Navigating Mental Health as an Asian International Student: Insights from OUR Personal Experiences

Navigating Mental Health as an Asian International Student: Insights from OUR Personal Experiences

Mental health is a vital aspect of overall well-being that affects individuals from different cultures and nations. As an Asian international student, I came to the United States in order to embark on a journey to pursue my education in a foreign country. Alongside the excitement and opportunities, I soon realized that navigating mental health in this new cultural environment posed unique challenges. In this blog post, I will share my personal experiences and insights after interviewing three other Asian International students, trying to explore the cultural perspectives on mental health and help-seeking behaviors among Asian international students like us.

Data from the World Health Organization (WHO) show that mental health disorders impact millions of people worldwide. Asian populations are no exception to this global concern. Asian international students make up a significant portion of the student population in various Western countries. Being an Asian international student means dealing with a multitude of stressors, including adapting to a different cultural context, academic pressures, language barriers, and social isolation. However, the way we perceive mental health and seeking help is heavily influenced by our cultural backgrounds. One of the primary cultural barriers we face is the stigma associated with mental health. Growing up, I witnessed mental health being brushed under the rug, considered a shameful topic in my community. Seeking professional help was often viewed as a sign of weakness or an excuse to avoid responsibilities. This stigmatization has deeply rooted itself in our cultural beliefs, creating barriers to open discussions and seeking the support we need.

Moreover, stigma, attitudes toward mental health, and familial and social expectations also play a significant role in our help-seeking behaviors. Research from the APA, provided by Wang, Wang, Chuang, and Heppner in 2017, revealed that many Asian international students underutilize mental health services due to cultural barriers, concerns about confidentiality, and stigma surrounding mental health.

To gain a deeper understanding of these cultural perspectives, I conducted interviews with Asian international students like me. Through these three interviews, the diverse experiences, challenges, and help-seeking behaviors were brought to light, allowing for a more comprehensive understanding of our needs.

Let me share some of the personal experiences shared by interviewees, giving you a glimpse into the varied cultural perspectives on mental health you might have never known before:

Interviewee 1 (J) - Chinese International Undergraduate Student majoring in Economics:

J initially held stigmatizing views toward mental health, considering it as an excuse to avoid schoolwork. However, through his study in sociology, he began to question this stigma. Despite his growing awareness, his parents still hold confusion and skepticism about mental health issues, which is a common sentiment in Chinese culture. The perception of mental health as a weakness creates additional barriers to open discussions and seeking help.

Interviewee 2 (S) - Singaporean International Graduate Student majoring in Social Work:

S believes that mental health is deeply interconnected with other aspects of health, emphasizing a holistic perspective. He mentioned that mental health is increasingly discussed in Singaporean society, but there is limited understanding of the nuances and mental health policy among politicians and society at large. While mental health is increasingly discussed, seeking therapy and affordable mental health support remains stigmatized, hindering accessibility for those who need it.

Interviewee 3 (A) - Vietnamese International Undergraduate Student majoring in Psychology:

A highlighted the prevalence of mental health concerns in Vietnam and the limited understanding and trust in mental health services among her family. In Vietnamese society, there is openness to discussing mental health, but proactive engagement and practical initiatives are lacking. The cultural values of competitiveness and hard work contribute to the development of mental health challenges.

These three interviews provide valuable insights into the influence of cultural, educational, and societal factors on mental health opinions and beliefs. Cultural values, beliefs, and stigma significantly shape individuals' perceptions of mental health and help-seeking behaviors. Educational experiences play a role in reshaping understanding, and societal attitudes and discourse impact the acceptance and awareness of mental health.

As an Asian international student, I also have personally experienced the challenges associated with mental health, which was mentioned in my last blog post, The Hope. The stigma, cultural expectations, and limited awareness of mental health resources create barriers to seeking help. However, through research and personal insights, we can begin to unravel these challenges and work towards a more supportive and inclusive environment for Asian international students.

My hope is that the Office of International Affairs, as well as individuals interacting with international classmates, co-workers, and friends, will actively work towards creating an inclusive and supportive environment. By embracing cultural diversity, providing necessary support, and fostering meaningful connections, we can ensure that someone who studies, works, and lives abroad can feel valued, empowered, and well-integrated. Together, let us build a community where everyone can thrive and contribute their unique talents and perspectives.

Tips for Supporting International Students:

• Provide patience, understanding, and support.

• Avoid stereotypes and generalizations. No judgment!

• Encourage connections and friendships.

• Create a safe space for open discussions.

• Be open-minded and respectful.

