Being an Asian American mental health provider, I understand how navigating through the American mental health system can be difficult, especially when considering the complexity of taking a medication for your mood. In many Asian cultures, individual willpower and the healing power of nature are highly valued. It is common to see a strong emphasis on a holistic approach and focus on achieving a balance within our bodies, treating the root cause instead of the symptoms. Herbs and natural supplements are often preferred, and medications are reluctantly accepted unless symptoms are intolerable.
My goal for writing this blog is to address some common concerns I’ve seen in my clinical practice. I would like to give you the correct information to empower you to make your own decisions when it comes to deciding whether or not to take any medication. Cultural beliefs and backgrounds are relevant, but it is also important to not make decisions based on bias or outdated information before ruling out medication all together. Western medication can be a helpful option, but by no means is the only or best solution.
Concern: “Taking Western medications only helps with symptoms, it is not solving the core issues.”
Absolutely right. I often use the analogy that taking medications is like using your windshield wiper while you drive in the rain. The purpose is to clear your vision and help you drive better, not to stop the rain. Psychiatric medications are not meant to cure your depression or anxiety. They might make it a little easier to think, sleep, or eat, so you have the headspace and energy to tackle the root causes, whatever they are. Many Asians view psychiatric medications as a “complementary/alternate treatment”, while exercise, meditation, herbs, or therapy are their “primary treatment”. Taking psychiatric medications does not mean you have to give up your other modalities for healing that you are used to/believe in. If you are considering taking psychiatric medications, have a conversation with your prescribers, so they can give you more information about possible interactions or things to be aware of.
Concern: “Western medications don’t work for Asians.”
This is a very common and valid concern. There are a lot of different health-related practices that are drastically different between the West and East (e.g. eating and daily habits during and after pregnancy is a big one that clients usually refer to). Additionally, most scientific research for medications does not focus on Asian populations. With that said, clinically we do see these medications alleviate mood symptoms among Asian populations. Responses to medications always vary among individuals regardless of our race and ethnicity; responses can also be affected by our daily habits, supplements we take, and a lot of other different factors. Just like not all Asians respond to Chinese medication the same way either – some of us are “hot” while some of us are “cold” according to Chinese medicine. If you have specific concerns, it is important to discuss those with your provider.
Concern: “It’s shameful to rely on medications for emotional problems.”
Shame is a very prevalent emotion among Asians especially when we have to show “weakness” or are required to seek help. Taking psychiatric medications is often the final step we decide to take reluctantly after we have tried many other methods on our own, so it can feel like giving up and letting go of our control. However, what might help instead is to look at taking psychiatric medications as a way to gain back control. Whether it is a last resort or not, it is our attempt to help ourselves feel better, so we can be present for ourselves and our loved ones again. Going back to the windshield wiper example, medications are like the wiper, it is a tool we use to help clear our mind and vision. You are still in the driver’s seat, in control of the vehicle.
Concern: “Psychiatric medications are addictive.”
There are some medications that have abusive potential (e.g. benzodiazepines, stimulants) and people can get addicted to them. These are prescribed in a more restricted manner with extreme caution. But most medications that are used to treat mood symptoms do not have abusive potential. A common misconception with these medications is when people say they are “addicted”, they are actually referring to a feeling of being ill or worse when they stop taking the medication. There are a lot of reasons why this might happen – stopping “cold turkey” or not taking medication as prescribed are some of the most common reasons. It’s like when you have been taking blood pressure medication for a while and suddenly stop, some individuals can experience rebound hypertension because their bodies do not have time to adjust to the change. This does not mean they are addicted to the medication. If you think it’s time for you to stop or reduce the dosage of your medication, talk to your prescriber to come up with a plan.
Concern: “There are too many side effects”
There is a whole art when it comes to managing side effects and that’s why working with a provider you feel comfortable is so important. Many medications do have their own side effects, just like some natural herbs and supplements. However, different medications work for different individuals, and certain side effects may or may not apply to you.
The dosage of the medication is another major factor in how one experiences side effects. The higher the dosage, the more likely side effects can be bothersome. It can be very helpful to start with a low dosage and give your body time to get used to the medication. Also, some side effects that are troublesome for some (e.g. increased appetite, sedating), can be very beneficial for others and not all side effects are here to last. For example, when starting selective serotonin reupdate inhibitor such as Prozac or Zoloft, one may initially experience some upset stomach, but it usually does not last for longer than a few days.
There’s no one size fits all when it comes to medications. Talk to your prescriber about the potential side effects of each medication and come up with a plan to minimize or manage them. If certain side effects are intolerable, there are often other options you and your prescriber can consider.
Taking medication can be an extremely difficult decision, but it does not mean you have to give up your cultural beliefs and values. Having a conversation with a prescriber you trust can help demystify the prescribing process and rationale for choosing certain medications. Remember, the medications are just there to help, and you are always in the driver’s seat!
Jianne Lo (She/her) is a psychiatric nurse practitioner originally from Hong Kong, currently practicing in NYC at Rivia Medical. She received her training from Yale School of Nursing and is passionate about providing culturally appropriate and holistic mental health care for Asian Americans. She works with adults and offers both psychotherapy and medication management services.
Dr. Dana Wang is a practicing adult psychiatrist in New York City. She is devoted to delivering the best care for her patients and advocating for emotional wellness as preventative care. She believes in a holistic approach to emotional wellness: listening to each patient and creating a partnership to maintain and improve lifelong health. Dr. Wang completed her psychiatry residency training at Harvard Medical School, during which she also completed a fellowship in psychodynamic psychotherapy. She has presented her work at local, national, and international conferences, and co-authored book chapters and peer-reviewed articles. She is a passionate advocate for addressing stigma and mental health service disparities in Asian Americans.
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