A Cross-Cultural Analysis of Clinical Depression: Rural Coastal Highlands of Guatemala

Abstract

In the summer of 2007,1 was given the opportunity to spend three months living at the mission of the Catholic Diocese of Helena, Montana, in Santo Tomas, Guatemala, whose Mayan people are dramatically marked by a socio-political history of radical violence, instability, and poverty. The purpose of the thesis was to conduct research on Mayan psychological health in conjunction with the mission’s Clinica Maxena, the main provider of basic health services to this area. As a result of qualitative and quantitative data gathered during this time, this thesis will attempt to describe the culturally specific understanding of depression in Guatemala, and demonstrate how this understanding can benefit the discussion of the etiology and treatment of depression. The Mayans demonstrate an astute understanding of psychological health characterized by a worldview radically different from our own. In particular, the Mayan view on psychological health cannot be easily compartmentalized due to its holistic view of the human person. In addition to a qualitative approach, the Beck Depression Inventory (BDI-II) was administered. Results showed that BDI-II scores of 49 Guatemalans were significantly higher than means of a published psychometric comparison of a normal group in Canada. Thirty-five percent of the Guatemalans’ scores were categorized as “severe,” and no one reported receiving psychological services. Herbal treatments for mood disorders are available through a Mayan medicinal-plant clinic. Almost all treatment options for depression also treat for anxiety. The psychosocial experience of the Mayan people and the nature of Mayan treatments for depression strongly support the HPA axis theory on depression.