641 The Loss of Sadness

Some experts estimate that up to a quarter of those who might be diagnosed as depressed under current criteria are actually suffering from normal reactions to loss. Psychiatrists take bereavement into account, but what about divorce or losing a job? Such events can result in sadness without requiring medication. In 1980, a change was made in the way depression is diagnosed that may lead to some people being falsely identified as mentally ill.  What are the risks of inappropriate diagnosis and unnecessary treatment for depression? Is there a way to make sure people who need treatment for depression can get it…and those who are simply dealing with stressful life events can avoid it?

Guests: Jerome Wakefield, PhD, DSW, is University Professor and Professor of Social Work at New York University. His book, written with Dr. Allan Horwitz, is The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder.
Michael First, MD, is Professor of Clinical Psychiatry at Columbia University and attending physician at Columbia-Presbyterian Medical Center. He is editor of the last two editions of the standard diagnostic manual for psychiatry and the mental health professions, the DSM-IV and the DSM-IV-TR. He is currently working on the next edition, which will be the DSM-V.