Oiginally published by The NY Times

I did not raise you to cry, my father would say when I fell off my bike, as he poured rubbing alcohol on my bloody 6-year-old knees. Not hydrogen peroxide – alcohol. Whenever I cried, which was usually when I did not get an A on a math test or saw a lost-dog poster or read about Anne Frank, my parents, immigrants from Ecuador, handed me a mirror to observe myself. They wanted to desensitize me to my own tears, to line my small heart with bulletproof glass, even if doing so meant making me hate my own weakness.

Undocumented life in America is hard on the mind and body. Poverty, precarious employment, poor access to health care, discrimination and trauma from the migration itself often lead to disorders like depression, anxiety and post-traumatic stress disorder. Access to mental health treatment is scant, the demands of simply surviving are overwhelming, the fear of being discovered discourages people from seeking care, and the stigma of mental illness has perpetuated a culture of silence that only worsens the suffering.

Enter the Trump administration. With its aggressive hunt for undocumented people like my family – capped off by the announcement on Tuesday that the president plans to end the Deferred Action for Childhood Arrivals program for the so-called Dreamers – the administration has placed new emotional and mental burdens on an already deeply stressed community. Thanks to DACA, I was able to get a state ID, land my first paid office job and fly without fear for the first time in my life. My best friend from college is in DACA, as are the children of nearly everyone I have interviewed for the dissertation I am working on. We know all too well people like the two young brothers from Maryland without criminal records who were deported after one of them, a soccer star, told immigration officials he had won a scholarship to college. Or the children on their way to school who filmed the detention of their parents on their phones while sobbing and screaming. Or the DACA recipient who hid in her closet as her father was arrested by armed ICE agents.

Some studies have found that the first wave of immigrants has a better mental health outlook than subsequent generations, which researchers say results from traditional family networks and values, as well as lower expectations for success. But such conclusions betray a misunderstanding. As a graduate student, I have interviewed dozens of undocumented people, including first-wave adults. Most of them speak of symptoms that we might call anxiety, depression and PTSD, even if the subjects themselves do not use this language, and have less familiarity with diagnostics and less access to treatment than their American-citizen children. These studies are from a more innocent time.

All of the immigrants I have interviewed and known throughout my life seem to accept chronic exhaustion, low self-esteem, fear and panic, low moods and fits of crying as normal for the melancholic migrant struggling to subsist without being arrested. Older immigrants are at the highest risk for mental health struggles, having aged out of manual labor, with grown children and dead parents, and being unable to receive health care.

Immigration and Customs Enforcement arrested a man during a traffic stop near his home in Riverside, Calif.CreditMelissa Lyttle for The New York Times

My parents have lived in this country for 30 years, and they have seen their share of ghosts. I recently learned that my father hid his father’s death from me for three years because he did not want it to affect my mental health. Unable to travel, he could not bury him. I made my way through Harvard and Yale as an undocumented student. But even safe in my Ivy League college town, I have nightmares – of Immigration and Customs Enforcement officers, of swastikas. When I travel the country meeting undocumented immigrants for my dissertation, I see my father’s face in theirs and I know this astigmatism will always be with me. Anytime my parents take too long to text me back or when they call me at an unusual time, I panic. When I hear them say, Just reminding you to wear sunscreen today! I want to laugh in relief.

And then I worry that nothing but death will liberate me from the constant anxiety. We all live with the thought: My life as I know it might end now. Or now. Or now. The uncertainty is torture.

Here are some of the people I have met while researching my dissertation. Alejandro is a 49-year-old day laborer from Mexico who rents a room in Staten Island, to which he returns only at night to eat a dinner of oatmeal with milk and sugar, and then sleep. He has crossed the border four times to see his children but is too old for that now. Some of the trips were traumatizing. On one, a middle-aged man got so dehydrated that he could no longer swallow. I can’t stop thinking of his face, the look in his eyes, he says. Alejandro himself got so tired on that trip that he felt like giving up and surrendering to death, perhaps to be eaten by bobcats. But two young men lifted him up and pushed him by his shoulders up the slopes of a mountain. They didn’t want me to die, and I didn’t want to let them down, so I lived, he recalled. I can’t stop thinking about them. When the news comes on, I worry I will see their faces.

