Abstract
Despite increased interest and research into personal accounts of depression, it has seldom been studied specifically from the point of view everyday life. Our aim is to highlight how depression progresses in relation to everyday activities, and to interpret the process using a theory of everyday life. Semi-structured interviews were conducted with 55 persons (31 women, 24 men) in their 40s who self-identified as having been depressed. Depression typically progressed as follows: It originated in a difficult life situation, which was coped with by trying to manage or by escaping to drinking. Eventually, it was not possible to carry out everyday duties. Seeking treatment and sick leave signified a disconnection from everyday obligations. Leisure activities as well as support from close people helped in coping, and gradually a new, more meaningful and enjoyable everyday life developed. Disconnection, rest, reflection, reorientation, and reorganization of life seemed to build a pathway out of depression. Thus, a depressive episode could be interpreted as a process in which the person first disengaged from the unreflected everyday and then reflectively re-engaged to it.
During the history of scientific interest in depression, several conceptions of its nature have been proposed, ranging from the biomedical (see Albert, Benkelfat, & Descarries, 2012) to the psychological (e.g., Beck, 1967; Freud, 1917/1964), the psychosocial (Brown & Harris, 1978), and the societal (Ehrenberg, 2010). Consequently, research on depression has been seen to resemble the tale of blind men and an elephant. As Hal Arkowitz and Scott O. Lilienfeld (2014) state, “To understand the causes of depression, we have to see the entire elephant – that is, we must integrate what we know at multiple scales, from molecules to the mind to the world we live in”. Each way of theorizing depression highlights a different aspect of it. In this article, we aim at formulating one aspect still: that of depression as a problematic relation to everyday life.
Qualitative research has tackled the dimensions of experience of depression from the point of view of the sufferer and thus brought to light its everyday context. One of the seminal works in this tradition has been David Karp’s (1996) book Speaking of Sadness, which aims at illuminating the subjective experience of depression and especially the meanings that people ascribe to aspects of this experience. Another path-breaking study has been Rita Schreiber’s (1996) analysis of depression as a process of deconstructing and reconstructing the sufferer’s self. Moreover, Janet Stoppard’s (2000) pioneering book Understanding Depression elucidates women’s depression as reflective of the material and discursive dimensions of women’s position in the patriarchal society.
Around and after the beginning of the 2000s, qualitative research on depression has proliferated, focusing attention on the experience of living with depression in relation to the socio-cultural definitions which surround and shape it. Attention has been given to the process of recovery, or coming to grips with depression (Lafrance, 2009; Ridge & Ziebland, 2006; Smith, 1999), the identity changes relating to recovery (Browne, 2017; Fullagar & O’Brien, 2012; Schreiber, 1996), the gendered nature of depression (Valkonen & Hänninen, 2013; Emslie, Ridge, Ziebland, & Hunt, 2006; Stoppard, 2000), ways of coping with depression (Fullagar, 2008), and lay conceptions of depression (Kangas, 2001). In many of these studies, some aspects of how everyday life is affected by depression have been illuminated. However, depression as a process has, to our knowledge, not yet been systematically analyzed in relation to the theoretical concept of everyday life. This is the purpose of our article. The main idea is that during the process of depression, the relation between the sufferer and their everyday life changes.
Everyday life has been the object of mainly philosophical and sociological studies (see, for example, Sandywell, 2004). In various ways, it has been used to capture the mundane, routine, reproductive, and repetitive aspect of human life. Among different theoretical views of everyday life, at least three kinds can be discerned: those who see everyday life as inauthentic, dull, and gray, as something that does not allow a person to live to their fullest (e.g., Lukacs and Heidegger, see Felski, 2000); those who see everyday life in its ordinariness and repetitiveness as the necessary basis of human life, something that can be more or less authentic albeit having a tendency to become alienated (e.g., Heller, 1984); and those who see everyday life as (partly) a ground for unalienated, playful existence (e.g., Burkitt, 2004).
