YOUNG PEOPLE’S VIEWS OF THEIR DEPRESSION IN RELATION TO THE CONCEPT OF ILLNESS

1. YOUNG PEOPLE’S VIEWS OF THEIR DEPRESSION IN RELATION TO THE CONCEPT OF ILLNESS • Mervi Issakainen • Doctoral student • “Coping with depression in social context” -project • University of Eastern Finland • QRMH3 – conference 25.8.-27.8.2010, Nottingham, England

2. This presentation • Depression is a common and impairing affliction among Finnish young people (e.g. Raitasalo & Maaniemi 2009). • Young people tend to hide their feelings of depression and do not seek help (e.g. Draucker 2005; Wisdom et al. 2006). • The aim of the study: to understand how young people with experiences of depression view the conception of depression as an illness. • Having experiences of depression is defined by the young people themselves.

3. Data collection • The study is conducted via internet -> a website for data collection • Participants: 82 young people (75 women and 7 men between 14 – 34 years of age) • Methods: - written narratives (N=61, the length varies from couple of sentences to over 7 pages) - 2 online group discussions (348 messages including mine, from one sentence to 1,5 pages) - 4 online individual interviews (67 messages including mine, from one sentence to 1,5 pages)

4. Data analysis • The concept of illness occurs 79 times -> the analysis concentrated on those parts of the data • Thematic analysis: - coding the data by searching themes reflecting the views of depression as an illness - organizing the codes under different themes and sub-themes - re-coding the data based on the detailed coding frame

5. Results • The cultural conceptions of (young people’s) depression: - Depression is a mental illness - Depression is a matter of pulling oneself together • The young people’s response to these conceptions: - Depression is an illness as any other

6. Depression as a mental illness The cultural conception of depression which means (to the young people): • being pushed outside the normal people’s decent life • experiences and fear of being labeled as mad

7. ”It was mentioned, in some earlier writing, that someone has heard (about himself) that ”the X will probably murder everyonesoon”. I’ve, also, heard someone saying, as a joke, though, that I’m the next school killer…” (26-year-old man, 2. group discussion)

8. Depression as a matter of pulling oneself together The cultural conception of depression which means (to the young people): - feeling guilty and being accused of - experiences and fear of not being listened to or taken seriously

9. ”I never answered, why I don’t want other people to know about my depression and, I believe, I figured the answer now. The biggest fear is, probably, that my illness would be belittled by saying it will go away, by commenting with a joke etc. Sometimes, I really have to fight to make my partner understand how bad my situation really is.” (20-year-old woman, individual interview)

10. Depression as an illness as any other The young people’s own views of their depression: - it is a serious illness - nothing less - it is only an illness - nothing more --> depression is an illness as any other --> the needed compassion and time to get their life back on track

11. ”In my opinion, it should be talked about, a lot, so that young people would get it that it is not “teen age angst”, but a serious illness. Thank you.” (16-year-old woman, narrative)

12. ”...I’ve, also, heard someone saying, as a joke, though, that I´m the next school killer. I would never want to hurt anyone else, though, I’m feeling bad. I don’t hate the world or blame it for my condition.This is only an illness from which I, surely, am capable of recovering some day.” (26-year-old man, 2. group discussion)

13. Conclusions • The cultural conceptions of depression seem to support understanding it either as “a mental illness” or as “a matter of pulling oneself together”. • Especially, young people’s depression tend to be belittled. • The young people sought a compromise between the extreme conceptions by hoping that depression would be viewed as “an illness as any other”. • Experiences of depression are legitimized by comparing them to physical illnesses (cf. Lafrance 2007). However, young people do not, necessarily, subscribe to the biomedical conception of depression.

14. References • Draucker, C. B. 2005. The interaction patterns between depressed young people and the important adults in their lives. Qualitative Health Research 15 (7), 942 – 963. • Lafrance, M. N. 2007. A bitter pill: A discursive analysis of women’s medicalized accounts of depression. Journal of Health Psychology 12 (1), 127 - 140. • Raitasalo, R. & Maaniemi, K. 2009. Mielenterveyden häiriöt aiheuttavat nuorille yhä enemmän sairauspoissaoloja. Sosiaalivakuutus 47 (4), 22 – 24. • Wisdom, J. P.; Clarke, G. N. & Green, C. A. 2006. What teens want: Barriers to seeking care for depression. Administration and Policy in Mental Health Services Research 33 (2), 133 – 145.

15. Thank you!

16. Ethical considerations • The website provided information about the study • Participants used pseudonyms • I do not report the pseudonyms, because, the same pseudonym may be used in some other online environment representing individual’s online identity (Kuula (2006). • The data between the participant’s computer and the service was encrypted by using the SSL-certificate