Living in the shadow of fear: adolescents' lived experience of depression.

AIM: This paper reports a phenomenological study whose aim was to gain an understanding of what it was like to be an adolescent living with depression.
BACKGROUND: Depression is a significant mental health problem among adolescents. Identifying the meanings that adolescents assign to their experiences with depression is needed in order to develop interventions that will improve their care and quality of life.
METHOD: The study took place in a city in Western Canada. Fourteen adolescents (13.5 to 18 years) diagnosed with depression participated in individual open-ended interviews and focus group interviews between July 2001 and June 2002. Field notes were recorded. Thematic statements that were representative of the adolescents' lived experience were isolated from the interviews and field notes. Using all the phrases, sentence clusters and field notes, the data were then reduced until essential and incidental themes emerged.
FINDINGS: "Living in the shadow of fear" emerged as the essence of the adolescents' experiences and ultimately defined what it was like to live with depression. The shadow of fear was associated not only with fear of a return of the "bad" feelings related to their depression, but also to fear of not getting help, not surviving the "bad" feelings, and fear of having to do all the "hard work" in overcoming the "bad" feelings. This essence was supported by four themes: "containing the shadow of fear", "keeping the self alive", "maintaining a sense of belonging in the world" and "feeling valued as a human being".
CONCLUSIONS: Adolescents with depression need adequate resources and support throughout the illness trajectory, including those periods when their depression is under control.