[2] For example, a qualitative study revealed that some countries did not recognize post-natal depression as an illness; rather, it was viewed as a state of unhappiness that did not require any health interventions.
[5][6] Although the collectivism of Eastern cultures creates a strong support system for the group, it produces many stressors that can lead to depression and anxiety.
This combined with the cohesiveness of the group can make social mistakes very public and result in feelings of shame and embarrassment by the individual at fault.
A study by Pewzner-Apeloig and colleagues (1994) found that differences in the way depression was experienced in terms of guilt between African and Western cultures existed.
The biggest challenges Eastern immigrants must face when they travel to America are the sudden loss of a support system, child rearing, and limited knowledge about the American way of life.
[13] Coming from a collectivist culture that places great emphasis on relationships, immigrants may mourn the loss of their friends and family.
[14] Tensions within the nuclear family may also arise as children assimilate to the mainstream culture and language and identify less with their immigrant parents.
Research shows that the level of distress and the likelihood that one will develop depression is higher in first generation immigrants than subsequent ones.
Some have hypothesized that this is due to their inferior positions in the culture, in which they may experience domestic violence, poverty, and inequality that can greatly contribute to depression.
[17] A study by Ngcobo and Pillay reports a high level of depression in black South African women (83.34%) and a gender difference ratio of four to one.
[18] Depression in South Africa is often linked back to low socioeconomic factors and loss through death and abuse.
[18] This is a result of the laws of apartheid and the inadequate psychological services that followed, as well as factors such as under-reporting, misdiagnosis, language barriers and cultural differences.
Considering the stigma associated with mental illnesses in the Arab culture, it is not surprising that many Easterners express depression and anxiety through somatic complaints.
[25] Many Easterners believe that symptoms of depression and anxiety are simply a part of life and do not require medical attention.
[32] The Arab American Institute Foundation estimates that there are over 3.5 million individuals with Arab-speaking ancestry residing in the United States, with thousands more arriving from the Middle East every year.
Arab American immigrants make for an interesting case because they face additional discriminatory stressors associated with the events of the 9/11 attacks and political tensions in the Middle East.
Islamic therapy, for example, involves Quran recitation by an imam to repel moral deviance from the soul of the individual.
[34] A study completed on depressed Pakistani patients also reported that the participants believed that medicine could rid them of their symptoms but had little to no knowledge of psychotherapy.
Within communities, discrimination on the basis of race and ethnicity is also a strong contributor to the elevated number of depressive symptoms among Latino youth.