A Young Woman Shares Her Experience Being an Asian American with ADHD

I’m proud of my Filipino heritage and my identity as an Asian American, but I can’t ignore the role stereotypes and culture can play in delaying diagnosis and enforcing stigmas around mental health. I attempted to conform to these stereotypes not to be seen as “weird,” as there were already ways I didn’t fit the norm as a child. Looking back now, I realize that was another form of masking.

Bringing culture into the conversation can feel challenging. At times, I felt like I was betraying my culture by criticizing certain aspects. However, it’s important to look at it with compassion and fairness. For many Asian cultures, it’s still considered taboo to talk about mental health. This was what I experienced for most of my childhood.

However, recently, my parents have opened up to conversations on mental health topics. I’ve come to understand that my parents were also affected by expectations from our culture, so were their parents, and as much as I wish it weren’t true, so too will the next generation. But that doesn’t mean we can’t change some things for future generations.

The model-minority myth and neurodivergence

The model-minority myth is characterized by the stereotype that Asian Americans are high achievers in academics and the workforce. These stereotypes can create barriers in seeking and accepting care, or even in getting a diagnosis in the first place. For some, the pressure to conform to the stereotype of high academic achievement may actually have a positive effect on grades. This may result in neurodivergent traits being overlooked, leading to late diagnosis and burnout.

Since I was a child, I felt pressure to conform to Asian American stereotypes. I felt as though others expected me to be an overachiever, to get good grades and to do so quietly. But as a child, I couldn’t seem to develop any of those traits. I was inattentive, forgetful and loud. My peers and teachers often pointed that out. It was humiliating to me at the time, but these are traits I now give myself grace for. This was largely due to having undiagnosed attention-deficit/hyperactivity disorder (ADHD) for most of my childhood.

According to the Journal of Racial and Ethnic Health Disparities, “Asian Americans are underutilizing mental health services.” The Journal of Attention Disorders states that they are also one of the lowest-represented groups when it comes to ADHD. Research on Child and Adolescent Psychopathology states, “AA (Asian American) youth were 73% less likely than white youth to receive an ADHD diagnosis.” Additionally, Research on Child and Adolescent Psychopathology states, “AA children with ADHD were 46% less likely than their white peers to have received treatment for ADHD.” As suggested by the Journal of Attention Disorders, a contributing factor may be the model-minority myth.

What may cause stigmatizing behaviors?

There are many ways stigmas can be reinforced. As mentioned above, stereotypes play a role in reinforcing stigma. However, culture can often heavily contribute to reinforcing stigmas.

Engaging in culture is inseparable from the human experience. Culture affects our thoughts, values and behaviors. A huge part of my culture is the idea that I am indebted to my parents' hard work, which I’m expected to pay off by doing well in school to eventually get a good job. This is reflected through the cultural value of “Utang Na Loob,” which translates to “debt of gratitude.” This also applies to broader Asian culture through the concept of “filial piety,” which is the expectation to respect and obey elders. This often translates to authoritarian parenting styles, which the Children and Youth Services Review suggests, may make it harder to seek mental health care.

It’s important to look at culture under a critical lens, while also embracing the benefits it has to offer. However, even if there are negative aspects of a culture, it should never be vilified. Instead, it’s important to consider what can be improved upon to support the well-being of others.

In the 5th grade, my teacher expressed concerns suggesting I should see a specialist. My parents weren’t agreeable to the idea, and so they didn’t take any action. In middle school, the school counselor sent me home with the paperwork to see the school therapist regularly. My parents were distraught, stating concerns about how I’d be perceived socially. Stanford Medicine states, in some Asian cultures, mental conditions are seen as a moral failing.

Current research and path forward

For mental health care, it’s important to recognize the unique experiences of different groups of people, like Asian Americans and the LGBTQ+ community, and tailor care to their needs. That seems to be where a lot of research is headed. According to Social Science and Medicine, mental health care seems to be responding to the need for intersectional care. Merriam Webster defines intersectionality as “the complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism and classism) combine, overlap or intersect especially in the experiences of marginalized individuals or groups.” Intersectional mental health care involves addressing all parts of one’s identity that may affect their well-being, including ethnicity, culture, sexual orientation, gender, socio-economic status, neurodiversity and disability.

As the awareness for the need of intersectional mental healthcare grows, so too has the recognition that more research needs to be done to support this. Specifically, neurodivergence in Asian American communities has been historically underrepresented in mental health research. The Journal of Racial and Ethnic Health Disparities states that part of improving care and research for Asian Americans is a call to disaggregate data, which is to differentiate ethnicities rather than grouping all Asians together. While there are things that are generally common in the Asian American experiences, it’s important to explore what specific barriers to care each culture faces.

Being able to share and practice my culture is something of high importance to me. But I want to ensure I’m doing so in a way that aligns with my values. These are conversations that deserve to be had. Because reflecting on how culture affects mental health benefits the culture itself.