Depression Narratives Research Articles

'Impaired in life': Analyzing people's accounts of depression in Ethiopia - Implications for a cultural-eco social approach to global mental health.

Depression is a global crisis and a major concern in mental health interventions, particularly in low- and middle-income countries (LMICs), where it significantly impacts disability, quality of life, and economic stability. These chronic stressors have been used to argue for scaling up the detection and treatment of depression as a public health and development priority. This study aimed to explore illness narratives of depression among patients' and to gain insights into multifaceted suffering, its impact on persons' lives, and help seeking. This study is part the broader study which examined global mental health, biopolitics, and depression in Ethiopia, conducted in hospice setting to explore the conception of depression in Bahirdar city, Northern Ethiopia, among patients and health care providers. In this study, we focus on patients' accounts of depression. We employed an ethnography method using in-depth interviews, fieldnotes, and observation to collect the data. A thematic analysis was used to analyze the data. Drawing from cross-cultural and critical psychiatry perspectives, we situate depression within its cultural-eco social framework. The study revealed that patients' experiences and conception of depression are deeply intertwined with Ethiopia's sociocultural, economic, and spiritual context. Depression was often described as a state of being 'impaired in life', reflecting the complex interplay of individual struggles and societal pressures. Integrating quotes from patients, we demonstrated in this analysis the ways in which biographically specific challenges, societal pressures, and mental well-being are understood by study participants in accordance with Ethiopian cultural and religious norms. The study suggests moving beyond narrow interpretative frameworks in GMH praxis to understand and address the complex dimensions of depression in Ethiopia and similar contexts. The study advocates for a cultural-ecosocial approach to depression, emphasizing the need for mental health interventions that consider the broader social and cultural factors contributing to mental distress.

The Connection between Pronouns and Distorted Thinking: Depressed Selves in an Online Depression Community

Limited studies have investigated the presence of cognitive distortion and emotional disturbance in online depression narratives. Additionally, the intricate relationships between the expression of depressive emotions, the construction of the depressed self and the manifestation of cognitive thinking lack an intuitively perceived connection. This study explores the affective cognition of a group of young individuals who shared their depressive emotions on the ‘Zoufan’ Weibo page. A set of 2000 comments was selected and coded, which revealed a prevalence of negative emotions within the community. Pronouns, a pivotal discursive resource and a cue for studying identity work, were further mapped with the top 10 negative emotions. Exploratory analyses revealed the four most salient distorted thinking patterns: self-isolating thinking, self-blaming thinking, absolutist thinking, and catastrophic thinking. The implication of this study lies in assisting both the public and Internet users in recognizing pronouns as nuanced emotional and cognitive cues of online depression narratives.

Discourse and Madness in Shadows in the Sun

ABSTRACT This article is on the narrativization of mental illness regarding Gayathri Ramprasad’s memoir Shadows in the Sun (2014). Ramprasad’s rendition of her depression becomes an act of defiance because the production of discourse by a madwoman is a relatively new phenomenon. Ramprasad not only produces discourse but also intends it to be healing for people with depression. This is because Ramprasad herself benefitted from first-hand narratives of depression. Whether the putative healing effect of storytelling can be reckoned originating from romanticizing depression by making it look desirable is the research question addressed in this article.

Disorders of Mood: The Experience of Those Who Have Them

Abstract Mood disorders are common, painful, and closely tied to suicide and alcohol and substance use. They are also treatable. Mania and depression, a part of the human record for as long as it has been kept, were well-recognized and described by physicians of antiquity. Our knowledge of mood disorders has broadened and deepened in the many centuries since those early times, and crosses many scientific and clinical fields, including genetics, neuropharmacology, neuroimaging, psychopathology, and neuropsychology. We have as well a rich history of personal narratives of depression and bipolar disorder that gives a different but essential perspective; I present several of these accounts here.

