Mental Health Issues Facing the Asian American Community

In 2020, Asian Americans experienced mistrust, insults, and even physical attacks because people erroneously believed they contributed to the creation and spread of the virus that causes COVID-19.

The COVID-19 pandemic is not the first time that Asian Americans have encountered racism. It’s also not their only mental health concern.

Some people think that all Asian Americans are academically gifted, work in successful careers (usually in a science- or technology-related field), earn lots of money, and have cooperative personalities that further enhance their success. In this stereotypical perspective, Asian Americans are a model minority group.

While some Asian Americans meet these criteria, others don’t. Some might feel inadequate if they don’t conform to these expectations. Others feel ashamed if they do.

Speaking of shame, some Asian Americans struggle to reconcile the expectations of their families’ ethnic cultures with American culture. Some feel that they’re not fully a part of any world.

This sense of disconnect can create loneliness, depression, and anxiety, which can lead to addiction and other conditions. But the stereotypes of Asian Americans can compound such problems. People might think that members of the group are so successful that they don’t need assistance.

Asian Americans might internalize these beliefs and think that they’re flawed if they need help. They may be afraid to admit that they have problems. They might worry that others will think that they’re failures or that they’ll bring shame to their families.

But not seeking treatment for addiction and other mental health concerns can make them worse. Asian Americans — and all groups — can benefit from a little help sometimes. It is important to be informed about statistics of meth use, benzodiazepine abuse statistics,  cocaine usage statistics, and how they affect Asian America community.

Who Are Asian Americans?

While this is a simple question, the answer is more complex. That’s partly because the continent of Asia is so huge and complex.

In its simplest terms, Asian Americans are people living in the United States who originally lived in an Asian country or have parents or other ancestors who lived in an Asian country. To many U.S. residents, Asian Americans are immigrants from countries in Eastern Asia — China, Japan, the Koreas, the Philippines, or Vietnam, for example — or their descendants.

This might be true for some people, but it doesn’t recognize the origins of millions of other Asian Americans. They may have ties to Southeast Asia, to India and surrounding areas, to the Middle East and Iran, and countries that were once part of the Soviet Union (Armenia and countries ending in -stan). Speaking of the former Soviet Union, part of Russia is in Asia, and so is part of Turkey.

Due to this complexity, discussions of Asian Americans frequently focus on ethnic communities with the largest populations. According to the Pew Research Center in 2012, the biggest groups of U.S. Asians were

• Chinese Americans: 4,010,114 million people
• Filipino Americans: 3,416,840 million
• Indian Americans: 3,183,063 million
• Vietnamese Americans: 1,737,433 million
• Korean Americans: 1,706,822 million
• Japanese Americans: 1,304,286 million

Added together, this accounted for about 15.3 million Americans from just these six areas. The numbers mean that Asian Americans are a significant part of the U.S. population.

Family Expectations and the Asian American Community

A number of Asian Americans from East Asian countries also face significant mental health challenges. In part, this is due to the expectations some may feel from their cultures and families.

Family is very important to many Asian Americans. The Pew Research Center reported in 2013 that compared to all U.S. adults, Asian Americans are more likely to be married (59% of the Asian American population versus 51% of all U.S. adults) and more likely to raise children in homes with married parents (80% versus 63%). In addition, 28% of Asian Americans lived in households that contained at least two generations of adults, double the percentage of white Americans.

Such family ties can provide support, but they can also contribute to pressure. Some Asian American families expect their members to work hard to achieve academically and professionally.

Amy Chua’s 2011 book Battle Hymn of the Tiger Mother explored how Asian American parents expect their children to excel in areas such as academics and music. Terms such as tiger mom and tiger dad have been used to describe people with such aspirations for their children.

Achievement and the Asian American Community

Intertwined with these familial expectations is the emphasis that many Asian Americans place on hard work. The 2013 Pew Research Report noted how 39% of Asian Americans surveyed said that Asian American parents from their ethnic group placed too much emphasis on their children’s academic achievements but only 9% of all parents shared the same concerns. Similarly, 93% of Asian Americans surveyed said that their ethnic group was “very hardworking,” but 57% said that all Americans worked hard.

Extremely high expectations affect all age groups. U.S. News & World Report has called Henry M. Gunn Senior High School in Palo Alto, California one of the top high schools in the United States. A majority of its students, 81%, participate in Advanced Placement classes and its students have earned other accolades.

Many of Gunn High School’s students are also minorities. A 2015 CNN story noted that the school had an Asian American population of 44%. It also noted that the school experienced many suicides, including four suicides in the previous six months. Three of the students were Asian American.

