The Loss of Sadness

Paperback | April 5, 2012

byAllan V. Horwitz, Jerome C. Wakefield

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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 beenaccompanied 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 normalhuman 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, andfatigue - 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 normalsadness 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 diagnosisof 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 currencydespite 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 diagnosticrevolution 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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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 beenaccompanied by a massive upsurge in the consumption of...

Allan V. Horwitz, PhD, is Board of Governors Professor of Sociology at Rutgers University. He is the author of numerous articles and books on various aspects of the sociology of mental illness including The Social Control of Mental Illness, Creating Mental Illness, and, with Jerome C. Wakefield, All We Have to Fear (forthcoming from Ox...

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Format:PaperbackDimensions:304 pages, 6.1 × 9.21 × 0.59 inPublished:April 5, 2012Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199921571

ISBN - 13:9780199921577

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Table of Contents

Robert L. Spitzer: Foreword1. The Concept of Depression2. The Anatomy of Normal Sadness3. Sadness With and Without Cause: Depression From Ancient Times Through the Nineteenth Century4. Depression in the Twentieth Century5. Depression in the DSM-IV6. Importing Pathology Into the Community7. The Surveillance of Sadness8. The DSM and Biological Research About Depression9. The Rise of Antidepressant Drug Treatments10. The Failure of the Social Sciences to Distinguish Sadness from Depressive Disorder11. ConclusionNotesReferencesIndex