Abstract
Prominent consumer depression manuals issued in recent years circulate a standard depression script as scientific knowledge. The script, asserting that a broad spectrum of depressions are brain illnesses that require antidepressant treatment, is in fact highly contested among researchers. This paper reviews the logical problematics of these manuals, and how such discourse promotes the diagnosis and pharmaceutical treatment of behaviors ranging from mild symptoms to severe depression. In keeping with the trends of pharmaceutical advertising and State health policy, these manuals encourage consumers to self-scrutinize risky behavior, and to treat common behavioral and mood distresses with antidepressants. Ultimately, these activities of self-management function to produce a more productive citizen population.
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American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Andrusenko, M. P., Sheshenin, V. S., & Iankovleva, O. B. (1999). Use of Tianeptine in the treatment of late-life depression. Zh-Nevrol-Psikhiatr-Im-S-S-Korsakova, 99(2), 25–30.
Birmaher, B. (1998). Should we use antidepressant medications for children and adolescents with depressive disorders? Psychopharmacology Bulletin 34(1), 35–39.
Birmaher, B., Ryan, N. D., Williamson, D. E., Brent, D. A., & Kaufman, J. (1996). Childhood and adolescent depression: A review of the past ten years. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1575–1583.
Boyce, P., & Hadzi-Pavlovic, D. (1996). Some historical aspects. In G. Parker & D. Hadzi-Pavlovic (Eds.), Melancholia, disorder of movement and mood: A phenomenological and neurobiological review (pp. 9–19). Cambridge: Cambridge University Press.
Breggin, P. B, & Breggin, G. R. (1991). Toxic psychiatry: Why therapy, empathy and love must replace the drugs, electroshock and biochemical theories of the “New Psychiatry.” New York: St. Martin's Press.
Breggin, P. B, & Breggin, G. R. (1994). Talking back to prozac: What doctors won't tell you about today's most controversial drug. New York: St. Martin's Press.
Brody, J. (1997, February 4). Quirks, oddities may be illnesses. New York Times, pp. B9, B11.
Brophy, B. (2000, January 10). Kindergartners in the prozac nation. US News On-Line. Retrieved January 10, 2000 from http://www.usnews.com/usnews/issue/prozac.htm
Brown, L. (1992). A feminist critique of personality disorders. In L. Brown & M. Ballou (Eds.), Personality and psychopathology: Feminist reappraisals (pp. 206–208). New York: Guilford Press.
Browne, A., & Finkelhorn, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 66–77.
Chesler, P. (1972). Women and madness. New York: Avon.
Cole, M. G., Elie, L. M., McCuster, J., Bellavance, F., & Mansour, A. (2000). Feasibility and effectiveness of treatments for depression in elderly medical inpatients: A systematic review. International Psychogeriatrics, 12(4), 453–461.
Cruikshank, B. (1999). The will to empower: Democratic citizens and other subjects. Ithaca, NY: Cornell University Press.
DeJong, H. F., Kool, S., van Aalst, G., Dekker, J., & Peen, J. (2001). Combining psychotherapy and antidepressants in the treatment of depression. Journal of Affective Disorders, 64 (2–3), 217–229.
Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Sotsky, S. M., Collins J. F., et al. (1989). National Institute Of Mental Health Treatment Of Depression Collaborative Research Program. General effectiveness of treatments. Archives of General Psychiatry, 46(11), 971–982.
Erni, J. N. (1994). Unstable frontiers: Technomedicine and the cultural politics of “curing” AIDS. Minneapolis, MN: University of Minnesota Press.
Fischer, S., & Greenberg, R. (1989). The limits of biological treatments for psychological distress: Comparisons with psychotherapy and placebo. Hillsdale, NJ: L. Erlbaum Associates.
Foucault, M. (1961). Madness and civilization: A history of insanity in the age of reason. New York: Vintage.
Foucault, M. (1966). Order of things: An archaeology of the human sciences. New York: Vintage.
Foucault, M. (1973). The birth of the clinic. New York: Vintage.
Foucault, M. (1975). Discipline and punish: The birth of the prison. New York: Vintage Press.
Foucault, M. (1976). The history of sexuality: An introduction. (Vol. 1). New York: Vintage.
Foucault, M. (1988). Technologies of the self. In L. Martin, H. Gutman, & P. H Hutton (Eds.), Technologies of the self: A seminar with Michel Foucault (pp. 16–49). Amherst, MA: University of Amherst Press.
Gardner, P. (2000). Memory and personality disorders. Unpublished manuscript. Northeastern University.
Glenmullen, J. (2000). Prozac backlash: Overcoming the dangers of Prozac, Zoloft, Paxil and other antidepressants with safe, effective alternatives. New York: Touchstone.
Hales, D. R., & Hales, R. E. (1995). Caring for the mind: The comprehensive guide to mental health. New York: Bantam Books.
Healy, D. (1997). The anti-depressant era. Cambridge, MA: Harvard University Press.
