The Effect of Perception of Social Roles on Depression - Research Paper Example

Running head: THE EFFECT OF PERCEPTION OF SOCIAL ROLES ON DEPRESSION Social roles as they relate to depression: The effect of depression on the elderly Name of Client Name of University Name of Class Social roles as they relate to depression: The effect of depression on the elderly Introduction It is difficult to fully assess the effects of depression on the elderly because of the onset of illness and the resulting affects of a diminished health and the medications that are required to sustain life. However, there is evidence that the changing social roles that accompany the advancement of age contributes to the potential for a deterioration of mental health. Looking at the work that has been developed on the issue, this study will review relevant issues that will be assessed in order to answer research questions that define the focus of the work. Hypothesis Depending upon the level of the intensity of role involvement, there will be some correlation to the level of depression or other life-altering mental illness for the aged after a decrease in role functionality. Newman and Newman (2009) state specifically that there are four dimensions of which social roles are analyzed, and we will propose that the higher the intensity of the identification of the role will produce a higher probability of depression or other types of mental illnesses. We will broaden our scope to include of the number of roles as part of our study. Key Terms Elderly. For the purposes of this study, the term elderly will be used to define an individual who has reached a point of life where significant changes in social roles has placed them in the last stages of their life. This is defined this more closely as being age 60 and above. Joint family system. Comprises of two or more nuclear family systems that form a corporate economic unit (Taqui, Itrat, Qidwai, & Qadri, 2007). Nuclear family system. A group of people joined through legal and familial means consisting of a single adult, a partnered couple, or a partnered couple and their children (Taqui, Itrat, Qidwai, & Qadri, 2007). Reciprocal role. A role that is defined by a matching role within the social order. Examples include student and teacher, parent and child, and the salesperson and the customer (Newman & Newman, 2009, p. 71). Social role. A loosely defined set of behaviors within which a social function has been defined with an accepted code of what is considered normal within that role. (Newman & Newman, 2009, p. 70). Methodology Introduction In searching for answers to the questions that relate to the relationship between social roles and depression, a thorough research of relevant literature will provide a framework within which to answer the research questions. This study has been conducted through the use of research that has been done and reported by those who have developed conclusions through their own studies. The studies are analyzed for relatable content and the information is connected in order to define answers to the questions that have been posed here. Research Questions The following questions will be used in order to provide a framework for the focus of this study: 1. What is the relationship between depression and aging? 2. Is there a relationship between the relationship between depression and aging, and the culture in which the person belongs? 3. How does the perception of social roles impact the incidence of depression among the elderly? 4. Do the changes in identity that occur as a person ages affect the development of depression among the elderly? 5. What are the best approaches to effectively treating psychopathological maladies of the elderly? Procedures In order to discover the way in which depression is related to aspects of growing older within society as it relates to social roles, secondary resources were found for relative content. Databases, books, and journals were searched for literature that is relevant to the topic. The internet was a valuable resource for discovering relevant information as subtopics and concepts can be defined and developed by intelligent use of search options. Through the search of google books, Jstor, and Ebesco, the information was discovered and utilized to its best advantage. Analysis The information that was discovered during the search for relevant research has led to conclusions based on studies that are related by topic and subtopic to the research questions at hand. While a statistical measure was not utilized, a qualitative approach was used in creating an understanding of the experiences that related to the topic. As well, using the relative quantitative information that was available allowed for creating relationships between the statistics and the experiences. By creating relationships between qualitative and quantitative data, the research on the topic will have both the experiences and the statistical foundation to support the conclusions that are draw. Assumptions, Limitations and Delineations The following assumptions have been made in order to create the conclusions of this study: 1. The previous work of qualified researchers is credible and has been conducted in the manner that is described within the work. 2. The conclusions and connections that are drawn have been made in good faith and without prejudice. 3. The published work was verified for its content and the stated qualifications of the researchers are honest and valid. The following limitations have been discovered in relationship with the way in which the study has been designed 1. The study will be limited to the research that has come before and will be subject to conclusions drawn by others. 2. The study will be limited to the availability of research through the methods of discovery that are available to search for information. 3. The study will be developed within a previous understanding of the topic and will therefore be subject to interpretations founded on that understanding. The following delineations will affect the way in which the researchers are able to define the conclusions. 1. The culture from which the researchers have had experience will affect the way in which the interpretations of the available literature will be made. 2. The literature that is used will be found through available resources, but may not include information that is not available through the methods used by the researchers. 