baldclutchIn an abbreviated version of the argument they expound in their book The Loss of Sadness: How Psychiatry Transformed Normal Misery Into Depressive Disorder, psychologists Allan Horwitz and Jerome Wakefield say that the epidemic of depression arises from changes in the definition of the disorder, and specifically the loss of context. There is a bereavement exclusion but it is the only place where psychiatrists recognize that there is a difference between a ‘normal’ reaction to a painful loss and a depressive disorder. In fact, in my training, the ‘naive’ comment, “You would be sad too if that was going on in your life” was presented derisively as the caricature of ignorance about depression. The ‘bible’ of psychiatric diagnoses, The Diagnostic and Statistical Manual (DSM), currently in its fourth edition, devalued the time-honored recognition by physicians that the context in which symptoms arose was an important considderation in determining whether what the person was experiencing was normal. This goes hand in hand with other pressures in my field to medicalize and pathologize normal emotional reactions, of which I have written with concern here in the past.

via Psychiatric Times