Towards an Ethics of Reading: Syntax and Self-Care in Depression Narratives

ABSTRACT The representation of mental illness in literature has led to various renewed forms of engagement with the figure of the reader. Depression texts, in particular, provide the stage for a conversation about how the reader must be oriented toward depression in its written form (a textual and therapeutic counterpart to the talking cure). In this regard, a close reading of David Foster Wallace’s “The Depressed Person” reveals the demands placed by the depression text on the reader for a careful practice of reading – as in, the mimicry of therapeutic care, a convoluted carefulness in language. This textual demand is reflected in the grammatical and syntactical choices in the short story and in the stylistic tension between elements of novelistic discourse (omniscient third person narrator, deadpan realism, long hypotactic sentences, etc) and clinically prescribed modes of narrating depression. This forces the reader to engage with – if not take on – the role of a caregiver (i.e., the reader marked by a therapeutic function) and to participate in the writer’s desire for a companion in his self-care process.

Digital conversations about depression among Hispanics and non-Hispanics in the US: a big\u2010data, machine learning analysis identifies specific characteristics of depression narratives in Hispanics

BackgroundDigital conversations can offer unique information into the attitudes of Hispanics with depression outside of formal clinical settings and help generate useful information for medical treatment planning. Our study aimed to explore the big data from open‐source digital conversations among Hispanics with regard to depression, specifically attitudes toward depression comparing Hispanics and non-Hispanics using machine learning technology.MethodsAdvanced machine‐learning empowered methodology was used to mine and structure open‐source digital conversations of self‐identifying Hispanics and non-Hispanics who endorsed suffering from depression and engaged in conversation about their tone, topics, and attitude towards depression. The search was limited to 12 months originating from US internet protocol (IP) addresses. In this cross-sectional study, only unique posts were included in the analysis and were primarily analyzed for their tone, topic, and attitude towards depression between the two groups using descriptive statistical tools.ResultsA total of 441,000 unique conversations about depression, including 43,000 (9.8%) for Hispanics, were posted. Source analysis revealed that 48% of conversations originated from topical sites compared to 16% on social media. Several critical differences were noted between Hispanics and non-Hispanics. In a higher percentage of Hispanics, their conversations portray “negative tone” due to depression (66% vs 39% non-Hispanics), show a resigned/hopeless attitude (44% vs. 30%) and were about ‘living with’ depression (44% vs. 25%). There were important differences in the author's determined sentiments behind the conversations among Hispanics and non-Hispanics.ConclusionIn this first of its kind big data analysis of nearly a half‐million digital conversations about depression using machine learning, we found that Hispanics engage in an online conversation about negative, resigned, and hopeless attitude towards depression more often than non-Hispanic.

Sequential Sadness: Metaphors of Depression in Clay Jonathan’s Depression Comix

© Media Watch 12 (1) 33-45, 2021ISSN 0976-0911 | E-ISSN 2249-8818DOI: 10.15655/mw/2021/v12i1/205456 Sequential Sadness: Metaphors ofDepression in Clay Jonathan’s Depression Comix Sathyaraj Venkatesan & Arya SureshNational Institute of Technology (Trichy), India Abstract Graphic medicine embodies a nuanced understanding of illness about the undercurrents in the systems of healthcare and society. Depression narratives in graphic […]

From Lay Depression Narratives to Secular Ritual Healing: An Online Ethnography of Mental Health Forums

The article aims at analysing online depression forums enabling lay reinterpretation and criticism of expert biomedical discourses. Firstly, two contrasting interpretations of depression are reconstructed: expert psy-discourses are confronted with the phenomenological descriptions of lay experiences, with a special emphasis on online forums as empirical platforms hosting such debates. After clarifying the general theoretical stakes concerning contested ‘depression narratives’, the results of an online ethnography are introduced: the main topics appearing in online discussions are summarised (analysing how the abstract tensions between lay and expert discourses appear in the actual discussions), along with the idealtypical discursive logics (analysing pragmatic advises, attempts of reframing self-narratives and expressions of unconditional recognition). Finally, based on these analyses an attempt is made to explore the latent functionality of online depression forums by referring to a secular ‘ritual healing’ existing as an unreflected, contingent potential.

The Utilization of Cultural Movements to Overcome Stigma in Narrative of Postnatal Depression.

