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It is a double cruelty that depression often silences its sufferers. Beyond its affective pain, whether the illness manifests as a withdrawal from social interaction or as a permanent physical escape via suicide, individuals experiencing the symptoms of depression often seem to have limited linguistic resources available to them.1 According to many sufferers, words cannot describe the pain of depression, and yet it is ironically a condition largely known through the words that they do find. Access to treatment occurs only through the interpretive act of diagnosis, and diagnosis itself depends on the report of recognizable symptoms. The patterns of expression through which individuals articulate their experiences as, for example, matters of brain chemistry, fundamentally shape their ideas of health and illness. Collectively, these patterns constitute a “discourse of depression,” which exceeds the utterance of any one statement, but which is also reiterated within each statement. In other words, to recognize a particular string of words as referring to or explaining depression, speakers draw on a collective memory that results from repeated patterns of articulation . In the act of recognition, speakers and hearers validate and perpetuate the discourse’s structuring power. As language scholars have long recognized, the words in which ideas are presented are not neutral; they fundamentally shape the entities to which they refer. While notions of strong linguistic determinism have been discredited, the operation of linguistic relativity—the idea that language, as a cultural phenomenon , does influence thought and behavior—forms the basis for much social critique. Studies in language and gender in the 1970s and 1980s, for example, demonstrated the nonuniversality of ostensibly neutral nouns and pronouns such as “man” and “he”—in research that asked individuals to locate pictures to represent “chairman” (which collected largely male images) and “chairperson” (which collected mixed sex images)—despite the then-current 13 1 bbbbbbbbbbbbbbbbbbbbbbbb Depression, a Rhetorical Illness arguments that masculine terms were always assumed to be inclusive. As a result of these analyses and the awareness campaigns they launched, public discourse has shifted toward more self-consciously “gender-neutral” discursive practices.2 For studies of medical language, this case is instructive, cautioning against contemporary beliefs that assume neutrality within diagnostic labels. Indeed, as the historian Laura Hirschbein has pointed out, as early as the 1970s, “the supposition that depression was a disease of women had become entrenched to the point that studies done entirely on women were presented as studies on depression itself.”3 Underlying beliefs about depression may lead researchers to make assumptions about both the illness and the identities attached to it. Compiling research on depression that fails to account for the necessarily gendered identities of sufferers ignores differences in socialization and emotional expression between men and women. Such generalized results then perpetuate the assumption that depression is a woman’s illness, because women are most likely to be recognizable in the research results. In much the same way, the construction of symptom statements—for example, “excessive crying”—has material effects on which individuals receive diagnoses and, consequently, treatments. Such symptom statements rely on assumptions about gender and about depression embedded in the discourse. What constitutes excessive crying? The answer depends on normalized emotional responses, and a judgment of excess results at least in part from comparison to the reports of research studies such as those Hirschbein critiques for their gender bias. The contemporary discursive landscape of depression is increasingly dominated by corporate pharmaceutical interests, whose powerful marketing machines have supported a proliferation of new disease entities.4 Such new diseases are represented to us through language designed to mask gendered assumptions and to appeal to the broadest possible audiences. This language is predicated on the close association between disease and its particular pharmaceutical remedy, as Andrew Lakoff succinctly describes the equation: “‘depression’ should be treatable by an ‘anti-depressant.’”5 The logic—encoded in the simplicity of the prefix anti-—excludes myriad additional mechanisms and circumstances that might affect the experience and treatment of depression. In response, the tools of rhetorical analysis offer important counterstrategies for maintaining a complex, situationally sensitive knowledge of health and illness. To suggest that language and rhetorical analysis might materially affect the experience of depression is to accept what humanities scholars have labeled the “linguistic turn,” whereby discourse takes on a specific critical meaning, and objective reality is available only through the nonneutral mediation of language . Discourse, following Michel Foucault, refers to the collection of statements a culture makes about a given subject within a particular...

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