The Model Minority Stereotype

Given the cultural pressures to work hard and conform to the expectations of their families, Asian Americans might face stress to succeed. They might also face related pressures, such as the model minority stereotype.

According to the University of Texas Counseling and Mental Health Center, the model minority stereotype is a “cultural expectation placed on Asian Americans as a group that each individual will be: smart (i.e., ‘naturally good at math, science, and technology’), wealthy, hard-working, self-reliant, living ‘the American dream’, docile and submissive, obedient and uncomplaining, spiritually enlightened and never in need of assistance.”

But if they do conform to these expectations, Asian Americans might feel psychological distress because they believe that they’re conforming to stereotypes instead of acting on their own. This distress is called stereotype threat.

It’s difficult to achieve any kind of success, even in the best circumstances. If people automatically expect Asian Americans to succeed and think something’s wrong if they don’t, it could cause Asian Americans to question their self-worth.

Self-doubt could cause them to work even harder and place even more pressure on themselves. It can produce even more stress, but that could create a particularly vicious cycle. People might be so anxious about wanting to succeed that this stress could ultimately hurt their ability to achieve it.

Culture Clash and the Asian American Community

Pressure to conform to such high achievement standards and family expectations can cause considerable stress. Some Asian Americans have turned to using drugs or drinking large amounts of alcohol to cope with this pressure as well as stress caused by cultural conflicts.

“Culture clash” is the term one Chinese American woman used to explain the differences between her and her parents, who were raised in China. As the young woman explained in a 2008 article in the Journal of Ethnicity in Substance Use Disorder, her parents expected her to be a dutiful daughter and succeed academically, but she felt that these expectations were Chinese and clashed with her American life.

The young woman said that she may have turned to drug use because her Chinese background discouraged her from expressing her emotions. In the same article, a young woman who was born in India and immigrated to the U.S. as a teenager called herself an “in-betweener,” someone who didn’t really fit in with other Indian immigrants or with Indian Americans born in the U.S.

She also used drugs, as did another young Asian American woman in the article, a young Filipina lesbian, who said her drug use was a form of “self-medication” to cope with “the fact that I had real emotions about stuff that I couldn’t understand.”

The Asian American Community, Discrimination, and Stereotypes

Using drugs or alcohol to cope with painful feelings is common. In fact, the COVID-19 pandemic has driven many people to do just that. Stay-at-home orders and the fear of catching or spreading the disease has shut down workplaces, schools, and other places. The world has also dealt with canceled events, and lockdowns have kept us from seeing the people we love and doing the things we like to do.

Given these restrictions, changes, and uncertainties, many people are lonely, sad, depressed, and/or anxious. People who immigrated from Asia or have Asian ancestry may be experiencing all these stressors. On top of that, they could be facing discrimination because others might think they look Chinese, and China is believed to be the origin of the virus that causes the disease.

Due to its suspected origin in China, some people have called the coronavirus that causes COVID-19 names such as the China virus, the Wuhan virus, and even the kung flu. (Its technical name is SARS-CoV-2.)

A 2020 survey of 400 Asian and Asian American people who lived in the United States found that since the COVID-19 pandemic began

• More than 40% reported increases in symptoms of depression and anxiety as well as sleep problems.
• Almost 30% faced more discrimination than they did before the pandemic.

“It’s not just the incidents themselves, but the inner turmoil they cause,” said Haruka Sakaguchi, a photographer who emigrated from Japan to the United States when she was a baby. Sakaguchi has photographed people who have experienced assaults or harassment to bring attention to this problem.

Discrimination against Asians and Asian Americans is not new. Prejudice against Chinese laborers who worked on U.S. railroads dates to the 1800s, as do the Chinese Exclusion Acts, laws against immigrants from that country that lasted until 1943.

The United States federal government also sent Japanese immigrants and their descendants to prison camps during World War II because it feared they would assist U.S. enemies in the war.

Even before COVID-19, many Asian Americans have faced more informal yet still harmful forms of racism and harassment. They’ve faced stereotypes that say that they’re academically gifted, career-driven, wealthy, emotionally repressed, not masculine (for men), sexually exotic (for women), and even that they’re bad drivers. Stereotypes can create or worsen anxiety and other mental health outcomes.

Depictions of Asian Americans in the Media

The media has also perpetuated racist depictions of Asian Americans. Early in the COVID-19 pandemic, many news outlets in New York published pictures of people wearing masks. Many of the people were Asian, although the area’s outbreaks occurred in non-Asian communities.

