SunForum: Understanding Depression in a Chinese Online Community

More than 350 million people worldwide suffer from depression. Major depressive disorder has a hugely negative impact on psychological well-being, work, and family life. Yet culture may shape how depressed patients interpret their symptoms, choose treatments, and behave. This paper reports a case study, including participant observations and interviews, of the Chinese online depression community, SunForum. Our findings reveal that Chinese cultural beliefs (e.g., the power of inner self-control) and Chinese beliefs about traditional medicine (e.g., the integrated body-mind relationship) significantly affect patients' understandings of depression, illness management, and social interactions. These beliefs create problems of understanding depression in society - including family members, friends, co-workers, and others - and present various challenges for depressed patients who can become marginalized, suffer discrimination, and lose their jobs. We draw implications for how Chinese society as a whole may respond to the misunderstanding of mental illness and the raising of public awareness. We also propose specific social media design to support depressed patients as they seek online information and social support.

[1]  N. Kuiper,et al.  Self and Other Perception in Mild Depressives , 1982 .

[2]  W. Neuman,et al.  Social Research Methods: Qualitative and Quantitative Approaches , 2002 .

[3]  Kwok Leung,et al.  Beliefs in Chinese culture , 2010 .

[4]  Yulia E. Chentsova-Dutton,et al.  Understanding Depression across Cultural Contexts , 2016 .

[5]  M. Sarchiapone,et al.  Public attitudes toward depression and help-seeking in four European countries baseline survey prior to the OSPI-Europe intervention. , 2013, Journal of affective disorders.

[6]  Santosh Kumar Kalwar,et al.  Comparison of Human Anxiety Based on Different Cultural Backgrounds , 2010, Cyberpsychology Behav. Soc. Netw..

[7]  Tatsuya Suda,et al.  Anonymity and roles associated with aggressive posts in an online forum , 2012, Comput. Hum. Behav..

[8]  Jing Wang,et al.  Life After Weight Loss: Design Implications for Community-based Long-term Weight Management , 2015, Computer Supported Cooperative Work (CSCW).

[9]  Alan D. Lopez,et al.  The global burden of disease, 1990–2020 , 1998, Nature Medicine.

[10]  S. Sulaiman,et al.  Attitude toward depression, its complications, prevention and barriers to seeking help among ethnic groups in Penang, Malaysia. , 2009, Mental health in family medicine.

[11]  Enzo Pasquale Scilingo,et al.  Wearable Monitoring for Mood Recognition in Bipolar Disorder Based on History-Dependent Long-Term Heart Rate Variability Analysis , 2014, IEEE Journal of Biomedical and Health Informatics.

[12]  G. Parker,et al.  Do the Chinese somatize depression? A cross-cultural study , 2001, Social Psychiatry and Psychiatric Epidemiology.

[13]  Anthony F. Jorm,et al.  Stigma about Depression and its Impact on Help-Seeking Intentions , 2006 .

[14]  Kirsti A. Dyer,et al.  Internet Use for Web-Education on the Overlooked Areas of Grief and Loss , 2000, Cyberpsychology Behav. Soc. Netw..

[15]  Shuqiao Yao,et al.  The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? , 2008, Journal of abnormal psychology.

[16]  陈晓东,et al.  Mental Health Law of the People’s Republic of China , 2012 .

[17]  Kathleen M Griffiths,et al.  Explicit and implicit information needs of people with depression: a qualitative investigation of problems reported on an online depression support forum , 2011, BMC psychiatry.

[18]  A J Rush,et al.  Perception of social interactions in depressed psychiatric patients. , 1982, Journal of consulting and clinical psychology.

[19]  J. Barendregt,et al.  Global burden of disease , 1997, The Lancet.

[20]  Jari Porras,et al.  Quantifying Cultural Attributes for Understanding Human Behavior on the Internet , 2013, HCI.

[21]  Cameron Marlow,et al.  Social network activity and social well-being , 2010, CHI.

[22]  Dan Zhang,et al.  Depression and Culture--A Chinese Perspective. , 1995 .

[23]  Jiang Yang,et al.  Sweet Home: understanding diabetes management via a chinese online community , 2014, CHI.

[24]  John M. Levine,et al.  To stay or leave?: the relationship of emotional and informational support to commitment in online health support groups , 2012, CSCW.

[25]  T Hesketh,et al.  Health in China: Traditional Chinese medicine: one country, two systems , 1997, BMJ.

[26]  Xin Yu,et al.  Mental health system in China: history, recent service reform and future challenges , 2011, World psychiatry : official journal of the World Psychiatric Association.

[27]  R. Kessler,et al.  The epidemiology of depression in metropolitan China , 2008, Psychological Medicine.

[28]  J. Overholser,et al.  Recovery from major depression: the role of support from family, friends, and spiritual beliefs , 2005, Acta psychiatrica Scandinavica.

[29]  A. Kleinman,et al.  Culture and depression. , 1986, The New England journal of medicine.

[30]  Michael Harris Bond,et al.  Believing in Beliefs: A Scientific but Personal Quest , 2009 .

[31]  P. Chodoff,et al.  Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China , 1987 .

[32]  M. Moreno,et al.  "Facebook depression?" social networking site use and depression in older adolescents. , 2012, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[33]  Kathleen M Griffiths,et al.  Stigma about Depression and its Impact on Help-Seeking Intentions , 2006, The Australian and New Zealand journal of psychiatry.

[34]  Arthur Kleinman,et al.  Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China , 1987 .

[35]  Atta Abbas,et al.  DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION , 2013 .

[36]  Santosh Kumar Kalwar,et al.  Conceptualizing and measuring human anxiety on the Internet , 2014 .

[37]  C. Antaki,et al.  Social Support and Unsolicited Advice in a Bipolar Disorder Online Forum , 2009, Qualitative health research.

[38]  Robert I Westwood,et al.  Chinese Conflict Preferences and Negotiating Behaviour: Cultural and Psychological Influences , 1991 .

[39]  Y. Ying,et al.  The Conception of Depression in Chinese Americans , 2002 .

[40]  H. Russell Bernard,et al.  Social Research Methods: Qualitative and Quantitative Approaches , 2000 .

[41]  David W. McDonald,et al.  Bringing the field into focus: user-centered design of a patient expertise locator , 2010, CHI.

[42]  G. Parker,et al.  Depression in the planet's largest ethnic group: the Chinese. , 2001, The American journal of psychiatry.

[43]  Mark S. Ackerman,et al.  Collaborative help in chronic disease management: supporting individualized problems , 2012, CSCW.

[44]  Norman Sartorius,et al.  Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey , 2013, The Lancet.

[45]  G. S. O'Keeffe,et al.  The Impact of Social Media on Children, Adolescents, and Families , 2011, Pediatrics.