年輕人憂鬱復原經驗的敘事研究

Abstract

本研究旨在探究年輕憂鬱症患者復原歷程的經驗，並聚焦過程中的因應策略與行動影響因素。本研究以敘事研究為研究方法，邀請四位過去曾受診斷為憂鬱症，但已與醫師共同討論認為症狀已緩解，且至今已停藥一年以上皆維持穩定狀態的年輕研究參與者前來進行半結構訪談。並以「類別—內容」為主，「類別—形式」為輔，進行研究資料分析，從憂鬱症當事人的主觀經驗出發，了解在憂鬱症復原歷程中促使憂鬱症當事人採取自助策略之因素與帶來幫助的行為策略。研究結果發現：1. 每位研究參與者在其復原歷程中皆經歷了七項主軸經驗：（1）驚覺逐漸失去原有的自己；（2）為自己的困境尋找解答，決定行動；（3）尋覓適配的治療服務，帶來轉機；（4）願承受憂鬱並嘗試取回主控權；（5）不可或缺的社會支持系統資源；（6）鬆動憂鬱慣性框架；（7）開創不同的生活。2. 研究參與者啟動自我幫助歷程包含四個主題：（1）生活中覺察到憂鬱症狀；（2）發覺症狀的影響並未消退；（3）透過外在資源對自我有更多的覺察；（4）獨立特質與問題解決觀點。3. 研究參與者在復原經驗中積極影響之策略則包含：（1）自主穩定配合藥物治療；（2）對於治療抱持積極主動的態度；（3）進行有興趣的活動本身就能帶來正向情緒；（4）正向的行動結果有助於提升滿足感與掌控感；（5）向內照顧，透過正念或閱讀相關書籍進行自我覺察與關照；（6）向外尋求心理諮商的輔助；（7）建立屬於自己的社會支持系統；（8）社會支持下，更能發揮自己的力量；（9）和自我進行對話，重新建構自我，為生活帶來不同的視野」等九個主題。本研究根據上述結果，提出對於未來研究方向，以及對於健康實務工作者、憂鬱症當事人與陪伴者之建議。This study aims to explore the resilient experiences of young adults in their recovery process from depression on the important factors of coping strategies and actions. Narrative research was used as the methodology in this study. Four young participants previously diagnosed with depression but have both remitted and maintained stable conditions without medication for one year were invited to complete the semi-structured interviews. The analysis of research data was conducted primarily using a"categorical-content" approach supplemented by a "categorical-form" approach. Based on the subjective experiences of individuals with depression, the study sought to understand the helpful strategies and factors during their recovery process, as well as the factors that prompt individuals with depression to adopt self-help strategies. The study found that: 1. Each participant experienced seven core themes during their recovery process: (1) Gradual realization of losing their former self; (2) Seeking solutions for their predicament and deciding to take an action; (3) Finding appropriate therapeutic services that brought a turning point; (4) Accepting depression and attempting to regain control; (5) Idispensable social support system resources; (6) Loosening the grip of inertial depressive frameworks; (7) Creating adifferent life. 2. In the process of initiating self-help strategies during depression recovery, four themes emerged: (1) Awareness of depressive symptoms in daily life; (2) Recognizing the persistent impact of symptoms; (3) Gaining increased self-awareness through external resources; (4) Independence and a problem-solving perspective. 3. Participants adopted several strategies that positively impacted ones recovery: (1) Autonomously consistent adherence to medication; (2) Maintaining a proactive attitude towards treatment; (3) Engaging in activities of interest that generated positive emotions; (4) Positive outcomes from actions enhanced a sense of satisfaction and control; (5)Engaging in self-care and self-awareness through mindfulness or reading relevant literature; (6) Seeking external assistance through psychological counseling; (7) Establishing a personal social support systems; (8) Enhancing personal strengths under the support of social networks; (9) Self-dialogue to reconstruct self and bring new perspectives to life.Based on these findings, this study provides recommendations for future research directions and practical suggestions for health practitioners, individuals with depression, and their companions.