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RESEARCH IN PROGRESS

The Monster Within: Understanding the Narratives of Depression

Shubhra Hajela

Received: 18 June 2012 /Accepted: 13 September 2012 /Published online: 6 November 2012# National Academy of Psychology (NAOP) India 2012

Abstract The study examines how lay people under-stand and recover from depression. Narrative interviewsexploring the same were conducted with twenty fiveparticipants. Each narrative offered an idiosyncratic un-derstanding of the unique journey of depression. Severalpatterns from the narrative emerged which were collect-ed as themes—depression was seen as a normal, ex-plainable and sometimes even expected phenomenon incase of extreme negative events, psychiatrists were con-sidered opaque in understanding the experience of de-pression, and lay understanding of depression of theparticipant and their social group deeply affected self-recovery. The study offers insight into how a vastmajority of the population goes through depressive ex-perience in face of personal tragedies and recoverswithout much professional help. It thus has implicationsfor augmenting the recovery of lay people from depres-sive symptoms.

Keywords Depression . Narratives . Laypsychology .

Self recovery

The madman as defined by others is part of society’scultural heritage. Whether “madness” is explained byreligious authorities (i.e., as demonic possession), by

secular authorities (as disturbance of the public order),or by medical authorities (as mental illness), the madthemselves have remained largely voiceless.(Chamberlain 1990, p. 323)

The opinion of the experts such as psychiatrist, psy-chologist, and researcher is considered to be conclusivein the mainstream academic psychology and psychiatricliterature. The viewpoint of the person suffering frommental illness although considered important is many atimes considered as subjective and unreliable. This re-search is undertaken to understand the lived experienceof depression and self-recovery from it using narrativesof participants who had recently suffered and recoveredfrom depression.

Lay Perspective in Psychology

The concept of—lay/naïve psychology as a legitimatefield of study was promoted by Heider (1958). Hebelieved that an ordinary person has a profound under-standing of himself and of other people, which was byand large unformulated and vaguely conceived. He con-sidered people as lay (naïve) psychologists who actedon and made meaning of their experiences on the basisof their beliefs and assumptions about themselves,others and the world.

Kelley (1992) similarly proposed the concept of personalconstructivism and conceptualized ordinary man as a scien-tist, a concept well worked upon by Lillard (1998). Heemphasized that a study of lay psychology would be closerto the study of—real experiences of people, in that theknowledge generated would be an insider perspective ratherthan the outsider view of the researcher.

S. Hajela (*)Indian Institute of Management, Raipur,Raipur, Indiae-mail: [email protected]

S. Hajelae-mail: [email protected]

Psychol Stud (January–March 2013) 58(1):10–19DOI 10.1007/s12646-012-0164-8

Hutto and Ratcliffe (2007) opined that lay psycholo-gy had its foundation in the basic belief that, as humanbeings, we all spend considerable amount of time andenergy in trying to understand ourselves and others,which helps us navigate through our social worlds.Lay psychology is therefore said to serve as heuristicsthat influence people‘s judgments, social action andbehavior (Geary 2005).

Despite its advocacy, attempts continued to discreditlay psychology on the ground of being subjective andunscientific. However, with the growing influence ofphenomenology, postmodernism, constructionism, cross-cultural studies in clinical psychology which pointed outtowards differences in the experience and expression ofpsychological phenomenon, the importance of lay psy-chology was accepted. All these developments gave animpetus to the view that an individual or the lay personplays an active role in understanding (Richardson andUebel 2007).

Reactive Depression: A Major Health Problem

We seem to live in an age of depression. Within thedomain of clinical psychology and psychiatry, depres-sion is predominantly studied as a universal form ofmental disorder with affective (sadness, irritability, joy-lessness),cognitive (difficulty concentrating, memorydisturbance), behavioral, and vegetative (sleep, appetite,energy disturbances) complaints, with an atypical courseand predictable response to treatment and therapy(Chodoff 2002; Gottlieb et al. 2011). It is believed thatthe aforesaid characteristics are typical of any type ofdepression and may be present in various combinationsin individual patients.

In the practice and study of clinical psychology andpsychiatry various systems of categorization of depres-sion have been forwarded. One of it is on the basis ofunderlying cause of depression. According to it,endoge-nous depression is seen as a result of some biologicalcause, is acute in nature while reactive depression arisesout of certain life incidents or stressors and is also lessacute (Sartorius et al. 2002).

Whatever be the type, depression takes its toll onboth the personal and economic fronts. On a personallevel,depression involves serious personal, interperson-al consequences. It causes significant psychologicaldistress, reduces quality of life, and increases themortality from cardio vascular diseases (Shah et al.2011). It may also contribute to family and maritalbreakdown. On an economic level, depression causesabsenteeism from work, low motivation, and lowproductivity.

