Stigma, Gender Inequality, and Depression in Bangalore, India

Major depressive disorder takes on a unique shape and stigma in India. In this work, we set out to explore presentations of psychological distress among psychiatric outpatients at a mental health institution in Southern India. During the process, we were struck by the report of women who expressed symptoms of depression. Of the 32 women who participated in the study, 75% qualified for a diagnosis of a current major depressive episode. Their narrative accounts of their experience suggested that the depressive symptoms appeared to be the direct result of social arrangements that constitute, in Farmer's terms, structural violence. The stigmas of being impoverished and female in a socio-culturally patterned context appear to give rise to experiences that contribute to depressive symptoms for the women in the present study. Although only a partial response to gender based suffering, psychiatric treatment seemed the only acceptable means of coping with their circumstances. The paper concludes by moving beyond a reductionistic model of psychiatric disease and symptomatology to explore more direct ways of addressing the suffering that women experience as a consequence of structural violence.