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

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

The Surveillance of Sadnes
If you are a typical resident of New York City, the chances are that you+U0027ll visit your primary care physician at some point over the next year. If your doctor follows the advice of the New York City Commissioner of Mental Health, he or she will ask you to fill out a questionnaire that asks: [Over the past 2 weeks, how often have you been bothered by any of the following problems?]1Each of nine symptoms are rated as 0 (not at all), 1 (several days), 2 (more than half the days), or 3 (nearly every day). Here are the nine symptoms:
1. Little interest or pleasure in doing things.
2. Feeling down, depressed, or hopeless.
3. Trouble falling or staying asleep, or sleeping too much.
4. Feeling tired or having too little energy.
5. Poor appetite or overeating.
6. Feeling bad about yourself, or that you are a failure or have let yourself or your family down.
7. Trouble concentrating on things, such as reading the newspaper or watching T V.
8. Moving or speaking so slowly that other people could have noticed; or the opposite, being so fidgety or restless that you have been moving around a lot more than usual.
9. Thoughts that you would be better of dead, or hurting yourself in some way.

The instrument is scored as follows: if five or more of the nine symptoms, including one of the first two, score 2 or 3 (a total score of at least 10), then you would receive a diagnosis of Major Depressive Disorder; you would be diagnosed with minor depressive disorder if at least two questions, including one of the first two, fall in the 2 or 3 range (a total score of at least 4). For example, if you felt down and tired most days for the past 2 weeks (i.e., for 8 days or more), you would qualify for a diagnosis of minor depressive disorder; if on most days for

-144-

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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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