Our use of the concept of everyday life has been informed mainly by Agnes Heller (1984) and Rita Felski (2000). By this concept, we refer to the process, consisting of myriads of small actions, in which people strive to lead a good life in the circumstances they find themselves. The views of what constitutes a good life are derived from the socio-cultural milieu, and the individual circumstances are the end result of a person acting in socially shaped living conditions. Heller (1984) says, It is a tough world into which we are born and in which we have to make our way. In this tough world, people work, eat, drink (usually less than they need) and make love (usually by the rules); people rear their children to play a part in this tough world and timorously guard the nook they have managed to corner to themselves; the order of priorities, the scale of values in our everyday life is largely taken over ready-made, it is calibrated in accordance with position in society, and little in it is movable. (p. 15)
As Heller (1984) argues, everyday life is, to a great extent, non-reflective and habitual, and this is necessary for human life. A person does not ask every morning “why am I doing this?” or “could this be done differently?” Even the question “do I like this?” is often sidestepped. In Heller’s (1984, p. 166) terms, everyday life is guided by pragmatic rather than theoretical attitude. Psychologists John Bargh and Tanya Chartrand (1999) have argued, on the basis of huge amount of psychological research, that indeed everyday life is for a significant part lived on autopilot mode, that is, is based on automatic self-regulation, including pursuing certain goals. The authors presented above agree that routine, habituation, and automation are necessary for human functioning, but they also agree that in certain circumstances, conscious self-regulation is possible.
Everyday life is characterized by inertia, a tendency toward stability by adhering to certain standards, aims, and ways of doing things, if not prevented. To a certain degree, this is necessary for a fluent running of collective life and for psychological adaptation. As Francesca Emiliani and Stefano Passini (2017) note, everyday life provides people with a sense of stability and continuity. In spite of these stabilizing forces, everyday life can, however, be subject to change in certain circumstances, especially when obstacles emerge preventing the usual conduct of life. As Heller (1984, p. 131) notes, repetitive praxis and thinking, characteristic of everyday life, often makes a person slow to recognize the necessity of inventive thinking in problematic situations.
An important aspect of everyday life is its collective nature: In everyday life, people act in different relations with each other and on the basis of shared understandings of their collective world (Emiliani & Passini, 2017), as co-reproducers of collective practices. Everyone is expected to carry out their role in securing the continuity of the everyday, not quite unlike a worker at a conveyer belt.
We claim that depression can be viewed as a situation in which carrying out everyday life on the habitual, automated basis and being smoothly integrated to the collective practices has become impossible. In this article, we analyze the process of depression from this point of view on the basis of interviews conducted with 55 middle-aged Finns who had experienced a bout of depression.
Materials and Method
The data were collected within the research project “Living with depression in social context”. In the part of the project dealt with in this article, we focused on people in their 40s, as this is the life phase in which the formative years of young adulthood are definitely left behind and changes related to aging have not yet begun to take place. Unlike typical qualitative studies of depression, which have included only women (e.g., Browne, 2017; Lafrance, 2009; Stoppard, 2000), we wanted to study both women and men to obtain a wider picture of the similarities and differences between genders. The differences between genders is not, however, the focus of this specific article. We also wanted to ensure that our sample includes people from different backgrounds and, therefore, decided to send an invitation to interview to a random sample.
We recruited the participants by way of a questionnaire sent to a random sample (1500 men, 750 women) of Finnish citizens, half of whom lived in a rural area and half in the capital city of Finland, who were born between 1960 and 1969. In connection with the questionnaire, we asked those who self-identified as having been depressed for at least 2 weeks within the last 2 years to send their contact information if they were willing to participate in the interview study. As a result, the material consisted of interviews conducted with 31 women and 24 men.
The occupations and life situations of the participants varied: The sample included teachers, nurses, entrepreneurs, office workers, and factory workers, as well as unemployed and retired persons. Most participants lived in a heterosexual marriage or relationship, and they typically had children aged between 15 and 25 years. For the majority of the interviewees, a health care professional had ascertained their depression, even though they did not always have received a formal diagnosis. Half of the interviews were conducted by a woman and half of them by a man.
The interviews followed the ideas of narrative interviewing (e.g., Wengraf, 2001). Accordingly, we asked the participants to tell their story of depression freely and the telling was supported and prompted by the interviewer’s comments, probes, and specifying questions when needed. Similar to the interviewees of Michelle Lafrance (2009), when our interviewees spoke of their depression, they actually spoke more about their everyday life as about their depression per se. They often started their story by telling something about their background and depicting the context and process of their first bout of depression, if the latest was not the first. Then, they told about the background of the latest bout and described its procession till the day of the interview. Often, but not always, the depression had already faded at that time, and it could be reflected retrospectively. The interviews lasted 1 to 4 hr. They were audio-recorded and later transcribed verbatim.
