The Experiences of Depression Among Middle-Class African American Women: A Mixed Model Study

This dissertation is a mixed model study that primarily used Grounded Theory to explore middle-class African American women’s perceptions and experiences with depression, the mechanisms that put them at risk for and protect them from depression, and their perceptions of wellness. Depression is the leading cause of mental illness in the United States. However, when African American women experience depression it tends to be underdiagnosed, misdiagnosed, under treated, or more chronic and acute and there is little research available regarding middle-class African American women’s experiences with depression. To understand women’s perceptions of depression and wellness, as well as the mechanisms that protect them and put them at risk for depression, it is especially important to study depression among middle-class African American women—who although they may be viewed as an example of racial progress, have mental health outcomes that are lower than those of middle-class Whites, but are more chronic and severe. This study employed a mixed model design that primarily used the qualitative method of Grounded Theory. In-depth interviews were conducted with 30 middle-class African American women between the ages of 30 and 45. In accordance with Grounded Theory, the interviews were open-ended, allowing for unanticipated statements and stories to emerge. The use of Grounded Theory was purposeful, as it created the opportunity to deeply explore the women’s social and subjective lives specifically as it related to their experiences with depression. Findings: The analysis revealed a middle-range theory regarding the women’s experiences with depression: living in between. Living in between is multipronged and includes the following: (1) the intersection of race, class, and gender in the women’s lives, (2) the fact that they are often forced to choose between their identities, (3) the acknowledgement of the disparities, contradictions, tension, navigation and negotiation that take place in their lives, (4) the straddling of multiple worlds and statuses, and (5) recognition of the burdens and benefits in middle-class African American women’s lives. The findings also reveal how the women’s expectations and realities are in disaccord and contribute to their living in between. Lastly, the women’s perceptions of wellness emerged along a continuum with three distinct categories. The findings from this study provide social work practitioners, educators, and researchers with new knowledge regarding the experiences of depression among middle-class African American women and provide a theory of living in between that can be used to inform future research and the development of more effective models of practice and treatment.