Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit.

Many patients report sadness or distress during consultations with primary care doctors. Such emotions may be related to grief and other life stresses, including the stress of physical illness. Sometimes sadness appears out of the blue, without obvious relation to external causes. Over recent decades there has been an increasing tendency, especially in primary care, to diagnose depression (commonly major depressive disorder) in patients presenting with sadness or distress and offer them antidepressant medication. In this paper we offer a critical review of the diagnosis of major depressive disorder, show how and why this broad diagnostic label has resulted in overdiagnosis and overtreatment, and suggest how the approach to diagnosis and management of depression should change to reduce stigmatising the sad and provide better help for those who most need vigilant care and medical treatment. Evolving views of what constitutes depression