When she was 14 years old, Diana Chao began having migraines. She often felt dizzy as she walked. Sunlight seemed to pierce her skull.
“It felt like shards digging into my eyes,” said Chao, now 20 and a sophomore at Princeton University.
After a week of constant pain, her parents took her to an optometrist. That’s when they learned she was “swelling from the inside out,” Chao recalled. She had uveitis, an inflammatory eye disease that can send the pressure inside an eye soaring and render people temporarily blind.
For the next four years, Chao visited ophthalmologists, rheumatologists, and many other specialists in Los Angeles to find a cause. Episodes of temporary blindness resurfaced every few months, as she underwent a battery of tests.
“But every single test came back fine,” Chao said.
Until one ophthalmologist said she’d seen the condition in several patients with mental illness. That’s when it clicked for Chao, who had been diagnosed with bipolar disorder as a teenager. Her body might be reacting to her mind.
It’s not uncommon.
Research shows that mental illness can often manifest as physical symptoms. Depression can show up as headaches, anxiety as gastrointestinal issues, or post traumatic stress disorder as back pain.
The phenomenon is especially common among Asian Americans, multiple studies show. More research is needed to understand why, but psychologists suggest it may relate to the stigma around mental illness in many Asian cultures that prevents people from discussing it openly, as well as traditional Eastern views of an interconnected mind and body.
But many clinicians are unaware of these somatic, or physical, symptoms of mental illness among Asian Americans, leaving a population of more than 21 million underdiagnosed and undertreated.
Chao, a mental-health activist and an avid researcher, looked into the connection between uveitis and psychological distress. While there have been cases linking the two since the 1980s, it isn’t known whether one actually causes the other.
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