One of the messages I hope I could get across is that we as Asian Americans in our generation, we should cut our parents some slack when they rail against mental health.
Below is an abridged audio transcript of Episode 29, the eighth episode for Season 3 of Rock The Boat: Against All Odds, edited for clarity.
In this episode, we speak to David Mou, an Asian American psychiatrist who earned his MD from Harvard Medical School and MBA Harvard Business school.
Social stigma, shame, and other cultural factors often prevent Asian Americans and other minorities from seeking help for mental health issues. If you’ve been debating whether or not to seek out a therapist, or are generally in the process of making a decision your parents might disapprove of, you might like our conversation with David.
In this episode:
Dealing with parents who disapproved of choosing psychiatry as a specialization
Advice on how to deal with altercations in our professional and personal relationships
Tips on how to deal with anxiety
I. How David Got Into Psychiatry
David: My name is David Mo. I'm a psychiatrist by training. I'm a co founder and medical director for Valera Health, which is a digital Health company based out of Brooklyn. I spend most of my time in Boston and on the side I run a private practice called measured Wellness that's based out of Austin
Lucia: David conducts research on how technology can help better predict and prevent suicidal behaviors. His company Valera Health is a behavioral health care management startup that developed an app to help clinicians remotely monitor patients with anxiety and depression.
Lucia: David has been named 'Top 10 under 35 for Healthcare' by LinkedIn, as well as '40 under 40' for healthcare innovation by MedTech Boston.
Lucia: David is originally from Cincinnati Ohio. He was a normal kid who liked to play sports and sometimes get into fights. In Cincinnati, David had two defining features: he was asian, and he was a twin. David and his brother Danny are very similar despite the fact they like to think they’re not. They both score in the top 1% for extroversion. They’re both loud, both love being around people, and they’re both doctors.
David: It was always interesting to have a copy of you walking around with you at all times.
Lucia: David went to Harvard, majoring in biology. After college he spent a year in Paris doing neuroscience research, where he discovered his extroversion wasn’t fitting for the lab environment. He decided to go to medical school, where he found his interest working with mental health patients. He loved learning about people’s stories.
David: It was because there's no other specialty where you could sit with the patient for 60 minutes, for an hour and a half and just hear their life story. I remember when I was on the medicine service for the surgical service. I would be very interested in hearing. Well, why are they here? Where do they come from? What's their story what's causing them to? But now but you don't have time to talk about that. It was really that I meandered into something that I really love more so than anything else.
Lucia: So that’s how David found his passion. His mother on the other hand, wasn’t happy with his choice. She thought mental health illnesses were infectious.
David: She would say, "Is something wrong David? Is this, are you depressed? How are you? Do you have a problem that I'm not aware of?" So she really pulled out all stops to try to get me to not do psychiatry.
Lucia: Luckily, David is the rebellious type.
David: Good good news, is that I've developed a habit of not listening to my mom for many decades. So it didn't really rock my motivation one way or the other. So we went through it, but it's really caused a lot of stress.
Lucia: For eight years, David has worked with students at Harvard, where he lives in a dorm/apartment as a resident. He says he has a very common conversation with Asian American students that mirrors those he had with his mom.
David: So if you come up with an analogy that idea is that lets say you're taking organic chemistry, and it's really hard and you're not doing well in the class.
Real strength is not just trying and banging your head against the tree over and over and over again and keep on doing poorly strength is Seeking a tutor and then getting better grades in the same way mental Wellness is along that Dimension as well.
So real strength is actually acknowledging, "Hey, there's something wrong here. I'm not. I'm not doing great and I want to seek help that's evidence-based."
Lucia: David says it’s okay to seek mental health help without disclosing to your family. Especially if you feel like telling them will cause any issues.
II. Finding a Therapist
Lucia: So what should you expect if you’re in the process of finding a therapist for the first time? David says, honestly? Your first experience with a therapist might not even be good.
David: I can almost guarantee you it's not going to be super helpful.
Lucia: Building trust in a relationship takes time, often weeks. Fit is important but hard to know up front.
David: For the vast majority of people, this is...it's one of the greatest tragedies of this very wealthy country, which is that we don't have enough therapists and psychiatrists to see to see the demand that is there.
Especially the problems that we face as Asian Americans is a relatively unique problem. And so having someone who is Asian-American would actually be helpful and that again narrows the field pretty aggressively.
Fit is very very very hard to know up front when you meet with someone and over an hour.
Frankly, a lot of my Asian American friends quit after three, four weeks and they say well that didn't work and I said you don't even know whether it worked or not.
They said well, they are expecting it to work like an antibiotic, when in reality it takes longer to build this relationship. So I think those are two barriers, but I wish that people knew a little bit more about just the nature of how therapy works.
