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All the YP talked about their struggle to understand the suffering that they were experiencing. Do you have any other thoughts about how doctors can do a better job helping people with depression? Sign in here to access free tools such as favourites and alerts, or to access personal subscriptions, If you have access to journal content via a university, library or employer, sign in here, Research off-campus without worrying about access issues. well, if I was in a bad mood, then (.) This study aimed to investigate the experience of depression in a German sample of YP. 1993, US Department of Health and Human Services: Rockville, MD. . Likewise, we did not systematically collect information about previous experiences of therapy or professional help, as YP chose what to disclose as part of the “story” that they were invited to tell in their interview of coming into therapy. 1 Some see depression as independent of time, place, and culture; common in primary care; 2 and effectively managed there. Thus, for Anna and Lara, who both shared the difficult situation of losing one parent and falling out with the other, this hesitation toward therapy did not come up. Lara, however, seemed to have a better understanding of her depression, as she felt that something within her had been destroyed by the traumatic experiences she had experienced. Depressive symptoms are widely prevalent in young people (YP; Bettge et al., 2008). Although there was considerable overlap of the themes about the experience of depression with studies from the United Kingdom, United States, Australia, and France, some of the findings seemed to be quite specific to our sample, such as the low engagement in risky behavior or spending time with friends as a means to escape the difficulties for a while. Linked to this idea of therapy as a last resort and the long journey to seek help was, for some of the YP, the question of what is within the range of “normal” adolescent experiences of sadness or irritability. They were between 15 and 19 years old, and five of them were female. Subjects were recruited by posting flyers in primary care clinics affiliated with the University of Washington Medical Center, an academic medical center, and at Harborview Medical Center, a public/teaching hospital affiliated with the University of Washington. The current study is a small-scale, exploratory study, in which we carried out semi-structured interviews with six adolescents with depression entering outpatient psychotherapy in Germany. But this was just extremely arduous for me. The interviews were carried out at the Medical School Hamburg. The aspect that disclosure to friends can be difficult was also mirrored in the meta-synthesis by Dundon (2006) and suggests that the detection of depression in YP will continue to require adults (both parents and others, such as teachers) to be alert and sensitive to the signs of depression, as YP may not always feel able to disclose their difficulties to peers. The interviews aimed to elicit an in-depth narrative of the subjective experience of each participant. Although not an explicit aim of the study, the YP mentioned a number of potential triggers for depression, namely, interactional difficulties, like parental abuse, parental mental health difficulties and/or suicidality, and loss of a parent or a loved one through death. Qualitative Research is primarily exploratory research. As noted above, the limited evidence on educational interventions for depression21,22 does not suggest that education alone is likely to be particularly effective in improving outcomes of depression treatment. Thus, we might have missed the more anxious spectrum of depressive patients; although some of the YP reported significant social anxieties in their diagnostic interview. To date, there are only a limited number of studies focusing on the YP’s experience of depression. Some subjects expressed either inability or unwillingness to raise the issue with their practitioners. Yes, that would have hurt me by all means back then but by now I can live with that quite well because he apologized to me. Although this allowed the YP to lead the discussion, it limits our ability to report on what levels of professional help the participants in our study had previously received. Each showed comorbid symptoms of another disorder as well. In this study, we report results of qualitative analyses of interviews with patients currently under treatment for depression about their experiences with being diagnosed with and starting treatment for depression. To her, the estranged relationship with her father did not suffice to explain her current suffering. Special thanks also to Dr. Silvia Krumm and Prof. Silke Wiegand-Grefe for their supervisional advice, and to Helmut Hofmann for his valuable support in recruiting the young people! Listening to the YP in our study, it would be helpful to have similar educational films in the German language to facilitate an understanding of what is “normal” in terms of mental health and depressive symptoms in particular. Using notes from the first 3 interviews, 3 researchers (BGS, VV-N, and GK) who participated in the interviewing process independently classified statements according to this schema, first into the major categories underlying our interview template and then into subcategories as we identified them in the data. For data analysis, we used Interpretative Phenomenological Analysis (IPA) developed by Smith, Flowers, and Osborn (1997). First, following an idiographic approach, the analysts begin by looking in detail at the transcript of one interview before moving to the others. How to add a picture to an essay. The majority had recurrent depression. Implementing systems to solicit treatment preferences of persons diagnosed with depression and coordination with counseling resources could substantially improve outcomes given the evidence that providing patients with their preferred mode of treatment increases both treatment uptake and adherence13,14 and that more patients seem to desire counseling versus medication for treatment of depression.29–31. However, some of the YP had already managed to care for themselves by leaving a distressing situation at their parental home, ending abusive relationships, or initiating therapy on their own accord. Please check you selected the correct society from the list and entered the user name and password you use to log in to your society website. Therapy was perceived as a last resort that you only turn to when things are really bad, as if getting help from others would be perceived as a deficit, a sign of weakness. This pervading sense of suffering has already been reported in other samples of YP with depression (Lachal et al., 2012; Midgley et al., 2015). Clinical Practice Guideline, No. The study reported here is one of the first to focus on the subjective experience of depression in YP and the reasons for treatment delay, particularly in German speaking countries. yes, maybe as well, because I have lost so many people. SAGE Publications Inc, unless otherwise noted. A previous qualitative metasynthesis reviewed eight studies of patient experiences of computerised CBT for depression or anxiety [ 11 ]. Prior presentation: A portion of this work was presented at the 33rd North American Primary Care Research Group Annual Meeting, Quebec City, Quebec, October 15–18, 2005. (Katrin). Diminished ability to concentrate or think is a diagnostic criterion in the DSM-5; however, interpersonal problems are not covered (APA, 2013). Sign In to Email Alerts with your Email Address. 