Academic journal article Social Alternatives

Rethinking the Relapse Cycle of Depression and Recovery: A Qualitative Investigation of Women's Experiences

Academic journal article Social Alternatives

Rethinking the Relapse Cycle of Depression and Recovery: A Qualitative Investigation of Women's Experiences

Article excerpt

Introduction

In this article we develop a critical analysis of the effects of dominant constructions of recovery in light of research we have undertaken with 31 women about their experiences of recovery from depression as part of the first author's doctoral study (funded by an Australian Research Council [ARC] Discovery grant). The study employs a qualitative methodology within a feminist post-structural framework to examine the discourses that shape how women negotiate the 'imperative to recover' in Australia as an advanced liberal society (Rose 2007). In this context we use discourse to signify a 'set of common assumptions which although they may be so taken for granted as to be invisible, provide the basis for conscious knowledge' (Cheek 2000, 23; Foucault 1980). Discursive analysis enables the effects of certain ways of thinking about depression and recovery to be identified in relation to everyday experiences, research and policy.

While the policy shift towards a recovery orientation promises major conceptual and practice changes in mental health services there is a need for further consideration of what this means in relation to women's everyday lives. We argue that the current framing of recovery in mental health policy positions this as an individualised problem that effectively minimises more critical understandings of the gendered dimension of depression and recovery. The 'recovery imperative' that is evident within current policy emphasises how individuals can assume responsibility for controlling and managing their lives in order to maximise their social and economic participation. Without a more critical understanding of women's experiences of depression and recovery current policy directions may fail to address the complex social conditions that undermine individual and social well-being.

We begin our analysis with an examination of the construction of depression and recovery within policy discourses to foreground how professional practices of treating depression influence the way women think about the recovery process. We move on to briefly outline the research project and identify two key themes concerning how women at midlife negotiated biomedical, gendered and social discourses of recovery as they moved through depression. The first key theme identifies the complex interrelationship between biomedical and the gendered understanding of women's everyday experiences of depression and recovery. Women articulated how gender relations contributed to depression and had to be renegotiated in the personal process of recovering their lives and sense of self. The second theme identified how women experienced recovery in relation to the chronicity of depression with respect to normalised assumptions about linear progression towards a recovered self that was 'normal' and free of depression. To conclude we consider women's experiences in relation to whether the individualised 'imperative to recover' may be implicated in perpetuating a cycle of recovery and how we might begin to rethink recovery from a gendered perspective.

The Emergence of Recovery in Depression Policies

The adoption of a recovery focus within the National Mental Health Plan 2003-2008, marked a significant change in the way services were to be delivered, and how mental illness was conceptualised (Ramon, Healy and Renouf 2007). Prior to this policy shift mental illness was positioned as a collection of chronic and unrelenting biomedical and/or psychological disorders from which there was little hope of recovering one's life. The National Mental Health Plan has adopted as its guiding principle Anthony's 1993 definition of recovery as both a 'process and outcome' that involves a change in 'one's attitudes, values, feelings, goals, skills or roles' in order that one can live a 'satisfying, hopeful and contributing life' (Australian Health Ministers 2003, 11). This notion of personal recovery is considered to be the most widely 'accepted contemporary definition of recovery' and has been influenced by a range of psychiatric rehabilitation professionals in the United States and the rise of the consumer movement (Roberts and Wolfson 2004, 38). …

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