My husband and I moved to Taiwan to teach English for the summer at a private high school/ junior high school in Taiwan. There are around 5,000 students at this school both boys and girls. The school includes academic departments as well as a vocational training school. I am doing my thesis research to see how education affects gender in Taiwan. This is part of what I noticed.
My first incidence of learning about the different way of viewing depression in Taiwan was when a young girl announced that she had been dealing with a great sadness during church. She explained to the congregation how she would sleep all the time and she didn’t understand why she was unhappy. Her family didn’t know what to do. So she spent time praying and exercise her faith to solve the problem. This was interesting to watch and see how she tried to define her issue through her culture. Had she been in America or another more ‘westernized’ country, this problem of great sadness would have been diagnosed, as depression and she would have been given medicine and an opportunity for therapy. But here she was left to her own devices to solve this problem.
My second encounter with depression was in one of my English as a Second Language (ESL) classes. We read a story about a girl who was experiencing chemical depression in one of their English textbooks. As an exercise, I had the class split into two according to what they believed about depression. Those that believed depression is an emotional problem on the right and those who believed it was a medical problem on the left. Out of 34 students only 6 believed that it was a medical problem and five of those people were boys. I sat and watched as the students in groups of four (most of them being consisting of all girl groups) stand up and say how depression was solely emotional and could be solved by simply changing your life-style and living healthier or talking to your friends. Anyways, the group of 6 were the only ones to really do the assignment well by reading online then condensing what they read into their own words. The one girl did the best in articulating what the problem was medically. She explained that according to research the brain stops transmitting brain signals that make you happy and your body doesn’t produce the chemicals to make you happy. All of this was very difficult for her to read and understand as she had to look up and translate individual words in order to present the information in English. So she did a lot of work to be able to present her information to the class. She was very serious about her belief. I asked the entire group why they believed that depression was a chemical imbalance and they indicated they believed the story in their textbook. I wonder if there was something more to her individual belief.
Granted that in some cases of depression a life-style change can work and be a successful way of coping with depression. But in other cases, depression can be caused by a chemical imbalance or is more than just changing your life style. Chemical imbalances can be spurred by a change in circumstance…for women this includes menstruating, being pregnant, giving birth, or menopause. It can also be caused by getting a new job or having a change, which causes stress levels to rise. It can also be caused when dealing with traumatic issues such as domestic violence. This has been cited as one of the main causes for depression and suicide in Taiwan.  The majority of these depression cases remain untreated due to social stigma. 
Knowing this, it was so tragic to watch girl after girl stand up and say that depression was solely an emotional problem. “The prevalence of Major Depressive Disorder in Taiwan is 1.0 percent for women and 0.7 percent for men.”  On top of this these women are left on their own to solve a largely medical problem by eating healthy or exercising more. These girls I watched claim that depression is only an emotional problem are the future of Taiwan statistics—continuation of the already horrifying reality. These girls have been inculcated to believe that depression is the same as being sad and is never an illness.
I can just imagine these wonderful girls facing some tragic domestic violence situation and they don’t have anyway to help themselves, they sink into depression then become apart of the numbers that contribute to the suicide statistics in their country and in China. “The suicide rate for women in China is 25 percent higher than for men, and the rural rate is three times the urban rate. In Western countries, men are at least twice as likely and sometimes four times as likely as women to commit suicide, studies show. But in China, being young, from the countryside and female is an especially lethal combination. Because the women who commit suicide are almost exclusively poor, their desperation is a reminder of the social inequalities that plague China and the difficulties hindering government efforts to raise rural standards of living.” 
It would be interesting to come back someday and specifically study where this idea that depression should be treated by changing of the diet is being perpetuated. Is it in the school or in the home? This ESL test book is the first exposure they have had to the idea that it could be a medical issue and it was almost unanimously rejected. Why? What makes them hold so strong to this cultural fallacy? It is these sort of ideas that make Chinese cultures the ones with the higher suicide rates. “The WHO estimates that 1.5 million Chinese women attempt suicide each year and 150,000 of them succeed, giving China the unfortunate distinction of being the only country in the world where more women commit suicide than men.”  Perhaps, (I am not saying I have the solution to everything) if we can figure out from where this idea is stemming, then we can stop it or counter it with another truth. That depression often needs to be treated medically.
 Joumal of Nursing Research, The Experiences of Taiwanese Women Who, Hsiu-Fen Hsieh, Jui-Ying Feng, Bih-Ching Shu, VOL. 17, NO. 3, (2009).
 Dunitz, M. (Editors: M. Briley & S. Montgomery), The Prevalence of Depression, Antidepressant Therapy at the Dawn of the Third Millennium, 1998) page 191-21
 “In Rural China, A Bitter Way Out”, Washington Post, http, 2007, 12 June 2007
 Margi Laird McCue, Domestic violence: a reference handbook, Edition 2, 2007