A Systematic Review of Culturally Specific Idioms of Anxiety and Depression Among Refugee Women Across Displacement Contexts

Abstract

 Mental health research with refugees is largely driven by Western diagnostic frameworks, such as categories of anxiety and depression. But recent research has suggested that psychological distress is expressed and also comprehended in distinct ways across cultural contexts. This review aims to examine how refugee women use culturally specific idioms to express experiences of anxiety and depression across displacement contexts. A comprehensive search across databases like JSTOR, Google Scholar, Elsevier, PubMed and APA PsycINFO resulted in the identification of 89 unique records, out of which five studies met the rigorous inclusion criteria requiring either qualitative or mixed- methods research designs, adult refugee women, and documented anxiety and/or depression, and explicit mention of culturally specific expressions of distress. The findings indicated that refugee women consistently articulate distress through idioms that function across embodied, emotional, relational and spiritual/ moral dimensions, they describe anxiety and depression through expressions such as “deep sadness,” “stress, too many thoughts,” “fear,” somatic complaints, and metaphors of a “tired” or “crying” heart or soul. These idioms situate suffering within gendered experiences of intimate partner violence, displacement, poverty, and social isolation, and they strongly shape stigma, help‑seeking patterns, and engagement with formal mental health services. They also overlap with clinical symptoms but women frame their distress mostly within social, relational and contextual realities rather than individual pathology. Across diverse populations and displacement contexts, distress is articulated as a meaningful response to loss, insecurity and hardship. This review amplifies the importance of recognising refugee women’s own explanatory models and calls for culturally grounded mental health assessment and intervention.