— Wynne Lee, in a March 29, 2012, journal entry.
Wynne Lee's mind was at war with itself — one voice telling her to kill herself and another telling her to live. She had just turned 14.
She tried to push the thoughts away by playing video games and listening to music. Nothing worked. Then she started cutting herself. She'd pull out a razor, make a small incision on her ankle or forearm and watch the blood seep out. "Cutting was a sharp, instant relief," she said.
Some days, that wasn't enough. That's when she'd think about suicide. She wrote her feelings in a journal in big, looping letters.
At first, Wynne thought she felt sad because she was having a hard eighth-grade year. She and her boyfriend broke up. Girls were spreading rumors about her. A few childhood friends abandoned her. But months passed and the feelings of helplessness and loneliness wouldn't go away.
"I was really happy as a kid and now I was feeling like this," she said. "It was really unfamiliar and scary."
Wynne didn't know where her despair was coming from. The word "depression" was not in her vocabulary. She knew, however, that she was failing — she was defying expectations of who she was supposed to be.
Growing up in Southern California's San Gabriel Valley, a well-known destination for Asian immigrant families with high educational and economic aspirations, she believed she was supposed to work hard, get good grades and make her Taiwanese immigrant parents proud. She wasn't doing any of that, and she didn't know how to ask for help.
When it comes to mental health care, Asian Americans often get short shrift. Researchers say people in this minority group, which makes up about 5 percent of the U.S. population, are less well studied and less likely to seek treatment than other ethnicities. While rates of suicide in this group tend to be lower than national rates overall, Asian Americans are far from homogeneous. Although research has been limited and sometimes dates back years, some studies suggest that depression and suicidal impulses can be more pronounced among young people, women and Asians born in the United States.
According to 2007 data from the National Center for Health Statistics, female Asian Americans ages 15 to 24 were second only to Native Americans in their rate of suicide deaths. A study in 2005 found that Asian American college students are more likely to seriously consider suicide than their white peers.
In addition, researchers have found that women of Asian ancestry who were born in the United States are at higher risk of suicidal thoughts and attempts than others, including immigrant Asian women and U.S.-born Asian men.
Many Asian immigrant families are less inclined to reach out for help until there is a crisis, experts say. "A lot of Asians avoid seeking treatment until the disease is advanced," said MaJosé Carrasco of the National Alliance on Mental Illness. As director of the group's multicultural action center, she seeks to raise awareness about mental health care for different communities.
And even when Asian Americans do reach out, they often find both medication and psychotherapy a poor fit. What patients who seek care "are telling us is that they don't think that psychotherapy, which is designed for white Americans, really works for them," said Hyeouk Chris Hahm, an associate professor at the Boston University School of Social Work.
Parents sometimes stand in the way of treatment, intentionally or not. Kids can be burdened by the sacrifices made for their benefit.
"It takes a few generations before they can finally be free," said Ranna Parekh, director of the division of diversity and health equity for the American Psychiatric Association.
— — —
"I've missed school for almost a week now (three days). I mean I feel really bad . . . ."
— Wynne Lee's journal, Sept, 15, 2013
At the beginning of her freshman year in high school, Wynne frequently woke up feeling exhausted and unable to get out of bed. She would curl up and go back to sleep under the red blanket she'd had since she was a toddler.
Wynne's mom, Maggie Huang, begged her daughter to go to school. She yelled at her and took away her phone. Wynne still refused to go. "I thought she was just being lazy," Huang said.
Altogether, Wynne missed 47 days in ninth grade — more than a quarter of the school year. She arrived late at school on another 21 days. The next year, she missed 39 days and was tardy 63 times.
Her grades fell. Administrators at Diamond Bar High School warned her that things had to change. The district attorney's office threatened her parents with prosecution because of the absences.
Huang said she and her husband, Jack, believed they were doing everything they could for their three children, who were born after their parents came to the United States. They didn't know where they had gone wrong with Wynne.
They lived in a middle-class community east of Los Angeles, in a beautiful two-story home. Wynne's father works for a manufacturing company. Huang stays home with Wynne and her younger brothers, helping them do homework and taking them to after-school activities and to museums and parks on weekends.
"I just worried," Huang said. "I was so worried." But she didn't know what to do.
Wynne was just finishing middle school when Huang went into her room, read her journal and saw the comments about suicide. Scared, Huang told the school counselor. A social worker came to the house to talk to the family about getting help.
Huang enrolled in a parenting class and tried to talk to her daughter more about her feelings. She asked for advice from her sister, a high school counselor in Taiwan. "She said it was a stage and that I needed to be patient," Huang said.
But things only got worse. One afternoon Wynne asked for a ride to see a friend. She had skipped school that day and her mom said no. They argued. "I couldn't do it anymore," Huang said. She called the police.
Wynne ran downstairs and grabbed a bottle of prescription pills. She swallowed as many as she could.
Paramedics rushed Wynne to an emergency room; then she landed in a psychiatric facility. She remembers sitting in a room with a huge window, coloring pictures. Doctors told her she had depression. Finally, Wynne had a name for what was wrong.
— — —
"The suicidal thoughts are seeping back here and there by droplets. . . . Therapy and counseling are so not . . . helping me either. All we do in these sessions is chat. I'm not feeling any better."
— Wynne Lee's journal, May 18, 2014
After the hospital, Wynne went into an outpatient counseling and treatment program.She saw several therapists but didn't feel a strong connection with any of them. A psychiatrist suggested that she take antidepressants, but Wynne rejected the idea. "I just wanted to get better on my own," she said.
At home, she rarely came downstairs to eat with her family. She feared being a burden to them. Her 11-year-old brother, Kevin, said she often locked herself in her room. He could hear her crying. "It was hard to watch her like that," he said.
Near the end of her sophomore year in high school, Wynne's mother took her out to dinner. Sitting across from her daughter at the Cheesecake Factory, Huang told her that she loved her. She said she believed that Wynne would succeed — no matter what.
"That's when I started to open up to her," Wynne said.
Wynne's feelings were beginning to shift, though she didn't know exactly why. But it helped to talk to her mom that night. She wrote in her journal afterward: "This is going to be the best summer ever."
That fall, her outpatient clinic invited her to participate in a panel for Hollywood screenwriters and producers who wanted to learn more about mental health. "I was nervous," Wynne said, but the experience gave her confidence. Talking to others about her depression seemed to help.
In the past few months, she said, it has been easier to control intrusive, chaotic thoughts. "I can keep them on a leash," she said. "Before, they were everywhere."
Although she stopped therapy, she now believes she got something from it. "I used to be hotheaded and had tough times resolving conflicts," she wrote in her journal. "But that's before counseling."
Her energy returned. She took a test to graduate early from high school and enrolled in community college, where she is taking a drawing class. She started dancing again.
On a recent night, she stood in a dance class's front row in a gray tank top, picking up the routine quickly and flipping her long hair to the music. During a break, she caught her breath. "I feel really, really good," she said.
Wynne said she knows that the depression, and the loneliness, may return. "I've accepted it as part of who I am," she said.
But as she ran back toward the blaring music, it seemed the last thing on her mind.
This article was produced by Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.
