Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: A review of the past decade of literature on the subject of depression in South African
women revealed a paucity of research that documents the perspectives of low-income
women who have been diagnosed with depression. Informed by this and recent feminist
critiques of the concept of depression, this study aimed to bring traditionally overlooked
perspectives to the fore by providing rich descriptions of the subjectively lived
experience of depression, as recounted by low-income women themselves. This feminist
phenomenological study took place in a poor, rural community in the Western Cape
Province of South Africa. Semi-structured in-depth interviews were conducted with ten
low-income women who had been diagnosed with depression. The transcribed
interviews were analysed using Interpretative Phenomenological Analysis. A number of
important findings emerged. Firstly, participants were seen to express somatic
complaints ahead of (and more frequently than) disclosures of sadness. Secondly,
participants often described experiencing their psychological distress as anger, anxiety
and a changed sense of self. Thirdly, participants generally attributed these experiences
(and their overall distress) to a history of childhood trauma, the loss of important
relationships, being physically, sexually or emotionally abused, feeling under supported
and overburdened by multiple responsibilities, living in dangerous communities, and/or
the various consequences of poverty. Finally, it was observed that while symptoms of
suicidal ideation and intent were present in many of the women interviewed, strong
religious and cultural norms existed and generally functioned to silence and deny the
subject. Overall, the women’s subjective experiences, understandings and descriptions
of depression allowed a more complex picture to emerge than that which is currently
offered by mainstream biomedical models. Consequentially, the current
conceptualisation of the term “depression” was deemed to be inadequate, specifically
because it does not fully capture low-income women’s experiences of distress, and also
because it tends to obscure the possible impact of socio-economic and political contexts
on their mental health. Implications of these findings include firstly, that not only does
the diagnosis of depression serve to medicalise women’s misery, but it may
simultaneously serve to obscure their feelings of anger, anxiety, sadness, hopelessness
and other symptoms of distress that are intrinsically linked to their disadvantageous
social and living conditions. Secondly, the findings indicate that the use of traditional
diagnostic and suicide assessment interviews may be unhelpful or even irresponsible in
some South African contexts. Finally, many of the study findings warrant further
investigation and psychological research. Recommendations to this end are thus
included and stress the need to use theoretical perspectives and research methodologies that are sensitive to the multilayered, complex psychological experiences of depression
in low-income women. / AFRIKAANSE OPSOMMING: ’n Oorsig van die afgelope dekade se literatuur oor depressie by Suid-Afrikaanse vroue
dui op ’n gebrek aan navorsing oor die perspektiewe van vroue uit lae-inkomstegroepe
wat met dié toestand gediagnoseer word. Na aanleiding hiervan sowel as onlangse
feministiese kritiek op die konsep van depressie, was hierdie studie dus daarop
toegespits om tradisioneel miskende perspektiewe na vore te bring deur middel van ’n
ryke beskrywing van die subjektiewe ervaring van die lewe met depressie soos vroue uit
lae-inkomstegroepe self daarvan vertel. Hierdie feministiese fenomenologiese studie is
in ’n arm, landelike gemeenskap in die provinsie Wes-Kaap, Suid-Afrika, onderneem.
Semigestruktureerde diepte-onderhoude is gevoer met tien vroue in die laeinkomstekategorie
wat met depressie gediagnoseer is. Die getranskribeerde onderhoude
is op vertolkende fenomenologiese wyse ontleed. ’n Aantal belangrike bevindinge is
gemaak. Eerstens het die meeste deelnemers somatiese klagtes gehad voordat (en meer
dikwels as wat) hulle oor hul neerslagtigheid en terneergedruktheid gepraat het.
Tweedens het heelwat deelnemers hul sielkundige nood as woede, angs en ’n gewysigde
selfbeskouing beskryf. Derdens het die vroue merendeels hul ervarings (en hul algehele
nood) aan ’n geskiedenis van kindertrauma, die verlies van belangrike verhoudings,
fisiese, seksuele of emosionele mishandeling, ’n gebrek aan ondersteuning tesame met
’n oormaat verantwoordelikhede, hul gevaarlike woonbuurte en/of die verskillende
gevolge van armoede toegeskryf. Laastens is waargeneem dat hoewel die ideasie en
voorneme van selfdood wél as simptome by baie van die respondente opgemerk is, daar
terselfdertyd sterk godsdienstige en kulturele norme bestaan waarvolgens dié onderwerp
oor die algemeen doodgeswyg en ontken word. In die geheel skets die vroue se
subjektiewe ervarings, begrippe en beskrywings van depressie ’n meer komplekse
prentjie as wat hoofstroom- biomediese modelle tot dusver gebied het. Dus blyk die
huidige konseptualisering van die term ‘depressie’ onvoldoende te wees, veral omdat dit
nie die ervarings en nood van vroue uit lae-inkomstegroepe ten volle vasvang nie, en
ook geneig is om die moontlike impak van sosio-ekonomiese en politieke kontekste op
dié vroue se geestesgesondheid te misken. Die implikasies van hierdie bevindinge sluit
eerstens in dat die diagnose van depressie nie net hierdie vroue se nood ‘medikaliseer’
nie, maar terselfdertyd dalk ook hul gevoelens van woede, angs, hartseer, hopeloosheid
en ander simptome van nood wat ten nouste met hul minderbevoorregte maatskaplike en
lewensomstandighede verband hou, verberg. Tweedens dui die bevindinge daarop dat
die gebruik van tradisionele diagnostiese en selfdoodevalueringsonderhoude in sekere Suid-Afrikaanse kontekste nutteloos en selfs onverantwoordelik kan wees. Laastens
regverdig baie van die studie se bevindinge verdere ondersoek en sielkundige navorsing.
Aanbevelings in hierdie verband word dus ingesluit, en beklemtoon onder meer die
behoefte aan teoretiese perspektiewe en navorsingsmetodologieë wat gevoelig is vir die
meervlakkige, komplekse sielkundige ervarings van depressie by vroue uit laeinkomstegroepe.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/86512 |
| Date | 04 1900 |
| Creators | Dukas, Carla Justine |
| Contributors | Kruger, Lou-Marie, Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 221 p. |
| Rights | Stellenbosch University |
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