The Manifest and Latent Structures of Medicalization and Psychologization in Lay Depression Discourses — A Word Embedding Analysis of Online Forums

Abstract

Online depression forums are emerging platforms of the e-mental health sector. Exploring the ongoing lay discourses has the potential of better understanding first-person accounts of depression and developing new technologies of health promotion. Based on these premises, the article analyzes the hypothesis concerning the discursive transformation of sadness into depression (elaborated by Horwitz and Wakefield), that is the ‘medicalization’ and ‘psychologization’ of social suffering. While these generic theoretical diagnoses describe a long-term discursive transformation, they rely on a limited methodological toolset as they are based on the retrospective examination of key discursive sources (such as the consequent generations of DSM). While these analyses certainly have a heuristic value, their conclusions require further empirical testing. Our analysis focuses on the largest English-language online depression forums, while relying on word-embedding modelling. Our results do not simply reinforce or falsify the original hypotheses; instead, they imply a more complex model: on manifest level, the medicalization or psychologization of social suffering is detectable only partially; however, on a latent level, many of these solutions still follow either an instrumental-medical or a supportive-psychological logic. Based on these results, the reinforcement of online forums hosting social suffering discourses of depression is suggested.