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BMJ. 2007 September 1; 335(7617): 413.
PMCID: PMC1962868
Is Depression Overdiagnosed?

Walking the Black Dog

Christopher L Manning, chief executive officer, Primhe

Parker is chief executive of the Black Dog Institute, not exactly a non-hyperbolic term for “an educational, research and clinical facility offering specialist expertise in mood disorders.”1 2 Perhaps one of the reasons why people like me who walk the Black Dog become so endlessly frustrated is that those who apparently stand for greater understanding of, and help for, folks like me, seemingly do very little to help the public and media to comprehend the complexity of the depression predicament.

In addition to working out ways to live with, and recover from, this oft devastating condition, we have constantly to endure those who have never been there, or who have been poorly treated when they have been (with whatever intervention), eroding our experience and neutralising our narratives. A condition that is, to many of us, the most physical we have ever experienced is reduced to the level of an extreme form of appropriate emotionality (which it may admittedly be in some cases) and access to medical treatment is questioned to the point of marginalising our predicament even further. This is effectively the equivalent of saying that people with a diagnosis of diabetes are just a little bit “oversugary” and making them feel bad about taking insulin.

It's not the case (in the United Kingdom) that everyone is being put on drugs. That is the type of catastrophising overgeneralisation that those of us who have had cognitive behavioural therapy are encouraged to dump. The improving access to psychological therapies programme is even now developing collaborative effort to enable stepped care thinking and processes to be applied to those with depression so that at least we can manage better the twin whirlpools of overmedicalisation of appropriate emotionality and the underdiagnosis of a potentially fatal illness.

Notes

Competing interests: CLM chooses to take an SSRI to deal with his own experience of depression as a relapsing condition in spite of all the other interventions on offer. The charities for which he has worked (Depression Alliance) and works (Primhe) actively seek (and have to seek) essential funding from various pharmaceutical companies and complementary therapy and psychological intervention providers to enable their work.

References

1. Parker G. Is depression overdiagnosed? Yes. BMJ 2007;335:328 (18 August.) [PMC free article] [PubMed]
2. Hickie I. Is depression overdiagnosed? No. BMJ 2007;335:329 (18 August.) [PMC free article] [PubMed]

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