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Review of “An Illness of Power: Gender and the Social Causes of Depression” by Alex B. Neitzke

4/26/2016

10 Comments

 

by Larry Monocello

In this article, Neitzke argues that the higher prevalence of diagnosis of depression in women  cross-culturally is the result of the biomedical framework’s removal of a patient from her social surroundings. She argues that this removal obscures the fact that a diagnosis is often made without consideration of the fact that women live in “a patriarchal system of gender as it interacts with a social, political, and economic order…limits or altogether preventing the examination of social and economic mechanisms in the causal pathways of mental disorders” (60). She argues that the DSM-III’s definition of depression mapped to “feminine” behaviors and characteristics, and, circularly, depression became “identified with women, as primarily a disease of women” (62). Statistics, showing that women suffered from depression more often than men, “objectively” legitimated the category. Further, the mechanistic analogies used by biomedicine, and therefore the assumptions biomedical researchers and practitioners come to espouse as reality, served to “bracket-out gender and other social influences” (63), denying them the ability to attribute their “disorder” to anything other than their biology.

One of the many strengths of this article is the author’s attention to ethnographic work on depression. Referencing anthropologists work on depression cross-culturally, she shows that the experience of depression is culturally constructed. She explains how, in some cultures that valorize instead of marginalize the depressed (e.g., Gaines and Farmer’s (1986) work on the Visible Saints of France), outcomes and experience are different. She argues that the biomedical/psychiatric model of depression is disempowering to women for that very reason: the culture around depression is hostile, and yet the culture is not considered in the model, erasing a very real factor from consideration. As a result, she calls for a truly biopsychosocial model of depression to address this flaw.

Importantly, Neitzke notes that her criticism of the biomedical psychiatric model of depression as erasing the consideration of gender can also be extended to considering the erasure of sexuality and race/ethnicity. This made me consider a couple of questions that I would like to leave up for discussion:

Over the course of the semester—aside from our discussion of poverty—we haven’t spent much time discussing the experience of marginalized groups (sexual and racial minorities, women, etc.). Critically considering the topics of past discussions, how do you think that the utilization of a feminist or racially-sensitive lens would affect our interpretations of what we have read thus far? 

Is a feminist/racial/queer neuroanthropology necessary? Is it even possible? What would it look like? 


Neitzke, Alex B. 2016. "An Illness of Power: Gender and the Social Causes of Depression."  Culture Medicine and Psychiatry 40 (1):59-73. doi: 10.1007/s11013-015-9466-3.
10 Comments
Julia Wolfe
4/26/2016 06:51:21 pm

I'm very confused by this question. Maybe I'm missing something, and I'm not sure I can even articulate why, but I find the question offensive. Thinking out loud here, since I'm not sure where I'm going, so bear with me. Why wouldn't it be necessary? I guess part of my issue is that while it may not bear those names, I'm sure that kind of anthropology exists already. I hope this makes sense to someone cause I'm not even sure it makes sense to me.

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Myra Barrett
4/26/2016 07:47:25 pm

I think I understand what you mean. One of the most important principles in anthropology, in my opinion, is cultural relevance. I feel like a feminist/racial/queer lens is already built into the nature of ethnography. It would be great to see more studies and research specifically related to these topics, but, unless a researcher is looking at race or feminism specifically, there wouldn't seem to be a connection in every case. Does that make any sense?

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Michelle Bird
4/26/2016 07:36:13 pm

I thought Larry's question was very interesting - the author of the article points out that depression is a cultural construct, and argues that phenomena of women experiencing depression more frequently than men do is a result of being separated from their social environment (one that's usually patriarchal - since depression is related to culture, it would make sense that a woman may not fit in as well into a world mediated primarily by men and thus experience feelings of isolation or sadness, the hallmarks of "depression"). This said, I think Larry's question centers more around whether or not we should be viewing this from a different angle, or if it's even possible to see it through a "feminist or racially-sensitive lens" since this patriarchal system is so embedded into our culture.