Background: Despite affecting 15% of new mothers, experience of postnatal depression has often been hidden by stigma, cultural beliefs, and lack of medical understanding. We examined the barriers to women sharing their experience and gaining help, using their own words to illuminate the experiences of stigma and injustice. This study examines the narratives of women across the twentieth century, explores cultural movements that framed and contextualized their experiences, and marks how women became more empowered to speak of maternal distress.Methods: Narrative literature was identified via searches of literature catalogs. Narrative accounts provided a lens through which to analyze cultural understandings of postnatal depression according to historical method. Contemporary medical and sociological literature discussing postnatal depression was used to contextualize the social climate within which these narratives were written. This work combines historical analysis with philosophical framework to develop insight into patient experiences of mental ill-health and associated stigma.Results: This research identified three core cultural movements providing women with a framework in which to discuss their experiences of postnatal depression: the labor movement in the early twentieth century, the second-wave feminism movement in the mid-twentieth century (ca. 1960–1980), and the so-called “Prozac revolution” emerging at the end of the twentieth century. These movements provided distinct culturally acceptable etiologies around which women were able to frame their experience of postnatal depression. This provided women with space in which to share and process their experiences and aided them in overcoming contemporary stigma against mental illness by challenging disparaging stereotypes of the depressed mother.Conclusions: Despite the stigmatizing nature of mental illness, women have demonstrated resilience and ingenuity by utilizing acceptable cultural movements to reframe their experiences of postnatal depression, challenging traditional perceptions of motherhood and effectively earned recognition of their sufferings. During this period, concordance between patient perceptions of postnatal depression and clinical understandings of the condition has been variable. Highlighting the detriment to therapeutic relationship when discordance is present, the narrators have demonstrated the need to destigmatize illness and facilitate cooperation between physician and patient and remind clinicians of the importance of placing patient experience at the center of care.

Politics and notions of the self in depression narratives: Revisiting Martínez-Hernáez’s typology.

Politics and notions of the self in depression narratives: Revisiting Martínez-Hernáez’s typology.

Is this what depression looks like? Visual narratives of depression on social media

Humans are inherent storytellers that in turn shapes our identity. The tendency to talk about health and illness is called ‘illness narratives.’ Most research on illness narratives is generated from diaries, interviews, and surveys. However, text is not the only means of expression. An alternative is to produce images of illness, known as ‘visual illness narratives.’ Depression is a common and serious illness, which can lead to serious health hazards. Despite the increased use of images on social media, little research has been done on visual narratives of depression. The current study examines such illness narratives elicited through images on Tumblr. Fourteen patients with moderately severe depression (Mean age = 27), mostly female (N = 12) were recruited from a counselling centre. Participants were presented with 72 depression-related images from Tumblr in a semi-structured interview. Participants sorted the images into three piles, based on personal relevance, and then talked in detail about each image. Inductive thematic analysis identified six themes providing rich insights into participants’ depressive states, dysfunctional thoughts, suicidal ideation, lifestyle changes, help-seeking, and social struggles. The study offers insights to improve care for depressed individuals using visuals of depression on social media.

Neurochemistry and subjunctivities of depression in Kerala, South India

The narrative of depression as a neurochemical imbalance in the brain or, more precisely, a deficiency of the neurotransmitters serotonin and norepinephrine – largely produced by commercial interests of the international and national pharmaceutical industry and spread globally by international diagnostic systems – has found its way into the offices of mainstream psychiatrists in Kerala. In the clinical encounters, social, economic and existential suffering is thus transformed into a medical condition, treatable with pharmacological means. On the one hand, the setting of a psychiatric outpatient department largely shapes the way depressive patients express their subjectivities. On the other hand, the diagnosis (and explanation) of depression as neurochemical imbalance and the prescription of drugs influences the way patients experience their suffering. Using two ethnographic examples, the aim of this paper is to analyze how subjectivities are construed and shaped in the process of negotiating depression in clinical encounters in mainstream psychiatric institutions in Kerala and how multiple framings and ontologies of affliction are assembled in them. Subjectivities of depression are, it will be argued, less coherent than ambigious and fractured, unstable and fragile. They engage, accentuate and sometimes merge different, often contradictory discourses. They should therefore better be referred to as ‘subjunctivities’. The idiom of depression often becomes a rhetorical device to emphasize affiliation to a scientific medical discourse or citizenship and is often a statement to emphasize ‘scientific temper’ and modernity and to demarcate oneself from backwardness and superstition.