Depression rate in India seems to be alarming. It isreported that depression in any form (grief reaction, adjust-ment disorder—depressive type, major depression, bipolaraffective disorder) affects 10 % of the entire population ofIndia (Chandrashekhar 2007). Moreover, out of everytwenty-five patients who come to psychiatric O.P.D of pri-vate hospitals, ten suffer from clinical depression. One inevery five Indians suffer from depression at some point orthe other in his/her life. Fifteen percent of the depressed endin suicide while 80 % of those who had committed suicidewere depressed (Times of India, August 22, 2004).

The growing incidence of depression as a major healthhazard was emphasized by World Health Organization. Itpredicted that depression would be the second major diseaseafter heart disease by 2020 (Gilbert 2001). It pointed out thegrowing incidence of depression in South East Asia, andheld rapid urbanization, industrialization, more stress onindividual achievement, breaking of joint family structuresand social conditions like riots, terrorism as major contrib-utors to the increased rates of depression (Times of India,August 22, 2004).

The problem of depression becomes all the more acute incase of India where statistics point out towards the paucityof mental health manpower (only 2500 psychiatrists, 600clinical psychologists, 500 psychiatric social workers, 600psychiatric nurses available for the entire country with apopulation of more than 102 crores) (Chandrashekhar2007). This paucity has been cited as one of the reasonsfor the neglect of depressed people. It has been consideredthat people suffering from depression do not get enoughsupport from the less number of professionals available.This is further complicated by the fact that the awarenessregarding depression and mental health in India is consid-ered to be low. Moreover the stigma of going to a psychia-trist makes the situation even worse by sometimesrestricting the depressed opting for help.

In the present context, therefore, it becomes impor-tant to know as to how the lay people perceive depres-sion. How they experience it and more importantly howdo they assign meaning to it, live with it and deal andovercome it. It can be hypothesized that the informationthey give and the knowledge generated from this work,regarding depressive behavior, construal of depressiveexperience and coping patterns could be of some usein the formation of guidelines that might help the de-pressed, their families, counsellors/clinicians be moreeffective and sensitive towards the depressed.

Let Me Tell you a Story: Why Narratives?

The present study makes use of narratives as a tool forunderstanding the experience of depression. The reason

Psychol Stud (January–March 2013) 58(1):10–19 11

being narratives are one of the most natural and significantways people make and express meaning. They are based onthe philosophical position that we are essentially story-tellers, we live in a storied world, and that our own livesand experiences are storied (László 2008; Rankin 2002;Fochtman 2008). Narratives are thus considered indispens-able in studies that intend to explore the personal, uniqueand contextualized understanding of a phenomenon.

It is precisely due to these reasons that narratives are usedextensively in identity research (Bar-on and Gilad 1994),nursing (Raholm 2008), counseling and therapy (Botella etal. 2004), trauma studies (Hall 2010; Haene et al. 2010),marital violence (Riessman 1993), occupational identity andcareer choices (Roberts and Rosenwald 2001).

The Participants

Narratives of twenty five participants were selected for thepresent study. These narratives were chosen out of a largerpool of narratives (32) because they were considered moreemotionally open, elaborate and detailed.

The selection criteria for the original sample (32) fromwhich these twenty five narratives have been chosen werebased on three dimensions: first, was evidence of self-recovery from depression (Approximately 37 general physi-cians and Psychiatrists were contacted from different citiesfrom whom the contact details of drop out depressedpatients were known. These were the potential participantsof the study. On contacting them only those who had recov-ered from depression without any medical help and whowere ready to be a part of the study were explained the aimsof the study, nature of their contribution and the process ofnarrative interview), second, the psychiatrists/general physi-cians were asked to give the contact of only those drop outpatients who had suffered from mild depression. This wasalso checked with the participants who confirmed (on thebasis of the diagnosis made to them) that they had sufferedfrom mild depression. It was also ascertained from theirprevious medical history that they had no previous episodeof depression nor were aware of any family member whohad suffered from depression. The third criterion was therecency of the depressive episode (18–30 months from thetime of taking the narrative interview).

The participants whose narratives are taken for thepresent study belonged to Allahabad, Lucknow, Benaras,Gorakhpur, Delhi, Hyderabad and Bangalore. All of themhad recently (18–24 months from the time of taking narra-tive interviews) suffered from depression owing to a tragicevent in their lives. This event has been termed as ‘Criticalevent’ as it is considered very important and life definingevent by the participants. Such an event was characterisedby emotional upheaval and turmoil and had changed the life

trajectory of the participant. Broadly the critical event wascategorised into two patterns—one, the loss of a closerelationship, either due to sudden death or estrangement orsecond, the loss of a deeply loved and believed dream,aspiration, or professional goal. This critical event was seenas a starting point of depression by the participant. They hadall consulted the psychiatrists and general practitioners forsymptoms like general persistent lethargy, sleeplessness, notfeeling hungry, weight loss, apathy and loss of interest andwill power in their lives.

