Expression and Treatment of Depression among Haitian Immigrant Women in the United States: Clinical Observations

By Nicolas, Guerda; DeSilva, Angela M. et al. | American Journal of Psychotherapy, January 1, 2007 | Go to article overview

Expression and Treatment of Depression among Haitian Immigrant Women in the United States: Clinical Observations


Nicolas, Guerda, DeSilva, Angela M., Subrebost, Kelly L., Breland-Noble, Alfiee, et al., American Journal of Psychotherapy


Existing research demonstrates that culture has a profound impact on the expression and manifestation of mental illness, especially on depressive disorders among ethnically diverse populations. Currently, little research has focused on the Haitian population, despite the growing number of Haitians living in the United States. This paper discusses clinical observations of the expression of depression among Haitian immigrant women living in the United States. Specifically, this paper examines three distinctive types of depression (pain in the body, relief through God, and fighting a winless battle), explains their symptoms, and provides case examples to illustrate the expression of each type of depression. Additionally, the paper describes treatment processes for each type of depression and makes recommendations to mental health providers with respect to each type of depression. The information provided in this paper highlights the importance of a more systematic and scientific investigation of depression among Haitian women, men, and youths in the United States.

EXPRESSION AND TREATMENT OF DEPRESSION AMONG HAITIAN WOMEN IN THE UNITED STATES: CLINICAL OBSERVATIONS

Culture significantly influences the way individuals from various cultural backgrounds experience and express depressive symptoms (Carter, 1995; Lutz, 1985; Kleinman & Kleinman, 1985; Manson, Shore, & Bloom, 1985; Sue & Zane, 1987; Ward, Sellers, & Pate, 2005). Specifically, researchers have outlined the ways in which individuals from different cultures present with depression (Brown, Schulberg, & Madonia, 1996; Kleinman & Kleinman, 1985; Lutz, 1985; Manson, et al., 1985; Sue, Fujino, Hu, Takeuchi, & Zane, 1991; Sue & Zane, 1987; Ward, et al., 2005). These studies have found that an individual's cultural background influences both the manifestation of the illness as well effective and appropriate interventions. This paper addresses the impact of culture on the diagnosis and treatment of depression by first reviewing current literature related to several ethnic groups, and then providing a description of some types of depression found among one specific ethnic group, which has not yet been examined - Haitians. Although this paper does not discuss the nuances of each specific ethnic group, the following review of some cultural groups highlights the profound impact that culture has on the diagnosis and treatment of mental illness.

CULTURAL EXPERIENCE of DEPRESSION

Research on specific ethnic groups shows how culture plays a role in the experience of depression among various ethnic groups. For example, in a comparative study of Australian and Vietnamese nursing students' perceptions of depression, Fry and Nguyen (1996) found that culture and self-concept influenced the experience of depression. This study revealed that the Vietnamese students believed that a "superior person" would not allow troubling thoughts or emotions to overtake his/her life. The researchers describe this belief in comparison with Australian students, who identify with Western belief systems, and do not subscribe to the notion of control over one's feelings versus seeking help for suffering (Fry & Nguyen, 1996). The results of Fry's and Nguyen's (1996) study illustrate one way culture can affect an individual's understanding and experience of depression.

In another study examining culture's influence on depression, Brown and colleagues (1996) conducted a comparative study of the psychiatric history and presenting symptoms of African Americans and European Americans suffering from major depression. Results of the study indicate similarities between African Americans and Whites in primary mood symptoms and condition severity. Differences existed, however, in their experiences of somatic symptoms, psychiatric and medical comorbidities, physical functioning, and levels of observed distress. Whereas the White individuals were more likely to report mood disturbances, African Americans focused on physical symptoms and psychosocial Stressors. …

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