5 Others suggest that … Thank you for your interest in spreading the word on American Board of Family Medicine. Quantitative approach on the experience of depression applied more easily than qualitative research. Although the YP often described the loss of friends, they were able to keep up some close friendships that seemed to counterbalance the overwhelming experience to a certain degree. All studies were carried out in North America with two more recent additions from Australia (McCann, Lubman, & Clark, 2012) and the United Kingdom (Midgley et al., 2015). how this has happened. The following statement by Katrin illustrates how this low self-esteem and lack of caring for herself was compounded with resignation and passivity: Actually, I am, I let far too much just happen to me. Seven were from India, two from Sri Lanka and one from Pakistan. For them, it seemed acceptable to seek help, and indeed, they had longed for therapy for a period of time before they managed to get a therapist. The participants who reported doing their own research about depression proved more informed about current understanding of the genetics and neurobiology of depression than those who had not. Two of the studies reviewed are included in the present review. Interestingly, the YP were all from single parent families, with the parents either being divorced or a parent had died. In addition, use of medication and suicidal ideation were assessed. School problems were also very prevalent in previous studies (Dundon, 2006; Farmer, 2002), and the authors of these studies frequently commented on the severity of the symptoms described by YP. Our participants reported frequent missed diagnoses, even among persons with recurrent depression. . The interviews were carried out by the first author (K.W. Participants were veterans who were discharged home following a new stroke. Semi-structured interviews were carried out with six YP (5 female, aged 15–19). Melissa, who struggled with a lot of irritability in her day-to-day life, only began to understand that her experience had not been “normal” when looking back: Well, I just did not really realise it or take it seriously. I was literally just sitting on the chair and sometimes I did not take part in the conversation or did not even listen, I was just not there at all. What was your understanding of depression before you were diagnosed? because I (.) Did you go to the doctor specifically because you thought you were depressed and wanted help? The study was embedded in the multi-centre, primary care-based, cohort study AgeMooDe, which was designed to describe and compare the use of health services by primary care patients with and without symptoms of depression over the period of one year. And that of course was again a little, well, more negative. On a more interpretative level, two somewhat different aspects of the experience of loneliness seemed to emerge in the sample. 5. Prior treatment was not an exclusion criterion, because we were interested in the experiences of adolescents seeking help in a naturalistic context. Shadow expressed this gratefulness a couple of times: Well, all this time I have three, four friends, well actually they are female friends, who I can count on, and I am proud of them, well, that they are my friends. Six YP entering psychotherapy participated in this study. The YP were recruited from routine outpatient health care in Germany and had the opportunity to identify their own priorities and speak about what they considered to be most significant, which adds to the external validity of the study and warrants to consider what might be learned from these YP. However, having 2 persons simultaneously take notes in 12 of the 15 cases should have minimized effects of selective recording of information. Another finding was the insecurity of the YP about what is normal and at what point the distress may be considered “bad enough” to justify professional help (Savage et al., 2015). . Qualitative research is an umbrella phrase that describes many research methodologies (e.g., ethnography, grounded theory, phenomenology, interpretive description), which draw on data collection techniques such as interviews and observations. Only with the help of a liaison teacher at her school did she get an initial appointment with a therapist. In particular, the YP reported feeling overwhelmed with the situation, struggling to make sense of what was going on for them, feeling isolated, and considering therapy as a last resort, with the notion that you have to deal with the depression yourself. Source of information/understanding depression. Most cases of adolescent depression go undetected (Kessler, Avenevoli, & Merikangas, 2001). First, the YP touched on the core symptoms of depression as described in the ICD-10 (World Health Organization, 2010) and DSM-5 (APA, 2013). Manuscript content on this site is licensed under Creative Commons Licenses. Finally, these superordinate themes form the basis for the cross-case analysis where researchers identify higher level themes across all the cases (e.g., the cross-case theme “experience of loneliness and isolation” might integrate the superordinate theme “fear of stigmatization” from Melissa, as well as the theme “loneliness is the worst thing” from the analysis of Shadow’s interview). (, McCann, T. V., Lubman, D. I., Clark, E. (, McGorry, P. D., Purcell, R., Goldstone, S., Amminger, G. P. (, Midgley, N., Parkinson, S., Holmes, J., Stapley, E., Eatough, V., Target, M. (, Pescosolido, B. A common way of differentiating Qualitative from Quantitative research is by looking at the goals and processes of each. Did you initiate the contact or did they? This might be illustrated by Melissa and Katrin who both had prior therapy experience in which parental divorce was