Research Article Qualitative Health Research 2024, Vol. 0(0) 1–13 © The Author(s) 2024 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/10497323241274723 journals.sagepub.com/home/qhr “Accepting the Poem of Destiny”: Identity Reconstruction in a Chinese Online Depression Community Xin Li 1 and Kaibin Xu 2  Abstract As online health communities become important platforms for people with depression to express themselves, digital narratives provide a lens for understanding their identity work. Drawing on the communication theory of identity (CTI), this article explored the members’ identity reconstruction by analyzing their narratives posted in a Chinese online depression community. The four levels of identities constructed by the members include “laggard” and “pioneer” at the personal layer, “idler” and “fighter” at the enacted level, “stress-maker” and “escaper” at the relational layer, and support providers and receivers at the communal layer. These identities at different levels usually interact in the narratives, showing that identity gaps exist among the members. The study shows that the members’ autobiographical accounts of depression entail multiplicities and ambivalences, denying the dominant and stigmatizing representation of it by common sense and the media as a reductionist downward and one-way experience that is valueless and offers no possibility for personal growth. The findings regarding the communal level of identity show that narratives can help the narrators to create bonds of solidarity of an experience that is often marginalized. Keywords depression; identity; illness narrative; digital narrative; online health community Depression is one of the most common types of psy- chiatric disorders and refers to an individual “who, for 2 weeks or longer, becomes depressed, loses interest, or is unable to feel happy in everyday activities, accompanied by problems in specific areas such as sleep, eating, energy, concentration, or self-worth” (American Psychiatric Association, 2013). By affecting the individual both physically and mentally, depression increases the health risks of the individual (WHO, 2022). It also disrupts individuals’ social functioning and their ability to function in the family, school, and performance at work (Lerner et al., 2010). The prevalence of depression and the rel- evant social consequences have made it a major public health issue affecting the globe. China has approximately more than 54 million people suffering from depression, among whom 30 million are adolescents (Depression Research Institute, 2020). Depression among college students has also become a common social phenomenon (Liu et al., 2019). The chronic, recurrent, and harmful nature of depression disrupts people’s daily life and conception of the self. In the face of identity threats posed by major life changes, people often make identity adjustments and create new identities to adapt to current life circumstances, such as modifying goals and expec- tations for the future, adapting to the harm, and under- standing emotional responses (Voorhees, 2023). Managing the impact of the illness and normalizing life is a manifestation of the affected individual’s adoption of the new identity (Charmaz & Rosenfeld, 2010). However, stigmatization in society and mass media influences the identity reconstruction of people living with depression. As a form of negative feedback, stigmatization not only undermines the well-being of people with depression but also leads them to develop an identity crisis and reduces 1 College of Communication Science and Art, Chengdu University of Technology, Chengdu, China 2 Foreign Studies College, Hunan Normal University, Changsha, China Corresponding Author: Kaibin Xu, Foreign Studies College, Hunan Normal University, Changsha 410081, China. Email: 2103477077@qq.com