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The Loss of Sadness
How psychiatry transformed normal sorrow into depressive disorder
Allan V. Horwitz and Jerome C. Wakefield
304 pages
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234x156mm
978-0-19-531304-8
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Hardback
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21 June 2007
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This item is printed to order and supplied on a firm sale basis. Items which are printed to order are normally despatched and charged within 5-10 days.
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- Controversial, high-profile thesis that depression is largely a made-up phenomenon by the mental health profession
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.Readership: Broad audience of both specialist and non-specialist health professionals (including mental health professionals - psychiatrists, clinical psychologists, epidemiologists, social workers, sociologists), and general readers.
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Allan V. Horwitz, Professor of Sociology, Rutgers University, USA, and Jerome C. Wakefield, Professor of Social Work, New York University, USA
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"...one of the most important books in the field of psychiatry published in the last few years...a brilliant book with a significance well beyond its narrow but important subject." - Spectator "This wonderful book will alter professional thinking." - Nursing Standards "...an interesting and thought-provoking book that underscores the need to examine more fully each patient's psychological illness and the factors contributing to it...[a good book for] anyone interested in understanding depression more fully and the place normal sadness has in our society." - Doody's Notes "...[this book] could alter the official definition of depression, change the way we get mood-enhancing
drugs, and clarify how effectively our culture delivers well-being." - Reason Magazine "Allan Horwitz and Jerome Wakefield's important book... is part of a gathering blowback against the pathologisation and medicalisation of the ordinary human condition of sadness after loss... what they do accomplish in critiquing psychiatric diagnosis of depression is important enough to make much of this book required reading for depression researchers and clinicians." - The Lancet "...a work of deep scholarship..." - Hugh Freeman, Times Literary Supplement
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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
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