I am Dr. David Bull and welcome to Depression Insights. Now anyone can suffer from depression, but not everyone deals with it in the same way.
So to discuss a wide variety of cultural, demographic, and social differences I'm joined by Dr. Myrna Weissman, who is an Epidemiologist
and Dr. Alvin Pousaint who is an Author, Professor of Psychiatry and noted expert on race relations.
Let's start with probably the most discernible difference that's of gender. I am looking at you Myrna, women are four times more likely to suffer from depression than men, why?
Well, that is one of the mysteries but we have some clues. The periods of greatest risk for depression begin in adolescence. The next is in the postpartum period after childbirth.
And the perimenopausal period just before the menopause, and the rates of onset starts to go down in the menopausal period. This all suggests that there is something hormonal.
But we don't really know, and there's certainly some combination. Depression is a complex genetic disorder which is triggered by environment.
Is there an issue that women do tend to talk about their problems more? Because we do know that a lot of men suffer from depression but don't talk about it and it does go undiagnosed.
Well that accounts for some of the difference, some of it is accounted for by not discussing it, and also by using alcohol to suppress the symptoms. But that doesn't account for all of it.
Well, I think part of it is, is cultural, but I think what she mentioned about hormones and ever perhaps some genetic factors and other things may be an issue in terms of who gets depression.
Do you think that with men there is much more – and I am sort of paraphrasing here, but is there much more a sense of failure?
There could be, if they are depressed, there's the sense of worthlessness.
In fact, I think it may be with some men that they feel there is a great expectation that they have to cope, they have to take care of people, they have to be the man of the house and so on.
Tell me about sort of African-American men particularly, if they are diagnosed with depression how do they deal with the whole medicalization, saying, actually you do, you have a mental illness?
Well, I think some perhaps more will accept that, but we know from surveys that a large percentage of the African-American community really do not see depression as an illness, as a health problem.
They think it's something that happens to you. It may be their lot in life, but they may not see it as a mental health problem.
There is a lot of denial about depression but blacks invented culturally the blues.
So it's almost fine to externalize it, to talk about it when it doesn't relate to you.
Yes, you don't want to personalize and say it's me and I'm depressed and so on
but you are talking about the misery you see around you, in other people, which means you are also seeing it in yourself.
I see this often in many of the minority population, that are poor, who come into the clinic. They have enough troubles and they don't want the stigma of having a mental illness.
And in fact many times they do have depression but it's related to a very specific event.
And if you can help them or provide services, or get them to services where they can deal with that, many of those blues will go away.
On the other hand there are those who have a serious recurrent depression that requires a much more vigorous or maybe a different kind of treatment.
Okay, so we talked about gender, we talked about race. Let's talk about the thing I'm particularly interested and which is age.
What advice would you give to someone who says I am really worried about my older relative, I really think they are depressed, what can I do?
First of all ask and make sure that their close family members ask how they are doing, and ask what their mood is and their outlook on their life.
The second is to try to help them to have less social isolation…to have friends, family come in to visit, that's important.
So make time.
Make time and try to find others who can make time
I have seen instances where an older person has been depressed. And the family members actually think it's dementia instead of depression. It's very important to make that distinction.
So really the take-home message is, make sure you talk, make sure you try and get the advice, get the help, there is help there.
And let's hope that the health-care system will be able to provide more time with the family doctor to spend with the patient. Or services that are ancillary that can help. It doesn't take a lot.
Very wise words indeed, Myrna and Alvin, thank you so much indeed. And thank you for watching Depression Insights.