Symptoms of depression and their management among low-income African-American and White mothers in the rural South

Abstract

Objective. This study examines experiences of depressive symptoms among a group of 32 low-income, African-American and White mothers of young children who resided in rural Eastern North Carolina, USA.

Design. Women's experiences of depressive symptoms were elicited through a series of longitudinal ethnographic interviews, including an explanatory models interview specifically designed to elicit their beliefs about the causes, symptomatology and help-seeking behavior and management of depressive symptoms.

Results. A content analysis of interview data indicated that most women (11 African-Americans and 15 Whites) reported having depressive symptoms currently or in the past. Both African-American and White women perceived the main causes of these symptoms as being relationship problems with a spouse, a partner, or a family member; lack of finances; and parenting stresses. There were no differences in the depressive symptoms African-American and White women reported, but there were differences in how they managed these symptoms and where they sought help. Most of the African-American women sought no formal treatment (i.e., pharmacotherapy and/or psychotherapy), but instead turned to their religious faith to deal with their feelings. White women were more likely to seek formal treatment.

Conclusion. These findings provide insights into the ways in which women in one nonurban area in the USA explained and experienced depressive symptoms and demonstrate differences in help-seeking behaviors that can be linked to beliefs about depression and perceptions of societal responses to those who have it, as well as to perceptions of and experiences with the health-care system. Results have implications for the implementation of education, intervention, and treatment programs in more culturally sensitive ways.

Keywords:

• depressive symptoms
• African-American women
• low-income
• explanatory models

Acknowledgments

We would like to thank the women who participated in this study and shared their lives with us. We also thank Deborah Peacock and Clara Holder-Taylor who conducted most of the interviews. We are grateful to Wendell Fortson, Rachel Haase, Marsha Michie, and Karey Sutton for their valuable feedback on drafts of this paper. The Family Life Project was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01-HD-39667) with co-funding from the National Institute on Drug Abuse and the Maternal and Child Health Bureau (R40-MC04293-01-03). The Family Life Project (FLP) Key Investigators include Lynne Vernon-Feagans (PI), Martha Cox, Clancy Blair, Margaret Burchinal, Linda Burton, Keith Crnic, Ann Crouter, Patricia Garrett-Peters, Mark Greenberg, Stephanie Lanza, Roger Mills-Koonce, Debra Skinner, Emily Werner, and Michael Willoughby. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Key messages

Several findings emerge as key in this study:

1. The majority of White and African-American women in our study report having experienced depression at some point in their lives.

2. African-American and White women describe the causes and the symptoms of their depression similarly, but they manage it in different ways.

3. Both African-American and White women viewed counseling to manage their depression as expensive and potentially stigmatizing. The majority of White women chose medication to manage their depressive symptoms while African-American women turned to their religious faith.