Depression is a severe mental illness estimated to affect around 300 million people worldwide and is currently the leading cause of disability in the world (WHO, 2017). It is classified as a disorder of affect and is diagnosed on the basis of specific criteria stipulated in manuals such as the DSM V and ICD 10. It has been repeatedly argued that psychiatric classification in its present form fails to offer the appropriate framework for understanding and explaining the subjective experience of depression resulting from its focus on operationalized criteria for diagnosis and assessment and the absence of appropriate theoretical and methodological framework for the study of consciousness and how changes in its essential aspects (such as embodiment, temporality, and intersubjectivity) are related to reflective manifestations and signs of mental illness (e.g. Parnas and Zahavi 2002; Fuchs 2010; Parnas et al. 2012). In line with these considerations, I engage in a phenomenologically inspired examination of the experience of depression in particular as it is described in two formats of first-person testimonies, namely published autobiographical accounts and anonymous responses to an online survey conducted in the United Kingdom and Bulgaria.
The testimonies of depression consistently describe a radically different way of being, which, I propose can be explained and understood as originating from changes in three major structures of subjective experience – the pre-reflective experience of what it is possible to do, the pre-reflective experience of what one is able to do, and the pre-reflective experience of sharing a world with others, which encompass the essential aspects of subjectivity. I examine how the alterations in the main structures are related both to changes in embodiment, temporality, and intersubjectivity and to the various reflective manifestations in affective experience, thought, and action such as specific emotions, moods, bodily sensations and feeling, cognitive styles, and action patterns. The latter in particular can occur in various combinations and are shaped and coloured by the complex social and cultural context surrounding mental illness in general and depression in particular. With respect to the influence of the cultural and social meaning on the individual manifestations and variations in the experience of depression, I examine the impact of socially shared culturally specific conceptions of depression by contrasting such reported by participants in an anonymous survey from Great Britain and Bulgaria. While in both cultural groups depression is understood as either a pathological psychological reaction or an illness characterized by changes in brain function, in Bulgaria the former understanding is both more prevalent and associated with higher degrees of social stigmatization and subsequently less recognition of subjective suffering and attribution of responsibility. This can result in experiences akin to those commonly established by disturbances in the pre-reflective experience of intersubjective disconnectedness and accentuate already present feelings of shame and guilt. I draw attention to the fact that social stigmatization, in particular its structure and subjective experience, can also be studied within a broadly phenomenological framework on the basis of different first-person account in order to develop practical measures for the prevention of the social stigmatization of mental illness.
| Identifer | oai:union.ndltd.org:uni-osnabrueck.de/oai:repositorium.ub.uni-osnabrueck.de:urn:nbn:de:gbv:700-20190108999 |
| Date | 08 January 2019 |
| Creators | Paskaleva-Yankova, Asena |
| Contributors | Prof. Dr. Achim Stephan, Prof. Dr. Jan Slaby |
| Source Sets | Universität Osnabrück |
| Language | English |
| Detected Language | English |
| Type | doc-type:doctoralThesis |
| Format | application/zip, application/pdf |
| Rights | Attribution-NonCommercial-NoDerivs 3.0 Germany, http://creativecommons.org/licenses/by-nc-nd/3.0/de/ |
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