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6 ‘I’m sick!’: how the way one talks about their mental health diagnosis guides their journey to recovery
  1. Isabelle Jacques
  1. Université du Québec à Montréal (UQAM), Montréal, Canada. Centre affilié universitaire- Centre de recherche de Montréal sur les inégalités sociales, les discriminations et les pratiques alternatives de citoyenneté, Montreal, Canada


Objectives For this conference paper, I will present the results from my Master’s thesis in Sociology in which I aimed to study the effects of one’s relationship to their mental health diagnosis. More specifically, I explore the effects a mental health diagnosis has on the path to recovery of those who must learn to live with a new definition of self. In a context where mental health over-diagnosis is more and more decried, it is important to understand the ways in which it affects individuals’ identity. This study schematized different levels of identification with the diagnosis, its impact on recovery and its effects on coping.

Method I analysed of a sample of 680 messages published in 2017 on a Quebec online discussion forum (qualitative data analysis with NVivo). This forum offers a platform for individuals diagnosed with one or more of the following mental health disorders to connect with one another: depression, bipolar and anxiety. The content analysis focused on three themes: 1) the forms of self-identification to a diagnosis, 2) the experience described by the forum participants and their ways of positioning themselves towards them, and 3) the types of personal adaptations illustrating the self-understanding of diagnosed individuals and the aims and means used to adapt to the difficulties they have experienced (inspired by Robert K. Merton’s Typology of Deviance).

Results The results allowed to identify 1) the types of diagnosis self-identification through speech patterns such as: ‘I’m sick’, ‘I have a disorder’, ‘I have a problem’, ‘I doubt’, ‘who am I ?’, ‘I’m not sick !’ 2) the understanding of the nature of one’s problem (physicho-chemical, bodily, self, environmental) and 3) the modes of adaptation to the lived experiences (goals and means used to cope with it) associated with each type. The different categories of analysis led me to construct a typology of diagnosis that exhibits six figures of appropriation: resigned, expert, resilient, client, suffering and distanced. This typology aimed to illustrate the link between one’s relationship to their diagnosis and one’s positionality towards ways to get better.

Conclusion A strong identification to one’s diagnosis limits one’s ability to explore alternatives to the biomedical approach (medication and medical follow-ups) which leaves the individual with a feeling of hopelessness if these means fail. In contrast, the lack of identification to one’s diagnosis results in individuals who are more destitute and suicidal, because the responsibility to cope weighs entirely on the individual. Speech patterns that promote optimal recovery show profiles of individuals who identify moderately with their diagnosis and who favour a variety of coping methods (medication, healthy relationships, sport, spirituality, etc.). We conclude that consultation of individuals for their diagnosis must consider that one’s lived experience should not merely be presented as an ‘illness’ to be treated. Health professionals must emphasize the complexity of life courses and the multitude of coping mechanisms one can take on the path to recovery.

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