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Like the condition itself, which has the highest identified prevalence of any mental disorder in countries like the United States and the United Kingdom, books on depression are common, whether memoirs of the experience of depression, or discussions of its causes (one or many) or its treatments (again, one or many). A book on the history of depression suggests a somewhat more distinctive angle. However, while Jonathan Sadowsky is a professor of the history of medicine at Case Western Reserve University, those expecting a narrative history of depression will be disappointed. In several respects, this book does not feel like a history at all. This is because Sadowsky's dominant concern is to engage with, and actively examine, different ways of thinking about, analysing and treating depression, including psychodynamic ideas, chemical understandings and diagnostic framings. Some historical context is incorporated into these examinations, but it is mostly not centre stage. If there is a distinctive edge to the book, it comes more from its global engagement and the challenging approach to the data and the arguments.
The book begins with a Preface which sets out some of Sadowsky's assumptions: ‘that depression is shaped by history and culture’; that it is not necessary ‘to choose between understandings of depression as biological, psychological, or social’; and ‘that there is a politics to depression, a politics of inequality’ (p. ix). This explicit listing of the author's assumptions is hardly typical of a historian and gives some indication of the approach Sadowsky adopts. He also justifies his use of the term ‘empire’ in the title, indicating that there is an empire both in the sense that depression ‘became a dominant way of interpreting mental distress’ and in the sense that ‘this linguistic shift then began to spread globally’ (p. xiii).
Chapter 1, ‘Depression is a Thing’, covers a range of issues in which history plays only a small part, such as what constitutes a ment