The Medicalization of “Depression” Across the Globe

Recent decades have witnessed an increased reliance on the American approach to mental illness as a global script. These definitions of and treatment responses for mental health problems have been transmitted despite classic and new concerns from consumers, professionals, and scientists about the categorical schemas used. Yet, little data exist to show whether and how individuals, across societies, construct the set of symptoms that are used in formal psychiatric diagnoses of depression. Specifically, this question of global medicalization raises issues of how individuals label problems of living and what attributions they report as underlying the problems. Drawing from the “layers of belief” concept, we examine the multiplicity of attributions and labels that individuals across 17 societies assign to a scenario meeting DSM-IV criteria for an “official” diagnosis of depression. These include social, biological and moral causes, and, designations of physical or mental illness or “the ups-and-downs of life”. Here, we directly address the global spread of the medicalization of depression among the public in 17 societies as diverse as Brazil, South Africa, Germany, China, Iceland, and the United States. This is particularly important as more recent insights from medicalization theory highlight consumers as one of the major engine of medicalization within and across societies. Our findings indicate that there is a great cross-national variation in the medicalization of depression, yet a significant proportion of the public in all societies relies on Western scripts when formulating their ideas about what depression is and what should be done about it.