Learn about mental health in Asian communities and how struggles are often dismissed or ignored, and the harm this brings to Asian Americans
Edited by Kayla Luga
The conversation of mental health in the Asian-American community has been long clouded with discomfort, silence and misconception. The culture created by the influx of Asian immigrants beginning in the 19th century values success and family over all else, creating a stigma surrounding mental health that to this day has barely improved. Because of both cultural and societal factors, it can be very difficult for Asian-Americans to seek help or even recognize the need for it in the first place, oftentimes due to confusing concepts such as neurasthenia.
Neurasthenia, or as it is described in Japanese and Chinese culture, “nervousness”, is a physical and mental condition defined by fatigue, dizziness, dyspepsia, irritability and more. This diagnosis is very broad and vague, but generally is defined by feelings of lethargy accompanied by various somatic symptoms. It is widely believed by medical officials that the symptoms for neurasthenia are similar to many pre-established psychological diagnoses in the DSM (Diagnostic and Statistical Manual of Mental Disorders) diagnostic criteria, ranging from depression to schizophrenia. In fact, any Asian-American patients that meet the DSM diagnostic criteria for other mental health disorders describe their symptoms to healthcare professionals as neurasthenia. As noted in several medical journals, such as that of psychologist Arthur Kleinman, neurasthenia was to be considered a “biculturally patterned illness (a special form of somatization) related to depression or other diseases."
It is the somatization of neurasthenia that makes it so much more appealing than mental health diagnoses to Asian-Americans. Asian-Americans report a higher level of self-stigma than other groups in America, meaning they feel inferior to others without mental health issues, and are commonly doubtful that individuals with mental health issues could be contributing members of society. This causes individuals to hide their symptoms and avoid health due to the stigma created within their community, as well as fear that they may be deemed “failures” for coming forth with their own problems. Because the diagnosis of neurasthenia can quite easily cover symptoms of depression, anxiety or panic disorders, those who suffer from serious mental health issues and instead are diagnosed as neurasthenic may not receive the treatment they need. The symptoms are vague enough to apply to several different conditions, and serves almost as an umbrella term in some cases for several distinct diagnoses. The socially more “acceptable” label placed on neurasthenia, however, means that it has remained a common diagnosis in Asian and Asian-American culture. In this way, the distress associated with mental health issues is indicated without the baggage of social stigma to accompany it.
Before the issue of neurasthenia can be addressed in the Asian-American community, however, it is important to acknowledge the inadequate mental healthcare system for AAPI in the United States. With the current system, it is at times difficult for Asian-Americans to receive adequate care as is appropriate to their cultural background. Asian-Americans (and Pacific Islanders) are the most diverse community in America with over fifty racial and ethnic groups speaking more than 100 different languages and dialects. However, when it comes to mental health treatment, they are often lumped into a single racial category. Many providers may even be unable to address mental health issues that are specific to Asian-Americans, often due to cultural and linguistic differences. These structural barriers harm not only individuals, but also the community as a whole.
Neurasthenia barely scratches the surface of the deep-rooted mental health stigma in the Asian community, but instead serves as an example of how the stigma has taken form in a popular medical diagnosis. With time and open-mindedness, however, it is possible that one day this issue can be resolved both on an individual and societal level.
Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071745/#__sec1title https://pubmed.ncbi.nlm.nih.gov/9298316/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568160/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071736/ https://www.ncbi.nlm.nih.gov/books/NBK44245/ https://www.urban.org/urban-wire/fighting-stigma-mental-health-among-asian-americans-and-pacific-islanders
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