Wednesday, April 30, 2008

The Loss of Sadness

by Allan V. Horwitz and Jerome C. Wakefield

Two researchers are making a case — no coincidence that revisions are underway for a fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — that the diagnostic criteria for Major Depression have led to over-diagnosing and the pathologizing of normal sadness. Long story short: the DSM entry for depression makes an exemption for bereavement but not for other significant life events (romantic betrayal, financial woes, and so on and so forth) that can result in profound sadness, i.e., can cause symptoms that meet the criteria for a diagnosis of depression if the symptoms are taken in isolation and no consideration is given to the context in which they arose, which leads to people being medicated for normal kinds of sadness that would abate with time, ultimately feeding the expectation that no one need ever feel sad and "there ought to be a pill for that."*

Ultimately, I think the book is too in-depth and sometimes too technical for a lay audience. I actually learned everything I wanted to know from this lengthy review.

*See also my review of Happiness: a history.

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