Speaking of Sadness, based on fifty in-depth interviews, provides first-hand accounts of the depression experience while discovering clear regularities in the ways that personal identities are shaped over the course of an "illness career." The book also emphasizes the inextricable connection between depression and the social contexts of people's lives.

Combining a scholar's care and thoroughness with searing personal insight, David A. Karp brings the private experience of depression into sharp relief, drawing on a remarkable series of intimate interviews with fifty depressed men and women. By turns poignant, disturbing, mordantly funny, and wise, Karp's interviews cause us to marvel at the courage of depressed people in dealing with extraordinary and debilitating pain. We hear what depression feels like, what it means to receive an "official" clinical diagnosis, and what depressed persons think of the battalion of mental health experts--doctors, nurses, social workers, sociologists, psychologists, and therapists--employed to help them. Ranging in age from their early twenties to their mid-sixties, the people Karp profiles reflect on their working lives, career aspirations, and intimate relationships, and confide strategies for overcoming paralyzing episodes of hopelessness. Throughout, Karp probes the myriad ways society contributes to widespread alienation and emotional exhaustion.