QY is a second-year graduate student at the University of Chicago, Crown Family School of Social Work, Policy, and Practice.   Qy just completed her first year internship with No Shame On U.

Wang, L., Wang, K. T., Heppner, P. P., & Chuang, C.-C. (2017). Cross-national cultural competency among Taiwanese international students. Journal of Diversity in Higher Education, 10(3), 271–287. https://doi.org/10.1037/dhe0000020

Something New

Something New

People who know me for even a short while know I’m not the best at trying new things - and this doesn’t just mean new foods.

Change has always been hard for me, even if it’s the kind of change I want or actively seek. It’s like when I moved to Chicago - I wanted to move for a long time, I researched the heck out of everything, but I was still highly anxious when the time came to actually move to a new state and start a new job.

Even smaller changes can be tough for me. I moved a block and a half recently, and even though I was counting down the days until I’d be living in a much nicer place, I was still anxious about the details until I was completely settled in.

I’m also the same way in therapy. My therapist likes introducing new techniques to me, but if I’m having a hard time, it’s difficult to work on something new instead of doing something familiar - even if it doesn’t work as well.

One of the challenges I’ve set for myself during this grieving process is to explore different kinds of therapy. In addition to talking with my therapist regularly, I have also been looking through a variety of books to get advice about how to deal with some of the challenges I’m facing. And some of the things are, well, let’s just say they’re a bit out of my wheelhouse.

I recently started a writing course, my first in several years, and I was expecting it to be like writing down answers to the questions my therapist asks me. This is a grief writing course, so I knew I would be writing about Nana and my thoughts about losing her, but I went in with some assumptions that I didn’t realize would make it difficult to do the writing as assigned.

I assumed that I would be writing about what happened in the real world and the feelings I’m experiencing, rather than trying to tap into my rather depleted imagination that I’m mostly using for the nastier kinds of “what ifs” at this point. I didn’t think I’d be responding to other people’s stories about grief and trying to work myself into their metaphors. And most of all, I didn’t think I’d be spreading out the main section of the New York Times on the floor one evening to help me write a poem.

I’ve never liked poetry much, so I wasn’t really inclined to participate - but just like when life throws other things at me that make me feel uncomfortable, I try to still engage. I spread out the pages and followed the instructions to read words and phrases at random until I found something that stuck out to me, and then highlight those words and use them for the basis of a poem.

Even though this was a new kind of therapeutic work, I still found it helpful once I pushed through the uncomfortableness. I looked through environmentally based stories about rhinos getting their horns filed and world news stories about families urging their young ones to not become martyrs. And somehow, these stories and others started to turn into a poem, because Nana used to love the New York Times. My family used the fact that she could read and understand the stories at age 94 as a barometer of her health, and the fact that I was now reading it and she wasn’t even alive felt very poignant.

I’m not sure if I’d want to incorporate poetry into my regular therapeutic practice, but grieving for Nana has taught me that, when some situations feel far too huge to handle, it might mean that a new technique is necessary - even though I still struggle with trying new things. If I don’t have the resources to tackle feelings that feel too big, there might be something else out there that can teach me how to process things in a healthier way.

POEM:

I used the New York Times, because, like me, it’s something

you love(d)

when you were alive and well

you went “peacefully” but

it’s a mess and

we are absolutely going to suffer from this

I wish I could see your ghost

so I would know you’re never really dead

but even with seeing so little, I know too much

to believe I could have any control

of the pacing and direction of this grief

and my life without you

with challenges, a longer journey, shying, shrinking

I hope you are somewhere you can be at peace

and able to read the New York Times

but at the same time

I need you alive, not dead

 Michelle Cohen, a writer in the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

When “Special” Hurts

When “Special” Hurts

Growing up with OCD, I felt like the only kid in the world who ever had this particular condition.

Other kids at my school discussed ADD and ADHD, and were often on similar medications, but no one other than me really knew what OCD was or what it felt like. In addition to dealing with a disorder that controlled much of my everyday life through constant obsessions and compulsions, I felt like I had to go through this struggle alone because no one really understood what I was going through.

My family were my greatest allies during this time, even though they also didn’t know what it felt like to grow up with this kind of mental illness. I was lucky to have them by my side, but even so, I felt strange that I had to explain so many things that were just a basic part of my existence to them (and any other, incredibly rare person who was willing to listen).

As I got older, I met more people who either had OCD themselves or also felt misunderstood by their peers growing up. Thankfully, it’s been years since I’ve felt so isolated, but a certain particularity of grief is bringing some of these old feelings back.