According to the participants they had suffered from milddepression, as their psychiatrists/general practitioners hadput it. All of them had sought medical help in the form ofpsychiatric help or by consulting general practitioner’s whenthey or their family members could, “no longer tolerate thedeterioration of health and everyday joy in life, endlesspining, regular crying, erratic behaviour and death wishesthat loomed large and prominent”, in their lives.

All the participants had after two or three visits stoppedconsulting their psychiatrist/general practitioner on accountof them feeling, ‘misunderstood and lost’, ‘awkward’, ‘self-conscious’, ‘not respected’, and ‘feeling as though one is inan opaque relationship with the psychiatrist’, ‘lack of emo-tional closeness with the psychiatrist/doctor’ and ‘not beingable to see self as a patient’. These remarks could suggestthe psychiatrists/physicians lack of empathy with the partic-ipants. The participants also seemed to terminate the treat-ment as they showed an unwillingness and disbelief totaking medicines as a cure to their depression. Many sawmedication unnecessary and irrelevant in understanding andproviding answers to their ‘emotional problems’ or ‘empti-ness in living’ or because they could not see themselves as‘mental patients’ and medicines as relieving them of their‘problems in living’.

The participants also seemed to terminate the treatment asthey found it difficult managing the after effects of themedicines. Still others reported inability to comprehendand deal with the after effects of the medication provided.They typically reported feeling dry mouth, nervous, restless,queasiness in stomach, nauseous and sleepy the entire day—an additional challenge that they had to bear everydaybesides fighting their depression. There were also few otherinstances in which they were given more medicines by theirdoctors to help them manage the after effects of originalmedicines given. This was seen as ‘unnecessary over med-ication’ by them and the treatment was later left.

None of the participant reported getting depressed in theirlives before this critical event, nor did they report any familyhistory of depression. They had suffered from depression foran average of 2 to 3 months and had at the time of narrativeinterview sessions recovered from it. Recovery was definedby them as ‘getting back with life’, ‘moving ahead in life’,‘getting hold of a sense of life’, ‘regaining life’ and was

12 Psychol Stud (January–March 2013) 58(1):10–19

conceptualized as a subjective sense of getting out of thesituation, and being released from the emotional grip andtrauma of the depressive episode.

At the time of narrative interviews the participants agerange was 24–35 years, eighteen were females and the restmales. All the participants were undergraduates in arts,science or engineering with the exception to one who wasenrolled as a doctoral student.

Protection of the Participants

Narrative is replete with personal meaning; so it becomesnecessary to protect and respect the personal lives of theparticipants. It was specially so in this case where thenarratives were about painful events in their past. Alsonarratives involve much contribution and active involve-ment of the participants as such it became a necessity tofully inform and protect the participants.

That the participants truly understand, are informed andrealize their contribution in the work was one of the prom-inent ways of building on their trust. They were informed indetail the nature of the study, the participation expected outof them and how their narratives would help the researcher.They were explicitly informed that they would be requiredto talk about their experiences in detail and that they couldwithdraw or withhold any information they were not com-fortable with. Recording of the narrations was done onlywith prior permission and was stopped whenever theyappeared uncomfortable.

Even during the entire process of narrations the partic-ipants were never pressurized to talk about any aspect. Thedecision on the amount and nature of disclosure of personalinformation was left solely to the discretion of the partic-ipants. They also had full freedom to opt out of my researchwhenever they wanted. Pseudonyms were used and all iden-tity markers were removed when writing final reports.

Sessions with the Participants

An unstructured interview was used to elicit narratives fromthe participants. Two sessions at the places predecided bythe participants were conducted. The first session involvedthe interview session and was non directional. It coveredbroad topics like what triggered depression in the first place,what happened during the depression, how participantsidentified depression, and finally how did they overcomedepression. During the interview, the participants wereencouraged to illustrate their opinions using anecdotes fromtheir personal life. Such instances enlivened the narrativesessions, provided illustrations for their standpoints, andhelped in providing a canvas to understand their entire story.

Besides recording the narrations, additional information,such as body language, tone, and tearfulness was also noteddown. Each session lasted for about two to two-and-a-halfhours and then the narratives were transcribed.

