Being depleted and being shaken: An interpretative phenomenological analysis of the experiential features of a first episode of depression.

OBJECTIVES This article presents a detailed idiographic analysis of patients' experience of first-episode depression. DESIGN This is a qualitative interview study using interpretative phenomenological analysis (IPA). METHODS Semi-structured interviews were carried out with a purposive sample of seven patients presenting to a mental health service in London, UK with symptoms of first-episode major depression. There were four males and three females; mean age was 44 years. Interviews were audio-recorded and subjected to IPA. RESULTS Participants described a significant loss event prior to onset of depression. The depression involved a major diminishing of the life-world with relational, corporeal, and temporal depletion. This depletion was accompanied in each case by occasional extreme emotions, frenzied thoughts, confused sense of self. CONCLUSIONS Depression can represent a major existential threat to the sufferer. We discuss how our findings can illuminate the extant literature. The study suggests the value of exploring these existential features in early therapy. PRACTITIONER POINTS Offers a detailed phenomenological analysis of core experiential features of first episode depression: being alone, being empty, life is over. Also reveals an unstable dynamic of major psychological depletion interrupted by emotional and cognitive agitation involving confusion, lack of confidence, and/or trust. Provides rationale and material for intensive exploration of these features in therapy.