A recent study in The Archives of General Psychiatry suggests that 25 percent of all Americans diagnosed with depression are actually just dealing with the normal disappointments of life, like divorce or the loss of a job. Their sadness is being treated like a medical condition. They were given drugs, when what they really needed was support:
The study also suggested that drug treatment may often be inappropriate for people who are experiencing painful — but normal — responses to life’s stresses. Supportive therapy, on the other hand, may be useful — and may keep someone who has been through a divorce or has lost a job from going on to develop full-blown depression.
Obviously, it’s tough to know where sadness ends and clinical depression begins. And nobody wants to return to the days when society stigmatized depression and pretended like it didn’t exist. But until we have a biological marker of depression – or something more conclusive than a vague checklist of symptoms – shouldn’t we err on the side of restraint? Shouldn’t psychiatrists seek to avoid medicalizing sadness? When confronted with a borderline case – the patient might be sad or they might be depressed – why not try supportive therapy or cognitive behavioral therapy first, before getting that prescription for Prozac? Sadness sucks, but it also serves a purpose.