Voices If My Parents Stayed in Hong Kong, I May Not Be Alive Today By Katharine Chan, MSc, BSc, PMP Katharine Chan, MSc, BSc, PMP LinkedIn Katharine is the author of three books (How To Deal With Asian Parents, A Brutally Honest Dating Guide and A Straight Up Guide to a Happy and Healthy Marriage) and the creator of 60 Feelings To Feel: A Journal To Identify Your Emotions.She has over 15 years of experience working in British Columbia's healthcare system, leading patient safety incident investigations, quality and systems improvement projects, and change management initiatives within mental health, emergency health services, and women's health. Her expertise in facilitating, storytelling, coaching, and promoting tough and honest conversations provides the foundation for her site, Sum (心,♡) on Sleeve. Learn about our editorial process Updated on September 16, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Ivy Kwong, LMFT Medically reviewed by Ivy Kwong, LMFT LinkedIn Twitter Ivy Kwong, LMFT, is a psychotherapist specializing in relationships, love and intimacy, trauma and codependency, and AAPI mental health. Learn about our Medical Review Board Print Verywell / Madelyn Goodnight Care and Trigger Warning This article contains content that may be sensitive to some individuals. It references self-harm, disordered eating, and suicide. If reading this brings up uncomfortable feelings for you, you can speak confidentially with trained advocates for free. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Suicide in Asia and Hong Kong When I was growing up, every so often, my mom would bring up a Hong Kong news story about a teenager dying by suicide over grades. Parents would lose themselves as their children left this world through their apartment windows. Statistics on suicide are often underreported and challenging to retrieve. However, it is estimated that approximately 60% of the deaths due to suicide occur in Asian countries. In 2011, the suicide rate in Asia was 30% higher at 19.3 per 100,000 compared to the global rate of 16.0 per 100,000. Research has shown that school distress and academic pressure are associated with depression and suicidality. Specifically, a study that looked at Hong Kong Chinese female students ages 13–18 revealed that suicidal ideation was significantly associated with academic self-concept, depression, test anxiety, and perceived parental dissatisfaction with academic performance. A study categorized suicide data of Hong Kong primary and secondary school students to understand the student suicide population and potential causes for their deaths. It showed the deceased student profiles had four distinct characteristics, including "school distress," "hidden," "family and relationship," and "numerous issues." In 2019, the Alliance for Children Development Rights and Youth Policy Advocators published survey results that assessed the Hong Kong education system. They collected responses from 461 Hong Kong secondary school students and those who graduated from secondary school in the last three years. Half of the respondents stated that student suicides were related to the problematic education system. 81.8% and 68.3 % of the respondents identified "overemphasis on academic studies and performance" and "over-competitive academic atmosphere" as significant sources of stress, respectively. The Toxicity of Being "Well-Rounded" In some ways, I believe that my upbringing in the West helped prevent a similar outcome; I’m grateful that my parents immigrated to Canada to raise us and that I didn't live in Hong Kong for these reasons. My childhood and adolescence were filled with perfectionist tendencies. I excelled academically. I put a lot of pressure on myself to do well. In high school, I was an overachiever who wanted to do everything right. It wasn’t just about school and grades because I learned from an early age that academics are about knowing how to work the system. I did what the teachers wanted me to do and they rewarded me for my efforts. Give me an assignment and I will complete it, check over it, and hand it in on time. Tell me when a quiz, test, or exam is and I will study for it. I stayed on top of my schedule so that I always showed up on time, never missed a deadline, and was always prepared. I knew if I put just enough effort into school, I could stay at the top of my class. Therefore, it came easily to me. But it was a double-edged sword. Because I thought school was so easy, I became extremely hard on myself. There was no room to make mistakes because I was petrified to have one failure define me. I had a black-and-white view of the world. There was no room to make mistakes because I was petrified to have one failure define me. I had a black-and-white view of the world. So I set the bar higher and higher. I started focusing on other aspects of my life and trying to be “perfect” in those. I had this deep desire to be as well-rounded as possible. From social relationships, popularity, fitting in, body image, sports, volunteer work, extracurricular activities, and work experience to not being perceived as too Chinese or too White-washed—all those expectations consumed me. On the outside, one might see a super-talented kid who had all the opportunities in the world. But on the inside, I struggled with depression, anxiety, disordered eating, and self-harm. Disordered Eating and a Sense of Control In grade nine, I developed bronchitis and couldn’t eat properly for weeks. I lost a significant amount of weight. I started getting a lot of attention for how I transformed my body. On the outside, one might see a super-talented kid who had all the opportunities in the world. But on the inside, I struggled with depression, anxiety, disordered eating, and self-harm. Food became a type of control I had in my life. And the more I could control it, the better I felt, the more confidence I exuded, and the more people I felt wanted to hang around me. I created a bunch of rules around food, what I could or could not eat, how much or how little, and how I would punish myself if I fell off the wagon. I