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Confining Freedoms:

The Interplay Between Culture and Depression Among Elderly Female Immigrants from the Former Soviet Union

By Patrick Bilder
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For an immigrant from the former Soviet Union (FSU), the foreign shores of the United States at once resound with all-embracing hope and froth in writhing currents of despair. Although the collective dream within the colossal, soviet migration wave of the 1990’s embraces popular, US ideals of freedom and opportunity, the embodiment of these ideals clashes with an ironic vehemence against the FSU immigrant’s cultural predisposition. Socioeconomic instability was a major motivation for departure from the FSU, yet the search for heathcare, employment, and housing presents a severe dilemma for the émigré: one is, at best, unaccustomed and, at worst, averse to fundamental decisions that appear matter-of-fact to the average, US-born citizen, a condition that reflects personal evolution in a social environment that eliminates personal choice. Similarly, release from religious oppression has given rise to religious isolationism as language barriers prevent large numbers of refugees from actively sharing their faith within American communities. Sadly, extended families that comigrate to maintain unity despite these obstacles later undergoe painful schism in the U.S. as the second and third generations pursue personal and financial independence in lieu of traditional, family-oriented routines. Homeland sorrows are replaced with foreign counterparts and confine the unprepared to an unfamiliar suffering, founded partly on an inevitable supposition that quests for happiness abroad will remain as fruitless as they were back home.

Not surprisingly, a substantial proportion of the FSU immigrant population faces clinical depression and many of the cases are thought to have arisen as a result of psychologically debilitating, circumstantial factors related to the cultural transition (Miller and Chandler, 2002). Among the affected, middle-aged and elderly female immigrants represent the highest risk demographic and receive higher depression rating scale scores as compared to both the general population and other immigrant groups (Gutkovich et al., 1999). According to Dr. Anna Potash, whose New York-based psychiatric practice includes eastern european immigrant populations living in Brooklyn and the Bronx, most of her older, female patients from the FSU exhibit “severe culture shock”. She notes that, although female patients generally tend to tolerate cultural changes with more fortitude than their male counterparts, many elderly immigrant women are often simultaneously mourning a deceased spouse. In most cases, this heartbreaking, isolating experience is further compounded by diminishing emotional and financial support from children, an issue unlikely to have arisen frequently within the pre-migration, family-centric social structure of the FSU. Unfortunately, Dr. Potash explains, the immigrant grandmother has trouble adjusting to the set of U.S. social rules ingrained upon her native-born children or grandchildren. And failing to follow some of the simplest norms could unduly strain family ties. “Back home, she can visit her children without calling. Here, she must call on them in advance. If she calls after 9 PM, for example, it might lead to conflict.”

Among some eastern european expatriates, the implications of disrupting the family network is considered carefully in advance. Dr. Sonya Violetta, a 31-year old Russian scientist who migrated with her mother and newborn son to assume a two year post-doctoral position in the Bronx, reflects daily on this subject. She often worries that her mother, although elated to live with her daughter and to fulfill a customary, prominent role in childcare, might suffer emotional damage as their stay lengthens. Her greatest concern involves the possibility of severing her mother’s strong attachment to a self-reliant agrarian lifestyle in the Russian countryside, a passion that enables both parents to provide for their children well after retirement. “Back home, my parents feel that they can feed themselves. They only need to buy bread, milk, and meat. They work on the land. Older women might say ‘this potato, this carrot, this squash, this onion is for my children or grandchildren’. ” Russian children, in turn, live with and care for their ageing parents until death. “Unlike in the U.S.,” she observes, “there are no retirement homes.” Dr. Violetta also predicts that if her mother were to spend her remaining years abroad, she would forgoe plentiful employment opportunities afforded Russian women in their 60s, 70s, and occasionally 80s and 90s. Although jobs commonly filled by this demographic, such as school security attendant, librarian, or hospital file clerk, pay meager wages, their intangible rewards, including a sense of independence and a supportive friendship network, are of major psychological benefit.

The observations of Drs. Potash and Violetta serve as a reminder that the wondrous ethnic diversity in our nation depends upon the psychological well-being of it’s constituents. As such, significant research efforts have been undertaken to examine the contribution of sociocultural and demographic variables on depressive symptoms in elderly female immigrants from the FSU (Miller et al., 2006; Miller and Chandler, 2002; Miller et al., 2004b; Miller and Gross, 2004). Many of these studies concur that both the degree of acculturation, as often measured by the acquisition of language skills, and the extent of social isolation exhibit strong positive and negative correlations, respectively, with mental health status. These findings are proposed to guide interventions that provide cultural and language training opportunities within impoverished ethnic enclaves. In addition, the strong association between immigrant depression and cardiovascular disease validates the well-known link between psychological and physical health and calls for culturally-sensitive social and medical services (Miller et al., 2004a). By comparison to other possible host countries, general post-migrational “contextual factors”, or the immigration-related U.S. policies in the healthcare, social, and legal systems also constitute critical factors that influence the frequency and severity of depression, an observation that warrants careful consideration in future policy design (Miller and Gross, 2004).


Gutkovich, Z., Rosenthal, R. N., Galynker, I., Muran, C., Batchelder, S. and Itskhoki, E. (1999)
Depression and demoralization among Russian-Jewish immigrants in primary care.
Psychosomatics, 40, 117-25.
Miller, A. M. and Chandler, P. J. (2002) Acculturation, resilience, and depression in midlife women from the former Soviet Union. Nurs Res, 51, 26-32.
Miller, A. M., Chandler, P. J., Wilbur, J. and Sorokin, O. (2004a) Acculturation and cardiovascular disease risk in midlife immigrant women from the former Soviet Union. Prog Cardiovasc Nurs, 19, 47-55.
Miller, A. M. and Gross, R. (2004) Health and depression in women from the former Soviet Union living in the United States and Israel. J Immigr Health, 6, 187-96.
Miller, A. M., Sorokin, O., Wang, E., Feetham, S., Choi, M. and Wilbur, J. (2006) Acculturation, social alienation, and depressed mood in midlife women from the former Soviet Union. Res Nurs Health, 29, 134-46.
Miller, A. M., Sorokin, O., Wilbur, J. and Chandler, P. J. (2004b) Demographic characteristics, menopausal status, and depression in midlife immigrant women. Womens Health Issues, 14, 227-34.

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