The adults in my life helped their children self-soothe with silly nursery rhymes they were raised with like, “sana, sana, culito de rana (heal, heal, little frog’s tail),” which my folks would jokingly reference into my adolescence and adulthood each time I expressed emotional pain they couldn’t quite understand.

Though they’re supportive of my mental health treatment, my parents have never wholly understood why I’ve struggled in ways they haven’t. I was born in the US, which has inherently granted me access to the education and rich life experiences they wanted for me. My parents and two elder siblings fled Nicaragua in the late 1980s, escaping the socialist rule of the Sandinistas, a left-wing political organization that made living conditions for working-class families like my own harsher. Though they left behind relatives and faced life-threatening violence on their journey to the US, they arrived with pockets full of optimism and the will to prosper in a country and language foreign to them. Their indoctrination into American society wasn’t easy, but they consider the perilous experience of crossing the border one of their biggest life hurdles—something that is now decades in the past. However, the realities of vacillating between two entirely different cultures has come with its own set of mental health challenges for me.

Yes, my parents, siblings, and Nicaraguan-American relatives suffer from their own mix of anxieties. However, I’ve always been singled out as the one whose a tad bit more…in their words, sensitive. How is it that immigrant folks who fled their native country appear to have better mental health than me, an American who was raised in safety with comforts like Fruit Loops and Nickelodeon? Experts call this phenomenon the “immigrant paradox.”

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The immigrant paradox has been defined by the Society for Research and Child Development (SRCD) as a phenomenon that explains why US-born youth are more likely to experience higher rates of mental health problems than youth who immigrated from a foreign country. Amy Marks, PhD, a professor of psychology and department chair at Suffolk University, who has written about the paradox for years, underscores the research and tells Health that folks who were born abroad seem healthier than folks born here in the US—though this is different for some Latinx groups.

Though the outcome of anyone’s mental health is multidimensional (for immigrants, factors such as national origin, race, how they arrived to their new country, gender, and socioeconomic status are important to consider), according to a 2009 study published in the American Journal of Public Health, the longer immigrants spend in the US, the higher their risk of psychiatric disorders become. This is partially due to the systemic discrimination, victimization, and rejection these families collectively face in this new country, plus family conflict that arises as a result of acculturation—the adjustment to new cultural and social norms.

According to Marks, immigrants and first-generation folks from immigrant families are acculturating into a society built on racist and oppressive systems that have existed for hundreds of years. In other words, people from Spanish-speaking Latin American countries are adopting a predominantly white, English-speaking norm. “If you’re born into that system and you come from a non-European background with darker skin, that may have more pronounced effects on you,” Marks says, explaining how discrimination affects the mental health of populations such as the Latinx community. Positive social standing, “family harmony,” and easier integration into US culture offset the risk of developing mental health disorders.

Despite the love and coddling I received as a child, my household was also rife with alcohol overconsumption, which exposed me to the long-lasting harms of domestic violence and other forms of physical and emotional abuse. Some of my earliest memories are of crying in my bedroom, slamming the door in fear, and feeling isolated after witnessing drunken altercations between my mother and father.

Marks says that it’s well-documented that alcohol and drug use are linked to mental health disorders, and that while the reasons for this consumption are murky, they’re essentially coping mechanisms that lead to disorders like depression, which trigger further challenges. She notes that while these patterns are prevalent in US society, particularly for young people, there’s a disproportionate surge in groups that are more oppressed—like my own Latinx community.

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According to a 2007 study published in the journal Social Science and Medicine, as Latinxs acculturate, they’re likely to adopt unhealthy behaviors such as smoking, excess alcohol consumption, and poor eating habits. My father’s destructive relationship with alcohol only worsened the longer he lived in the US. I had my own coping mechanisms growing up: frequent temper tantrums, overeating, and antisocial tendencies. Of course I didn’t realize back then that these behaviors were actually signs of post-traumatic stress disorder, but I did know on some level that I needed more than nursery rhymes.

It’s not that Latinx immigrants do not suffer from mental health disorders, it’s that first-generation and US-born Latinxs suffer at more disproportionate rates because of systemic pressures and inadequacies they grow up experiencing. The Latinx population is a deeply diverse one, and acculturation and enculturation varies. What that means is that a Latinx person’s experience in the US is vastly different depending on said person’s nationality, socioeconomic status, and ability to assimilate into the dominant American culture, per a 2007 article published in the journal Research in Human Development as well as a 2009 article from Social Science and Medicine. 

This immigrant paradox theory not only aligns itself with my own experiences, but also numerous other studies. According to a 2008 study published in The American Journal of Psychiatry, for instance, immigrants demonstrate a pattern of lower risk for mental health disorders—particularly depressive disorders, anxiety disorders, and substance use disorders—despite migrating and resettling in a new country, which is associated with its own set of mental health risks. It is hypothesized that these immigrant groups fare better because of the strong family bonds and close-knit communities Latinxs are part of. Older generations of immigrants don’t seek mental health support because their cultures offer coping skills that are key to staying resilient, such as religious traditions that can be implemented into daily life. (My grandmother always keeps her rosary nearby, for example.)

“There’s an incredible amount of will and tremendous hard work and optimism for so many immigrants,” Marks says. “When you talk to the parents who came from abroad, they say they came from very little and still support their family back home. They’re very motivated and they’re not focused on the systems. But the children who grow up here notice their family’s legal status, their own access to higher education, and other factors that take a toll on mental health. If you compare the mental health challenges over time across generations among Latinx young people against their non-Latinx white peers, there’s very disproportionate suffering.”

I was a highly anxious, overachieving kid who fretted about everything. Though they didn’t do so intentionally, my parents freely spoke about their low income and rising debt in front of me. Yes, witnessing those conversations—and already living in an otherwise tumultuous household—took a toll on my mental health, but it also lit a fire beneath me. As early as elementary school, I understood that pursuing a college education was one way to escape the confines of living paycheck to paycheck, the first step in living more prosperously in my adulthood. And so I focused on earning good grades and becoming a model student, one set on achieving the American dream.

In one context, the paradox explains why children of immigrants outperform the children of native-born US parents. An article published in the journal Social Science Research in 2016 hypothesized that children of immigrants are more likely to enroll in college, be employed or in school, and are less likely to have a criminal record as young adults or to have a child than children of non-immigrants.

Another way to look at this paradox is to consider the anxiety that comes as a result of fear. As a child, I didn’t realize my parents were not US citizens; I assumed they were privileged with the same set of inalienable rights as any of my peers’ parents. However, I realized later in life that the process of naturalization not only takes decades, but is also tiring and expensive. My family spent thousands of dollars working with lawyers to fight to achieve residency status, and later to apply for citizenship.

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In fact, my mother remained a US resident, not a citizen, in the early years of the Trump administration, which has worked to limit immigrants in this country. I frantically insisted she apply for citizenship following the president’s inauguration, and the fear of her deportation—a scary threat given the government’s insistence on building walls between Latinx populations and American-born white ones—took a toll on my mental health. She thankfully was able to achieve citizenship in 2019.

To further illustrate this, Marks turns to the example of mixed-status families, in which at least one member of the unit lives in the US with fear of getting deported, while the others have residency or citizenship. “In our research we find that just living in a household with one person who doesn’t have papers is just as stressful and anxiety-provoking than being undocumented yourself. It’s because of the threat of separation, which is a traumatic experience,” Marks says, emphasizing that those worries don’t go away for the US-born children of immigrants who may be adolescents or adults. Marks also notes that these situations can cause first-generation Americans to adopt behavior such as excess drinking or smoking, which is common in the US.