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Is Grief Always Depression?

The American Psychiatric Association thinks so.

Theodore Dalrymple


June 17, 2012 - 12:00 am
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One may legitimately wonder what kind of human relationships the APA expects people to have: certainly not very deep ones. Indeed, the APA probably would count having deep and lasting relationships as pathological, as a risk factor for “depression” later on when the objects of these morbid relationships die. Better to keep everything on an even, superficial level; then there will be no cause for grief. Sorry: depression.

The APA seems to view loving relationships as the British working class used to view teeth: better not to have any, since they only give you trouble in the end. In response to criticism, however, the APA has — according to the editorial — conceded the following:

A footnote will be added [to its criteria for the diagnosis of depression] indicating that sadness with some mild depressive symptoms in the face of loss should not necessarily be viewed as major depression.

The tone of regret in this concession, of having been wrung unwillingly from those who have made it, would be comical were there not just a hint of tragedy about it. Psychiatrists, after all, spend their lives observing people: it obviously takes years of study, training, thought, discussion, reading, and reflection to know so little about them. Such ignorance does not come naturally:

O God! A beast that wants discourse of reason

Would have known better!

When I finished reading the editorial, I felt thoroughly depressed — or do I mean unhappy? At any rate, one thing is certain: I need help.

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Theodore Dalrymple, a physician, is a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute. His new book is Second Opinion: A Doctor's Notes from the Inner City.
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