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Appendix 4

Sample interview

[13/12/89b - first interview]

<case 23>

<diagn adjustment>

<admit 01>

<intno 01>

<sex m>

<age 20>

<topic why>

<p M> OK, the obvious question that I always start off with is if you can just tell me why you're here.

<p P> Uh...because I committed [suici], I tried to commit suicide two times in two weeks, from the first one I did. Like the first time I did it, they let me out because I had to go and get my stomach pumped.

<p M> Out from here?

<p P> Uh........

<p M> Gen, JG_Strijdom?

<topic preadmit>

<p P> Uh, no.........The South, I had my stomach pumped out at the South_Rand hospital. Uh, they put me on a drip. Then Thursday they let me home. Then two weeks later I did it again, but this time I did it even more amount...of pills [ja]. It was 31, no the second time I did it was 31 lithium carbonate, and there was 11 calmettes and 5 sleeping pills. And the first time I had my stomach pumped out it wasn't, wasn't so bad because I was mostly unconscious, but the second time it was very painful because I was mostly awake [shit]. I kept on trying to puke, and uh...nothing came out. And afterwards I just sat up and I, it

just all came out [gmm].

<p M> It doesn't sound pleasant in the least.

<p P> No, it doesn't [laughs]. It's not very nice.

<p M> ...Could you maybe fill me in on the sort of details a bit more, you know, apart from the suicides? What, what brought it on and so on, over the past two, three weeks.

<p P> Uh, OK I was at College in X, because I was studying a panelbeating course, because my work sent me there. OK, and I was under a lot of pressure from that. I think that was one of, one of the reasons why I did it. And then I went back to, work, and then a guy that I was working with, they fired him, because he asked for a raise. He was a Black. And they put me with this Portuguese guy who uh didn't suit me so good. I didn't really like him. And...they still put me with him after the first time I did it [back again!]. And that even made me worse. And I even said to myself, here we go again. I couldn't handle it. Two days, and the third day again I cracked, I couldn't handle it. I went home, and took a overdose of pills, tried to kill myself.

<topic other>

<p M> ...Who have you been seeing, if anybody, like a psychiatrist or psychologist?

<p P> Uh, it's a Dr C, it's a female doctor...She's not, I don't think she's here, but she's got something to do with Valhalla.

<p M> Some connection with Tara.

<p P> Ja, she, she pulled some strings. Her and this other doctor, my house doctor Dr V.

<p M> I see. Uh, how long have you been seeing her?

<p P> Well I only went there the first time I did it, I went there on a Thursday after I left the hospital, I went to see her. And they drew some blood from me, to see how my blood is, and...they said I've probably got hepatitis, so [inaudible] a week. So she said to me I must come back on Thursday to check if I've properly got it. I went back. Uh...I, I had the symptoms of it, but I didn't have it [I see]. Because my eyes were all yellow, swollen up a bit, and all that. So I went there on a Thursday. So I've only seen her twice...And it wasn't really, how would you say...they didn't really get it all out at that time [ja], the first time, and the second time I went to her.

<topic profess>

<p M> What does she think of your difficulties, how does she sort of make sense of it?

<p P> Uh, I wouldn't really know, because I didn't. Like I gave to her the main pointers, like I was under a lot of pressure from, from college, I was coming back and worried about my

marks. And uh worried about work, especially this guy. [inaudible] Black was fine [inaudible] otherwise. And uh, and I was under a lot of pressure because I had just bought a new car...and the payments, when I was at X the payments got a bit, like I was supposed to be saving, but I wasn't, because it was so boring, eventually you'd just spend your money. When I came back I was under a lot of pressure. Like I was about a week away from date of having to pay and I only had [inaudible] rand in the bank. And it was over R260 I had to pay back for the car, you know? That was also bugging me. And...[inaudible] also because my mother and father are divorced...for the second, for the second time. Like the first time you think ah this is the pits man I haven't got a father man, I don't see him so often. You can't do the things you would like to do, you know [ja]. And uh...then they got married again, and I thought great I've got him back [ja]. And you just starting to get, like I used to do cycling with him [mmm], I got into that, you know and broke up again, and got divorced [mmm].

And started all over again. I think that's also one of the reasons [ja]. That's it, that I can think of.

<topic treat>

<p M> What do you hope, if anything, to get from being here? How do you think will it help you to be here?

<p P> Well, put it this way, I didn't want to come here. For one I heard from a patient at JG_Strijdom who said this place was all barbed wires and guard dogs around it, and all that. Which I saw for myself is not, it's...But I'd still rather be at home because I could, because I have to just finish something on my car which hasn't been finished. I must finish that. I would just like to get out, just get freedom you know [ja]. Like I'm not allow to, got to swim under supervision. Like if I swim I just swim you know, I'm a good swimmer. Uh...I'd like to go out, go to disco, movies...socialise with my friends quite a lot. Like all of them are in the motor trade [mmm]. One is a panel beater, one does, you know, piston what do you call it...he like grinds the pistons, different valves and that...

<p M> So over here you're kind of right out of that - away from everybody.

<p P> Ja. I'd still prefer to be home. Be able to do what I want.

<p M> If, if they do help you, how do you think will it happen?

<p P> How do I think it would happen? I think the only way it would happen is if I co-operate, and that's the only way I'm gonna get discharged from here quickly [ja]. So I'd rather co-operate.

<topic treatprof>

<p M> [laughs] Ja. What does uh the psychiatrist that you spoke to, what has she got in mind for you being here?

<p P> I dunno...I dunno. For one she must think I'm mad because I committed suicide, tried to commit suicide. I must seem a bit of a loony...And, I dunno...I dunno what she was thinking. I don't even know if she, I don't even think she knows I'm here. So...