The second session involved my presenting to partici-pants a transcribed copy of the narratives and understandingthem with the individual participants. This was done toensure that participants feel that they are being heard inthe way they feel is true to their experiences. Such a sessionalso enables in asking some direct questions for any elabo-ration, clarification and also as an opportunity for the par-ticipant to unlock any further comments, thoughts that wereevoked. It is this joint understanding that led to the identi-fication of cardinal events and catalyzers (Barthes 1977;Rude, Gortner and Pannebaker (2004)). Cardinal eventswere those that were accorded the most importance by thenarrator. Catalyzers were appendages to the cardinal eventand were identified as instances that led to the cardinalevents. Both these helped in understanding the overall plotof the narratives.

Although very personal and individual yet narratives hadvarious elements in common in varying combinations. Likefor example, each narrative involved a series of facts orevents (e.g., “I appeared for civil services this third time),a description of the events or experiences arising out of it (“Iwas nervous yet hopeful that I would qualify it this time”),an evaluation of event or the experience (“it was depressing,not being able to qualify it even when I tried my best”) and amore complex self-reflection on what the event or experi-ence meant for the participant (― I wanted to see myself asthe best, someone my parents would be proud of, I wanted toprove myself). These elements provided the basic inputs tounderstand the meaning of the narratives. It appeared thatmeaning was inextricable linked with the narrative structure.Invariably, an event was followed by its evaluation, and itsunique meaning for the individual.

Common themes were also identified through a processof ‘thematic decomposition’. (Stenner 1993). The processseparated the chunk of narrative into coherent themes orstories which reflect subject positions allocated or taken upby a person (Davies and Harre 1991; Riessman 1993).

The Storied Lives

All sorrows can be borne if we can put them into astory. (Arendt 1958, p. 175)

The narratives revealed that the participants had undergonethe episode of depression after the occurrence of the criticalevent in their lives. Before this incident none of them hadreported any previous episode of depression. The analysis


thus examined the process associated with the occurrence ofthe critical event, the meaning these participants gave to thisevent, construction of depression, its appraisal, its experience,the thoughts associated with it, coping and self—recoveryfrom it and the whole episode in retrospect.

Setting the Stage: Life Before Depression

Understanding life before the depressive phase served animportant purpose of laying bare the context to understandthe development and experience of depression. This gave anexplanation to the personal meaning that of the critical eventin the participant‘s life. In this process, the dreams, thoughts,preconceived ideas, preferences, fears, anxieties of the partic-ipants came to be known. It threw light on the lives of theparticipants and revealed their worldview (understanding oftheir worlds and their place therein), hopes, desires, limita-tions, and apprehensions.

The participant’s life before depression was varied.Contrasting patterns emerged from the narratives: one wasa life marked by a sense of well-being and satisfaction andthe other full of anxieties and doubts, leading to dissatisfac-tion. Sunita‘s life was characterized by an overall feeling ofwell-being and satisfaction. She was happily married to theman she loved and was planning to raise a family. Shedescribed her life as, “It was the best time of my life.Almost like been given whatever you ask for. We were sohappy in our small world; everything seemed so perfect andfell in its place. A dream come true. We were planning tostart a family and everyone was excited and expectant.”

On the other hand Preeti‘s, life was marked by anxietiesregarding her future and self-doubts. For quite some timeshe was turned down prospective suitors, the reason sheattributed to her being of dark complexion. This was furtherstrengthened by the fact that her parents were stressed andpressurized by extended family members to get her married.She revealed her anxieties as, “You know how Indian mar-riages work. You either have to be very pretty or very rich.Sadly I was neither. Being a 33 year old female, not suitablefor marriage and been increasingly dependent on parents, isa curse. Everyone looks at you as if you are some sort ofmisery, a sense of shame, a source of burden to parents. Iwas ashamed, sad and very worried not only on my accountbut for the sake of my parents as well. Growing up as darkskinned, skinny girl made me conscious and I felt low,unconfident,ugly, and somewhat unwanted.”

It can thus be said that for some participants, the scene fordepression was set much earlier when their individualdoubts, weaknesses, anxieties, problems adjusting to newsituations, and inherent dissatisfaction played major roles infeeding into depression, while in other cases; depressionarrived with a sudden shocking tragic event into the previ-ously happy life of the participants.

The Life Changing Event: Onset of Depression

The critical event was seen as the starting point of depression. Itwas imbued with much importance, brought marked changes intheir lives, was described as a turning point in the participant‘slife and was marked by significant emotional turmoil.

The critical event was either a suffered loss of a closerelationship due to unexpected sudden death or estrangementor unfulfillment of a dearly held life goal, dream, or aspiration.Sometimes the event could also be called as a proverbial laststraw that gave away to long held grievances, injury, insults ornegative emotions aroused from any of the aforesaid.

