From “Suem Sao” to “Rok Suem Sao” and After: An Ethnography of the Diagnosis and Treatment of University Students Diagnosed with Major Depressive Disorder

Abstract

This ethnographic study explored the subjectification and psychiatrization journeys of Bangkok youths who went from realizing they were suffering from Suem Sao (Depression) to being diagnosed with Rok Suem Sao (Major Depressive Disorder). Through ethnographic interviews, the research examined how cultural perceptions and societal stigma influenced the acceptance and internalization of their depression diagnosis and its social and personal consequences. Focusing on seven young adults, a complex interplay between culture and medical diagnosis was revealed. Firstly, pre-psychiatrization, participants generally accepted their psychiatric labels, often due to the perceived authority and credibility of professionals. Secondly, during psychiatrization, some participants felt dissatisfied with the treatment as doctors strongly relied on prescriptions and lacked communication skills, particularly incorporating inappropriate scenarios of Dhamma into the treatment or unintentionally gaslighting conversation. Thirdly, post-psychiatrization, this study documented the pervasive stigma associated with depression, which significantly impacts an individual’s willingness to seek help, tell others, and their subsequent treatment experiences, such as discrimination, feelings of hiding, and burden from having depression, particularly in academic environments. Participants reported a range of responses to their diagnoses, from relief at having their feelings validated by doctors to continued struggles with accepting their condition amidst ongoing stigmatizations.