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The following was written by and from the perspective of The Aerogram contributor Taimour Fazlani

Not so long ago I wrote an open letter on mental health in South Asian communities which was rooted in my own experiences with anxiety (“We Need to Talk About How Mental Health Affects South Asian Men”). After some time, spurred by questions and comments from readers and my own research, I began to have doubts about one element, summarized as this argument:

“Languages such as Urdu, Punjabi and Gujarati do not have adequate terms to communicate about mental illness. As a result, derogatory terms are used.”

This argument was derived from a study of UK South Asian communities which presented findings that some South Asian languages, including Urdu, Punjabi, and Gujarati, do not have adequate terminology when it comes to mental health illnesses, and therefore oftentimes derogatory terms are used such as ‘pagal’ (‘Breaking Silence’: A Consultation on Mental Ill Health in South Asian Communities, 2008). Other writing like this piece called “Finding a word for ‘mental health’ in Urdu and Punjabi” refer to this point too. The author writes:

“At that time I didn’t know it was referred to as a ‘mental health’. Why? Because there is no term for what ‘mental health’ is in Urdu or Punjabi.”

“In its literal translation it means something like ‘problem with the brain’, which implies ‘being mental/crazy’. In my experience there was a lot of stigma, ignorance, discrimination and oppression against those that were identified as ‘mental/crazy’.”

Such derogatory terms and attitudes stem partly from a lack of understanding in regards to these South Asian languages and their capabilities to provide terms to discuss mental health illnesses. To move forward towards being able to tailor mental health services for South Asian communities from a perspective that enables mutual learning, that perception of the languages requires some challenge.

One way to challenge this perception is through poetry in south Asian languages, shayhree very much included in this. Over the generations, South Asian writers have used poetry as a means of providing expression to the vast human experience, including mental health experiences.

Mental Health In Urdu & Hindi Poetry

Urdu poetry presents Faiz Ahmad Faiz (1911-1984) who explored mental health through his poems. One such poem was “Tanhai” which delved into loneliness with these words:

Put out the flames, my poor, sad heart, and empty the chalice

It’s time to bolt the doors shut

No one will visit here anymore

Read the rest of “Tanhai” in English and in Urdu online here. Similarly another one of his poems explores emotionality through the Urdu language — “Gulon Mein Rang Bhare” in which Faiz wrote:

‘Qafas udaas hai yaro sabaa se kuchh to kaho

Kahiin to bahr-e-Khuda aaj zikr-e-yaar chale’

‘My caged body is cheerless today,

Someone please fill hope in the morning breeze.

For god’s sake! don’t let it not go empty,

Let it carry with it the story of our friends.

(Read a full English translation online here.) The context of the poem is a plea directed towards a beloved and the sorrow that existed without their presence. In other words, Faiz’s poem can be understood as expressing states of mind such as clinical depression following a ‘heartbreak’. This particular poem is also decorated in words such as ‘udaas’ (translation – sadness, sorrow, heavy-hearted), words which are linguistically relevant and ultimately useful in discussing mental health illnesses and their symptoms.

The use of poetry written in a South Asian language to express the experience of living with mental health illnesses can also be found in contemporary use. Take for example “Living With Schizophrenia” by Dr. Seema Mehrotra. A Hindi poem that that explores living with schizophrenia through the experiences of a sufferer, it reads in part in its English translation:

They say I have schizophrenia

But by placing the label upon me,

Why do they deny my humanity? My character is far from schizophrenia….

Allow me, too, to live with dignity and self-respect

Don’t deny me my rights…

Mehrotra’s poem gives expression to living with schizophrenia in a society where the sufferer feels encapsulated by imposed labels due to their mental health illness. Labels which ultimately according to the poem’s author rob them of basic human rights.

Encouraging Mental Health Discussion

In poetry, South Asian languages have been able to provide a way to express how mental health illness sufferers feel. There are other practical avenues which can be implemented for South Asian communities with South Asian languages in mind, avenues which might ultimately benefit those suffering from mental health illnesses. For instance, the re-introduction via religious centers, community centers and libraries of keywords in South Asian languages relatable to moods and emotions experienced in mental health illnesses would benefit sufferers, providing the ability to give wider expression to how they feel.

