Navigating the Mental Health Space as an Immigrant
Mental health is, for the most part, an under-researched, under-reported, and under-discussed matter in the U.S. As a country and society, we are far less aware of mental health’s influence on our daily lives, especially among older generations. However, we are starting to see an attitude shift among Generation Z and younger Millennials. They are more open to having honest conversations about their mental health compared to previous generations. According to a 2020 survey conducted on behalf of the American Psychological Association, 34% of Gen Z adults 21 % of Gen X, 19 % of millennials 19%, 12% of boomers, 8% of older adults reported declines in their mental health when compared to the previous year.
Recently, I decided to talk about mental health on my podcast. In fact, I dedicated an entire season to it. Why you may ask? I believe that public discourse around mental health is sometimes sidelined to the detriment of individuals and communities. For one, I don’t want my kids to feel ashamed about owning their emotions in front of others.
As someone who grew up in a traditional Pakistani household, the concept of mental health is even more complicated, almost fraught. I always perceived therapy as something frivolous and not really a part of my culture. There is a general perception that we should discuss such matters with family or close friends because mental health is private and shouldn’t be shared with strangers. The idea of sharing one’s most intimate thoughts with a therapist is viewed as a violation of family privacy. In South Asian cultures, therapy is considered a Western construct that only white people partake. Depression is a sign of being ungrateful, adding a layer of resistance. Furthermore, there is a lack of appropriate vernacular to express our respective mental health struggles. The dissonance between how we feel internally & our outward persona is almost palpable.
In Pakistan, where a sizeable majority of people struggle to meet their basic needs, access to therapy is a luxury that many cannot afford. However, the need for mental health support is no less acute, and spiritual guides, clergy, and family have often filled the gap.
However, when I moved to the U.S., that support system was no longer with me. Given that I did not subscribe to the idea of seeking therapy for a long time, I could not fully comprehend or even verbalize my vulnerability & the trauma associated with immigrating to the U.S.
During an initial couple of years after the move, I felt a strong sense of alienation, loneliness, and depression. I had moved away from family, friends, and my familiar environment. I was away from sights and sounds, the hustle and bustle of my native city, Lahore. Coming from a collectivist society, I yearned for a more robust support system, and the U.S.’s hyper-individualism culture was somewhat challenging to warm up to. People seemed more detached, less caring at times. It was also post-9/11. America was far more paranoid than I had expected it to be. There were random acts of microaggression targeted at me based on my identity and religious affiliation. I would consciously brush aside these incidents since I was still a stranger trying to fit in, which meant not to ruffle any feathers.
As I settled into a new country and had kids, I wrestled with the idea of sharing my inner thoughts with my children or making them comfortable with the notion of how to navigate the mental health space. My kids saw me as a strong, resilient human who could never falter & I somehow decided to play along as the stigma around mental health remained. Unfortunately, like me, many immigrant parents assume “the designated super-human” role, a label that can be taxing on their mental health and set unrealistic expectations for their kids to measure up to. Due to the courage it takes to leave our countries of origin and start over in a new place, we are seen as unsung heroes, which is valid to a large extent. However, the burden to maintain that persona discourages us from working through our emotions.
But it all changed a couple of years ago when I started to feel anxious again. I understood the trigger for it; I had miscarried. At the time, I was experiencing a host of emotions; shame, guilt & loss. I had miscarried in the past, but this time, the ache was more pronounced; I don’t know why but it felt different. I was gradually falling into depression. It was challenging to get out of bed in the mornings. My body and soul were hurting in tandem. I wasn’t as present for my family. I was struggling to overcome the trauma, but it was hard. The worst part was self-blame. What could I have done differently to change the outcome? Maybe fewer gym visits or healthier eating habits? I was going down a rabbit hole without realizing the impact it had on my psychological well-being. Although supportive, my husband did not fully comprehend my pain, mostly because he frequently traveled for work and seldom witnessed the tide of emotions I experienced during that time.
But I knew I needed help since my mental state was impacting my everyday life. So hesitantly, I decided to seek ‘therapy,’ a somewhat dreaded word that many South Asians tiptoe around. The first time I called the therapist’s office, I hung up without talking. The second time I called, I got the appointment, but I changed it a few times before finally committing to an in-person session. Even then, I was filtering through a lot of information; it was a visceral reaction to feeling weak. Initially, I was also scared to talk about or even acknowledge going to the therapist. I knew that people in the community would judge me. Sadly, seeking therapy is conflated with being crazy. I could not even get myself to confess my treatment to my parents. I still haven’t told them because of the fear that my parents would misconstrue my going to a therapist to reflect poorly on their upbringing and wonder if their love wasn’t enough?
However, I confided in my siblings, who have always been there for me. It took a lot of introspection and courage to open about my mental health journey. Even still, many of my friends don’t know about it.
Since 2020, I have had more time to reflect and explore the concept of a more meaningful lived experience; I have realized that mental health is such an integral part of who we are. We must expand the mental health lexicon to include feeling lonely, burnt out & sometimes just plain sad because those are the emotions I was experiencing when I took the leap. I understand that not everyone has access to mental health in the U.S., mainly due to our broken healthcare system. Seeking therapy is a privilege many don’t enjoy. But it is crucial to have an open dialogue around the subject to support those in our society who need help.
We can start by making mental health more accessible. There is a growing list of resources like Brown Girl Therapy, a free online platform designed to provide a safe space for first and second-generation immigrants on mental health issues. It’s time to recalibrate our approach to seeking help, especially within our communities.