Depression is different for African-Americans than Caucasian-Americans or Latin-Americans, and the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the primary source of diagnostic information for clinicians, psychiatric drug regulation agencies, health insurance companies, the legal system, is getting it wrong, according to Sirry Alang, assistant professor of sociology and anthropology at Lehigh University.
Alang came to the conclusion that all of psychiatry is wrong on depression by spending a year in year in black neighborhoods and giving informal interviews, she says, and found that that African-Americans perceive depression as a weakness rather than as a health condition.
"It is impossible to effectively diagnose and treat depression among African Americans if their perspectives about depression are not taken into account," she explains. But the population she spent time with expressed depression through classic depressive symptoms, such as feeling hopeless, loss of sleep, and losing interests in activities, so what's the difference? The difference is they considered everything depression. Symptoms like anger, agitation, and the frantic need for human interaction were also considered by them to be indicative of depression. That is inconsistent with symptoms outlined in the DSM-V so rather than educate people on what depression actually is, she believes DSM needs to be more subjective. Like gender, depression becomes whatever you say you are. That's impossible when making health policy.
"For example, clinicians might 'miss' symptoms like anger if they are focused on depression as defined by the DSM-V," says Alang. "But they won't miss these symptoms altogether if they are open to the possibility that some African Americans have their own beliefs about depression, and that they might express symptoms consistent with those beliefs but inconsistent with how the DSM-V classifies depression."
Alang detailed her beliefs in a study called "'Black folk don't get no severe depression': Meanings and expressions of depression in a predominantly black urban neighborhood in Midwestern United States."