Understanding Depression across Cultural Contexts

Yi, a young U.S.-born Hmong woman, is seriously distressed. She is having difficulty sleeping; she has lost her appetite; and she lacks interest in her studies. Yi also says that she has little energy and is having a difficult time balancing school and family obligations. Although she does not spontaneously use emotional terms to describe how she feels, when asked she agrees that she is unhappy and anxious. All these symptoms are consistent with DSM criteria for major depressive disorder (American Psychiatric Association, 2013 ). And yet Yi reports other symptoms that are not typically associated with major depression. She describes bodily aches and pains, especially in her stomach and liver. She has become particularly concerned about what other people think of her, making it hard for her to get along with her family. Finally, she reports that at night, the spirit of a disgruntled ancestor visits her, right before she is about to fall sleep. These encounters sap her energy. Although she says that she knows other people who have been visited by spirits, she is nonetheless concerned about experiencing these visits herself.