Older women's experiences of depression: a hermeneutic phenomenological study

Accessible summary This study describes what it was like for four older women to live with depression . . . Each woman was interviewed up to three times and we found: Depression had a major effect on the women's beliefs about themselves, resulting in a self-loathing and a feeling of failure. The women's self-loathing caused them to believe that other people thought badly of them, which led them to withdraw from family and friends. Consequently, these older women were unable to be in meaningful relationships with other people. This contributed to them feeling alone and isolated. The findings were supported by the themes of: self-loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being-alone; misinterpreting self and other people; the stigma of mental illness - society and self; and seeking understanding from other people. The older women in this study were more able to talk to other people when met with understanding. The study identifies ways nurses can develop relationships with older women who have depression and how they can best help them. Nurses can build relationships based on understanding and trust by being caring, empathetic and respectful. When nurses and other people demonstrate a willingness to listen and understand the older woman's world then relationships are established. The findings can be a resource for older women with depression and people who want to understand depression from the perspective of older women who have experienced it . . . Abstract This hermeneutic phenomenological study, informed by Max van Manen and Martin Heidegger, describes what it is like for four older women to live with depression. Each participant was interviewed up to three times. Interviews were semi-structured, audiotaped and transcribed verbatim. Data were analysed using van Manen's methodological themes and Heidegger's philosophical concepts of Being-in-the-world and Being-with-others. The themes that emerged were: self-loathing; being overwhelmed by the feelings; hiding from the world; the struggle of everyday life; Being-alone; misinterpreting self and other people; the stigma of mental illness - society and self; and seeking understanding from other people. The findings revealed that depression had a major effect on the women's beliefs about themselves, resulting in a self-loathing and a feeling of failure. The participants described how their self-loathing caused them to believe that other people thought badly of them, which led to their withdrawal. Their inability to connect contributed to them feeling alone and isolated. These women were more able to talk to other people when they were met with understanding. This has implications for the therapeutic nurse-patient relationship, which is fundamental to mental health nursing, because the relationship should be based upon an understanding of the patient's world.