There was no ethics committee at our university at the time of the start of the data collection (2009), and when such a committee was established, it did not review studies that had already begun. Thus, we were not able to obtain an ethical review for our study. Otherwise, the research process conformed to the WMA Declaration of Helsinki. In the initial information leaflet, the purpose of the study and the terms of participation were explained and the recipients were requested to submit by post their contact information if they wished to participate. During the interview, the interviewer took into account the visible emotions of the interviewee and was prepared to react to them in an appropriate way. The data have been stored securely and we have made sure that the identity of the participants is not revealed in the reports of the study.
The data were analyzed by first reading through the transcripts several times to get a preliminary idea of through which stages the depression process typically proceeded. We then created a coding scheme including the six stages typically mentioned (context of the latest bout, fending off depression, depression becoming apparent, measures taken to treat depression, coping with depression, and outcome of depression). After that, we singled out from each transcript the passages that referred to each of these stages. All the phases were not present in every interview, but most of them included at least four of these.
The following description of the depression process is a synthesis of the retrospective accounts by the participants. Instead of recounting individual stories, we present the overall story of depression that can be discerned from the interviews (following the idea of “narrative analysis” by Polkinghorne, 1995).
Findings
In the following section, we present, in chronological order, the various aspects of everyday life our interviewees saw as relating to the progress of their depression. The description of the depression process starts from the context in which the latest bout of depression had started and continues through the stages during which the person’s grip of everyday life is gradually lost and then regained. However, it has to be noted that not everyone’s depression process involved every phase.
Everyday Life Becomes Problematic
The first phase of the process to be analyzed is the point at which the latest bout of depression started to develop. Even though the participants often recognized the roots of depression in their earlier life stages, almost all could pinpoint an especially challenging life situation as the catalyst for the onset of the latest bout of depression. As a male interviewee said, “There are two sources to my depression, home matters and work matters.” The situation was not necessarily explicitly referred to as the cause of depression, but as the context of the beginning of depression. An example of this is the following explanation from one participant: “It all started when my father died.”
Pinpointing the onset of depression in an everyday context revealed that the interviewees did not primarily view it as an abnormal condition or illness, which would require finding an explanation outside everyday knowledge (cf. Brinkmann, 2014). A biomedical or even a psychological concept of depression was not widely heard in the narratives of the interviewees. Instead, they seemed to refer to more of a situational model (Keyes, 1985), which points to having too many troubles, sorrows, or stress as the reasons for feeling depressed. This does not mean, however, that they were unfamiliar with ideas of depression as illness or even as madness. A female interviewee told she had been consoled by the words of her doctor who had said, “It’s just that your heart is aching.”
Women typically, but by no means exclusively, associated their depression with events and circumstances of family life, such as divorce or a child’s illness or mental health problems. An extreme example of this was a woman whose several relatives had died within a short time frame, and eventually, it also turned out that her children had been sexually abused by a seemingly helpful relative. In contrast, sometimes a rather ordinary event, such as getting pregnant for the third time, was felt as overwhelming. In many cases, bouts of depression followed each other reflecting the changes in life situation: [The first time I was depressed was when my children were small and my husband left me for another.] And then we had a very good life after I had recovered and we [the children and I] were very close, we had an own thing, until the younger child reached puberty and fell into depression.
Men typically related the onset of their depression to work issues or financial problems. Work overload was the most often mentioned context for the men’s depression, and it was often seen as intertwined with family troubles.
The history of my depression starts ten years back, from the last [economic] depression. We worked really long hours, 36 hours at the maximum . . . We were young singles, we even sold our holidays to the company. It was totally insane. That was when the first signs of burnout . . . but as I was below thirty I thought talk about burnout was nonsense, and then like in the spirit of the Winter War [a war between Finland and the Soviet Union in 1939-1940 in which Finland succeeded in defending itself] we thought we just WORK now, of course we can. But then I hurt my shoulder very badly in a traffic accident and it started the process of new training and new jobs and moving to another city . . . And since then I had gathered myself all kinds of things to do and no money was coming from anywhere and my child was small. . .
