Culture is shaping our identity. Cultural norms, beliefs, and practices influence, to a large extent, the way we think, feel, and act. It defines accepted ways of behaving. We learn the norms and values during the process known as primary (family) and secondary socialization (education, media, religion, workplace). Sociologists argue that the norms and values we learn through these processes either encourage or discourage us to act in certain ways. In addition to this, they frame our outlook on life.
Culture is also considered to be one of the influences on psychological processes. Some mental disorders are particularly common for certain populations. Moreover, culture contributes to the causation of certain mental disorders and affects the way patients describe (or present) their symptoms. This article will explore how culture and society influence mental health and why this is significant for anthropology.
How culture affects mental health should not be generalized based on grouping all individuals from a racial, ethnic or cultural group together, as this can lead to stereotyping. It should be kept in mind that factors such as age, income, gender, and social class can influence how we perceive and understand different cultures.
Risk factors common to mental health and mental disorders can be categorized as follows:
- Individual – such as genes (varies by mental disorders), gender, language disabilities, child abuse or neglect
- Family – such as social disadvantage, paternal criminality, admission to foster care
- Community or social – such as violence, poverty, racism, and discrimination
What is culture and how it relates to mental health?
Culture is defined as a shared set of norms, values, beliefs, and rules of behavior that allow a specific social group to function. Therefore, culture affects how people behave, what they believe in, what they consider normal, and what they value. In psychology:
Culture is to society what memory is to individuals. In other words, culture includes traditions that tell ‘what has worked’ in the past. It also encompasses the way people have learned to look at their environment and themselves, and their unstated assumptions about the way the world is and the way people should act (Triandis in Gross, 2005: 862).
There are many ways in which culture has been found to influence the diversity of experiences of people with mental illnesses. Studies have also shown that culture affects how patients describe their symptoms to clinicians and the meaning people give to their illness. This in turn affects whether people view their condition as real or intangible, a mental or physiological phenomenon, or warranting sympathy or scrutiny. Finally, culture can determine whether people feel motivated or demotivated to seek treatment. Overall, culture influences how people cope with problems that they may face on a day-to-day basis.
Four ways in which culture impacts mental health
According to Mental Health First Aid USA (2019), although every culture and person is different and faces unique experiences, culture can impact mental health in four main ways:
Each culture and society has a different perspective on mental health. In many cultures, there is a growing stigma around the topic of mental health. Various mental health conditions and their symptoms are considered a weakness that people should feel embarrassed about and hide. The cultural stigma means that it can be more difficult for someone who struggles with mental health issues to seek help.
Another way in which mental health is affected by culture is related to how people describe and feel about their symptoms. Culture can influence whether someone decides to recognize his condition and seek help to talk about their physical and emotional symptoms. In different cultures, people present their symptoms in different ways.
Each culture also has a certain level of support for someone in the community struggling with their mental health. Often, minorities are left to find mental health support and treatment on their own. Thus, various cultural factors can affect how much support someone has from their family and community.
Depending on various cultural factors, it can be difficult and/or time-consuming to find resources and treatment in certain cultures. In some cultures, it is not always easy to find and talk to someone who understands specific mental health issues, experiences, and concerns.
Influence of culture on mental disorders
According to the report “Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General”, there are various ways in which culture and society can contribute to the causation of mental illness. However, how it influences mental health varies by disorder. Any mental disorder is caused by biological, psychological, social, and cultural factors. Some factors are stronger and some weaker, depending on the type of disorder (Mental Health: Culture, Race, and Ethnicity Report, 2001).
Depression is a psychological disorder that affects people’s mood, how they feel, think, and behave. This mental disorder can cause a variety of emotional and physical issues while disrupting normal day-to-day activities. It causes a persistent feeling of sadness and loss of interest. It is also called “major depressive disorder” or “clinical depression” (Mayo Clinic, 2018).
Psychological issues, such as depression, can be strongly influenced by cultural and social factors. There are an estimated 340 million people in the world affected by depressive disorders. This means that it is the most common mental disorder. In 1973, the World Health Organization (WHO) researched more than 1,300 people in 10 countries in their “International Pilot Study on Schizophrenia”. They found that prevalence rates for major depression varied from 2 to 19 percent across countries (Mental Health: Culture, Race, and Ethnicity Report, 2001).
According to Moghaddam (2002), happiness and sadness are a social construction, thus:
…Depression, as it is medically recognized and treated in Western societies, is fundamentally a social construction. This is not to say that people in other historical eras and in other societies have not experienced the same biological processes as depressed people in Western societies today, but that the meanings and implications of experiences arising from such processes have been different in major ways… (Moghaddam in Gross, 2005: 790).
How does culture affect the development of depression?
For example, in modern western societies, such as the United States, people put a lot of emphasis on presenting themselves in a positive, happy way. This is regarded as a norm. Meanwhile, in Eastern cultures, such a style would be seen as negative. However, emotions that are considered negative in western culture, such as sadness or melancholy, have always been a part of normal life in Eastern cultures. For example, religious ceremonies of Shiite Muslims involve participants weeping, self-flagellation, and experiencing misery.
Many studies also suggest that major depression is less heritable than, for example, bipolar disorder or schizophrenia. People from western cultures seem to report feelings of guilt, self-blame, and loneliness. This is not as common in non-western societies. And it is often believed to not be caused by anything within us, but rather by fate or external phenomena, such as the rain season (Gross, 2005: 790).
