Unspoken Hurts
Mental Health Needs of Immigrants & Second-Generation Americans
Immigrants and second-generation Americans bear the weight of invisible emotional burdens that are rarely acknowledged — by society, by their families, and sometimes even by themselves. While immigrants narrate stories that point to their resilience and success, many in the immigrant population also experience anxiety, depression, identity conflict, and unprocessed trauma. Therefore, mental health care that recognizes these lived realities is not a luxury—it is essential.
The Psychological Journey
Migration restructures an individual’s inner world through key life transitions such as disconnection from extended family, loss of community, cultural displacement, and, in certain cases, exposure to discrimination, violence, persecution, or extreme hardship. Even those who migrate for economic opportunity can develop chronic stress associated with the pressures of adapting to a new language, different social norms, and power structures.
Even as they achieve success and some kinds of happiness, many immigrants recount a lingering sense of sadness for the life they left behind, the identity they once held, or the version of themselves that felt fully understood in their native environments. What they experience is termed cultural bereavement, and that translates to feelings of distress, irritability, emotional numbness, or a persistent feeling of being alienated.
Moreover, immigrants often do not find a safe space for expression, and this can redirect their emotional distress back into the body, which shows up as physical symptoms — headaches, fatigue, digestive issues, chronic pain, and sleep disturbances are common in immigrant populations.
The Shame
Some immigrant cultures stigmatize, minimize, spiritualize, or moralize mental health concerns. They normalize beliefs in which individuals are taught to endure suffering quietly, pray harder, stay strong for the family, or avoid “bringing shame” by talking about emotional pain. As a result, some immigrants postpone therapy until symptoms become completely unmanageable.
This silence does not mean the pain is less real—it simply means it is carried alone.
Culturally responsive therapy views this reluctance as a tendency arising out of tradition, survival, and deeply held values. It creates a safe, nonjudgmental space where clients feel respected, not pathologized, or viewed differently.
Caught Between Two Worlds
Second-generation Americans face challenges that, although different, are equally complex. Their growing up necessitates a journey through two cultural realities: one at home and another in the outside world. Switching between two environments may create confusion regarding identity, an absence of a sense of belonging, and difficulties in self-expression.
Many second-generation clients demonstrate an intense need to succeed—not only for themselves, but for their families. Parents’ sacrifices are never forgotten, and failure, often taken personally, can feel catastrophic. This dynamic results in problems — anxiety, perfectionism, burnout, and fear of disappointing loved ones.
Moreover, immigrant children become adults before their time in that they find themselves burdened with adult responsibilities, serving as translators, advocates, or emotional anchors for their families. While this responsibility can build strength and problem-solving skills, these unrealistic parental expectations can create a sense of failure and helplessness, keep needs unrealized, and present difficulties in setting boundaries in later life.
Also read: Feeling Disconnected? 10 Ways to Reconnect with Yourself
Generations of Grief
Another factor compounding the problem is trauma across generations. Unresolved trauma passes down from one generation to another. Parents who suffer the consequences of displacement, violence, poverty, or systemic discrimination may fail to regulate their emotions, trust people, and never speak openly about their past.
The outcome can be strict control or emotional distance, which children may never understand. Without a common language to bridge the gap, family conflict can intensify, leaving both generations feeling misunderstood and alone.
Therapy that recognizes intergenerational and cultural context can help families and individuals find meaning out of these patterns—without blame— so steps toward healing are taken.
The Barriers
Despite an explicit need, immigrants and second-generation Americans often face obstacles such as:
- Limited access to affordable or insured care
- Language differences and lack of bilingual providers
- Fear related to immigration status or institutions
- Mistrust rooted in past discrimination
- Lack of mental health education or representation
These barriers reinforce the belief that help is “not for people like us.” Changing this narrative requires that care be made accessible, inclusive, and culturally informed.
How Culturally Responsive Therapy Helps
Culturally responsive therapy recognizes that mental health does not exist in a silo. It is inseparable from culture, family, faith, migration history, or systemic realities. It honors the clients’ values and perspectives, guiding them on their healing journey by helping them develop emotional insight, coping tools, and self-compassion.
Effective therapy for immigrant and second-generation clients may include:
- Exploring identity and the sense of belonging
- Addressing intergenerational expectations and boundaries
- Processing displacement trauma and loss
- Navigating bicultural stress and discrimination
- Reframing strength to include rest, support, and healing
When clients feel seen and understood within their cultural context, therapy becomes a sanctuary for healing.
You don’t have to carry the burden alone.
If you are an immigrant or a second-generation American feeling overwhelmed, conflicted, or emotionally exhausted, Laura Pearl specializes in therapy for immigrants in Upper East Side, New York.
