IDEAS home Printed from https://ideas.repec.org/a/sae/socpsy/v71y2025i1p78-89.html

‘Impaired in life’: Analyzing people’s accounts of depression in Ethiopia – Implications for a cultural-eco social approach to global mental health

Author

Listed:
  • Gojjam Limenih
  • Arlene MacDougall
  • Max well J Smith
  • Elysee Nouvet

Abstract

Background: Depression is a global crisis and a major concern in mental health interventions, particularly in low- and middle-income countries (LMICs), where it significantly impacts disability, quality of life, and economic stability. These chronic stressors have been used to argue for scaling up the detection and treatment of depression as a public health and development priority. Aim: This study aimed to explore illness narratives of depression among patients’ and to gain insights into multifaceted suffering, its impact on persons’ lives, and help seeking. This study is part the broader study which examined global mental health, biopolitics, and depression in Ethiopia, conducted in hospice setting to explore the conception of depression in Bahirdar city, Northern Ethiopia, among patients and health care providers. In this study, we focus on patients’ accounts of depression. Method: We employed an ethnography method using in-depth interviews, fieldnotes, and observation to collect the data. A thematic analysis was used to analyze the data. Drawing from cross-cultural and critical psychiatry perspectives, we situate depression within its cultural-eco social framework. Results: The study revealed that patients’ experiences and conception of depression are deeply intertwined with Ethiopia’s sociocultural, economic, and spiritual context. Depression was often described as a state of being ‘impaired in life’, reflecting the complex interplay of individual struggles and societal pressures. Integrating quotes from patients, we demonstrated in this analysis the ways in which biographically specific challenges, societal pressures, and mental well-being are understood by study participants in accordance with Ethiopian cultural and religious norms. Conclusion: The study suggests moving beyond narrow interpretative frameworks in GMH praxis to understand and address the complex dimensions of depression in Ethiopia and similar contexts. The study advocates for a cultural-ecosocial approach to depression, emphasizing the need for mental health interventions that consider the broader social and cultural factors contributing to mental distress.

Suggested Citation

  • Gojjam Limenih & Arlene MacDougall & Max well J Smith & Elysee Nouvet, 2025. "‘Impaired in life’: Analyzing people’s accounts of depression in Ethiopia – Implications for a cultural-eco social approach to global mental health," International Journal of Social Psychiatry, , vol. 71(1), pages 78-89, February.
  • Handle: RePEc:sae:socpsy:v:71:y:2025:i:1:p:78-89
    DOI: 10.1177/00207640241280620
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/00207640241280620
    Download Restriction: no

