The prevalence of depression has been increasing. However in a number of cultures depression is stigmatised, preventing many to seek help, which further exacerbates a condition that already adversely impacts very vulnerable individuals

It is estimated that one in four will suffer with a mental disorder, with depression predicted to be the second highest disease burden by 2020 and produce the greatest decrement on health in comparison to other chronic condition.

Several studies found that the rate of diagnosis varied depending on how the patient presented. Since in some cultures visiting a doctor with depression is culturally unacceptable and is therefore, more common for these people to present with somatic symptoms which is referred to as, ‘ticket behaviour’.

A Study looking at opinions of Arab's in Dubai showed differing opinions among woman in the importance of crying when depressed. With the older generation viewing it as shameful believing that their inner feelings should be hidden, as highlighted in one quote,’we are Arabs, we never cry, we endure, but these new generations, they are so soft and weak, they cry for any reason’. Whereas the young generations felt that expressing emotions was more beneficial,’a woman who cries feels better’.

As a result of several cultures integrating into society it is important for a doctor to have an appreciation as to how a patient's culture will affect their presentation, beliefs and acceptance of a diagnosis of depression.