?????????Prozac Saved My Life????????? vs. ?????????Prozac Ruined My Life?????????: Investigating the Adoption, Constitution and Maintenance of Distinct Interpretations Associated with Depression and its Medical Treatment.

摘要

Beyond the brute pain of depression, individuals enduring this problem also commonly face a more subtle, added burden related to both societal and personal confusion about the basic nature of depression and its appropriate resolution. This dissertation study seeks to better understand diverging interpretations or narratives at play in the experiences of those facing depression by examining the language of actual survivors. In particular, the complexity of individuals??? decisions regarding possible medication use is investigated. Through fourteen in-depth interviews with survivors reflecting diverse (both positive and negative) psychiatric experiences, three specific questions are explored: 1) How exactly do individuals come to adopt a particular narrative of depression and its treatment? 2) What are the most meaningful differences between varied narratives that arise? 3) After being adopted, how do particular narratives appear to be maintained over time? The first section of the report describes basic patterns across survivor accounts???first, in reviewing individual synopses of each narrative (Ch. 3), and second, in documenting key interpretive themes across all interviews (Ch. 4-5). The second section moves into more direct analyses of these narratives, taking up explicitly the three empirical questions in turn. Chapter 6 identifies multiple resources that individuals draw upon in the adoption of distinct treatment narratives (e.g., intense levels of confusion and urgency; comments from friends/family; drug effects). Ensuing moments are proposed as powerfully cementing and galvanizing specific interpretations of both depression and associated medication use. Chapter 7 explores several issues underlying some of the most meaningful differences between narratives (how participants interpret the role of biology, agency, medication and surrounding relationships). In Chapter 8, strategies that appear to be associated with the maintenance of particular treatment narratives are examined. Among other things, analysis of patterns across accounts points to a striking role for diverging narratives in the unfolding treatment experiences of those facing depression. Since such individuals typically have little awareness that their treatment experience can be interpreted in fundamentally different ways, nor that these distinctions may have substantial implications for how their experience ultimately unfolds, a more thoughtful and broad-based deliberation involving both professionals and those facing depression is subsequently proposed.