The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder

By Allan V. Horwitz; Jerome C. Wakefield | Go to book overview

The Concept of Depression

The poet W. H. Auden famously deemed the period after World War II the [age of anxiety.]1For Auden, the intense anxiety of that era was a normal human response to extraordinary circumstances, such as the devastation of modern warfare, the horrors of the concentration camps, the development of nuclear weapons, and the tensions of the cold war between the United States and the Soviet Union. Were Auden still alive, he might conclude that the era around the turn of the twenty-first century is the [age of depression.]2There would, however, be a crucial diference between the two characterizations: whereas the age of anxiety was viewed as a natural response to social circumstances that required collective and political solutions, ours is viewed as an age of sadness that is abnormal—an age of depressive psychiatric disorder that requires professional treatment.

Consider Willy Loman, the lead character in Arthur Miller+U0027s classic play Death of a Salesman and possibly the fictional character most representative of American life during the decades following World War II.3As he enters his 60s, despite his fervent belief in the American dream that hard work will lead to success, Willy Loman has never accomplished very much. He has heavy debts, his health is failing, he is barely able to continue working at his job as a traveling salesman, and his sons despise him. When he is finally fired from his job, he is forced to admit to himself that he is a failure. He kills himself in an automobile accident in the hope of getting his family some money from an insurance settlement. The tremendous popularity of Death of a Salesman on its introduction on Broadway in 1949 stemmed from Willy Loman+U0027s embodiment of the Everyman in American life who embraced the goal of achieving great wealth but found himself destroyed by it.

Death of a Salesman received a very different response during its revival 50 years later.4According to a piece in The New York Times titled [Get That Man Some Prozac,] the director of the revived version sent the script to two psychiatrists, who diagnosed Loman as having a depressive disorder.5The playwright, Arthur Miller, objected to this characterization, protesting: [Willy Loman is not

-3-

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The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder
Table of contents

Table of contents

  • The Loss of Sadness - A Textbook iii
  • Foreword vii
  • Preface xi
  • Contents xv
  • 1: The Concept of Depression 3
  • 2: The Anatomy of Normal Sadness 27
  • 3: Sadness with and Without Cause 53
  • 4: Depression in the Twentieth Century 72
  • 5: Depression in the Dsm-Iv 104
  • 6: Importing Pathology into the Community 123
  • 7: The Surveillance of Sadness 144
  • 8: The Dsm and Biological Research About Depression 165
  • 9: The Rise of Antidepressant Drug Treatments 179
  • 10: The Failure of the Social Sciences to Distinguish Sadness from Depressive Disorder 194
  • 11: Conclusion 212
  • Notes - Notes 227
  • Reference 249
  • Index 281
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