Depression: A Cross-Cultural Perspective

Human beings have experienced psychological disorders since the ancient ages which can be categorized into different groups. Psychological or otherwise known as mental disorders can be defined as patterns of behavioral expression or mental symptoms that can have various impacts on someone’s normal life (Anderson, 2002). Usually, they make the individual to be greatly distressed. There are several psychological disorders which have been diagnosed and listed in the psychiatric universal records.

They include adjustment disorders, anxiety disorders, cognitive disorders, dissociative disorders, impulse-control disorders, and mental disorders as a result of a general medical condition like depression due to diabetes. Clinical depression, one of the psychological disorders, can be defined as a mental illness that affects both the emotional and physical behavior of an individual over a period of several weeks (Anderson, 2002).

It is characterized by such feelings as worthlessness, suicidal tendencies, sense of guilt, failure in concentration and decision-making, fluctuating appetite and sleep patterns and general loss of interest or pleasure. The depressed person will also exhibit weird behavior like shouting, violence, agitation, drug abuse, and general difficulty in social relationships. There are different perspectives of regarding depression as a psychological disorder.

This research paper seeks to explore depression from a cross-cultural perspective with key focus on the conceptions of depression, its epidemiological aspects, different manifestations of depression, the evaluation of depression as a disorder, and the various hypotheses concerning depression.

Under ordinary psychiatric diagnosis, depression has been regarded as being due to biological, genetic and psychological factors (Aldwin & Greenberger, 1997). Just like any other disease, depression has got no single cause. Extreme levels of neurotransmitters found in the brain caused by varying levels of body hormones can result in depression at a biological level. Other types of depression are genetic and can be inherited down the family lineage and in most cases result in bipolar disorder.

Stressful experiences at work place, school, or home can play a significant role in the onset of depression among persons with the genetic makeup that increases the vulnerability of falling ill. Furthermore, recent research suggests that major depression can be experienced as a result of psychological changes involving the structure and functioning of the brain. These causes are the ones that have been clinically diagnosed by psychiatrists.

However, there seems to be other perspectives of looking at depression among human beings, especially across different cultures and religious inclinations. Current researches into depression focus mainly on its cross-cultural understanding with an aim of investigating specifics and universals in its experience.

According to recent research, different cultures have greatly varying experiences of depression despite the core syndrome being universal across the cultures. This reflects how the meanings of illness can be generated within a given social context (Schwab & Schwab, 2002).

Culture can be defined as an external and internal variable within a given society which involves both practices and representations in terms of beliefs, knowledge, and ways of thinking, attitudes, and other hosts of subjective experiences. There are forces associated to a particular culture that enhance, shape, and carry on mental disorder. Many researchers have argued that virtually all emotions are a result of social experiences and hence depression as an emotion is socially contrived.

The emotional behavior of individuals is judged relative to the standards set within the given social context (Karasz, 2005). It is therefore crucial to note that these cultural factors play a central role in the quest for accurately understanding depression as a disorder.

Research findings reveal that women score higher compared to men across most cultures when it comes to vulnerability of being depressed. In Ghana, women who experience depression at the age when they can no longer bear children, otherwise referred to as menopause, consider it to be as a result of evil spirits and sorcery (Field, 1990).

In this case, if a woman becomes depressed, the society will not consider it as a mental illness. No medical help would be sought if such a woman was nervous, restless, lacked sleep, and other behavioral manifestations due to the cultural teachings in place concerning such experiences. It would be a struggle in vain to try and challenge such beliefs head on. Understanding the culture and trying to explain the medical perspective in a more clear language that can be comprehended by the lay people is recommended.

A research conducted by Bashiri and Spielvogel (1999) revealed that women are at more risk of experiencing depression compared to men across different cultures. There is a period during which there is increased risk of experiencing mental disorders and is normally called the postpartum period. It is commonly reported among new mothers.

The report further suggests that about 10% to 15% of new mothers in North American and Europe are prone to depression. The ability to detect this depression especially among new mothers demands the recognition of symptoms of depression. It may also require special screening using specialized/standardized instruments which may prove difficult when handling women from diverse cultures.

