"What if I had never been depressed?": effect of counterfactual thinking on stigma for individuals who have experienced depression

Abstract

Depression is identified as one of the most common mental illnesses in the United States (NIMH, 2014). To understand such prevalence, many researchers have focused on the cognitive patterns associated with depression, suggesting that depressed individuals focus their attention on experiences of disappointment, worthlessness, and rejection (Gotlib & Joormann, 2010). This may include counterfactual thinking patterns that center upon detrimental “what ifs” that impede meaning-making, a process known to benefit individuals and reduce stigma. Accordingly, the purpose of the current study was to explore the relationship between depression, counterfactual thinking, and stigma. Using a mixed methods design, participants were randomly assigned to consider ways in which their life might have been better or worse if they had never had depression. They also completed a series of questionnaires and open-ended questions. The results indicated that individuals who were randomly assigned and prompted to think either about negative and positive counterfactuals perceived higher levels of stigma than those in the control group. Additionally, individuals who wrote about ways their life would be better without depression reported greater meaning making than those who wrote about ways their life could have been worse. Lastly, systematic differences in emergent themes of meaning-making were identified between groups. The current research sheds light on depression narratives and how individuals create meaning about depression.