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Abstract
Metaphors are essential for articulating emotional and psychological experiences that resist literal expression, especially in contexts of mental illness. This study explores how Malay-speaking individuals diagnosed with Major Depressive Disorder (MDD) use metaphorical language to express emotional distress, identity, and cultural meaning. Drawing on 38 clinical interviews conducted at the University of Malaya Medical Centre, metaphorical expressions were identified using the Metaphor Identification Procedure (MIP), complemented by Frame Semantics, Affective Metaphor Theory, and Critical Metaphor Analysis. Six dominant metaphor themes emerged confinement, burden, descent, disconnection, combat, and divine trial each reflecting cognitive schemas and Malay-Muslim cultural scripts. Particular attention is given to metaphor simile hybrids and polysemous anchors, which carry affective and spiritual meaning. The study demonstrates how metaphor’s structure lived experiences and mediate between individual suffering and cultural worldviews. These findings contribute to ongoing debates in metaphor research on cross-cultural variation, affective intensity, and clinical communication. The study advocates for metaphor literacy in mental health settings. It aligns with recent work in metaphor studies that emphasize discourse, stigma, and identity in mental health narratives.