Depression and the perpetuation of an incapacitated identity as an inhibitor of return to work.

The aim of the current study was to conduct a qualitative investigation of attitudes to work among people diagnosed with clinical depression. It was of particular interest to understand the role played by illness in attitudes to recovery. The economic and social burden of adult depression on society is becoming increasingly apparent. It has been argued that recovery from mental illness of this kind is most appropriately understood in 'functional terms' (i.e. 'getting on with life beyond illness'). One important goal in this process is return to work. Accordingly, in-depth semi-structured interviews were conducted with 19 people formally diagnosed with clinical depression. These interviews were the analyzed using Interpretative Phenomenological Analysis: a method of investigation and analysis concerned with making sense of participant experiences and accounts of their ill-health. This process identified three master themes, only one of which is the focus of this paper. This theme pertains to the unwitting role that can be played by the health care system in reinforcing the 'sick role' and in so doing providing a continued justification for an 'off-work' identity. Consequently, this study provides an unusually penetrating insight into the way depression can, through institutional practices, become inextricably part of someone's identity, with important implications for functional recovery.