Communication and Control in the Co-construction of Depression: Women's Accounts of Their Interactions with Health Practitioners

Abstract

Issues of communication and control have been implicated in the evolution of mental health problems, the process of seeking help and the outcomes of this process. This paper explores control and communication processes in the course of women's help seeking for depression. Although depression rates are consistently higher for women than for men, there is little information on women's experiences of seeking support or treatment. Feminist theory and research highlight the centrality of power and control for women's health and wellbeing, but examination of mechanisms mediating power and powerlessness within treatment contexts is lacking. This study utilises a predominantly qualitative methodology to explore how 14 women diagnosed with depression describe interactions with health practitioners. Building on previous theoretical positions, we develop a framework to encompass the complexities of the women's accounts, providing insight into processes by which women and health practitioners co-construct healthcare interactions. The findings suggest that for these women, the commonly posited dichotomy between understandings of depression as either a biomedical or sociocultural construct was less salient than, and mediated by, issues of control and communication. Financial and systemic considerations emerged as contextual mediators of both the women's and health practitioners' degree of control in working towards improved health outcomes.