Rethinking Depression: A Cultural Perspective

Depression is often associated with sadness, low energy, or disinterest in daily life. But as an art therapist working across cultural contexts, I’ve learned that depression is far more complex than it’s often portrayed, and deeply shaped by our personal histories, identities, and cultural environments.

In many of the communities I work with, especially within collectivist or Middle Eastern cultures, depression doesn’t always show up in recognizable or diagnosable ways. It often hides behind physical symptoms, family roles, or societal expectations. Understanding these hidden expressions of depression is key, not only for offering effective support but for reducing shame and expanding compassion.

The Cultural Masking of Depression

In collectivist cultures, emotional suffering is frequently expressed through the body. Instead of saying, “I feel hopeless,” a person may say, “I haven’t been sleeping,” or “My stomach always hurts.” These aren’t imagined complaints, they are very real, somatic responses to unprocessed emotional pain. This phenomenon, often referred to as somatization, isn’t unique to any one culture, but it’s especially prevalent in environments where psychological distress is less accepted or where speaking openly about mental health is taboo. In these spaces, the body becomes the voice. Beyond the physical, cultural values can play a significant role in how depression is experienced and internalized. For example, maintaining the family’s image or “saving face” may discourage someone from speaking up about their struggles. Instead, they may push themselves to appear functional, helpful, or emotionally strong, even when they are deeply unwell. This pressure to perform wellness can be exhausting and isolating, reinforcing the very symptoms they’re trying to hide.

Depression is also shaped by identity, particularly when a person feels caught between who they are and who they’re expected to be. A young woman raised to prioritize others may feel guilt or fear when asserting her independence. A man told to “be strong” may experience his emotional sensitivity as failure. Over time, these inner conflicts can build into depressive symptoms: numbness, apathy, exhaustion, or self-doubt.

In therapy, part of the work involves gently examining these roles and asking: Who assigned them to you? Are they still serving you? What would it mean to let them go, even slightly?

This process isn’t easy, especially when roles are reinforced by family, religion, or community, but it’s often essential to recovery. Depression is not always a problem to be “fixed,” but sometimes a signal that something inside us no longer fits.

A Final Word

Depression is often about disconnection: from the self, from others, and from a sense of meaning or vitality. This disconnection can stem from loss, trauma, unexpressed grief, or the chronic suppression of one’s needs or identity. As an art therapist, I have witnessed that art allows us to explore these disconnections in a way that feels safe and non-verbal. I’ve witnessed clients express what they couldn’t say aloud through imagery. In these moments, art becomes a mirror to the emotional world, revealing patterns and pain that may have remained unconscious or dismissed. When clients begin to externalize their inner experience through art, they often shift from “What’s wrong with me?” to “This is what I’ve been carrying.” That shift, from shame to insight, is one of the first steps toward healing.

Depression is not always loud. It’s not always dramatic. It doesn’t always look like what we expect. But when we learn to listen, through the body, through culture, through art, we begin to understand its language. If you’re struggling, know that your pain doesn’t have to look a certain way to be valid. And if you recognize parts of yourself in this piece, consider it a quiet invitation: to pause, reflect, and if it feels right, reach out.