Mental health remains a stigmatized issue in many South Asian families, where cultural expectations and generational beliefs discourage conversations about psychological well-being. Instead of seeking help, individuals suffering from depression, anxiety, and other mental health disorders are often encouraged to suppress their emotions. However, research indicates that ignoring mental health struggles does not merely affect psychological well-being but can contribute to severe physical health conditions, including hypertension, diabetes, and autoimmune diseases. The mind-body connection is well-established in scientific literature, and chronic stress resulting from unaddressed mental illness can have physiological consequences.
The Mind-Body Connection: Chronic Stress and Physical Illness
The relationship between mental health and physical health is part of the body’s stress response system. Chronic stress, when experienced over long periods without relief, can activate the hypothalamic-pituitary-adrenal (HPA) axis, leading to an overproduction of cortisol. Elevated cortisol levels contribute to systemic inflammation, insulin resistance, and dysregulation of the autonomic nervous system, all of which increase the risk of chronic diseases.
A study found that individuals with untreated depression had a 40% increased risk of developing cardiovascular disease compared to those without mental health issues. This is concerning for South Asians, as they already exhibit a higher predisposition to heart disease due to genetic factors, dietary habits, and sedentary lifestyles. When compounded by untreated mental illness, these risks become more pronounced.
Hypertension and Cardiovascular Disease in South Asians
Hypertension is one of the most common health concerns among South Asians, with studies indicating that South Asian individuals are more likely to develop high blood pressure at a younger age compared to other ethnic groups. Stress and anxiety play a role in the development of hypertension. When stress is prolonged, as seen in individuals struggling with untreated depression or anxiety, the body remains in a heightened state of alertness, leading to persistent elevation in blood pressure.
South Asians have a higher prevalence of hypertension-related complications, including stroke and heart failure. Furthermore, a study demonstrated that individuals with generalized anxiety disorder had a 52% greater likelihood of developing hypertension. The reluctance to seek mental health support in South Asian families exacerbates these issues, as individuals may turn to maladaptive coping mechanisms such as smoking, alcohol consumption, or emotional eating—factors that further elevate cardiovascular risk.
Diabetes and Mental Health: A Bidirectional Relationship
South Asians have one of the highest rates of type 2 diabetes worldwide, with research suggesting that they develop insulin resistance at lower body mass indexes compared to other populations. While genetics play a role, psychosocial stressors significantly influence diabetes onset and management. Individuals with major depressive disorder were 37% more likely to develop type 2 diabetes, while those with diabetes were at increased risk for depression and anxiety.
Diabetes and mental health is particularly concerning within South Asian families, where diabetes is often managed with dietary restrictions rather than comprehensive lifestyle changes that address stress and mental well-being. Traditional South Asian diets, rich in carbohydrates and refined sugars, can exacerbate blood sugar fluctuations, particularly in individuals experiencing high levels of stress. Without acknowledging the role of mental health in disease progression, diabetes management remains incomplete.
Autoimmune Diseases and the Impact of Psychological Distress
Autoimmune diseases such as rheumatoid arthritis, lupus, and inflammatory bowel disease are on the rise among South Asians, and emerging evidence suggests a strong link between chronic psychological distress and immune dysfunction. The body’s inflammatory response is tightly regulated by the nervous and endocrine systems, both of which are affected by prolonged stress and mental health disorders.
A study in Nature Reviews Immunology (2021) demonstrated that individuals with post-traumatic stress disorder (PTSD) and chronic depression had significantly higher levels of pro-inflammatory cytokines, which are implicated in autoimmune disease pathogenesis. South Asians, particularly those in immigrant communities, may experience high levels of acculturative stress, family-related pressures, and intergenerational trauma, all of which contribute to chronic inflammation and immune dysregulation.
Furthermore, women in South Asian families face additional burdens due to gender norms that prioritize caregiving roles over personal well-being. Research in The Journal of Autoimmunity (2019) found that women with prolonged exposure to stressors were at significantly higher risk for autoimmune conditions, a finding that has particular relevance given the cultural expectations placed upon South Asian women to fulfill familial obligations regardless of personal distress.