The Possibilities of Grace amid Persistent Depression

Chronic and recurring depression presents challenges to theologians working on the doctrine of grace. First, its frequent misrepresentation inhibits accurate perceptions of God’s loving presence in this context. Second, like all suffering, it threatens the affirmation of divine benevolence upon which the doctrine is predicated. Third, the moral complexities of depression obfuscate grace’s healing effects. To meet these challenges and clarify the contextual work of grace, the author draws on depression narratives to identify the effects of grace as gratuitous, elevating, and healing expansions of possibility that many sufferers experience as depression persists.

Polyphonies of depression: The relationship between voices-of-the-self in young professional women aka 'top girls'.

While the analysis of depression narratives has become increasingly common practice within critical mental health research, this work rarely investigates how these accounts intersect with particular social identities. The recent emergence of the 'top girl' identity, a new cultural slot on offer for young women, is underpinned by the rise of neoliberal and post-feminist discourses in the Western world. To explore whether this new feminine subjectivity is indeed taken up by young women and how it shapes their experience of depression, we conducted in-depth interviews with 13 young professional women in Aotearoa/New Zealand. Based on a dialogical approach to theorising and researching subjectivity, we identified repetitive inter-relations between different voices-of-the-self and the voices of depression. The most pervasive pattern in the sample consists of what we have termed demanding voices associated with the 'top girl' position, which construct depression as an individual deficit thereby discouraging young women from exploring the sociocultural origins of their distress. In contrast, resistant voices emphasise relationality and a (re)connection with meaningful values and, therefore, seem to be productive for individual recovery.

Talking about depression during interactions with GPs: a qualitative study exploring older people\u2019s accounts of their depression narratives

BackgroundOlder people can struggle with revealing their depression to GPs and verbalising preferences regarding its management. This contributes to problems for GPs in both detecting and managing depression in primary care. The aim of this study was to explore older people’s accounts of how they talk about depression and possible symptoms to improve communication about depression when seeing GPs.MethodsAdopting a qualitative Interpretivist methodological approach, semi-structured interviews were conducted by IG based on the principles of grounded theory and situational analysis. GPs working in north east England recruited patients aged over 65 with depression. Data analysis was carried out with a process of constant comparison, and categories were developed via open and axial coding and situational maps. There were three levels of analysis; the first developed open codes which informed the second level of analysis where the typology was developed from axial codes. The typology derived from second level analysis only is presented here as older people’s views are rarely reported in isolation.ResultsFrom the sixteen interviews with older people, it was evident that there were differences in how they understood and accepted their depression and that this influenced what they shared or withheld in their narratives. A typology showing three categories of older people was identified: those who appeared to talk about their depression freely yet struggled to accept aspects of it (Superficial Accepter), those who consolidated their ideas about depression aloud (Striving to Understand) and those who shared minimal detail about their depression and viewed it as part of them rather than a treatable condition (Unable to Articulate). The central finding was that older people’s acceptance and understanding of their depression guided their depression narratives.ConclusionsThis study identified differences between older people in ways they understand, accept and share their depression. Recognising that their depression narratives can change and listening for patterns in what older people share or withhold may help GPs in facilitating communication to better understand the patient when they need to implement alternative approaches to patient management.

No one is listening: Members of the Deaf community share their depression narratives

ABSTRACTThis exploratory case study conducted in Manitoba, Canada examined a unique social justice issue in the field of mental health, namely, how Deaf adults, all American Sign Language first-language users who were diagnosed with Depression, manage their symptoms in a mental health system that is based on spoken, not signed communication. Using in-depth individual interviews, and a hand-drawn Person and Environment Map, this study offers rich in-depth narratives of the experiences and challenges faced by members of the Deaf community seeking mental health assessment and intervention.

