TY - JOUR
AU - E. Bromley
AU - D. Kennedy
AU - J. Miranda
AU - C. D. Sherbourne
AU - K. B. Wells
A1 - 
AB - Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma.
BT - Current anthropology
C5 - General Literature
CP - 5
CY - United States
DO - 10.1086/688506
IS - 5
JF - Current anthropology
N2 - Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma.
PP - United States
PY - 2016
SN - 0011-3204; 0011-3204
SP - 610
EP - 631
EP - 
T1 - The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking
T2 - Current anthropology
TI - The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking
U1 - General Literature
U2 - 27990025
U3 - 10.1086/688506
VL - 57
VO - 0011-3204; 0011-3204
Y1 - 2016
ER -