Depression

June 13, 2009

In my request for feedback a few weeks ago I got an interesting note about depression. Here is the gist of it:

“Being a Cameroonian living now in the US, the one thing I notice here that really put me off is Depression. I mean I never seen anybody being depressed in Cameroon even though we don’t have it there easy… So do you think I’m right about Depression not being common in Cameroon. And if indeed I am, how do you explain that people are more depressed in the US with all the facilities to life they have?”

This topic came up in a conversation I had a few months ago. It’s very interesting because I agree with the reader. I don’t see depression in Cameroon either. Why? I’ll explore some of the possibilities in this post, but please keep in mind that I don’t really have the basis to have a professional opinion on this matter.

Firstly, there is a difference in culture – collective versus independent. If someone in the US is sad because a loved one died or they lost their job, generally they’ll want to be alone, to work out their problems, emotions, and thoughts on their own time. We might do something nice like prepare a meal for someone that recently lost their spouse but would by no means impose on them that we eat it together. Cameroonians, on the other hand, will generally tackle their pain or sadness together, either as a large extended family or as a community. A Cameroonian burial is a much longer and involved process than in the states. In some tribes the wife of the deceased will wear black and sit on the living room floor, even sleep there, for an entire week as family and friends fill the house and give their condolences. I remember in my Peace Corps training someone suggesting that we not tell people we are sad because in American-speak that’s usually code for “I want to be left alone.” In Cameroonian-speak it would more likely mean “I need you to stay with me until you’ve helped me overcome my sadness.” Being sad is not really a normal emotion save for prescribed times like when you’re dressed in black sitting on your living room floor. Or even during the long burial process, there is a certain time when everyone else allows themselves to feel sad and cry about the loss. To my American eyes it looks quite bizarre when that prescribed time for sadness is over and everyone seemingly goes back to normal. What does this mean regarding depression? Well, it might mean that a Cameroonian would be more likely to seek out help before an American, that he would see unexplained sadness as abnormal and work to rectify the situation immediately.

Another issue is pharmaceutical companies and psychologists. I think it is safe to say that depression is over-hyped and over-diagnosed in the US. Either the cause or an effect of that is that prescription drugs for depression are over-advertised and pushed very hard on medical professionals. There was a study a couple of years ago that showed that a lot of people being diagnosed with depression were in fact just sad because of concrete circumstances in their lives. One reason that Americans seem more depressed than Cameroonians could be due to this factor. Depression is in your face so often that maybe we’re not as depressed as we think. Either we’re being diagnosed wrong or we just think lots of other people are depressed because of how much advertising we’re subjected to. Or maybe the rate of depression is high and it’s precisely due to these issues. Maybe all this talk about depression is making people depressed. A constant worry about whether or not you’re depressed, whether or not you should take Prozac or Zoloft could eventually create a placebo effect that turns your worries into reality. Our minds often have more power than we realize.

Another possibility – fish. I think I remember reading that Japan has the lowest rate of depression of any country that has conducted such a study. Many people attribute that low rate to omega-3s, something found in fish oil that is said to counteract depression. The fact that Japanese eat lots of fish and therefore take in large quantities of omega-3s is a possibility for why they are so rarely depressed. Cameroonians also eat lots of fish. Even if you don’t have the money to eat fresh or frozen fish, you will still most likely flavor your sauces with dried shrimp and other small fish. The North, being much farther away from the sea, though, has a much more beef-centered diet. It would be interesting to hear the opinion of someone from the North regarding Cameroonians and depression.

Looking beyond psychological and nutritional possibilities, maybe it’s genetic. Maybe the genetic code of Cameroonians simply doesn’t allow for depression and Americans have an overabundance of people with the ‘depression gene’. This would be the easiest way to explain this matter. And maybe what I was saying with regard to Cameroonian customs is an effect of and not the cause for a people without sadness. I think I have a mild cycle of depression and it didn’t stop when I got to Cameroon. Of course I could never consider myself 100% culturally Cameroonian and being vegetarian I don’t eat fish, but this could still indicate that it’s a genetic and not a local phenomenon. There are several pockets of Cameroonian communities in the States. Having plenty to miss with regard to their homeland, food and culture, it would be interesting to know if they still go without depression.

Whatever the answer, there is one thing that the reader alluded to that I completely disagree with and that’s the idea that ‘facilities of life’ should diminish depression. One thing I’ve learned being here is that the human body and the human mind are incredibly adaptable. I often tell the story of Victor Frankl to my 7 Habits classes. His family was exterminated, and he was imprisoned and experimented on in a Nazi concentration camp. But despite all of this mental and physical torment, he took comfort in finding space between a stimulus and his response – his ability to choose his reaction no matter how dire his situation. He knew that this freedom was one quality that the Nazis could never take away from him. He found a way to be mentally at ease in a death camp! No matter what the circumstances our body and psyche will work to find some level of comfort in its surroundings. Circumstances are never objective. They are relative to each person and even in time. What has a negative affect on me now might be completely neutral in one year’s time. It’s very possible that a 15 year old will suffer through more stress and anguish when her first boyfriend breaks up with her than someone else when their mother dies. It is in our nature to try to make things objective – a middle school boyfriend is less important than one’s mother, life in the US is easier than life in Cameroon – but life, and especially our emotions, are not that way. Along these same lines, someone who has three houses, five cars, and a yacht probably has a bigger desire for stuff than someone living without hardly any amenities. Often the more stuff we have, the more we want. When we have very little it’s more likely, though not always true, that we learn to like and live with what we have. Jesus alluded to this when he said “It is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God.” If anything, the facilities of life and the stuff that Americans have more of don’t make our existence easier but just create even more desires which could in turn cause depression

I’d be very interested to get more opinions on this subject, whether you’re Cameroonian, American, or just have an idea, let me know what you think. And if you’re a psychology student looking for a thesis or a reason to fill out a Fulbright application, maybe this is your ticket.

Tim