| Summary: | Depression is most often first diagnosed during adolescence. Diagnosis rates of depression in adolescents have increased in recent years, in the context of sociocultural changes. Adolescents appear to conceptualise depression and recovery differently to mental health services, and their narratives are therefore marginalised. Adolescents’ position within social hierarchies mean they lack power to challenge the marginalisation of their narratives. The way in which
depression and recovery are conceptualised have implications for the support that is offered. Conceptualisations of depression and recovery have changed throughout time and within different sociocultural contexts, suggesting that the
concepts of depression and recovery are socially constructed. This contrasts with the dominant discourses drawn upon by mental health services, which often endorse the idea that depression is a mental illness resulting from underlying biological dysfunctions, and recovery is the absence of symptoms. This study was underpinned by a social constructionist epistemological stance. It aimed to analyse the discourses drawn upon by both adolescents and widely
accessed websites, to conceptualise depression and recovery. Incorporating adolescents’ conceptualisations into support that is offered could reduce the power imbalance between adolescents and mental health services.
Participants were recruited through charities for children and young people’s mental health, and social media. Semi-structured interviews were completed with 12 adolescents who identified themselves as experiencing depression to explore the discourses that they drew upon in their conceptualisations of depression and recovery. Widely accessed websites for comparative analysis were identified from a Google search and participants’ suggestions, and ten were analysed. A combined discourse analysis approach was used, informed by principles of discursive psychology and Foucauldian discourse analysis, to analyse data from interviews and websites.
Adolescents drew upon four primary discourses to conceptualise depression and recovery: Medical discourse assumed but doubted; Disempowerment through relationships; Physical embodiment is a marginalised narrative; From dismissed child to responsible adult. Two further discourses were used by adolescents to conceptualise the disempowerment they experienced within relationships that related to depression and recovery: Positioned as different and From isolation to connection.
The results suggest that adolescents’ use of medical language does not represent their acceptance of psychiatric principles of depression and recovery. Participants instead favoured the alternative discourses they drew upon. Adolescents are dismissed by services when they use their own language to conceptualise depression and they therefore rely on medical language to communicate their experiences. This has been assumed to reflect their experiences as medical ones, which the results of this study throw caution to. Adolescents are disempowered throughout their experiences of depression, and recovery represented an increase in responsibility for them, reflecting the transition to adulthood. Disempowerment may therefore contribute to adolescents’ experiences of depression. Adolescents, caregivers, schools, should attend to adolescents’ conceptualisations of depression to reduce the
power imbalance between adolescents and mental health services.
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