Strategies Used by Mexican-Americans to Deal with Depression

Alison Druck , PhD, Principal Investigator
Alexa K. Stuifbergen, PhD, RN, FAAN, Principal Investigator

Purpose: When community health planners attempt to address a mental health issue, they often have a good understanding of the behavioral illness, but a poor understanding of how people attempt to cope with the illness. Many studies have focused on the causes of depression in the Mexican-American population (e.g., Black, Markides, & Miller, 1998; Aranda, Castaneda, Lee, &Sobel, 2001), which include lack of social support, marital and occupational difficulties, and medical conditions. Acculturation studies by Lang (1982) and Miranda and Umhoefer (1998) suggest that bicultural Latinos, those who are able to maintain their culture and incorporate skills from the host culture, are less depressed than those who are highly acculturated or have low acculturation. Though a few interventions have been described for depressed Hispanics (Ruiz, 1998; Garza-Trevino, Ruiz, &Venegas-Samuels, 1997), the majority of studies dealing with Mexican American populations describe dimensions of maladaptive coping behaviors such as alcoholism (Golding, Burnam, Benjamin, &Wells (1992). No studies describe to whom Mexican- Americans turn for relief, advice, counseling, or treatment of depression. Having this information, community health planners can choose to teach appropriate interventions with appropriate providers for primary prevention (Munoz& Ying, 1993) and treatment of depression. The purpose of this study was to explore the experience of depression and the strategies used to deal with depression in a sample of Mexican-Americans living in southwest New Mexico. Research questions included:

? How do Mexican-American individuals describe their depression?
? What strategies do Mexican-American individuals use to deal with their depression?
? What strategies have been helpful to Mexican-Americans in dealing with their depression?
? What community-based resources have been helpful or would be helpful in coping with depression?

Sample and Date Collection: The sample for this qualitative descriptive study consisted of 20 Mexican-American individuals residing in Las Cruces, NM, who belong in one of three stages of acculturation (Miranda and Umhoefer, 1980): one-third who speak only Spanish (n=6), one-third who speak only English (n=7), and one-third who are bi-lingual (n=7). Subjects participated in one sixty-ninety minute interview, conducted in either Spanish or English.

Instruments: A semi-structured interview guide based on the literature review was used to ask subjects to describe their experiences with depression, and how they manage their depression. Subjects also completed a demographic data form, and current feelings of depression were assessed by completion of the Center for Epidemiological Studies- Depression Scale (CES-D; Radloff, 1977). Both of these forms were available in Spanish and English.

Findings: Participants reported using a variety of strategies to manage their depression. They indicated that they “do stuff” for other when they are feeling down, whether family members or less fortunate individuals in their community. Medication was mentioned by several, as were alternative treatments. Spending time with family was a dominant theme. Participants reported that mothers are a very important part of their lives, especially during difficult times. Talking and silence were also mentioned as strategies. The findings are important to nursing practice in several ways. First, they suggest that Hispanic women may decide about returning to a treatment setting based on how they are treated during the initial visit. For less acculturated women, medication and traditional psychotherapy may be less well received and alternative strategies may be more effective. Programs including individuals’ mother and other family members may be more accepted and more effective for this group of individuals.

Dissemination: Dr. Druck presented at CHPR’s research conference, Promoting Health in Underserved Populations, and disseminated an abstract of her study and findings at the 2003 Nursing Leadership Conference in Austin, Texas.