The Suppression of Depression as Multimediation: Psychiatric Diagnoses Under Myanmar's Military Dictatorship.

IF 1.5 4区 医学 Q2 ANTHROPOLOGY
Culture Medicine and Psychiatry Pub Date : 2025-09-01 Epub Date: 2025-03-23 DOI:10.1007/s11013-025-09899-3
Stefan Ecks
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Abstract

Myanmar has experienced decades of military dictatorship, civil wars, religious violence, economic crises, and natural disasters. While these conditions would suggest very high rates of depression and anxiety, government statistics report an exceptionally low depression rate of 0.00006%, compared to the global rate of 3.4%. This study combines analysis of epidemiological data, ethnographic observation of clinics, and in-depth interviews. I argue that Myanmar's low depression rates cannot be explained by the usual arguments about treatment gaps, lack of providers, or medication accessibility. Instead, I suggest that the military regime suppresses depression because it sees it as a form of political protest. While conditions like schizophrenia are readily diagnosed and treated as "purely biological," mood disorders are suspect expressions of dissent. Through living value theory (LVT), I explore health as a process of multimediation. The dictatorship's suppression of depression emerges as the strategic muting of medical interventions in favor of amplifying non-medical remediations.

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抑郁症的多重抑制:缅甸军事独裁统治下的精神病诊断。
缅甸经历了几十年的军事独裁、内战、宗教暴力、经济危机和自然灾害。虽然这些情况表明抑郁症和焦虑症的发病率非常高,但政府统计数据显示,与全球3.4%的抑郁症发病率相比,抑郁症发病率非常低,仅为0.00006%。本研究结合流行病学资料分析、诊所人种学观察及深度访谈。我认为,缅甸的低抑郁症发病率不能用治疗差距、缺乏提供者或药物可及性等常见论点来解释。相反,我认为军政府镇压萧条是因为它把它视为一种政治抗议形式。虽然像精神分裂症这样的疾病很容易被诊断和治疗为“纯粹的生物学”,但情绪障碍是异议的可疑表达。通过生命价值理论(LVT),我探索了健康作为一个多中介过程。独裁统治对抑郁症的压制是对医疗干预的战略性沉默,有利于扩大非医疗补救。
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来源期刊
CiteScore
3.70
自引率
5.90%
发文量
49
期刊介绍: Culture, Medicine, and Psychiatry is an international and interdisciplinary forum for the publication of work in three interrelated fields: medical and psychiatric anthropology, cross-cultural psychiatry, and related cross-societal and clinical epidemiological studies. The journal publishes original research, and theoretical papers based on original research, on all subjects in each of these fields. Interdisciplinary work which bridges anthropological and medical perspectives and methods which are clinically relevant are particularly welcome, as is research on the cultural context of normative and deviant behavior, including the anthropological, epidemiological and clinical aspects of the subject. Culture, Medicine, and Psychiatry also fosters systematic and wide-ranging examinations of the significance of culture in health care, including comparisons of how the concept of culture is operationalized in anthropological and medical disciplines. With the increasing emphasis on the cultural diversity of society, which finds its reflection in many facets of our day to day life, including health care, Culture, Medicine, and Psychiatry is required reading in anthropology, psychiatry and general health care libraries.
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