A recent 60 country World Health Organisation study found that depression is the most serious chronic illness, worse than angina, arthritis, asthma, and diabetes. Unfortunately, the majority of people who experience depression live in low income countries where help is least likely to be available.
The New York Times has a fascinating article on an ongoing project in Goa, India, that screens every attendee at a local health centre and then uses psychological therapy to help with low mood or anxiety.
It’s not a simple case of just using Western techniques in a new environment.
As the NYT article mentions, mental illness carries a significant stigma in many cultures. For example, a diagnosis may not only be stigmatising for the affected person, but it may also mean the person’s children are less likely to be thought of as suitable marriage partners, potentially affecting the whole family’s future.
Futhermore, depression is known to present quite differently in some non-Western cultures. Studies have found that people are more likely to report ‘somatic symptoms’ such as diffuse pains or tiredness, rather than low mood or emotional problems.
This is partly due to stigma, but sometimes because certain languages don’t have the same, or even such a varied vocabulary for emotions and mental states.
I’m currently working with a Pakistani psychiatrist who often surprises me by pointing out that even what I assume are relatively straightforward words, such as depression or anxiety, might not have a direct translation in some Asian languages.
All of these issues mean that the treatment centre in Goa tackles the issue in a slightly different way:
Most are also apparently wary of visiting a mental hospital. In India, the stigma of mental illness remains strong. To minimize the problem, health workers avoid using the words ‚Äúmental illness,‚Äù ‚Äúdepression‚Äù or ‚Äúanxiety‚Äù with patients, relying on more commonly used words like ‚Äústrain‚Äù and ‚Äútension.‚Äù
The patients ‚Äúare happy to talk,‚Äù Dr. Sudipto Chatterjee, a psychiatrist at Sangath, said, ‚Äúas long as you stay away from the idea of mental illness.‚Äù
I find the issue of having different vocabularies for our mental states fascinating.
The philosopher Wittgenstein noted how difficult it is to agree on common words for internal states because errors are so hard to correct.
If a mother and child see a rabbit and the child says “elephant!”, the mother can point to the rabbit and correct the misnomer. But what can a mother, or anyone do, if someone ‘misnames’ an emotion?
Or to put it another way, as we don’t have external things to refer to for internal states, how do we ever agree on a vocabulary that is at all meaningful?
I’m always curious when I come across differences concerning emotion words in other languages. For example, Spanish has the same word (verg√ºenza) for shame and embarrassment.
From my native language perspective it strikes me as amazing that another language doesn’t individually label these two states which seem to have such different personal and social implications.
I’m sure there are many reverse examples and many other emotional vocabulary mismatches across the world’s languages.
Link to NYT article ‘Psychotherapy for All: An Experiment’.