A feminist phenomenological description of depression in low-income South African women

[摘要] ENGLISH ABSTRACT: A review of the past decade of literature on the subject of depression in South Africanwomen revealed a paucity of research that documents the perspectives of low-incomewomen who have been diagnosed with depression. Informed by this and recent feministcritiques of the concept of depression, this study aimed to bring traditionally overlookedperspectives to the fore by providing rich descriptions of the subjectively livedexperience of depression, as recounted by low-income women themselves. This feministphenomenological study took place in a poor, rural community in the Western CapeProvince of South Africa. Semi-structured in-depth interviews were conducted with tenlow-income women who had been diagnosed with depression. The transcribedinterviews were analysed using Interpretative Phenomenological Analysis. A number ofimportant findings emerged. Firstly, participants were seen to express somaticcomplaints ahead of (and more frequently than) disclosures of sadness. Secondly,participants often described experiencing their psychological distress as anger, anxietyand a changed sense of self. Thirdly, participants generally attributed these experiences(and their overall distress) to a history of childhood trauma, the loss of importantrelationships, being physically, sexually or emotionally abused, feeling under supportedand overburdened by multiple responsibilities, living in dangerous communities, and/orthe various consequences of poverty. Finally, it was observed that while symptoms ofsuicidal ideation and intent were present in many of the women interviewed, strongreligious and cultural norms existed and generally functioned to silence and deny thesubject. Overall, the women's subjective experiences, understandings and descriptionsof depression allowed a more complex picture to emerge than that which is currentlyoffered by mainstream biomedical models. Consequentially, the currentconceptualisation of the term 'depression was deemed to be inadequate, specificallybecause it does not fully capture low-income women's experiences of distress, and alsobecause it tends to obscure the possible impact of socio-economic and political contextson their mental health. Implications of these findings include firstly, that not only doesthe diagnosis of depression serve to medicalise women's misery, but it maysimultaneously serve to obscure their feelings of anger, anxiety, sadness, hopelessnessand other symptoms of distress that are intrinsically linked to their disadvantageoussocial and living conditions. Secondly, the findings indicate that the use of traditionaldiagnostic and suicide assessment interviews may be unhelpful or even irresponsible insome South African contexts. Finally, many of the study findings warrant furtherinvestigation and psychological research. Recommendations to this end are thusincluded and stress the need to use theoretical perspectives and research methodologies that are sensitive to the multilayered, complex psychological experiences of depressionin low-income women.

[发布机构] Stellenbosch University