THE FACES OF HARDSHIP

A social scientist challenges the model of depression, arguing the rise in diagnosis reflects socio-economic suffering

- STORY: THANA BOONLERT

In Sai Mhok, the number of those diagnosed with depression was below average until 2023, when it experienced an unprecedented spike as the village saw the presence of psychiatrists for the first time.

Previously, physicians assisted instead due to a shortage of medical staff in remote areas. Today, following an exodus of working-age adults, only youths and seniors live in the community.

At the time, Poramin Tangopasvilaisakul, a lecturer at the Faculty of Social Sciences, Srinakharinwirot University, was conducting research for his PhD. He met Tha, who felt jai jep (heart pain), which was diagnosed as depression. Studies show that many in the Northeast experience this symptom. Soon, he learned that their vulnerable background had forced them to work hard and care for their families.

"It is unlikely that they suffered from depression, but doctors said otherwise. The DSM [Diagnostic And Statistical Manual Of Mental Disorders] can't be used to explain the situation — it must be contextualised. Tha told me that they all experienced jai jep, especially leftover youth [a term for uneducated and unproductive youth]. It was the beginning of my research," he said.

Speaking at a seminar at Kasetsart University, Poramin explained that depression can be expressed in many ways. Whereas psychiatrists regard it as an illness, social scientists read it as an idiom of distress. Meanwhile, those in Sai Mhok feel jai jep. This inspired Poramin to study how depression can be understood in a specific context and a local hospital permitted him to observe clinical cases.

"Should depression be seen in a different light? Imagine you were poor and abused. Why don't you run away? In my hypothesis, depression is moral subjectivity that pieces fragments of yourself together," he said.