Analysis of the Historical, Cultural, Structural and Critical Factors of Anxiety and Depression Using Sociological Imagination

This essay will examine and analyse the historical, cultural, structural and critical factors that may have contributed to anxiety and depression, through utilising the sociological imagination framework. Firstly, the definition and prevalence of anxiety and depression will be delved into on a national and global scale, which will highlight the important nature of the issue. The historical perspective of anxiety and depression will then be explored by assessing how events such as colonisation have been key contributors to this health issue. Cultural trends and practices including social media and child marriages will be investigated, as well as the impact that it has on anxiety and depression. Additionally, key structures and organisations including school life, will be closely studied to determine the effect of academic stress on anxiety and depression. Finally, a critical perspective will be applied, discussing biological factors surrounding mental health and possible interventions to combat this issue. Thus, through sociological analysis, it will be argued that historical, cultural and structural factors have contributed to anxiety and depression as a public health issue.

Anxiety and depression are often identified by medical professionals as potentially debilitating conditions that can affect one’s physical and mental health (Lifeline Australia, 2020). Anxiety and depression have become increasingly more prevalent within Australian society. This is demonstrated by statistics delivered by the Australian Bureau of Statistics (ABS), which revealed that 3.2 million Australians have an anxiety related condition, an increase from 11.2% in 2014-2015 (Australian Bureau of Statistics, 2018). Similarly, the number of people suffering from depression increased from 8.9% in 2014-2015 to 10.4% which is equivalent to 1 in 10 people (Australian Bureau of Statistics, 2018). Globally, more than 300 million people suffer from depression, whilst 25% will be affected by a mental health condition at some time in their lives (Roberts, 2018). The prevalence of anxiety and depression within our society is a significant issue as people with depression are three times more likely to commit suicide, as well as three times more likely to engage in violent crimes (Department of Health and Human Services 2014; Fazel et al. 2015). Depression and anxiety have an immense economic impact, as the World Health Organisation in 2019 (WHO), estimated that these two disorders cost the global economy up to $1 trillion US dollars each year. This notably impacts people’s quality of life, places strain on health care systems and services, and thus generates detrimental consequences to society. The importance of good mental health is once again highlighted by WHO as they emphasise “there is no health without mental health” (World Health Organisation 2004, p.10). It has been reiterated that anxiety and depression affect a large number of people, communities and economies both directly and indirectly.

Colonisation is a historical event in history that has played a significant role in the occurrence of anxiety and depression present in Indigenous communities. Indigenous individuals are still to date experiencing overwhelming feelings of trauma and grief as a direct result of this historical event (Lavalle & Poole, 2009). All of these factors are thereby linked to depression, anxiety and suicide. Colonisation has created a feeling of emptiness within Indigenous people “with respect to their identity,” due to being forcefully separated from the “fundamental essential elements of Aboriginal life” (Brown et al. 2012, p.7). The intergenerational effects of this occurrence are brought to light by Cynthia C. Wesley-Esquimaux as she states that,“present indigenous communities are a direct legacy of their traumatic past” (2002, p.7). Lifeline Australia has revealed that the suicide rate for Indigenous Australians in 2015 was more than double the national rate, which currently sits at 12.6 per 100,000 people. This is a direct reflection on the impact that colonisation still has on anxiety and depression in current Indigenous populations. Land reclamations, environmental dispossession, racism, the stolen generations and segregation of Indigenous people to other civilians have all been incidences caused as a direct consequence of colonial practices. This, in turn, has contributed to a “denigration of identity,” as well as in addition to feelings of “grief, anger, hopelessness and helplessness” (Lavallee & Poole 2009, p.274). A study conducted in 2012 investigating depression amongst Aboriginal men, concluded that participants viewed their depression as a “loss of connection to social and cultural features of Aboriginal life,” correlated to the legacy of colonialism (Brown et al. 2012, p.1). Additionally, a statement from a participant in the study also revealed the destructive impact of colonisation, particularly its effects on mental health. The man explained how “in the old days…there was probably no depression prior to White man’s influence” (Brown et al. 2012, p.5). This was in stark contrast to today’s society where he felt there are “two lots of rules, no respect, [and] hardly any culture” (Brown et al. 2012, p.5). Therefore, it has been demonstrated that colonisation and colonial practices significantly place Indigenous communities and individuals at a higher risk of anxiety and depression.

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Cultural trends and practices including social media and child marriages, have proven to have dreadful consequences on mental health in adolescents and children. It is clear that social media platforms have swiftly become an integral part of young people’s lives, with 90% of adolescents aged between 13-17 in America adolescents utilising social media (Lenhart, 2015). It is interesting to note that the prevalence of anxiety and depression in young people has increased by up to 70% from 1998 to 2017 (Keles, McCrae & Grealish, 2019). Previous studies hold social media primarily accountable for this phenomenon. According to a study that evaluated 467 participants aged 11-17 years old, 47% were categorised as anxious, whilst 21% were regarded as depressed (Woods & Scott, 2016). Similarly, it was discovered in a 2018 study conducted that, “How emotionally and behaviourally attached an individual is to social media” needs to be taken into consideration when assessing the relationship between anxiety and depression and social media use (Shensa et al. 2019, p.117). Actions such as overlooking important responsibilities and relationships have been identified as consequences of social media, which may lead to depression and anxiety (Shensa et al., 2019). Another cultural practice that has been identified as having an impact on anxiety and depression for young individuals is child marriage. Victims of child marriage are subject to significant levels of abuse, forced sexual relations, and the denial of freedom. Many feel as if though “there is no one to trust or speak to about their situation,” leading to profound feelings of anxiety and depression (Mwachindalo n/d p.1). It is estimated that this custom affects over 60 million girls globally, with Niger having the highest rate of child marriage in the world, with over 75% of children aged between 15-19 already married (John, Edmeades & Murithi, 2019). The most considerable implication of child marriage is domestic violence, which includes sexual and emotional abuse. Qualitative data derived from a study undertaken in Nigeria and Ethiopia has presented how child marriage leads to “significant emotional distress and depression” (John, Edmeades & Murithi 2019 p.5). It was additionally discovered that, “Child brides were more likely than those who marry later to be stressed and anxious” (John, Edmeades & Murithi 2019 p.6). When a young girl is wedded to an older man it “creates an inequitable power imbalance” which allows the man to feel in ownership “to her attention, body and reproductive capacity” (Mwachindalo n/d p1). According to the International Council of Research On Women (ICRW), married adolescents are at a higher risk of domestic violence in comparison to women who marry later. It has been proven that women experiencing domestic violence are at a substantially higher risk of developing a range of mental health disorders, including depression and anxiety. Specifically, the likelihood of acquiring depression was 2.7 times greater, and anxiety four times more (Trevillion et al. 2012).

