Prologue
The wide-ranging experiences that women have shared through this research continue to haunt our understandings of depression and recovery. As we write this book we have been written, moved through the liveliness of stories, metaphors, silences that entangle speakers, listeners, writers and readers. We invite readers to engage with this book as a co-constituted process of reading-writing through visceral connections—guts, brains, hearts, skin, words, images, surfaces—to explore how gender matters. This is a provocation that seeks to question normative ways of thinking and responding to affective states, emotional life and biomedical claims to truth. Drawing inspiration from creative analytic writing practices, we aim to offer ways of reading-moving otherwise, tracing out a vital feminist politics of personal and public feeling.
Certain stories are impossible to forget: they disturb us and the process of researching-knowing in unanticipated ways. Conducting her 39th interview, Wendy arrives in a cul-de-sac of a public housing estate in an outer suburban area:
I knock on Michelle’s door, no response. I wonder what to do, so I call. In a slurred voice Michelle answers, apologising about how the medication that she has been ‘forced’ to consume sedates her, making it difficult to rise much before 10 am. My discomfort grows, the blush of shame spreads as my initial thoughts of drunkenness flash by, I am caught by an ambivalence about whether to continue or not with the interview. As Michelle struggles to emerge from the miasma of the medication , I compose myself. She wants to tell me about her experiences. I set up the recording device and begin the interview.It is harrowing, I am drawn into Michelle’s complex story in deeply unsettling ways. Sadness, anger agitating my guts , the injustice of her circumstances. I try to follow as Michelle oscillates between worlds, descending and surfacing. We stop the interview several times and at Michelle’s insistence we continue. Occasionally she looks up when we talk about the everyday things that matter in recovery when she has lost so much. She writes when she can, crochets to pass the time and sticks to her routine of walking to the shops each day to see familiar people. But the medication troubles her deeply, slows her thinking and actions, yet her doctors ‘won’t listen’ . Little of this struggle is apparent in the transcript, it reads in a seemingly coherent manner with a few stops here and there. Michelle’s account of depression-recovery was haunted by her disconnection from any meaningful infrastructure of care.
Talking about this interview, re-reading transcripts, we all feel the weight of another woman’s suffering that remains invisible, unrecognised in ways that matter deeply. Her story pushes at the boundaries of what is assumed to be known about depression and recovery, what is ‘helpful’ and how women’s lives become (in)visible in particular contexts. Haunting, it reverberates through our research, compelling us to re-turn to questions of how gender materialises in matters of mental ill health. For us it raises many questions about how feminism can contribute to the creation of different futures.
Introduction
Despite the gains made in Organisation for Economic Co-operation and Development (OECD) countries across the spheres of education and employment, many national surveys (e.g. in Australia and the United Kingdom) repeatedly identify that women report higher rates of distress than men (depression, anxiety, self-harm, body dissatisfaction, suicide attempts and eating disorders) (Brown, 2017; McManus, Bebbington, Jenkins, & Brugha, 2016). While acknowledged as a variable in population health statistics, gender is largely ignored as an analytic category warranting deeper investigation. The rise of ‘common mental health disorders’ has been conventionally framed in terms of affective or cognitive problems of mind or brain that can be remedied through recovery-oriented behavioural, psychopharmacological or lifestyle interventions. Advances in neuroscience, psychiatry, clinical psychology, psychopharmacology and digital health technologies all play a significant role in materialising (gendered) knowledge about the complex, invisible and immaterial dimensions of mental or emotional distress in the contemporary moment (Blackman, 2012; Rose & Abi-Rached, 2013; Ussher, 2011). What is curiously missing from public discourse about tackling depression or anxiety are the critical insights of feminist researchers who have long documented the historically situated relationships between women’s emotional lives, the politics of mental health diagnosis and various forms of discrimination, inequity and violence (Appignanesi, 2011; Chandler, 2016; McDermott & Roen, 2016; Stone & Kokanovic, 2016; Stoppard, 2000; Ussher, 1991; Wiener, 2005). At stake in these debates is the key issue of how women’s experiences of mental health come to be culturally imagined and felt as personal troubles, rather than as ‘public feelings’ that are deeply entwined with historical, sociocultural, economic and political conditions (Cvetkovich, 2012). When gender is acknowledged in mental health policies, professional practices and biopsychosocial research, it most often figures as a static category of identity (the sameness of all women, the sex/gender difference from men) that ignores the institutional practices, cultural contexts and affective relations that shape the diversity of women’s1 lives.
Stepping back from the diagnostic authority that so commonly shapes public and personal knowledge of mental (ill) health, this book considers how embodied experiences of distress (thoughts, feelings and actions) are imbricated in ‘depression’ as an organising device (Duff, 2014; McLeod, 2017). The classification of different types of depression within diagnostic cultures (Diagnostic and Statistical Manual of Mental Disorder, DSM-V) (American Psychiatric Association, 2013) promises a sense of certainty (experience as illness) that stands against often uncertain, frightening and overwhelming affects (symptoms, life histories and events) that individuals are supposed to recover from. With respect to this entanglement with the phenomenon that is depression, we ask how recovery as a t...