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Some of the doctors began to ask how this fitted with the grief exception.

It’s not caused by your life – it’s caused by your broken brain. All over the world, they were being encouraged to tell patients that depression is, in fact, just the result of a spontaneous chemical imbalance in your brain – it is produced by low serotonin, or a natural lack of some other chemical. Then, as the years and decades passed, doctors on the frontline started to come back with another question. It was called “the grief exception”, and it seemed to resolve the problem. In that situation, all these symptoms are natural, and not a disorder. None of this applies, they said, if you have lost somebody you love in the past year. The authors conferred, and they decided that there would be a special clause added to the list of symptoms of depression. So, the doctors wanted to know, are we supposed to start drugging all the bereaved people in America? If you lose someone, it turns out that these symptoms will come to you automatically.

If they followed this guide, they had to diagnose every grieving person who came to them as depressed and start giving them medical treatment. However, after a while they came back to the authors and pointed out something that was bothering them. The manual was sent out to doctors across the US and they began to use it to diagnose people. For a doctor to conclude you were depressed, you had to show five of these symptoms over several weeks. In the latest edition, they laid out nine symptoms that a patient has to show to be diagnosed with depression – like, for example, decreased interest in pleasure or persistent low mood. It was called the Diagnostic and Statistical Manual. American psychiatrists had produced a book that would lay out, in detail, all the symptoms of different mental illnesses, so they could be identified and treated in the same way across the United States. I n the 1970s, a truth was accidentally discovered about depression – one that was quickly swept aside, because its implications were too inconvenient, and too explosive.