Such pictures thus linked COVID-19 with Asians and Asian Americans. They depicted masked people as outsiders and as people to be feared instead of welcome members of the community. The pictures also erased people’s individuality, depicting Asians and Asian Americans as a monolithic entity that doesn’t receive the same consideration that people of other groups receive.

Similarly, some news outlets have used the term Chinese virus to refer to the virus that causes COVID-19. Scholars believe that such terms have strengthened a phenomenon known as the Americanness bias, in which people perceive Asian Americans as more foreign and less American than other U.S. residents.

This perception is also related to the perpetual foreigner stereotype. This is a belief that people from some groups are foreigners and not part of the larger culture, even if they’re native or longtime members of that culture.

According to researchers, “the perpetual foreigner stereotype significantly predicted lower hope and life satisfaction for Asian Americans” and made members of minority communities feel marginalized and less equal. It could affect their identities and overall well-being.

Addiction and the Asian American Community

Substance use disorder and addiction is one mental health challenge that members of Asian American communities face. Here, too, stereotypes abound.

People might think that Asian Americans are obedient, so they won’t use drugs. They might think that their bodies can’t handle alcohol, so they don’t drink. But members of this community do use alcohol and drugs and sometimes struggle with them.

Biologically, some Asians and Asian Americans have trouble processing alcohol. When some members of these groups drink alcohol, they experience a condition known as an alcohol flushing response.

Known by other names, such as alcohol flush reaction, Asian glow, the Glow, Asian flush, and Asian flush syndrome, alcohol flushing responses occur in people who have a less-active version of the enzyme that breaks down the alcohol byproduct acetaldehyde. Medically, this condition can cause:

• Redness in the face
• Warmth in the head, face, and neck
• Wheezing and difficulty breathing
• Accelerated heart rates
• DNA damage that can lead to different types of cancer

It can also have psychological effects. Journalist Lucas Kwan Peterson, a journalist of Asian descent, said that when he was in high school, he was already anxious about fitting in with his mostly white classmates. The flushing response made his anxieties worse. Certain drugs can be very dangerous, like crystal meth brain damage can have psychological effects.

As a young person, Kwan Peterson worried that not drinking would hurt his social life, but as he grew older, he realized that he doesn’t care “as much what other people think.” He added that many of his friends have also started drinking less as they’ve aged and that many places now offer more options for nondrinkers.

Asian Americans and Mental Health Treatment

While Kwan Peterson said that he doesn’t care about what others say about his drinking, other Asian Americans still care about the opinions of others. More specifically, they’re concerned about what people in their communities will say if they seek assistance to treat mental health disorders such as addiction.

Sometimes, members of Asian American communities might hold erroneous beliefs such as:

• Sharing your problems means that you’re burdening people and lack the ability to solve problems on your own.
• Admitting you have problems means that you’re not strong and not conforming to what your community and society expect of you.
• Experiencing mental health problems is nothing compared to the trauma and sacrifices others in your community have had to endure.
• Using therapy and other secular approaches don’t honor a person’s spiritual beliefs because you’re not using spirituality or religion exclusively to handle your problems.
• Going to therapy didn’t help before, so it won’t help now.

Some Asian Americans might want to express their feelings more because they live in a culture that emphasizes freer expression, but were raised among relatives who don’t encourage such expression and consider mental health assistance a sign of weakness. It is important to seek help; like the heroin help hotline or the cocaine addiction hotline.

Perceptions of Mental Illness and Barriers Treatment

People in other minority communities sometimes share these views. For example, African Americans who responded to one survey reported that they

• Preferred using religion to address their problems.
• Worried about the stigmas surrounding mental illnesses.
• Were “not very open to acknowledging psychological problems.”

Similarly, Asian Americans may be reluctant to seek mental health assistance because of “social stigma, shame, and saving face,” according to researchers who have studied mental health in Asian Americans.

Saving face means maintaining a reputation and losing face could mean losing one, so it could mean an Asian American person who has a mental illness or has received treatment for one might be reluctant to admit it because it could damage their reputation within certain communities. Since many Asian Americans have such strong family bonds, they might also fear that admitting a mental illness could shame their families as well.

Other burdens to mental health treatment include the fact that some Asian Americans are new immigrants and might lack the language skills, money, or knowledge of U.S. culture to seek assistance in their new home.

Asian Americans might find it more difficult to find therapists or other treatment that acknowledges or reflects their ethnic background. Treatment that isn’t culturally sensitive might not address how Asian Americans often have to work to reconcile their ethnic backgrounds with U.S. cultural norms.

Furthermore, Asian Americans might experience discrimination that could provide another obstacle to finding help. Discrimination and prejudice are also factors that contribute to discrimination in the first place, which illustrates how harmful these factors can be.