The document summarizes a study that explored the experiences of previously clinically depressed adults in New Zealand. [13 participants were interviewed and discussed perceived causes of their depression such as early trauma, bullying, attachment issues, and avoidance behaviors. The predominant theme was stress and anxiety. Many participants linked experiences like childhood trauma, loss, and bullying to causing their depression. The study highlights the importance of addressing social factors and stressors rather than solely biological explanations for depression.]

1. Reflections on Depression
Hilary Bradley
Cheryl Woolley
Dave Clarke

2. Presentation Outline
 This Study
 Method and Analytical Approach
 Results
 Limitations
 Conclusions

3. This Study
 Much is known about the prevalence of
depression, but little about the qualitative
experiences of people who have experienced
depression.
 This study explores the experiences of
previously clinically depressed adults in New
Zealand.
 It is unique in that this group of people were able
to reflect on what depression meant to them –
causes, coping strategies etc. - from their current
non-depressed outlook.

4. Method
Participants
 13 volunteers – 5 women, 8 men
 All had DSM-IV diagnosis of unipolar depression at the beginning of
a Dietary Intervention Study (DIS)
 Present research utilised interview data collected one year after
completion of that study
Data Collection
 Semi-structured in-depth interviews by independent interviewer
 Explored perceptions of causes of depression, attachment, earliest
recollections, trauma, school life, changes since original study,
aspects of original study that were helpful

5. Analytical Approach
Thematic Analysis
 Flexible
 Inductive latent analysis
 Six phases of thematic analysis (Braun & Clarke, 2006)

6. Predominant Theme
Stress and Anxiety

7. Quote
 “I just put it down to being so stressed out,
not coping. Yeah. It’s many factors but
putting your finger on it, I don’t know”
 “If I’ve got assignments due or lots of stuff
happening that I can’t control then I’ve
noticed that like, at Teachers College
when I was actually there full time, it
triggered it again and I just couldn’t cope
and I had to get sleeping pills and things
so I could sleep...”

8. Common Sub Themes
 Early Trauma
 Bullied
 Attachment
 Avoidance

9. Early Trauma
 11/13 perceived to have experienced
childhood trauma
 Earliest memories
 Childhood illness
 Multiple traumas including loss and
adjustment

10. Loss of Support
 “...I have come to the conclusion that I
was suffering from a degree of depression
at that period I left home and got to
Auckland. I had no social network up there
at the time. I was boarding rather than
flatting. I was an 18 year old,
fundamentally lonely I suppose for those
first few months...”

11. Bereavement
 INT: “You had a couple of fairly major
traumas happen when you were younger.
You had a friend who was killed. How did
that affect you?”
 “Um, quite bad. I can still remember just
about everything that happened that
afternoon. It would have been 10 years
ago last week...Pretty messed up...I didn’t
sleep for God knows how many days, let
alone eat.”

12. Bullied
 9/13 bullied at school
 Attribute to cause of depression
 “That’s a good question. Probably fairly young.
Probably just before or just after I started
primary school maybe. Just when the bullying
started.”

13. Bullied Cont.
 Bullied as source of anger
 Not changed over last generation – needs
to be addressed
 “…because when you’re bullied you do
get a lot of anger and I have kids in my
class who are bullied at school and they
have so much anger and it reminds me so
much of me.”
 Linked to suicidality?

14. Negative Attachment Styles
 Overprotected – dependency
 “Because when you are in formative years doing those
things are part of growing up and you’re forming your
own personality but if they are suppressed, physical or
mentally, then you don’t develop them and so therefore I
believe it has an effect on my total overall depression.”
 “Oh because I was a soft touch. Because I was
mollycoddled at home...It was certainly a desire on the
part of the bullies to dominate and I was a subject that
wasn’t too difficult to dominate at the time I think.”

15. Attachment Cont.
 Poor communication/conflict
 Father’s expected therefore accepted
 “No. I never really talked to him”; “He was so busy
making ends meet”; “working such long hours at
work...he was just too tired to be dealing with us...”
 Abuse, mostly parental, mostly emotional
 Problematic sibling relationships

16. Avoidance
 Avoiding situations that cause distress –
ignoring stress increased its intensity
 Dependence on significant others
 Hiding and escaping
 Avoid confrontation
 Often starting at school or before

17. Quote
 “I, um, would hide pretty much. Try to
escape things. I am not one for
confrontation. I don’t like it so yeah, my
friend and I, at school, we would just try to
stay away from the other girl who was
bullying me because it was just easier and
even now I think I still try to avoid things if
I’m not comfortable with it, try to stay away
from it.”

18. Discussion
 Perceived stress and factors associated with it
strongly correlated to clinical depression
 GP’s prescribing anti-depressants without
addressing causes
 Stress can be successfully addressed at school
level
 Bullying needs to be addressed in schools
 Social components including context rather than
biological or medical model

19. Context
 “I think being able to talk about it. You know, the idea,
because I don’t you see, I keep it to myself and I have
also tried talking it over with my doctor and also a doctor
I have got here and it’s clear cut they’ve got no bloody
idea of what I’m talking about, you know because, you
know, the first time I tried to talk about that problem, I
mean, the psychologist gave me a book to read and that
was just, I mean you had to be frigging stupid to come
up with that as a possible solution to someone who’s
saying “I don’t study”. That book caused me heaps of
problems!”

20. Limitations
 Small sample size
 Emotional content difficult to ascertain
 The presence of the interviewer may have
influenced their responses.
 Participants had regular contact with
previous researchers which might
influence how they currently perceive their
depression.

21. Conclusions
 Perceived stress, anxiety, trauma, avoidance,
loss and bullying strongly correlate to clinical
depression
 Social components including context
 Bullying needs to be addressed
 Relapse likely if social issues are not addressed
 Research the role of avoidance with regard to
depression
 Anxiety or depression?

22. References
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23. Hilary.Bradley@bopdhb.govt.nz