There's no meaning in chocolate: a narrative study of women's journeys beyond the disruption of depression

摘要

Professional treatment, mainly medical and psychological, dominates research and clinical practice concerning women and their recovery from depression. This thesis challenges the assumption that women cannot be 'experts' actively involved in their own recovery. This study explored the narratives of eighteen women in Aotearoa New Zealand whose lives had been seriously disrupted by depression. They had found ways other than, or in addition to, professional solutions that helped them to live undisrupted meaningful lives. The research used a narrative inquiry approach informed by authors from across the social sciences including Arthur Frank, Jerome Bruner and Rivka Tuval-Mashiach. The underpinning social constructionist understanding of depression is informed by the work of Jane Ussher and Janet Stoppard. The women whose individual narratives provide the core data for the study ranged in age from 32 to 70 years at the time they told their stories. Their lives had been disrupted by depression at different times during the last 50 years of the twentieth century. Five of the women met as a group with the researcher as the analysis began, and their ideas informed significant aspects of the conclusions.The women had all experienced major depressive disorder, although this was not always formally diagnosed. Their recovery had involved a range of responses from outside the professional mainstream including physical, mental, social and spiritual aspects. Each woman had sought and found a 'formula' that was 'right' for her. The narratives showed all the women talked of their experience with depression and recovery in an holistic and contextualised way. They all talked about 'chocolate' solutions which provided symptom relief, and 'deeper' and often more complex sets of solutions which enabled them to discover or re-discover meaningful ways to live. Meaning-making often involved growing spiritual or transpersonal awareness in the broadest sense. A surprising finding was that the patterns of recovery were not related to the severity of the depression at the worst time. Rather, it emerged that the ways the women talked about their recovery journeys mirrored their stories of the 'jolly good reasons' why they were depressed; the more complex and lengthy the story leading up to the worst times, the more complex the formulae required for recovery. The implications of the research for clinical practice and for policy makers are that depression and recovery need to be seen as gendered, contextualised, and holistic. Women need opportunities to discover and take advantage of a range of 'things' so that they can find their own 'right formula' for recovery. This formula may involve professional treatment including anti-depressant medication and psychological therapy, but it is likely to involve many other things as well. This study challenges the notion that recovery needs to be guided by a professional expert, and creates hope for women being able to learn from each other's experiences.