Anne's essay is a meditation on how "depression" has become a catch-all diagnosis for a range of ills that technically don't qualify for the DSM diagnosis of Major Depressive Disorder. The reason this is important, as Anne points out, is that if we don't have the diagnosis right then we can't get the prescription right. Specifically, the "disease model" behind the DSM Major Depressive Disorder diagnosis is ill-equipped to capture the psychic pain and relational distress that arise not from brain pathology but from the failures of social support networks.
From Anne's article:
“Depression” [now] seems to signify social ills for which we have no solution, from violent, homicidal behavior, to health illiteracy, to our culture’s neglect of the elderly. Constructing societal deficits as a medical problem does everyone a disservice—because treatment specific for depression won’t work for people who don’t really have depression. People who need social support can be expected to benefit most from programs that provide social support—not from psychiatrists.I think that's key. "The psychological pain [that] arises within social systems." By calling this pain "depression" we're often blaming the victim rather than attending to our failure, the failure of our social systems. How we fail each other as friends, family members, neighbors, parishioners, citizens and as fellow travelers on the journey through this vale of tears.
The patient with bona fide depression will benefit from treatment with antidepressants or proven psychotherapies. For the lonely great-grandmothers, the junk food addicts, and the violent paraplegics, there has to be another form of intervention. We must turn from the inappropriate use of the disease model of emotional distress and understand that individuals’ psychological pain arises within social systems as well as within their own brains.
Anne's essay concludes:
Using the word “depression” to describe inexplicable or violent behavior sends two false signals: First, that society has no obligations with regard to our happiness—because misery is a medical problem—and second, that a depressed person is in danger of committing abhorrent acts. Depressed people need help. “Depressed” people do, too—but not the same kind.May the church take heed.