  Horwitz and Wakefield suggest that genuine depression is caused by a dysfunction on the part of a loss-response system that evolved to respond to losses that threaten to deprive us of reproductive resources. In depression the system misfires. It causes a loss-response in situations where it should not. Whether or not that is convincing, the argument that Horwitz and Wakefield make about the conflation of depression and sadness stands on its own merits. They make the case that the DSM conception of depression respects neither folk psychological common sense nor previous psychiatric consensus about depression. They conclude that the concept of depression defined by this diagnostic syndrome represents a major conceptual break. Our use of the new concept, they suggest, means that many people who are just normally miserable for understandable and ordinary reasons are being diagnosed as depressed. This leads to unnecessary alarm about an epidemic of depression as well as carrying unfortunate consequences for many people who are wrongly diagnosed. However, it is certainly open to those theorists opposed to the bereavement exclusion to insist that if depression is the result of an underlying system that misfires, it could misfire in response to bereavement. The proposal is not that everyone who grieves should be called depressed, but that there are reactions to bereavement that are severe enough to meet the criteria for major depression and should be classed as such. 