    File URL: https://libkey.io/10.1177/00207640241280620?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Roberts, Tessa & Shrivastava, Ritu & Koschorke, Mirja & Patel, Vikram & Shidhaye, Rahul & Rathod, Sujit D., 2020. "“Is there a medicine for these tensions?” Barriers to treatment-seeking for depressive symptoms in rural India: A qualitative study," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Pamela Y. Collins & Vikram Patel & Sarah S. Joestl & Dana March & Thomas R. Insel & Abdallah S. Daar & Isabel A. Bordin & E. Jane Costello & Maureen Durkin & Christopher Fairburn & Roger I. Glass & Wa, 2011. "Grand challenges in global mental health," Nature, Nature, vol. 475(7354), pages 27-30, July.
    3. Paul E Farmer & Bruce Nizeye & Sara Stulac & Salmaan Keshavjee, 2006. "Structural Violence and Clinical Medicine," PLOS Medicine, Public Library of Science, vol. 3(10), pages 1-6, October.
    4. Haroz, E.E. & Ritchey, M. & Bass, J.K. & Kohrt, B.A. & Augustinavicius, J. & Michalopoulos, L. & Burkey, M.D. & Bolton, P., 2017. "How is depression experienced around the world? A systematic review of qualitative literature," Social Science & Medicine, Elsevier, vol. 183(C), pages 151-162.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Mayston, Rosie & Frissa, Souci & Tekola, Bethlehem & Hanlon, Charlotte & Prince, Martin & Fekadu, Abebaw, 2020. "Explanatory models of depression in sub-Saharan Africa: Synthesis of qualitative evidence," Social Science & Medicine, Elsevier, vol. 246(C).
    2. Panter-Brick, Catherine & Eggerman, Mark, 2018. "The field of medical anthropology in Social Science & Medicine," Social Science & Medicine, Elsevier, vol. 196(C), pages 233-239.
    3. Vishal Bhavsar & Shuo Zhang & Dinesh Bhugra, 2019. "Conceptualizing globalization for mental health research," International Journal of Social Psychiatry, , vol. 65(2), pages 87-91, March.
    4. Turner, Alex J. & Fichera, Eleonora & Sutton, Matt, 2021. "The effects of in-utero exposure to influenza on mental health and mortality risk throughout the life-course," Economics & Human Biology, Elsevier, vol. 43(C).
    5. Karimli, Leyla & Ssewamala, Fred M. & Neilands, Torsten B. & Wells, Christine R. & Bermudez, Laura Gauer, 2019. "Poverty, economic strengthening, and mental health among AIDS orphaned children in Uganda: Mediation model in a randomized clinical trial," Social Science & Medicine, Elsevier, vol. 228(C), pages 17-24.
    6. Michael A. Flynn & Pietra Check & Andrea L. Steege & Jacqueline M. Sivén & Laura N. Syron, 2021. "Health Equity and a Paradigm Shift in Occupational Safety and Health," IJERPH, MDPI, vol. 19(1), pages 1-13, December.
    7. Ziyu Liu & Ya’nan Wu & Shunping Li, 2025. "Facilitators and barriers to healthcare services among patients with Atypical Hemolytic-Uremic Syndrome: a qualitative study," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 12(1), pages 1-14, December.
    8. Colin Forsyth & Sheba Meymandi & Ilan Moss & Jason Cone & Rachel Cohen & Carolina Batista, 2019. "Proposed multidimensional framework for understanding Chagas disease healthcare barriers in the United States," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 13(9), pages 1-23, September.
    9. Yang, Lawrence H. & Chen, Fang-pei & Sia, Kathleen Janel & Lam, Jonathan & Lam, Katherine & Ngo, Hong & Lee, Sing & Kleinman, Arthur & Good, Byron, 2014. "“What matters most:” A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma," Social Science & Medicine, Elsevier, vol. 103(C), pages 84-93.
    10. Vinay Basavaraju & Manisha Murugesan & Channaveerachari Naveen Kumar & Guru S Gowda & Santhosh Kumar Tamaraiselvan & Jagadisha Thirthalli & Shashidhara Harihara Nagabhushana & Narayana Manjunatha & Su, 2022. "Care at door-steps for persons with severe mental disorders: A pilot experience from Karnataka district mental health program," International Journal of Social Psychiatry, , vol. 68(2), pages 273-280, March.
    11. Marlow, Marguerite & Christie, Hope & Skeen, Sarah & Rabie, Stephan & Louw, Jacobus G. & Swartz, Leslie & Mofokeng, Shoeshoe & Makhetha, Moroesi & Tomlinson, Mark, 2021. "Alcohol use during pregnancy in rural Lesotho: “There is nothing else except alcohol”," Social Science & Medicine, Elsevier, vol. 291(C).
    12. Richardson, Eugene T. & Malik, Momin M. & Darity, William A. & Mullen, A. Kirsten & Morse, Michelle E. & Malik, Maya & Maybank, Aletha & Bassett, Mary T. & Farmer, Paul E. & Worden, Lee & Jones, James, 2021. "Reparations for Black American descendants of persons enslaved in the U.S. and their potential impact on SARS-CoV-2 transmission," Social Science & Medicine, Elsevier, vol. 276(C).
    13. Nerea Almeda & Carlos R. García-Alonso & José A. Salinas-Pérez & Mencía R. Gutiérrez-Colosía & Luis Salvador-Carulla, 2019. "Causal Modelling for Supporting Planning and Management of Mental Health Services and Systems: A Systematic Review," IJERPH, MDPI, vol. 16(3), pages 1-20, January.
    14. Thalia M. Sparling & Megan Deeney & Bryan Cheng & Xuerui Han & Chiara Lier & Zhuozhi Lin & Claudia Offner & Marianne V. Santoso & Erin Pfeiffer & Jillian A. Emerson & Florence Mariamu Amadi & Khadija , 2022. "Systematic evidence and gap map of research linking food security and nutrition to mental health," Nature Communications, Nature, vol. 13(1), pages 1-11, December.
    15. Metzl, Jonathan M. & Hansen, Helena, 2014. "Structural competency: Theorizing a new medical engagement with stigma and inequality," Social Science & Medicine, Elsevier, vol. 103(C), pages 126-133.
    16. Brandon C. Welsh & Margaret Beazer & Scott H. Podolsky, 2024. "Social Medicine for Social Justice: Perspectives on Violence Prevention," The ANNALS of the American Academy of Political and Social Science, , vol. 714(1), pages 56-72, July.
    17. Ilaria Tocco Tussardi, 2025. "The Future of Healthcare Management: A Social Medicine Perspective," IJERPH, MDPI, vol. 22(6), pages 1-4, May.
    18. Yu Shen & Wenkai Sun, 2025. "The winter depression: coal heating and mental health in China," Journal of Population Economics, Springer;European Society for Population Economics, vol. 38(1), pages 1-32, March.
    19. Shinu Vig, 2025. "Climate change and mental health of women in developing countries," Climatic Change, Springer, vol. 178(6), pages 1-20, June.
    20. Friedman, Joseph & Calderon-Villarreal, Alhelí & Heggebø, Kristian & Balaj, Mirza & Bambra, Clare & Eikemo, Terje Andreas, 2021. "COVID-19 and the Nordic Paradox: a call to measure the inequality reducing benefits of welfare systems in the wake of the pandemic," Social Science & Medicine, Elsevier, vol. 289(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:socpsy:v:71:y:2025:i:1:p:78-89. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.