Being able to give expression to your symptoms in all the languages you speak could be quite useful for a number of reasons. One important reason being the fact that it would help the sufferer and the mental health professional in being able to obtain the right diagnosis. For example, there is a significant difference between generalized anxiety disorder and anxiety stemming from post-traumatic stress disorder. The strengthening of communication methods for bilingual users may help in obtaining the right diagnosis and ultimately the right course of treatment.

Likewise, the re-introduction of key terminologies in South Asian languages may also be useful in family and community settings when people wish to discuss and explore mental health illnesses and their causes. According to the 2008 UK study mentioned earlier, ‘Breaking Silence’, causes of mental health illnesses are often misunderstood, resulting in the use of religious or spiritual leaders rather than qualified professionals.

While this article is centered towards counter-arguing elements from my initial piece, there’s one significant fact that remains:

Mental illness does not discriminate, and its impact on South Asian communities is as prevalent as it has ever been.

This means that there’s much to be done, and I firmly feel that using South Asian languages will play a key role in strengthening and ultimately empowering the communities and sufferers.

Read more on TheAerogram.com.

Wednesday, June 27, marks National HIV Testing Day (NHTD) 2018. This year’s theme, according to the Centers for Disease Control and Prevention (CDC), is “Doing It My Way, Testing for HIV.”

The theme plays off a larger HIV testing and prevention campaign called “Doing It,” which is part of the CDC’s Act Against AIDS initiative. The micro-campaign highlights the fact that people have unique reasons for getting tested. The campaign encourages folks to share their HIV testing stories on social media with the hashtag #DoingItMyWay and, in Spanish, #HaciéndoloAMiManera. For example, you could tweet or describe in a Facebook post what motivates you to get tested for HIV. Or you could simply promote HIV testing and awareness, like some of the tweets included on this POZ page.

On its National HIV Testing Day web page, the CDC notes:

About 1.1 million people in the United States have HIV, and 1 in 7 of them don’t know it. Many people have HIV for years before they get a diagnosis. For those who are living with undiagnosed HIV, testing is the first step in maintaining a healthy life and reducing HIV transmission. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care and those at high risk get tested at least once a year. Some sexually active gay and bisexual men may benefit from more frequent testing (every 3 to 6 months).

Knowing your HIV status gives you powerful information to help keep you and your partner healthy. Join POZ in raising awareness about the importance of HIV testing and early diagnosis of HIV. Share why and how you are getting tested for a chance to be featured on the “Doing It My Way” social wall.

The CDC offers a wide variety of HIV testing resources, including social media banners for #NHTD and its #DoingIt campaign.

Read more on POZ.com.

Links to related resources:

• Download social media kits and resources from the CDC
• Learn more about NHTD from HIV.gov
• Read the CDC’s National HIV Testing Day Dear Colleague Letter
• Read this HIV.gov blog which reports on progress toward the National HIV/AIDS Strategy’s 2020 target for HIV status awareness.
• Read or listen to “HIV Negative: Last Tested on [Enter Date Here]”
• Read this article from HIV.gov, “National HIV Testing Day Efforts Increase HIV Testing but Testing Opportunities Still Missed During Most Health Care Visits”
• Read POZ blogger Shawn Decker’s recent blog post on raising HIV testing awareness, “#DoingItMyWay and Why I’m Positively for HIV Testing”
• Learn the POZ Basics on HIV Testing and click through POZ’s interactive special “When Should I Get Tested?”
• For related POZ information in Spanish, click here. (Para información sobre como hacerse la prueba del VIH, haga clic aquí)
• Read the 2017 National HIV/AIDS Strategy Progress Report (pdf)
• Learn about unique testing incentives at a Southern health center in POZ’s article “Want Beyoncé and Jay-Z Tickets? Then Get Tested for HIV.”
• Find a testing site near you using the HIV Testing Sites & Care Services Locator

This article was written by Steve Dubb and originally posted by the Nonprofit Quarterly. 

