In plain words

Somatization means that emotional pain, stress, or mental health conditions like depression or anxiety show up as real physical symptoms in the body, such as headaches, stomach pain, deep fatigue, or dizziness, rather than or alongside feelings of sadness or worry. This is a well-documented and common way people experience distress across many cultural communities, and it does not mean the symptoms are imagined or less real. Telling a provider about your physical symptoms is a completely valid way to start a conversation about your mental health.

Feeling unwell in your mind and feeling unwell in your body are not separate worlds. Across many cultures, emotional pain is felt and described through the body, through family, and through faith. None of these is the wrong way to experience distress. This guide explains a few patterns that often surprise people when they reach mental health care in the United States, so you can recognize what you are feeling and find care that fits who you are.

At a glance
  • Emotional pain often shows up first as physical symptoms like headaches, fatigue, or stomach pain, a common and valid pattern called somatization.
  • Communities name distress in their own ways, and a good provider listens in your words instead of forcing one label.
  • You have the right to care that respects your language, culture, and faith, and to a free, qualified interpreter for mental health visits.

Distress often shows up in the body

For many people, stress, depression, or anxiety appear first as physical symptoms: headaches, deep tiredness, stomach pain, dizziness, a tight chest, or trouble sleeping. This is called somatization, and it is common and valid across many cultures (Kirmayer, 2001). You are not imagining it, and the pain is real. The body and the mind share the same nervous system, so when life is heavy, the body often carries it. The U.S. National Library of Medicine explains how stress affects the body, and the National Institute of Mental Health lists physical signs of stress such as headaches, body pain, and lost sleep.

This matters because telling a provider about physical symptoms is a normal and respected way to begin. You do not need the “right” mental health words. You can simply say, “I have headaches and I cannot sleep,” and a good provider will take it seriously and ask more. NIMH offers tips for talking with a provider about what you are feeling.

You can start simply

You do not need the "right" mental health words. You can say, "I have headaches and I cannot sleep," and a good provider will take it seriously and ask more.

Cultures name distress differently

Every culture has its own words and ideas for emotional suffering. Researchers call these cultural concepts, or idioms, of distress, and they shape how people understand what is happening to them (Kirmayer, 2001). A feeling that one community calls “thinking too much,” another calls “nerves,” and another calls depression. A good provider does not force your experience into a single label. Instead, they ask what you are going through in your own words. Clinicians can also use a tool built into the standard U.S. diagnostic manual, the DSM-5 Cultural Formulation Interview, to learn about your background, your community, and what you believe is causing your distress (American Psychiatric Association, 2013). Below are a few of the names different communities use for distress, and some of the questions a provider may ask to understand your world.

Words communities use for distress

Communities around the world have their own names for emotional pain, and each name carries real meaning. Finding out that your experience has a name, and that clinicians and researchers have studied it, can help you feel less alone. Here are a few examples that have been described in medical and mental health research:

  • Ataque de nervios (“attack of nerves”) is described among many Latino communities. It usually comes on after a stressful event and can bring a wave of intense emotion, such as anger or grief, panic-like feelings, or a sense of losing control, sometimes lasting for hours; it often draws family and community support toward the person (Moitra et al., 2018). People who have had an ataque are also more likely to be carrying anxiety or depression (Guarnaccia et al., 2010).
  • Susto and nervios are used across Latin America. Susto, sometimes translated as “fright,” is often connected to a frightening or shocking event, and in some traditions it is understood as the spirit being startled from the body (Martínez-Radl et al., 2023). Nervios describes ongoing nerves, worry, and upset felt in the body. Both are real ways of naming stress and low mood (Weller et al., 2008).
  • “Thinking too much” is used in many cultures to describe painful, repeating thoughts you cannot stop. In Shona-speaking communities in Zimbabwe it is called kufungisisa (Patel et al., 1995). Across many countries it overlaps with what clinicians call depression, anxiety, or post-traumatic stress, while remaining its own way of describing suffering (Kaiser et al., 2015).
  • Hwabyung, described among Koreans, comes from anger and hurt held inside for a long time, and it can be felt in the body as well as the mind (Min, 2008).

You do not have to use any of these words, and you do not have to fit any of them. They are here to show that your way of feeling and naming distress is real and shared by others. Whatever words you use, a good provider will listen and work to understand what you mean.

A provider may ask about your background

Many mental health providers in the United States are trained to ask about your world, not only your symptoms. One tool built into the standard U.S. diagnostic manual is the DSM-5 Cultural Formulation Interview, a short set of open questions a provider can ask near the start of care (American Psychiatric Association, 2013). You do not need to prepare for it, and there are no wrong answers. It simply gives you room to explain things your own way. It asks about things like:

  • How you see the problem. What would you call it, and how would you describe it to your family or friends? What worries you most about it?
  • What you believe is causing it. What do you think is behind it, and what do the people close to you, or your community, believe is causing it?
  • What helps and what makes it harder. What supports you, such as family, faith, or friends, and what stresses are making things worse? Does your background or who you are play a part?
  • What you have already tried. What have you done on your own to feel better, and what help have you looked for before, whether from family, healers, faith, or doctors? Did anything get in the way?
  • What kind of help you want now. What would be most useful to you at this point?

These questions are a way for the provider to understand you and to shape care that fits your life, so you are seen as a whole person and not only a set of symptoms.

