KNAYSI: A consequence of culture
Many psychiatric disorders can be understood as dependent on particular environments and stresses
As Christopher Broom, public editor for this newspaper, noted in his article last month, columns before and after an event give readers a greater chance to participate. Last week, I wrote about an upcoming panel that would discuss mental health at the University, and why its interdisciplinary approach to the topic would prove so advantageous. In this column, I will focus on one particular idea of the panel — culturally-influenced mental illness — and discuss its importance in thinking about student mental health at the University.
One panelist, Carrie Douglass, a professor of anthropology, gave an informative overview of medical anthropology. One concept she discussed was “culture-bound syndromes,” the illnesses manifested and recognized only in specific societies or cultures. Early on in her talk, she made a particularly striking statement: “I think perhaps all forms of mental unhealth are culture-bound syndromes.”
In this column, I will investigate Douglass’ claim. Just how much of mental disorder can be explained as culture-bound syndromes? How useful is to think about mental health (in America and, more specifically, at the University) in terms of culture-bound syndromes? It provides an interesting departure from how we traditionally think about mental disorder.
The idea of culture-bound syndromes might sound a little bizarre or abstract to someone unfamiliar with anthropology or mental health. So before I discuss the implications culture-bound syndromes at the University, I will define the concept and elucidate its relationship to biomedicine.
As Professor Douglass notes in her introductory course “Medical Anthropology,” there are three basic psychiatric categories: psychotic disorders (for example, schizophrenia), mood disorders (such as depression) and anxiety disorders (which include a variety of phobias and hysterias).
These basic types of mental illness, she observes, hold true for every society, yet the specific way they manifest themselves depends on the unique cultural environment. There are different stressors in a major American urban city versus rural China, for example. Culture-bound illnesses describe this — they emerge under specific cultural contexts and often in specific demographics. Anorexia, for example, is probably well-known in upper-middle class America and upper-middle class Germany (because they are very similar cultural environments), but is likely unheard of within Inuit populations on the Arctic tundra.
So certain aspects of a culture, including its social norms and practices, can cause individuals within that culture to feel certain kinds of stress, and this stress can bring about particular unhealthy thoughts, behaviors or physiological responses. Schizophrenia — a thought disorder with a strong genetic component which is present in all populations and expresses itself via nearly identical symptoms — might be the least culturally-determined of mental disorders. But if culture-bound syndromes do not account for every mental illness, then they at least apply to most.
The theme of culturally-dependent mental illness surfaced across the panel in one form or another. As moderator of the panel, I witnessed many professionals offer their advice about maintaining mental health. Tim Davis, Director of the University’s Counseling and Psychological Services (CAPS), essentially suggested students identify the major sources of stress at the University and then alter their relationship with the culture in some way. This, he emphasized, is best attempted without medication. Dean Sandra Seidel, professor of biology, and Dr. Pamela Ross, a former emergency medicine physician, made similar comments. Seidel focused on breathing exercises and changing one’s philosophical outlook. Ross emphasized the importance of medical care that considers the unique needs and circumstances of its community.
Such comments suggest a specific framework within which we can think about our mental health at the University. Identify the sources of stress in your life: Is the stress coming from friends and family? Or perhaps implicit expectations and influences within University culture? Or are you just putting a negative spin on otherwise-neutral aspects of your life?
To be sure, medication can be necessary in more extreme circumstances. But the average student who manages his anxiety or depression in our high-pressure college environment should first address the sociocultural factors of mental health. This might include changing his behavioral responses to academic and social pressures, altering his friend groups or modifying his general outlook towards the University.
Viewing mental illness and health from Professor Douglass’s anthropological perspective, we provide a framework for so much of what we already know intuitively. Keeping culture-bound syndromes in mind, we are able to systematically move our attention from the mental and physical symptoms of illness to their complex causes.
George Knaysi is an Opinion Columnist for The Cavalier Daily. His columns run Tuesdays.