Let’s say a patient walks into my office and says he’s been feeling down for the past three weeks.

Should I give him a diagnosis of clinical depression? Or is my patient merely experiencing what the 14th-century monk Thomas à Kempis called “the proper sorrows of the soul”? The answer is more complicated than some critics of psychiatric diagnosis think.

To these critics, psychiatry has medicalized normal sadness by failing to consider the social and emotional context in which people develop low mood

most psychiatrists would concede that in the space of a brief “managed care” appointment, it’s very hard to understand much about the context of the patient’s depressive complaints. And yes, under such conditions, some doctors are tempted to write that prescription for Prozac or Zoloft and move on to the next patient.

But the vexing issue of when bereavement or sadness becomes a disorder, and how it should be treated, requires much more study.