<topic lay>

<p M> What about your folks. How do they make sense of what's happened to you?

<p P> ...Uh, how do you mean?

<p M> How would they explain it?

<p P> To me?

<p M> Or to somebody else maybe.

<p P> Well...Well the first time my mother, my father, and my mother's couple of friends knew about it...Well most of my mother's friends knew about it, and my father's. But uh the

second time I don't even think they wanted to tell their friends about it [inaudible]. And...I think that's more-or-less it...

<p M> Are they in favour of your being here?

<p P> They're in favour but I'm not.

<topic other>

<p M> Ja. Uh, would you say that you have, or experienced depression.

<p P> Yes, definitely. Uh...because of work, changes, like... going back, like at College we started at seven and finish off at two, and you relax the rest of the day, or study...And then

coming back to work is. You know like in a way going to College was like a holiday for me. And weekends we had free, didn't have to do, most of the week after College was free, except if we were studying. And then to go back to work, in a way made me so...angry, being back. Like when I was at, when I was at College like sometimes I wished I was back at work. When I'm at, when I'm at College I wish I was at, you know at work. And at College, and vice versa, or versa visa.

<topic define>

<p M> [laughs] Whichever. The story of one's life [ja]. Uh could you perhaps describe to me what depression is like, maybe pretending that I, I really have no idea.

<p P> ...Mmm...OK, uh, it's when, it's when, when all your...all your thoughts about what happened in the past, and maybe about what's gonna happen in the future, like come together, and they start working, like uh, making like, how would you say, like energy [ja]. And then, then you can't get rid of this energy and then working, and you, people moaning at you, that's going in also [ja]

[interruption for tea]

<p M> Uh, I don't know if you could sort of pick up the thread. You were sort of describing depression to me.

<p P> OK, it's when all like the energy builds up inside, inside your mind...And then you start start to uh...You start to wonder what to do with yourself, because you've got so much in your mind...And you just eventually do something drastic, or, or you just walk out on the job, or you try to commit suicide like I did [mmm]. And it's...especially if you don't have anybody to talk to, it even gets worse [ja], it stays in [ja], you know. Then you can't get it out, let your feelings...go out [ja]. That's what I think depression is [laughs].

<p M> Uh, very often people mention depression as at least one of the things that bother them and uh just about everybody has got their, their own version of depression, you know. Uh, I'm sure there are some official versions, but I'm not very clued up on that [inaudible] what people say themselves [inaudible] unofficial versions as well.

<p P> Ja.

<p M> Uh when do you get depressed, when does this build-up start?

<p P> Uh...say when you've had a hard day at work, or you......or something tragic has happened in you family, like say someone died, or even an animal that you, that you loved, you know?...

<topic measles>

<p M> Uh...OK, maybe I could ask you the sort of two gimmicky questions I have. The one is if you could tell me what's in your view, in what ways is depression the same as an illness like measles, and in what ways is it different?

<p P> Uh...Different to measles. OK, well measles is...uh, kind of, well it's a disease that most children get...And it's, you've just got to like lay [sic] down and relax, and depression

is different because you've got all this energy building up, and you want to get it out, and you want to talk to somebody...Like when you've got measles, like everybody knows you're sick [ja], you've got measles and they come and visit you and, you know, but depression nobody knows you've got it [ja]. Nobody knows you're say depressed. That's what I think the difference is.

<topic weight>

<p M> OK, the second gimmicky thing is basically the same question, but to do with a chronic weight problem.

<p P> [laughs] Uh...well, for me that wouldn't be a problem, because I'm not fat, so......OK...depression, the difference between fat?

<p M> Ja, and the ways in which it might be the same.

<p P> OK well, OK, OK say, say I'm fat, right? And I'm trying to lose all this weight, but I know it's going to be hard, so it's starting to worry me. So, and then trying to lose it,

I see shucks I haven't lost a kilo yet. And you keep on trying, and you still aren't losing, it's making you even angrier, and it's still building up inside of you, and, and you just want to,

like, scream!, because you're trying to lose all this weight... and you're so, and you're starting to get depressed. So I'd say it's more or less, the same [ja]. Because you're trying to lose

weight and the harder you're losing weight, you worried about losing weight also. And when you start to worry, you start to get depressed.

<topic purpose>

<p M> Uh, is there any point in being depressed? Can anything good come from it?

<p P> Uh......I'd say yes, it can be good points, and there could be bad points. Because a good point is you can talk to somebody and get that information out. And you feel [shwwwwww], that's a relief to get that out [ja, I see]. Then, a bad point of it is, if you don't, if you don't get it out, you don't talk to somebody, then you get more depressed, and more information goes into your brain. And if someone moans at you, you feel stuff them. Maybe they're right moaning at you. You know it, but you don't...want to take it, take that person's advice [mmm].

<p M> So you're sort of saying that the goodness of depression might be that it forces you to bring things out which you otherwise wouldn't have?

<p P> Ja, if you didn't have it.

<topic other>

<p M> OK, well uh the last thing is, if I see you again in two weeks

<p P> If I stay here

<topic prognosis>

<p M> Ja [laughs]. Uh, how do you predict will things have changed for you by then?

<p P> Well, as I'm not here out of my own will, uh I've got to try my best, I can only gain something, I can't lose anything [ja]. So I can only gain something, and go out, and give the world another bash, you know [ja]. See how it goes. Maybe, maybe this place would have helped me, and maybe I don't tell them anything.

<p M> How do you mean by that?

<p P> Maybe I don't want to tell them. Maybe, maybe it's too... personal for me to tell.

<p M> Right. I don't know to what extent they'll try and dig it out of you.

<p P> Maybe they haven't got a spade! [laughs]