As American Melancholy reveals, if you read about depression anywhere today—medical journal, popular magazine, National Institute of Mental Health pamphlet, or pharmaceutical company drug promotional literature--you will find three main pieces of information either explicitly stated or strongly implied: depression is a disease (like any other physical disease); it is extraordinarily prevalent in the world; and it occurs about twice as frequently in women as in men. Yet, depression was not classified as a disease until the 1980 publication of the American Psychiatric Association's Diagnostic and Statistical Manual-III (DSM-III). How is it that such an illness, thought to affect between 14 and 17 million Americans, was not specifically defined until the late twentieth century?
American Melancholy traces the growth of depression as an object of medical study and as a consumer commodity and illustrates how and why depression came to be such a huge medical, social, and cultural phenomenon. It is the first book to address gender issues in the construction of depression, explores key questions of how its diagnosis was developed, how it has been used, and how we should question its application in American society.
"An interesting, useful, and exceptionally readable review of the evolution of the idea of depression as a diagnosis in the United States."
"Hirshbein illustrates how and why depression became a medical, social, and cultural phenomenon. In paying careful attention to the role of gender in shaping the conception and treatment of depression, Hirshbein adds a new component to the literature on and understanding of depression. Highly recommended."
"Laura Hirshbein's analysis of the explosive growth of depression in American society, psychiatry, and pharmacology emphasizes the overlapping roles of the medicalization and commercialization of mental states; the contemporary hyper-consumerist American's habits; the quest of psychiatric communities for professional and scientific security; and the drive, relentless and resourceful, by global pharmaceutical companies for new markets. This book is likely to be regarded eventually as the finest and most in-depth account around of gender and depression."
"Laura Hirshbein demonstrates that the modern diagnosis of depression is only a recent creation and reveals more about our society and culture than our mental states. In tracing the manner in which depression entered medical diagnostic systems, she has made a major contribution that should force us to question claims about the pervasive nature of this diagnosis."
"American Melancholy provides new insight into a diagnostic category that has become central not only to modern psychiatry but also to the very definition of ordinary life in late twentieth-century America. Perhaps its greatest contribution lies in Hirshbein's careful attention to the role of gender in shaping the conception and treatment of depression."
"A badly needed book, executed brilliantly. Hirshbein's arguments are nuanced but forceful, and many readers should find themselves questioning commonly held notions about depression and diagnosis. Her analysis of gender, in particular, should compel re-evaluations of vast bodies of research on psychiatry and mental illness."
Acknowledgements Chapter One: Prelude to Depression Chapter Two: Redefining Treatment, Patients, and Disease in the Ever-Expanding Diagnosis of Depression Chapter Three: American Moods and the Consumer Solution Chapter Four: Gender, Depression, Diagnosis, and Power Chapter Five: Feelings and Relationships Epilogue: Real Men, Real Depression Notes Index
LAURA D. HIRSHBEIN is a practicing clinical psychiatrist and medical historian at the University of Michigan.
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