‘Tis the Season

by Shej Shahriar

I wake up to a cloudy sky, wind blowing, and leaves falling on the ground. It’s that time of year - when you’re supposed to get excited about the holidays, seeing family, and the year wrapping up. But it’s also getting cold and dark outside, and it makes you feel lonely, and it’s harder to get out of bed and get things done. Sometimes it’s just hard to be a person.

‘tis the season for depression.

But what if you suffer from depression or anxiety year-round? Then the so-called “joyous” holiday season just makes things worse. Everyone around you is celebrating, seeing family while you’re trying your hardest to keep it together and smile for the sake of others. This is especially worse for South Asian Americans.

1 in 5 South Asians report experiencing a mood or anxiety disorder in their lifetime, according to the South Asian Public Health Association. Even though this rate is alarming, South Asian Americans have the lowest rate of utilization of mental health services, which leads to the worsening of the underlying illnesses.

Why is this such a big problem? US South Asians often express greater stigma towards mental illness than other groups. Whether it’s seeing those with mental illness as “weak”, or bringing shame to the family, or simply not understanding mental illness, to the sheer lack of South Asian clinical workers and therapists, it’s incredibly difficult for South Asians struggling with a mental disorder to reach out for support.

Due to the stigma around mental health issues, many South Asians don’t even notice their illnesses until very late. Furthermore, South Asians commonly experience psychological distress as physical symptoms, a phenomenon known as somatization. Somatization – the production of recurrent and multiple medical symptoms with no discernible organic cause – will often lead those suffering from a mental health issue to seek out a physician for their physical symptoms. However, according to a study by the National Institute on Minority Health, with South Asians, psychological help is usually not sought out after a physical cause for the illness cannot be determined.

Traditional South Asian families, even those which have immigrated to Western countries, are very collectivist, which can explain the reason behind withholding from seeking professional mental health services. The concept of collectivism stresses a strong, close, and resilient family, often pushing traditional gender norms, a patriarchal structure, and obedience to elders. This leads to suppressed stresses and conflicts between family members in an effort to keep the household peace, but increases the toll on individuals’ mental health, resulting in somatization.

So what do we do about it?

It’s actually really funny. I always thought I was aware of how to take care of your mental health and ask for help when needed. I was fifteen when I first started to feel depressed. I knew what was causing it, so I thought I could just process my feelings and get through them. But we know it’s not that simple. I tried to hide it as best as I could; being the eldest daughter in a brown family, putting my feelings on hold for the sake of everyone else was a skill I had mastered.

But people noticed.

I mean, of course, they did. I wasn’t myself anymore. My smiles became fake, I was constantly distracted, forcing myself to be present. And then one day my dad said “Shej why have you been so upset?” Oh my gosh, he noticed, I’m not alone. “You need to get over it. Everyone’s noticing that you’re upset. It’s not that big of a deal.”

I felt shattered.

I decided that was it. I couldn’t tell anyone how I felt because they noticed and simply didn’t care. So I bottled it up into a pit in my stomach. So much so that by the time I was a sophomore in college, my stomach gave out. Physically. I couldn’t eat more than a few bites without being so nauseous - I had to throw up.

So of course I went to the doctor and did the whole hmm what could possibly be wrong with me, running all the tests, with everything coming out negative. Until he said “uhh I’m pretty sure this is anxiety induced” and prescribed anti-anxiety meds.

It’s been three years since, and it’s still an uphill battle to even mention “mental health” to my parents – whilst I’m on anxiety meds. Let that sink in. Since then I’ve heard the whole shebang of “maybe you should try to weed off those meds”, “you don’t need a therapist, they’re only for crazy people”, “don’t tell anyone about your anxiety, what will people say?” It’s been hard. It’s been isolating. 

It’s just been a lot. 

So every year when everyone is excited to “go home for the holidays” I’m filled with extra anxiety because I don’t know what’s gonna happen with my anxiety, which will get attacked, or the depression, which inevitably gets worse with the weather. This is the case for so many South Asian Americans, both in my generation and older generations. And the saddest thing is that most of the anxiety is related to familial stress and the inability to communicate.

While the holidays and wintertime are of course joyous and filled with fun and shopping and seeing friends, it’s also important to remember that people close to you might be suffering and doing their very best to hide it. So look out for them, and yourself. The holidays are a time to show people that you care and love them, so take the time to talk about things that are important, even if they’re uncomfortable. 

Find mental health resources below: 

https://output.com/blog/free-mental-health-wellness-resources-aapi

https://khalilcenter.com/mental-health-service-landing-page/

http://joinsapha.org/community-guide/mental-health-resources/