III. Mental Health is A Luxury
Lucia: While David thinks it’s okay to seek mental health help without telling your family, he also thinks we should cut them slack, because being educated about mental health is a luxury.
David: It actually it's not a Chinese specific thing to have stigma against mental health. If you look, most countries have a stigma against Mental Health. It's an exception for Western cultures, wealthy Western countries, to not have that stigma.
So if you go to Nigeria, if you go to other countries, many of these countries have a strong stigma against mental health and they have these stereotypes for what psychiatrists are like.
So if you think about it, mental health is a luxury. It means that you're not dying from tuberculosis or worms or something else.
IV. David's Ethos
Lucia: In his work today, David sits with patients who are seen societally as bad people. Murderers, rapists, abusers. But David says empathy helps him understand them, as people.
He tells us a story about a patient he had who was a convicted murderer who had physically abused his wife.
David: His wife was in the hospital and so I was primed to not like him already. And when I first met him, he was very mean to me. He wouldn't talk to me. He would say, "Get out or else I'm going to hurt you." The line everyday was okay well, I just want to make sure that you're safe and then he would kick me out and you can kick me out and eventually we said okay, we're going to have to discharge this patient.
Lucia: The last day David went to visit this patient, he decided to take a different approach, expecting the man’s reaction to be as difficult as before.
David: And I said, "Sir. I just hope that everything goes well. We're just trying to help you right now. I apologize that we kept on bothering you," and he said...he paused for a second and invited me in the room and started crying and this is a big guy covered with tattoos, what people would consider a skinhead and
he said, "I'm sorry. I'm being an asshole. I don't want to be an asshole. I have been like this all my life."
Lucia: He told David his life story, how his mother was a prostitute and a drug dealer and how since he was five years old his mother would kick him out of the house and leave him on the streets, sometimes for days. In the winter, he would sleep under the porch.
David: So as you begin to learn about all of this trauma and all this history behind his background, what he became is so much out of his control and out of...It's the cards that he was dealt and they weren't good ones.
And so when we say we look at this guy and if you pull back and we blame him for all the bad things that he couldn't go do right, we're discounting a very rich history a very traumatic history of circumstance that he had no control over and so the idea is that if you can feel empathy for this guy...and I did.
Lucia: Since we were sitting down with a trained psychiatrist, we couldn’t help but ask him for advice on how to deal with anxiety.
His first tip is to treat sleep like the Holy Grail.
David: If you have poor sleep, there's a lot of research that shows that you are just going to be much more anxious the next day. And this has to do with a lot of neurological things.
So knowing that, how can you optimize for your sleep and very simple things you can do to do this.
So one, avoid coffee, I would say after noon or 1:00 p.m. If you want to drink Diet Cokes, get that all out of the way in the morning and stop.
Alcohol is terrible for sleep. This is I think counterintuitive to a lot of people. It actually really messes up your sleep. So I try to cut that out as much as possible. three. Screen time is really really bad in the hours before you sleep. So this is something I have trouble with but it's something that there are fixes for.
Now I understand that we are all glued to our screens for many reasons good and bad. So one half measure I've been able to do is that I get rid of blue light on all my devices. So your phones should have a blue light filter you could just turn it on and it gets rid of the blue light which is the light that primarily keeps you awake.
Lucia: He also says that Meditation works. There are free apps like Headspace, Calm, and Aura. We wouldn’t mind some sponsorship from Headspace, haha.
Also, putting time limits on work to make time for wellness.
David: It's very important to designate when you're taking a break so that you could fully take a break. So if your work kind of bleeds into when you go home, you say, "I'm going to just send an email later tonight," even though you're out hanging out with your friends. That's going to be a lot of mental load that you're going to be carrying that you're not fully aware of.
VI. Rocking the Boat
Lucia: And as always, we asked David what Rocking the Boat means to him.
David: Not being constrained by our racial designation or are the cards that are handed to us if. We don't need to define ourselves by any specific metric that others have bucket us into and I think that's really important for us to be able to be aware of that and transcend that. And part of that is just doing whatever it is that you want to do rather than what other groups both internally and externally tell you to do.
You have to know yourself and have a good foundation before you can go out and shake up the world. So think about it that way.
If you don't know yourself and you're going off and doing things, there are a lot of variables out there that could surprise you later on and, I don't know about you, but I'm not a fan of surprises.
It’s understandable that seeing a therapist is a form of luxury but with the rise of mental health apps like TalkSpace, meditation apps, and so many more online resources, you can find something that works for you. You can also check out our blog post listing out mental health resources, many of them specifically tailored to the Asian American and Pacific Islander (AAPI) community.
As David mentions, practicing mental wellness is similar to physical wellness. It’s something we all have to practice in order to develop strength.