Happiness: Enough Already

Yet by these criteria, any number of reactions to devastating events qualify as pathological. Such as? For three weeks a woman feels sad and empty, unable to generate any interest in her job or usual activities, after her lover of five years breaks off their relationship; she has little appetite, lies awake at night and cannot concentrate during the day. Or a man's only daughter is suffering from a potentially fatal blood disorder; for weeks he is consumed by despair, cannot sleep or concentrate, feels tired and uninterested in his usual activities.

Horwitz and Wakefield do not contend that the spurned lover or the tormented father should be left to suffer. Both deserve, and would likely benefit from, empathic counseling. But their symptoms "are neither abnormal nor inappropriate in light of their" situations, the authors write. The DSM definition of depression "mistakenly encompasses some normal emotional reactions," due to its failure to take into account the context or trigger for sadness.

That has consequences. When someone is appropriately sad, friends and colleagues offer support and sympathy. But by labeling appropriate sadness pathological, "we have attached a stigma to being sad," says Wakefield, "with the result that depression tends to elicit hostility and rejection" with an undercurrent of " 'Get over it; take a pill.' The normal range of human emotion is not being tolerated." And insisting that sadness requires treatment may interfere with the natural healing process. "We don't know how drugs react with normal sadness and its functions, such as reconstituting your life out of the pain," says Wakefield.

Even the psychiatrist who oversaw the current DSM expresses doubts about the medicalizing of sadness. "To be human means to naturally react with feelings of sadness to negative events in one's life," writes Robert Spitzer of the New York State Psychiatric Institute in a foreword to "The Loss of Sadness." That would be unremarkable if it didn't run completely counter to the message of the happiness brigades. It would be foolish to underestimate the power and tenacity of the happiness cheerleaders. But maybe, just maybe, the single-minded pursuit of happiness as an end in itself, rather than as a consequence of a meaningful life, has finally run its course.            

© 2008