Feeling labeled, judged, lectured, and rejected by family and friends over depression: Cautionary results for primary care clinicians from a multi-centered, qualitative study

BMC Family Practice (Impact Factor: 1.67). 06/2012; 13(1):64. DOI: 10.1186/1471-2296-13-64
Source: PubMed


Family and friends may help patients seek out and engage in depression care. However, patients’ social networks can also undermine depression treatment and recovery. In an effort to improve depression care in primary care settings, we sought to identify, categorize, and alert primary care clinicians to depression-related messages that patients hear from friends and family that patients perceive as unhelpful or detrimental.

We conducted 15 focus groups in 3 cities. Participants (n = 116) with a personal history or knowledge of depression responded to open-ended questions about depression, including self-perceived barriers to care-seeking. Focus group conversations were audio-recorded and analyzed using iterative qualitative analysis.

Four themes emerged related to negatively-received depression messages delivered by family and friends. Specifically, participants perceived these messages as making them feel labeled, judged, lectured to, and rejected by family and friends when discussing depression. Some participants also expressed their interpretation of their families’ motivations for delivering the messages and described how hearing these messages affected depression care.

The richness of our results reflects the complexity of communication within depression sufferers’ social networks around this stigmatized issue. To leverage patients’ social support networks effectively in depression care, primary care clinicians should be aware of both the potentially beneficial and detrimental aspects of social support. Specifically, clinicians should consider using open-ended queries into patients’ experiences with discussing depression with family and friends as an initial step in the process. An open-ended approach may avoid future emotional trauma or stigmatization and assist patients in overcoming self-imposed barriers to depression discussion, symptom disclosure, treatment adherence and follow-up care.

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Available from: Richard L Kravitz, Oct 10, 2015
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    • "Information obtained in open-ended discussions involving individuals with a personal knowledge or history of depression indicate that the messages delivered by family and friends made them feel labeled, judged, lectured to, and rejected.2 "
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    • "Similarly, individuals of higher socioeconomic status are more likely to acquire hearing aids (Laplante-L é vesque et al, 2012; Lupsakko et al, 2005), and are more likely to take up treatment for alcohol dependency (Tucker et al, 2004), and participate in health screenings (Wee & Koh, 2011). Likewise, increased perceived social stigma is associated with lower likelihood of acquiring hearing aids/hearing assistive technologies (van den Brink et al, 1996; Wallhagen, 2010), as well as with lower rates of help seeking and intervention for depression (y Garcia et al, 2012), and chronic pain (Slade et al, 2009). "
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