate, can we?

  • Robert Roberts

    Well, they can all go back to their countries if they don’t like it here. America for Americans.

  • Sharon

    I relate to this so much. As an Asian American woman, I struggled in college with depression and social anxiety. So much that I had to drop out. It is a huge relief to know that I’m not the only one experiencing this.

  • Danny

    To me if your kids want to be american let them be if they don’t then they don’t. Because this is america, that’s what most Asian parents don’t understand. Especially the family that use to be poor like my family. All my brothers and sister are very successful in school and jobs. I have ten brothers and sisters, I’m the only traditional one in my family. I don’t speak very good english and don’t go to college and my parents hate it a lot. But really I don’t care because I like to be what I am. My sibling like to be american that’s just them, it doesn’t bother me at all. You want your kids to live good with no depression as a real asian parents, you have to understand how to be one in america not like in Asian Country. I do agree most Asian parents do have that pressurized but there’s a limit to not over do it because it will make it worst. My parents was doing it too but they don’t abuse us just talk a lot until they finally realize this is america. Wish you all with this kind of pressurized can understand for your parents too, because some haven’t figure out things in a proper way yet. Good luck.

  • Daniel

    Yeah I’m depressed too, I couldn’t finish college because of it. I’m still trying to finish, though I will say its hard to be an artist without self-esteem. I put myself through years of college so I got to see what happened to much of our asian community over the years. It has been a nightmare to watch over and over again the damage done to our vulnerable community. The truth is asian men and women don’t have a chance to talk to one another in many schools or colleges, white people where bullying us apart. Please talk to us, if you thought for a second any harm to you wasn’t harm to us then your mistaken.