started throwing up whenever I binged. I can still remember the chalky feeling behind my teeth and the sourness that lingered in my mouth after each episode. By grade 10, I had created so many unrealistic expectations and goals for myself that my grades started to slip. My average dropped from 97% to 93%. Although for many, this decrease seems minimal, it was a devastating blow for me. I couldn’t keep up with the thing I told myself was the bare minimum. If I couldn’t even do that, then what am I good for? So I started cutting. Every time I received a less-than-perfect mark or broke a rule of mine, I would use a razor to make superficial cuts along the natural wrinkles on the inside of my wrist. They were like little paper cuts that barely bled but gave me the pain I felt I deserved. There were several dark moments during that year where I contemplated ending it all. What Could Have Been My boyfriend at the time noticed the cuts on my wrist. He asked me what was going on. At first, I denied everything. I told him I scraped it on a door. But he didn’t believe me. He was relentless, interrogating me with question after question. So I broke down and confessed. The concern that he showed shocked me into finally realizing the gravity of the situation. For so long, I was inside my head, completely convinced that my self-destructive behaviors were justified. He kept checking in on me. We had numerous conversations about the pressures I put on myself. He reassured me that I’m an amazing person and that many people love and care about me, especially him. If I grew up in Hong Kong, I don’t know if I would have had a boyfriend who would have intervened at that point in my life. Given the competitive nature of the school system, long hours of study, and homework demands, I probably wouldn’t have had time to date. Coincidently, Hong Kong’s suicide rate was at a historical high of 21.5 per 100,000 in 2003, which was around the same time when I began my healing. For so long, I was inside my head, completely convinced that my self-destructive behaviors were justified. The most important person who supported me during this time was my sister. Once I had told someone about what was going on, I felt safe enough to tell her. She’s three years ahead of me. As the less academically focused and more free-spirited sister, she gave me insight into her life outside of high school, her travel plans, and what happens when we leave that fishbowl and enter the real world. She gave me hope for the future and helped me understand that there is so much more to life than grades and teenage social dynamics. She was my trusted confidant who listened and always stayed open-minded. If I had lived and grown up in Hong Kong, my sister may not have been who she is. Maybe her views would be less open. Maybe she would have moved away for University. Maybe our relationship would have been more distant. Maybe my parents would have pitted us against each other more. Lastly, living away from my relatives helped minimize the amount of social gossip and drama my parents had to face. We would get regular phone calls from our aunts and uncles about how our cousins were doing academically; however, it was difficult for them to compare us because of how different our school systems were. The distance between us removed the external pressure for me to do well and give honor to my family. If I grew up in Hong Kong, my fears of shame around seeking help for my mental health and the constant comparisons may have been that straw that broke the camel’s back. Should You Tell Your Parents About Your Depression? I will never know what could have been; however, those years were a crucial part of my life. Every day, I’m grateful I was able to see the light at the end of the tunnel. Although it was barely lit, it helped me get to a point where I could be alive to share my story. To anyone who is struggling right now in the trenches of depression, please talk to someone, a friend, a family member, a coworker, or a healthcare professional. You’re not alone and you don’t have to be. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database. Earlier Intervention Is Needed for Children at Risk for Self-Harm 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chen YY, Chien-Chang Wu K, Yousuf S, Yip PSF. Suicide in Asia: opportunities and challenges. Epidemiologic Reviews. 2012;34(1):129–144 Chan WSC, Law CK, Liu KY, Wong PWC, Law YW, Yip PSF. Suicidality in Chinese adolescents in Hong Kong: the role of family and cultural influences. Soc Psychiat Epidemiol. 2009;44(4):278–284. Lee MTY, Wong BP, Chow BWY, McBride-Chang C. Predictors of suicide ideation and depression in Hong Kong adolescents: perceptions of academic and family climates. Suicide Life Threat Behav. 2006;36(1):82–96. Wong A, Lai CCS, Shum AKY, Yip PSF. From the hidden to the obvious: classification of primary and secondary school student suicides using cluster analysis. BMC Public Health. 2022;22(1):693 HK education system rated two of of five by students, with “overemphasis on academic performance” most serious complaint. South China Morning Post. Young Post. Yang CT, Yip PSF. Changes in the epidemiological profile of suicide in Hong Kong: a 40-year retrospective decomposition analysis. China popul dev stud. 2021;5(2):153–173. By Katharine Chan, MSc, BSc, PMP Katharine is the author of three books (How To Deal With Asian Parents, A Brutally Honest Dating Guide and A Straight Up Guide to a Happy and Healthy Marriage) and the creator of 60 Feelings To Feel: A Journal To Identify Your Emotions. She has over 15 years of experience working in British Columbia's healthcare system, leading patient safety incident investigations, quality and systems improvement projects, and change management initiatives within mental health, emergency health services, and women's health. Her expertise in facilitating, storytelling, coaching, and promoting tough and honest conversations provides the foundation for her site, Sum (心,♡) on Sleeve. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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