While the health disparities are certainly real, there have been many gains as well. For instance, the American Indians Religious Freedom Act, which only passed in 1978, required federal agencies to “eliminate interference with the free exercise of Native religion,” helping fuel a revival of American Indian spiritual traditions that improve community resiliency.

Read more of the original article on NonprofitQuarterly.org.

Muslims and Sikhs in New York City have experienced a significant level of harassment in recent years, a new survey published by a city agency has found.

Nearly half of Sikh respondents to the study and 42 percent of Muslim respondents reported experiencing verbal harassment, threats or taunting that referred to their race, ethnicity or religion. 

The survey of 3,105 Muslim, Arab, South Asian, Jewish and Sikh New Yorkers, published by the city’s Commission on Human Rights, is an attempt to capture the experiences of these minority communities and to quantify how often bias incidents are reported to community or governmental organizations.

The participants, who were all at least 16 years old, were asked about incidents that occurred between July 2016 and late 2017, “a timeframe that encapsulates the climate pre- and post-election,” the authors said. The report refers to policy changes enacted during this time that were “threatening” to some New York communities. 

Nearly 2 in 5 respondents, 39 percent, said they had been verbally harassed in reference to their race, ethnicity or religion, with some people ― 27 percent ― saying that they had experienced this abuse more than once.

Just 9 percent of respondents claimed they’d been physically assaulted because of their race, ethnicity or religion. Black, predominantly Muslim women living in the Bronx were particularly vulnerable to bias-motivated assault, with 19 percent claiming they’d been physically attacked. 

In focus groups conducted before the survey, the researchers found that two specific incidents were frequently brought up by religious minorities: being followed by a security guard or salesperson in a store, or being purposefully pushed or shoved on a subway platform. The commission incorporated questions about these two situations into its study. The survey found that 18 percent of participants claimed they were followed by store staff, while 14 percent reported being shoved on a subway platform. 

About 23 percent of both Muslims and Sikhs reported being followed by store staff. Sixteen percent of the survey’s Muslim participants said they’d been intentionally shoved on a subway platform. Specifically, 27 percent of Muslim Arab women wearing a hijab reported being intentionally pushed.

Albert Fox Cahn, legal director for the New York chapter of the Council on American-Islamic Relations, said it’s “completely unacceptable” that Muslim New Yorkers who wear a hijab are encountering these attacks. 

“While we all have been jostled on the subway, let’s be clear that we’re talking about the number of respondents who report being ‘intentionally shoved,’” Cahn told HuffPost in an email. “I think that critics need to recognize how dangerous any physical altercation on our subway platforms can be, and how quickly a shove can escalate into something life-threatening.”

The study also sought to measure how often religious minorities in the city reported harassment to community or faith-based organizations, the NYPD, the Commission on Human Rights or other groups. Overall, nearly 71 percent of participants said they chose not to report bias incidents. The biggest barrier to alerting a community or governmental organization was respondents’ belief that no one would take their claim seriously.

Cahn said he hopes the fact that so many victims fail to report their experiences is a “wake-up call” for the city.

The city’s human rights commissioner, Carmelyn P. Malalis, said that her agency plans to use the data from the survey to better address and prevent these incidents. The commission has launched an ad campaign on social media and on 15 ethnic media outlets to help spread awareness about where people can go for help. 

“No one in New York City has permission to discriminate against or harass others because of who they are, where they pray, or what country they come from,” Malalis said in a statement. “The NYC Commission on Human Rights takes bias-motivated incidents very seriously and we are dedicated to combating them.”

Nationwide, the FBI found that religious bias motivated 1,538, or 21 percent, of hate crimes in 2016, the latest year for which federal data is available. Twenty-five percent of the incidents were anti-Muslim, while 0.5 percent were anti-Sikh.

But the advocacy group Sikh Coalition believes the actual number of hate crimes is much higher ― since the FBI’s data is based on voluntary reports by U.S. law enforcement. The Sikh Coalition estimates that the Sikh community in the U.S. is experiencing an average of one hate crime per week since the start of 2018.

Read more on HuffingtonPost.com.

