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Depression in South Asian Culture

It has recently been revealed that mixed anxiety and depression is the most common mental disorder in Britain. Statistics published by the Mental Health Foundation has found that 9% of the people meet the criteria for diagnosis. Depression is a mental illness that is becoming more frequently explored and understood by society. However, there is often the need to demand it to be taken seriously, particularly from those who come from an Asian culture. More studies are beginning to show the relation between the treatment of depression and race, revealing that some societies are more understanding of the illness than others.

The race a person belongs to can absolutely affect the way depression is dealt with. Naseem Joban is a university lecturer of Psychology but also works in a clinic to help people with mental disorders. She worked a lot with South Asian women in her time working in a clinic in Southall, an area predominantly belonging to that race. She says that South Asian women in London were almost “a forgotten group of people”, not being offered sufficient help. “They weren’t offered any counselling but not just that, there wasn’t the support mechanisms of other women, other people.” Naseem suggests that doctors are slowly becoming more aware of depression in Asian communities but that it isn’t good enough. “They’re slowly realising that there is an issue that needs to be dealt with but the services are still not really out there to support Asian women.”

Naseem suggests that there is a huge stigma surrounding depression and the way it is perceived. She says that it is brushed off, not really seen as being a mental illness. “It’s a little bit more than just that. There some sort of an emphasis for people to ‘snap out of it’, or that they’re making it up and there’s a lot of force involved.” She points out that sufferers are undergoing a loss of control and that the South Asian community fails to understand it. “There’s a lot of blame and judgment, it isn’t just ignored.”

The South Asian culture is known to label problematic issues a taboo. Therefore discussion and open dialogue is not made use of to progress the South Asian community into the changes of the 21st Century. Depression has proven to be amongst the unspoken taboos. Sayed Sabzvari is of Pakistani origin and he believes it to be difficult to be Pakistani and suffering from depression. “People tend to shy away from admitting that they are depressed. It's like showing weakness. The rare occasion that someone does admit it, they do so to close ones” Sayed admits that he has not told his family that he is suffering from depression. “If they know they are going to just overwhelm me with questions and make me more depressed than do anything to help.” He also goes on to say that many people don’t know how to handle the situation if they find out someone is depressed. His sister is the sole person he has told stating, “she’s easy to talk to and she’s the only one I can talk to”.

Anita is a young adult of Indian descent, finding her way through university. Her depression started when she left college and has been more deeply affecting her since she has entered university. “A lot of people have very little understanding and knowledge about depression. People might see you down all the time and not know you’re depressed. They don’t know how to deal with you or how to act around you, which makes it increasingly difficult to try and overcome.” She also reveals that being a British-Indian can actually make things even more difficult “I think is actually admitting a problem and that happens with loads of other issues such as marriage problems or disability like learning disability. Another thing is taking medication. I feel like there's this weird thing in Asian cultures where people don't want to take medication and I've been like told by a few family members don't take any meds that the doctors try to give you.”

A research agency called Ethnos shed light on judgment that sufferers may face within their community in a mental health survey on ethnic minorities. A third of South Asian people report experiencing some form of discrimination from within their own communities because of their mental illness. Anita also mentions that her Indian heritage requires every member of the family to play in active role and to be social. Acting otherwise may break ties with the community, ultimately isolating the person with depression further and therefore possibly worsening the level of depression. “Depression is disregarded as a serious problem. It is seen as a ‘phase’ that will be overcome with time rather than with treatment, whether they be medicinal, religious, or societal”. Research by the charity Mind has revealed that middle-aged Punjabi women understand the meaning and effect of depression but they see it as a natural process of life. This therefore results in them preferring to attend services at a religious institute, instead of seeking medical treatment or advice by a doctor.

Sulafa Yassin is a psychotherapist who describes depression as an experience of “low moods and a loss of interest and pleasure for the majority of the day”. She emphasizes the need of treating depression through early intervention, stating “therapy is more likely to be successful in addressing the depression if it is addressed in its early stages.” Depression can have a ripple effect; once it has affected the person it goes on to impact family, friends, sometimes even the surrounding community. “The community, if it does not understand the process of depression, tends to isolate the individual.” This has been more evident in South Asian communities where the person is seen as strange or antisocial. “In some cultures it is difficult to accept depression as a clinical diagnosis and thus no treatment is sought. At times this rejection of the diagnosis is from the individual but can also be from the families.”

Sulafa’s experience with South Asian clients has also supported the claim that it is more difficult to treat depression in the culture. “I have found that some clients (regardless of their cultural background) will refuse a diagnosis of depression believing that one can easily overcome their symptoms without any professional intervention. I have also found that in some cases the individual or family may attribute the cause of their symptoms to something else for example 'evil eye', 'black magic' etc. So they seek alternative spiritual intervention.” However, it is difficult to place blame on a community when it is essentially down to the family. “Although I do believe culture can play a role in the influence of overcoming depression, it is only because of the influence it might have in effecting whether the diagnosis is accepted and how open an individual or their family is to professional intervention.”

Stacey is the same age as Anita, but the response she received was different. “I really think community can help depression. I think the first stage to overcoming depression is recognising how you're feeling and realising that it's okay to feel like that.” Stacey also points out that British culture has a “stiff upper lip” mentality of not showing emotions. “You are unable to express how sad or anxious you are to anyone because showing extreme emotions (especially at work or school) is seen as odd.”

Stacey’s mother also suffered with depression, which made it easier on her. She had the right support system from her mother that played a hand in overcoming her depression. Her school, whilst giving mixed reactions, also played a role in helping her: There was no sense of guidance and support or care from the senior management. Some individual subject teachers who knew me well knew that I wasn't acting normally so they did support me in a way, enough to make it through my a levels”. Her teachers were White British, as is her mother, suggesting that their understanding gave her a coping mechanism until she learnt to heal in her own way.

Although Stacey believes that the White/British culture also represses the expression of depression, like the South Asian culture, through her answers and speaking to more sufferers it is evident that it is not the same. “My spirituality and faith helped the process also, the belief in a God that loved me and had a plan for my life gave me a small security and sense of purpose that kept me fighting the depression.” And Stacey, unlike Anita was able to turn to medication, “It helped me cope with the big tasks, until I felt ready to take control of my life again and come off them.” As Stacey said, her mum went through depression so it was easier for her, however if Stacey’s mother belonged to the South Asian culture, it is easy to assume her mother would have been reluctant to addressing the issue directly and being open to Stacey taking medication as an option.

Within the South Asian community, adherence to social norms such as doing well academically, being married, and maintaining a visible social life, is key to sustaining respect. Mental illness tends to disrupt these norms. Distinctly, white British culture has modernised in terms of values. The average white British person is not appraised for their decision to remain unmarried and to focus on other aspects of their lives. The pressure of the culture can severely influence a person in their solution to overcoming depression. The lack of openness in discussing depression in South Asian communities aids the stigma surrounding it. It consequently becomes a cycle that is passed down through generations, disabling the opportunity for expression and ultimately makes asking for help more difficult.EndFragment

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