Causes of depression: perceptions among people recovering from depression.

AIM: This paper is a report of a study to explore perceptions of the causes of depression among Taiwanese people recovering from depression. BACKGROUND: Depression is a leading worldwide cause of disability. The prevalence of depression in general, and the incidence of suicide in particular, are causing concern in Taiwan. The suicide rate here has doubled in the last decade and the use of psychotic drugs has also increased. People's perceptions of their condition determine when and how they access and utilize services. METHOD: A purposive sample of 40 participants (21 women and 19 men) recovering from depression after discharge from four hospitals in Taipei was recruited. In-depth, qualitative interviews using a narrative style were carried out in 2003. The tape-recorded interviews were transcribed and analysed for themes. FINDINGS: Participants perceived the causes of their depression as being mainly social and cultural in origin. The main identified causes were: stress in marital relationships; conflict in extended families; changes in life circumstances and early life experiences. Women participants viewed their depression as being caused by their 'dominant' (traditional) husbands, who still thought that women should stay at home to take care of their children and the housekeeping and who refused to share these roles. Women also felt socially isolated when joining their extended marital families. CONCLUSION: These findings have implications for community nurses' education and practice in relation to depression. Uncovering and addressing conflict and stress in marital relationships and in extended families is challenging, especially for nurses who traditionally work within medical models of care delivery.