“Am I Truly Depressed or Just Pretending To Be?” A Discourse-Analytical Approach to Online Illness Narratives by People Living With Depression on Zhihu

This study employs an integrated discourse-analytic approach, synergizing semantic macro-analysis with the appraisal framework in Systemic Functional Linguistics, to investigate how individuals with depression in China struggle to make sense of their illness through narratives shared on Zhihu. Our analysis identifies three recurrent thematic stages in this sense-making process. The first, “Am I truly depressed or not,” is featured by personal emotions of insecurity, disinclination, and unhappiness, reflecting a wavering illness identity during the early stages. The second, “I can’t have depression,” reveals a shift toward institutionalized emotions, marked by negative self-judgments of tenacity, capacity, and veracity, alongside personal dissatisfaction, which embodies deeper identity conflict and denial as the illness progresses. The third, “You are just sick,” centers on appreciation like positive valuation and composition, through which recovered or recovering individuals articulate constructive understandings of the illness and appropriate coping strategies. The study analyzes and discusses the barriers that impede illness definition and opportunities that facilitate this process. The findings provide valuable insights for developing culturally-sensitive clinical interventions and public health communication strategies that can better support depression patients in navigating their illness experiences in the Chinese context.