The predominance of family matters in women’s accounts, and work issues in those of men, is interesting given that both men and women usually had both a family and a job. It appears that what is at the forefront and what is in the background in life are different for men and women. This is in line with the idea of everyday life theorists (e.g., Felski, 2000) that home as the center of everyday life is specifically women’s realm. In addition to family and work, onset of a physical illness was relatively often mentioned by women and men alike as the context of depression.
In terms of everyday life, we could say that the context of depression was such that it constituted a serious challenge to the continuity of everyday practices by increasing demands and posing new problems to be solved or losses to be coped with. New elements or challenges were difficult to accommodate to the previous way of life. Increased practical or mental efforts were thus necessary to keep on living as usual. This situation can be seen as an instance of everyday life in which inventive thinking is called for, but one still tries to get by with repetitive thinking (Heller, 1984, pp. 129-131).
Trying to Hold On: Fending Off Depression
As the problematic situation continued, various strategies were needed to manage one’s feelings while keeping the structures of everyday life as intact as possible. This exemplifies the inertia of everyday life.
The first way of dealing with the problematic situation was often to increase one’s efforts to manage it. A few examples for this are to work longer hours as a response to rising demands at work or to sacrifice one’s own needs to secure the well-being of family members.
One of the strategies to keep depression at bay was “building firewalls” between life spheres so that problems in one life sphere would not spill out to another. This made it possible to have a refuge on the safe side of the wall. Depending on what the problems were, the safe side was either at home or in the work place: “What kept me on the surface was my own family and the couple relationship” or “work was, for me, a breathing hole.” Several interviewees noted that when going to work, they stepped out of their (depressed) private self, and that playing the work role like an actor provided temporary relief.
Keeping life spheres separate was not always possible, and the problems from one sphere could cast a shadow on the other. For example, a woman with difficulties at home felt she could not face her co-workers, and spent her meal breaks alone in her office, causing irritation in others. One man’s attempts to cope with heavy workload by constantly working overtime were not welcomed by his wife.
Women often told how they tried to keep at least one spot in their home, or their own appearance, as neat and controlled as possible. “The bigger chaos prevailed inside of me, the neater was my home.” Among men, a common way of dealing with stress was “hiding behind a bottle,” that is, drinking alcohol, which often brought about new problems. “I had to go to the local health care because I tried to mend the problem in a wrong way, that is by increasing my alcohol consumption.”
During this phase, lowering of mood and energy level often led to giving up earlier hobbies and free time activities, which was then a part of a vicious circle. “The thing that has absolutely deteriorated is my own social activity in hobby circles.”
Fending off depression thus meant defending the main structures of everyday life, or at least parts of it, by making various adjustments. This can be seen as reflecting the inertia of everyday life. However, fending off facing the reality ultimately led to everyday life becoming more fragile and less satisfying, fluent, and secure.
Losing Grip
At some point, it was simply impossible to carry out everyday life as usual; “the camel’s back broke” was a recurring way to characterize the situation. Routines, which are the essence of the continuity of everyday life (Emiliani & Passini, 2017), could not be maintained, and one could not fulfill their role at workplace or at home. This was the point at which the depressed person, or their close ones, realized that something was really wrong.
As one participant stated, “For example, the dishes would pile up in the sink because you just don’t have the energy to put them in the dishwasher.” Several women indicated they could manage only the minimum of household chores, like preparing meals for the family, and sometimes not even that. Some men described how they left their bills and taxes unpaid and continuously exceeded the limits of their credit cards. Some of them mentioned that they did not even care about their health and safety, and took greater risks. Several interviewees also referred to the ideation of suicide.
At this point, the reality of something being seriously wrong could not be ignored. A female interviewee described how she began losing her grip in a very evocative way: “I stood over there in the kitchen. My mother called. I just started to cry and said now I need help. I can’t manage anymore.” Sometimes, it was other people who were first to realize the extent of the situation: “At first I didn’t realize it myself. My friends did, as I didn’t take the kids out anymore.”
These statements indicate that a step has been taken beyond the boundary of “normal,” when everyday life has lost its power to provide structure, continuity, and meaning to life. The habitual role expectations dissolve and the depressed person enters, more or less officially, into the domain of a sick role (Parsons, 1951), when the person is freed from everyday routines and is expected and allowed to concentrate on getting better.
