A snippet from this recent report in NewsWeek.
It's hard to say exactly when ordinary Americans, no less than psychiatrists, began insisting that sadness is pathological. But by the end of the millennium that attitude was well entrenched. In 1999, Arthur Miller's "Death of a Salesman" was revived on Broadway 50 years after its premiere. A reporter asked two psychiatrists to read the script. Their diagnosis: Willy Loman was suffering from clinical depression, a pathological condition that could and should be treated with drugs. Miller was appalled. "Loman is not a depressive," he told The New York Times. "He is weighed down by life. There are social reasons for why he is where he is." What society once viewed as an appropriate reaction to failed hopes and dashed dreams, it now regards as a psychiatric illness.
That may be the most damaging legacy of the happiness industry: the message that all sadness is a disease. As NYU's Wakefield and Allan Horwitz of Rutgers University point out in "The Loss of Sadness," this message has its roots in the bible of mental illness, the Diagnostic and Statistical Manual of Mental Disorders. Its definition of a "major depressive episode" is remarkably broad. You must experience five not-uncommon symptoms, such as insomnia, difficulty concentrating and feeling sad or empty, for two weeks; the symptoms must cause distress or impairment, and they cannot be due to the death of a loved one. Anyone meeting these criteria is supposed to be treated.
Yet by these criteria, any number of reactions to devastating events qualify as pathological. Such as? For three weeks a woman feels sad and empty, unable to generate any interest in her job or usual activities, after her lover of five years breaks off their relationship; she has little appetite, lies awake at night and cannot concentrate during the day. Or a man's only daughter is suffering from a potentially fatal blood disorder; for weeks he is consumed by despair, cannot sleep or concentrate, feels tired and uninterested in his usual activities.
Horwitz and Wakefield do not contend that the spurned lover or the tormented father should be left to suffer. Both deserve, and would likely benefit from, empathic counseling. But their symptoms "are neither abnormal nor inappropriate in light of their" situations, the authors write. The DSM definition of depression "mistakenly encompasses some normal emotional reactions," due to its failure to take into account the context or trigger for sadness.
That has consequences. When someone is appropriately sad, friends and colleagues offer support and sympathy. But by labeling appropriate sadness pathological, "we have attached a stigma to being sad," says Wakefield, "with the result that depression tends to elicit hostility and rejection" with an undercurrent of " 'Get over it; take a pill.' The normal range of human emotion is not being tolerated." And insisting that sadness requires treatment may interfere with the natural healing process. "We don't know how drugs react with normal sadness and its functions, such as reconstituting your life out of the pain," says Wakefield.
Even the psychiatrist who oversaw the current DSM expresses doubts about the medicalizing of sadness. "To be human means to naturally react with feelings of sadness to negative events in one's life," writes Robert Spitzer of the New York State Psychiatric Institute in a foreword to "The Loss of Sadness." That would be unremarkable if it didn't run completely counter to the message of the happiness brigades. It would be foolish to underestimate the power and tenacity of the happiness cheerleaders. But maybe, just maybe, the single-minded pursuit of happiness as an end in itself, rather than as a consequence of a meaningful life, has finally run its course.
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