Cultural Dimensions of Depression in Bangladesh: A Qualitative Study in Two Villages of Matlab

Abstract

This article reports the results of a qualitative study conducted in two villages of Matlab to explore the cultural dimensions of depression. Participants included adult men and women with and without a history of depressive episode (n=42), formal and informal healthcare providers (n=6), and caregivers (n=2). Adults (n=10) with a history of depressive episode were selected from a 2005 survey conducted by ICDDR,B. A case vignette was used for eliciting local terms for depression, perceived causes, impact, and treatments. Hardly anyone recognized the term bishonnota (literal translation of depression) used in the past survey. The participants thought that the vignette was about chinta rog (worry illness), and they spoke of somatic symptoms in relation to this condition. When explored further, they mentioned sadness and psychological complaints. Men felt that it affected them more while women felt the opposite. They associated chinta rog with poverty and social issues with impacts on marriage, work, and education. From their responses, it seemed that they preferred a psychosocial framework attributing the cause to thoughts and emotions, resulting from social causes. Commonly-suggested treatments were more income, better relationships, and tablets. Former health providers were often the first choice for help-seeking. The study hopes to ‘culturally inform’ the formal healthcare providers and programme planners.

Epidemiology of depression in diabetes: International and cross-cultural issues

“…For example, research among South Asian populations has shown that patients with depression usually link their depressive symptoms to different causes, for example any upsetting conditions, accidents or daily occurrence of events, unfavourable living conditions, financial problems or physical illness, and therefore consider it as a natural occurrence Chodhury, 1979;Farooq et al, 1995;Salim, 2010). In our own research, individuals with diabetes reported that problems with managing their diabetes led to feelings of low mood and hopelessness .…”

“…The actual term 'depression' itself is often absent from the languages of many cultures or rarely used (Salim, 2010;Hamdi et al, 1997;Manson, 1995), or it is construed differently Bhugra and Mastrogianni, 2004;Lee, 1998).…”

“…Earlier (western) studies suggested that somatisation (the process by which psychological distress is 'converted' to somatic symptoms) was the cultural equivalent of depression, typically occurring in non-Western cultures (Patel, 2001). However, there is now growing evidence from studies in primary and general health care settings that somatic symptoms are common presenting features of depression throughout the world regardless of cultural background Chowdhury, 1979;Farooq et al, 1995;Katon and Walker, 1998;Simon et al, 1999;Salim, 2010;Desjarlais et al, 1995).…”

“…Reporting somatic symptoms depends on how somatisation is defined crossculturally (Simon et al, 1999;Lynch and Medin, 2006;Salim, 2010). Some symptoms may be universally recognised and some culturally distinct, but all are meaningful within particular cultural contexts.…”

Food Insecurity Mediates the Effect of a Poverty-Alleviation Program on Psychosocial Health among the Ultra-Poor in Bangladesh,

“…In a qualitative study of the social construction of psychosocial health and its underlying causes in rural Bangladesh, local informants identified poverty as the main cause of poor psychosocial health (36). Poverty was defined as a chronic shortage of everyday necessities and/or the inability to meet daily needs.…”