Depression or "Proper Sorrows"—Have Physicians Medicalized Sadness?

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Sir: Most patients who feel “down in the dumps,” “blue,” ordepressed will first see their primary care physician—not a psychiatrist.How that family practitioner or general practitionersees the patient’s complaint—ordinary sadness? major depressiveepisode?—will have momentous implications for thepatient’s health and well-being. Now, in their book The Loss ofSadness, Allan V. Horwitz and Jerome C. Wakefield argue that”normal sadness . . . has three essential components . . . it is context-specific; it is of roughly proportionate intensity to the provokingloss; and it tends to end about when the loss situationends . . . “^2(p16)