If we didn't have culture, we would be either dead or very seriously socially free.
Humans are designed to live as cultural animals. Our brains are adapted to learning, whether it involves reacting to stimuli, evaluating options or paving the way to new ones. Our minds are formed by the culture we live in, and that very same culture becomes internalized in our upbringing. Every cultural phenomenon is deeply engraved in the crevices of our brains, affecting personality and attitudes. An individual, who is born with a blank slate for a mind, imprints the culture of its origin with rapid speed, learning to adapt, grow and prosper.
The acquisition of culture for humans is an interesting phenomenon and comes largely by way of language. As toddlers begin to listen and understand the meaning of words, their world begins to take shape and set itself against the backdrop of a culture, an order and a way of life. Language grants us rights and permission to interact with a culture, much the same way as citizenship grants certain rights and privileges within a country. Language brings with it color and reflection, placing a name on objects, ideas, attitudes and cultural phenomena.
Accordingly, children pick up their culture from words; however, words are not the only tool that play a role in the formation of an individual within a culture. Behavior is another important element of learning. For example, in the town of Kisii, southwest of Kanya and home to the Gusii people, mothers and fathers do no speak to their sons and daughters unless they are old enough to respond to their conversation. Children are taught early on to learn through observation rather than direct language. Parents invest time into modeling the rules of the house as well as any expectations that they might have in regards to behavioral conduct. In fact, African culture in general teaches children to practice their respect through silence, thus granting elders cultural reverence. [i]
So what does any of this have to do with conditions of the mind? The two things that are universal and shape culture are: language and actions. This too has place when thinking about mental illness. Can a person experience anxiety, depression, panic, hallucinations or any other range of symptoms if we do not have words for those symptoms? Is someone schizophrenic if they are named a different name, such as "spirited one"? Culture reveals how those within it perceive a phenomenon. Culture also plays a role in the categorization process of a phenomenon. Is it conceivable for example, that people might relate better to the words "spirited one" vs. a phrase of "mental illness." These two words in conjunction convey a prejudice and an attitude that presupposes a negative influence.
In her early 30s, a woman by the name of Ruth Benedict entered Columbia University in the pursuit of graduate studies in anthropology. The year was 1921 and the field had just been gaining recognition through the works of Margaret Mead, also a student of anthropology at the time. Benedict spent most of her life studying the interconnections involved between various cultures and psychology. In her widely popular book entitled Patterns of Culture, Benedict discusses how culture dictates what is normal and abnormal for individuals. As an example, Benedict discusses that in the Indian, Shasta community of California, the culture views someone with frequent seizures as a leader, coated with a clout of respect. This comes in drastic contrast to the Western view and treatment of seizures as a sickness and a disease. Another interesting example Benedict uses is the contrast of a person with an optimistic worldview and sunny disposition in the Polynesian Islands. In the Western society those qualities and disposition are welcomed and encouraged, whereas the Polynesian culture considers those traits to be "crazy."
As one is born into a culture, it is of common mindset to assume that their culture makes most sense and is most functional. It would also be safe to assume that most individuals born into a culture adopt the values and ideological viewpoints of that said culture. However, certain cultural traits when left unchecked and passed down through several generations can be quite unhealthy. One glaring such trait is the spread of social media, which in part allows for ego gratification through several channels. In fact, not so long ago, the committee on DSM-5 formation was debating whether or not to exclude Narcissistic Personality Disorder from the Diagnostic and Statistical Manual of Mental Disorders due to a wide spread phenomena of social media, which arguably makes most people into narcissists based on the outlined category for that disorder.
Moving beyond the Western template for evaluation of brain-based conditions and into other cultural mindsets, the picture of what does and does not make sense becomes more global and complex. A DSM-5 definition of depression in the West does not include headaches, whereas in other countries to receive that diagnostic label, one must experience headaches. Similar echoes can be seen with anxiety disorders. Due to a number of anxiety disorders such as: social anxiety, post-traumatic stress disorder, obsessive-compulsive disorder, etc., the catchall symptoms also vary slightly as far as diagnostic labels are concerned.
We could compile a list of all the symptoms and behaviors to come up with universal diagnoses, but in the end, would still have very little idea as to who was actually healthy and who was ill given the cultural contexts at play. The catalog of symptoms, as we use it today, serves as an explanation for those that suffer with anxiety, anger, phobia, sadness, etc. The language we use to describe it all functions as a catalyst to those explanations and it is in the translation of cultural phenomena that we as individuals decide who is civilized, who is savage and who is mentally ill.
[i] LeVine, R.A., Dixon, S., et al. (1994). Child Care and Culture: Lessons from Africa. Cambridge, Cambridge University Press.