Kaufman, J., & Charney, D. (2001). Effects of early stress on brain structure and function: implications for understanding the relationship between child maltreatment and depression. Developmental Psychopathology, 13(3), 451–471.
King, R. A., Riddle, M. A., Chappell, P. B., Hardin, M. T., Anderson, G. M., Lombroso, P., et al. (1991). Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. Journal of the American Academy of Childhood and Adolescent Psychiatry, 30(2):179–186.
Kirk, S. A., & Kutchins, H. (1992). The selling of the DSM: The rhetoric of science in psychiatry. New York: Aldine De Gruyter.
Kleinman, A. (1995). Writing at the margin: Discourse between anthropology and medicine. Berkeley, CA: University of California Press.
Koverola, C., Pound, J., Heger, A., & Lytle, D. (1993). Relationship of child sexual abuse to depression. Child Abuse and Neglect, 17(3), 393–400.
Kramer, P.D. (1993). Listening to Prozac: A psychiatrist explores antidepressant drugs and the remaking of the self. New York: Viking.
Kutchins, H., & Kirk, S. A. (1997). Making us crazy: DSM: The psychiatric bible and the creation of mental disorders. New York: The Free Press.
Long, P. W. (1998, May). Major depressive disorder [Electronic version]. Mental Health. Retrieved May 6, 1998 from http://www.mentalhealth.com/dis/p20-md01.html
Meiselman, K. C. (1990). Resolving the trauma of incest: Reintegration therapy with survivors. San Francisco: Jossey-Bass Publishers.
Meyer, S. E, Chrousos, G. P, & Gold, P. W. (2001). Major depression and the stress system: A life span perspective. Developmental Psychopathology 13(3), 565–580.
Miller, T. (1993). The well-tempered self: Citizenship, culture and the postmodern subject. Baltimore: The John Hopkins University Press.
Molnar, B. E., Buka, S. L., & Kessler, R. C. (2001). Child sexual abuse and subsequent psychopathology: Results from the National Comorbidity Survey. American Journal of Public Health, 91(5), 753–760.
National Alliance of the Mentally Ill. (1999), November–July 2000). Email alerts [Email messages]. Received between November 1999 and July 2000.
National Alliance of the Mentally Ill. (1999a). Understanding major depression: What you need to know about this medical illness [Brochure]. Arlington, VA: NAMI.
National Alliance of the Mentally Ill. (1999b). Women and depression [Brochure]. Washington, DC: NAMI.
National Alliance of the Mentally Ill (2000, June 15). Women and depression [Brochure]. Retrieved June 15, 2000 from www.nami.org/helpline/women.html
National Institute of Mental Health. (1999). Depression awareness, recognition and treatment Program (D/ART) [Program papers]. Retrieved October 10, 2000 from www.yearbooknews.com/html/DART.html
National Institute of Mental Health. (2000a). Depression fact sheet [Factsheet]. Retrieved October 10, 2000 from http://www.nimh.nih.gov/publicat/depresfact.cfm
National Institute of Mental Health. (2000b). Depression—What every woman should know [Brochure]. Retrieved October 10, 2000 from the World Wide Web: www.nimh.nih.gov/publicat/depwomenknows.cfm#ptdep1.
National Institute of Mental Health. (2000c). The invisible disease–Depression [Brochure]. Retrieved October 10, 2000 from www.nimh.nih.gov/publicat/invisible.cfm
National Mental Illness Screening Project. (1999, October 10). Retrieved October 10, 1999 from http://www.nmisp.org/depression.htm
Nowakowska, E., Kus, K., Chodera, A., & Rybakowski, J. (2000). Behavioural effects of fluoxetine and tianeptine: Two antidepressants with opposite action mechanisms in rats. Arzneimmittel Forschung, 50(1), 5–10.
Oppenheim, J. (1991). Shattered nerves: Doctors, patients and depression in Victorian England. New York: Oxford University Press.
Oppenheimer, G. (1992). Causes, cases, and cohorts. In E. Fee & D. M. Fox (Eds.), AIDS: The making of a chronic disease model (pp. 49–83). Berkeley, CA: University of California Press.
Papolos, D., & Papolos, J. (1997). Overcoming depression: The definitive resource for patients and families who live with depression and manic-depression. New York: HarperPerennial.
Parker, G., & Hadzi-Pavlovic, D. (Eds.). (1996). Melancholia, disorder of movement and mood: A phenomenological and neurobiological review. Cambridge: Cambridge University Press.
Pasquino, P. (1991). Theatrum politicum: Geneology of capital—Police and the state of prosperity. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 105–118). Chicago: University of Chicago Press.
Porter, R. (1987). A social history of madness: The world through the eyes of the insane. New York: Weidenfield & Nicholson.
Rose, N. (1990). Governing the soul: The shaping of the private self. London: Routledge.
