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Going To Therapy Can Be Hard, Especially For Immigrants — Here's How To Start

AILSA CHANG, HOST:

The immigrant community faces a number of stressors. Pursuing citizenship, legal residency and much of the rhetoric surrounding immigration can be anxiety-inducing. And while immigrants often face unique stressors that can contribute to mental health problems, research shows that they are less likely to seek help. Financial barriers, privacy concerns and social stigma tend to get in the way. But help is out there, whether you're looking for counseling yourself or trying to convince a loved one to try it. NPR's Lauren Hodges found some icebreakers for immigrant communities on NPR's Life Kit podcast.

LAUREN HODGES, BYLINE: Sonoya Ahmed's (ph) parents emigrated from Pakistan in the 1980s to Texas, where she was born. She says her father was having some trouble expressing his feelings, so she suggested therapy.

SONOYA AHMED: He said, in his accent - do you think I'm crazy? Therapy is for crazy people.

HODGES: Ahmed calls it an uphill battle just to talk to her parents about therapy.

AHMED: In many cultures, there is this importance placed on what others would think. And so immigrant parents like my own are afraid of how they'd feel if others saw them seeking help. Even if no one is judging them, they are judging themselves.

HODGES: Pahoua Yang works with migrant communities at the Amherst H. Wilder Foundation. She, too, gets a lot of pushback from her clients when she encourages them to start therapy.

PAHOUA YANG: We don't want people to know that our family member is struggling because we don't want to get a bad reputation in the community.

HODGES: Here's some good news. Therapy is confidential. Whatever is shared with a licensed mental health professional is legally protected by law. Unless someone is a threat to themselves or others, it's all between client and therapist. But if you need a more pressing reason to get some of that stress off your chest - it turns out, ignoring your mental health can be just as dangerous as ignoring your physical health.

CHRIS LIANG: When people experience high levels of stress, things happen at a biological level.

HODGES: Chris Liang is head of the Gender, Race, Inclusion and Trauma lab at Lehigh University. He studies the effects of untreated stress on the human body.

LIANG: Cortisol levels go up. And when they stay high, that stress can have detrimental impacts, not just on the psychological health of the person but also on their physical health.

HODGES: There are hints that high stress and high cortisol levels over time may increase the risk of memory and concentration problems and are associated with elevated risk of Type 2 diabetes and heart disease. And if you have a backlog of issues and trauma to address, it's best to get started as soon as you can. So let's do that.

First, if you're insured, your insurance company can give you a list of therapists who take your plan. And don't be afraid to interview them first. Ask if they have experience with your culture or your specific issue. But let's say you don't have insurance. You can start with your local college campus. If you're a student, counseling is free at most schools. And if you're not, many colleges have low-cost - sometimes free - clinics with therapists in training. You can find those clinics at hospitals, too. Try an app, like BetterHelp and Talkspace, where a therapist can help through text, audio and video chat. Or look for a support group in your area. Psychology Today can help you there. Just plug in your ZIP code.

I know all this can be a little overwhelming. Don't feel like doing any research or even getting off your couch? There's a free 24-hour mental health hotline with 15 languages managed by Integral Care. Call 512-472-HELP.

And if you're still not sure about sharing your struggles, remember that you might not be hiding them that well anyway. Research shows we tend to take things out on those closest to us or even use them as stand-in therapists in lieu of professional help. Sonoya Ahmed, who tried to talk to her dad about therapy, says that's a pretty common dynamic in immigrant families like hers.

AHMED: We end up holding various amounts of resentment towards them for putting the weight on us - carrying their trauma and struggles.

HODGES: So you're doing this for them, too.

Lauren Hodges, NPR News.

(SOUNDBITE OF MUSIC)

CHANG: For more tips on how to start therapy, check out NPR's Life Kit podcast at npr.org/lifekit.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

Lauren Hodges is an associate producer for All Things Considered. She joined the show in 2018 after seven years in the NPR newsroom as a producer and editor. She doesn't mind that you used her pens, she just likes them a certain way and asks that you put them back the way you found them, thanks. Despite years working on interviews with notable politicians, public figures, and celebrities for NPR, Hodges completely lost her cool when she heard RuPaul's voice and was told to sit quietly in a corner during the rest of the interview. She promises to do better next time.