Why Depressive Symptoms Cause Distress: The Clients’ Perspective

BACKGROUND: Depressive symptoms are associated with distress, but research has not focused on the processes underlying this association. METHOD: We interviewed 18 patients experiencing depressive symptoms to identify the various reasons why depressive symptoms cause distress. Digital recordings were transcribed and grounded theory methods were used in analyzing the data and building theory. RESULTS: We identified 14 reasons for why patients find depressive symptoms distressing. These reasons frequently were particular thoughts, behaviors, or subsequent outcomes in response to the symptom; in other cases, the experience of the symptom itself directly caused distress. CONCLUSIONS: We present a general model of direct and indirect symptom-distress relationships that may help target clinical interventions for depression.