How Being a First-Generation American Affected My Mental Health

Researchers call it the “immigrant paradox”—I call it my life as an anxious, overachieving kid.

When I began my regular visits to a psychotherapist in my mid-20s, it raised concerns within my family, particularly my parents. “Pero que paso? Vamos a rezar (But what happened? Let’s pray),” they exclaimed. In Latinx households like the one I was raised in, discussions about mental health were scarce, and the luxury of seeking professional help was often out of reach due to financial constraints. For my family, putting food on the table took precedence over matters of emotional well-being. As a child, if I displayed signs of sadness or worry, I was encouraged to cultivate positivity, hold onto hope for a brighter future, or turn to the comforting pages of the Bible.

Latinx Mental Health: A Complex Challenge

My family’s experience was not unique. Latinx individuals often face significant social and economic barriers to accessing healthcare, including mental health services. According to the Centers for Disease Control and Prevention, many Latinxs come from lower-income backgrounds, lack insurance, or have undocumented legal status, among other challenges. Data from the American Psychiatric Association in 2017 further revealed that only one in 20 Hispanics received services from mental health specialists. This disparity can be attributed to factors such as stigma, discrimination, limited awareness, and a lack of insurance coverage.

While my parents were supportive of my decision to seek mental health treatment, they struggled to fully comprehend why I faced challenges that they hadn’t. I was born in the United States, which afforded me educational opportunities and a wealth of life experiences they had longed for. In contrast, my parents and elder siblings fled Nicaragua in the late 1980s, escaping the oppressive rule of the Sandinistas. Their journey to the U.S. was perilous, marked by violence and separation from loved ones. Despite these hardships, they arrived with hope and determination, viewing the border crossing as one of their most significant life hurdles, now a distant memory. However, the complexities of navigating two disparate cultures took a toll on my mental health.

Despite my family’s resilience, they, too, grappled with their anxieties. Yet, I always seemed to bear the label of being more “sensitive” than the rest. How could it be that immigrant parents, who had faced extraordinary challenges, appeared to have better mental health than I, an American born into safety, comfort, and familiar childhood delights like Fruit Loops and Nickelodeon? This phenomenon is commonly referred to as the “immigrant paradox.”

Understanding the Immigrant Paradox

The Society for Research in Child Development defines the immigrant paradox as a phenomenon wherein U.S.-born youth experience higher rates of mental health issues than their immigrant counterparts. Those who were born abroad often exhibit better mental health outcomes. However, it’s essential to note that this phenomenon varies among different Latinx groups, as explained by Amy Marks, PhD, chair of the psychology department at Suffolk University.

The immigrant paradox is not only mirrored in my personal experiences but is also supported by numerous studies. A 2018 review in Current Epidemiology Reports, for example, reveals that immigrants, despite facing the challenges of migration and resettlement, tend to have lower risk profiles for mental health disorders, including depression, anxiety, and substance use disorders.

This paradox is often attributed to the protective factors within immigrant communities. Strong family bonds, tight-knit social networks, “family harmony,” and a smoother integration into U.S. culture collectively mitigate the risk of developing mental health disorders. Moreover, older generations of immigrants often rely on coping mechanisms rooted in their cultural traditions, such as religious practices woven into daily life.

It is vital to recognize that an individual’s mental health is influenced by a myriad of factors, including national origin, race, age at immigration, gender, and socioeconomic status.

Acculturation Stress and Mental Health

The process of acculturation, particularly for first-generation individuals and immigrant families, involves adapting to a society built on longstanding racist and oppressive systems. Latinx individuals, hailing from Spanish-speaking Latin American countries, often find themselves adopting the predominantly white, English-speaking norms of American society. Discrimination and systemic bias, which are prevalent issues for the Latinx community, have a substantial impact on mental health.

My own childhood was marked by moments of domestic turmoil and excessive alcohol consumption within my household. Witnessing these disturbing scenes exposed me to the enduring consequences of domestic violence and various forms of emotional and physical abuse. Some of my earliest memories consist of hiding in my bedroom, fearful and isolated after witnessing alcohol-fueled altercations between my parents.

According to the National Institute on Drug Abuse, alcohol and drug use are closely linked to mental health disorders. These substances often serve as coping mechanisms, leading to conditions such as depression, which, in turn, exacerbate the challenges faced by individuals, as noted by Marks. While these patterns are observed across U.S. society, they are particularly pronounced in marginalized groups, such as the Latinx community.

A 2021 study published in the Journal of Psychoactive Drugs highlights that as Latinxs acculturate, they are more likely to adopt unhealthy behaviors like excessive alcohol consumption and drug use. My father’s struggle with alcohol only worsened over time as he spent more years in the U.S. As for myself, I developed my own coping mechanisms during childhood, including frequent temper tantrums, overeating, and antisocial tendencies. At the time, I didn’t recognize these behaviors as signs of post-traumatic stress disorder, but I did sense that I needed more than nursery rhymes to navigate my emotional struggles.

The Complex Landscape of Latinx Mental Health

It is important to clarify that Latinx immigrants do experience mental health challenges. However, the immigrant paradox highlights that first-generation and U.S.-born Latinxs often face mental health disparities due to systemic pressures and the unique experiences that come with them.

The Latinx population is extraordinarily diverse, and the process of acculturation and enculturation varies significantly. The Latinx experience in the U.S. is shaped by factors such as nationality, socioeconomic status, and the ability to assimilate into American culture, as documented in various studies.