Being Loose: Nothing Matters
The phase in which one really is torn apart from the structures of everyday life was depicted by many interviewees as devastating and unreal. The feelings described ranged from those familiar to everyone to those that are barely imaginable for those who do not have a personal experience of depression. A common feature of otherwise very variable descriptions was their totality, for example, “Everything is filled with unpleasantness” and “I felt like I was in a dark tunnel in which there was not even a tiny hole for the light to come in.” At the extreme, there was no emotional relation to the world at all: “My depression was so deep I didn’t feel anything.”
It could be said that cutting loose from the practical and mental structures of everyday life made one’s whole life seem as devoid of meaning. This reveals how essential everyday life is for psychological well-being.
Bearing Being Loose: Seeking Professional Help
In most cases, being deeply depressed was so painful that the depressed person used all their last reserves of energy to seek help. Most of the participants had made contact with health care professionals because of not feeling well. Usually the first, and often only, kind of help that was offered was a prescription for antidepressants. The interviewees felt that this was just a substitute for proper care. “It feels like they treat the problem but not the person . . . It’s more like pill-care.”
Getting psychotherapeutic help was difficult and required plenty of energy and determination, which a depressed person usually lacks; getting a referral, finding a therapist, applying for reimbursement, and so forth were often considered overwhelming.
All the time I have in my mind that I should do all this paper. . . things. . . applications . . . B-statem. . . what are they, to the KELA [the Social Insurance Institution of Finland], all these . . . when one is absolutely exhausted.
Getting therapy was a slow and difficult process, whereas the depressed person has a desperate need to access help quickly and easily. “It should be possible to get therapy more or less whenever one wants.”
All kinds of talking help were viewed as positive, especially by women. An example of the potential effectiveness of even a brief professional contact was in one interviewee’s description of how a psychiatric nurse had given her advice to start writing down her life story—which she had done, to great avail. Also, peer support groups were often seen as helpful. On the contrary, some male interviewees had found practical support for sorting out their messy financial situation as more helpful than talking about their psychological problems.
Sick leave could provide an opportunity to rest, to disconnect from work, and to think about the future—provided one did not feel the sick leave was stigmatizing or obliging them to spend their time usefully. For some, a period in hospital was the only way to really detach from ordinary life.
The world of mental health care, with its varied professions (“psycho. . . psychi. . . what was it”), forms of treatment, referrals and reimbursements, consultations and hospitals, was initially foreign to the interviewees, and clearly outside the domain of their everyday lives. From this perspective, it could be viewed as helpful to the person to gain distance from their habitual routines.
Therapy, sick leave, and hospitalization all provided the opportunity to take time for reflection and reorientation and allowed the depressed person to focus on themselves. In terms of everyday life, this can be seen as a leave from the routine carrying out of everyday practices and disengagement from one’s previous roles in the collective everyday life.
Trying to Regain the Grip: Everyday Support
In addition to professional help, the everyday support from family members and colleagues in the work place was a vital component for eventually working one’s way out of depression.
Several participants outlined that others should never tell a depressed person to just “pull yourself together.” Doing so was felt to signify both a lack of understanding and lack of acceptance of the depressed person as depressed. Depression was seen by the interviewees as something that has its natural course, which should be respected. So, “don’t rush me” was their main message to others.
The support of family members was seen as very valuable. The participants did not expect family members to act as therapists; several of them actually told how they did not want to talk about their depression with their spouse. Instead, small gestures that demonstrated acceptance by the spouse were considered meaningful. As a male participant said, “In the couple relationship it would be enough if your spouse stroked your hair a bit.” Also, practical help in household chores was appreciated both as an opportunity to rest and as a gesture of understanding and acceptance. Family members were thus not expected to lead—and definitely not to force—the depressed person out of depression, but to help them survive it.
Discussions with a trusted friend who had experienced similar problems were considered essential opportunities for reflection. Similarity of experiences ensured both understanding and mutuality in terms of help. However, several interviewees found that they lacked such a contact—depression is still so stigmatized that they had wanted to keep it secret or did not want to burden their friends.
Conversely, it was also important to experience at least moments of escape from depression, which our participants referred to as “breathing holes” or “bright spots”: moments of pleasure and joy (Simone Fullagar, 2008, called these “counter-depressants”). These could be found in leisure activities, such as sport. Women often mentioned gardening, walking in a forest, doing handicraft, and reading as their favorite leisure activities. “It starts already in January, the browsing of seed catalogues.” The men highlighted more traditional masculine activities such as doing construction work or playing in a band “I play bass, just as a kind of therapy.”
