One of my clients, Mary*, crossed the border into the United States with her mother when she was five years old.

When she came to see me as a teenager, she was deeply depressed. She didn’t see the point in going to high school or working towards a career—because she was undocumented, how was she going to go to college, or get a job?

Mary is not alone. Around 345,000 children of undocumented immigrants attend public schools in the state of New York. Their parents’ legal status has a real and profound effect on their everyday lives—including their mental health.

Last week, the Trump administration released details of its new immigration enforcement policy.

The policy expands the number of people who are targeted for removal, and who can be deported immediately, without hearings. This, combined with the increasingly hostile rhetoric surrounding immigrants, and the first ICE (Immigration and Customs Enforcement) raids under the Trump administration, has had a significant impact on the mental health of my clients. Even though ICE still primarily targets undocumented individuals with criminal records (i.e. felonies, assaults, DUIs), the fear of being deported has become more intense throughout the whole immigrant community —even those who are permanent U.S. residents.

As a social worker at Mount Sinai Adolescent Health Center, I work with young people in New York City every day. Most of my clients are low-income people of color, and many have experienced trauma in one form or another. Even though it’s often discussed in relation to war, trauma can be any emotionally painful and distressing experience. A lot of different immigration experiences are traumatic, from being abused by coyotes to travelling in tiny, hidden compartments, to being suddenly separated from family.

However, you don’t have to experience trauma first hand to develop symptoms of Post-Traumatic Stress Disorder (PTSD), such as hyper-vigilance, hyper-arousal, intense fear, hopelessness, and nightmares.

If someone is constantly exposed to the trauma symptoms and coping strategies of a loved one, they may develop those symptoms as well. This is known as secondary traumatization.  It can affect youth who were born in the United States but have undocumented family members.

These young people know that they have family members who are at risk for deportation.

Many pick up on their family members’ fear, and it influences how they experience the world and relate to others.  They may notice that their dad flinches and grows quiet when he sees a police car.  As a result, young people may develop a deep distrust of law enforcement, and are much less likely to report crimes and abuse. Young people may even unconsciously mimic some of the behaviors and coping mechanisms of their loved ones, especially their parents. This could mean avoiding situations that cause stress, remaining constantly on guard, or even abusing alcohol or other drugs.

In addition, I have clients who end up constantly watching or reading the news.

While it’s great to be informed, thinking constantly about deportation can affect your emotional health in a serious way. Young people may find it hard to fall asleep, only to have nightmares when they finally do. Lack of sleep can affect your memory, concentration, impulse control and mood. This means that it’s harder to pay attention in class, to eat healthily, and to keep yourself from snapping at the people you care about. It may also make symptoms of anxiety and depression even worse.

Many people who are undocumented avoid getting the help they need because of their status.

It’s on every medical provider and social worker to fight the stigma of being undocumented. Language matters. I prefer to say “undocumented” instead of “illegal” because the word illegal implies that someone is a criminal, which the vast majority of undocumented immigrants are not. Not having immigration documents does NOT make someone “bad,” but this is still a common misconception that many young people internalize.

But this doesn’t mean that young people with undocumented family have no options.

Mary, my undocumented client dealing with depression, improved dramatically after she realized just how resilient she was. Resiliency isn’t a trait that you have or don’t have—it’s a skillset that anyone can cultivate within themselves. Being resilient means being able to respond and adapt to tough situations. It involves being able to make plans, view yourself positively, and recognize and manage your feelings. It does NOT mean that you don’t feel pain, anger or sadness.

Without a doubt, DACA (Deferred Action for Childhood Arrivals) helped Mary tremendously. After it went into effect, Mary got a scholarship to college and began to plan her future. Her mood certainly improved. But Mary was able to take advantage of those opportunities because she put the work into her own mental health and, with my help, cultivated her own resilience.

If you cannot concentrate at school, find it hard to fall asleep, or can’t motivate yourself to go to school or work, consider talking to a therapist or medical provider.

Medical and mental health providers will not report undocumented immigrants to officials. We are here to help and support you. If you live in New York City and are 10-22 years old, Mount Sinai Adolescent Health Center will give you completely free, confidential mental health services. We also provide free legal services if you want advice or to learn more about your rights. We will not ask about your immigration status.

Next week, we will talk more about specific actions that young people with undocumented family can take to stay safe and take care of their mental health.

*Mary’s name has been changed to protect her privacy.

Susann Cortes, LMSW is a social worker who provides individual short-term and long-term therapy for adolescents at the Mount Sinai Adolescent Health Center.  Susann is passionate about exploring and maximizing individuals’ inner strengths and talents while validating their life experiences, including trauma, and genuine motivation for change.  She specializes in trauma, PTSD, and behavioral therapies.

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.