The loss of sadness

From Scientific American:

Jonah Lehrer, the editor of Mind Matters, asked Allan Horwitz, professor of sociology at Rutgers University, and Jerome Wakefield, professor of social work at New York University, a few questions about their recent book, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Illness.

LEHRER: In your book, you take a critical look at major depressive disorder (MDD), a mental illness that will afflict approximately 10 percent of individuals at some point during their life. In recent decades, the number of cases of MDD has sharply increased. Are we currently experiencing an epidemic of depression? Or is this surge due to changes in diagnosis?

HORWITZ AND WAKEFIELD: Our book argues that, despite widespread beliefs to the contrary, the rate of depressive disorders in the population has not undergone a general upsurge. In fact, careful studies that use the same criterion for diagnosis over time reveal no change in the prevalence of depression. What has changed is the growing number of people who seek treatment for this condition, the increase in prescriptions for antidepressant medications, the number of articles about depression in the media and scientific literature, and the growing presence of depression as a phenomenon in popular culture. It is also true that epidemiological studies of the general population appear to reveal immense amounts of untreated depression. All of these changes lead to the perception that the disorder itself has become more common.

In fact, we think what has really changed is that since 1980 psychiatry and the other mental health professions have used a definition of depression that conflates genuine depressive disorder with intense, but normal, states of sadness. Since the third version of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III) was published in 1980 psychiatry has relied primarily on a list of symptoms for its definition of depressive disorder. So someone who has five symptoms out of a list that includes things like depressed mood, loss of interest in usual activities, insomnia, fatigue, lessened appetite, an inability to concentrate and similar symptoms for as brief a period as two weeks is considered to have a depressive disorder. (continue reading)

I question making any depression a disorder other than natural sadness as I think many of us have had lifetimes of issues that can cause great sadness, but it’s good to see it all being questioned in any case.

3 thoughts on “The loss of sadness

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  1. David: Awesome definition of “depression”! – Or, as Gianna says, not only of “depression” but of all mental distress. – Couldn’t but quote it in a post on my Danish blog, that I felt, I had to write because the Danish news reported “depression”-Google searches were skyrocketing in this country. One of the Danish hotshots shouts with joy: “It’s like the public is about to understand, that mental illnesses also are diseases. And that there in some cases – especially when it comes to depression – are good possibilities for treatment.” OMG!

  2. Yes, it is good to see it being questioned. I generally tend to think that depression is symptomatic of someone awakening to the dissonance of the world around them, rather than as symptomatic of themselves being a problem.

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