Explores how society has come to medicalise depression, and maintains that there are more productive ways of looking at what previous generations of analysts would distinguish or define in other ways e.g. as symptoms of loss or bereavement, mourning or melancholia – terms which have lost currency within current psychiatry. Leader questions whether this is the function of the medical/pharmaceutical paradigm on offer – one
‘which aims to restore the sufferer [of depression] to the optimal levels of social adjustment and utility,with little regard for the long-term causes and their psychological problems …the more that society sees human life in these mechanistic terms, the more that depressive states are likely to ramify. To treat a depression on the same model as, say, an infection requiring antibiotics, is always a dangerous decision. The medicine will not cure what has made the person depressed in the first place, and the more the symptoms are seen as signs of deviance or unadapted behaviour , the more the sufferer will feel the weight of the norm,of what they are supposed to be. They become casualties of today’s view of human beings as ‘resources’, in which a person is just a unit of energy, a packet of skills and competencies which can be bought and sold in the marketplace’
Leader argues that this concept is flawed, and that we should be looking at human stories of separation and loss, that we are often affected by events in our lives without realizing their importance or how they have changed us. ‘Depression is a vague term for a variety of states. Mourning and melancholia , however, are a more precise concepts that can help shed light on how we deal – or fail to deal – with the losses that are part of human life’. He points out that often mourning is often seen as ‘getting over’ a loss, but asks if we ever truly get over our losses, but rather make them part of life, either fruitfully, catastrophically, but never painlessly.
The depression of terms such as melancholia, which has bee replaced by ‘depression’ is fully discussed. What were often complex case histories written up by psychoanalysts have now become statistics and charts – with the actual voice of those suffering often not heard anywhere as they are categorised and put into boxes created by the DSM. Leader observes that to find anything worthwhile written about the concept of loss, for example, he would have to look through the fiction section of a bookshop – he goes on to ask therefore what role creativity has in the process of loss and mourning, and could the arts play a vital role in in making sense of the losses we suffer in life?