When Crazy is Not Enough

WHEN CRAZY IS NOT ENOUGH

BY DEBBIE ALMOCERA

A recent article from the American Psychiatric Association suggests that Asian Americans have continued to underutilize mental health services for various reasons.

People of Asian descent tend to delay seeking help and treatment for mental health issues and/or emotional disturbances. Although one can easily surmise that this pattern must be a function of cultural beliefs regarding mental health in general, it could also be due of the lack of culturally sensitive and competent helpers. Whatever the primary reason maybe for this trend, the fact remains that this particular population needs to raise its awareness on the importance of addressing mental health needs just like any other medical issues.

Having spent the first 28 years of my life in another country, my brain is molded by thinking patterns (including potentially distorted ones), assimilated throughout those years in my culture of origin. Despite what one might consider a successful integration into the current culture I’m immersed in (especially after 20+ years), I continue to find myself gravitating towards a belief system that is dangerously close to endorsing a culture where mental health is relegated to the background, and mental illness is but a sign of “weakness and frailty in spirit”.

Traditional Asian beliefs, or at least what I have learned during those “younger” years of my life, have taken their roots in my brain quite comfortably. Perhaps the most “problematic” would be my deep-seated belief that mental health issues are secondary only to basic economic needs, and that if the latter is addressed, the mind will achieve “peace”.

Furthermore, that people could simply think their way out of their misery. Of course, years of training and graduate school have since then worked slowly into my brain. I had to unlearn some of my preconceived notion of what mental illness is, and find a balance between antiquated belief systems and scientific medical research on mental health. I have to say, this balance is pretty fragile.

Since we now know that the human brain achieves full development in our mid-20s, then it must be safe to conclude that mine is now on a speedy spiral lurch downward.

When friends come to me for “advice”, regardless of my assertion that I don’t give advice, my initial response is usually based on my “cultural relationship” with them. I highly encourage Asian friends to seek therapy when needed, but also remind them of the tenacity and resilience inherent in their culture, the courage that brought them across oceans to be in a foreign land, and the perseverance that they have continued to exhibit in preserving the values they strongly believe in. I remind them of their fighting spirit, their brave soul, their strong faith. Yes, my “advice” is tainted with non-scientific logic, but most of the time, that is all they want to hear.

Of course, when one is suffering from a true major depressive disorder or other types of mood disorders for that matter, I don’t hesitate to recommend therapy and other treatment modalities, including medications. I would encourage talking to physicians about proper medications. But first I have to break into, and work on cultural boundaries that precipitate fear of treatment. Initial resistance to treatment for fear of being branded as “crazy” or “weak”, or becoming an embarrassment to the family, is not uncommon. Once these barriers are crossed, people are usually receptive to treatment.

One of my dearest friends asked me if I ever get “depressed”. She says my life must be “just wonderful” since I know exactly what to do when faced with problems. I told her what I do is no different from what she does. I yell and scream when I’m upset, I call my friends, I eat tons of chocolate and ice cream, I cry, then I put one foot in front of the other, and move on.

There is plethora of treatment available for Asians, and Asian Americans who suffer from mental illness, and refuse to seek help. We simply have to raise awareness and promote education regarding mental health to this specific population, and remind them that mental illness is a medical condition, affecting people regardless of age, gender, and culture. As my friend said to me after a long explanation on mental illness, “You’re not just crazy, you’re really ill”.

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Debbie Almocera is a licensed therapist working in the behavioral medicine department of one of the largest hospitals in St. Louis, Missouri. For her, there has not been a more fulfilling and rewarding career than the one she has now. She can be reached at dholderle@yahoo.com