Seeing Depression Through A Cultural Lens

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.

Barry S. Fogel, M.D. is an academic psychiatrist and neurologist, Professor of Psychiatry at Harvard Medical School, and a physician at the Brigham and Women's Hospital Center for Brain/Mind Medicine. He has devoted his career to the study and improvement of care at the interface of psychiatry, neurology, and general medicine. He co-founded the American Neuropsychiatric Association and the International Neuropsychiatric Association. His current research focuses on analysis of big data to assess the impact of personal identity on the presentation on outcomes of depression, and on developing a new drug for neuropsychiatric disorders including movement disorders, PTSD, autistic stereotypies, and tinnitus.

Xiaoling Jiang, Ph.D. is a scholar of comparative literature and culture. She received her higher education in China, Japan, and the United States. She served on the faculties of Kobe University and Harvard University, and was on the editorial board of Culture Studies, China's leading journal of comparative culture. She is fluently trilingual, and personally tricultural. Since completing her work on this book, her academic focus has been the mental health of Asian college students in English-speaking countries and its relationship to issues of cultural identity and cultural conflict.

Preface

Part One: Constructing the Cultural Lens
Chapter 1: Picturing Depression: Faces, Backgrounds and Foregrounds
Chapter 2: Faces of Clinical Depression
Chapter 3: Beyond Shades of Gray: Depression and the Bipolar Spectrum
Chapter 4: Dimensions and Implications of Cultural Identity
Chapter 5: Cultural Identity and Personal Biography
Chapter 6: Unnatural Deaths
Chapter 7: Depression and Social Class: A Four-Dimensional View
Chapter 8: Cultural Correlates and Clinical Consequences
Chapter 9: Ancient Wisdom Meets Modern Science: Depression in Traditional Medicine

Part Two: Depression and the Cultures of Places
Chapter 10: China: Confucian Harmony and Dissonance
Chapter 11: Japan: Invisible Double-Edged Swords
Chapter 12: South Korea: Han and Passionate Intensity
Chapter 13: Depression in the "World's Happiest Countries"
Chapter 14: American Regional Cultures and the Geography of Mood

Part Three: Depression and the Cultures of Occupations
Chapter 15: The Dark Side of Creative Talent
Chapter 16: Physicians in Pain: Depression in the Medical Profession
Chapter 17: Flying High, Feeling Low: The Mental Health of Airline Pilots
Chapter 18: Truck Driving Blues

Afterword

Acknowledgments