Monthly Newsletter

April 2023

Navigating the Melting Pot: Acculturation Stress and Mental Health

By Sara Bahraini, M.D.

The D.C. Metropolitan Area is unique for many reasons, one of the most celebrated being its multiculturalism. People from all over the world have immigrated, sought refuge, or been displaced here, hoping for freedom, civil rights, and the American Dream. It would logically follow that moving to a country with better conditions would improve mental health, but research in acculturation suggests a more complex relationship. Let’s take a closer look.

Acculturation describes the changes in values, beliefs and behaviors that result from minority groups interacting with the majority culture where they live. It describes how members of ethnocultural groups interact with their greater society. Acculturation stress refers to the challenges associated with reconciling the differences or conflicts between multiple cultures and establishing one’s personal relationship with them. It can include the challenges associated with migration, language barriers, religious differences, racism, differences in etiquette, and even the differing perspectives between parents and children born into different majority cultures. For these reasons and more, a person’s relationship with their culture(s) of origin and the majority culture where they reside can significantly impact their mental health.

Four patterns of acculturation have been proposed and studied: Assimilation, Separation, Integration and Marginalization. Assimilation describes the scenario of a person adopting the culture of their new home, while rejecting their culture of origin. An assimilated immigrant of Cuban origin living in the U.S. would simply identify as “American.” Separation describes the scenario of a person retaining their culture of origin while rejecting the culture of their new home. A separated immigrant of Pakistani origin living in the U.S. would simply identify as “Pakistani.” Integration describes the scenario of a person identifying with both their culture of origin and the culture of their new home. An integrated Korean immigrant living in the U.S. would identify as “Korean-American.” Marginalization describes the scenario of a person alienating both their culture of origin and the culture of their new home. A marginalized Moroccan immigrant living in the U.S. would not identify with either culture. When asked how they identify, they might say, “When I’m with Moroccans I feel American, and when I’m with Americans I feel Moroccan…I don’t fit in anywhere.”

Most of the currently available psychological and sociological research on acculturation suggests that, of the four proposed patterns, integration is associated with the least depressive symptoms, while marginalization is associated with the worst. When compared to integration, marginalization is associated with over three times the risk of anxiety-related symptoms, and separation is associated with almost six times the risk. Depending on one’s culture of origin, their manifestation, understanding and approach to addressing symptoms of anxiety and depression may differ greatly from what is commonly taught to healthcare trainees in their new countries of residence, adding barriers to effective treatment.

If you find yourself relating to the contents of this article, you may benefit from exploring how it impacts your life and relationships in therapy. A culturally competent clinician can help you recognize how each culture in your life has benefited or challenged you, and what parts of each culture are most consistent with your personal values, goals, and beliefs. Therapy can help you identify helpful and unhelpful perspectives you have developed from your interactions with different cultures, deepening self-awareness and understanding, and allowing you to live more meaningfully and intentionally.



J. Berry, Immigration, acculturation, and adaptation, Appl. Psychol. 46 (1) (1997) 5–34.
B. Choy, K. Arunachalam, Gupta S, M. Taylor, A. Lee, Systematic review: Acculturation strategies and their impact on the mental health of migrant populations,
Public Health in Practice, Volume 2, 2021, 100069, ISSN 2666-
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