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The Loss of Sadness. How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Allan V. Horwitz and Jerome C. Wakefield. Depression has .
Table of contents
- The Loss of Sadness - Hardcover - Allan V. Horwitz; Jerome C. Wakefield - Oxford University Press
- Frequently bought together
- The Loss of Sadness
- The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder
Do they all have mental disorders? The authors' analysis derives from Wakefield's definition of mental disorders as "harmful dysfunctions" arising from abnormalities in the evolved mechanisms that regulate emotions and behavior. Emotions, including negative emotions such as anxiety and sadness, exist only because they gave a selective advantage in certain situations.
Normal and abnormal emotions can be distinguished only by determining if the person is in one of those situations. Loss is certainly the crucial situation that elicits sadness, but is depression just excessive sadness as the authors report? Many now believe that sadness and normal depression symptoms are aroused by different situations: Horwitz and Wakefield review this research, but they do not pursue the implications, perhaps because the task of deciding what is and what is not normal is already problematic enough.
The authors also imply that drug treatment is appropriate mainly for persons with disorders. However, general physicians routinely use medications to block the suffering associated with normal protective responses, such as pain and cough. A genuinely medical model for psychiatry would try to find and correct whatever is arousing anxiety, depression, or other defensive responses.
If the cause cannot be found or corrected, then treatment to block the defense and relieve suffering is entirely appropriate. However, general physicians know the purpose of pain and cough.
The Loss of Sadness - Hardcover - Allan V. Horwitz; Jerome C. Wakefield - Oxford University Press
Psychiatrists lack comparable knowledge about when low mood is useful. This is the missing foundation on which scientific diagnostic criteria for depression will eventually be constructed. For now, Horwitz and Wakefield's suggestion is sensible; the diagnosis of major depression should be excluded if symptoms result from major life events.
If this book cannot change the DSM criteria for depression, nothing will. The authors emphasize how many interests converge to block major corrections in DSM. But I will wager that future historians will give equal weight to current psychiatry's imitation of the reductionist methods that have worked so well in the rest of medicine, even though what we lack is a functional understanding of emotions comparable to the functional framework physiology offers for the rest of medicine.
We've noticed that you're using an ad blocker Our content is brought to you free of charge because of the support of our advertisers. Okay, I get it. Mar 20, Sally rated it really liked it Shelves: A well-argued refutation of the validity of broadening of the definition of depression to include normal sadness, as has happened with using strictly symptomatic diagnositic criteria.
The authors propose a return to the criteria used since antiquity through most of the 20th century, that include context, so that depression is sadness "without cause" or "without proportional cause. That the book has a foreword by Robert Spitzer, father of the DSM, even though the authors' position opposes that in the DSM, says to me that this is a consideration of the issue by top scholarly players.
Mar 28, Bob rated it really liked it. This book is written by two very thoughtful professionals in the field who do not want to see every human thought, feeling and emotion turn into an over-treated disease, disorder or condition, and then medicated.
Frequently bought together
Some mood swings maybe many and emotional adjustments are simply normal reactions to life. So why are so many people in this country seemingly suffering from depression and why are anti-depressants one of the biggest selling drugs? The answer is that the definition of depression has been set in such a way that many more people than should will be diagnosed as suffering from depression.
Many then, and are, being medicated who are not really suffering from depression but are simply responding to a life circumstance, like the loss of a job or the breakup of a romantic relationship. The problem is that reaction to these life events will express the same symptoms as those delineated in the latest version of the mental health diagnostic manual, the DSM, which has broaden what depression.
And in some circles they all should be medicated, at least if we loved them they would be.
In the end we must remember that sadness is an inherent part of the human condition, not a mental disorder. The desire to banish all bad feelings from life reveals a disturbing; one might even say a less than human view of life, philosophy as to the way life should be lived. Jun 22, Christopher Dubey rated it liked it Shelves: I read the first chapter and part of Chapter 2. I agree with the basic premise that contemporary psychiatry is wrongfully overdiagnosing sadness as a disorder.
However, the writing is repetitive, dry, and often abstract, despite well-done references. There are unnecessary literary quotes, like of Mary Shelley.
The Loss of Sadness
The authors also make assertions that might appear logical, but actually lack good reasoning. I especially dislike their assertions about what human behaviors are 'designed by natural sele I read the first chapter and part of Chapter 2. I especially dislike their assertions about what human behaviors are 'designed by natural selection,' which are unfounded and as faith-based as religious beliefs. And I have a science degree, so I'm not against science.
As someone in Mad Pride and antipsychiatry, the basic premise is an important one, but it's been done before and I think the authors' arguments would have been better as an essay than a book-length manuscript. Jun 26, Stan rated it really liked it. The book makes a compelling case for how the practice of psychiatry has conflated sadness with major depressive disorders MDD. The book goes into more detail than many readers will feel is necessary, but it is certainly worth a look.
Mar 11, Libby marked it as put-down-for-good Shelves: It's smart, insightful and balanced. Unfortunately, it also keeps putting me to sleep. Jul 17, Jenny rated it really liked it. Liked it, but then it agreed with many of my own opinion of psychiatry. I think the idea of normal sadness is something we need to deal better with in the mental health field.
Oct 02, Varsha Naik rated it liked it.
The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder
Aug 01, Doreen rated it it was amazing. Well worth the read so far. David rated it it was amazing Aug 18, Paul rated it liked it Feb 05, Hakim Zamani rated it it was ok Jun 29, Jennifer rated it really liked it May 14, Joshua rated it liked it Dec 13,