I am someone who, in therapy, wants to read every book about what I’m going through. I sign up for Facebook groups, read blog posts and essays online, and basically just spend a lot of time trying to find resources for exactly what I’m going through.

Usually, this counteracts the feeling of isolation I had when I was a kid. If I see articles or Facebook posts written by people going through an experience I’m struggling with, I don’t feel rare or like my difficulty is an unsolvable problem. Instead, I feel hope - if other people can get through this, so can I!

As soon as Nana got sick, I struggled to find materials for people grieving before a death - grieving someone who has essentially lost their mind and stopped being the person you knew and loved. Even with Amazon’s massive bookstore, I was only able to find one anticipatory grief journal. It helped me a lot, and I reassured myself that once the death did actually happen, I would be able to find more resources to help me cope.

In the weeks since Nana’s death, I have looked for all sorts of resources. It’s true that there are grief support groups online and in person, many books to read, and journals that I can use to continue my work from before her death. But there’s one gap I wasn’t expecting - a downside of sorts to the kind of relationship I had with Nana.

People always told me growing up - and still tell me - that I was so lucky to have a grandparent who cared so much about me. When I went to college, I was surprised to see so many of my peers losing interest in the grandparents they still had, or reacting surprisedly to me receiving letters from Nana that came with love instead of a check. Most people I knew who had living grandparents as an adult weren’t close with them, so when they died, it was more about losing a particular family tradition or a source of extra income as opposed to a close relationship.

But for me, Nana has always been one of the closest people in my life. She’s been a huge part of my support system since literally the day I was born, and I wanted to see how other people my age learned to live without a key part of their support system.

It’s here that I realized that, just like when I was growing up, I had an unusual situation that no one else around me understood.

Even with all the books out there - including ones that feature sections for different kinds of loss - none of them mention what it’s like to lose a grandparent.

Articles are few and far between, and most of them deal with helping small children.

Most support groups I’ve found don’t accept someone unless they have had one of three kinds of loss (parent, spouse, or child) or have lost someone to a specific disease (Nana’s was rare enough that there isn’t really much out there).

Even my therapist had to advise me how to adapt advice from books and articles written for people in other, more common grief situations to fit my rarer one.

I understand that I’m lucky to have had such a close relationship with Nana in my life, but the recurrence of this feeling of being “special” doesn’t exactly help. I wish there were more resources for people my age - more ways for those of us who were lucky enough to have a grandparent who really, truly loved us to figure out ways to move forward in the grieving process and in life.

As a writer, I’ve found a solution that works for me - I started exploring my grief through an individual writing class featuring 30 days of prompts that can fit any kind of grief. Even though the person who wrote the class lost her spouse, the prompts get at the feelings that are similar even in different kinds of loss. And, just like my OCD blog posts, I hope to share some of them one day so that other people might not feel quite so alone after losing someone who meant the world to them but wasn’t a “typical” relationship.

Michelle Cohen, a writer in the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

Filling the Hole

Filling the Hole

Most people who know me wouldn’t be surprised that I unpacked every box and hung every picture in my new apartment in under three days - but I have to admit that’s a little fast even for me. I enjoy being organized, but I’m not someone who needs to have everything put away immediately in most circumstances.

I’ve moved before, but never at a time like this. I’ve never felt such strong internal pressure to get everything unpacked, and then, the morning after I finished, I woke up and felt strangely lost. It didn’t take me long to figure out why.

Moving - even though I was just moving a block and a half - is a distraction that requires a lot of brainpower and constant effort. There are a lot of moving parts (pun intended) and there were so many things on my to-do list that I could almost completely forget everything else that was going on if I prioritized the move completely.

But then, I found myself sitting in my lovely new office chair wondering what to do with myself. It wasn’t that I didn’t have distractions; I had all my familiar things plus my brand-new 6,000-plus piece LEGO Rivendell set. But I felt this overwhelming sense that nothing would be good enough to fill the hole.

Usually, I consider boredom or dissatisfaction in my life to be like a hole in my head that I can fill in a variety of ways. But now, it’s my heart that has a hole - a Nana-shaped hole that no matter what else I try to put in there, it won’t be the right shape.

My regular therapist and the grief counselor I saw when she was out of town agree that I’m doing the best I can and that things will eventually feel more settled. But until then, I feel the urge to throw myself into as many big projects as possible so that I don’t have time to sit around and think about the loss I’ve had. Since I know I get lost in my head, I’m trying to get lost in more pleasant things than grieving for the whole rest of my life that Nana won’t get to see.