Honestly, I'm having a hard time thinking of how one might conduct a study through a feminist point-of-view. I know some feminist archeologists have studied certain ancient cultures (I'm vaguely familiar with studies on Greek and Roman societies which have centered around grasping a more complete picture of the lives (and wants, needs, and real issues) of women, primarily achieved through extensive analysis of the poet Sappho and other records that mentioned women or were (very rarely) written by them), but it's exceedingly difficult to find materials and accurate information because women were so obscured from regular society. In the context of this article, I think it would be extremely useful to gain a different perspective on what depression is and what it means, though I can imagine it would be difficult when one shares the same cultural constructs as the society they are studying. I wonder if one day, in a few hundred years, if people will study depression and label it to be as sexist as the view the ancient Greeks had concerning womanly "hysteria" being a problem of a 'wondering womb' - seriously, ancient doctors blamed a vast majority of women's health problems on their womb (apparently it could float around and disrupt everything from menstruation to digestion to even causing neurological problems - here's a link: http://exhibits.hsl.virginia.edu/antiqua/gynecology), for which the only lasting cure was pregnancy. Fathers of daughters with health problems were encouraged to marry them off as quickly as possible, because they "believed" her womb would be stabilized if she were having sex and giving birth to sons (ie. producing legitimate citizens, which would secure her social position and usually gave her more freedom and kind treatment from her husband, and respect from other women within the society - an acceptance in society which would improve their quality of life drastically). Otherwise, they treated things with an odd form of aromatherapy.

Basically, there still seems to be a lot of underlying sexism prevalent in medicine in our society, especially as it concerns depression (not surprising considering we stole a bunch of ideals and structures from the ancient Greeks - why not "hysteria" too?). I have no idea how one would go about conducting anthropological studies on modern societies through a "feminist" lens, but I definitely think it would yield some interesting results that could support the movement for gender acceptance while eliminating stereotypes that have generated a ridiculous amount of pharmaceutical support.

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Nick Roy
4/27/2016 07:12:45 am

I agree. Throughout this semester, I've been trying to think of ways a queer perspective could be incorporated into neuroanthropology specifically. I do not think that it is impossible to incorporate a queer, feminist, or racial perspective into this area. These perspectives are also necessary.

While ethnography may be able to incorporate these perspectives in, one must not forget that the other side of neuroanthropology is neuroscience and psychology. Those two fields have been fraught with problems in incorporating perspectives other than those of predominately white, straight, men.

For this field to be truly of worth to both anthropology and psychology, it must be able to incorporate perspectives outside those that have historically dominated science. Otherwise, neuroanthropology contributes nothing to psychology and contradicts current anthropological theory.

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Michelle Bird 2nd post
5/5/2016 08:50:38 pm

After our class discussion, I felt even more strongly about the need to employ a different lens while analyzing some of the issues we have thus far, simply because it is always necessary to make sure that the people that change will affect will actually benefit from it - a lot of harm has been done accidentally to groups that were already marginalized whose views weren't accurately represented by well-meaning people (including and especially anthropologists), and it is certain that no harm can come from being careful.

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Mirjam Holleman
4/27/2016 08:47:17 am

That's a great question, and I agree with the comments above. I think a neuroanthropological perspective on marginalized groups would start by, (as Lende and Downey suggest in the concluding chapter of "The Encultured Brain"), not essentialize these categories (e.g. by focusing on "the" queer perspective, "The issue" of race, "the" feminist view) but rather take into consideration that “what it means to be a member of a racial or ethnic group or a man or a woman [or what it means to have a disability], is not simply an exemplar of a category, but is itself liable to shifting meaning and impact across our lives and context” (p. 405).
I look forward to our discussion in class today!

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Molly Jaworski
4/27/2016 09:48:41 am

Before addressing Larry's question. I first want to discuss the article he reviewed. While I do agree that in some cases depression in women can have a cultural cause such as the patriarchal stigma that is discussed, it seems as though the author dismissed the biomedical framework around depression all together. At least that is what I am getting from this review. I do not like that the author focusses on this idea of a patriarchal cause of depression in woman. I grew up in a home of all females my mother, sister and I. I grew up without this patriarchal stigma in the household. Even in my extended family where there is a male presence in the home, it always seemed more of a matriarchal system. Despite my upbringing and lack of patriarchal stigma I was still diagnosed with depression. Depression can very well be influenced by environment but it is unfair to ignore that many cases are also a result of biology such as mine. I suffer from a serotonin imbalance which is what causes my form of depression and is strictly biological.

Larry's question, asks whether or not a feminine lens would affect our analysis and view on readings we have discussed thus far. In my opinion, the nature of ethnography, as Myra states, has this lens built into it. I wouldn't classify it as a lens and instead as a topic that could be studied because the nature of anthropology is to be unbiased as much as possible. Adding a feminist lens would in my opinion defeat the purpose of the ethnographic analysis .

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Molly Jaworski
5/5/2016 09:12:54 am

After discussing the topic further in class I am a little more open about the idea of adding a lens to some of the topics we have studied thus far. I still feel however that the nature of the subject is to be unbiased and adding a lens could affect the anthropological aspect of some of the works we have read. I feel that these lenses should be processed as their own individual studies instead, examining them neuroanthropologically.

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    This blog is group authored by Dr. DeCaro and the students in his ANT 474/574: Neuroanthropology.

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