title: Isolation, feeling 'stuck' and loss of control: understanding persistence of depression in British Pakistani women.
abstract: BACKGROUND
  Persistent depression is more commonly experienced by British Pakistani women. The processes by which this results in an experience of chronic depression are not well understood.
  
  
  METHODS
  Qualitative thematic analysis of 15 in-depth interviews with British Pakistani women being treated for depression in primary care, collected in the process of a larger three-centre research project to explore experience of depression and its treatment (the QUEST-D study) in England.
  
  
  RESULTS
  Three key overlapping themes emerged: a) 'feeling stuck'--for many of the women, the persistence of depression was experienced as inescapable because it was related to family conflict that seemed impossible to resolve; b) 'isolation'--which might be externally determined by social and cultural factors but also in some cases appeared to be self-imposed; c) 'control'--issues related to loss of a sense of control in depression, and attempts to regain it.
  
  
  CONCLUSIONS
  The study was carried out in only one area of the United Kingdom, East Lancashire. It formed part of a larger study to explore views of treatment, and there were therefore limited opportunities for further development of some of the themes that have subsequently emerged in this secondary analysis of the data.
  
  
  CONCLUSIONS
  Psychological therapy for this population needs to be tailored to specific needs by identifying and addressing both the underlying cause(s) and the specific consequences of depression and associated social isolation for each individual person.
authors.affiliation: School of Community Based Medicine, University of Manchester, United Kingdom. Linda.Gask@manchester.ac.uk
authors.forename: Linda
authors.initials: L
authors.lastname: Gask
authors.forename: Saadia
authors.initials: S
authors.lastname: Aseem
authors.forename: Ayesha
authors.initials: A
authors.lastname: Waquas
authors.forename: Waquas
authors.initials: W
authors.lastname: Waheed
mesh_terms: D000328:Adult; D000368:Aged; D032882:Comprehension; D003466:Cultural Characteristics; D003863:Depression / Q000208:ethnology* / Q000523:psychology*; D054242:Emigrants and Immigrants / Q000523:psychology*; D054541:Family Conflict / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D011320:Primary Health Care; D012494:Sampling Studies; D012931:Social Environment; D012934:Social Isolation / Q000523:psychology*; D012944:Social Support; D006113:United Kingdom / Q000453:epidemiology; D014930:Women / Q000523:psychology*