Marginalized Communities and Mental Health

Individuals who come from non-European backgrounds with darker skin often face pronounced effects of discrimination on their mental health. This discrimination compounds the challenges faced by Latinx communities in the U.S. The pressures of acculturating into a predominantly white, English-speaking society can be overwhelming, particularly for those born into a system where systemic bias is deeply ingrained.

Family Dynamics and Mental Health

Research consistently demonstrates a link between family conflict and the risk of mood disorders. Latinx adolescents, according to the American Psychiatric Association’s 2017 data, report higher rates of suicidal thoughts, suicide attempts, and injuries resulting from suicide attempts compared to non-Latinx white and non-Latinx Black populations.

Margarita Alegria, PhD, a psychiatry professor at Harvard Medical School, emphasizes that while immigrant parents often display remarkable resilience, their children growing up in the U.S. are acutely aware of their family’s legal status, educational access, and other factors that can contribute to mental health challenges. This leads to disproportionate suffering among Latinx youth when compared to their non-Latinx white peers.

The Drive to Succeed

As a child, I was highly anxious and driven, burdened by concerns about our family’s financial struggles. Although my parents did not intend to, they often discussed their limited income and rising debt in my presence. While these conversations undoubtedly affected my mental well-being, they also ignited a sense of determination within me. From a young age, I understood that pursuing a college education was my ticket to breaking free from the cycle of financial instability that had characterized my childhood. I was determined to achieve the American dream, and I channeled my energy into excelling academically.

In one sense, the immigrant paradox explains why children of immigrants tend to outperform their counterparts whose parents are native-born U.S. citizens. A 2016 study published in Social Science Research proposed that children of immigrants are more likely to enroll in college, remain employed or in school, and are less likely to have a criminal record or become parents at a young age compared to children of non-immigrants.

Immigrant Rights and Fear

Another aspect of the immigrant paradox is the anxiety stemming from the fear of deportation. As a child, I was oblivious to my parents’ immigration status and assumed they possessed the same rights as my peers’ parents. It was only later that I realized the arduous and costly nature of naturalization. My family spent thousands of dollars working with lawyers to secure residency status and later apply for citizenship.

During the early years of the Trump administration, my mother remained a U.S. resident, not a citizen, which added another layer of fear to our lives. The constant threat of deportation, exacerbated by the government’s efforts to build barriers between Latinx populations and white Americans, took a toll on my mental health. Thankfully, my mother was able to achieve citizenship in 2019, relieving some of that anxiety.

The Importance of Belonging

A 2019 study published in World Psychiatry found that growing up in a minority setting can elevate psychiatric risks, as these minority populations often feel a diminished sense of belonging and internalize feelings of inferiority. In contrast, Latinxs who maintain a strong connection to their culture tend to experience better mental health outcomes. I was fortunate to be raised in a neighborhood where bilingualism was the norm, and my Latinx peers celebrated our shared culture. This prevented me from feeling like a minority, even though I held minority status in the broader American context.

Margarita Alegria emphasizes the positive impact of living in a community that reflects one’s own ethnicity. Attending schools with a significant Latinx student population and having teachers who share that background can create a more supportive environment for Latinx youth.

My Mental Health Journey

In my early adulthood, I turned to self-help books, seeking solace and guidance for the distressing thoughts that often consumed me. Running and engaging in sports became my lifeline, helping me stay afloat amidst emotional turbulence. Over time, I began to make friends who had previously sought mental health treatment, making the idea of seeking help less daunting. In my mid-20s, armed with health insurance and a degree of independence, I turned to online resources and conducted my own research to find a psychotherapist. Google became my mental health guide, leading me to a therapist with whom I have now shared nearly three years of personal growth.

Upon seeking help as an adult, I received a diagnosis of generalized anxiety disorder. Over the years, I embarked on a healing journey with the guidance of my Latinx therapist, engaging in cognitive-behavioral therapies (CBT) and incorporating mindfulness practices like meditation and journaling into my routine.

It took years of introspection for me to realize that it’s okay to seek help and to communicate my emotional struggles. Establishing a sense of community in each therapy session with a bilingual Latinx provider allowed me to feel pride in my Nicaraguan heritage and embrace the unique challenges it brought.

Accessing Immigrant Mental Healthcare

First-generation Latinx individuals, like myself, are encouraged to seek appropriate mental health care. Visiting a Latinx mental health provider can be particularly beneficial, as they understand the nuances of identity and how it influences mental health challenges. Evidence suggests that approaches like CBT and acceptance- and mindfulness-based therapies are effective in addressing the anxiety associated with adverse childhood experiences.

Several organizations, including the American Society of Hispanic Psychiatry and Therapy for Latinx, offer nationwide databases for Latinx mental health specialists. Additionally, Mental Health America provides resources in Spanish. For those facing financial constraints, the Substance Abuse and Mental Health Services Administration can connect individuals with affordable treatment options at the local level.

Embracing My Heritage

Being the child of Nicaraguan immigrants has bestowed upon me a profound appreciation for my family’s resilience and the hardships they endured to provide a better life for me. While I wish I had learned about the immigrant paradox earlier in life, the experiences I’ve had have shaped me into who I am today. My heritage is a source of pride, and I wouldn’t trade it for any other. In sharing my journey, I hope to shed light on the complexities of Latinx mental health and encourage others to seek the support they need, knowing that they are not alone in their struggles.