And that of course was again a little, well, more negative. Sixth, we have no way of knowing whether addressing the shortcomings in diagnosis and patient education about depression we have identified will, in fact, improve outcomes of depression treatment. As Samantha revealed with a sense of resignation. Lack of social support was also an … There are certain steps that guide IPA (Smith & Osborn, 2007). 11. . Results: Thirteen papers that considered mothers’ (n = 199) experiences of PPD were included in the review. Each step of the qualitative analysis process was independently audited by N.M. as suggested (Smith et al., 2009). In this theme, we capture the reluctance to seek professional help, as well as individual coping attempts. Isolation was further expressed by indirect accounts of a fear of stigmatization that “you, you just can’t talk about it,” as Shadow put it. The YP also spoke about ongoing and strong feelings of aggression and irritability, which seem to be quite common for adolescent depression (Crowe et al., 2006; Farmer, 2002; Lachal et al., 2012; Midgley et al., 2015). To improve detection, screening tools for depression in YP should be developed based on the descriptions of the adolescents themselves, as was recently done by Lachal and colleagues (2012) with the French Adolescent Depression Rating Scale (ADRS). Quantitative approach on the experience of depression applied more easily than qualitative research. We used a qualitative descriptive approach24 based on our interview template. Overall, the level of suffering was considerable in this sample. What was your understanding of depression before you were diagnosed? 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. The accounts differ, however, in the way that the aggression is experienced, such as being rather diffuse or having a clear object (the YP themselves or close ones), as in the case of Lara who felt strong anger toward the abusive family member: Intense aggression . Participant Statements about Missed Diagnoses of Depression. (.) But that was just painful for me seeing him like that, the way he is suffering, because he really suffered from it—that I was in such a bad state. There were 7 Caucasian, 6 African American, 1 Asian American, and 1 Native American subjects. Participant Statements about Barriers to Getting Information about Depression. For Melissa and Katrin, the overwhelming emotions felt like a blockage or a dam: Everything in my head is blocked. We cannot be sure whether YP with depression but without further comorbidities would have reported similar experiences, in particular in terms of the high degree of irritability, which is a common symptom in posttraumatic stress disorder. Dundon (2006) reviewed the current state of research in her meta-synthesis and was able to include six qualitative studies of depressed and non-depressed adolescents. Semi-structured interviews were carried out with six YP (5 female, aged 15–19). For instance, irritability has been identified as an additional characteristic of adolescent depression alongside low mood in the DSM-5 (APA, 2013). Furthermore, sleeping problems, difficulties concentrating, and, related to this, the negative impact on education were common in our sample, as has been found in other interview studies (Crowe et al., 2006; Farmer, 2002; Lachal et al., 2012; Midgley et al., 2015). A second theme that is strongly related to the overwhelming nature of the feelings is the experience of loneliness and isolation, which was described by all the participants in the study. Later on in the interview, he also emphasizes that his father could not get his head around his son’s situation, possibly mirroring his own struggle: “. In an Australian study, this “struggle to make sense of their situation” (McCann et al., 2012, p. 334) was a central theme as well. Doepfner, M. (, Savage, H., Murray, J., Hatch, S. L., Hotopf, M., Evans-Lacko, S., Brown, J. S. L. (, Weitkamp, K., Klein, E., Wiegand-Grefe, S., Midgley, N. (, Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., . However, one of the core symptoms of depression in the diagnostic systems, “change in appetite and weight gain/loss,” was not discussed by the YP in our study, or in previous studies (Lachal et al., 2012; Midgley et al., 2015), suggesting that this may not be a core symptom that YP associate with their experience of depression. Qualitative research was synthesised to understand how healthcare professionals (HCPs) manage late-life depression, particularly regarding psychological therapy referrals. Our participants reported that they generally received limited information from practitioners about depression and the treatment options available, both in primary care and mental health care settings. The feelings of loneliness and isolation, the third theme, were very pervasive in the interviews and central to the experience of suffering for the YP. This review collated qualitative research evidence and provided additional insights into experiences and perspectives of women with postnatal depression. Enter multiple addresses on separate lines or separate them with commas. 1993, US Department of Health and Human Services: Rockville, MD. Participant Statements about Prediagnosis Understanding of Depression. For Shadow, this loss in performance had only been transient: Well, um, in school I completely deteriorated um in that period of time . The findings suggested that these women should be better supported both in terms of their mental health and with infant feeding. For more information view the SAGE Journals Article Sharing page. Other people have worse problems than me.” but at a certain moment one does not manage by oneself any more. She called up a number of therapists who only put her on waiting lists and did not give her an initial appointment. This first step includes careful reading of the transcript and commenting on what seems interesting or significant not only in relation to the general research question but also in terms of use of language or the sense of the person themselves that comes across. They all met the ICD-10 diagnostic criteria for mild to moderate depressive episodes. It was found that clinicians had little time to negotiate the complex issue of depression and so prioritised physical over mental health needs in older people. A Qualitative Study of Depression in Primary Care: Missed Opportunities for Diagnosis and Education, The Most Frequently Read Articles of 2019, National Survey of Decision-Making for Antidepressants and Educational Level, Better Doctor-Patient Relationships Are Associated with Men Choosing More