what will the neighbors think?
Overcoming mental illnesses in the South Asian American
On the surface Ronak Patel's family seems perfect;
her life story mirrors so many other first-generation Indian-American
women. Ronak's parents immigrated to America, carrying dreams of opportunities
along with their luggage. They found a home in a New Jersey suburb,
and had two children, Ronak and her older sister. They settled into
a tight-knit Indian community where families formed the entire neighborhood
and secrets did not exist. People saw them as the perfect family.
Yet Ronak and her family were silently managing a devastating, too
often invisible disease.
When Ronak was a teenager, she began to observe sudden
changes in her
mother's moods and actions.
"It started when I was in the ninth grade," says Ronak. "Her mood
swings came out of nowhere without any warning signs or indications."
One minute, Ronak and her sister were laughing about something with
their mother and the next minute her mother would be angry with them.
As these mood changes became more erratic, Ronak's family realized
there was something seriously wrong.
Seeking help proved more difficult than making a
doctor's appointment, Ronak explains. The most difficult task was
to convince her mother to see a psychiatrist in the first place. "Like
most people with a mental illness, mom was ashamed to try to find
help," says Ronak. Her mother wanted to maintain her family's flawless
image. Eventually, though, she saw that she had lost control and decided
to seek help. She was diagnosed with a bipolar disorder, a depressive
disorder that affects 1.1 million women in the United States.
According to the National Institutes of Mental Health
(NIH), bipolar disorder is a manic-depressive illness that causes
changes in a person's mood, energy, and functional ability. The symptoms
of the disorder are severe and are not the typical mood changes most
people experience. Depression is the most rapidly growing illness
among women worldwide. In the United States alone, depressive illnesses,
including bipolar disorder, affect twice as many women as men and
these numbers are on the rise.
|According to the NIH, women outnumber men in almost all types of mental illnesses such as anxiety disorders, eating disorders and Alzheimer's disease. Schizophrenia, one of the most chronic and disabling of these diseases, affects approximately 1.1 million women of all races and ethnicities.
So the Patel family story
is not unique; many South Asian women struggle with mental illnesses.
In fact, according to a 1990 study at the University of Toronto, women
of South Asian ethnocultural backgrounds are particularly at risk
for developing depression.
But why is this particular demographic at such a great risk? Dr.
Chhaya Maisuria, a psychotherapist at Hollinswood Hospital in Queens,
New York, says that women of South Asian descent are particularly
vulnerable to developing mental disorders due to cultural pressures
and constrained lifestyles. In Dr. Maisuria’s doctoral dissertation
at the University of Hartford, she determined that cultural identification
plays an important role in the psychological well-being of first generation
and immigrant Indians in America.
“We are walking on the border of both Indian and American cultures
with the constant pressure to choose sides,” says Dr. Maisuria.
“There is a perpetual sense of ‘not feeling
which can lead to depression and other mental disorders.” Dr.
Maisuria says that South Asian parents believe their daughters should
be “Americanized” in regards to education, but should
be more “Indian” when it comes to family obligations and
feminine duties, thus many South Asian American women have conflicted
A significant amount of research
has been done in England about the status of first generation South
Asians raised in Western society. In a study published in the British
Journal of Psychiatry, hospital statistics show cultural conflict
as the primary reason that South Asian women attempt suicide. According
to a factsheet published by the Health Education Authority of England,
South Asian women have, “conflicting values, beliefs and differences
in expectations between generations and genders. Beliefs around
divorce, widowhood, marriage outside culture or religion, and the
preservation of family honor can negatively affect individuals and
cause mental health problems.” Along with cultural conflicts,
religious beliefs sometimes forbid certain activities that are accepted
in Western society, such as dating and alcohol use. Within their
families, many of women have thus found communication difficult
and support lacking.
One therapeutic outlet Ronak recalls was SAMHAJ,
a program from The National Alliance for the Mentally Ill based
in New Jersey. SAMAJ focuses on educating their local South Asian
population about the causes and treatments of mental illness. The
organization provides support group meetings, creates numerous publications,
and has also created a comic
book that tells the story of a young Indian-American woman's
struggle with bipolar disorder.
Dr. Maisuria believes that, regardless of race
and gender, there is a stigma that surrounds mental disorders. This
type of illness is not as easily accepted and understood as a physical
illness--often mental illnesses are not seen as treatable, let alone
curable. A mental illness should not be thought of as an absolute
state, however, says Dr. Maisuria, because there are treatment options
and cures available to reverse the course of the disease. In addition,
Dr. Maisuria believes that educating people about the prevalence
of mental illness is essential in convincing those who suffer from
the disease to seek treatment.
Ronak Patel and her family know the effort that
is needed daily to help Ronak’s mother. Even now, as her mother
is coping with psycotherapy sessions and medications, Ronak stresses
the most important lesson she learned from this experience: “There
were times that I wanted to give up, but my father wouldn’t
let me. He said the four most important words to me--Never give
up hope. And I never did.”
|Places to Find Help:
-The American Psychological Association (APA) recommends
going to a primary care physician, contacting a local psychological
association, or the department of mental health or the American
Psychological Association (www.apa.org) directly. These resources
are not just for patients, but for family members as well.
-Another viable option is confiding in friends. A recent
WebMD survey of women found that depressed women are more
likely to communicate their problems to friends rather than
to their primary care physicians. Most women (62%) who have
experienced symptoms of depression such as sadness, anxiousness
or stress, talk with their girlfriends, while three-fourths
do not talk to their physicians.
- SAMHAJ, an organization in Sommerset, NJ, offers free self-help
group for South Asian families. The meetings are once a month
and are open to anyone.
Amisha Parekh, 25, is currently finishing her Masters in Public Health at George Washington University in Washington, DC. She will be traveling to India for 9 months to work on building public health programs in rural communities.
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