Gayle Shepardson, Chatham High School and Brian, Wayland High School

Depression: a cross-cultural examination

 

Treatment of Depression - and Treatment Issues

United States
 
Himalayas

Love and work

Family

Exercise

Diet

Social connections-
Religion, neighborhood, activity groups

Volunteering-
giving of one's self

Ways to avoid depression

Avoid introspection - self-centered reflection on one's life and one's past. Avoid the circumstances that can lead to introspection - such as being alone. If someone tries to lead you to discuss introspective thoughts/feelings minimize how much you talk about these things. (Desjarlais, 113-115)

Keep focused to avoid slips of attention when you would be susceptible to witch harm; avoid thinking of far off places and past emotional memories because your heart-mind (sems) will go there and can unbalance you/ distract you.

Keep ritual purity of body and as far as possible of mind. Accumulate merit for karma's sake.

Medication - tricyclics and SSRIs (e.g. prozac) to restore proper balance of neurotransmitters

Forms of treatment
Self-guided recovery- seek out your friends and family.
Individual Therapy - traditional counselling to work through conflict; "anger turned inwards" orientation Shaman intervention - "family summons a ... shaman (who) divines how the spirit was lost, where it has wandered, and how best to retrieve it. He then ritually searches for and attempts to 'call' the lost life-force back into body of his patient." (ibid, 13) - see side link for more on shamanism and shaman related treatments

Cognitive-behavioral treatment - removal of distorting beliefs and replacement with appropriate explanations of real life events; reward systems for positive behavior

Family therapy

Communal support - e.g for mourning deaths there are rituals to perform at regular intervals after the death up until a final ritual one year after the death. (ibid, 143)

Songs are widely used to highlight expected future areas of grief and to teach people the accepted process of how to work through that grief - (ibid, 121) - this can be compared to the "Blues" in the U.S. culture. - These songs allow people to voice emotions that aren't socially accepted when voiced as a personal problem/discussion. Here are two examples:

Lice fill my hair
but I've no mother to extract them
thoughts fill my heart
but I've no mother to explain them to
(quoted in ibid, 116)

and:

My father, my father
why has your life been shortened
father when your life was shortened
your daughter found herself to be nowhere
(quoted in ibid, 106)

In fact, a correct translation of the poem/songs cited above would not include any personal pronouns.

Medication and therapy can both be effective but it is best to combine cognitive-behavioral therapy with medication

Placebo effect.

Efficacy issues

Shaman intervention works best when the cause of distress is inter-personal or social, not when the cause is a purely somatic complaint. (ibid, 228)

Placebo effect

Stress

Individualism

Insufficient grieving mechanisms of mainstream society

 

Sample cultural issues
Western style counseling would not work because the person does not want to discuss what is in their heart-mind (sems).

Negative cycle - when someone is feeling depressed and most needs social support, their friends and family members tend to stay away.

Above a dead tree,
No birds circle
Around a daughter feeling tsher ka,
Neither friends nor family come (quoted in ibid, 104)

 

This site was created by Brian Newmark and Gayle Shepardson at the NEH Summer Institute "Cultures and Religions of the Himalayan Region," held at the College of the Holy Cross, Summer 2006