On the surface, it may appear simple. Depression is a disorder that can impact any individual—regardless of race, ethnicity, class, age, sex, or sexual preference. Technically, this is true. However, cultural expectations can very much influence the entire experience. The risk factors, symptoms, and treatment options are similar in any geographical area. The perception? That’s a different story.

Meanwhile, you must never ignore depression or take it lightly. It is a disorder that can result in self-harm and suicidal ideation. How, then, do we approach treatment when cultural expectations move the goalposts? Attempting to answer that question is an evolving process.

What Do We Mean By “Depression?”

Across all cultures, there are misconceptions about this particular mental health condition. Feeling “depressed” is not the same as being diagnosed with a Major Depressive Disorder. It’s not even close.

Everyone gets sad or lonely at times. Anyone can struggle through times of low self-esteem. These are normal and inevitable parts of life. To be diagnosed with depression, you must be displaying five or more of the following symptoms for at least two consecutive weeks:

• Being in a depressed mood almost all day, every day

• Marked loss of energy

• Significant changes in sleep patterns (too much or too little)

• Feeling worthless, hopeless, or guilty

• Unable to enjoy activities that once gave you pleasure 

• Noticeable changes in weight and/or appetite 

• Restlessness 

• Decrease in concentration and the ability to make decisions 

• Chronic thoughts of death, dying, or suicide 

Clearly, this is much more than feeling blue. Never underestimate the potential symptoms of depression. 

What Do We Mean By “Cultural Expectations?”

Depending on a person’s religion, nationality, ethnicity, age, gender, class, etc., the symptoms of depression may be viewed quite differently. In some countries, depression is identified almost exclusively via its physical signs. Also, each culture may define “suffering” differently and, in turn, perceive it differently. 

In other words, a man in one location could be shamed into silence if he talked about feeling worthless. Meanwhile, in another setting, even the tiniest mention of such a self-perception might be instantly medicalized. 

Translation: When treating clients in a culturally diverse country like the U.S., cultural expectations must be discerned and factored in. 

Treatment Across Cultures

There is some good news in this area. As the world metaphorically shrinks, people are exposed to ideas that were once not in their normal realm of thinking. For example, certain psychotherapeutic modalities that are popular in the West (especially the U.S.) are gaining traction in other parts of the globe. Meanwhile, a concept like mindfulness that was once identified with the East is fairly established elsewhere. That said, this is not a situation to be left to chance. 

Some ideas to ponder if you think depression and cultural expectations are colliding in your life:

• If someone in your family is displaying signs of depression, get them assessed. However, take the time to consider cultural factors before suggesting a consultation or visit.

• Take stock of your own mental well-being. Are you shrugging off red flags due to years or decades of cultural conditioning? It could help to speak with a therapist to answer this question.

• Before choosing a mental health practitioner, find out how culturally aware and sensitive they are. You will not benefit from a one-size-fits-all approach. You need personalized care. You need a counselor that takes your beliefs and perceptions into account.

Now What?

Clearly, these intertwining issues can sometimes present quite a challenge. Therefore, the best first step is to get more information. With that in mind, I invite you to reach out. I’d love to speak with you during a free consultation and find out more. 

Learn more about Depression Therapy.