Society's perceptions and the over-diagnosis of Depression

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Depression—also known as major depressive disorder or clinical depression—is most widely known a mental illness where the patient is so sad that he is unable to function normally in life (4).  A person suffering from depression displays signs of hopelessness, worthlessness, helplessness, and restlessness (1).  Pessimism and insomnia are common symptoms, as well as appetite gain or loss (1).  Apathy and loss of interest in once-fun activities are also ways to spot depression (4).  However, where is the fine line between a mere case of the blues and a serious depressive disorder?

Statistics show that antidepressants have become the most prescribed drugs in the United States (2).  Of the 2.4 billion drug prescriptions recorded in the year 2005, 118 million of those were for antidepressants, with high blood pressure drugs coming in second at 113 million prescriptions (2).

Recently, the market for antidepressants has been growing most quickly for an unexpected group: preschoolers.  Over a million preschoolers have been diagnosed with clinical depression (3).

How does one differentiate inability to get work done due to depression from just pure laziness?  What about the other symptoms, such as restlessness, pessimism, and apathy?  Many people display these characteristics, and while they may not be optimal for one’s personality, they are, after all, part of that person, and who is to say that such qualities are signs of a mental illness?

Similarly to how everyone has a different personality, everyone also sees the world in their own way, because the way one sees the world is a combination of all of one’s senses, but the brain makes up a lot of what is received through the sensors.  If our perception of images or sounds is made up by the brain, then quite possibly our perception of people is not all right either.  We may just be judging others too harshly.  If someone cannot finish their work and seems unmotivated, we are quick to say there is something wrong with that person.  Why?  What is wrong with not being able to finish a task?  What is wrong with being unmotivated?  Uninterested?  Why must someone show interest in activities to be considered normal?

If so many people are being diagnosed with depression, and most depressed people are currently not seeking any help (3), maybe depression is overly diagnosed.  Antidepressants only make an effect on about 35% of the people who use them (3).  If many people were actually depressed, then why do the antidepressants not affect their condition?  Again, maybe most people are not actually depressed.

So what, then, actually is depression?  If the social norm did not require everyone to be hard-working and interested in their work to be normal, would people think they are depressed?  Maybe people would be happy with the way they are, since society would not deem them worthless, and in turn, they themselves would not feel worthless.

If society did not expect anything from a person and that person still felt hopeless and useless, then maybe that person would actually be depressed.  In that case, the antidepressant would probably help such a person.

(1) http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml
(2) http://www.cnn.com/2007/HEALTH/07/09/antidepressants/index.html
(3) http://www.upliftprogram.com/depression_stats.html
(4) http://en.wikipedia.org/wiki/Major_depressive_disorder

Comments

Paul Grobstein's picture

defining depression

"If many people were actually depressed, then why do the antidepressants not affect their condition?"

Maybe because "depression" ought to be defined as a brain state, rather than as something that responds to particular therapeutic agents?  See, for example, Exploring Depression

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