基本説明
New in paperback. Hardcover was published in 2007. Argues that the increased prevalence of major depressive disorder is due not to a genuine rise in mental disease, as many claim, but to the way that normal human sadness has been "pathologized" since 1980 when DSM-III was published.
Full Description
The Loss of Sadness argues that the increased prevalence of major depressive disorder is due not to a genuine rise in mental disease, but to the way that normal human sadness has been 'pathologised' since 1980. That year saw the publication of the landmark third edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-III), which has since become a dominant force behind our current understanding of mental illness overall. As concerns at least major depression, the authors argue that the DSM's definition of the condition is too broad and that as a result virtually all research and clinical approaches to the condition have been based on a flawed understanding about it. The social, political, and scientific implications of this are far-reaching - from the overselling of antidepressants to treat ordinary sadness, as Big Pharma exploits the DSM for its own purposes; to intrusive and expensive depression screening programs at all levels of society, as well-meaning but misguided initiatives translate the DSM into simple terms to catch any whiff of depressive pathology in our midst; and funded research into the 'epidemic' of depression, which advances the field very litttle and the public even less. Ultimately, the definition of depression that is in operation today has formed the basis for an entire system of social control (e.g. community-wide screening initiatives, intrusive public health policy) that benefits psychiatry, primary care providers, and the pharmaceutical and insurance industries by turning everyone else into a potential consumer of services, needed or not. The authors do recognise that depression is a devastating illness that affects some people. Their chief concern is with the use of this diagnosis as a catch-all for anyone who has experienced sadness for more than a few weeks at a time. The result is a pointed yet nuanced critique of modern psychiatry that will stir controversy of the sort that will reacquaint us with sadness as a primary human emotion and that could productively influence the way that depression the actual illness is characterised in the future.
Contents
1. The concept of depression ; 2. The anatomy of normal sadness ; 3. Sadness with and without cause: depression from ancient times through the nineteenth century ; 4. Depression in the twentieth century ; 5. Depression in the DSM-IV ; 6. Importing pathology into the community ; 7. The surveillance of sadness ; 8. The DSM and biological research about depression ; 9. The rise of antidepressant drug treatments ; 10. The failure of the social sciences to distinguish sadness from depressive disorder ; 11. Conclusion
