An investigation of experiences diagnosed as depression in primary care-From the perspective of the diagnosed

Research suggests that there may be divergences between scientific conceptualizations of depression and laypersons' own viewpoints regarding these same experiences. We conducted a qualitative investigation of patients' perspectives to examine these incongruences. The study used in-depth interviews of individuals who screened positive for depression while seeking primary care services for medical conditions. Descriptions of patients' experiences were analyzed via phenomenological psychological methods. Participants were dealing with profound ruptures to what they were living for-their dreams for work, relationships, and a meaningful life. This declining sense of purpose was accompanied by parallel experiences of constrictions in energy, action, and body, but participants' focus remained on the threatened goals and values in question (and less on their personal or bodily experiences). They did not explain their situation as indicative of having a depressive illness. We argue that these findings-especially the emphasis on life purpose and social context-can provide a grounding framework through which various theoretical conceptualizations (biomedical, cognitive, etc.) can derive greater connection and meaning in relation to patients' concerns and the community. We discuss the implications for bridging the gap between science and community in ways that better incorporate the vicissitudes of daily life.