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 Centre for Addictionand Mental Health |
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Cultural ExpectationsHear me, Understand me, Support me: What young women want you to know about depressionIn this section: On this page: They say you can't choose your parents, nor your religion or sex. What if you could? Since the day I was born, I have always fantasized about the "what ifs." Would I have been treated by my parents differently if I were a boy, or would boys like me more if I had blonde hair and blue eyes?. . . Perhaps it is a conditioned feeling or the need to be like everyone else, but growing up in a very diverse community, I was never proud of my Vietnamese heritage . . . Some are proud of who they are. They're proud of their heritage. In other cultures, the rules are more strict, and when [your parents] try to impose those rules when you're living in Canada, it's a lot harder. You say, "Well, my friends don't have to do that." Our parents had to work harder when they came to Canada, or back home. They had to do so much. So they don't see our problems. [Their] problems were something to be sad about. I think many young black women who are depressed get stereotyped as angry, aggressive and violent. If a physician does not fully understand how culture and race play a role in how you express yourself and your feelings, illnesses such as depression may be undermined or overlooked. It is very difficult for black females to find physicians who can relate to them. There needs to be more diverse doctors and other health care professionals in hospitals, clinics and community health centres. Diversity should also be represented in drop-ins and schools. It makes it even harder for me that I'm from another culture and living in Canada and then my family expects me to [abide] by the rules of my country, not Canada. . . . I have a huge family . . . You find them everywhere, and I just try to run away, kind of. What is it like to be a young woman in today's world? Culture, race, language and religion are important facets of every young woman's identity. It is very important to explore issues of identity, expectations and experiences that have been positive and negative in relation to a young woman's heritage, language, race, religion or culture, to begin to fully understand her reality within her social context and her family life. We encourage the exploration of cultural expectations as they relate to all young women who have a heritage, language or religion that is different from their social context and may conflict with that of their parents, or that in any way undermines their full development into autonomous adults. As we are all products of our environment and our upbringing, beliefs, values, attitudes, practices and traditions are passed from generation to generation. However, many of these elements of culture shift over time and differ radically from place to place. Young women whose parents' beliefs, values, attitudes, practices and traditions differ greatly from those around them - including those of friends and teachers, and what is shown by the media - can feel pulled in different directions. While parents may expect them to conform to certain behaviours and roles, Canadian society's expectations and what is considered "normal" can seem very different. This can be particularly difficult for young women who often find themselves restricted by any culture's rules. While there are traditions that provide positive and healthy encouragement for young women's development, few, if any, cultures are free from stereotypes that undermine young women and set up impossible contradictions. Dominant culture pressures young women to be emotional (but not angry), to strive to be attractive and responsive to men (but teen pregnancy is scorned and birth control is sometimes discouraged) and to depend on others (but be their caretakers). Furthermore, stereotypes associated with particular cultures (e.g., viewing black women as strong and able to withstand almost any emotional burden) may make it more difficult for young women to express and cope with everyday emotions of anger and sadness, and harder for them to recognize and seek help for depression; when crying or sadness is seen as a weakness, young women may not want to reveal their emotions or may receive little sympathy when they do. Family and community pressures and expectations may cause a lot of stress for some young women. Parents and young women may hold differing views around career choices, for example; parents may pressure young women to seek traditional careers for women. Parents may also expect young women to do a disproportionate amount of housework compared to males in the household. Divergent cultural expectations can also intensify tensions about young women's intimate relationships. Since relationships tend to be a very important part of any young woman's life, dating, same-sex relationships and even whether or not a young woman chooses her own mate can be huge sources of stress. Cultural ideals and stereotypes can cause intergenerational conflict. This can be particularly true in families that have immigrated to Canada: parents or grandparents may dismiss young women's struggles, saying that their difficulties pale in comparison to their own trials, and that the young women really have nothing to complain about. The young women in the VALIDITY project described the importance of recognizing diversity - by acknowledging that individual women experience depression and express (or manifest) it in different ways. While mental illnesses have similar symptom profiles across cultures, how people describe, interpret and manifest their symptoms vary with race, ethnicity and culture, and can depend on how the person communicates, what is culturally appropriate and how behaviour is affected by such daily experiences as stigma, language barriers, religious intolerance, racism and discrimination. Depression or other mental illnesses may be seen as shameful and kept secret. In some cultures, a person who is depressed may be revered or seen as "special" and may receive support from family and friends. This is why it is important to take time to develop a relationship that will create trust, so young women can talk about cultural expectations and the issues that might make them vulnerable to depression. The way a culture sees mental illness influences what is considered to be a mental health problem and what kind of help is preferred. Thus, employing standard Canadian approaches to treating depression, including commonly used psychotherapies and psychopharmacological medications, may not help people from every ethnic and cultural background to the same extent. This can be insensitive and damaging for some, and may miss many crucial aspects of young women's lives. Develop your awareness of various cultures, including dominant culture, and their expectations of young women. Learn about ways in which depression is viewed in different cultures and ways that cultural expectations of young women can contribute to depression. Rather than thinking of cultural differences as either good or bad, listen to a young woman as an individual and think about how her experience of anxiety, depression or anger might be an expression of an inner struggle with competing cultural expectations. Do not stereotype or make assumptions. No community is homogenous. Young women from the same cultural background may differ in English language proficiency, education, level of acculturation, family situation and other characteristics. Make it a priority to establish trusting relationships with young women. This may be a challenge, especially when their age, socio-economic status, race or ethnicity differs from the professionals working with them. But listen with respect and empathy to young women's stories, observe body language and ask non-judgmental questions. Explore with young women sources of pressures in their lives. Let young women talk about their issues from their perspectives. Letting a young woman know that you are interested in what she has to say is vital to building mutual respect and trust. Acknowledge sources of conflict with family members. Remember that cultural competence (i.e., the willingness and ability of a system, agency or professional to value the importance of culture in the delivery of services to all segments of the population) is key to providing support for young women from diverse cultural backgrounds. Extreme conflicts may arise between young women and their families around issues concerning relationships, particularly same-sex relationships or relationships with people outside the family's religion or ethnocultural background. A young woman may have a supportive lesbian network at school but may be afraid to tell family members, who would have a hard time understanding her sexuality or why she may not be interested in marrying a man. Some young women in interracial/-ethnic relationships, with partners of the same or the opposite sex, may experience added parental/family conflicts. In conversations, listen for cues to such conflicts. Encourage women to seek ways to maintain dialogue with families. Familiarize yourself with professionals in the community who have expertise in these areas and who might be helpful to refer the young woman to for additional support. Part of a young woman's cultural experiences may centre on immigration or refugee status. It's important to become familiar with the kinds of experiences that young immigrant or refugee women may have had prior to coming to Canada. For example, separation from close family members and friends, time spent in transition or in refugee camps, experiences with war, political violence and associated trauma, or even adapting to a lower standard of living in Canada than she was used to in her country of origin are all significant experiences that will shape a young woman's ability to cope with her life situation. When assessing how best to help, keep in mind that a young woman may prefer a female doctor or counsellor to feel that she can open up about her feelings. If the young woman needs the services of a translator, it is important that the translator understands the cultural context and does not just translate the words. Family members should never be used as translators. Encourage and help young women to find groups that can support them as they explore and try to deal with their issues. The young women of VALIDITY consistently pointed to talking with other young women as a strong source of support: Peer support can be invaluable in helping young women to find their way. Connect with agencies and groups that relate to a young woman's cultural experiences and background to see if they provide peer mentoring, support or counselling for young women. Agencies or groups could include settlement organizations, LGBTTTIQQ* community centres, faith-based centres and groups, etc. Finally, acknowledge that young women's experiences are real and relevant, and that manifestations of depression and other symptoms of physical and mental health problems may be related to multiple and intersecting pressures in their lives, of which cultural expectations are a powerful aspect. For further information, see the following resources: Elizabeth Patterson International Student of the Year Award Health and Social Services for Canada's Multicultural Populations: Challenges for Equity Aboriginal Youth http://www.pauktuutit.ca/ The medicine wheel: Understanding "problem" patients in primary care. La Fédération de la jeunesse canadienne-française La Fédération de la jeunesse franco-ontarienne (FESFO) Nadir, A. Young, Muslim, and female in America: Their stories, their voices. Canadiens et Canadiennes d'origine africaine, antillaise et asiatique Metis National Council of Women National Organization of Immigrant and Visible Minority Women of Canada Native Women's Association of Canada (NWAC) Ontario Aboriginal Health Advocacy Initiative (OAHAI) Pauktuutit Inuit Women's Association Southwest Ontario Aboriginal Health Access Centre |
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Last updated: May 02, 2007 11:22 AM Published: Jul 18, 2008 7:25 PM ID#P24659 |