The sudden shocking experience was in the case of Savitaand Sunita at the unexpected death of their husbands in a carcrash and heart attack. Loss was accompanied by feelings ofshock, meaninglessness and purposelessness in life. Thesesudden and unexpected events resulted in confusion and dis-may. Depression in such cases seemed to seep in only whenthe full import of the situation was understood, when theinitial numbness and shock gave way to an understandingand interpretation of the loss. Said Savita, “Everything hap-pened so quickly, at one point he was there, at the other, gone.I didn’t feel as if he was dead. Felt as if he has gone to themarket or work and would return eventually. I did not knowhow to react. I think it was only after few months when Istarted running my life that his loss was evident and glaring.Even the minutest thing cried for his help. Separating myselffrom him, living alone and living with the realization that Icould never see him again was the most difficult thing that Ihave ever dealt with. It made my heart bleed.”

In the case of Madhu, the critical event served as last strawin the already built-up negative emotions. Despite threeattempts and preparing for civil services with all her effortshe was unable to qualify for it. She narrated an incident whenshe for the first time felt “no longer in control of situation orcapable of controlling waging tongues.” She recalled, ―Itwas quite a few days when the results had come, obviously myroll number was not there and I was coping with that. But youknow the Indian mentality, the crab mentality. Someone oughtto pull you down, remind you that you are a failure. I don’tunderstand why people don’t get that poking in someone’s lifeor making fun is never helpful. But I made that known to myroommate’s boyfriend. He was for some reason continuouslypassing sly remarks. At first I took it politely, but there has tobe an end somewhere. That shameless fellow did not under-stand it and at last I just erupted like a volcano. He stoppedbut then who can stop all the people talking and askingquestions for which I didn’t have a reply”.

Identification and Labelling of Depression

The critical event in the lives of participants spurred thegrowth of negative feelings and thoughts that seemed to


crystallize into depression. The event involved a momentumor the development of changes within the behaviour reper-toire, thinking pattern, feelings, and overall experiences ofthe participant. This marked change in behaviour, however,was reported to be slow, gradual, overpowering and many atimes uncontrollable.

From the narratives, it became clear that the participantswere first to notice, become aware of and consciously makean attempt to understand the source of gradual changes inthe feeling and thinking state which also affected theirgeneral behaviour and outlook in life. These changes intheir life included growing overpowering sadness, tearful-ness throughout the day or most part of the day, feelings thatthings will never be ‘right’ again, powerlessness, apathy,carelessness in keeping or maintaining house and generalappearance, inability to experience nothing pleasurable,growing feelings of unexplained anger, helplessness, frus-tration, feeling oversensitive and vulnerable, a strong disliketowards relatives, friends, co-workers, family members anda marked decrease in tolerance level.

It is only when these changes arose arbitrarily without anyjustification and explanation that an attempt was made tounderstand them. Identification, labelling and understandingthese changes was done by these participants in most of thecases with the help of relatives, close friends and familymembers who also noticed these changes and verbalised itas the participant, “not being himself”, “losing oneself”,“being a stranger—with the feeling that she is now a com-pletely different unknown person now” and “not knowinghim anymore.”

The participants were taken to the psychiatrists by theirfamily members and in few cases by close friends andrelatives when they could not bear, “the condition and painof living” of the participants. The psychiatrists were alsocontacted as it was believed that other than providing psy-chological help they could also provide relief in symptomslike changes in sleeping and eating patterns, general lassi-tude and overall health. It is during such meetings that theidentification and labelling of depression was done by thepsychiatrists.

The changes in thinking, feeling and behaviour patternscan be illustrated broadly by using two metaphors—‘shortfuse’ and ‘pressure cooker’. In narratives where ‘short fuse’metaphor has been used, participants typically reported feel-ings of being out of control and snappiness/quick temperover apparently trivial incidents that normally did not botherthem. For example, Asim in his narration reported an ev-eryday event in his professional life as a teacher “that wasthe last day of submitting the project and as expected fewstudents did not submit during class hours. Now this issomething that we know, expect and is almost a regularfeature in every class. This happened with me as well.After taking my class, I was sitting in my room and was in

general engrossed with my problems that one of the studentscame to deposit her file. Now I don’t know what happenedbut I started shouting at her. I just could not control myanger. I have no remembrance of what I said to her but all Iremember is that I went on and on till she ran outside theclassroom weeping. I was shocked at my behaviour while Isat at my desk all red and panting.”

Such outbursts typically made participants guilty whentaken seriously by others and when the reactions were leftunaddressed with a feeling of being misunderstood, left out,lonely, and guilty.

