The Seven Beliefs

Abstract

Depression is a common condition seen by both primary care and mental health clinicians that can be difficult to address with patients because of longstanding societal stigma against mental illness, time pressures of primary care practice, and a variety of other patient-specific factors. Cross-cultural clinician-patient encounters may additionally increase this barrier. The Seven Beliefs by Drs. Lozano-Vranich and Petit, a psychologist-psychiatrist team, provides a helpful resource for Latino patients coping with depression and the clinicians who care for them. The book covers a broad view of depression symptoms, diagnosis, and treatment and includes specific information about cultural factors unique to Latinos that may help or hinder recognition and treatment of depression. The target audience is young Latina women, although men and women of any age will benefit from the information provided. The book's chapters are divided into 7 chapters or beliefs. Chapter 1, “Believe in Yourself,” addresses the importance of recognizing oneself as a unique person within the context of the diversity of the Latino community. The authors address the stresses of being an “American Latina” with often conflicting role expectations. Chapter 2, “Believe in the Signs,” provides information on the cardinal signs of depression. The authors review diagnoses of major depressive disorder, dysthymia, seasonal affective disorder, premenstrual dysphoric disorder, postpartum depression, and bipolar disorder. As in the other chapters, case vignettes illustrate the information. Although this book is geared for Latinas, this chapter, in particular, would be helpful for anyone wanting basic information about depression. In chapter 3, “Believe in Change,” several psychosocial stressors are addressed including death and bereavement, sexual trauma, domestic violence, and divorce. Each topic is covered briefly, and the authors' major point is to raise the reader's consciousness and allow for contemplation in order to change one's own situation. The longest chapter in the book, and, arguably, the most useful, is chapter 4, “Believe in Your Body.” In this chapter, Lozano-Vranich and Petit address the impact of depression on somatic symptoms and provide strategies for improving exercise, sleep, nutrition, and stress levels. Each section is clearly written, and the information is summarized in tables or highlighted boxes. The authors also provide an algorithm for readers suffering from caregiver stress. The last section of this chapter provides an overview of the medications commonly used to treat depression. The guidelines for medication use provide a common-sense approach for patients to follow. For example, point 1 of the 8 guidelines is: Don't stop the medication unless your doctor tells you so, even if you are feeling better. Make the decision with your doctor. Stopping too soon can cause symptoms to return or you can develop a discontinuation syndrome, which gives you flu-like symptoms that are temporary but uncomfortable (p. 136). Chapter 5, “Believe in Your Spirit,” acknowledges the importance of spirituality to Latinos and distinguishes between religion and spirituality. The authors discuss the potential importance of a variety of spiritual practices including prayer, curanderismo (a Latino folk-healing tradition), relaxation, meditation, psychotherapy, yoga, and creative writing. Readers most likely will find helpful the recognition and validation of a range of spiritual techniques. Some professionals might object to placing psychotherapy in this chapter; however, the integrated discussion of all these techniques may actually decrease the resistance of the individual who is reluctant to see a therapist. Chapter 6, “Believe in Traditions,” discusses some important traditions of Latinos and promotes their positive elements. Using the first-person plural voice, Lozano-Vranich and Petit reflect on some unique cultural traits and gently point out the situations in which those traits may contribute to mental health problems. Latinos are a tremendously proud, highly private people who strive to keep their problems quiet and within the confines of the family; dignity is enormously important, and unity, love, and security with the family are held in high esteem. Latinos are very family-oriented and often keep secrets and tolerate problems in order to maintain balance at home. When we take these qualities to an extreme, denying ourselves the help we need when we are ill, we wind up suffering needlessly in an attempt to show others that we are strong (p. 185). Chapter 6 will be helpful for clinicians who treat Latino patients, both to provide perspective on particular cultural traditions and to provide ideas for capitalizing on the strengths of those traditions and minimizing the harms. The authors discuss the common Latino behavioral and somatic manifestations of stress, as well as emotional- and gender-based relationships and the importance of understanding the broader context of the individual, including family situation, migration experience, political forces, and economic pressures. The final chapter, “Believe in Your Future,” summarizes the book and provides a forward-looking perspective for the reader. The “Modern Latina Rules” outlined in this chapter include recognition of one's unique identity, balancing traditional values with modern expectations, and the importance of individualism and independence of spirit, caregiving to both self and others, fulfillment in life, and self-respect and mutual support. The Seven Beliefs is written between a ninth- and tenth-grade reading level, so it will be useful for individuals who can read at that level or higher. I would recommend this book to both individuals suffering from depressive symptoms and their loved ones. The “Recommended Readings and Resources” section lists books, pamphlets, organizations, hotlines, and Web sites that address a variety of mental health concerns. The text provides an excellent overview of depression and all the domains that may affect the depressed person. The authors are well-known in the mental health community and maintain a bilingual health information Web site (www.alsofa.org) or “A bilingual cyber-couch for your well-being.” The information on this site appears to be accurate and appropriate. The Seven Beliefs does not currently appear to be available in Spanish. I would eagerly anticipate a Spanish edition.