Is Depression a 'Disease'?

It is worth considering when an everyday ‘problem in living’ becomes something that should be categorized as a mental health problem. It is a fact of life that we all have to deal with difficult life situations.

Sometimes these may make us anxious or depressed, sometimes we might feel as though we are ‘unable to cope’ with these difficulties. But they are still problems that almost everyone encounters. Many people have their own strategies for coping with these problems, some get help and support from friends and family and in more severe cases perhaps seek help from their doctor or GP.

However, at what point do problems of living cease to be everyday problems and become mental health problems? In particular, we must be wary about ‘medicalizing’ problems in daily living so that they become viewed as ‘abnormal’, symptoms of illness or disease, or even as characteristics of individuals who are ‘ill’ or in some way ‘second-class’.

A 2018 survey of over 1000 GPs by the Mental Health Charity Mind found that more than 40% of consultations with patients seen by GPs involved mental health issues (Mind, 2018[1]), and experiencing depression is one of the most common reasons for consulting a doctor or GP in the UK (Singleton, Bumpstead, O’Brien et al., 2001[2]). In order for GPs to be able to provide treatment for such individuals, there is often a tendency for them to over-diagnose mild or moderate depression (Middleton, Shaw, Hull & Feder, 2005[3]), or even misdiagnose symptoms as depression when validated assessments would not indicate a diagnosis (Carey, Jones, Meadows, Sanson-Fisher, D’Este et al., 2014[4]).

For example, while epidemiological studies in the early 2000s suggested that the prevalence rates for depression in the general population were fairly constant, there was at the same time a significant increase in depression being diagnosed by GPs and physicians, and a significant increase in the prescription of antidepressant medications (Dowrick & Frances, 2013[5]).

Effects such as this may have contributed to the common view expressed by laypeople that depression is a ‘disease’ rather than a normal consequence of everyday life stress (Lauber, Falcato, Nordt & Rossler, 2003[6]). If laypeople already view depression as a ‘disease’ or biological illness, and GPs are more than willing to diagnose it, then we run the risk of the ‘medicalization’ of normal everyday negative emotions such as mild distress or even unhappiness.