The Experience of Depression: A Qualitative Study of Adolescents With Depression Entering Psychotherapy

Katharina Weitkamp, Eva Klein, Nick Midgley, Katharina Weitkamp, Eva Klein, Nick Midgley

Abstract

There is a lack of research in health psychology on the subjective experience of adolescents with mental health disorders. The aim of this study was to explore the experience of depression and the journey into therapy of young people (YP) diagnosed with depression. Semi-structured interviews were carried out with six YP (5 female, aged 15-19). Interviews were analyzed using Interpretative Phenomenological Analysis. The following four key themes were identified: "Suffering is experienced as overwhelming," "An experience of loneliness and isolation," "Struggling to understand the suffering," and "Therapy as a last resort." Reasons for a delay in accessing treatment were not knowing what is "normal," the feeling that they have to deal with it by themselves, and/or the lack of a caring adult who supports the YP in getting help. The findings suggest the ongoing importance of reducing stigma and promoting mental health education for YP as well as parents, school staff, and health professionals.

Keywords: Interpretative Phenomenological Analysis; adolescence; depression; experience; health seeking; psychotherapy.

Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
    1. Bettge S., Wille N., Barkmann C., Schulte-Markwort M., Ravens-Sieberer U., The BELLA Study Group. (2008). Depressive symptoms of children and adolescents in a German representative sample: Results of the BELLA study. European Child and Adolescent Psychiatry, 17, 71–81. doi:10.1007/s00787-008-1008-x
    1. Bolton Oetzel K., Scherer D. G. (2003). Therapeutic engagement with adolescents in psychotherapy. Psychotherapy, 40, 215–225. doi:10.1037/0033-3204.40.3.215
    1. Bundesregister der Kassenärztlichen Bundesvereinigung [Federal Register of the National Association of Statutory Health Insurance Physicians]. (2011). Grunddaten 2011 zur vertragsärztlichen Versorgung in Deutschland. Retrieved from
    1. Costello E. J., Erkanli A., Angold A. (2006). Is there an epidemic of child or adolescent depression? Journal of Child Psychology and Psychiatry, 47, 1263–1271. doi:10.1111/j.1469-7610.2006.01682.x
    1. Crowe M., Ward N., Dunnachie B., Roberts M. (2006). Characteristics of adolescent depression. International Journal of Mental Health Nursing, 15, 10–18. doi:10.1111/j.1447-0349.2006.00399.x
    1. Delmo C., Weiffenbach O., Gabriel M., Stadler C., Poustka F. (2001). Scheduled Assessment of Depression and Schizophrenia, Kiddie-SADS—Present and Lifetime Version (K-SADS-PL) (5th ed.). Frankfurt a. M: Klinik für Psychiatrie und Psychiatrie des Kindes- und Jugendalters.
    1. Dundon E. (2006). Adolescent depression: A metasynthesis. Journal of Pediatric Health Care, 20, 384–392. doi:10.1016/j.pedhc.2006.02.210
    1. Farmer T. J. (2002). The experience of major depression: Adolescents’ perspectives. Issues in Mental Health Nursing, 23, 567–585. doi:10.1080/01612840290052776
    1. Fonagy P., Cottrell D., Phillips J., Bevington D., Glaser D., Allison E. (2015). What works for whom? A critical review of treatments for children and adolescents. New York: Guilford Press.
    1. Goodyer I. M., Tsancheva S., Byford S., Dubicka B., Hill J., Kelvin R., . . . Fonagy P. (2011). Improving Mood With Psychoanalytic and Cognitive Therapies (IMPACT): A pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: Study protocol for a randomised controlled trial. Trials, 12, 175. doi:10.1186/1745-6215-12-175
    1. Hjeltnes A., Moltu C., Schanche E., Binder P.-E. (2015). What brings you here? Exploring why young adults seek help for social anxiety. Qualitative Health Research, 1–16. doi:10.1177/1049732315596151
    1. Kaufman J., Birmaher B., Brent D., Rao U., Flynn C., Moreci P., . . . Ryan N. (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980–988. doi:10.1097/00004583-199707000-00021
    1. Kessler R. C., Avenevoli S., Merikangas K. R. (2001). Mood disorders in children and adolescents: An epidemiologic perspective. Biological Psychiatry, 49, 1002–1014. doi:10.1016/S0006-3223(01)01129-5