In addition to this, social factors such as poverty and violence also seem to be a great contributor to the development of major depression. This, however, does not mean that poverty and violence are only in a certain part of the globe. The socioeconomic status or country of origin (linked to race and ethnicity) can affect whether someone is more likely to be exposed to these types of stressors (Mental Health: Culture, Race, and Ethnicity Report, 2001).
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder, in short, PTSD, is a mental health problem that may be developed after experiencing extremely stressful and traumatic events. It was originally diagnosed in war veterans and is also known as “shell shock”, due to exposure to severe trauma including genocide, war combat, torture, or injury. Despite this, it is not a psychological disorder unique to soldiers. There are various traumatic experiences that can cause PTSD, but they are particularly common for certain populations.
Immigrants, refugees, and asylum-seeker communities often show higher rates of pre-immigration exposure to trauma. But migration itself is a stressful experience that can influence mental health. Later, as immigrants move to a new environment, they experience stress due to adapting to a new culture and it is known as acculturative stress (Berry et al., 1987). This does not mean that immigration can result in higher rates of mental disorders, but any trauma experienced during that process – can (Mental Health: Culture, Race, and Ethnicity Report, 2001).
Those working in emergency services also experience high-stress levels that can lead to post-traumatic stress disorder. For example, a study of over 800 fire-fighters, by McLeod (2000) found that individuals in different roles experience different levels of stress and cope in different ways. Sub-officers are the most likely to experience PTSD as they are the first on the scene of an incident and are the ones who are most intensely exposed to the trauma caused by fire or road accidents (Gross, 2005).
Coping styles in different cultures
People from different cultures cope with their daily problems in different ways. Based on various cultural influences and ideals, people decide how they are going to cope with mental problems and seek treatment. Some decide to see a psychiatrist or psychologist, while others seek treatment from traditional healers etc. Therefore, cultures shape both normative stressors and individuals’ responses to them.
Studies have found the relationship between culture and coping. For example, it has been found that some Asian American groups tend not to dwell on sadness and upsetting thoughts. Instead, they believe that it is better to avoid expressing such feelings. Such groups tend to rely on themselves when coping with distress and, for them, suppression is considered to be the best approach when facing personal problems or experiencing negative feelings (Narikiyo & Kameoka in Mental Health: Culture, Race, and Ethnicity Report, 2001).
In contrast, African Americans tend to be more proactive when they feel distressed. Instead of avoiding the problem, they tend to recognize it and turn to spirituality for help in coping with symptoms of mental illness. However, they tend to rely more on themselves and cope with distress on their own than whites (Sussman et al. in Mental Health: Culture, Race, and Ethnicity Report, 2001).
Culture of the health professionals
Finally, the culture of clinicians and health professionals impacts how they are trained and how they practice, which in turn can affect how they approach patients and may influence a diagnosis. Thus, culture affects how clinicians respond to certain illnesses. In addition to this, clinicians view symptoms, provide diagnoses, and treatments in a way that may be different from their patients’. Therefore, there may be cultural differences between the health professional and the patient, which can impact whether they understand their patient’s concerns or needs. Moreover, the clinician and the patient may have different views and beliefs on how a health professional should act, what causes the illness and what treatment should be provided (Mental Health: Culture, Race, and Ethnicity Report, 2001).
Cultural significance in anthropology
Mental illnesses occur throughout all cultures and societies, but the severity and the nature of presenting symptoms vary significantly. Culture and other factors (biological, genetic, and so on) can affect mental illnesses and mental health in general (Andrade, 2017). Psychologists need to adapt their methods in order to research the same processes in different cultures and to really study and understand the behaviors of people from all around the world. This is significant for anthropology because it allows researchers to explore the influence of different beliefs and values, which shows that human behavior is linked to, and cannot be separated from, its cultural context.
Moreover, it allows psychologists to test their own theories and find out whether the western psychology research and findings are relevant outside their own cultural context. For example, Sherif et al.’s field experiment on intergroup conflict and theory called “Robber’s Cave” failed the replication test outside North American settings. This means that not all theories apply to all cultures (Gross, 2005).
There is no doubt that culture can affect the way we experience distress and how we express it, cope with it, and seek help. Therefore, it is important that geopolitical determinants continue to be recognized as significant factors in developing and delivering mental treatment for those affected by mental illnesses (Bhugra et al, 2021).
Andrade, S. (2017) Cultural Influences on Mental Health. Available: berkeley.edu
Bhugra, D., Watson, C., and Wijesuriya, R. (2021) Culture and Mental Illnesses. International Review of Psychiatry. 33 (1-2). Available: tandfonline.com
Mental Health: Culture, Race, and Ethnicity (2001) A Supplement to Mental Health: A Report of the Surgeon General Office of the Surgeon General (US). Center for Mental Health Services (US); National Institute of Mental Health (US). Available: nih.gov
Gross, R. (2005) Psychology: The Science of Mind and Behaviour. 5th Ed. London: Hodder Education.
Mayo Clinic (2018) Depression (major depressive disorder). Available: Mayo Clinic
Mental Health First Aid USA (2019) Four Ways Culture Impacts Mental Health. Available: Mental Health First Aid