Further, Shorter advocates using the term nonmelancholia in reference to the low mood and sadness commonly referred to as depression. Using melancholia and nonmelancholia would contrast and distinguish between what he sees as “two different kinds of depression, as different as tuberculosis and mumps.” Rethinking the nature of depression in this way, he believes, would help clinicians refine their treatments. Rather than resorting to one-size-fits-all solutions—which all too often means prescribing an antidepressant—psychiatrists and therapists would look to a wider array of therapeutic tools.
Shorter’s perspective has much to recommend it. He can be fascinating as he traces the origins of the uses and meaning of depression and melancholia. And though his detailed chronicle of the endless squabbling that’s gone into the writing of different editions of the DSM is disheartening, it goes a long way toward explaining the manual’s weaknesses. Even so, as one fact follows another, his larger arguments can be hard to follow. His research is thorough, but it becomes trying to navigate.
In the end, the message both books provide is clear: as cloudy as the concepts of stress and depression have become, they can still be useful—but only if we can see through the layers of misuse and misunderstanding that too often veil their true meanings.
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