Participants also reacted with the emotional outbreakswhich were an expression to deeply held grievances, witha cumulative effect. Using the ‘pressure cooker’ metaphor,implying giving away after a series of stresses, the situationcan be explained in the words of Mahima, “Even a rubberband can break on excessive stretching, and here was mypatience being stretched out of all proportions. Everyday myin-laws made some or the other sarcastic comments on myfamily. I tolerated it at first because of my husband thenslowly it became too much, almost a routine. I was slowlyreaching my limits. And 1 day I just burst out when in frontof the entire family my father in law made fun of me, myparents and my upbringing. If they had any problem why didthey accept me as their daughter in law in the very firstplace?”

Dealing and Recovering from Depression: Fighting Backthe Demon Inside

The narratives show that all participants dealt with depres-sion in a twofold manner—by regulation of negative emo-tions and by generation/synthesizing and sustenance ofpositive emotions.

Synthesizing of positive attitudes and emotions. One ofthe strategies adopted by the participants in overcomingdepression involved cultivating, enhancing positive emo-tions and attitudes. The narratives demonstrated that con-scious direct attempts were made to synthesize positiveemotions generally with the help of family members and/or close friends.

Techniques involved self-praise, taking pride in oneselfor some aspect of self, engaging in meaningful work, prior-itizing being happy, indulging in selective comparison andattributing meaning to the depressive experience.

What seemed common to the generation of positive emo-tions was the reevaluation and explicit statement of thatrevaluation to the participants. Conscious attempts weremade to look at the positive side of things which seemedto break the brooding over the negative event. For example,the critical event provided a chance for the individual to takepride in some aspect of oneself. The episode provided themwith a chance to delve into themselves and realize their


strengths and merits. Said Rollie, who was depressed afterlosing her long term relationship due to the incessantdemands for physical relations from his side, “I do feelsad, heartbroken and yes I terribly miss him but then I longfor him less when I reason out that we both wanted differentthings….I stuck to my limits in the relationship…at least Iunderstood the extent of my involvement very well…I real-ized how far I could go and when to put my step down, I justcould not bring shame to my family. I knew if I would havedone that I could never have been able to face myself orpapa, mamma…now if he didn’t understand that then he hadto go…I am just proud of the fact that I didn’t let myselfdown, though yes it pained a lot, I did spend some great timewith him, we were so very much together.”

Rollie realized her limits and also drew pride from her,“strength that gave her immunity towards shameful act.This seemed to have acted as a pillar of strength, whichenhanced the positive emotion of being proud of ones value.This might have helped her deal with depression as positiveself-appraisals, realization of her value system self mighthave counteracted depression.

Similarly, Ravi, failed to get admission to his ‘dreamcollege’ even when he tried his best. It pained him to realizethat the best school of acting and drama did not considerhim to be a good actor and lacking in acting skills. He feltdejected and saw his dream and image being crushed.Coping for him involved a reappraisal of his abilities andhis self-concept. From an image of a failed actor he build hisself-concept as a “dreamer and struggler”. He seemedproud of the very fact that he had tried his best despite alloppositions from family and largely saw himself as a fighter.Thus distancing himself from the event he admired hisefforts and a “dare to dream attitude” applauding himselfand his efforts. In his words,

At least I had tried….I worked very hard and I’mproud of it. I gave my all. It hurts a lot to see thatthe efforts have gone haywire but at least I now knowwhat could have been done…. most of all I will neverrepent that I never tried and there is always a secondchance. I have a dream and I’m better than most whodo not have one nor know what they want in life. Truethat I wanted that some things in life be the way Iwanted but at least I think I had the capacity to thinkforcefully. Now I think, trying and losing is any daybetter than not trying at all.

Engaging in a meaningful task beyond one‘s personal interestalso seemed to work against depression. Typically it involved adiversion of attention, resources and energy, leaving little timeand resources to ruminate on on depression. For example, Ritu,had been very lonely and dejected after a series of failedmarriageproposals. Realizing that she—was a growing burden on familyand a disgrace her parents║, she started to believe that she was

unworthy to have a companion. Slowly she became a recluse,shunning any public gatherings, disliking herself, angry at herfamily that she lost her self-confidence. Owing to her experiencein Social work she was asked by her aunt to join a local non-governmental organization (NGO), where she found solace inbeing with children. She reported, “At first when I joined thisN.G.O it was because of my selfish interest, I had to be out of thehouse, I couldn’t bear the sly comments of my family, or some-times even my resentment towards them. I just started coming tothis NGO and at first would spend the whole day sulking orsometimes even crying. However, I just drifted my attentiontowards these children. It’s really hard to miss them. Its actuallywonderful and is an eye opener. I mean children who areorphans are so very happy and here I am. I have everythingyet I crib, yet I am unhappy, yet I cannot manage my life.Working here taught me to look at the world beyond my own….-it’s a feeling like there are some problems that are beyond me,perhaps even larger than my own problems…I think I shouldremember it always. It gives courage.”

