How do we conceptualize depression?: A mixed methods study

Despite being extensively discussed, the concepts of mental disorder in general and depression in particular remain unclear and no consensual definitions are yet established. Empirical research on how professionals and laypeople think about depression also points to tensions and lack of consensus. However, there still remains much work to be done in order to more effectively and clearly elucidate how depression is conceptualized. Specifically, there has not been an in-depth analysis of the beliefs, values, and justification that guide practitioners in their everyday work regarding mental disorders in general and depression in particular. The purpose of the current mixed methods convergent study was to fill this gap. Specifically, this study utilized the Behavioral Shutdown Model as a conceptual framework to develop the Understanding Depression Interview for exploring mental health professionals and laypeople’s conceptualizations of depression in terms of its nature, diagnosis, etiology, and treatment. Utilizing qualitative and quantitative research methodology, this investigation found that in certain aspects mental health professionals and non-experts conceptualized depression differently (e.g., psychiatrists tended to confer more importance to the biological aspect of depression than the other groups). The investigation also found that participants shared many beliefs about depression across groups. For instance, mental health professionals differentiated between a disease and a non-disease type of depression. Also, some participants from different groups struggled diagnosing cases where there was a clear psychosocial stressor because they recognized that the symptoms met the criteria for diagnosis with a depression disorder but did not want to pathologize a normal reaction to a stressor. Implications and limitations are discussed