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Dr. Shaifali Sandhya

Mental Health On College Campus: Three Deadly Knots For Asian-Americans

This is part 1 of a 3-part series on the Mental Health On A College Campus: the soaring levels of stress and suicide on college campuses, particularly among Asian-American women; the difference between anxiety and depression; and what colleges can do to instill a sense of happiness independent of achievements, and the importance of developing the art of talking about feelings.

A recurring dream troubles Connie each night. She’s walking when the darkness knots her feet, creeps up all around her, and she falls.

When she first came to the US from Fujian, China at eleven years old, she told herself, “No one is here to support you. You must support yourself.” Through the crossfires of insomnia, exhaustion, crying, overeating, and panic attacks, she grappled strenuously through to high school.

A few times, she tried to share her feelings with her mother, who reprimanded her, “You’re a lazy bum. Just get faster reactions.” In a Major Depressive Episode, people may tend to show psychomotor retardation, where they move sluggishly, avert their eyes, sit slumped or speak slowly. When her mom interpreted the lethargy inherent in depression mistakenly to be laziness, Connie thought, "maybe the problems will go away in high school." When they didn’t and she talked to her father, his response was, “You don’t have problems. You think too much.”

This Fall, Connie will be one of the twenty million freshmen starting college and navigating other challenges of young adulthood. Today’s college students have many worries and campus life is rife with anxieties: What will I do when I graduate? Do I have enough to pay for the semester, the year? Will I gain the freshmen fifteen, or thirty? How do I balance classes, academic work, clubs, friends, finding internships, keeping in contact with family, and a job without being overwhelmed? For students everywhere, along with vast possibilities, campuses are cauldrons of uncertainty amidst pressures and perfectionism.

Graph: What is your client's top-most concern? For 25,475 college students, clinicians chose one primary concern per client

Source: Center for Collegiate Mental Health, PennState, Annual Report 2014

For the American freshman today, stress is at its all time high.While male college students experience similar pressures as women (Read Julie Scelfo, New York Times, 2015), the statistics are particularly alarming for Asian American female students. Recent research indicates growing alcoholism, drug abuse, and HIV risk. Information compiled by the American Psychological Association sheds light on the epidemic of silent despair:

  • Suicide is the second leading cause of death for Asian-Americans aged 15-34

  • US-born Asian-American women have a higher lifetime rate of suicidal thoughts (15.9 percent) than that of the general U.S. population (13.5 percent)

  • Among Asian-American adults, those aged 18-34 have the highest rates of suicidal thoughts (11.9 percent), intent (4.4 percent) and attempts (3.8 percent) compared to other age groups

  • Asian-Americans college students are more likely than White American students to have had suicidal thoughts and to attempt suicide

Earlier this year, Luchang Wang, a Yale University undergraduate, wrote in an FB message that she was in “deep emotional pain” before she jumped to her death from San Francisco’s Golden Gate Bridge. Of the nineteen suicides on the MIT campus in the last 15 years, 42% involved Asian American students. Asian American college students like Luchang and Connie experience greater rates of stress and are more likely to think about suicide than their non-Asian peers.

Connie was raised in Fujian, China by her maternal grandparents. Her father left for the US when she was ten months old and worked odd jobs six days a week, mostly repairing window casements and doors. Her mother followed him shortly thereafter. When her grandparents could no longer support Connie, she was sent to the US. When Connie arrived in their tiny Chinatown one bedroom apartment, she “didn’t even know ABC.” Her parents and younger three siblings, whom she had never met, felt like “familiar strangers.”

Three deadly knots underpin poor mental health in Asian American students:

  • We tend to think of students as being depressed and unable to cope with high pressure – but they may carry a predisposition to depression. High suicide or depression rates are associated with existing and/or untreated family psychiatric illness, due to shame and ignorance of mental illness.

  • We tend to think of Asian-American families as “collectivist” who put their “families first.” The primacy of family assumes open communication, but in fact communication is generally quite poor in Asian American families. Career trumps communication about feelings. Amy Chua writes in The Battle Hymn of the Tiger Mom:

“The Chinese mother believes that (1) schoolwork always comes first; (2) an A-minus is a bad grade; (3) your children must be two years ahead of their classmates in math; (4) you must never compliment your children in public; (5) if your child ever disagrees with a teacher or coach, you must always take the side of the teacher or coach; (6) the only activities your children should be permitted to do are those in which they can eventually win a medal; and (7) that medal must be gold.”

  • Many families, not just Asian American ones, tend to think of authoritative parenting with rationed praise as critical for their child’s success. They believe that a child’s success is measured not by the authenticity of their true feelings but through possessing any number of such assets: beauty, career, hard work, intelligence, accolades, etc. This flies in the face of child development experts who believe that every child has a need to be noticed, understood, taken seriously, and loved by her parents.

When families develop the art of not talking about feelings, children learn to deny their own feelings, particularly negative ones. As adults they may not know how to regulate their negative emotions and resort to dealing with them through addictions (work, sex, alcohol, video games, and so forth). If they are in intimate relationships, when conflicts occur, they may find themselves caught in cycles of punitive or cutting off relationships.

A high-stress and high achievement campus culture activates such preexisting vulnerabilities. Thoughts of suicide and suicide attempts peak during high school and college – a time when social groups are being formed and the pressure to fit into them is the highest. This suggests the important role peer relationships can play in managing depression and enhancing a sense of belonging.

At some level, students like Connie know something is amiss with them. “When I’m in college,” says Connie of the depression, “I want this to be over and done with...I just need someone to be there mentally.” Students like Connie are only too relieved and empowered when they find someone they can talk to.

How do you find a sense of accomplishment independent of material achievements? Colleges must foster learning and critical inquiry about the self in imaginative ways too as students embark onto life’s defining moments. It is up to the colleges to provide students with the resources to connect to themselves, with one another, especially for those who are not used to doing so.

It is not an easy task to teach anyone to attend, value, respond, and regulate their feelings, but colleges must rise to the task or else, allow some of their best and brightest to fall into the darkness.

In part 2 of Mental Health On A College Campus, I’ll describe the difference between anxiety and depression and how colleges can help students develop a sense of happiness.

Executive Coaching|Chicago: Dr. Shaifali Sandhya offers professional career coaching for high school and college students, and executives to assist them in driving positive change in their life. She has a practical and insightful approach conducted in a confidential environment uniquely tailored to meet their needs such as: increasing creativity; engagement; team motivation, and bottom-line; or reducing stress, to plan for an impactful future. Dr. Sandhya has coached teams in organizations like Mckinsey and provided consultation to industry leaders in the areas of law, architecture, and technology.

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