Some participants dealt with depression by lowering theirexpectations of themselves and others and accepting thingsas they were. Raghu had suffered from depression after abike accident had left him crippled. He recalls, “I wouldspend a lot of time, sometimes the entire day, and nightthinking why this happened to me. There were so manyquestions and no answers. There were times when I justcould not stop thinking, I could not accept this. I was inpain, for me it was as bad as dying, actually dying wasbetter in many ways. I just did not want to see myself as adependant feeding on the sorry glances of others. At a pointof time I almost was fighting with God, had no faith in Him.Then 1 day, when I could not take it any longer, I just askedmy mom as to why it happened to me. She just stood there,looked at me closely and said, why not you? I was leftspeechless, I was aghast. I did not at that time make any-thing of it, for I was not looking for this answer. But deepdown inside I knew this was true. I could ultimately find ananswer and I think it helps.”

What seemed common in strategies used for generation ofpositive feelings is a conscious attempt to find and share thatmeaning in the aftermath of the critical incident. It also involveda reassessing the situation in a positive manner. Growingresearch in the area of sense making and benefit finding in thecontext of stressful events show that such efforts leads to betteradjustment to stressful events (Park 2010). This typically hap-pens because the crisis situation challenges and breaks down anindividual’s ‘assumptive world’, a network of schemas thatguides individuals’ journey of life and provides order andpredictability. Meaning making through the framework of reli-gion, spirituality, personal growth is seen as an attempt toregain, reconstruct meaning in life and get a control over it.Such a finding is replete in Post traumatic growth literature(Tedeschi and Calhoun 2004; Joseph and Linley 2006).


Dealing with negative emotions. The participants dealtwith their negative emotions by talking it out, writing downtheir feelings and leaving everything to the will of god,accepting the role of luck in their lives and looking at thebrighter side of the episode.

The role of others, especially parents, siblings, partners,were seen as being helpful in dealing with depression. Almostall the participants reported confiding in either a family mem-ber or a friend. These participants reported, feeling light,cathartic, understood and listened to. However participantshad different reasons for confiding from mere physical prox-imity to receiving advice or it being cathartic, the participantsseemed to find talking out their problems very helpful. SaidKavitha, “I was so very sad, very very lonely and saw no onearound. It was killing me; all was just so negative and gloomy.I wanted to cry and I went downstairs and saw my motherthere. I just went to her, did not talk at all, and laid my head onher lap and cried out. Very surprisingly, she did not ask meanything then but shuffled my hair and let me cry. That felt sovery good, so very relieved, I felt that I could confide in herand later when I felt better I confided in her.”

The narratives also suggest that social support becameavailable if the loss suffered was seen as socially acceptable.On the converse, if the loss was considered less normativeand socially sanctioned it was less likely to arouse sympa-thy, validation and support.

The role of others was seen as important and decisive evenafter the participants seemed to have overcome the depressiveexperience. Participants reported that their parents, siblings aswell as romantic partners seemed to be on vigil against anynegative thought that pervaded their minds.

Still some other participants accepted the role of luck in theirlives. SaidAsim,“Most of the timewe fight with our luck..if only Icould have done this, if only I had better people, if only I couldfind some work of my own choice. I guess, fate is not a subject ofcompromise or fighting against…its giveness is total.”

Venting their negative emotions by crying and by writingor maintaining a personal diary was also a very commontechnique involved. Besides seen as being cathartic, nonjudgmental, writing was seen as a means to reorganizewords, thoughts, feelings and events, which to an extenthelped participants, plan and reconsider their options ionfuture. Rajesh maintained a personal diary which served as aconfidante in times of depression. He proclaims, “I am not avery open person and during those days I was always in mycocoon. Just didn’t have the energy or the wish to talk. I justtook to writing, not regularly whenever I wanted to saysomething or whenever my feelings were overwhelming, orwhenever I was tired carrying the weight of my thoughts.Now when I see it I can see the change it had brought to me.From my nonsensical ramblings I finally made some sense.It was as if I could displace myself and watch over myselfthinking and writing. Things became clearer.”