School institutions are an integral structure in society, however recent evidence has suggested that academic stress can increase the prevalence of anxiety and depression. Several medical professionals have articulated their concerns in regard to education being a primary source of stress for high school and university students. A study undertaken in India demonstrated that academic stress and examination related anxiety “was positively related to psychiatric problems” (Deb, Strodl & Sun 2015, p.29). The gravity of this issue is yet again emphasised by the amount of hospitalisations and suicides due to school related mental illness. The study highlights that many adolescents “are referred to hospital psychiatric units, exhibiting symptoms of depression and anxiety,” and tragically 6.23 students everyday in India commit suicide as a result of academic stress (Deb, Strodl & Sun 2015, p.29). These results are similarly replicated in other studies globally including America where it has been concluded that, “Within the past 7 years the likelihood that a college student will suffer from depression has doubled” (Howard 2006, p.92). Survey results from The Journal of the American Medical Association unveiled that 45% of students felt “so depressed” that they “could barely function” (Howard 2006, p.93). It has been suggested by researchers that this particular generation is more susceptible to mental health issues as a result of academic stress, due to certain traits that millennials possess (Howard, 2006). This includes the fact that millennials are high achievers, with many experiencing constant pressure from their families to be successful. In their pursuits to achieve the “trophy kid status” they experience extreme stress and burnout (Howard 2006, p.95). If one does not accomplish their goals this can translate to feelings of defeat, as well as depression. Overall, expectations from parents as well as being a high achiever can cause academic stress, which increases the probability of developing anxiety and depression.

Whilst all the factors discussed in the essay thus far do contribute to anxiety and depression, they are not the sole reason. Anxiety and depression are often caused by a range of factors combined. Although psychosocial factors contribute to this issue, biological causes play a key role also which have not been recognised enough. When diagnosing such disorders, classification systems are used. However, such methods assume that, “One hat fits all” as it does not take into consideration “the enormous depth, breadth and variances in mental illness” as well as “the individuality and complexities of the sufferers” (Parliament of Australia 2006, section. 5.6-5.13) This led to Wilhelm Greisinger developing the biomedical model for mental illness which states that, “Mental disorders are caused by biological abnormalities” and that biological treatment is recommended (Deacon 2013, p.847). Current treatments, including medication, cognitive behavioural therapy and changes to diet and exercise, do not emphasise as strong as a biological focal point as they should. Even though medication is used to treat chemical imbalances, “Approximately half of psychotropic drug prescriptions are written for individuals without a psychiatric diagnosis” (Deacon 2013, p.847). This reinforces the fact that current diagnostic methods are not catered well enough to the individual and are far too subjective. After reflecting on this issue, it can be inferred that an “increased investment in neuroscience” will improve current diagnostic and treatment methods by offering “biological tests” and specific “pharmacological treatments” (Deacon 2013, p.847). A study conducted by Verma, Kaur & David in 2012 proposes a blood test to diagnose depression to determine ethanolamine phosphate levels, as people with depression typically have less in their blood. It has shown to have led to a correct diagnosis 82% of the time, and thus should be strongly considered as a future diagnostic tool (Verma, Kaur & David, 2012). Similarly, anxiety disorder should be diagnosed using neuro-imaging, as it has been emphasised by researchers that there are significant changes in brain anatomy when anxiety is present (Maron & Dutt, 2017). These methods would benefit rural Indigenous communities, university students, as well as countries where child marriages take place. This will additionally allow medical physicians to make a more knowledgeable decision regarding the referral of a patient to a psychiatrist. It will act as a guide for “conducting clinical interviews” as well as “assess[ing] the response to interventions” (Parliament of Australia 2006, chapter 5). Although the biological analysis of anxiety and depression is essential to developing more personalised and effective treatments, it is still crucial to obtain qualitative psychological data and combine them together to improve the outcomes of these disorders.

It has been reinforced throughout this essay through the sociological imagination as a framework, that historical, structural and cultural influences have impacted upon depression and anxiety. It was identified how colonisation has played a role in the current prevalence of anxiety and depression. Cultural aspects of society including social media and child marriages were discussed as contributors to this issue. Additionally, school life was recognised as a structural factor that may influence anxiety and depression, in particular academic stress. Upon reflection, a critical analysis of all factors discussed was incorporated, and innovative measures including personalised biological treatment was examined. The implication of the concept created by C.Wright Mills widely known as the ‘sociological imagination’ is essential for both individuals in the health industry and societies to understand so that they able to analyse the issue from an array of perspectives. This, in turn, will allow medical professionals to be able to effectively view global societal issues through a sociological framework.

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