Re: I need help from a psychologist or psychiatrist... but not like th
Hey, a psychiatric thread I actually feel comfortable posting my professional opinion in; that's a rarity!
Reported rates of major clinical depression do vary quite a lot across the world (in contrast to some psychotic disorders, such as schizophrenia, which appear much more stable across the globe, though not uniform internally within any given country, and between population subgroups).
Still, it's very difficult to be absolutely sure of the basis of this variation. It could be a true variation, but it could also be a function of bias. Think about how data is collected - if you have a country with relatively low stigma attached to depression, a high awareness of the disorder leading to more people querying the possibility, and a relatively lax threshold for diagnosing it, combined with an incentive to report, reported rates are naturally going to higher than a country that does not have those variables, or has the opposite. Compensating for those biases is extremely difficult, and I'm far from convinced the commonly quoted studies in this area have adequate methodology to compensate even partially for these effects. Those biases will naturally mean the USA will have high reported rates, compared to say, Nigeria.
However, given the magnitude of the reported differences between countries, it's an interesting - if perhaps slightly shaky scientific practice - exercise, to think about what differences
might account for the different prevalence rates. Certainly it's harder to attribute the difference in rates between, say, Belgium and the USA, purely to those biases, since they do share many of the same cultural variables.
One key aetiological factor in depression is the presence of life stressors. One key life stressor is a mismatch between what people feel they SHOULD be able to achieve and what they ARE doing with their life. The various Whitehall longitudinal studies have fairly adequately demonstrated that this loss of perceived control is related to increased stress, and eventually to a position of learned helplessness, both of which - unsurprisingly enough - are associated with increased rates of depression (and, indeed, other stress-related issues & illnesses).
Societies are generally actively aspirational - people are usually continually encouraged to compare their situation with a cultural ideal. There are few societies which do not encourage adherence to some sort of ethical/moral framework. However, the technological, informational and economic development of modern Western societies can take this encouragement to levels unseen before in human history. The pervasiveness with which the cultural ideal is daily presented to us, and the ease with which we can compare ourselves to it is really quite remarkable.
The obvious solution to this is to develop a sense of
individual worth, which while
informed by societal expectation is not
determined by it. This, of course, is not an easy task, esp. given the strength of the many competing messages, and the general ease with which it is possible to avoid addressing the task. But that inner strength can allow one to overcome the sources of stress by realising the vacuity of the process by which they result in stress, and thus limit your exposure to risk factors associated with depression.
We may well all have some varying degree of genetic predisposition to depression, but one should not discount the importance of environmental factors in its aetiology. Controlling exposure to life stress, recognising the sheer
amusing silliness inherent in much of what we do - and have to do - in daily life, and so limiting its psychological impact on us, and managing one's response to the stress are lessons our societies will have to learn. Especially since there's no putting the genie back in the bottle in terms of our economic and technological development (and of course, they both bring MANY benefits as well as problems, which should not be discounted), and these issues will naturally become more significant as the pace of that development continues to increase.