Another way to deal with depression was to indulge indownward comparison or comparison with people who wereperceived to have fared more badly or were in a situationworse than the participant‘s. Rajiv was very ashamed of hisimmoral act of indulging in an illicit relationship. For a malebrought up in very strict and emotionally distant family,having an illicit relationship was almost condemning. Hisnarrative is replete with downward comparison. To protecthimself against intense feelings of shame and guilt he startedcomparing himself with the boys he believed were mostimmoral. He said, “Sometimes I wondered as to why I wasfeeling that way. What was so disgusting about me? After allI had friends who had done many things that they were notashamed of then why was I feeling that way. Why did I wantto die, why did I never want to go back to my family. I wasangry at my family who had given me the over consciousconscience. Maybe I had abnormal sense of guilt or toostrict standards, whatever I guess this huge sense of moral-ity does not work in the real world.”

Some participants also reported taking prescribed medi-cation for a while. Almost all disliked the after effects andhated calling themselves or even being compared to mentalpatients. Rajiv who was depressed after failing in businessand losing all his savings was taken to the psychiatrist by hiswife. He remarked, “Being suggested that I should visit apsychiatrist is the worst feeling ever. At first you doubt yoursanity and then the sanity of people recommending you that.I was shocked that my own family members did not under-stand what I am going through. Is it not natural to bedepressed when I have lost everything? I thought I was verynormal and I did not need a doctor to help me out. I neededa banker but no one suggested that. I did go to the psychi-atrist but he just would not talk to me. It was like aninterview, I was supposed to respond only to what he asked.My questions were answered by hmmm…hmmm…or a headnod. I was irritated. And to add insult to injury I just did notfit in the mental patients sitting there awaiting their turns.”That was the first and the last time he had visited a psychi-atrist. The feeling of not been listened to, understood waspredominant in his brief encounter with the psychiatrist.

Still some participant reported feeling dry mouth, sluggishand found themselves sleeping over their problems after tak-ing medication for some time. Preeti reported, “The whole daywas gone in sleeping and even when I was not sleeping I feltso dizzy that I hardly used to have an active mind. It wasalmost a dream like state. Maybe this is how it works. But Ididn’t like it. I used to feel anxiety and I hardly understoodwhat was happening. I actually don’t recommend anyone touse it. It adds to the gloominess of depression. At least when Iwas depressed I was aware of myself and other people here Iwas like absolute zero.” She added, “Medicines were nothing,they were just like botox for the mind, they could help soothethe wrinkles…. what about the underlying depression….no


matter how much anyone sleeps at one point or the other shehas to wake up and confront her depression.”

Looking Back: Retrospecting the Depressive Phase

While looking back at the depressive phase, both the par-ticipants derived some positive outcomes out of the entireexperience. This revolves around what can be called as self-reorganization, which involved a reorganization of one‘spriorities and professed values after the depressive experi-ence. For Sunita, the experience of depression served as avehicle of self-discovery, thus providing an opportunity tounderstand her strengths and weaknesses.

Depression, according to them, was not a disorder or amental illness. There was a resistance when being labeled asa patient or even in consulting a psychiatrist. Depression wasnot equated with mental breakdown or craziness because itwas expected and could be very well explained in their cir-cumstances. Sunita justified her depression in the followingmanner, “Even if you place metals like gold, iron, steel,copper, and expose them to heat you’ll see that each one ofthem will react. It’s because of the heat they are exposed to.However, some will probably expandmore than others. This issimilar with human beings when they are exposed to adversity.One is most likely to get depressed, some being moredepressed than others but ultimately the event seems todemand depressive behavior to it. Then, what is abnormalhere? It’s perfectly justified and understood in some cases.”

Implications of Present Work

This article is an attempt to understand depression as anexperiential reality and subjective construction of a layper-son. Lay beliefs of health and illness were used by partic-ipants to explain depression, its maintenance and evenguided their recovery from it. There is thus a greater needto explore the role of lay beliefs in maintenance of a psy-chological problem/illness and also in guiding recoveryfrom it.

The present study is an illustration showing that laypeople view health and illness as something integrated intodaily life. This in itself is a marked difference and a shiftaway from bio medical framework of understanding healthand illness, which in a major way dissects a rich experienceof depression into a list of symptoms with atypical courseand predictable response to treatment. Such a study thuscalls in for greater emphasis to be given to a holistic con-textualised personal understanding of depression. How laypeople then make meaning out of their experiences of healthand illness thus becomes important.

The study also has implications for furthering and main-tenance of a trustworthy relationship between the patient

and the psychiatrist. In a haste to provide ‘medical relief’to patients psychiatrists might run the danger of emphasis-ing only on the facts of the experience rather than alsoemphasising on what the patients make out of these facts,the nature of medical assistance expected and their personalbeliefs on their personal problems. In such a scenario thepatient might not get the empathic understanding so desiredyet understated in the relationship. There is thus a greaterneed to be sensitive towards the need/belief of patient andformulate treatments that stand true to them.

Acknowledgments The author would like to thank Prof. A.K. Dalalfor his invaluable guidance.

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