More than 1 in 4 Latina high-schoolers have thought about committing suicide.

Suicide attempts among Latina teenagers are at a higher rate than their non-Hispanic White female and Hispanic male peers, according to a Salud America! research review.

That’s why it is important to explore the reasons why and what to do about it.

Latinas and Mental Health

In the Latino community, mental health problems often are not spoken about. There is a stigma attached to it. Or people just don’t know enough about it, according to an article. That’s especially true for Latinas.

“The expectations of what makes a ‘good’ Latina are often rooted in propriety and maintaining appearances, specifically when it involves something as personal as mental health or illness,” wrote Liz Magallanes in a Latino USA op-ed.

Latina teens experienced high levels of stress and conflict with their parents due to differences in upbringing, which plays a pivotal role in Hispanic teenage girls’ suicide attempts.

Further, Latinos are less likely than other ethnic/racial groups to call a suicide crisis line when having an actual suicidal crisis.

“Expressing difficulty in grappling with these issues, women may be dismissed as ‘too emotional,’ leaving any productive conversation about breaking the status quo, out of the question,” Magallanes wrote. “It is far too difficult for some then to even consider seeking help from a mental health professional.”

Latina Celebrities, Authors Shed Light to Mental Health Issues

Latina singer Demi Lovato knows firsthand the challenges and stigma of dealing with depression and building resilience. That’s why she teamed up with a nonprofit to bring free mental health sessions to each of her upcoming tour dates, Billboard reports.

Magallanes called it “a step in ensuring communities of color are supported by others who understand what they are experiencing.”

Other Latinas are making similar breakthroughs.

Journalist and filmmaker Raquel Cepeda directed a documentary, Some Girls, which tackles issues in the Latina-American community. The specific focus is on “troubled teenage girls in a Bronx-based suicide prevention program who feel rejected by mainstream America.”

Erika Sanchez’s book, I Am Not Your Perfect Mexican Daughter, focuses on the importance for young people of color dealing with mental health issues to feel seen and heard.

“I think it’s important to talk about mental health. I’m tired of the stigma. People need to see it as a part of health in general. If you’re not mentally well, you’re not physically well. People think [depression] is a character flaw when it’s a mental illness that needs treatment” Sanchez said in an article.

Latina celebrities that have spoken freely about their mental health issues knew seeking professional help was the key to recovery. This includes Selena Gomez, who has shared about her anxiety, panic attacks and depression that goes along with her Lupus condition.

When Latinas speak out, it also encourages and inspires others to take action and seek help concerning one’s own mental health issues.

“When provided with the language and support of family and community, developing the tools to overcome these challenges is possible,” Magallanes wrote.

Read more on Salud-America.org.

The following article was written by and from the perspective of Darby Saxbe, an Assistant Professor of Psychology at the University of Southern California.

Flinching as a gunshot whizzes past your window. Covering your ears when a police car races down your street, sirens blaring. Walking past a drug deal on your block or a beating at your school.

For kids living in picket-fence suburbia, these experiences might be rare. But for their peers in urban poverty, they are all too commonplace. More than half of children and adolescents living in cities have experienced some form of community violence – acts of disturbance or crime, such as drug use, beatings, shootings, stabbings and break-ins, within their neighborhoods or schools.

Researchers know from decades of work that exposure to community violence can lead to emotional, social and cognitive problems. Kids might have difficulty regulating emotions, paying attention or concentrating at school. Over time, kids living with the stress of community violence may become less engaged in school, withdraw from friends or show symptoms of post-traumatic stress, like irritability and intrusive thoughts. In short, living in an unsafe community can have a corrosive effect on child development.

Few studies, though, have specifically looked at the toll community violence may take on the growing brain. Recently, I studied this question in collaboration with a team of researchers here at the University of Southern California. Our goal: to see whether individuals exposed to more community violence in their early teen years would show differences in the structure and function of their brains in late adolescence.

