"Like a photographic portrait, a picture of a person's depression shows a face, connected to a body, framed by a background, and set within a foreground. As a person might have a prominent forehead, a dimple in her chin, or a few missing teeth, an individual's syndrome of clinical depression strongly expresses some characteristic symptoms and expresses others weakly or not at all. In the background are many transpersonal features that influence mood and its somatic and behavioral expressions, including cultural norms and social determinants of health. In the foreground are individual circumstances that caused or contributed to the person's illness, and ones that currently offer hope or worsen despair. Depending on the photographer and when the photo was taken, background and foreground are complex or minimal, blurred or in focus. Lighting might accentuate or attenuate specific facial features - as diagnostic criteria for Major Depressive Disorder count some symptoms of clinical depression and exclude others. The entire body might be visible or just the head - as general health issues, nutritional state and biomarkers are variably included in a case history"--
Seeing Depression Through a Cultural Lens, the collaborative work of a clinical neuroscientist and a scholar of comparative culture, examines the effects of cultural identity on the epidemiology, phenomenology, and narratives of depression, the bipolar spectrum, and suicide. Culture is associated with emotional communication style, 'idioms of distress,' the conception of depression and of bipolar disorders, and how people with mood disorders might be stigmatized. It is linked to structural factors--environmental, social, and economic circumstances--that create or mitigate the risk of depression, sometimes precipitate episodes of illness, and facilitate or impede treatment. Culture shapes depressed people's willingness to disclose or acknowledge their condition and to seek care, their relationships with clinicians, and their acceptance or rejection of specific treatments. Cultural context is essential to understanding suicide. It underlies people's motives for suicide, factors
that promote or prevent suicide, the social acceptability of death by suicide, and availability of lethal means of self-harm.
Cultural identity is always intersectional, comprising elements related to race and ethnicity; gender; age, generation, and life stage; education; social class; occupation; migrant or minority status; region of residence; and religious belief and practice. This book explores the implications of each of these dimensions using salient concepts from the social sciences, memorable narratives from literature, film, and the clinic, and quantitative findings from epidemiology and psychometrics. It offers readers a framework for culturally aware assessment and management of depression, bipolarity, and suicidal risk in diverse individuals and populations.
