How To Recognize & Address Your Mental Health Needs
In recognition of September as National Suicide Prevention Awareness Month, we hosted a very insightful and inspiring panel about the reality of South Asian mental health experiences, including the unique barriers and stressors and tips on how to recognize and address mental health needs when seeking care. This blog post summarizes the second half of our interview.
We had the opportunity to talk with Dr. Mala Nayak (MN) and Sangita Biswas, LMFT (SB). Dr. Nayak attended medical school in Mumbai and did her residency in Psychiatry at Stanford. Sangita is a licensed marriage and family therapist in the East Bay.
It’s clear there are harmful impacts of the reluctance to seek care that we so often see in the South Asian community. What we haven’t discussed yet, however, is how we can better recognize and address needs as more of us begin to get comfortable with the notion of seeking mental health support.
How do we know if we or someone else needs mental health support? What signs should we look out for?
MN: “At the most basic level, we should seek support if there is a change in functioning.” In young people this may be a reluctance to go to school or to hang out with friends; in older people, it may manifest as having problems at work or being more irritable at home. Specifically, you may notice changes in the following:
Thought patterns: these might include feelings of helplessness or hopelessness, bizarre thoughts, paranoia, unusual sensory experiences (i.e. hearing or seeing things), and obsessions.
Emotions: feeling sad all the time, irritable, angry, upset, agitated or being easily triggered, euphoria, tearfulness.
Behaviors: these might include changes in your sleep, appetite, energy, concentration, or motivation.
To clarify, while having negative changes in thoughts, emotions, or behaviors is natural, we should consider seeking support if we notice a cluster of these things or notice the changes becoming more persistent over time. Identifying patterns is key.
In the South Asian community, we don’t often have the vocabulary or consent to respond to these emotions. So we often see bodily symptoms (e.g. headache, stomach problems, GI issues), and notice individuals going from medical doctor to medical doctor trying to figure out the root cause of the issue. We also tend to externalize the problem by seeing it in others instead of within ourselves, and this results in fighting with others like your spouse or your children.
Do you have any tips for those who might want to help someone in need? What’s the best way to approach such a sensitive conversation?
MN: We can always start with observations about changes in functioning, thoughts, emotions, or behaviors. Try to keep these to just simple and concrete observations; do not prescribe motives or assume you know what might be happening. Keep in mind that the person might not always be ready for that conversation at that time, which is okay because it shows that you care and have the fortitude to listen to whatever they are going through. We sometimes withdraw our support when we see the other person is not as open as we expected, but we should “let them sit with it for a bit and be ready to listen whenever they are.” Reaching out is such an important piece of this.
When they are ready to bring it up with you, make it a priority to listen and practice active listening. Be open, listen with empathy, and without judgment or bias. They may not be ready to share everything at once; give them the space to share at the pace that is comfortable for them. You can also open up about yourself; this might help the other person feel more comfortable sharing their struggles. As you talk about it, be collaborative, do not forget you are both on the same side, so let the other person feel like they have found an ally. This gives the other person a sense of empowerment and agency to take care of their mental health.
When is the right time to seek care?
MN: As soon as possible.
“Just like in physical health, the longer something goes untreated, the harder it is to treat.” It is time to seek care if you are experiencing some of the signs and symptoms we talked about, if you’re feeling stressed, or if you’re not functioning at the level you know you are capable of.
I work as a psychiatrist, which means my work involves medication management, medication will help you feel better, but it will not turn your life around. The rest of it is the work you have to do to change your lifestyle, and this becomes harder to do the longer you are entrenched in your existing lifestyle of isolation and withdrawal.
Also, think of treatment as a way to take an hour away from your busy week just to self-reflect and focus on understanding yourself better.
What should we look for in a provider to ensure they can address our unique needs through culturally-responsive care? Does it have to be a South Asian provider?