    1. Korczak D. J., Goldstein B. I. (2015). Childhood onset major depressive disorder: Course of illness and psychiatric comorbidity in a community sample. The Journal of Pediatrics, 155, 118–123. doi:10.1016/j.jpeds.2009.01.061
    1. Lachal J., Speranza M., Schmitt A., Spodenkiewicz M., Falissard B., Moro M.-R., Revah-Levy A. (2012). Depression in adolescence: From qualitative research to measurement. Adolescent Psychiatry, 2, 296–308. doi:10.2174/2210676611202040296
    1. McCann T. V., Lubman D. I., Clark E. (2012). The experience of young people with depression: A qualitative study. Journal of Psychiatric and Mental Health Nursing, 19, 334–340. doi:10.1111/j.1365-2850.2011.01783.x
    1. McGorry P. D., Purcell R., Goldstone S., Amminger G. P. (2011). Age of onset and timing of treatment for mental and substance use disorders: Implications for preventive intervention strategies and models of care. Current Opinion in Psychiatry, 24, 301–306. doi:10.1097/YCO.0b013e3283477a09
    1. Midgley N., Ansaldo F., Target M. (2014). The meaningful assessment of therapy outcomes: Incorporating a qualitative study into a randomized controlled trial evaluating the treatment of adolescent depression. Psychotherapy, 51, 128–137. doi:10.1037/a0034179
    1. Midgley N., Parkinson S., Holmes J., Stapley E., Eatough V., Target M. (2015). Beyond a diagnosis: The experience of depression among clinically-referred adolescents. Journal of Adolescence, 44, 269–279. doi:10.1016/j.adolescence.2015.08.007
    1. Pescosolido B. A., Jensen P. S., Martin J. K., Perry B. L., Olafsdottir S., Fettes D. (2008). Public knowledge and assessment of child mental health problems: Findings from the National Stigma Study-Children. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 339–349. doi:10.1097.chi.0b013e318160e3a0
    1. Prochaska J. O., Norcross J. C. (2001). Stages of change. Psychotherapy: Theory, Research, Practice, Training, 38, 443–448. doi:10.1037//0033-3204.38.4.443
    1. Ravens-Sieberer U., Wille N., Erhart M., Bettge S., Wittchen H. U., Rothenberger A., . . . Doepfner M. (2008). Prevalence of mental health problems among children and adolescents in Germany: Results of the BELLA study within the National Health Interview and Examination Survey. European Child and Adolescent Psychiatry, 17, 22–33. doi:10.1007/s00787-008-1003-2
    1. Rutter M. (1980). Changing youth in a changing society: Patterns of adolescent development and disorder. Cambridge, MA: Harvard University Press.
    1. Savage H., Murray J., Hatch S. L., Hotopf M., Evans-Lacko S., Brown J. S. L. (2015). Exploring professional help-seeking for mental disorders. Qualitative Health Research. Advance online publication. doi:10.1177/1049732315591483
    1. Smith J. A., Flowers P., Larkin M. (2009). Interpretative phenomenological analysis—Theory, method and research. London, England: Sage.
    1. Smith J. A., Flowers P., Osborn M. (1997). Interpretative phenomenological analysis and the psychology of health and illness. In Yardley L. (Ed.), Material discourses and health (pp. 68–91). London, England: Routledge.
    1. Smith J. A., Osborn M. (2007). Interpretative phenomenological analysis. In Smith J. A. (Ed.), Qualitative research (pp. 53–80). London, England: Sage.
    1. Weitkamp K., Klein E., Wiegand-Grefe S., Midgley N. (submitted). Therapy expectations of adolescents with depression entering psychodynamic psychotherapy: A qualitative study.
    1. Wittchen H. U., Jacobi F., Rehm J., Gustavsson A., Svensson M., Jönsson B., . . . Steinhausen H. C. (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology, 21, 655–679. doi:10.1016/j.euroneuro.2011.07.018
    1. World Health Organization. (2003). Caring for children with mental disorders—Setting WHO directions. Geneva, Switzerland: Author.
    1. World Health Organization. (2010). International statistical classification of diseases and related health problems (2nd ed., 10th rev.). Geneva, Switzerland: Author. doi:10.1016/j.jclinepi.2009.09.002

Source: PubMed

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