Personal recovery and depression, taking existential and social aspects into account: A struggle with institutional structures, loneliness and identity.

Background: Although depression is one of the most studied mental illness phenomena, the studies attempt to understand depression as different phases, turning points and transitions, but depression has an existential and social resonance. There is progress to be made in seeking to understand how people experience, cope and process, living with depression. There is a need of supplementary and alternative approaches that goes beyond medicine and traditional treatment of psychiatric disabilities.

Aim: The aim of this study was to explore perceptions and challenging issues related to living with depression, allowing the researchers to get a deeper understanding of existential and social aspects.

Method: A phenomenological-hermeneutic study design was applied, based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through observations and semi-structured interviews.

Findings: Several of the interviewees were lonely at home as well as at the hospital. This caused experiences of sheer isolation with feelings of sadness enhancing desperation concerning what to do with themselves. This could even cause physical feelings of pain. In different ways, the interviewees expressed how being with other people filled their lives with relationships and closeness. Health care professionals were focused on applying structure into the users' everyday life, shadowing the person's individuality, strengths and resources. The prioritizations between users and healthcare professionals were not always in concordance. The interviewees experienced recurrent situations where their authority and individuality were ignored or felt non-existent.

Conclusion: Existential and social aspects are vital in regard to understanding people living with depression. However, personal recovery can be diminished by controlling structures and lack of a caring guidance, creating feelings of stigmatization missing out on autonomy, causing inner doubts. A recommendation is that we challenge institutional structures and accelerate education developing the healthcare professionals' empathic competences and ability to make wise judgments, empowering the users' autonomy.