Connecting community violence to the brain

My colleague Gayla Margolin, an expert on youth exposure to violence, has been following a sample of Los Angeles-area youth for over a decade. When these teens were about 13 years old, she asked them to fill out a checklist of community violence experiences: hearing gunshots, witnessing a beating, seeing someone do drugs, watching someone get arrested or chased by the police, seeing someone get chased by a gang, or seeing someone get threatened with a beating or stabbing. For our current study, we added these items together to get an overall sense of how much violence each teen had witnessed in his or her neighborhood.

About four years after they took the community violence survey, when the youth were around 17 years old, we asked 22 of them to lie down in a magnetic resonance imaging (MRI) machine while we scanned their brains. When we examined the images we’d collected, we zeroed in on two small but critically important structures near the base of the brain: the hippocampus and the amygdala.

The hippocampus, a curved structure shaped like the seahorse it is named after, plays a role in learning and memory. Stress hormones seem to shrink this structure, and adverse childhood experiences like abuse and neglect have been linked with smaller hippocampal volumes later in life. One recent review of research on child maltreatment found that early abuse and neglect predicted smaller hippocampal size in 30 out of 37 studies that looked at the connection.

In our current study, we also measured the size of the amygdala, an almond-shaped structure located close to the hippocampus that is known for its involvement in emotion and threat-related processing. Childhood adversity has also been tied to the size of the amygdala, although this research has been mixed: Some studies have found that people exposed to early stress show smaller amygdala volumes, some show larger amygdalae and some show no relationship at all.

In addition to looking at the size of the hippocampus and amygdala, we also looked at patterns of interconnection between these structures and other regions of the brain. Which parts of the brain “talked” more to each other, as reflected by more tightly correlated levels of activation.

A neural signature of community violence?

In our data, we found that witnessing violence in early adolescence predicted smaller volumes of both the hippocampus and amygdala in this group of teens.

We didn’t measure the absolute size of these structures – instead, we tested the relationship between community violence and brain volume. In other words, if our participants told us at around age 13 that their neighborhoods were higher in crime and violence, the size of these critical brain structures looked smaller about four years later, compared to teens who reported less community violence. Interestingly, this link held up even after we controlled for the youth’s socioeconomic status (family income and education) and their present-day exposure to community violence.

We also found that, among youth exposed to more community violence, the right hippocampus showed stronger connections with other brain regions linked to emotion processing and stress, perhaps suggesting that these youth were more vigilant to potential threat. If you’re used to encountering dangerous situations, maybe you and your brain learn to stay alert to avoid the next potential threat that lurks around the corner.

Our study dovetails with other research on early stress and the brain but is the first to specifically look at the link between community violence and the size and connectivity of the hippocampus and amygdala. Our sample was quite small and limited by the fact that we scanned the youth only once, in late adolescence. Therefore, although our measure of community violence was collected about four years before the scan, we have no way of knowing for sure whether community violence actually led to changes in the hippocampus and amygdala. It’s possible these brain differences preceded the youths’ exposure to community violence. For these reasons, this study should be considered preliminary and needs to be corroborated by much more research.

Despite its limitations, this work takes a first step in showing that community violence is linked with detectable differences in the teen brain in ways that are consistent with other forms of early adversity like abuse and neglect. These effects might be due to stress hormones that flood the developing brain and affect the growth of neural structures like the hippocampus and amygdala.

Youth with smaller hippocampal volumes may show learning and cognitive difficulties, whereas smaller amygdala volumes have been linked with depression risk and behavior problems. In other words, if, as we suspect, community violence has a toxic effect on the brain, downstream effects may emerge both at school and at home. And those effects converge with the deficits in attention, cognition and emotion regulation that other researchers have already noted in youth exposed to community violence. They may even endure into adulthood and contribute to a cascade of risk for further problems in employment and education.

Although community violence may be widespread, that doesn’t mean it’s acceptable. Developing kids and teens deserve to feel safe at home, in their schools and in their neighborhoods. As our results and those of many other studies show, growing up in a violent or chaotic environment seems to leave traces on the brain, and may put youth at risk for other problems down the line. Although we don’t usually think of street lights, after-school programs and revitalized park spaces as brain-building improvements, public investment in urban neighborhood safety and quality may have wide-ranging benefits for teens at risk.

Read more on TheConversation.com.