Making sense of the evolving nature of depression narratives and their inherent conflicts

Originally a psychiatric diagnosis fashioned by Western psychiatry in the twentieth century, depression evolved to encompass varying lineages of discourse and care. This article elucidates some of the current challenges—as well as emerging discourses—influencing the category of depression. Depression-like experiences are shaped by (at times conflicting) subjectivities, claims to knowledge, material realities, social contexts and access to resources. With no unified understanding of the category of ‘depression’ available, lay people, social scientists and neuroscientists, GPs, psychiatrists, talking therapists and pharmaceutical companies all attempt to shape narratives of depression. The current paper focuses on patient narratives about depression—in the context of these wider debates—to better elucidate the ways in which depression discourses are publicly developing along varying lines. In conclusion, the paper suggests that we could better conceptualise the resulting ‘depression(s)’ with concepts such as ‘society of mind’ and notions of subjectivity unbounded by individuals.

Depression at work, authenticity in question: Experiencing, concealing and revealing

Australia and the United Kingdom have introduced policies to protect employees who experience mental illness, including depression. However, a better understanding of the experiential issues workers face (e.g. sense of moral failure) is needed for the provision of appropriate and beneficial support. We analysed 73 interviews from the United Kingdom and Australia where narratives of depression and work intersected. Participants encountered difficulties in being (and performing as if) 'authentic' at work, with depression contributing to confusions about the self. The diffuse post-1960s imperative to 'be yourself' is experienced in conflicting ways: while some participants sought support from managers and colleagues (e.g. sick leave, back-to-work plans), many others put on a façade in an attempt to perform the 'well' and 'authentic' employee. We outline the contradictory forces at play for participants when authenticity and visibility are expected, yet, moral imperatives to be good (healthy) employees are normative.

Lesley Sharp and the alternative geographies of Northern English Stardom

Abstract Historically, ‘North’ (of England) is a byword for narratives of economic depression, post-industrialism and bleak and claustrophobic representations of space and landscape. These impulses often manifest themselves in aesthetic or structural frameworks, which in turn speak to gendered authorial discourses in film, literature and television: the so-called ‘angry young man’ tradition, for example, and the British New Wave. This article seeks to destabilize this male construction of Northern English visual and narrative iconography by suggesting that female stardom offers an alternative means of encountering regional television drama. Female Northern performers function intertextually across multiple narratives to assert specific thematic qualities that both pertain to a radical regionality and enable a sense of agency, which disrupts hitherto dominant constructions of regional and gendered space. Analysing the work of Lesley Sharp as a case study, this article suggests that Sharp, a British actress who has almost always performed in Northern dramas, valorizes and occupies a powerful feminine and feminist space. Disrupting the authority of Northern masculinity, Sharp’s many performances as a range of complex female characters have, we argue, mobilized a shift in the location of a spatial identity and authority away from the realm of the masculine. Alongside other powerful Northern female performers, Sharp provides an alternative cartography that articulates the Northern landscape afresh and as such provides a more honest and inclusive view of the bodies through which it is performed.

“Halfway towards recovery”: Rehabilitating the relational self in narratives of postnatal depression

This article explores expositions of subjectivity in accounts of postnatal depression (PND). It examines the public narratives of 19 Australian women contributing to a health information website (healthtalkaustralia.org), collected across two Australian qualitative research studies conducted between 2011 and 2014. For the first part of the paper we analysed narrative data using a combination of phenomenological and psychoanalytic techniques. We found that postnatal distress was described in embodied, relational terms and that women depicted their distress as a pre-verbal intrusion into ‘known’ selves. We interpreted this intrusion as a doubly relational phenomenon - informed at once by a woman’s encounter with her infant and her ‘body memory’ of earlier relational experiences. For the second part we examined how and why women classified this relational distress as PND. We drew on illness narrative literature and recent work on narrative identity to explore why women would want to ‘narrate PND’ – an apparently antithetical act in an environment where there is a duty to be a good (healthy) mother. We highlight the dual purpose of the public PND narration – as a means of re-establishing a socially sanctioned known self and as a relational act prompted by the heightened relationality of early maternity. Our focus on the salutary aspects of narrating PND, and its links to relational maternal subjectivities, offers a novel contribution to the current literature and a timely analysis of a largely uninterrogated sociocultural phenomenon.