The dialects of depression
Karp, D. A. (1994). The dialects of depression. Symbolic Interaction, 17(4), 341-366.
This article attempts to examine clinical depression from the perspective of the sociology of medicine. In accordance with this approach, Karp assumes that there is a fluid relationship between social experience and illness—an assumption has special implications for the study of depression, which is an “illness” of the self that typically results in social withdrawal. For this reason, Karp examines the paradoxical fact that those suffering from depression typically want social connections despite the fact that their condition keeps them from maintaining such connections. Specifically, he is interested in determining what aspects of depression contribute to the social isolation that those who suffer from it experience.
The data used in this article were part of a two-stage research design intended to examine individual experiences with depression. During the first stage of the design, Karp spent a year and a half observing a self-help group for those suffering from depression, during which he focused on how group members developed a way to make sense of depression through their discussions. During the second stage, Karp conducted thirty-five in-depth interviews, which provide the basis for this article. He conducted 11 interviews with personal acquaintances, 21 interviews with respondents to a snowball sample that came from advertising in a local newspaper, and 3 additional interviews from referrals from the previous interviewees. Karp relied only on information provided by those who had been professionally diagnosed and treated, and used somewhat ambiguous qualitative methods involving grounded theory and a symbolic interactionist approach in order to produce his analysis. Karp ultimately found that a series of factors tend to increase the isolation of those suffering from depression: “(1) the intrinsic [isolating nature] . . . of the emotional experience of depression, (2) the failure of individuals to have a clear vocabulary for understanding their own predicament, (3) the incomprehensibility of depression to ‘normals,’ and (4) the stigma attached to ‘going public’ with one’s problem” (343). Karp noted that these factors operate to isolate those with depression, even though they often realize that social isolation will worsen their condition.
This article contributes to the sociology of psychology by virtue of its approach. By taking a social interactionist approach when examining depression, Karp sees a number of overlaps between the personal experiences of those suffering from depression, and the sociological aspects of/contributors to the disorder. However, he also notes that often times those he interviewed blamed themselves rather than social processes for their disorders. What this suggests is that even when sociological factors influence psychology, some who suffer from psychological “illnesses” may not be able to see the sociological impact upon their illnesses. Along this line, Karp suggests that, as of the mid 90s, researchers might begin to bridge the knowledge gap between personal experience and social forces by tracing the links between subjective experiences (in depression) and the social and personal structures that loosen social connections.