A woman named Sandy described a stampede in Queens after a fake post about an ICE raid circulated on social media. Panicked crowds knocked her down and dozens of people trampled over her, stepping on her head and neck. Pressed against a wall, she could not breathe and had a panic attack. A Mexican neighbor came back to pull her to safety.

William is a 16-year-old Dominican martial arts star who loves math and science but also struggles with anxiety and depression. After the election, I thought I was lower than everyone in society, that I had no voice or role or place here – an alien, like people say, he told me. He began to fear ICE was following him at all times and he had a nervous breakdown. But then I got to a point where I didn’t care because I knew I was going to commit suicide and nothing would bother me after death, he says. He was put on Zoloft and hospitalized for a week.

Claudia is a 60-year-old Colombian woman who is afraid to go to the doctor. She goes anyway because she’s being treated for cancer, but winds up running out of the doctors’ offices when the treatment is over, fearful that someone will turn her in. She tells me she doesn’t watch the news and has installed surveillance cameras outside her apartment in case agents come to her door. They don’t want us in this country, she says. We have to be careful. 

Experts on immigrant mental health say they have already seen a spike in symptoms since President Trump’s inauguration. Roberto Gonzalez, an assistant professor of education at Harvard who studies undocumented youth, says he has seen parents pull their children from school out of fear. This kind of elevated fear and anxiety can have detrimental physical and mental health effects in the long term, he told me. Many of the young people I’ve been studying have shown physical and emotional manifestations of stress: chronic headaches, toothaches, ulcers, sleep problems, trouble getting out of bed in the morning, eating issues. It will get only worse, he said, with Mr. Trump’s DACA announcement.

Rosa Maria Bramble, a social worker who works with undocumented families, including former ground zero cleanup workers with PTSD, told me that news of stepped-up enforcement triggers symptoms in her clients. I work with a number of people who fled their countries because of political violence or gender violence, and after they reached these shores their symptoms of PTSD began to mitigate, she says. Now they feel just as vulnerable and persecuted and terrorized as they did prior to being here.

Spreading fear and anxiety, of course, is part of the administration’s plan. Thomas Homan, the acting director of ICE, recently said: If you’re in this country illegally and you committed a crime by entering this country, you should be uncomfortable. You should look over your shoulder, and you need to be worried.

A common Spanish refrain is that dirty laundry is washed at home. But silence equals death. In lieu of comprehensive immigration reform, what can we do? Churches, community health centers and nonprofit organizations can provide referrals to bilingual therapists and conduct workshops on self-care, explaining depression and anxiety from a culturally sensitive perspective. Licensed therapists, psychologists and psychiatrists can offer care for reduced fees to low-income clients, and clinics can hire more bilingual practitioners. Teachers can check in with students from mixed-status families. All of this would be smart from a public health perspective. But it is also a moral imperative.

Every morning at 6:40, as he is going to work in construction, I text my father extravagant statements about my love for him. I do it again in the evening, urging him to rest, reminding him my dog has green eyes just like my grandfather, asking if he has ever been so adored, hoping that I can inoculate him and my mother against the evils of the current administration. We are a generation apart and have different ideas about what tactics can preserve the heart. Here is the child whom he taught not to cry, begging her father to accept her love as a substitute for everything else that is good and fair.

But love alone cannot cure what ails us, and neither can resilience or quiet strength.

Read more: www.nytimes.com/2017/09/08/opinion/sunday/mental-health-daca.html?action=click&pgtype=Homepage&clickSource=story-heading&module=opinion-c-col-right-region&region=opinion-c-col-right-region&WT.nav=opinion-c-col-right-region&mtrref=www.nytimes.com&assetType=opinion

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