Medicalization of Depression

While I recognize depression as a serious illness that can be effectively relieved by treatment, I think the American culture is increasingly biomedicalizing it.  The recent upsurge in cases of depression is not necessarily from a higher rate of the disorder, but rather a higher rate of its diagnosis.  The current definition of clinical depression requires that a patient display at least five criteria on a list of symptoms that includes a depressed mood, insomnia, loss of interest in activities, and fatigue.  This definition does not account for the context of these symptoms, which could be a natural response to events like losing a loved one or experiencing a serious illness.  I think the biomedical movement in the U.S. has allowed for this looser interpretation of depression.  People who identify with the definition of depression can now take advantage of medical innovation and seek treatment.  As the Conrad article on ADHD explained, Americans who have lost tolerance for mild symptoms can now seek out a diagnosis that legitimizes their suffering and makes it easier to understand.  Allan Horwitz and Jerome Wakefield, the authors of a book entitled The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Illness, explain this biomedicalization of depression as a result of several causes: efforts to standardize the diagnosis of the condition by revising its criteria, pharmaceutical companies finding a wider base for their market, and depressed people themselves, looking for an answer in a diagnosis.

I analyzed an advertisement for Zoloft, a popular antidepressant.  This brand is known for its characteristic ads that use cartoon, anthropomorphic blobs to represent people with depression.  I think using the blobs rather than live actors influences viewers to identify with the explained symptoms, rather than an arbitrary image of what depression looks like.  In this commercial, a lone blob wallows in a dark cave while a voiceover explains the symptoms of depression: feeling alone, anxious, and tired, and not enjoying once-loved activities.  This underscores our cultural view that depression is an unnatural condition that separates sufferers from the rest of society.  The biological mechanism of the medication is explained very generally while a cartoon image shows a simplistic animation of neurotransmitters.  Like most pharmaceutical ads, this one explains the side effects of Zoloft at the end, when the depressed blob finally makes it out of his cave and joins others with a smile.  The ad tells the viewer that depression must be diagnosed by a doctor, but its ending tagline—“When you know more about what’s wrong, you can help make it right”—reflects biomedicalization’s principle that people can play an important role in their own diagnosis and treatment.

Zoloft ad: http://www.youtube.com/watch?v=QIFnHfdgXaA&feature=relmfu

Article on Horwitz and Wakefield: http://www.scientificamerican.com/article.cfm?id=really-an-epidemic-of-depression

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