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Happiness

According to statistics one in five people experiences depression. If depression is so common, how do we know it is an illness and not just a normal part of being human?
Accepted:
November 25, 2005

Comments

Marc Lange
November 26, 2005 (changed November 26, 2005) Permalink

That is an excellent question. The distinction between health and illness is tremendously controversial. Some philosophers believe that the difference is fixed entirely by various facts about the natural world. These philosophers might point out that insofar as depression arises from the production of certain extreme quantities of some neurotransmitter or from some particular gene, which ultimately inhibits or prevents certain cells from carrying out their basic life functions (e.g., from employing a certain metabolic pathway to derive energy), then depression has a biochemical basis. On this view, that depression is common does not change the fact that it involves the malfunctioning of some part of the body, where "malfunctioning" can be cashed out in exclusively naturalistic terms. (But what, then, does it mean for a part of the body to function properly? What determines the body part's biological function? That is a controversial question.)

Other philosophers disagree. They believe that the distinction between health and illness rests on certain value-judgments, not entirely on natural facts. These value-judgments are reflected in which conditions society takes it to be appropriate to consult a doctor about, or in which conditions people regard as undesirable. Again, that depression is common does not in any way conflict with its being regarded as undesirable.

Of course, one might believe that value-judgments inevitably play a role in distinguishing health from disease, and yet also hold that the distinction between health and disease is not merely "in the eye of the beholder" because certain value-judgments are objectively correct and others are objectively mistaken. For instance, run-away slaves were diagnosed in antebellum South Carolina as having a disease ("drapetomania", I believe it was called) that caused them to run away. This classification of the run-away slaves might be considered inaccurate, and not merely as a matter of what we happen to desire.

However health and illness are characterized, the fact that one in five people experiences depression does not conflict with the idea that depression is an illness. After all, many people have dental caries, but they still represent illnesses, not good health. Remember that "depression" in the medical sense is distinct from feeling the blues. If there is "a good reason" for someone to feel down, then it is probably not depression in the medical sense.

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