Several participants also emphasized the importance of practical help and support that was needed when everyday life became overwhelming. For male participants, it seemed to be more important to tackle concrete, everyday problems, such as their messy financial situation, than to discuss emotional problems. A supportive workplace community and an understanding supervisor were also mentioned as playing a role.
All in all, having the space to go through depression in an accepting atmosphere, as well as reflection, distancing, and practical help, made it possible to survive depression in the context of everyday life. This can be seen as a preparatory stage for a renewed everyday.
Regaining One’s Own Grip on Life—Escaping the Stranglehold of the Unreflective Everyday
A considerable number of interviewees felt they had recovered by the time of the interview. However, this did not mean that they had returned to their previous way of living. Instead, they described how depression had changed them and made them change their everyday lives.
The participants had made concrete changes to make their lives easier and more satisfying. Examples given were changing jobs or giving up burdening social roles. “I realized I don’t have to think that a full-time worker is a good worker . . . I can try to find something that suits me better than full-time work.” The most extreme example was a man who had left everything behind and started a new life almost completely from scratch; he quit his job, got divorced, sold most of his property, and gave up all his friends except one, who had also been depressed.
At least as important were the changes that had taken on the level of way of thinking. Several interviewees described how they had consciously tried to get rid of unwarranted norms and conventions that they had previously tried to conform to. Women had abandoned their pursuit of being a “good woman”—one who is eager to please others, self-sacrificing, and devoted to housekeeping (cf. Fullagar, 2008; Lafrance, 2009). “I don’t have to please everybody anymore.” Similarly, several men had become more aware of the masculinist norms of success, competition, and perseverance (more of this in Valkonen & Hänninen, 2013) and learned to draw limits to what they tried to accomplish. These kinds of changes in attitude could, in turn, lead to changes in everyday practices.
The recovery process was seen to be slow and modest, proceeding in small steps. “I am reconstructing my life now, brick by brick.” A significant part of recovery was being open to small pleasures and joys, and actively seeking out moments of everyday happiness. “These are the tiny crumbs of life. In the old days I didn’t even notice them.”
In terms of the theoretical concept of everyday life, this would mean that the new routines and practices are constructed by paying attention to the rewarding aspects and affordances rather than demands of everyday life, thus gaining space for joy and aesthetic pleasure. Heller (1984) writes about the significance of moments of fulfillment: Union in love, the contemplation of the beautiful, artistic creation moral resolve—these and similar experiences awake in us powerful unmistakable feelings of ‘being-for-us’ . . . and though they are of the moment, it is a moment that recurs over and over again. (p. 267)
The Outcomes of Depression
Any ordeal in life ultimately gets its meaning from how it will be assessed in hindsight as a part of one’s life story. Among our participants, those who felt they had recovered were able to evaluate their experience from the point of view of what they had learnt from the bout of depression.
One outcome often mentioned was an increase in empathy toward other people’s suffering and an increase in the ability to respond in an appropriate way. “At least I’m not going to tell anyone to pull herself together when she’s depressed” and “I have started to understand those who say they are a bit stressed, and I tell them not to let their burden become too heavy.” According to several participants, depression had also prompted critical thought toward society—the norms of working life, gender roles, and the tendency to see societal problems as individual ones: “Nowadays everybody is required to do so much, but actually one should meet the real values in life.” Some participants revealed that after depression, they had more courage to defend themselves and to express their opinions. This can be seen as a step toward a less submissive everyday life.
Some participants told they had started to see the social origins of depression and indeed had started to think that the whole idea of depression is a way of blaming the individual when the problem lied actually at the level of the society. “That concept is used to explain things that are part of quite ordinary life or even very societal . . . they just put a box of pills to one’s hand and say it will be alright.”
When reflecting on the process of depression as a whole, many participants expressed the idea that whereas the experience had been extremely hard, it had nevertheless had a positive effect on their lives. Being “able to enjoy the small things” or “seeing colors as more vibrant” were mentioned as positive changes brought about by depression. In the words of a female interviewee, “One just has to be grateful for such an intensive course in life skills.” Once again in Heller’s (1984) terms, this can be seen as achieving a meaningful life: “The meaningful life is the ‘being-for-us’ of everyday life in an open world which is characterized by prospects of development through a succession of new challenges and conflicts” (p. 267).