Rothschild, A. J., & Locke, C. A. (1991). Reexposure to fluoxetine after serious suicide attempts by three patients: The role of akathisia. Journal of Clinical Psychiatry, 52(12), 491–493.
Russell, D. (1995). Women, madness and medicine. Cambridge, UK: Polity Press.
Showalter, E. (1985). The female malady: Women, madness and English culture, 1830–1980. New York: Pantheon Books.
Showalter, E. (1993). Hysteria, feminism and gender. In S. Gilman, H. King, R. Porter, G. S. Rousseau, & E. Showalter (Eds.), Hysteria beyond Freud (pp. 286–344). Berkeley, CA: University of California Press.
Showalter, E. (1997). Hystories: Hysterical epidemics and modern media. New York: Columbia University Press.
Smith-Rosenberg, C. (1985). Disorderly conduct: Visions of gender in Victorian America. New York: Albert A. Knopf.
Teicher, M., Glod, H. C., & Cole, J. O. (1990). Emergence of intense suicidal preoccupation during fluoxetine treatment. American Journal of Psychiatry, 147(2), 207–210.
Thase, M. (1999). When are psychotherapy and pharmacotherapy combinations the treatment of choice for major depressive disorder? Psychiatry Quarterly, 70(4), 333–346.
Treichler, P. (1987). AIDS, homophobia and biomedical discourse: An epidemic of signification. October, 43, 31–70.
Treichler, P. (1988). AIDS, gender and biomedical discourse: Current contests for meaning. In E. Fee & D. Fox (Eds.), AIDS: The burden of history (pp. 190–266). Berkeley, CA: University of California Press.
Treichler, P. (1992a). AIDS, HIV and the cultural construction of reality. In G. Herdt & S. Linderman (Eds.), The time of AIDS: Social analysis, theory and method (pp. 65–98). Newbury Park, CA: Sage.
Treichler, P. (1992b). AIDS and HIV infection in the third world: A first world chronicle. In E. Fee & D. Fox (Eds.), AIDS & the making of a chronic disease model (pp. 377–412). Berkeley, CA: University of California Press.
United States Center for Disease Control. (1998). 1995 Behavioral Risk Surveillance System [Health policy document]. Retrieved February 19, 1998 from www.cdc.gov/nccdphp/brfss/about.htm.
United States Center for Disease Control. (1998). 1995 Youth risk behavior surveillance system [Health policy document]. Retrieved February 19, 1998 from www.cdc.gov/nccdphp/dash/yrbs/sudi.htm
United States Department of Health and Human Services, Public Health Service. (1996–2000). Healthy people 2000 and 2010 [Health policy document]. Retrieved February 19, 1998 from http://odphp.osophs.dhhs.gov/pubs/hp2000
United States Department of Health and Human Services, Public Health Service. (1996, June). Healthy people progress review: Mental health and mental disorders [Health policy document]. Retrieved February 19, 1998 from http://odphp.osophs.dhhs.gov/pubs/hp2000/progrvw/mentalprog.htm
Ussher, J. (1991). Women's madness: Mental illness or misogyny. Amherst, MA: University of Amherst Press.
Ussher, J. (Ed.). (1997). Body talk: The material and discursive regulation of sexuality, madness and reproduction. New York: Routledge
van West, D., & Maes, M. (1999). Activation of the inflammatory response system: A new look at the etiopathogenesis of major depression. Neuroendocrinology Letter, 20(1–2), 11–17.
Vein, A. M., & Vorob'eva, O. V. (2000). Neurological masks of depression. Zh Nevrol Psikhiatr In-S-S-Korskava, 100 (5), 21–23.
Wagstaff A. J., Ormrod, D., & Spencer, C. M. (2001). Tianeptine: A review of its use in depressive disorders. CNS drugs, 15(3), 231–259.
Wallace, E. R. (1994). Psychiatry and its nosology: A historico-philosophical overview. In J. Z. Sadler, O. Wiggins, & M. Swartz (Eds.), Philosophical perspectives on psychiatric diagnostic classification (pp. 16–86). Baltimore: John Hopkins University Press.
Walsh, B. T., Siedman, S. N., Sysko, R., & Gould, M. (2002). Placebo response studies of major depression: Variable, substantial, and growing. Journal of the American Medical Association, 287, 1840–1847.
White, H. (1978). Tropics of discourse. Baltimore: John's Hopkins University Press.
Wirshing, W. C., Van Putten, T., Rosenberg, J., Marder, S., Ames, D., & Hicks-Gray, T. (1992). Fluoxetine, akathisia, and suicidality: Is there a causal connection? Archives of General Psychiatry, 49(7), 580–581.
Zuckoff, M. (2000, June 8). Prozac data was kept from trial, suit says. Boston Globe, p. A1.
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Gardner, P. Distorted Packaging: Marketing Depression as Illness, Drugs as Cure. Journal of Medical Humanities 24, 105–130 (2003). https://doi.org/10.1023/A:1021314017235
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DOI: https://doi.org/10.1023/A:1021314017235