Chicana and Chicano Mental Health: Alma, Mente y Corazón

3. Gender and Mental Health: Depression, Anxiety, and Substance Abuse among Chicanas

3 Gender and Mental Health Depression, anxiety, and Substance abuse among Chicanas I n the general population, the primary mental health diagnoses affecting women are major depression and anxiety disorders—in particular posttraumatic stress disorder (PTSD) as a result of gender and sexual violence (Alegria et al. 2007; Herman 1992) and intergenerational trauma. Women are likely to experience depression at twice the rate of men (Centers for Disease Control and Prevention 2010). A number of factors are associated with women’s higher rates of depression, including genetics, hormonal changes, and environmental and sociocultural context. Feminist scholars, including Jean Baker Miller (1974) and her colleagues at the Stone Center, argue that women’s position in society contributes to women’s higher rates of depression. This is particularly the case with women of color, who generally encounter multiple forms of gender discrimination and violence throughout their lifetimes (Alegria et al. 2007). Epidemiological studies find that nativity is a risk for lifetime psychiatric disorder among Latinas. Living in the United States is a risk factor for depression among women of Mexican origin and Mexican immigrants. US-born women who are English-language dominant are more likely to have experienced depression, anxiety, or substance use disorder than are immigrant women. The greater risk is attributed to pressures to acculturate— acculturative stress—and the need to navigate different cultural expectations (as discussed in chapter 2), which increases the risk for emotional distress (Delgado 2002; Torres 2010). Likewise, their psychological distress may be related to segmented assimilation, which results in underemployment, limited upward mobility, and possibly greater exposure to violence if the women live in high-crime urban centers or barrios (Rumbaut 1994). The risk is higher for third-generation women than for immigrants or second-generation Chicanas . Latinas also experience higher rates of depression than Latino men and rates similar to European American women (Alegria et al. 2007). Gender and Mental Health 53 Chicanas often attribute their emotional distress to problemas de la vida rooted in relational difficulties with family members—in particular parents, partners, and children. They also attribute emotional distress to role strain, economic pressures, or immigration problems faced by loved ones. Depending on their stage of life, Chicanas may focus primarily on relationships with parents, friends, intimate partners, and children, and in later years, on aging parents and grandchildren. Not prioritizing their own emotional needs tends to affect women’s sense of self, their self-esteem, and their sexuality (see Flores et al. 2009). Many adult Chicanas also experience in adulthood the sequelae of childhood parental separation, sexual and physical victimization, adult intimate partner violence (IPV), and sexual violence, which impact a woman’s spirit, mind, and body. As a result of such trauma, Chicanas may experience anxiety, depression, and increased risk for substance misuse or abuse (see Flores-Ortiz 1995, 1999, 2004; Flores 2005a). Over the past thirty years, many scholars have described the position of Latinas within the larger US society and the family and examined the role of gender discrimination and sexual violence in the mental health problems of women (Perilla, Bakeman, and Norris 1994; Ramos Lira, Koss, and Russo 1999; Ramos Lira, Saltijeral, and Saldivar 1995; Rodriguez et al. 2008, 2009; Russo and Denious 2001). These scholars conclude that irrespective of the primary cause of emotional distress, the sociocultural context of Latinas and the women’s explanatory model of mental health must be taken into account to fully understand and respond to their psychological , spiritual, and physical complaints. This chapter provides an overview of mood, anxiety, and substance abuse disorders and how adult Chicanas experience and express their emotional and spiritual distress. explanatory Models From a cultural perspective, mental health problems may be caused by imbalance from or within relationships, or imbalance between the heart, mind, and body. Chicanas who utilize a traditional explanatory model may categorize emotional problems as nervios, which in turn can be defined as a physiological manifestation of interpersonal imbalance. The cause of nervios is related to an individual not being true to his or her word (relational ), not living in integrity, or experiencing discord within important relationships. Symptoms include bouts of crying, tension, listlessness, loss Chicana and Chicano Mental Health 54 of appetite, irritability, and sadness (Avila and Parker 2000; Salgado de Snyder, Diaz-Perez, and Ojeda 2000). Mental health problems can also have spiritual causes: mal puesto (hex or curse) can be caused by a brujo/a (witch) or could...