Lived Experiences of Recovery from Severe Depression with Psychotic Symptoms and Suicidal Behaviors: A Phenomenological Study
Abstract
1. Introduction
Mental Health Care in the Thai Context
2. Materials and Methods
3. Results
3.1. Understanding and Reframing Internal Experiences
3.1.1. Making Sense of Trauma as a Step Toward Healing
“…I felt myself falling into a dark hole, filled with pain that wouldn’t go away. I couldn’t tell where I ended and the pain began. My thoughts and feelings were too much. I couldn’t breathe. There was no way out, only pain and the thought of death. But when I truly felt how deep the pain was, something in me started to look for a way to keep going…”(P6)
“…For a long time, I tried to forget everything. I thought ignoring it would make it disappear, but it only made the memories stronger. When I finally admitted to myself that I had been hurt, I could begin to understand why I felt so broken—and that I didn’t deserve to suffer in silence…”(P2)
3.1.2. Reconstructing Self-Narratives with Compassion
“…I used to see myself as broken and weak, like my story was only about failure. But when I stopped asking what was wrong with me and started asking what I needed, something shifted. I began to see someone who was trying, surviving, and worthy of kindness—not a problem to be fixed, but a person to be cared for…”(P2)
“…I always thought I was the problem—that I was weak, lazy, or just too broken. But in therapy, I started to look at myself differently. I began to see someone who had been trying to survive impossible things. That changed everything. I wasn’t just a diagnosis anymore; I was a human being with a story that mattered…”(P7)
3.2. Drawing Strength from Therapy, Relationships, and Self-Care
3.2.1. Therapy as a Journey of Self-Discovery, Healing, and Transformation
“…At my lowest, the voices in my head told me to end it all. I was lost, terrified, and certain death was my only way out. But beyond the medication, it was the emotional support that brought me back. With time, I began to feel, to see my thoughts and pain not as enemies, but as part of me. This care gave me the strength to face my darkest fears and made me believe that healing is possible, that life can begin again…”(P1)
“…Through psychotherapy, I began to feel a deep shift within. I started to understand my emotions, thoughts, and true needs, and how they were shaped by my past. I realized I could choose healing over pain. I opened myself to love, worth, and acceptance. I learned to protect and care for myself with compassion. I saw the child within me and chose to nurture that part with kindness. I am no longer alone. I am free to grow, to connect, and to believe that change is truly possible…”(P5)
3.2.2. Meaningful Relationships Built on Empathy and Mutual Care
“…At my darkest moments, all I needed was one person by my side, willing to listen without judgment and simply be with me. Their empathy and care gave me the strength to face pain and fear, making me feel seen, heard, and truly supported. These relationships became a lifeline, showing me that I wasn’t alone and that I was worthy of healing…”(P8)
“…When I couldn’t trust myself, I borrowed trust from others. My friend didn’t try to fix me—she just stayed. Sometimes she sat with me in silence. That silence meant more than words. It told me that I was worth being with, even at my worst…”(P4)
3.2.3. Self-Reconnection Through Understanding, Acceptance, and Compassionate Care
“…I began to return to myself, to sit with my pain without running from it. I stopped fighting my thoughts and allowed space for them to just be. As I let go of others’ expectations and met myself with kindness, I felt something shift. In that quiet acceptance, I found strength, stillness, and a sense of coming home…”(P3)
“…For a long time, I hated the parts of me that felt too much—too sad, too anxious, too fragile. But the more I tried to suppress those parts, the worse I felt. One day I decided to stop fighting and started listening instead. I realized those parts were trying to protect me. That changed everything. I didn’t need to get rid of them—I needed to care for them…”(P6)
3.3. Gradually Regaining Agency, Identity, and Meaning in Life
3.3.1. Restoring Autonomy and Decision-Making
“…For a long time, I felt like I had no control over my life. But as I began making small choices for myself, I started to feel more present, more alive. Each decision reminded me that I still had power, that my voice mattered…”(P9)
“…Even choosing what to eat felt like a big deal in the beginning. I had spent so long letting others decide for me, or just not caring at all. But the day I said, ‘No, I want this,’ I felt something shift. It wasn’t about the food—it was about realizing that I had a say in my life again…”(P7)
3.3.2. Rebuilding a Sense of Self by Rediscovering Identity
“…I had lost myself in trying to meet others’ expectations, but through reflection, I began to reconnect with who I truly was. It wasn’t about creating a new identity, but remembering the person I was before the pain. Rediscovering myself gave me the strength to move forward with purpose…”(P7)
“…For a long time, I only saw myself through the lens of depression—like that was all I was. But slowly, I started remembering the things I loved, the things that made me feel like me. Music, art, just walking in nature. Those weren’t cures, but they reminded me that I was more than my illness. That I still existed beyond the pain…”(P3)
3.3.3. Finding Meaning and Purpose in Life Through Growth and Connection
“…Through my journey, I began to see that my life could hold meaning beyond the pain I had experienced. I found purpose in my growth, in the connections I built with others, and in the ways, I could contribute to the world around me. It was through these relationships and the personal growth I embraced that I started to feel whole again. My struggles no longer defined me; instead, they became a part of my story, one that has meaning and direction…”(P4)
“…When I started volunteering at the crisis center, I wasn’t just surviving—I was showing others they weren’t alone. My pain taught me to listen and care. I never thought the hardest parts of my life could become meaningful, but they did. Helping others gave my story a purpose I never imagined…”(P6)
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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| Subthemes | Themes |
|---|---|
| Making Sense of Trauma as a Step Toward Healing | Understanding and Reframing Internal Experiences |
| Reconstructing Self-Narratives with Compassion | |
| Therapy as a Journey of Self-Discovery, Healing, and Transformation | Drawing Strength from Therapy, Relationships, and Self-care |
| Meaningful Relationships Built on Empathy and Mutual Care | |
| Self-Reconnection through Understanding, Acceptance, and Compassionate Care | |
| Restoring autonomy and decision-making | Gradually Regaining Agency, Identity, and Meaning in Life |
| Rebuilding a Sense of Self by Rediscovering Identity | |
| Finding Meaning and Purpose in Life through Growth and Connection |
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© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Aekwarangkoon, S.; Ward, E.; Duangsai, S.; Jearawattanakul, S. Lived Experiences of Recovery from Severe Depression with Psychotic Symptoms and Suicidal Behaviors: A Phenomenological Study. Int. J. Environ. Res. Public Health 2025, 22, 1606. https://doi.org/10.3390/ijerph22111606
Aekwarangkoon S, Ward E, Duangsai S, Jearawattanakul S. Lived Experiences of Recovery from Severe Depression with Psychotic Symptoms and Suicidal Behaviors: A Phenomenological Study. International Journal of Environmental Research and Public Health. 2025; 22(11):1606. https://doi.org/10.3390/ijerph22111606
Chicago/Turabian StyleAekwarangkoon, Saifon, Earlise Ward, Sirintra Duangsai, and Sangtien Jearawattanakul. 2025. "Lived Experiences of Recovery from Severe Depression with Psychotic Symptoms and Suicidal Behaviors: A Phenomenological Study" International Journal of Environmental Research and Public Health 22, no. 11: 1606. https://doi.org/10.3390/ijerph22111606
APA StyleAekwarangkoon, S., Ward, E., Duangsai, S., & Jearawattanakul, S. (2025). Lived Experiences of Recovery from Severe Depression with Psychotic Symptoms and Suicidal Behaviors: A Phenomenological Study. International Journal of Environmental Research and Public Health, 22(11), 1606. https://doi.org/10.3390/ijerph22111606
