Diagnosis, Treatment, and Contingency on (Gendered) Culture

While the previous chapter’s opening concerned itself with participants’ experiences of help-seeking, this chapter begins by looking at their experiences of what often followed: diagnosis and treatment. When it came to their views on the utility of diagnosis, their opinions were nuanced, and sometimes divergent: some embraced the ‘mental illness’ label while others rejected it outright. With regard to treatment, those who had been able to access therapy tended to speak of it in positive terms. The consensus on antidepressants, however, was far less clear. But what the women’s narratives did have in common was a thoughtful conceptualisation of SAD: they all eruditely expressed what ‘social anxiety’ meant to them. As to whether it warrants treatment, be that with therapy or pharmaceuticals, their accounts evoked the contingency of SAD’s classification as a ‘mental disorder’ on culture. This provided an opening to draw on constructs such as the culture-bound syndrome (CBS) and psychiatrist Peter D. Kramer’s ‘cosmetic psychopharmacology’. In so doing, the interaction between norms of femininity and the diagnosis ‘SAD’ is investigated.