How do depressed people feel perceived by others? A qualitative study from the patient's perspective

Depression is a condition which affects the individuals’ entire existence. The difficulty in emotionally tuning in to the environment and the resulting sensation of loneliness have frequently been described as salient points of depressive experience. To our knowledge there are no studies that phenomenologically analyze how depressed people feel perceived by others. Aiming to fill this gap, this study builds on a previous work, which carried out a literature screening and a thematic analysis on the subjective experience of depression. The narratives collected in this way were analyzed using a bottom-up qualitative method (Consensual Quality Research). Four main categories of experience related to perceived social apprehension of depression have been identified: (1) feeling guilty about not meeting others' expectations, (2) feeling socially misunderstood, (3) bringing to light an inconvenient truth that others do not want to see, and (4) hiding from exposure to the judgement of others. Conclusions Depressed patients often feel misunderstood by their social environment, which belittles or dramatizes their condition or doesn't realize how otherwise normal requests can instead cost a lot of effort, generating feelings of guilt and inability. This frequently pushes depressed individuals to try to hide their condition by isolating themselves or wearing a social mask. The difficulty in emotional attunement already present in depression can only worsen in the face of this feeling of incomprehension, generating a vicious circle of non-recognition that ends up maintaining the depressive state.