Barriers to Mental Health Treatment in South Asian Communities
Despite the clear connection between mental health and physical health, many South Asians avoid seeking psychiatric care due to stigma, lack of culturally competent providers, and misconceptions about mental illness. In a survey published in The Asian Journal of Psychiatry (2022), 64% of South Asian respondents stated they would be reluctant to seek mental health support due to fears of social ostracization. Many also reported that they were more likely to discuss mental health concerns with family members rather than professionals, even though family responses often involved dismissing symptoms or attributing them to temporary stress.
Religious and spiritual beliefs further complicate mental health treatment. While spirituality can be a source of resilience, it is often misused to invalidate the need for professional intervention. Many South Asian individuals are told to rely on prayer, meditation, or traditional healing practices instead of psychiatric care, delaying necessary treatment and exacerbating both mental and physical health conditions.
The Need for Integrated Care Approaches
Addressing the burden of untreated mental health conditions in South Asian families requires an approach that recognizes the overlap of psychological and physical health. Primary care physicians, who are often the first point of contact for South Asians seeking medical help, should receive training in recognizing the signs of mental illness and referring patients to culturally competent mental health professionals. Furthermore, community-based initiatives that educate South Asians on the importance of mental health in disease prevention can help reduce stigma and encourage early intervention.
Family involvement is also important in overcoming resistance to psychiatric care. Mental health professionals working with South Asian patients should consider incorporating family education sessions that address cultural concerns and discourage myths surrounding mental illness. By reframing mental health treatment as a component of holistic well-being rather than a source of shame, families may become more open to seeking appropriate care.
The silent suffering of mental health struggles in South Asian families has far-reaching consequences beyond psychological distress. Chronic stress, anxiety, and depression contribute to the development and worsening of hypertension, diabetes, and autoimmune diseases, leading to preventable mortality. Addressing mental health within South Asian communities requires increasing access to culturally competent care and integrating mental health awareness into discussions on overall well-being. The cost of silence is too high to ignore.
Vishwani’s opinions are her own and are for informational purposes only. They are not intended to diagnose, treat, or provide medical advice. Please consult a qualified healthcare professional for personalized medical care.
Vishwani Sahai-Siddiqui is a residency- and fellowship-trained psychiatrist, now a medical writer and editor, and the owner of The Cognitive Quill. For more information, please visit cognitivequill.com or email vishwanipsychmd@gmail.com.
South Asians and Mental Illness Series
- Therapy is for “Other People”: Why Many South Asian Parents Dismiss Mental Health Support
- The Burden of Being the ‘Good Child’: How South Asian Kids Suppress Mental Health Struggles
- Mental Health and Matchmaking: How Stigma Affects South Asian Marriage Prospects
- Spirituality Versus Psychiatry: Why Many South Asians Turn to Religion Before Therapy or Psychiatric Medication
- The Cost of Silence: How Ignoring Mental Illness in South Asian Families Leads to Physical Health Issues
- “The Son Belongs to His Mother”: South Asian Daughters-in-Law and the Mental Health Toll of Family Hierarchy
References
Awan, H., Mughal, F., Kingstone, T., Chew-Graham, C. A., & Corp, N. (2022). Emotional distress, anxiety, and depression in South Asians with long-term conditions: A qualitative systematic review. British Journal of General Practice, 72(716), e179–e189. https://doi.org/10.3399/BJGP.2021.0345
Karasz, A., Gany, F., Escobar, J., et al. (2019). Mental health and stress among South Asians. Journal of Immigrant and Minority Health, 21(Suppl 1), 7–14. https://doi.org/10.1007/s10903-016-0501-4
Vidyasagaran, A. L., McDaid, D., Faisal, M. R., Nasir, M., & Krishna, M. (2023). Prevalence of mental disorders in South Asia: A systematic review of reviews. Global Mental Health, 10, e35. Published online November 13, 2023. https://doi.org/10.1017/gmh.2023.72
Zavala, G. A., Haidar-Chowdhury, A., Prasad-Muliyala, K., Appuhamy, K., Aslam, F., Huque, R., Khalid, H., Murthy, P., Nizami, A. T., Rajan, S., Shiers, D., Siddiqi, N., Siddiqi, K., & Boehnke, J. R. (2023). Prevalence of physical health conditions and health risk behaviors in people with severe mental illness in South Asia: Multi-country cross-sectional survey. BJPsych Open, 9(2), e35. https://doi.org/10.1192/bjo.2023.12