3. The belief systems that are in place within the researchers will create boundaries through which some of the conclusions are drawn based on cultural connectivity. Summary While the use of secondary research allows for a strong overview of current trends and beliefs and is supported by statistics and quantitative conclusions, the study will have some limitations as the researchers have not conducted primary research on the topic. The relevant literature, however, has provided a framework within which the study of the topic has revealed relationships between the works that has been already done. In analyzing these works, the researchers have been able to formulate conclusions that have resulted in an attempt to answer the research questions. Literature Review As people transition in their developmental stages from adulthood to older adults, significant changes occur in the cognitive, physical, emotional, and social areas of their lives (Newman & Newman, 2009, p. 70). The social role theory describes the process of which individuals develop their identities based upon the roles they play in their gender, occupation, and society as a whole. Due to dramatic changes during the older adult stage, many adults face loss of friends, homes, financial stability, as well as a loss of social identity. It is in this time of great loss, we believe, the social role theory has great implications for counselors as we seek to assist the aged regain a sense of identity (Fry, 1992). Social Role Theory According to Newman and Newman (2009), there are four dimensions in which a social role depends on for development. The first dimension is defined by the number of roles a person fills within their life. The second dimension is the intensity of role development and how deeply the individual identifies with his or her role. The third dimension is defined by the amount of time the individual devotes to that role. The final dimension is determined by how structured or flexible the expectations of the role impact the life of the individual (p. 71). The roles in which a person will define themselves will change throughout life, some of which will be abandoned, while others will change as experience and age affect those roles. Some roles with dual definitions will be abandoned, but still retained in another sense of the word. As an example one may no longer be a child due to chronological age, but may still be the child of a parent. However the role of a child as defined within the social order will change and grow. Another example is that of the child whose responsibility is to learn and obey from a parent, but whose role changes as the parent grows older so that role becomes as caretaker as the parent lives beyond the ability to care from themselves (Newman & Newman, 2009, p. 71). The movements through the stages of age are defined through social roles in every culture across the world. As an example Dien and Huline (1997) show that the Tiriki of sub Saharan Africa have defined social groups that are defined by members who reach a certain age together. Those groups are Warrior, Elder Warrior, Judicial Elder, and Ritual Elder. The roles are specific and shared with other members of the group that share the same age range (p. 113). These roles provide a framework and identity for the members as they pass certain milestones within their culture. While not quite as distinct, most cultures have similar patterns of age related roles. Child, parent, and grandparent are examples of how divisions of roles can be attained through the achievements associated with those roles. Depression and Social Roles According to Ritzer (2005), attitudes and behaviors will shift according to the social roles that a person has within the stage of their life they currently occupy. There is a predictability of social order based on the way in which roles have been defined. However, this also means that expectations in regard to age and roles can restrict the way in which an individual experiences their position in society, thus defining what will happen by what is expected to happen (p. 652). According to Norman and Redfern (1996), there is a direct association between severe life events and the onset of depression. Such events include: separations and deaths major negative revelations or life-threatening illness to someone close financial or material loss enforced change of residence physical illness It is reported that 48% of elderly patients suffering from depression had experienced one or more of the above traumas within their life, and the event had directly preceded the depression (p. 146). The key to these events is that they all effect the social roles of the individual, thus affecting the perceived sense of self identity. According to Hua (2007) in his study of aging in Taiwan, the connection between doing purposeful work and depression is undisputed. As the study researched work and age, in combination with the purpose and importance of the work, it was discovered that individuals who were working for pay had less incidents of depression than those doing work with no pay, which was further increased when no work was done (p. 699). According to Norman and Redfern (1996), depression increases in association with retirement in men, while both sexes experience depression with the onset of illness (p. 147). King and Balswick (2005) discuss the stages of change within development when the social role changes and the individual becomes retired from their career. At first a honeymoon phase develops where there is a sense of enjoyment of the free time, but this will very quickly turn to a phase of the disenchantment stage where activities in play and leisure will no longer provide a sense of fulfillment. The majority of retirees will move in to the reorientation stage where they learn a new way to view their life and the activities that make up their days. Eventually, the retirement routine stage will be reached where new purpose is established within the framework of daily life. Depression can come into play whenever an individual gets hung up in one of these stages, particularly the disenchantment stage where there seems to be no activity that will provide a sense of purpose (p. 227) In a study done by Taqui, Itrat, Qidwai, and Qadri (2007), 400 elderly respondents in Pakistan were studied for the incidents of depression. Of the respondents, there was a 19.5% rate of depression as determined through a screening through GDS (geriatric depression scale). One of the problems observed within the study is that the social construction of family life is shifting from a joint family system to a nuclear family system, leaving many elderly disenfranchised and living alone. Sinha (2008) goes further to show that while 20% of all suicides in the west are committed by the elderly, in India where the joint family system is still the most common dynamic, the rate of suicide by the elderly is cut in half (p. 406). According to Bartels et al (2002), in the United States the figure mirrors the information in Pakistan in that 1 in 5 members of the elderly suffer from depression (p. 1420). The high rate of suicide among the elderly is difficult to assess, however, as the rate is attributed