The patient’s perspective on recovery from depression Self-management and professional treatment

This thesis concerns the knowledge and experience of patients with regard to self-management and professional treatment of major depressive disorder (MDD). It is concluded that there are a substantial number of self-management strategies that patients can use and perceive as helpful to recover from- and to cope with their depression. Most helpful strategies include active coping with depression and engagement in social and working life. Interestingly, substantial overlap exists between the strategies van Grieken found and the strategies perceived to be helpful for other mental or somatic chronic diseases. A core generic set of helpful strategies across different chronic diseases may therefore be helpful. There also seem to be an overlap across the different phases of depression. The strategies may therefore be used in primary- , secondary- or tertiary care treatments. Strategies could be carried out with a gradual intensity of support by professionals. Professionals need to adjust their role to engage patients to have an active role in their own healthcare with the use of these strategies. Moreover, the patients’ perspective about helpful and impeding factors in treatment do not differ substantially from carers and professionals, and emphasize aspecific factors to be helpful, such as a good therapeutic relationship, empathy and hope. If professionals would encourage patients to involve carers into treatment and make both perspectives explicit, professionals could adjust the specific needs of depression treatment for each individual patient to develop personalized treatment, ameliorate shared goals, and consequently accomplish better satisfaction, treatment compliance and effectiveness.