MN: Taking into account the cultural piece has become such an important part of mental health evaluation and understanding. You want a provider that:
Pays attention to your cultural background and applies it when it comes to treatment.
Shows interest in understanding your struggles from your cultural perspective.
Shows curiosity about how your background affects your psychosocial world.
Understands how differences in culture may impact the relationship between patient and provider.
SB: While it is not ‘required’ that your provider has the same background as you, it does have advantages for some people. If this is the first time you’re seeking mental healthcare, having someone with similar experiences can give you that “you know where I’m coming from” feeling. Also, if you are more comfortable talking about your emotions in one language, having a therapist that can speak that language is helpful.
On the other hand, it can be a deterrent and depends on who you’re talking to. When treating children or teenagers, having the same background might be counterproductive. Sometimes, when you look ‘familiar’ children see you as an “auntie” and will feel more judged. Ultimately, they will not be as open as you would expect and this can make it difficult to build a strong therapeutic alliance.
Remember: “Your therapist does not have to have lived your same experiences. They should help you make sense of yours.”
Since seeking mental health care and verbalizing emotions doesn’t come naturally to many of us in the South Asian community, what tips do you have to help someone feel more comfortable sharing their feelings with a provider in a session?
There are many things to remember if you want to feel more comfortable in therapy:
Understand that therapy is a great tool for feeling heard and understood and that needing or seeking help is not a sign of weakness.
Understand confidentiality: ensure your therapist is someone you don’t know but also understand they will not share your conversations with anyone else. If more people in your family are or will be in therapy, make sure they see a different therapist unless it is couples or family therapy.
Work WITH your therapist and look at the problem together. Therapy is an insight-based process grounded in reality, and you can gain concrete tools and skills from it.
Make sure you feel comfortable with your provider in terms of race, gender, ethnicity, language, and cultural background. This may not always happen on your first try.
Practice empathy, openness, and a non-judgmental attitude.
Although it depends on the individual, therapy is a process and it usually takes time to see results. Keep in mind that it is not your therapist’s job to give you the answers, it is more about helping you find them within yourself.
Do you have any resources our community can check out if they are in need of mental health support?
988 suicide and crisis hotline
It has been designated as the new three-digit dialing code that will route callers to what was previously known as the National Suicide Prevention Lifeline. This separates 911 calls from mental health crisis stabilization units.
The National Alliance for the Mentally Ill has a wealth of resources and it is invaluable for families of individuals with mental illness.
Has amazing educational content and its provider directory is searchable by location, insurance provider, areas of specialty/types of therapy, and demographics served. But also don’t be afraid to ask your primary care doctor, friends or family who may have great referral recommendations from their own experience.
Please refer to the bottom of this post for additional resources that are specific to our community
Any closing remarks you’d like to share?
Do not ignore your emotions.
The change starts with acknowledging the issue and giving yourself permission to take care of your mental health on the same level as your physical health.
Do not base your decision to seek help on what you see in others struggling with. Every experience is unique.
Pay attention to your sleep, diet, physical activity, relaxation, interests, and social interaction.
Bios
Dr. Mala Nayak:
Dr. Nayak has been working for the past 25 years at Momentum for Health, the largest non-profit provider of mental health services in Santa Clara county, providing medication management and psychotherapy services for the chronically mentally ill. In 2022, in response to the mental health crisis brought on by the global COVID-19 pandemic, Dr. Nayak has been working to set up a service for the South Asian community to navigate mental health issues through education, outreach and connection to services.
Sangita works extensively with the South Asian community, advocating how therapy works and the benefits of engaging in this work before it’s too late. One of her strongest beliefs is that the most effective way to remove the stigma around mental health is to help the community through dialogue and relevant content discussions. She conducts regular workshops for the community to raise awareness around mental health.
Additional Resources for the Asian Community (not an exhaustive list):
Asian Counseling and Referral Service:
Asian Pacific Institute on Gender-Based Violence
Asian Mental Health Collective
