Jerome C. Wakefield Books

Thirty years ago, less than five percent of the population was estimated to have an anxiety disorder; today, estimates exceed fifty percent, suggesting a tenfold increase. This rise raises the question of whether it indicates a genuine medical epidemic. The authors argue that psychiatry has largely created this "epidemic" by inflating natural fears into psychiatric disorders, resulting in over-diagnosis and over-prescription of anxiety medications. Current definitions of disordered anxiety focus on irrational anxiety disproportionate to real threats. However, the authors contend that fearing non-dangerous things—like heights or negative judgments—can be a normal part of human nature, as seen in some PTSD cases. They challenge the trend of labeling distressing conditions as "mental disorders" and propose a nuanced approach to differentiate between psychiatric disorders needing treatment and normal anxieties, which may seem irrational but are evolutionarily rooted. Many commonly diagnosed fears, such as those of snakes or social evaluation, have evolved in response to historical risks that are no longer relevant. By integrating insights from psychiatry, evolutionary psychology, sociology, anthropology, and history, the book deepens our understanding of anxiety and mental health in America.

Jerome C. Wakefield critically examines Freudian psychoanalysis by integrating Foucault's idea of 'power/knowledge' with the case of Little Hans. This analysis reveals how Oedipal theory has influenced and reshaped intimate family dynamics, challenging traditional perceptions of sexuality and attachment. The book offers a fresh perspective on the interplay between psychological theories and familial structures.

Depression is now the most commonly treated mental disorder, with claims that one in ten Americans experience it annually and 25% at some point in their lives. This has led to increased antidepressant use, widespread screening, and early diagnosis efforts based on a few symptoms to prevent severe conditions. In their work, Allan V. Horwitz and Jerome C. Wakefield argue that while depressive disorder is real and can be debilitating, the perceived epidemic reflects a reclassification of normal sadness as an abnormal experience. The DSM-III, published in 1980, shifted the diagnosis of depression to symptom-based criteria—such as depressed mood, loss of appetite, and fatigue lasting at least two weeks. The authors contend this approach is flawed as it overlooks the context of symptoms. They emphasize the need to differentiate between internal dysfunction and normal sadness due to external factors. The current DSM system complicates this distinction, leading to potential misdiagnoses, where typical emotional responses to distressing events, like job loss or relationship endings, could be incorrectly labeled as depressive disorder. This misinterpretation contributes to the perceived epidemic of major depression today.