'Normative orthodoxies in depression and the 'space' for alternative discourses'.

摘要

Irrespective of the country where one practices or the particular population(s) that one works with, the likelihood is extremely high that as a psychiatric nurse, you will encounter depressed people. Though the well documented problems in determining a caseon-case of depression mean that the associated epidemiological data should be treated with an appropriate degree of caution (see Tanney, 2000; Van Praag, 2004; 2005) the World Health Organization (2009) indicate that the global rate of depression continues to rise. At the same time, there exists a parallel and more compelling body of evidence that shows how the incidence of prescriptions for anti-depressants (most noticeably Selective Serotonin Reuptake Inhibitors - SSRIs) has risen dramatically during the last two decades, particularly in 'western' countries (see Barrkman, 2009; Hemels, Koren & Einarson, 2002; MIND 2009). With these data in mind, and with reference to mental health policy literature, national treatment guidelines and the not insignificant marketing campaigns of giant pharmaceutical corporations, the inescapable conclusion is that the contemporary orthodoxy for treating or 'fixing' depression is firmly embedded in a biological disease model and the corresponding (automatic) pharmacological response.