Why Depression Can Look Different in Asian American Families (And How to Get Support)

Authored by Marian Ting, LMFT

You may have seen loved ones in this situation, or lived through it yourself: days of fatigue, headaches, or irritability, working nonstop to avoid painful emotions, all while feeling more and more disconnected from life.

Depression does not always show up as crying or saying, “I’m sad,” and in Asian American families, it often shows up indirectly. Although Asian American communities are highly diverse, there are some common patterns that can make depression harder to recognize and more difficult to talk about.

Why depression can be hard to see

Many Asian cultures are collectivistic, meaning they prize community and family needs before those of individuals. This often comes from Confucian or Buddhist teachings passed down through generations. Cultural values often include respect for authority, work ethic, community harmony, and emotional restraint. In immigrant families, these values have often been important for survival.

Because of this, depression can be viewed negatively—as a burden on others, a sign of weakness, or of being too emotional. When mental health is not talked about at home, family members can learn to avoid feelings and stay silent when they are struggling. In many Asian American families, this kind of emotional suppression can contribute to mental health problems.

Another reason depression is not always easy to name is pressure to live up to the “model minority” image. The myth of the model minority portrays Asian Americans as hard-working, independent, and successful people, and makes it easy to feel ashamed for not being or looking fine.

Social support is vitally important for individuals who are depressed. But in Asian American families, reaching out can be seen as being a burden to others. This is partly because building harmony in the family can mean sacrificing your own needs. As a result, depression can hide behind overworking or caring for everyone else.

Signs that might be depression

For Asian Americans, signs of depression can often look like:

1. Physical complaints

   It can feel easier to tell others that you are having headaches, stomachaches, fatigue, or not sleeping well, instead of sharing that you are depressed. Shifting the focus to bodily problems is more culturally acceptable, but can leave symptoms untreated or make them worse.

2. Overworking or perfectionism

   Perfectionist behavior is often a way to make up for the fear that you are lacking or inadequate. When you are feeling deeply lost or battling negative self-talk, putting all your energy into work can feel like a way to compensate for feelings of not being good enough.

3. Irritability or anger

   Depression often makes it harder to stay emotionally regulated and tolerate daily stress. In families or cultures where vulnerable emotions are avoided, anger can feel like a safer way to express emotions or frustrations.

4. Pulling away from others

   Withdrawal is a common sign of depression, but for Asian Americans it can feel like a more dignified way to cope with vulnerable feelings. Instead of burdening others, you focus on fighting your inner battles privately.

5. Feeling like a failure

   Depression often includes exhaustion and difficulty staying productive. Falling behind in work or not being able to contribute to family life as before can make you feel like a disappointment to others.

Why getting help can feel hard

Asian Americans have low rates of seeking mental healthcare, including therapy. This is often due to cultural stigma, lack of knowledge, or not feeling understood by Western health professionals. Fear of judgment from family or friends can also make it feel safer to manage depression alone.

Additionally, if you have learned from a young age that rationality and critical thinking are more important than emotions, you might find it uncomfortable to seek out help for feelings like sadness, emptiness, or hopelessness. But your struggles are important, and finding the right support can make a meaningful difference.

How to get support

• Start by naming what you feel, even privately or in a journal.
• Talk to one trusted person, family member, or friend.
• Look for a therapist who understands your culture. The ADAA Find Your Therapist directory and Asian Mental Health Collective directory are good places to start.
• Start with your primary care doctor if therapy feels like too big a step.
• Remember that getting help is not dishonoring your family; instead, it can actually help you show up better for them.
• If you are currently having thoughts of harming yourself, call or text the Suicide and Crisis Lifeline at 988.