In low- and middle-income countries (LMIC) it is vital to understand acceptable, comprehensive, and culturally appropriate ways of communicating about mental distress. Diagnostic terminology is rarely used, may be stigmatizing, and is subject to misinterpretation. Local terms, such as idioms of distress, can improve mental health literacy and service delivery. Our objective was to examine lived experience and coping connected to distress and depression in an under-researched population: young men from LMIC urban slums. We conducted 60 qualitative interviews with men (ages 18–29) in Bhashantek slum, Bangladesh. Themes were generated using thematic analysis and grounded theory techniques. The heart-mind (mon), mentality (manoshikota), mood (mejaj), head (matha or “brain”), and body (shorir) comprised the self-concept, and were related to sadness, hopelessness, anger, worry, and mental illness. The English word “tension” was the central idiom of distress. “Tension” existed on a continuum, from mild distress or motivational anxiety, to moderate distress including rumination and somatic complaints, to severe psychopathology including anhedonia and suicidality. Respondents connected “tension” to burnout experiences and mental illness which was summarized in an ethnopsychological model. These findings can inform culturally sensitive measurement tools and interventions that are acceptable to the community, potentially increasing engagement and enhancing therapeutic outcomes.

在低收入和中等收入国家 (LMIC)，了解可接受的、全面的和文化上适当的精神痛苦沟通方式至关重要。诊断术语很少使用，可能带有污名，并且容易被误解。当地用语，例如苦恼的习语，可以提高心理健康素养和服务提供。我们的目标是在研究不足的人群中检查与痛苦和抑郁相关的生活经历和应对方式：来自 LMIC 城市贫民窟的年轻男性。我们对孟加拉国 Bhashantek 贫民窟的男性（18-29 岁）进行了 60 次定性访谈。使用主题分析和扎根理论技术生成主题。心（mon）、心态（manoshikota）、情绪（mejaj）、头（matha或“大脑”）和身体（shorir）构成了自我概念，与悲伤有关，绝望、愤怒、担忧和精神疾病。英语单词“紧张”是苦恼的中心成语。“紧张”持续存在，从轻度痛苦或动机性焦虑，到中度痛苦，包括反刍和躯体不适，再到严重的精神病理学，包括快感缺失和自杀。受访者将“紧张”与倦怠经历和精神疾病联系起来，并在民族心理学模型中进行了总结。这些发现可以为社区可接受的文化敏感性测量工具和干预措施提供信息，从而可能增加参与度并提高治疗效果。到中度痛苦，包括反刍和躯体不适，到严重的精神病理学，包括快感缺失和自杀。受访者将“紧张”与倦怠经历和精神疾病联系起来，并在民族心理学模型中进行了总结。这些发现可以为社区可接受的文化敏感性测量工具和干预措施提供信息，从而可能增加参与度并提高治疗效果。到中度痛苦，包括反刍和躯体不适，到严重的精神病理学，包括快感缺失和自杀。受访者将“紧张”与倦怠经历和精神疾病联系起来，并在民族心理学模型中进行了总结。这些发现可以为社区可接受的文化敏感性测量工具和干预措施提供信息，从而可能增加参与度并提高治疗效果。