title: Depression: the 'invisible grey fog' influencing the midlife health of African Canadian women.
abstract: Depression is a topic that is often avoided in discussions among Black women for a myriad of reasons. The purpose of this study was to investigate the midlife health of Black women living in the province of Nova Scotia, Canada. This paper will present one of the key findings of this research; midlife depression. It will examine the factors associated with depression among mid-life African Canadian women and how these women deal with depression. A triangulation of qualitative and quantitative methods guided by the principles of participatory action research (PAR) was used in the study. Data collection methods included 50 in-depth interviews of mid-life African Canadian women aged 40-65, focus groups, and workshops as well as the CES-D structured instrument. Purposive sampling method was the primary recruitment strategy and 113 people participated in the study. Although the women rarely openly discussed depression, they described depression as emotional feelings that range from "feeling blue" to being clinically depressed. Women viewed midlife depression as the consequence of a complex set of circumstances and stressors that they face. At midlife, Black women frequently recognize the importance of greater self-care and the need to pay more attention to their health, but they are reluctant to do so because they have to be "strong" in order to deal with their daily experiences of racism. Racism, among other things, leads to accumulated stress and undermines Black women's ability to cope and make healthy life choices. This signifies the implications of these research findings for clinical practice.
authors.affiliation: Dalhousie University, School of Nursing, Halifax, Nova Scotia, Canada. josephine.etowa@dal.ca
authors.forename: Josephine
authors.initials: J
authors.lastname: Etowa
authors.forename: Barbara
authors.initials: B
authors.lastname: Keddy
authors.forename: Julius
authors.initials: J
authors.lastname: Egbeyemi
authors.forename: Felicia
authors.initials: F
authors.lastname: Eghan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology*; D003863:Depression / Q000208:ethnology* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged / Q000523:psychology*; D009674:Nova Scotia; D036301:Qualitative Research