Cultural Differences and the Experience of Mental Disorders

Individuals from all cultures may have episodes of depression. How each person experiences depression, however, may differ considerably. Some cultures focus more on physical ailments than psychological distress. A depressed person may complain of a stomach ache instead of emotional sadness. In Puerto Rico, people may react to severe stress with symptoms such as heart palpitations and fainting. If a Puerto Rican immigrant displayed this behaviour in western society, he or she may be misdiagnosed (Guaraccia, et al, 1990).

doctorJust as some cultures and sub-cultures place value on showing emotion, other cultures prefer to avoid such displays. In many cultures to ask for help from a mental health practitioner is a sign of weakness. Any emotional problems should be dealt with by family only. In these cultures, discussing personal problems with a stranger is considered disrespectful. Interestingly, certain disorders appear to be the product of specific cultures. For example, eating disorders such as bulimia and anorexia are very much a Western affliction while a syndrome called Koro occurs in some Asian countries. A third case study (summarized from the DSM-III-R Case Book) describing a man with Koro is included at the end of this lesson.

Each culture has its distinct history and set of beliefs. When treating the mentally ill, practitioners need to be aware of these beliefs. For example, does the patient believe that abnormal behaviour is caused by germs, the “evil-eye”, or “too much bile gone to the head”? How do people usually treat disorders? Do they make coriander tea, take a pain killer, or wear a talisman (Adaskin et al., 1990)? The adjustment of immigrants to a new land does increase the risk of many health-related problems. According to Adaskin et al., immigrants often experience much stress; they may not speak the language, they no longer have the support of friends and family from the homeland, and they may experience a loss of status and self-esteem because occupations for which they were trained are often closed to them in North America. Doctors may work as hospital orderlies and teachers as store clerks. These changes greatly challenge their health – both mentally and physically.

When interacting with people of different cultures the differences in social norms can be quite large. In Canada, for example, many European descendents follow informal rules regarding social distance, hand gestures, eye contact, and facial expressions. The information that follows briefly describes what may be observed in Canadian society.