Exploring Interpersonal Relationship of Female Patients with Persistent Depressive Disorder: A Qualitative Study with a Phenomenological Approach

Abstract

Background: Persistent depressive disorder (PDD) is a chronic problem that is more prevalent among women than men. Various studies have revealed that these people experience many problems in their interpersonal relationships, which increase their suffering. Objectives: The present study was done to identify how people suffering from PDD experience interpersonal relationships that often seem troubled and broken. Methods: A phenomenological approach was adopted for this qualitative study. For this purpose, in-depth interviews were conducted with 21 individuals with PDD, focusing on exploring their experience and suffering in interpersonal relationships. All interviews were recorded and transcribed, and the transcripts were analyzed using Giorgi’s phenomenological descriptive method. Results: In general, five main themes and 16 sub-themes emerged. The main themes were: (1) Feeling empty of love and compassion; (2) feeling ignored; (3) ignoring others’ needs, conditions, and suffering; (4) feeling of being annoying to others; and (5) feeling confused and helpless in relationships. Conclusions: It seems that all five themes convey the message that these individuals demonstrate less skill in feeling compassion and receiving it from others. Therefore, it appears that long-term compassion-based interventions can effectively reduce the interpersonal suffering of these individuals. It should be noted that although these themes have commonalities in different cultural contexts, the culture can influence the content and intensity of these feelings.

The lived experience of depression: a bottom‐up review co‐written by experts by experience and academics

“…Individuals describe the inability to recognize and experience positive emotions such as pleasure: “I tried to lick the honey which formerly consoled me, but the honey no longer gave me pleasure” 22 . They also feel unable to experience happiness (“ I have of late lost all my mirth ” 34,44 ), love ( “My husband expects me to express my love for him, but I do not know where I can find this love”) 45 , or affection towards others (“ Because I was depressed last year, I became absorbed in my own self. I didn't care about others”, personal communication) .…”

“…This sometimes relates to guilt – all that one anticipates is punishment, something nasty is coming, and one awaits judgment 34 . Because of the impossibility of future positive change, depression is experienced as an eternal incarceration 69 : “One thing about depression is that it feels like it's gonna go on forever… it's never gonna end” 45 . And, if nothing can change, there is no escape other than death 34 .…”

“…Feelings of social and personal isolation, not being understood by others, and being cut off from the world, play a central role in the subjective experience of depression 34 . Interaction with other people becomes uncomfortable 99 ( “Part of what people say is upsetting, so I stay away from them” 45 ), meaningless ( “I feel like what people talk about is trivial and irrelevant” 43 ), or outright hurtful ( “The act of socializing seems like an act of self‐harm, to expose myself to get hurt”, personal communication ). The poet S. Plath, who struggled with depression, points out the emotional burden of being expected to keep up appearances: “ I also hate people to ask cheerfully how you are when they know you're feeling like hell and expect you to say ‘fine ’” 12 .…”