The Meaning of Madness by Neel Burton

Author:Neel Burton [Burton, Neel]
Language: eng
Format: epub
Tags: Medical, Psychiatry, General
ISBN: 9780956035301
Google: -dsYAQAAMAAJ
Publisher: Acheron Press
Published: 2009-11-15T00:07:40.199523+00:00

If, like the majority of medical conditions, depression could be defined and diagnosed according to its ætiology or pathology—that is, according to its physical cause or effect—such a state of affairs could never have arisen.

Unfortunately, depression cannot as yet be defined according to its ætiology or pathology, but only according to its associated symptoms. Given this, a doctor cannot base a diagnosis of depression on any objective criterion such as a blood test or a brain scan, but only on his or her subjective interpretation of the nature and severity of the patient’s symptoms.

As with schizophrenia, the problem is one of circularity: the concept of depression is defined according to the symptoms of depression, which are in turn defined according to the concept of depression. And so we cannot be sure that ‘depression’ corresponds to any real or distinct disease entity, particularly since a diagnosis of depression can be applied to anything from mild depression to depressive psychosis and depressive stupor, and overlap with several other constructs of mental disorder including dysthymia, adjustment disorders, and anxiety disorders.

One of the more absurd consequences of the ‘menu of symptoms’ approach to diagnosing depression is that two people with absolutely no symptoms in common (not even low mood) can both end up with the same unitary diagnosis of depression. For this reason especially, the concept of depression as a mental disorder has been charged with being little more than a socially constructed dustbin for all manner of human suffering.

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