There isn’t an easy solution for this hole. No matter how many projects I stuff inside, they won’t be more than a temporary fix. But I’m hoping that over time, the temporary fixes will feel more permanent and I’ll be able to have a better perspective on both the memories I cherish and the ones I won’t get to make.

For now, I just have to take it a day at a time and know that healing will come slowly but surely. All I can do is try to find a healthy balance between facing my feelings and distracting myself from them in a way that will enable me to feel stable and get things done at work, home, and beyond.

I’m filling the hole as best as I can. Nothing can replace Nana, but I have joined a new weekly board games group that makes me smile genuinely, I’ve started my most ambitious crochet project yet (a large stuffed Hobbes from the “Calvin and Hobbes” comic strip), and I’m playing plenty of “Legend of Zelda: Tears of the Kingdom” with breaks to deal with my own tears. I’m journaling, binging silly YouTube videos, and reading books about grief that are helping me put my feelings in a greater context.

I’ve struggled some with the idea that Nana wouldn’t want me to sit around and be sad, but that is going to be part of the process of learning to live with this empty hole that doesn’t go away. It’s new for me, and just like with other new things, I’m sure I’ll get there. But in the meantime, I’m trying to work with my head instead of against it by throwing positive obsessions at the problem until I can feel better in the moment - and at this point in the grieving process, I’ve been told that’s all I can really ask for.

Michelle Cohen, a writer in the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.

Moving Out, Not Moving On

Moving Out, Not Moving On

This week, I’ve been thinking a lot about moving.

It’s not just that I am moving from one apartment to another (technically moving neighborhoods, but literally only moving a block and a half) - even though that’s been taking up a lot of time and attention, I’ve also been thinking a lot about moving on.

I’ve noticed that, when I see someone who is grieving, they tend to receive feedback a few weeks into the process that they’re doing it too slowly and need to move on with their lives. I’ve also read about it in “It’s OK That You’re Not OK,” a surprisingly helpful grief book - people don’t know what to say or how to help, so they encourage (or urge) people to move on.

My therapist came back this week after her trip, and one of the questions I asked her was when I was supposed to move on. I know the grief process looks different for everyone, but as someone whose thoughts have always been extremely cyclical, I wanted to make sure I wasn’t going to enter some kind of indefinite cycle of negative thoughts that would just go on forever.

She told me that a deep grief like this is not something you ever fully move on from. It’s something to be lived with, not some goal to check off a to-do list. And while it’s important to keep my OCD in mind, it doesn’t mean I need to be nervous that I’m thinking about Nana a lot and missing her a ton.

In some ways, I am starting to get back to normal - or whatever “normal” will look like. I managed to organize everything for my upcoming move; I’ve joined a new board games club; I’ve been going to work and all of my usual activities even if my heart isn’t in it. I’ve even been able to give my default answer of “good, how are you?” when someone asks me how I am, rather than figuring out a polite way of saying that I’m not okay.

The move has been the biggest thing to propel me back toward the real world. After all, just because I’m sad doesn’t mean the apartment building I’m living in now won’t kick me out because my lease is up. My things won’t pack themselves, nor will my special items from New Zealand and Nana’s home carry themselves to the new apartment.

And so, I’m moving, at least in this way. I’m even getting excited about some parts of the move, like the nicer apartment and cheaper rent - but there are other things that make me not want to move, like the fact that I can’t show Nana pictures of my new apartment or get a letter from her in my new mailbox. These just remind me that, although I have a lifetime of happy memories of Nana, she won’t ever get to experience anything new I do, whether it’s getting married, publishing a book, or even something small and simple that I just want to share with her. Moving means I’m leaving the last apartment where I talked to her when she was herself, and also the place where I was when I found out that she died.

My therapist told me it’s useful to think of the grief process as moving forward, not moving on. I’m never going to be able to move on from the loss entirely, but I can move forward in a way that’s not quite so black and white, that enables me to get what I need to get done while still taking the time for reflection and self-care.

It can be tricky to find a balance like this, but the fact that I have to literally move apartments catapulted me head-first into the process. I know it won’t be smooth, but I try to think about the fact that even after Nana was not cognitively well anymore, she still remembered that I was moving and asked my mom about it every single day she could still talk. She still cared about me and loved me even when she was barely functioning, and the best way I can honor her is learning how to move forward - even in such a small thing as moving from one apartment to another.

Michelle Cohen, a writer in the Chicago area, was diagnosed with OCD at age 3. She hopes to educate others about her condition and end the stigma against mental illness.