Major Depressive Disorder (MDD) is a problem affecting many populations, especially among women. MDD is a recognized condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM), with the signs, symptoms, and causes varying among individuals. Sociocultural factors including economic status, marital status, lifestyle changes, and substance use may influence the development of depression disorders among women throughout the world.
This paper will explore these factors and their relationship to the development depression disorders in women and a brief plan for further research from a critical perspective examining the perception of depression among women who suffer from depression. Developing social programs to assist women who suffer from depression and preventing further occurrences of depression is the ultimate goal of further research. The Canadian Mental Health Association states, “Someone experiencing depression is grappling with feelings of severe despair over an extended period of time.
Almost every aspect of their life can be affected, including their emotions, physical health, relationships and work. For people with depression, it does not feel like there is a flight at the end of the tunnel – there is just a long, dark tunnel” (Canadian Mental Health Association, 2016). The symptoms of Major Depressive Disorder vary widely, and may include: a depressed mood for the majority of the day, most days; loss of interest in previously enjoyed activities; significant change in weight; insomnia or hypersomnia most days; fatigue; feelings of low self-worth; decreased ability to concentrate; and persistent thoughts of death.
At least five of these symptoms must be present for at least two weeks and must show a change from a person’s previous functioning (American Psychiatric Association). Studies have shown that people with depression are more 40-60% more likely to die prematurely than the general population. Some research has indicated that depression may predispose the individual to conditions such as heart disease, diabetes, human immunodeficiency virus, and suicide (Othieno, Okoth, Peltzer, Pengpid, & Malla, 2014).
MDD is most prevalent in individuals between the ages of 18 and 29, and is more prevalent in females than in males (American Psychiatric Association). The Canadian Community Health Survey on Mental Health conducted by Statistics Canada in 2012 reported that 4. 7% of the Canadian population over age of 15 years met the criteria of major depressive disorder (Public Health Agency of Canada, 2016). Specific causes of MDD are unknown; however, biological differences, brain chemistry, hormones, and genetics all seem to have a part in the development of depression.
Other factors that may put an individual at a higher risk for experiencing depressive disorders include: certain personality traits; traumatic life events; identifying as gay, lesbian, bisexual, or transgender with little to no support; abuse of drugs or alcohol; chronic illness; and some medications. Common treatment of Major Depressive Disorder includes medications and psychological counselling (Mayo Clinic Staff, 2016).
The history of slavery and maltreatment of African-Americans has contributed to high prevalence depressive disorders among African-American women in the United States (Hunn & Craig, 2009) This history has influenced the current situation among Black peoples having the lowest median household income in the United States. It is also cited that women continue to make less money than men do in the United States. Figure 2 in the report “Income and Poverty in the United States: 2015” claims that for every dollar a man makes, a woman makes eighty cents (Proctor, Semega, & Kollar, 2016).
When pairing these statistics, we can see that African-American women are likely in the lowest economic standing in the United States. Economic strain is a factor known to influence the development of depression, and it is found that approximately 48% of African-American women making very little money working as poultry workers in North Carolina had depression. Among the general population, it is estimated that 10-25% of women experience major depressive disorder in their lifetime (Hunn & Craig, 2009).
Marital status plays a role in the economic status as well as the social status of an individual. In many cases, loss of a spouse leads to a loss of income and possibly a change of living arrangements. A study done by V. Ramachandran et al. found that depression was a significant problem among elderly female populations in a sub urban area of India. They state that widows have strong feelings of loneliness, and have trouble feeling their purpose in life. The widows tend to be dissatisfied with their lives.
Within Hindu culture, widowers are not allowed to use tilak – a religious marking on the forehead – or wear ornamentation. This social change in lifestyle may partially explain the prevalence of depression among elderly females in India (Ramachandra, Sarada Menon, & Arunagiri, 1982). Saira Javed had found similar results in studying older Asian women in the cities of Rawalpindi and Islamabad of Pakistan. The researcher states that people need companionship in their last years of life, and generally, married elderly people are healthier and less prone to depression (Javed, 2014).
Substance use and substance abuse are also factors that influence the development of depression in individuals. In their study of depression in Kenyan university students, Caleb Othieno and colleagues found that an overwhelming majority of the participants who used tobacco exhibited some form of depression (Othieno, Okoth, Peltzer, Pengpid, & Malla, 2014). The National Comorbidity Survey conducted in 1991 found that individuals with depression were twice as likely to have substance abuse problems than individuals without mood disorders.
A few theories have been posed to explain the high correlation of substance abuse and mood disorders. Disorder Fostering Disorder states that “the pathological effects of a mood disorder or SUD (substance use disorder) may increase risk for the other. ” Overlapping Neurobiological Pathways theory proposes that there is a neurobiological sensitivity predisposition in vulnerable people that puts these people at a higher risk for both substance abuse as well as mood disorders.
Underlying Genetic Factors theory proposes that some individuals have a genetic predisposition for substance abuse and mood disorders. This theory states that a person’s genetics may make the person likely to develop a mood disorder, which they may self-medicate to feel better; or the using individual’s brain chemistry is changed causing the individual to develop mood disorders (Quello, Brady, & Sonne, 2005). I would like to see further research focusing on improving and implementing programs to help treat and prevent depressive disorders, specifically for women.
I would take a criticalinterpretive approach looking at the political, economical, and gendered factors that shape the experience of depression in women. The broad research questions would be: How do sociocultural factors influence the development of depression in women? How do these women perceive their illness? What programs can be implemented or improved to help these women cope with depression? What programs can be implemented or improved to prevent depression? An ethnographic approach would be used for gathering data.
Participant observation and interviews would be used gather the data on how women suffering from depression perceive their condition. Conducting interviews and engaging in dialogue with the participants would be used for collecting data about age, occupation, economic status, marital status, education, major life events, and life changes. Asking the women how they perceive their condition, how they cope with the condition, whether they take medication to treat their depression, whether they regularly seek therapy, and how well they believe the reatment methods work for them. Asking the women what kind of support systems they believe would help them handle depression. Participant observation would be used to see how depression affects the women’s daily lives and how the women react to bouts of depression. Are there certain triggers? Do these women actively try to prevent depressive episodes? The data gathered would be used to implement social programs to help women who suffer from depression and to help prevent the occurrence of depression in the future.
This paper discussed how sociocultural factors effect the development of Major Depressive Disorder in females worldwide. Depressive disorders are found more commonly in widowed women, women of low economic status, women who have experienced dramatic lifestyle changes, and women who use or abuse substances. A brief plan for further research was proposed for understanding how women with depression perceive the illness with the end goal of creating social programs and support systems for treating and preventing depression.
The Diagnostic and Statistical Manual of Mental Disorders recognizes Major Depressive Disorder as a legitimate mental illness with signs and symptoms varying among the individuals who suffer from depression. By acknowledging the sociocultural factors that influence the presence of depression among women, we can take steps toward improving the conditions and hopefully reduce the prevalence of depression among women worldwide.