Culture-Bound Syndromes

In addition to Western psychiatric disorders, Asian Americans also may experience culture-bound syndromes, such as shinjing shauariuo and hwa-byung.  These syndroms may draw upon Asian persons' mind-body connection.  In many Asian cultures, the mental ill are so stigmatized that sufferers may experience their anxieties as physical aches and pains

SHENJING SHUAIRUO, or neurasthenia, is a medical disorder triggered by stress.  The symptoms include sensation of pain or numbness, chronic fatigue, weakness, anxiety, and fainting.  Neurasthenia is an acceptable medical diagnosis because it conveys distress without the stigma associated with a psychiatric diagnosis.  

HWA-BYUNG, or "fire-illness," is a Korean folk illness.  Sufferers report such symptoms as a heavy feeling in the chest, sleeplessness, hot flushes, cold flushes, and blurred vision.  It is thought that hwa-byung might serve to provide sufferers with a way to conceptualize and resolve emotional distress. 

Getting Help

Such barriers as language, culture and little access to care keep many Asian Americans from receiving help for mental illness.  Asian Americans as a group are unlikely to seek help for mental illness from any source, and when they do they report low levels of satisfaction, according to as-yet-unpublished research by Takeuchi and Jennifer Abe-Kim, PhD, an associate psychology professors at Loyola Marymount University.

So how can the mental health community reach out to this group?

"Education," says Abe-Kim. "A lot of immigrants aren't aware of resources."

From my own experience, working with medical providers is particularly important because they are usually the first or only professionals seen by most immigrant and U.S. born Asian Americans with mental illness.  Furthermore, I would say mental health service providers need to go where the people are at such as schools, churches or community centers.  For example, Cut It Out, a national program originally created by antidomestic violence groups in Alabama, is working to prevent domestic violence by reaching out to women in nail salons.

Takeuchi and Abe-Kim say many cultural and mental health issue still need to be examined.  But, as for many minorities, the essential issue remains, in Takeuchi's words, "How do you fit into society?  How do people from different racial and ethnic groups find a "place" or a sense of belonging in thier neighborhodds, schools, or workplace?"