Perceived Early Warning Signs, Stressors, and Help-Seeking Barriers Related to Anxiety and Depression among Asian and Asian American Adolescents: A Qualitative Study

Abstract

Adolescence is a period in which anxiety, low mood, and other forms of emotional distress frequently emerge, yet young people’s own interpretations of these experiences remain insufficiently understood. This qualitative study examined how 14 high school students aged 13 - 18 who identified as Asian or Asian American perceived early warning signs of emotional distress, major sources of pressure, and barriers to seeking support. Semi-structured interviews were conducted via Zoom, and the transcripts were analysed through open, axial, and selective coding. Participants described bodily and emotional changes, including sleep difficulties, physical discomfort, exhaustion, and loss of motivation, as noticeable signs of worsening distress. Academic workload, uncertainty about the future, family expectations, and peer comparison were perceived as important stressors. Participants also described tensions within social support: although relationships could provide comfort, fear of judgment, limited perceived understanding, and social comparison could intensify isolation. A strong preference for managing problems independently further constrained help-seeking, a recurring pattern described here as a “self-reliance trap”. The findings do not establish prospective predictors of clinically diagnosed anxiety or depression. Instead, they demonstrate how adolescents construct everyday understandings of emotional risk and support. The study highlights the importance of developmentally appropriate, confidential, relationally safe, and autonomy-supportive forms of assistance.