Concepts of Stress and Depression: The South Asian immigrant experience

Background: Mental health has not been addressed appropriately in South Asian immigrant communities and poses a great public health problem. In a recent survey of health and disease among South Asian immigrants in Chicago, stress and depression emerged as central themes in respondents' lives and health.

Purpose: The purpose of this study is to describe the experience of mental health in recent South Asian immigrants including the etiology and management of stress and depression.

Methods: We conducted qualitative, semi-structured interviews in English, Hindi and Urdu with 75 respondents from a federally qualified health center and at a community center for South Asian immigrants in Chicago, Illinois. Age ranged from 20-70; 60% were women; 60% held advanced degrees; 70% were recent immigrants and 60% of the interviews were in Hindi or Urdu.

Results: Family life, finances, and children were the most often cited sources of stress, but they varied significantly by gender and religion. Other sources of stress included issues of acculturation such as changing cultural values, social isolation, and lack of job security. Gender and religion played a significant role in the management practices of stress. Sleeping problems, heart attack, and increased blood pressure were the most often reported physical manifestations of poor mental health.

Conclusion: South Asians contextualize mental health in a social rather than in a biomedical framework. Instead of chemical imbalances being the underlying cause of stress and depression, South Asian immigrants describe mental health issues as a result of circumstances in their lives.