The Form and Function of Self-Disclosure in Depressed Adolescents

Adolescent depression is a major public health concern, prevalence estimates of which indicate that from 9.5% (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003) to 11.7% (Merikangas et al., 2010) of adolescents may experience at some point; these depressive episodes have been linked to numerous physiological, psychological, educational and general functioning deficits. Although children and adolescents are known to be the subject of harsh stigmatizing beliefs (Perry, Pescosolido, Martin, McLeod, & Jensen, 2007), little research has been conducted on adolescents’ perceptions of mental health focused stigma experiences and coping mechanisms. Stigma experiences such as those experienced by persons with Mental Health (MH) concerns can lead many to manage the disclosure of their potentially stigmatizing feature, often choosing to conceal those features which can be concealed (Wahl, 1999b). The Visibility Management (VM) concept seeks to explain some of the underlying processes in how individuals cope with stigma through the manipulation of disclosure, allowing them to decide who in their lives is emotionally “safe” to disclose to, versus who may react negatively to such disclosure (e.g., stigma), resulting in concealment. This project sought to explore the processes by which depressed adolescents engaged in VM within the relationships of those other persons whom they consider important. This study of seven female adolescents with depression employed a multi-modal data gathering technique consisting primarily of qualitative interviews and utilized an innovative hand-on activity focused on the perceived strengths and weaknesses of the adolescent’s individualized social network. As a part of this process, I paid special attention to any reported incidences of the concept of a strategizing partner (Safe Other), reflecting a potential socially-based resource to depressed adolescents as originally described in the popular culture literature of the Autism Spectrum Disorder community. Subsequent between- and within-case analyses revealed that participants engaged in a complex decision-making process aimed at balancing their daily needs with the perceived burden their disclosure placed on others in their lives. This process often resulted in partial disclosure of their depression status. Finally, this work identified trends regarding the designation, utilization, and evaluation of a Safe Other indicating relevant directions for future research