Talking Controversy: Long-Term Users of Antidepressants and the Diagnosis of Depression

Abstract

Depression is a condition that is routinely diagnosed; however, controversies about the diagnosis remain. Some argue that depression goes undiagnosed, while others argue that the diagnosis is applied too readily and broadly. The focus of this article is how those with a diagnosis of depression respond to such controversy. We interviewed 11 long-term users of antidepressants, queried them about their diagnosis and medication history, and presented them with arguments about the diagnosis of depression. Informed by the methodology of discursive psychology, we attended to the rhetorical strategies participants used to argue for and/or against the over- and under-diagnosis of depression. We show how they employed strategies such as invoking biomedical knowledge and implicating patients as responsible for health care to defend their own diagnostic status and to legitimize depression as a routinely diagnosed condition. This article adds the voice of long-term antidepressant users to the debate over the diagnosis of depression.

Keywords:

• antidepressants
• depression
• diagnosis
• discourse analysis
• rhetorical strategies

Acknowledgements

The authors thank the participants for generously donating their time and for being willing to talk with us. The research was funded by a grant to Linda M. McMullen from the Social Science and Humanities Research Council of Canada (SSHRC).