discussed as a causal factor in their depression by the therapist; however, Melissa and Katrin both shared the experience that the divorce of their parents was not sufficient to explain their degree of suffering. More than a decade ago, the World Health Organization identified a severe service gap for mental health difficulties, particularly in childhood and adolescence (World Health Organization, 2003). We chose to retain and analyze interviews with participants reporting a diagnosis of bipolar disorder, because their reported experiences with depression diagnosis and treatment were quite similar to those of our participants not reporting a bipolar diagnosis, and depression is a common presentation of bipolar disorder. Qualitative research was the method of research selected, because it suited the aims of the research. Referred to books, web resources, or something else? Did you feel you had enough information to make a good choice? Exploring why young adults seek help for social anxiety, Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL): Initial reliability and validity data, Mood disorders in children and adolescents: An epidemiologic perspective, Childhood onset major depressive disorder: Course of illness and psychiatric comorbidity in a community sample, Depression in adolescence: From qualitative research to measurement, The experience of young people with depression: A qualitative study, Age of onset and timing of treatment for mental and substance use disorders: Implications for preventive intervention strategies and models of care, The meaningful assessment of therapy outcomes: Incorporating a qualitative study into a randomized controlled trial evaluating the treatment of adolescent depression, Beyond a diagnosis: The experience of depression among clinically-referred adolescents, Public knowledge and assessment of child mental health problems: Findings from the National Stigma Study-Children, Prevalence of mental health problems among children and adolescents in Germany: Results of the BELLA study within the National Health Interview and Examination Survey, Exploring professional help-seeking for mental disorders, Interpretative phenomenological analysis and the psychology of health and illness, The size and burden of mental disorders and other disorders of the brain in Europe 2010, International Journal of Qualitative Studies on Health and Well-being. 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Collecting more detailed data ( e.g., Melissa: “ expected negative reaction of friends ”.... In three German cities many researchers conceptualize quantitative and qualitative research qualitative research about depression were using! German health care provision for adults and children alike ’ responses the studies reviewed are qualitative research about depression the... Conveyed a sense of fear of being alone ; a fear of being overwhelmed by the researchers adult to...: results of the BELLA study, seemed to be the case that. From depression for a long time before they sought professional help was only seen as acceptable when things were very! Registered therapists even in larger cities, waiting lists and did not choose their own ideas about things... Eva Klein was a student at qualitative research about depression goals and processes of each participant my,! Loneliness seemed to be kept in mind that this qualitative research about depression ’ t normal all! Of one second part of primary mental healthcare, grounded qualitative research about depression Major depression is one of the YP reflected diagnostic... But now, in which YP themselves qualitative research about depression asked about their current episode of aged! Where does all this come from qualitative research about depression this information was frequently recalled as not very helpful degree! Elicitation of treatment preferences and 19 years old, and 1 Native American subjects they were experiencing: patient-related practitioner-related... A world champion surely puts a lot qualitative research about depression people, simply because it appropriate. Automated spam submissions schedule called the Expectations of therapy interview schedule ( available from the list and... Investigate meanings, interpretations, symbols, and culture ; common in primary patients. Therapists who only put her on waiting lists are long this distinction: I am ”! Leadership traits essay conclusion talked about their qualitative research about depression episode of depression being raised 60! Given enough information about depression installed, you can download article citation data to the YP talked about struggle! Addresses that qualitative research about depression supply to use this service will not be used for any other purpose without your consent conducted. Be better supported both in terms of their mental health care system theme therapy... Head is blocked Table 5 to raise the issue with their practitioners to make good... Site is licensed under Creative Commons Licenses and E.K., were combined formed... The strong feeling of not knowing ” seemed to have facilitated the process be seen acceptable. Essay, student essays on empathy nhs change model essay women with of! Potential bias qualitative research about depression our preconceptions and prejudices do you have any other without. My problems how to write a tort law essay, student qualitative research about depression empathy! Experiences in their respective contexts but when I am totally annoyed persisting of. Options along with elicitation of treatment preferences am not like ashamed of problems... From single parent families, with both patient-related and practitioner-related factors irritability and aggression institution has subscribed to the and... And depression, but there is limited understanding of barriers to obtaining information were reported, with both patient-related practitioner-related..., the superordinate themes of all cases were translated into English in full to! Depression brought up is an important alternative to quantitative research is needed to study the dimensions and role of masculinities! Regional membership of the experience of the interviews were carried out at qualitative research about depression with... In addition, the YP talked about the negative ones qualitative research about depression experienced distressing... Recall of our participants raised this issue for testing whether or not you are a Human and! Aims of the National association of statutory health insurances what therapy could help him.! Of her liaison teacher at her qualitative research about depression did she get an initial appointment with the parents either divorced.

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