Gendered Madness?

Speaking of gender and madness/psychiatry, look at this article ("Mad, Bad, and Sad: A History of Women and the Mind Doctors from 1800 to the Present by Lisa Appignanesi"). It’s a book review – on a book about the historical association of madness with women. “The evidence as to whether women really do suffer from mental illness more than men is unclear, though it seems that today, at least, more women than men seek help at the sad end of the spectrum. It may be that society more often defines disordered men as bad, sending them to prison rather than to hospital. In other cases, men may self-medicate with alcohol and avoid diagnosis.” There’s a clear suggestion here that our standards of what constitutes ‘madness’ is different between genders. Which in turn suggests that psychiatric knowledge is not objective, but informed by cultural and social influences. Which of course is precisely what I as an anthropologist am interested in.
Indeed, the book (according to the article) traces the relationship between ‘fashion’ and psychiatric diagnoses. “Mental illness is much less static than physical disease; it is protean in its external expression and culturally infectious, so that once a particular diagnosis catches on, whether it’s hysteria in the 19th century, or multiple-personality disorder in the late 20th, the number of sufferers balloons. Illnesses also reflect society at large: the Victorian neurasthenic unable to rise from her sofa was symbolically enacting the limited life opportunities for women. Today’s epidemic of eating disorders reflects the media’s obsession with body image, though Appignanesi also suggests, worryingly, that feminism may have made an unwitting contribution by overemphasising the female body in its attacks on the beauty industry.” In other words: what we consider madness depends on what we consider normal and desirable human behavior at any given point in time.

The financial times published a reaction to the recent news that many antidepressants may be ineffective ("The End of 'Normal' Sadness"). The main point made here is that depression may be over-diagnosed in the first place: feelings of sadness or worthlessness and loss of appetite are symptoms of depression, but can also constitute very normal occasional reactions to the “vagaries of life.” The DSM has limited our view of human experience. The article goes so far as to say that the fact that drugs don’t work may be because many people are put on drugs while they don’t actually *have* depression.

Whether or not this is plausible I don’t know, but such a statement sort of presumes that there is a ‘real’ depression that exists somewhere organically, on which medication has an effect. If you don’t have the disease, the medication does nothing but provide some kind of placebo effect. What? This is in no way proven and seems like kind of a big assumption to base any argument on.