Mixed Methods Study Design For Depression

Over the past several decades, studies have shown how women, no matter where they live globally, are at least twice as likely to be depressed when compared to men.

Theories for why abound. Explanations range from hormonal and other biological differences to social context and unequal caregiving and labor arrangements.

If you were conducting a mixed methods study into women’s experiences of depression to learn more about their lives and why they suffer more, what topics would you pursue? What themes would you focus on?

Hi @shihei, @ktabb, @Mohammadimr, @stellunak, @AnnalijnUBC - You may have thoughts on the topics you would pursue to learn more about lives of women experiencing depression. Please share your thoughts. Thanks.

Hi @Suneetharani, @panderekha, @Kalpana, @mhackett, @KarenBett, - We would love hear your thoughts on the topics you would pursue to learn more about lives of women experiencing depression.

As I mentioned in the data for depression thread, I think the 3 most interesting topics for understanding depression is: 1. past trauma, especially related to the child-mother bond and or sexual violence, 2. personality patterns that center on control, very fixed identity structures etc. The transition to motherhood, as well as other major life transitions concerning women, are more than anything an act of relinquishing control and the lack of social-emotional skills or other resources that would allow the mother to navigate uncertainty seems to be a major cause of depression 3. existence or lack of support networks in which the woman/mother can develop authentic, vulnerable, non-judgemental bonds.

I agree with stellunak’s suggestions provisionally but first I would love to see the research that found women 2x as likely to be depressed no matter where they were. That is an amazing finding. I would love to know how many societies were actually studied, when these societies were studied, etc. Until I saw that research and thoroughly digested it I would reserve any suggestions (other than thinking that stellunak has offered a sensible road map s once we understand what is going on as indicated in the data.

There has long been a question mark over this statistic about women being twice as likely to be diagnosed with depression than men (and men about 5x as likely to be diagnosed with personality disorder). The question arises from whether women report more symptoms because that remains more socially/culturally acceptable than men who report the same symptoms in most cultures. Do women experience more symptoms because that too is more culturally acceptable to acknowledge? When women and men present with identical symptoms to a GP, women are more likely to receive a prescription for treatment (antidepressants) than men => who are more likely to be told they should exercise more or some sort of behavioural ‘green prescription’. So there are systemic problems in the way we measure, categorise and enumerate our data.

Given the above, it is very important that researchers seek to explore these concepts and the stigma associated with experiencing, reporting and/or receiving treatment for depression.

FYI few people with lived experience like the label ‘sufferer’ or to read that they suffer. Suggest using alternative terms.

Thanks @mhackett, @stellunak and @boblf029 for sharing your thoughts.

Hi @Eva, @VTod, @jessgong and @marcia_scazufca - It would to be nice to hear your thoughts on this important discussion and the comments received. Thanks.

Thanks mhackett for articulating some of my inchoate concerns. I still would love to see the research before offering suggestions. But your observations make it abundantly clear that going forward we need to corroborate those findings about men and women with replications and especially with different research approaches if possible. For example if the research were experimental perhaps a survey might be attempted or if it were a survey perhaps a classical; experiment across different societies might be attempted. What we are aiming for here is not exactitude (whethe it is twice or one-and-a-haf times more is not the issue) but validity. Are we see depression, which has a series of specividc symptoms, or mere frustration, etc.

Many a time, depression in women is either dismissed/ignored/undermined or understood and attributed as madness. if it is post-partum depression, the woman is more likely to be called possessed and taken for “healing”. I would think the multiple understandings of depression by different people in different positions have to be taken into consideration to analyse the reception and representation of a woman with postpartum depression.
2. How does the affected woman understand her condition? Who gives her the clues to mould her image as a mother? Who gives her the yardsticks to measure her norma-abnormal identity and how does she use them?
3. Medical construction of depression: there is a need to explore how the trained medical doctors perceive pregnancy, motherhood and depression. Even today we get to see the gynaecologists (definitely not all) who do not speak to the woman concerned but explain “her condition” to the man and leave the decision to him. The medical industry for which the woman is a passive sample, becomes judgemental about her state of mind and body.
4. Cultural construction of depression: Cultural constructions of motherhood have no place for post-partum depression, for motherhood is a natural and smooth transition, according to the traditional cultural systems.
5. What would be the stand of the family about a woman with postpartum depression, whether it is clinical or circumstantial? Therapy or abandonment? If it is healing, what kind of methods and what kind of knowledge systems? How do they fight the societal stigma, is it by concealing the woman’s condition or by de-stigmatising depression?
6.if the woman has to go for treatment for clinical depression, what would be her place in family and society when she returns “normal”?

These are only some of the points that I would think are very important in the collection and analysis of data. Above everything, it is the woman’s response, even if it is silence, that would be central to a research like this.

Thanks @Suneetharani for sharing your thoughts on depression data. To collect data on the points you have mentioned, what questions or themes would you explore with participants?