Mental Health for International Students from Asia

Transitioning to college life can be difficult for any student, but international students living in a new country often face particular challenges. Below, learn about common mental health concerns among international students from Asia, how and where to seek support, and what to look for in a therapist who can help you navigate the major transition to college life abroad.

Common challenges among international students from Asia

It's difficult to predict what, exactly, your experience will be until you arrive on campus. That said, when international students start their studies, many experience the following social, educational, and emotional hurdles:

1. Challenges around loneliness and fitting in

It’s common for international students from Asia to experience feelings of loneliness and/or isolation. The language barrier can be a big factor.

I’ve often heard students say things like: “People speak differently here,” and “Textbooks are not written how people talk.”

If student doesn’t understand conversational English, it’s natural that they might not want to speak up much; many students are concerned that others will judge them negatively for their language skills.

Moreover, students who did not grow up in the United States may not be familiar with pop culture references like jokes, music, and movies. Sometimes, international students have no idea what their American peers’ references mean. Even humor can be different – sarcasm is often a type of humor that doesn’t exist, or manifests different in non-American cultures. This cultural barrier can make it harder for students to have conversations and form friendships.

As a result, international students may isolate themselves or interact with a limited group of friends from the same home country. Some of the “braver” students might try to befriend American students, but they may also feel pressured to split their time between these two groups.

2. Academic stress, caused by both different learning principles and high expectations

International students from Asia tend to face high levels of stress around academic performance. There are two major reasons for this trend.

First, the learning principles of the United States and Asia are very different. Western styles of learning often focus on self-expression, innovative ideas, presenting oneself before an audience, and group collaboration. On the other hand, eastern methods focus on exams, memorization, and learning from lectures. Students from Asia studying in the United States are often under a lot of pressure to quickly shift their learning habits and cope with new formats.

Second, students from Asia who choose to study in the United States may have been considered part of an elite class at their previous schools. They are often very competitive. Parents from Asia tend to invest a lot in their children’s academic pathways and often have extremely high expectations for their children. In many cases, it is very important for students not to disappoint their parents and ruin the family reputation.

3. Reluctance to ask for help from others

Traditionally, families from many Asian countries tend to keep issues within the family to protect their reputation.

There are also stigmas around mental health in the eastern world. People often equate mental health issues with “craziness,” “weakness,” or “failure.” These stigmas can prevent students from seeking help from mental health professionals.

Physical symptoms and different expressions of anxiety

I’ve seen in my practice that it’s common for mental distress to create physical symptoms among Asians.

For example, the term “shenkui” refers to a somatic symptom that Chinese people experience when they feel anxious. “Taijin kyofusho” is a physical symptom experienced by Japanese people with social phobias.

Many international students from Asia start to show physical symptoms (like headaches, stomachaches, diarrhea etc.) when they are in a psychologically distressed state.

Other warning signs include trouble concentrating, insomnia, and a loss of appetite.

If students notice themselves (or their friends) experiencing any of these symptoms in reaction to stress, it’s advisable to seek help from a mental health professional.

Symptoms of culture shock to be aware of

First of all, know that adjustment takes time. That is, international students from Asia may take some time to orient themselves to being in a different country.

This is not an easy phase, because they have to learn how to integrate the differences between two cultures and figure out how to be themselves in a new place.

Additionally, international students from Asia often suppress or deny their own personal and cultural values when they first arrive in the United States, because they are trying to merge into their new communities and be likable. This inner conflict often leads to stress, isolation, and depersonalization.

If you see students start to isolate themselves or only hang out with a certain group of peers (only Chinese peers or only American peers, for example), this may be a sign of culture shock.

Ways to address culture shock

1. Realize that there are no cultures that are inherently good or bad

There are many ways of living, and very different ways of living can be equally valuable. It is important to be aware of one’s own background and embrace it when you can, instead of denying it.

2. Be open to exploring American culture

Also, it is important to explore a new culture instead of avoiding it. Studying in a different country offers an opportunity for students to objectively look into the two cultures and decide what they most value from each. This kind of bicultural experience enriches students’ lives in the long run.

3. Share your experience with other students

Moreover, finding a group to share experiences can be very helpful and supportive. I encourage international students to befriend others who are having similar experiences, while also trying out clubs or activities that will give them a way to bond with all kinds of other students.

Recommended types of therapy for culture shock

Culture shock can be startling – at times, even surreal – but it's helpful to know that its impact will lessen over time. Until you reach that point, however, it can be helpful to talk with a therapist who's working with clients undergoing similar experiences. These therapy types may prove particularly helpful:

Acceptance and commitment therapy is one good approach for culture shock. Students need to learn how to face and accept their new environment, without avoiding or fighting their emotions. They can be encouraged to set meaningful goals and learn to use their strengths to cope in their new cultural environments.

Mindfulness practices and somatic experience are also both good for international students from Asia, due to the physical manifestations of mental health issues that I mentioned above. These approaches can effectively help students connect with their emotions and their bodies in order to increase self-awareness and learn new coping skills.

Advice for parents of Asian international students who may be struggling

Many Asian parents are shocked when they learn that their child needs a psychiatric evaluation or needs to go into therapy. They do not understand why their child, who was doing fine at home, has suddenly become so “fragile.” Often, parents do not want to believe that their children need help with mental health issues.

However, it’s important to remember that even American students seek out help from mental health professionals. The transition to college, pressure around academic performance, and issues with peer relationships are common sources of stress for all students, whether international or not.

Parents should see mental health professionals as a great resource for students to learn how to reduce stress and anxiety, which is especially important when they don't have a lot of other support in a new environment.

Again, seeing a therapist isn’t a weakness; it’s just one tool that can help students take care of themselves.

Many people think that students who come to the United States to study are very lucky and are already guaranteed great futures. And indeed, studying in the United States can be a treasured experience in many students’ lives. However, international students also need help and support in order to walk this path successfully.

Being aware of the unique challenges that international students from Asia face can help make this experience a happier, more productive one for everybody.