Active Depression Treatment, Evaluation of ethnic disparities in detection of depression and anxiety in primary care during the maternal period: combined analysis of routine and cohort data, The 12-Month Incidence and Predictors of PHQ-9-Screened Depressive Symptoms in Chinese Primary Care Patients, Suffering in Silence: Reasons for Not Disclosing Depression in Primary Care, The Journal of the American Board of Family This high level of suffering became clear through their frequent usage of words like “completely” or “extreme.” For example, Melissa described having “extreme problems concentrating,” before she went on to describe her current problems. Klinik für Psychiatrie und Psychiatrie des Kindes- und Jugendalters, The experience of major depression: Adolescents’ perspectives, Improving Mood With Psychoanalytic and Cognitive Therapies (IMPACT): A pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: Study protocol for a randomised controlled trial, What brings you here? In the quote, Shadow shows how he grappled with this change, which he would not have thought possible before: I did not notice it at all. There are several important aspects to the experience of loneliness: difficult emotions will come to the surface; feeling lonely, because the YP keeps the burden to themselves as a protection against potential stigma; keeping to themselves to protect others from suffering; or feeling isolated because of a lack of language for expressing the difficult experiences. The interviews were professionally transcribed verbatim, omitting any potentially identifying data such as names, professions, or places. Although some of these experiences could be seen as triggers for posttraumatic stress, none of the YP spoke of them in that way. However, the YP felt unable to confide in these friends and share their distress with anyone, for fear of being stigmatized or judged. Not being able to cope led to feelings of incompetence and self-criticism. The three phases of qualitative research are summarized in Fig. Quotes exemplifying these issues are provided in Table 4. FundingThe authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG) (WE 5615/1-1). This ambivalence was to some degree seen in this study too, and may have severe repercussions for the help-seeking behavior and the potential chronicity of mental health difficulties. and other studies have shown that stigma is a major barrier to diagnosis and treatment of depression.3,25–28 Education may help to reduce personal stigma associated with depression.22, Most of our participants reported that they would have liked more say in their choice of treatments. How was it given? This qualitative study interviewed 12 primary care patients 75 years of age or older with symptoms of depression in three German cities. Open-ended example questions might be, “Can you tell me how you came to be referred to psychotherapy?” or “In what way do these things affect your life?” This guideline was translated into German and then re-translated back into English by a professional translator and native speaker. Possible reasons for not inviting the YP were, for example, because they were in a state of crisis or because their mental health felt too precarious at this point to ask them to participate in research interviews. (.) And nobody ever noticed it. It was not only school, also football, I did not show any performance. Well, it is just annoying for me, because I try it and I don’t manage. Participants received €20 as compensation. Subjects were interviewed by 2 study members, with one acting as primary interviewer and the other focusing more on detailed note taking, with the exception of 3 cases where only 1 team member was available. In-depth interview. Second, recall of our participants may have been incomplete and/or biased. At the time of the interviews, the YP all spoke of the core symptoms of depression as described in the psychiatric literature, including depressed mood, loss of interest, fatigue, trouble concentrating, sleeping problems, and so on, but throughout their narratives, a strong sense of suffering and burden was prevalent. Exclusion criteria were pathology or a cognitive impairment too severe to participate, as rated by therapist or interviewer appraisal. well, if I was in a bad mood, then (.) At the start of the interview, participants were asked again for their consent to audiotape and were reminded that they had the right to withdraw from the interview at any time and that questions did not have to be answered. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. . One full stop is the equivalent of one second. Whereas for Melissa, the aggression seemed to come out of nowhere: And also often, that I simply (.) The other three YP spoke of having at least one caring parent, and in these cases, the sense of isolation and feeling alone with the difficulties was partly due to the YP not wanting to burden close ones: Well, I just did not want to tell [my parents] because I did not want them to worry or to feel guilty or something like that. Lara, who was grieving the loss of a parent and dealing with the abuse of a family member, felt “destroyed.”. Similar aspects of isolation were also reported in Dundon’s meta-synthesis, like feeling different and not wanting to burden others (Dundon, 2006). How to add a picture to an essay. Experiments typically yield quantitative data, as they are concerned with measuring things. The interviews were carried out by the first author (K.W. This pervading sense of suffering has already been reported in other samples of YP with depression (Lachal et al., 2012; Midgley et al., 2015). In this sense, the experience of the YP reflected the diagnostic criteria for adult depression. Mla summary essay sample. Qualitative Research is primarily exploratory research. The purpose of the second interview was to provide a diagnostic assessment and confirm the presence of a depressive disorder; but this data were not used in the qualitative analysis reported below. If you started treatment, how soon after this was your next contact with your provider? In a questionnaire study involving adolescents with depression in New Zealand, the researchers identified the aforementioned irritability as the most common characteristic alongside interpersonal problems and thought-processing symptoms (Crowe, Ward, Dunnachie, & Roberts, 2006). Be due to a discouraging parent, whereas for Anna, this was due to the spoke... Thank you for your interest in spreading the word on American Board of family Medicine find a therapist Email with! 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