Beyond a diagnosis: The experience of depression among clinically‐referred adolescents

Abstract

Policy-makers have identified an urgent need to improve our ability to detect and diagnose depression in adolescents. This study aims to explore the lived experience of depression in clinically referred adolescents. 77 adolescents, aged between 11 and 17 with moderate to severe depression, were interviewed as part of a randomised controlled trial, using the Expectations of Therapy Interview. Data were analysed qualitatively using framework analysis, with a focus on how the adolescents spoke about their depression. The study identified five themes: 1) Misery, despair and tears; 2) Anger and violence towards self and others; 3) A bleak view of everything; 4) Isolation and cutting off from the world; and 5) The impact on education. Researchers and policy-makers need to develop an understanding of depression grounded in the experiences of adolescents to improve detection and diagnosis of depression.

Children and young people's conceptualizations of depression: a systematic review and narrative meta‐synthesis

“…Among the clinical sample, diagnosed adolescents highlight a sense of isolation and anger/violence towards oneself and/or others as central symptoms of their experience with depression (Midgley et al . ). Older adolescents with depressive symptoms describe ‘struggling’ to make sense of their mental state (Meadus, ).…”

“…Social isolation was explained from some as a strategy providing relief (Meadus, ); however, for others was experienced as ‘making things worse’ (Migley et al . ). Other adolescents isolated themselves to avoid appearing different from peers (Farmer, ).…”

“…Identity (number of studies n = 17, HQ = 10, GQ = 7) Depression recognition in a vignette is examined in 10 studies, with (Siegel & Griffin, 1983). Among the clinical sample, diagnosed adolescents highlight a sense of isolation and anger/violence towards oneself and/or others as central symptoms of their experience with depression (Midgley et al 2015). Older adolescents with depressive symptoms describe 'struggling' to make sense of their mental state (Meadus, 2007).…”

“…In the clinical sample (n = 9), interviewed adolescents report denying symptoms to peers (Wisdom & Agnor, 2007). Adolescents with depression report feeling isolated, either due to feeling stigmatized or rejected (Woodgate, 2006) or due to purposefully withdrawing (Midgley et al 2015). Social isolation was explained from some as a strategy providing relief (Meadus, 2007); however, for others was experienced as 'making things worse ' (Migley et al 2015).…”

Framework analysis: a worked example of a study exploring young people’s experiences of depression

“…In this article, we draw on data from the IMPACT-ME study, which we used to examine the experience of depression among adolescents, which has been published elsewhere (Midgley et al 2015). The study was based on interviews with 77 young people (aged 11-17) who had been referred to a child and adolescent mental health service (CAMHS), and had been diagnosed with moderate to severe depression.…”