Depression: Part One

Before the depression, the drug use, my little brother was happy, cheerful, giving, loving, hardworking, honest, and self-driven. He lived a purpose driven life. That was before depression got a firm grip on him and nothing I did, seem to break that hold. Gone was the positive and fun loving young man, in his place was someone un recognizable and at times unloveable.

As the student body president of his high school, my brother had it all, great friends and popularity. He was loved by his classmates, teachers, and school administrators. He could do no wrong and was the perfect role model for his peers. He was an honor student and highly active in and out of school. This success story continues all through college and med school. He graduated at the top of his class from the University of Texas Tech with his Doctorate degree in Pharmacy, the first one in our Laotian community to do so. Armed with two bachelors and a Doctorate he set off to do his internship in Minneapolis, Mn and that was when everything changed tragically, for him and my family.

The internship went well and he enjoyed working with the patients at the hospital. Upon completion of his internship he received and accepted a job offer as a pharmacist at Walmart. All the years of studying and working seems to be finally paying off. He no longer had to struggle to make ends meet. He was making over $120,000 a year and seemed to be doing well financially and emotionally. That’s why I was in such a shock and disbelief when I received ” the call”.

To this day I can’t tell you what time or day it was when my brother’s friend/co-worker called to tell me that my little brother was taken to the hospital. She wouldn’t tell me anything except where to call which I immediately did. However, I was more confused when I called and the nurse said what sounded something like “psychiatric ward”. I was momentarily caught off guard and at a loss for words and she had to identify herself a second time. I thought my brother’s friend had given me the wrong number! So I decided to make sure before I hung up and explained who I was and asked how my brother was doing, fully expecting her to tell me that my brother was not a patient there.There was a slight pause before she told me to hang on while she got his nurse. When his nurse came on the line, she told me that I couldn’t talk to him yet because they had to stabilize him first. By this point, I realized that my brother had tried to kill himself and was a patient at the County Medical Center, in the psych ward. How did he go from treating patients to being one? After I got off the phone I don’t know how long I sat there desparately replaying all of our late night conversations to comb for clues and serch for signs of trouble. All I could remember from my conversations with him was that he was tired from working overtime moonlighting for a second pharmacy. He never mentioned that he was depressed or that he wanted to kill himself. I kept asking myself, what happened that drove him over the edge? And how was I going to explain to my parents what happened if I didn’t even know myself!

Much later that night I called my parents and told them my brother had tried to killed himself. The first thing my mom angrily shouted was, “Is he crazy?!” She just didn’t understand what he had to be depress about and was angry at him for trying to take his life. She asked me for the hospital number but I told her he was not ready to talk to anybody yet and that I would let her know when she could call. Even though I promised her I knew that if my brother was going to recover, I had to keep my mom from calling him because she would end up stressing him out more from her scolding and interrogation. While he was hospitalized I kept my promise and told my mom point blank if she wanted him to get better she needed to leave him alone until he was ready to tell her himself about what had happened.

My brother did not get better after his month long hospital stay but progressively worse to the point where we had a family friend check on him daily and taking him food.This constant viglance would go on for several months until I brought my brother to live with me in hopes that I could shake him out of his depression. Looking back now, I can see how utterly naive and foolish that was!

*** Part Two: Intervention

How do you de-stress?

Please feel free to tell us how you handle stress or what stresses you out.

Mental Illness in Southeast Asian Communities

youtube=http://youtube.com/watch?v=j-wMP2Q0Ifs]
*** My little sister, Khonsavanh works in the mental health industry.  I asked her to write this article to increase awareness about this issue that may be overlooked by Laotians and everybody in general. If you think you have a mental disorder, do not be afraid to seek help with a professional health care provider. In case some of you are not quite sure what exactly mental illness or disorder means, here\’s a good definition/example from answer.com:\”Serious mental illness or disorder impairing a person\’s capacity to function normally and safely: brainsickness, craziness, dementia, derangement, disturbance, insaneness, insanity, lunacy, madness, psychopathy, unbalance. Psychiatry mania. Psychology aberration, alienation.\”

I have worked in the behavioral health field since 1994-both with children, teenagers, and adults. I have worked in Kansas, Arizona, New Mexico, and Washington state inpatient and outpatient. In these 14 years I have only had 3 Asians on my caseload and these were within the last two years-at my previous job here in Phoenix as a Clinical Liaison for adults who were court ordered for treatment. I saw one Vietnamese man in Kansas who was involved in the mental health system but he was not my consumer (client). He was with another agency in another city and we had gone to a picnic in which that agency had invited us. I only saw him for a few hours but I can say that I am not sure that he was mentally ill or if he was placed with them because he did not speak English. Even though my grandfather is  Vietnamese I never learned to speak the language so I was unable to communicate with him.

