“Pull Yourself Up by Your Bootstraps”: A Response to Depression in Older Adults

Abstract

Although depression is one of the most common problems among adults in primary care settings, many do not seek or adhere to the treatment regimens suggested by their providers. Understanding the cultural model surrounding depression and its treatment in older adults might provide insight into the development of more effective strategies for addressing the problem in the clinical setting. In this study, the authors conducted semi-structured interviews with adults over age 65. Personal responsibility for the management of depression emerged as a pervasive approach to dealing with depression. Older adults used orientational and movement metaphors to describe the process of moving out of depression. They viewed initiation and follow-through of this process as the sole responsibility of the depressed individual. This attitude might be rooted in the cultural experiences of this particular cohort of older adults and has implications for their use of physical and mental health services for depression.

Keywords

depression aged cultural models

Get full access to this article

View all access options for this article.

References

Baer, R. , Weller, S. C. , Pachter, L. , Trotter, R. , Garcia, J. G. d. A. , Glazer, M. , et al. (1999). Beliefs about AIDS in five Latin and Anglo-American populations: The role of the biomedical model. Anthropology & Medicine, 6(1), 13-39.

Barg, F. K. , Huss-Ashmore, R. , Wittink, M. N. , Murray, G. F. , Bogner, H. R. , & Gallo, J. J. (in press). A mixed methods approach to understand loneliness and depression in older adults. Journals of Gerontology: Social Sciences.

Bogner, H. R. , Wittink, M. , Merz, J. F. , Straton, J. B. , Cronholm, P. F. , Rabins, P. V. , et al. (2004). Personal characteristics of older primary care patients who provide a buccal swab for APOE testing and banking of genetic material: The Spectrum Study. Community Genetics, 7(4), 202-210.

Chavez, L. R. , Hubbell, F. A. , McMullin, J. M. , Martinez, R. G. , & Mishra, S. I. (1995). Structure and meaning in models of breast and cervical cancer risk factors: A comparison of perceptions among Latinas, Anglo women, and physicians. Medical Anthropology Quarterly, 9(1), 40-74.

Chowdhury, A. M. , Helman, C. , & Greenhal, T. (2000). Food beliefs and practices among British Bangladeshis with diabetes: Implications for health education. Anthropology & Medicine, 7(2), 209-209.

Coreil, J. , Wilke, J. , & Pintado, I. (2004). Cultural models of illness and recovery in breast cancer support groups. Qualitative Health Research, 14, 905-923.

D’Andrade, R. G. , & Strauss, C. (1992). Human motives and cultural models. Cambridge, UK: Cambridge University Press.

deGruy, F. (1996). Mental health care in the primary care setting. In Institute of Medicine (Ed.), Primary care: America’s health in a new era (pp. 285-311). Washington, DC: National Academy Press.

Devins, G. M. , Orme, C. M. , Costello, C. G. , & Yitzchak, M. (1988). Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies-Depression (CES-D) scale. Psychology and Health, 2(2), 139-156.

10.

Garro, L. C. (2000). Remembering what one knows and the construction of the past: A comparison of cultural consensus theory and cultural schema theory. Ethos, 28(3), 275-319.

11.

Good, B. J. (1992). Culture and psychopathology. In T. Schwartz , G. M. White , & C. A. Lutz (Eds.), New directions in psychological anthropology (pp. 181-205). Cambridge, UK: Cambridge University Press.

12.

Holland, D. , & Quinn, N. (1987). Cultural models in language and thought. New York: Cambridge University Press.

13.

Kleinman, A. (1980). Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Los Angeles: University of California Press.

14.

Lakoff, G. , & Johnson, M. (1999). Philosophy in the flesh: The embodied mind and its challenge to Western thought. New York: Basic Books.

15.

Loewe, R. , & Freeman, J. (2000). Interpreting diabetes mellitus: Differences between patient and providers models of disease and their implications for clinical practice. Culture, Medicine and Psychiatry, 24, 379-401.

16.

McLellan, E. , MacQueen, K. M. , & Neidig, J. L. (2003). Beyond the qualitative interview: Data preparation and transcription. Field Methods, 15(1), 63-84.

17.

Mellers, B. A. , Erev, I. , Fessler, D. M. T. , Hemelrijk, C. K. , Hertwig, R. N. , Laland, K. , et al. (2001). Group report: Effects of emotions and social processes on bounded rationality. In G. Gigerenzer & R. Selten (Eds.), Bounded rationality: The adaptive toolbox (pp. 263-280). Cambridge: Massachusetts Institute of Technology Press.

18.

Radloff, L. S. (1977). The CES-D scale: A self-report scale for research in the general population. Applied Psychological Measurement, 1, 385-401.

19.

Shore, B. (1996). Culture in mind cognition, culture, and the problem of meaning. New York: Oxford University Press.

20.

Suh, E. (2004). Balancing relationships within a discordant world: The sociocultural context of breast cancer screening among Korean immigrant women. Philadelphia: University of Pennsylvania Press.