By contrast, the DSM 5 proposes to eliminate the bereavement exclusion. Anyone with depressive symptoms for just two weeks after suffering a significant loss would be diagnosed with major depressive disorder, massively pathologizing normal intense grief.

Depressive disorders caused by neurosis are, on average, two to three times more frequent in women.

The definition of Major Depressive Disorder (MDD) became purely symptom based. All conditions that display five or more of nine symptoms including low mood, lack of pleasure, sleep and appetite difficulties, inability to concentrate, and fatigue over a two week period are now considered depressive disorders.

Like Hippocrates, physicians throughout history have recognized that the symptoms of normal sadness and depressive disorder were similar. Depressive disorders differed from normal reactions because they either arose in the absence of situations that would normally produce sadness or were of disproportionate magnitude or duration relative to whatever cause provoked them.

He claims that there is a direct link between his depressive state and his fear of being sent back to Bangladesh.

The Finns may be a bit boring and depressive and there's a very high suicide rate, but by golly, they are qualified.

European economies, including Germany, are suffering, as the sanctions depressive impact aggravates the recessionary and deflationary forces that are already at work. By contrast, helping Ukraine to defend itself against Russian aggression would have a stimulative effect on Ukraine and Europe.

The distinction between contextually appropriate sadness and depressive disorders remained largely unchanged for two and a half millennia. But the psychiatric profession abandoned this distinction in 1980, when it published the third edition of its official diagnostic manual, the DSM III.

At the same time, due to the lack of understanding of depressive disorder and anxiety ailments, common citizens erroneously think that patients are in a fit of pique instead of giving them timely understanding and emotional support, which is also the main reason for a lower outpatient rate.

It would not be hard for psychiatry to develop a more adequate definition of depressive disorder that de medicalizes natural emotions of sadness. The diagnostic criteria could simply extend the current bereavement exclusion to cover conditions that develop after other losses and that are not especially severe or enduring.

This is surprising in an era when treatments that work should supposedly be used with some uniformity. In fact, despite a consensus that ECT is the most effective treatment for severe depressive disorder, it comes at the bottom of the list in most treatment regimens for mood disorders.

At the same time, a special variety of mental illness was first observed, which we would later call schizophrenia and depressive disorders different from a multitude of mental illnesses already known. It called into being a new term, madness, the first medical specialization (eventually named psychiatry ), and special legislation regarding the mad.

The claim that the spread of severe mental illness has reached epidemic proportions has been heard so often that, like any commonplace, it has lost its ability to shock. But the repercussions for international politics of the disabling conditions diagnosed as manic depressive illnesses (including major unipolar depression) and schizophrenia could not be more serious.

Both manic depressive illness and schizophrenia are psychotic conditions, characterized by the patient s loss of control over his or her actions and thoughts, a recurrent state in which s he cannot be considered an agent with free will. Obsessive suicidal thinking and paralyzing lack of motivation allow depressed patients to be classified as psychotic as well.

The DSM III s confusion of normal intense sadness and depressive mental disorder, which persists to the present, emerged inadvertently from psychiatry s response to challenges to the profession during the 1970 s. A powerful group of research psychiatrists was dissatisfied with the definitions of depression and other common mental disorders in the earlier, psychoanalytically influenced diagnostic manuals.

Traditional psychiatry thus adopted a contextual approach to diagnosing a depressive disorder. Whether a condition was diagnosed as disordered depended not just on the symptoms, which might be similar in normal sadness, and not just on the condition s severity, for normal sadness can be severe and disordered sadness moderate, but on the degree to which the symptoms were an understandable response to circumstances.

The clinical implications of the failure to recognize bipolar disorder in depressed patients include the under prescription of mood stabilizing medications, and an increased risk of rapid cycling swings between manic and depressive phases. But, perhaps as a consequence of concerted efforts to improve the recognition of bipolar disorder, during the past few years we have observed the emergence of an opposite phenomenon over diagnosis.

The clinical implications of the failure to recognize bipolar disorder in depressed patients include the under prescription of mood stabilizing medications, and an increased risk of rapid cycling  swings between manic and depressive phases. But, perhaps as a consequence of concerted efforts to improve the recognition of bipolar disorder, during the past few years we have observed the emergence of an opposite phenomenon over diagnosis.

Similarly, there is evidence that the prefrontal cortex a key structure in emotional regulation as well as in decision making and working memory shrinks in major depression. On the other hand, rather than atrophying, the amygdala, the seat of emotional memories, becomes hyperactive both in post traumatic stress disorder and depressive illness, and there is evidence from animal studies of a hypertrophy of nerve cells after repeated stress.

A second example it has been known since antiquity that normal people who recently experienced a significant loss especially of a loved one can have the same symptoms (e.g., sadness, insomnia, fatigue, loss of interest in usual activities, lessened appetite) as those indicating major depressive disorder. Thus, the DSM currently eliminates the recently bereaved from depression diagnosis unless they have certain extreme symptoms suggesting more than intense grief.