Depression: Depressive disorder widely known as depression is a common but serious mood disorder. As per the World Health Organisation, close to five per cent of adults suffer from depression globally and being the leading cause of disability. Studies show that women are twice as likely to experience depression during their lifetime compared to men (Kuehner,2016). In low and middle-income countries, depression among women is a widespread issue. Particularly, the prevalence of depression in women in Southeast Asia poses significant yet complex challenges. A multitude of factors, such as social dynamics, cultural norms, economic conditions, and the limited availability of mental health services, all play a role to why depression usually goes unrecognised and untreated in these regions.
Social Factors: Many South Asian languages, such as Bengali, Hindi, Nepalese, and Urdu scarcely have specific terms describing the concept of depression. Instead, individuals often use more culturally accepted terms and somatic metaphors to convey their distress. For instance, emotions are often expressed through physical complaints such as headaches, body aches, or stomach problems. This linguistic phenomenon poses a significant challenge for both individuals and healthcare providers in accurately identifying, diagnosing, and treating depression within these cultural contexts. For example, a 2004 study by Bhugra and Mastroianni recognises linguistic and cultural complexities as potential barriers leading to the underdiagnosis of depression in non-Western societies.
Cultural Factors: Mental health of Southeast Asian women is significantly influenced by cultural factors. Discussion of mental health is considered taboo in various South Asian communities, and depression is frequently viewed as a symbol of weakness or attributed to supernatural causes. For example, a study by Bhattacharya and colleagues in 2019 showed that Indian women use cultural expressions to articulate physical, emotional, and cognitive distress. These expressions are essential tools for communicating and understanding women’s experiences and challenges in Indian society. However, this cultural stigma prevents many women from seeking help, leading to a high number of undiagnosed and untreated cases of mental health-related conditions.
Economic Factors: Additionally, socio-economic factors play a substantial role in the mental health challenges faced by women in this region. Issues such as poverty, and violence against women exacerbate mental health problems. For example, a systematic review and meta-analysis conducted by Roddy and colleagues in 2023 found a fourth of perinatal women experience depression, in low and middle-income countries, especially amongst women facing additional stressors such as gender-based violence .Perinatal women who are struggling with depression, financial burdens, and violence, all of which can make it challenging for them to seek help for their mental health. These factors can significantly impact their ability to access the support and care they need during this vulnerable time.
Lack Of Mental Health Services: Access to mental health services is limited in many parts of Southeast Asia, particularly in rural areas. This lack of access exacerbates the issue as many women go untreated. For example, a study by Andary and colleagues in 2023 acknowledges the persistent stigma and insufficient resources in Southeast Asia pose significant challenges for those seeking mental health care.
Addressing depression among Southeast Asian women demands a comprehensive approach, including the promotion of awareness, reduction of stigma, enhancement of healthcare infrastructure, and provision of culturally sensitive mental health services. By addressing these issues, the mental well-being of women in this region can be significantly improved. Furthermore, comprehensive, country-specific data on depression in women is still lacking in many Southeast Asian countries, highlighting the need for more research in this Area.
References :
Andary, S., Bassani, J., Burrell, G., Cole, E., Evans, R., Redman, E., & Kumar, S. (2023). Barriers and enablers to access and utilization of mental health care services across Southeast Asia: A preliminary scoping review. Asia-Pacific Psychiatry, 15(4). https://doi.org/10.1111/appy.12549
Bhattacharya, A., Camacho, D., Kimberly, L. L., & Lukens, E. P. (2019). Women’s Experiences and Perceptions of Depression in India: A Metaethnography. Qualitative Health Research, 29(1), 80–95. https://doi.org/10.1177/1049732318811702
Bhugra, D., & Mastrogianni, A. (2004). Globalisation and mental disorders: Overview with relation to depression. In British Journal of Psychiatry (Vol. 184, Issue JAN., pp. 10–20). https://doi.org/10.1192/bjp.184.1.10
Kuehner Christine. (2016). Why is depression more common among women than among men? Pub Med.
Roddy Mitchell, A., Gordon, H., Lindquist, A., Walker, S. P., Homer, C. S. E., Middleton, A., Cluver, C. A., Tong, S., & Hastie, R. (2023). Prevalence of Perinatal Depression in Low- and Middle-Income Countries. JAMA Psychiatry, 80(5), 425. https://doi.org/10.1001/jamapsychiatry.2023.0069
World Health Organisation. (2023, March 31). Depressive Disorder (Depression). https://www.who.int/news-room/fact-sheets/detail/depression
© 2024 Dr Mukta Bhattarai Pandey (MD, PGDip Public Health, MRCP(UK), MRes)