Allan V. Horwitz

Jerome C. Wakefield

'The Loss of Sadness' argues that the increased prevalence of major depressive disorder is due not to a genuine rise in mental disease, as many claim, but to the way that normal human sadness has been 'pathologised' since 1980.

How Psychiatry Transformed Normal Sorrow Into Depressive Disorder

The Loss of Sadness

"This book tells a history of the Diagnostic and Statistical Manual of Mental Disorders (DSM), known as "psychiatry's bible." It has been at the center of thinking about mental health in the United States since it was first published in 1952. The author covers its various editions and their cultural and political effects"--

A History of Psychiatry's Bible

A Short History

PTSD

In this surprising book, Allan V. Horwitz argues that our current conceptions of mental illness as a disease fit only a small number of serious psychological conditions and that most conditions currently regarded as mental illness are cultural constructions, normal reactions to stressful social circumstances, or simply forms of deviant behavior. "Thought-provoking and important. . .Drawing on and consolidating the ideas of a range of authors, Horwitz challenges the existing use of the term mental illness and the psychiatric ideas and practices on which this usage is based. . . . Horwitz enters this controversial territory with confidence, conviction, and clarity."—Joan Busfield, American Journal of Sociology "Horwitz properly identifies the financial incentives that urge therapists and drug companies to proliferate psychiatric diagnostic categories. He correctly identifies the stranglehold that psychiatric diagnosis has on research funding in mental health. Above all, he provides a sorely needed counterpoint to the most strident advocates of disease-model psychiatry."—Mark Sullivan, Journal of the American Medical Association "Horwitz makes at least two major contributions to our understanding of mental disorders. First, he eloquently draws on evidence from the biological and social sciences to create a balanced, integrative approach to the study of mental disorders. Second, in accomplishing the first contribution, he provides a fascinating history of the study and treatment of mental disorders. . . from early asylum work to the rise of modern biological psychiatry."—Debra Umberson, Quarterly Review of Biology

Creating Mental Illness

Fears, phobias, neuroses, and anxiety disorders from ancient times to the present. More people today report feeling anxious than ever before—even while living in relatively safe and prosperous modern societies. Almost one in five people experiences an anxiety disorder each year, and more than a quarter of the population admits to an anxiety condition at some point in their lives. Here Allan V. Horwitz, a sociologist of mental illness and mental health, narrates how this condition has been experienced, understood, and treated through the ages—from Hippocrates, through Freud, to today. Anxiety is rooted in an ancient part of the brain, and our ability to be anxious is inherited from species far more ancient than humans. Anxiety is often adaptive: it enables us to respond to threats. But when normal fear yields to what psychiatry categorizes as anxiety disorders, it becomes maladaptive. As Horwitz explores the history and multiple identities of anxiety—melancholia, nerves, neuroses, phobias, and so on—it becomes clear that every age has had its own anxieties and that culture plays a role in shaping how anxiety is expressed.

Anxiety

Depression has become the single most commonly treated mental disorder, amid claims that one out of ten Americans suffer from this disorder every year and 25% succumb at some point in their lives. Warnings that depressive disorder is a leading cause of worldwide disability have been accompanied by a massive upsurge in the consumption of antidepressant medication, widespread screening for depression in clinics and schools, and a push to diagnose depression early, on the basis of just a few symptoms, in order to prevent more severe conditions from developing. In The Loss of Sadness, Allan V. Horwitz and Jerome C. Wakefield argue that, while depressive disorder certainly exists and can be a devastating condition warranting medical attention, the apparent epidemic in fact reflects the way the psychiatric profession has understood and reclassified normal human sadness as largely an abnormal experience. With the 1980 publication of the landmark third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), mental health professionals began diagnosing depression based on symptoms--such as depressed mood, loss of appetite, and fatigue--that lasted for at least two weeks. This system is fundamentally flawed, the authors 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 on by external circumstances. Under the current DSM classification system, however, this distinction is impossible to make, so the expected emotional distress caused by upsetting events-for example, the loss of a job or the end of a relationship- could lead to a mistaken diagnosis of depressive disorder. Indeed, it is this very mistake that lies at the root of the presumed epidemic of major depression in our midst. In telling the story behind this phenomenon, the authors draw on the 2,500-year history of writing about depression, including studies in both the medical and social sciences, to demonstrate why the DSM's diagnosis is so flawed. They also explore why it has achieved almost unshakable currency despite its limitations. Framed within an evolutionary account of human health and disease, The Loss of Sadness presents a fascinating dissection of depression as both a normal and disordered human emotion and a sweeping critique of current psychiatric diagnostic practices. The result is a potent challenge to the diagnostic revolution that began almost thirty years ago in psychiatry and a provocative analysis of one of the most significant mental health issues today.

How Psychiatry Transformed Normal Sorrow into Depressive Disorder

"Between Sanity and Madness: Mental Illness from Homer to Neuroscience traces the extensive array of answers that various groups have provided to questions about the nature of mental illness and its boundaries with sanity. What distinguishes mental illnesses from other sorts of devalued conditions and from normality? Should medical, religious, psychological, legal, or no authority at all respond to the mentally ill? Why do some people become mad? What treatments might help them recover? Despite general agreement across societies regarding definitions about the pole of madness, huge disparities exist on where dividing lines should be placed between it and sanity and even if there is any clear demarcation at all. Various groups have provided answers to these puzzles that are both widely divergent and surprisingly similar to current understandings"--

Mental Illness from Ancient Greece to the Neuroscientific Era

Between Sanity and Madness

This comprehensive treatment should appeal to not only specialists but anyone who is interested in how diagnoses of mental illness have evolved over the past seven decades—from unwanted and often imposed labels to resources that lead to valued mental health treatments and social services.

Gerald N. Grob

Employing historical and contemporary data and case studies, the authors also examine tonsillectomy, cancer, heart disease, anxiety, and depression, and identify differences between rhetoric and reality and the weaknesses in diagnosis and treatment.

Conundrums in Modern American Medicine

Diagnosis, Therapy, and Evidence

Teresa L. Scheid

This book offers the first comprehensive presentation of the sociology of mental health and illness, including original, contemporary contributions by experts in the relevant aspects of the field. Divided into three sections, the chapters cover the general perspectives in the field, the social determinants of mental health, and current policy areas affecting mental health services. The Sociology of Mental Health and Illness is designed for classroom use in sociology, social work, human relations, human services, and psychology. With its useful definitions, overview of the historical, social, and institutional frameworks for understanding mental health and illness, and non-technical style, the text is suitable for advanced undergraduate or lower level graduate students.

Allan V. Horwitz

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