Towards an understanding of depression in Chinese-Canadian women: Cultural, contextual and family perspectives.

摘要

In this dissertation, I employed a qualitative approach, which integrates constructivist and dynamic perspectives, to identify the cultural, contextual, and family parameters of the experience and expression of depression in Chinese Canadian women. The data suggest that while intra-cultural variation was evident, the interaction among cultural, contextual and family parameters had a significant influence on the experience and expression of depression in eight first generation Chinese immigrant women suffering from first episode depression.; At the contextual level, the interaction of their lack of proficiency in English and failure to acculturate left the women feeling isolated and more susceptible to depression. The women's developmental history and unfulfilled relationships with their spouses also intensified their psychological isolation and left them with a devalued sense of self.; Traditional Chinese values, Chinese medicine (TCM), a relational construal of self, emotional restraint, the nature of Chinese language, and the meaning of somatization all helped shape the expression and experience of depression. The manifestation of depression represented the blending of East and West. The women externalized their anger, had difficulty establishing close and satisfying intimate relationships, experienced low self-worth, lacked labels for the psychological components of depression, and did not differentiate somatic from emotional distress. Metaphors, aphorisms, figures of speech were common idiomatic expressions of distress. Depression for these women was a moral issue. Because of their depression, they felt helpless and hopeless, their sense of self crumbled and they felt they were going crazy. Their personal meaning of depression was revealed in common themes: unmet basic needs, the experience of being marginalized, limited/ineffective communication with one's partner, tensions associated with traditional Chinese values, and loss. While they delayed seeking help, they did not experience shame or loss of face often associated with help-seeking in Chinese. Defense mechanisms were commonly used coping strategies.; The study provided a greater appreciation for the conceptualization of culture, the relational orientation of self and the use of emotion among Chinese immigrant women. Sensitive assessment and intervention would take into account the context of the women's lives, their attachment to Chinese teachings and early emotional habits.