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The Loss of Sadness (Paperback)
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The Loss of Sadness (Paperback)
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Total price: R1,084
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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 a relationship-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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