For instance, the Edinburgh Postnatal Depression Scale (EPDS) cannot be used to detect depression among Japanese women. Depression in Asian, Hispanic, and African cultures are commonly expressed through somatization. In western cultures, however, depression is mostly expressed through guilt feelings and complaints of sadness as compared to the Asian, Hispanic, and African cultures (Schwab & Schwab, 2002).

Moreover, lower incidences of depression among Asian women in their home country were reported as compared to the immigrants in North America who reported higher rates of postpartum depression. This raises concern in the ways of assessing depression across cultures. Many psychiatrists use the conventional ‘Western’ ways to assess depressive disorders and ignore the consideration of ethno-cultural dimension.

As far as handling depression is concerned, cultural differences play a great role. In the Hispanic, Asian, and African cultures, postpartum rituals are performed in order to help new mothers cope with their motherhood lifestyle.

In the United States, immigrant mothers are encouraged to perform their respective rituals in order to relieve the risk of depression resulting from stress due to accumulation. As time goes by, the US and the European states are continually becoming multicultural and psychiatrists will want to familiarize themselves with the diverse rituals that assist in the transition to parenthood.

When treating depression, the use of description is unavoidable. However, the words used do vary greatly from one culture to another. Describing depression has two approaches which are both essential. Firstly, depression can be described as a feeling of sadness. Secondly, it is an illness that one can suffer from.

In many cultures, it may be much easier to find words to explain depression as a feeling of sadness. However, it may not be easy at all to describe depression as an illness. This fact calls for a deeper understanding of word usage in a given culture in order to clearly describe depression both as a feeling and as an illness.

Furthermore, different societies have different convictions concerning how depression can be treated. They seek assistance from different alternatives ranging from religious or traditional health care providers to modern health care services like counseling (Aldwin & Greenberger, 1997).

This diversity is due to various reasons. Modern medical services cannot provide answers to all health issues especially mental disorders. Therefore, people will seek divine intervention from priests, pastors, prophets, or traditional medicine men and magicians. These efforts are mostly driven by the belief that depression is caused by other supernatural forces.

As mentioned above, counseling is one of the methods of handling depressed individuals. It is the commonest method used in the Western societies. Just like any other method, counseling has developed within the western culture and is mainly based on psychological theories.

Prominent personalities conducted their researches on understanding and explaining mental disorders and were universally accepted within their cultures (Karasz, 2005). However, the theories are strange in other non-Western cultures and hence may not work effectively in the treatment of depression among such people. Besides this underlying fact, appropriate and locally accepted counseling approaches can be used successfully in these cultures.

It has been established that depression includes a wide range of mental disorders that differ significantly in their degree of severity and period of time over which it is experienced. The accuracy in understanding depression, therefore, calls for cultural, psychological, and biological consideration. Future researchers should concentrate on all the three key perspectives of depression.

This paper has broadly explored depression from a cross-cultural perspective. It has mainly focused on the various conceptions of depression, the assessment approaches used, epidemiological aspects, and the different cultural theories and hypotheses on depression. We can therefore conclude that the discussion of depressive disorders can never be complete without exploring the cross-cultural dimension.

References

Aldwin, C. & Greenberger, E. (1997). Cultural Variation in the Conception of Depression. American Journal of Community Psychology, 15 (6), 325-367.

Anderson, C. A. (2002). Depression: A cross-cultural Consideration. Personality and Social Psychology Bulletin, 32 (4), 427-442.

Bashiri, N. & Spielvogel, A. M. (1999). Postpartum depression: a cross-cultural perspective. A Journal of Psychiatry Update, 6 (3), 82-87.

Field M. (1990). Search for Security: An Ethnographic Study of Rural Ghana. A journal of Cross-Cultural Findings, 5 (2), 123-154.

Karasz, A. (2005). Conceptual Models of Depression: A Cultural Perspective. A Journal of Family and Community Health, 26 (7), 1425-37.

Schwab, J. J. & Schwab, M. E. (2002). Culture and Mental Illness: An Epidemiological Survey. American Journal of Community Psychology, 3 (6), 789-812.

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