from Part III - Illness and society
INTRODUCTION
Depression is a worldwide phenomenon (Blazer et al. 1994). Annually, the economic costs of this mental disorder due to loss of work and medical expenses run into tens of billions of dollars globally (Greenberg et al. 1993: 5). During the past few decades, diagnostic rates have risen yearly, and in the US (World Health Organization 2010c) and the UK 10 per cent of the adult population is diagnosed with depression each year (Office for National Statistics 2002).
Despite its prevalence, individuals suffering from depression appear to be subject to persistent stigma. In this chapter, following Kurzban and Leary, I understand stigma to be negative evaluations of an individual which can be “discrediting; negative attributions; perceived illegitimacy; or a devalued social identity” (Kurzban & Leary 2001: 188); this conceptualization leaves open the possibility for self-stigmatization as well. Worryingly, recent evidence seems to indicate that public education campaigns have been ineffective in the face of such stigma (Angermeyer & Matschinger 2004; Dumesnil & Verger 2009). This chapter puts forward an explanation for why the public appears to be “depression illiterate”. Employing a “folk theory” model of cognition, drawn from philosophy and psychology, I propose that the stigmatization of depression may result from individuals' implicit attempts to uphold a core common-sense set of optimistic beliefs about the world which are important for psychological well-being. This hypothesis – which I dub “the Pollyanna Backlash” – accounts for stigmatization by invoking two claims: (a) individuals adhere to positive, tacit beliefs about the world and themselves; and (b) individuals respond in a “quasi-scientific” manner to threats to their beliefs.
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