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The Loss of Sadness - How psychiatry transformed normal sorrow into depressive disorder (Hardcover, 2., A1/4berarb.)
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The Loss of Sadness - How psychiatry transformed normal sorrow into depressive disorder (Hardcover, 2., A1/4berarb.)
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Depression has become the single most commonly treated mental
disorder, amid claims that one out of ten Americans suffer from
this disorder every year and 25% succumb at some point in their
lives. Warnings that depressive disorder is a leading cause of
worldwide disability have been accompanied by a massive upsurge in
the consumption of antidepressant medication, widespread screening
for depression in clinics and schools, and a push to diagnose
depression early, on the basis of just a few symptoms, in order to
prevent more severe conditions from developing.
In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield
argue that, while depressive disorder certainly exists and can be a
devastating condition warranting medical attention, the apparent
epidemic in fact reflects the way the psychiatric profession has
understood and reclassified normal human sadness as largely an
abnormal experience. With the 1980 publication of the landmark
third edition of the Diagnostic and Statistical Manual of Mental
Disorders (DSM-III), mental health professionals began diagnosing
depression based on symptoms--such as depressed mood, loss of
appetite, and fatigue--that lasted for at least two weeks. This
system is fundamentally flawed, the authors maintain, because it
fails to take into account the context in which the symptoms occur.
They stress the importance of distinguishing between abnormal
reactions due to internal dysfunction and normal sadness brought on
by external circumstances. Under the current DSM classification
system, however, this distinction is impossible to make, so the
expected emotional distress caused by upsetting events-for example,
the loss of a job or the end of arelationship- could lead to a
mistaken diagnosis of depressive disorder. Indeed, it is this very
mistake that lies at the root of the presumed epidemic of major
depression in our midst.
In telling the story behind this phenomenon, the authors draw on
the 2,500-year history of writing about depression, including
studies in both the medical and social sciences, to demonstrate why
the DSM's diagnosis is so flawed. They also explore why it has
achieved almost unshakable currency despite its limitations. Framed
within an evolutionary account of human health and disease, The
Loss of Sadness presents a fascinating dissection of depression as
both a normal and disordered human emotion and a sweeping critique
of current psychiatric diagnostic practices. The result is a potent
challenge to the diagnostic revolution that began almost thirty
years ago in psychiatry and a provocative analysis of one of the
most significant mental health issues today.
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