to both the disease of depression and the declining quality of life that can be attributed to social functions and physical debilitations. There is an argument to be made that taking one’s life when the quality of life has decreased to such a point that it is irrevocable, that taking one’s life can be a rational action. In this case, the suicide is not linked to the disease of depression (Posner, 1996, p. 135). Suicide in the elderly has been determined to be more deliberate, less impulsive, and more successful than in younger subjects (Posner, 1996, p. 137). Physiological Depression in the Elderly According to Steptoe (2007), there is usually a decline of depression in the fifth and sixth decade of life. The increases of depression through the seventh decade can be attributed closely with the onset of illness. Many of the physiological symptoms of depression become realized in association with illnesses that may contribute to changes that bring on depression. As well, the debilitating effects of illness can create changes in the way an individual can fulfill their roles in life, thus providing a sense of loss and identity (p. 38). One of the difficult things in diagnosing depression in the elderly is that many of the key symptomatic indicators are also found as side affects of medications and symptoms of common illnesses. Three of the key factors, diminished appetite, fatigue, and sleep issues, are all found to overlap with a great many illnesses and resulting side effects from medications. Therefore, it is required to factor in both physiological and psychological indicators in order to properly diagnose depression (Rubin & Zorumski, 2005, p. 378). However, according to Eisler and Herson (2000), it is the perception of the state of health that is central to the way in which it is experienced. Those who dwell on the idea that their health is diminished or who perceive a deeper degree of debilitation from an illness will feel more of the effects of declining health, and will more than likely develop symptoms of depression. Subjective better health is associated with higher levels of satisfaction within the quality of the individual life (p. 398). Cultural Factors Regarding Aging and Depression When designing an appropriate program to address depression in the elderly, it is important to consider the aspects of cultural social association to age. The social roles that are developed within a culture for their aging population can affect the level with which satisfaction can be reached during the changes in life that occur with age (Walsh, 2009, p. 183) According to Dein and Huline (1997), the incidence of depression and dementia in the elderly in Japan is less than it is within the United States (p. 112). However, within the Cuban communities of south Florida, there is a high rate of depression within the elderly in association with language barriers, cultural displacement, isolation and loneliness (Sokolovsky, 2009, p. 344). One of the clear issues in regard to discussing aging is in taking into consideration the culture within which growing older occurs. Not only is the physical culture of the individual important to assessing the potential of depression for the aging and in determining how to approach a program towards better mental health, the social construction of the identity of the elderly must be assess in order to further assist in issues that surround getting older. According to Powel (2006), social constructs help an individual to answer the questions: Who am I? Where do I belong? What do I do? How do I do it? Where am I? Who are you? Why are you? These define reality within the experience of living (p. 44). Conclusions The issues with depression within the elderly are difficult to fully assess as overlap exists between many illnesses and side effects from medications and the symptoms of depression. However, the displacement that occurs during retirement provides a heighten lack of purpose and can lead to the onset of the disease. The changes that take place during the progress into the stage of becoming an elder within society can have traumatic consequences that precede a period of depression. As well, the incidents of suicide within the elderly population are significantly higher than in other stages of aging. Thus, the indication of depression that is undiagnosed provides a gap that statistics may not have calculated. The relationship between depression and the onset of old age is defined by the changes in both health and social status that occur past the age of 60. During this time, careers are abandoned, family becomes less centralized within the structure as children grow up and move to their own nuclear family, and the deterioration of health, all provide fertile ground in which depression can grow. The average rate of depression is that 1 out of 5 people past the age of 65 suffer from the disease. However, the statistics may not fully reflect the rate as there is a stigma associated to admitting to mental issues. The way a culture views its aging population will have an effect on the way in which an individual approaches the changes in social roles that will be experienced. As an example, in the United States were achievement and youthfulness are given a high priority, it might be more difficult to navigate the changes that indicate that those stages of life have passed. However, in a country where joint family groups are encouraged and where the wisdom of the elderly is appreciated, such as in Japanese culture, the level of depression within the older generations is decreased. The perception of age in relationship to the belief systems within the culture are central to the identities that an individual will develop and the social roles that will be filled. As social roles change, adjustment to the self perceived identity can develop into a confusing period of life. When the stages of acceptance to those changes become stalled, as it sometimes happens in the disenchantment stage (King and Balswick, 2005 p. 227), the growth of depression can be appreciated. The sense of identity that is necessary for satisfaction and quality of life can be severely shaken by the changes that take place as the onset of old age takes place. The way in which a person finds a new sense of identity is central to the way in which a person’s mental health can be maintained. As well, the way in which society perceives the roles of the elderly will have a great impact on the development of depression. The wisdom of the elderly is not always appreciated and is sometimes subverted by the burdens that the multiple complications of disease can put onto society. However, the appreciation and development of useful social roles for the aged can provide a more stable environment in which to grow older. 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