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Maybe yes, maybe no: Arguments about stigma and depression in interviews with family physicians

Maybe yes, maybe no: Arguments about stigma and depression in interviews with family physicians. Linda M. McMullen University of Saskatchewan, Canada. Introduction. stigma varies with the diagnosis the stigma of a diagnosis of depression is complicated who stigmatizes?.

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Maybe yes, maybe no: Arguments about stigma and depression in interviews with family physicians

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  1. Maybe yes, maybe no:Arguments about stigma and depression in interviews with family physicians Linda M. McMullen University of Saskatchewan, Canada

  2. Introduction • stigma varies with the diagnosis • the stigma of a diagnosis of depression is complicated • who stigmatizes?

  3. Methodology and Methods • discourse analysis • individual interviews with 11 family physicians (5 women, average age = 51 yrs, average yrs in practice = 21, most in full-time practice [public, private, salaried]) • two parts to the interviews • 20 extracts contained the word ‘stigma’

  4. Analysis: Qualifying StigmaExtract #1 Hedging the statement that there is less stigma I: Any sense of kind of why the younger crowd might be easier? P: Umm. Well, just uh their access to information is so much greater and I don’t know maybe there’s less I don’t know maybe there’s less stigma now than there was. Um I I’m not really sure but they’re they’re more comfortable coming in and talking about things. Just like they’re more comfortable coming in and asking for contraception they’re more comfortable coming in to talk about um screening for sexually transmitted diseases they’re more comfortable talking about like hey I’m a lesbian things like that so.

  5. Extract #2Hedging, then denying and casting suspicion on the statement that there is less stigma P: Just because of the uh stigma with uh with uh psychiatric illness and the weakness the people are perceived to be if they’re . . . if it’s in your head then it’s something you can get rid of, you’re, just got to be stronger. And it’s amazing uh people’s families support that too they want the people to be better so they should just pull their socks up and do it? I: Okay okay so those kinds of attitudes even within the family P: I I think very strongly in the family um maybe it’s getting a little better in the years I’ve been practicing but I don’t think so I: Yeah it’s kind of tough to say P: you know I think we’re getting some lip service too but not necessarily a deep understanding for it

  6. Extract #3Separating the stigmatized condition of depression from the less stigmatized acts of seeking treatment and being on antidepressants P: There’s still a lot of stigma to to having a depressive illness but it’s more acceptable to have that stigma because you can get better without being put into hospital. I: Okay do you mean kind of like there’s somewhat less risk maybe in talking about depression and mental illness or P: It’s no longer associated with having to be put into hospital so there isn’t going to be that uh great change in your life which will drag on after you because you were in the mental hospital. So it’s more acceptable to to come for treatment without without getting very very sick. Yeah I think that’s that’s a good way of putting it. Yes. Something can be done about it. That’s it. Yes.

  7. Extract #4Claiming less stigma, but then undermining the evidence P: Uh well I think the sense that they’re asking for it means it’s there’s less stigma associated with the um depression um unfortunately that some of the other mental illnesses is still not a not accepting you know schizophrenia is very very um just very frowned upon but depression almost seems like it’s a it’s almost a socially acceptable thing it’s almost like a I don’t want to say that the pendulum has swung so far that it’s cool to be depressed but it’s almost like it’s almost like it’s headed that way. So it’s sort of the fact that people are asking for medications reflects a shift in the population that it’s it’s now acceptable to ask for it. Um we we were talking about this earlier but it also reflects uh {pause} like society is very consumer minded. We like to buy things big screen TV nice stereo nice car. It’s almost like antidepressant medications are like in the seventies everyone was on Valium. I: It’s a designer kind of drug yeah. P: Yeah yeah it’s almost like it’s in fashion or it’s it’s it’s fashionable to be on them you know what I mean. People will be at the gym and so what are you on? Oh I’m on [name of drug name]. We’re not there yet but it it almost looks like it’s heading that way.

  8. Discussion • How might we understand the use of qualified arguments about stigma and depression? • many uses of the word ‘depression’ • difficult to know what constitutes evidence of less stigma • How might we understand the relative absence of talk of stigma in these interviews? • Implications – anti-stigma campaigns for depression?

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