The Impact of Depression on Middle-Aged African-American Men: A Grounded Theory Approach

Wednesday, 15 July 2009: 10:45 AM

Keneshia J. Bryant, RN, FNP-BC
Minute Clinic, CVS Pharmacy, Yorba Linda, CA

Learning Objective 1: The learner will be able to identify the current diagnostic criteria for Major Depressive Disorders and its limitations.

Learning Objective 2: The learner will be able to identify the African American males’ experience of depression.

The cost of Major Depressive Disorder (MDD) has impacted the world due to healthcare visits, hours of work lost and the impact on families.  Some questioned if the current diagnostic criteria for MDD based on the Diagnostic and Statistical Manual (DSM) represents people of both genders, and those from different racial and ethnic groups.  African American men and the impact of depression have not been explored.  Therefore this study was conducted to answer the following research questions: (1) how do African American men recognize symptoms of depression?  (2) How do African American men express symptoms of depression? And (3) what is the impact of depression in their lives?
 A grounded theory approach using semi-structured interviews was conducted to answer the research questions.  Ten African American men between the ages of 35 and 65 with a history of MDD were interviewed. 
The results showed that men evolved and sometimes revolved through a process.  The process began with some type of stressor(s) which then led to a change in their life which they referred to as a “funk”.  During the funk the men isolated themselves, experienced physical and mental changes, felt the need to mask their true feelings and finally there was strained interpersonal relationship.  Each of these variables was interactive and influenced by the coping mechanisms and men’s spirituality.  The third step in the process was a breakdown, at this time the men were overwhelmed by the depression and they lost control.  This then lead to enlightenment and the men knew they were actually depressed.  At times additional stressors would lead the men through the process all over again. 
The study results showed that it is important to approach MDD from a broader view, rather than just a list of symptoms.