There are a great deal of diagnoses that could qualify someone to have a serious mental illness (SMI) but the major ones are Bipolar Disorder, Schizophrenia, and Major Depression. Bipolar disorder is basically severe mood swings; Schizophrenia usually means the person hears voices, and Major Depression basically means you are so depressed you cannot function normally for 2-4 weeks. A person usually has to take medications to help relieve them of their symptoms. This is just a brief explanation-please read more about these diagnoses if you want to know more about them.

A person has to take medications for these diagnoses. The 3 Asians that I had personally worked with were Cambodian, Vietnamese/Caucasian, and Vietnamese. They were all men and their ages ranged from early to late 20’s to early 40’s. They were all court ordered to receive treatment because their behaviors were deemed a danger to themselves and others. Being court ordered meant that they had to see the psychiatrist monthly if they took medications and/or see their case manager monthly who would monitor their progress. The court order would last a year but if the person exhibits a need for a longer period of time-the psychiatrist can extend it. The Cambodian man was also developmentally delayed (low IQ) and was diagnosed with Schizophrenia. What made him interesting was that he could not speak English-but he had a Cambodian interpreter. The half Vietnamese half Caucasian man was diagnosed as having Bipolar-he stayed up for days on end, acting erratic, and had been off his medications. He spoke perfect English. The Vietnamese man had made some statements to his wife and others around him that he wanted to kill himself and others. He spoke limited English. I mention how well they speak English because it does matter in regards to how easy or difficult it is for them to get services and/or how they follow the court order. I found out that at times it does not take a lot to be court ordered and at times it takes a lot more than what someone says they overheard or saw.

I saw these 3 men at the beginning because I had to complete the assessment and their treatment plan. Then the case managers that I supervised took over the actual home visits and follow up. I also did some of these when the case managers could not. It still amazes me that there are not a lot more Asians-especially SE Asians receiving services. I am sure we all know some of the reasons such as: we do not ask for help, the community or family takes care of us or we don\’t recognize it as a problem. etc.

In Washington state-there was actually an agency called the Asian Counseling agency. However,I did not work for them. In fact, I did not know they even existed until I was moving. I thought this was great. Los Angeles also has a couple of agencies that cater to Asians with mental illness and New York City has a few too. One of my goals is to work in an agency that specifically works with Asians but there are none here in Phoenix. Just like with anything else. There are pros and cons in me working with just the Asian population.

Mental illness is still something that people hide-especially the Asian community. On the one hand they might like it that they see someone who looks like them but on the other hand they might feel ashamed or apprehensive about working with someone who looks like them. I have a double edged sword to deal with because there are even less SE Asians seeking mental health services. As some of you are aware :the biggest Asian population are Chinese, Japanese, and Filipino. There are even more Cambodians than Laotian or Thai people who seek out these services. Even in the agencies in Los Angeles, Seattle, Tacoma, New York-that target Asians-it is rare that they mean Lao and Thai people. In order for me to get hired in these agencies-there has to be a lot more Lao and Thai consumers than there are now. This is the reason why I work in agencies that work with the mainstream population. So when I do see an Asian consumer (client) both of us look at each other in surprise but it also gives me hope that in the future more of us will not be afraid or ashamed to seek help. I also see a little relief at times that they see someone who looks like them and can understand their culture. I am sure everyone knows that Asian (all kinds) have the same problems as Caucasians, African Americans, and Hispanic population. If any of you see a loved one or someone in your Asian community who needs services-please help them get these service. For further info, go to http://www.nami.org/Hometemplate.cfm or go to http://www.mhasp.org/coping/quiz.html to take a quiz on this issue.

Why are Laotians afraid to get help for mental illness?  Is it shame? Fear?Distrust? Lack of information or education? </blockquote