Feature

Treating sadness as a mental disorder

All sadness is not a

Allan Horwitz and Jerome WakefieldThe Philadelphia Inquirer

All sadness is not a “psychological disorder,” said sociologists Allan Horwitz and Jerome Wakefield. But try telling that to the psychiatric establishment. In the official diagnostic manual used by mental-health professionals, depression is defined as two continuous weeks of such symptoms as despondency, diminished pleasure in life, and difficulties in sleeping and eating. In the manual, it doesn’t matter why a person is despondent. If you’ve lost your job, or your romantic partner dumped you, or you’ve been given a diagnosis of cancer, you’re still deemed “clinically depressed’’ if you’re sad for two weeks or more. This goes a long way to explaining why the number of Americans diagnosed with depression has soared by 300 percent in recent years, while the use of antidepressants has also exploded. Real depression is a serious mental illness, but it’s a disservice to conflate it with sadness that’s a normal response to a serious loss. Context counts. Being sad after a major setback or disappointment is “a normal part of human nature” and, in fact, may serve an important purpose, such as giving us a “time-out’’ to grapple with what’s happened. Some feelings should be felt, not medicated.

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