Transforming Misery into Sickness: The Genealogy of Depression in the Diagnostic and Statistical Manual

Abstract

Psychiatric classifications, and the diagnostic categories they delineate, not only reflect and incorporate the psychiatric ideas and practices of the era in which they are developed, they are also shaped by the wider social, cultural and institutional context — factors such as welfare provision, the funding of health care, the character of mental health services, the activities of the pharmaceutical industry, and the society’s values and beliefs. The classifications and categories provide a way of ordering and structuring the diversity of mental states — thoughts, feelings and behaviours — that psychiatrists and other mental health professionals encounter. The classifications themselves in turn structure psychiatric thinking and activity, as well as the ideas and understandings of the lay public. This dynamic interchange between classifications and the social, cultural and economic milieu applies to psychiatric ideas and practices concerning depression as to other mental disorders.