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

By Allan V. Horwitz and Jerome C. Wakefield
(Oxford University Press, 2007)

There is an apparent epidemic of depressive disorder in this country if current statistics are to believed—one out of 10 Americans suffers this illness, and another 25 percent experience depression at some point in their lives. In response to this is a massive upsurge in the consumption of antidepressant medication and a push to diagnose depression early in order to prevent more severe conditions from developing.

Rutgers University professor Allan V. Horwitz and Jerome C. Wakefield, University Professor and professor of social work at NYU, argue in their recent book, The Loss of Sadness, that while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic actually reflects the way the psychiatric profession has reclassified normal human sadness—largely as an abnormal experience.

Since the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders, mental health professionals have been diagnosing depression based on symptoms that last for at least two weeks. The DSM system is fundamentally flawed, the Horowtiz and Wakefield maintain, because it fails to take into account the context in which the symptoms occur. They stress the importance of distinguishing between abnormal reactions due to internal dysfunction and normal sadness brought about by external circumstances, such as the death of a loved one, the loss of a job, the diagnosis of a serious physical illness, etc.

The Loss of Sadness is a pointed critique of modern psychiatry’s approach to major depression. By challenging the very means by which depression is diagnosed, this work is certain to spark debate for years to come.

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