De sociale vormgeving van depressie: tussen jobstijding en erepenning

Abstract

Up to now, depression has been primarily researched as an individual psychological trait, or as the reaction to an encumbering event of persons with a certain disposition to depression. In this study depression is analysed in a different way: from a sociological, symbolic interactionistic perspective. This throws light on the intersubjective meaning allocation, for instance between clients and their therapists or between writers and their imagined audience. The attention thus shifts from the body and mind of depressive individuals to the interpersonal communication and the historical and social context within which it takes place. The core concept is ‘social construct’. The central question is: which patterns of self-presentation arise in client-therapist interactions and in published first-person illness narratives? Do gender and time have relevance for understanding these patterns? Two empirical studies have explored this question: an analysis of 10 autobiographical texts about depression dating since 1990 and an analysis of 118 therapist designed reports of indication assessment interviews with Dutch clients with depressive symptoms from the second half of the twentieth century. Both studies were conducted using qualitative content analysis, wherever possible supported by quantitative calculations. The two empirical studies have shown that depressive feelings and thoughts are pliable to what is possible and desired in a specific situation. It is easier for persons who have more social-cultural capital to come forward with their depression. It is also easier when there is a professional group who has a remedy for such symptoms, and when it lends an understanding and sympathetic ear to the stories. The less this is the case, the more depression is experienced as a personal inadequacy and the more self-conquest it takes to open up to others about these problems. This applies to men as well as to women, but the construct process that is based on their genderscripts differs. Moreover, partial changes in the gender scripts are interwoven with changes in common sense views about depression, nowadays rather seen as a person’s own responsibility than as God’s will or destiny. Seen from this perspective, depression is not something that has always been the same throughout history. The content of the symptom is inextricably linked to the communicative context. It appears from this study that similar depressive experiences are presented differently depending on context. This can vary from feelings of doom to thinking of depression as a ‘praiseworthy ailment’ – and everything in between.