Asking for help is a strength

In many communities, people are taught to handle hardship quietly and alone, and reaching outside the family can feel like failure or shame; stigma like this can hold people back from seeking care, especially in some immigrant communities (Nadeem et al., 2007). Stigma can show up in many ways: worry that others will gossip, fear of being seen as weak or “crazy,” fear of bringing shame on your family, or fear that asking for help could hurt your job or your immigration case. These feelings are understandable, and you are not weak for having them. Seeking help is a strength, the same way seeing a doctor for chest pain is a strength. Care is also confidential: what you share with a licensed provider is protected and is not shared with your family, your employer, or immigration authorities without your permission. You can ask a provider directly, “Who will see what I tell you?” To learn more about what is and is not shared, see Confidentiality and what is reported. NIMH’s page on caring for your mental health and SAMHSA’s find help page are gentle places to start, and SAMHSA’s free, confidential National Helpline gives referrals in several languages.

If you have lived through hard or frightening events

Many immigrants and refugees have lived through things no one should have to face: war, violence, losing your home, a dangerous journey, being separated from family, or fear that followed you for years. If this is part of your story, please know that the ways your mind and body respond, such as bad dreams, being easily startled, trouble sleeping, sadness, or feeling always on guard, are common human reactions to danger and not a sign that something is wrong with you.

Most refugees go on to live healthy lives after resettlement, and many carry remarkable strength. At the same time, some carry heavier symptoms that can ease with support and care. The U.S. Centers for Disease Control and Prevention notes that many refugees have symptoms that can be managed or relieved with mental health screening and treatment. One review that combined many studies found that about one in three refugees and asylum seekers were living with post-traumatic stress, and about one in three with depression (Blackmore et al., 2020). You are not alone, and help exists.

You do not have to tell your whole story before you are ready, and you never have to share more than you want to. You can begin with how you feel today. For guidance made for your situation, see Mental health for refugees and asylees.

Family, community, and faith have a place

You do not have to choose between your community and professional care. If it helps you, you can bring a trusted family member or friend to an appointment, and you can ask your provider to include the people you rely on. You can also keep your care completely private. Both choices are valid, and the decision is yours.

Faith and religious communities are, for many people, the first place they turn when life is hard, and they can be a real source of comfort, belonging, and hope (Derr, 2016; Nadeem et al., 2008). Faith support and professional care can work together. Some clergy and faith-based organizations also help connect people to counseling and clinics, so a conversation with a trusted spiritual leader can be one good door among several.

Talking about feelings through an interpreter

If you and your provider do not share a language, you have the right to a free, qualified interpreter, and you do not have to bring your own. This matters even more in mental health care than in a regular checkup, because feelings, memories, and the exact words for them are hard to carry from one language into another. A word for sadness, fear, or shame in your language may have no perfect match in English, and small differences can change what the provider understands.

A trained interpreter is there to pass along what you say as fully and faithfully as possible, including the feeling behind the words, and to keep everything private. A few things can help:

  • Speak in short pieces so the interpreter can carry all of it, and say so if you feel something was left out or changed.
  • It is okay to ask for a professional interpreter instead of a family member or child. Loved ones may soften hard things, or feel too close to the pain to put it into words.
  • If it helps you feel safe, you can ask the clinic for the same interpreter at each visit, so you do not have to start over with a new person each time.

For more, see Working with an interpreter and Your right to an interpreter.

You can ask for care that respects your background

You have the right to ask for culturally responsive care: a provider who respects your language, culture, faith, and beliefs, and who works to understand your world. This is a recognized standard in U.S. health care, described in the HHS Office of Minority Health’s National CLAS Standards for culturally and linguistically appropriate services, part of its Think Cultural Health initiative. For concrete ways to find a provider who fits you, see Finding a therapist who fits you.

What is available varies by place

Culturally specific services, such as counseling in your language or programs built for your community, are plentiful in some areas and scarce in others. Where local options are thin, telehealth and a qualified interpreter can bridge the gap, and community and faith organizations often know the trusted local resources. To find services where you live, you can dial 2-1-1 or ask a community health worker.

The HHS Office of Minority Health "Think Cultural Health" page, which hosts the National CLAS Standards for culturally and linguistically appropriate services (captured June 30, 2026).

How to find care that fits you

You have real options for finding care that respects your language and background:

Call the clinic and ask

"Do you have providers who speak [your language], or who have worked with people from my community?"

"Can you provide a free interpreter?"

  • Ask the clinic directly. When you call, ask, “Do you have providers who speak [your language], or who have worked with people from my community?” and “Can you provide a free interpreter?”
  • Search for programs near you. On FindTreatment.gov you can find clinics and call to ask which languages they serve and what they charge.
  • Ask people you trust. A faith leader, a community organization, or a community health worker often knows which local providers are respectful and skilled with your community.
  • Consider telehealth. If no one nearby fits, a video or phone visit can connect you with a provider farther away who speaks your language, with an interpreter if needed.
  • Call 2-1-1 to reach a local operator who can point you to culturally specific services near you.

There is no single right way to get help. The goal is care you can trust and understand.

Sources

LINC is a research prototype, not a medical or legal service. Translation can be wrong; you have the right to a free, qualified interpreter. For anything high-stakes, do it with a community health worker or someone you trust. In a crisis, call or text 988, or 911 for immediate danger.