Conclusion
The overall picture that emerged from our data was that all the phases in the depression process were connected to everyday life in specific ways. The main story can be condensed in the following way: a person finds herself or himself in an overwhelming everyday situation and tries to manage it until eventually losing grip on the everyday altogether. Breaking totally loose from everyday provides an opportunity for reflection and reorientation. Recovery is a process of building everyday life anew, on one’s own terms, thus escaping the grip of an unreflected everyday life.
Our results indicate that depression is a phenomenon of context and process. Even if we leave the question open as to what the real causes of depression are, it is evident that its background and development, living with it, and its results are intertwined with everyday life, such as in social relations, work, household chores, and leisure activities. During the course of the depression process, different aspects of everyday life become relevant. Moreover, the influence of depression on a person’s life can be fully assessed only after the process.
Moreover, our results indicate that in hindsight, depression can be seen to lead to positive outcomes. This finding is in line with several previous studies that have approached depression from the recovery perspective (e.g., Browne, 2017; Karp, 1996; Ridge & Ziebland, 2006; Schreiber, 1996). A prerequisite of such outcomes seems to be that the depressed person is allowed to proceed through the process as supported, but at their own pace. Rest and disconnection, reflection, reorientation, and reorganization of life are essential, in this chronological order, for successful recovery.
Professional and everyday support systems are important factors in providing opportunities for surviving depression and changing it into a turn for the better. The participants were mostly disappointed with psychiatrists and medical doctors because they were seen to substitute listening and understanding with antidepressant prescription, but psychotherapists were often lauded for their help. It is also noted that psychotherapy should focus much more on a client’s everyday life (Dreier, 2008). In addition, it would prove helpful if low-threshold services could deliver both practical help and counseling, without labeling the client with a diagnosis. Moreover, increased knowledge among the general population, in terms of how they can help a close one through the different stages of depression, might significantly increase the level of support a depressed person needs.
Although there are grounds for seeing depression as potentially leading to a more authentic everyday life, it is necessary to make some cautionary notes. First, depression must not be romanticized. As Arthur Frank (1995) notes about the positively ending illness narratives, a happy ending does not wipe out the reality of suffering. In our study, even those interviewees who told that depression had changed their life for the better emphasized that the depression itself had been extremely hard and that they do not wish it even for their worst enemy. Depression is a most painful way to learn about life, a “tough school,” and it should be pondered whether some other ways of taking refuge from the pressures of everyday could be a lighter way to wisdom. Second, the results must not be overgeneralized. It has to be borne in mind that the ending of the depression story was not positive for all our participants; instead, for many, it did not have even an anticipation of a brighter future. Moreover, as the participants of our study were self-recruited, it is probable that especially those people who participated felt they have a positively ending story to tell. Third, one should not exaggerate. Even those participants who told that depression had meant a positive turn in their life did not describe their current life as absolutely happy. Neither did they think it was without the possibility of recurrence of depression; however, they told they felt more equipped to deal with the next bouts. And finally, one should not psychologize. While psychological interventions were often beneficial or appropriate for people suffering from depression, the process of recovery was not all about reflection, emancipation, and gaining insight. Practical aspects of everyday life were important in enabling or restricting the materialization of life changes that were felt necessary. Psychotherapy’s helpful outcomes may partly stem from it being a part of the social practices people are engaged with (Dreier, 2008). Moreover, depression was partly a bodily experience and many physical activities were found as helpful for recovery.
Regarding the theory of everyday life, the study points to the question of whether everyday life is essentially monotonous, empty, and gray, or something that can be fulfilling and significant (see Felski, 2000). On the basis of our findings, it seems that the structures of the everyday create a common ground for people living together and provides a feeling of security. This explains why such life structures are held onto so tightly, even when life has become unsatisfactory, a burden or even unbearable. Collapse of the everyday is frightening and painful, but the ensuing limbo provides room for renewal and revival in terms of finding meaning in life. After this episode, everyday life can once again be felt as authentic and valuable. An optimist would say that the increase in empathy, and heightened sense of awareness or reflectiveness, combined with critical thought about society, all triggered by depression, could even lead to a collective action to change the depression-inducing demands of everyday life.
Footnotes
Authors’ Note
Ms. Anne-Maarit Turunen conducted half of the interviews.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by the Academy of Finland, Grant Nr. 126951.