Who researches depression; what is done about it; who is treated; who is not; who is blamed; who is coddled; what is paid for; what is ignored: all these questions are determined in the sancta of power. Politics also determines fashions in treatment: Should people be placed in institutions? Should they be treated in the community? Should the treatment of the depressed remain in the hands of doctors, or should it be assumed by social workers? What kind of diagnosis is necessary to warrant a government-funded intervention? The vocabulary of depression, which can be enormously empowering to marginal people who have no way to describe or understand their experiences, is endlessly manipulable. Those more advantaged members of a society experience their illness through that vocabulary, which is nonconspiratorially spun by Congress, by the American Medical Association, and by the pharmaceutical industry. Definitions of depression strongly influence the policy decisions that in turn affect the sufferers.
