Manufacturing Depression

At the present time I am reading Manufacturing Depression by Gary Greenberg. This is an informative, mindshifting, entertaining history of how we have arrived at such a large portion of us clinically diagnosed with clinical depression and put on pharmaceuticals. You don’t have to agree with Greenberg to find much of value here.

Excerpt from Chapter 1 of Manufacturing Depression by Gary Greenberg

Manufacturing Depression

…The captains of the pharmaceutical industry are merely doing what they get paid the big bucks to do—to sail their corporate ships expertly on the winds and currents of the times. And the times, with some help from Big Pharma, have delivered them an ideal consumer for their product: someone convinced that unhappiness is a problem for their doctors to treat.

The history of the invention and production of depression is a strange and elusive kind of secret. Most of what I’m going to expose here isn’t buried in corporate files. It’s as obvious as a commercial for Prozac—or, for that matter, as the fifty thousand copies of Recognizing the Depressed Person that Merck distributed to doctors in 1963 or Symposium in Blues, the compilation album of blues songs that they paid RCA to press and send out three years later with prescribing information for their latest antidepressant inserted up its sleeve. It’s laid out in black and white in the scientific literature, which documents, in addition to all that breathtaking neuroscience, the poor performance of antidepressants and the failure of the serotonin imbalance theory to explain depression. It’s right there in the way that over the last century or so, medicine has shaped a climate in which we feel a bone-deep conviction that disease is something biochemical, that health and illness are scientific categories, and that doctors are dispensers of magic bullets aimed at molecular bad guys. It’s on the front page of the newspaper where stories about America’s drug war stand as daily reminders that we are very confused about taking drugs to change our moods—a confusion that is largely circumvented when we instead take drugs to treat a disease.

These are the raw materials of depression, and they’ve been assembled in the clear light of day, hidden, like Poe’s purloined letter, in plain sight. I’m going to show you how depression has been manufactured right before your eyes—not in order to deny that depression exists or even that it can, in some cases anyway, rightly be considered a disease that can be cured by drugs, but in order to provide you with another tool to figure out what to do if recalcitrant sadness sets in and sends you to your doctor’s office. Because Peter Kramer is both right and wrong about the climate of opinion—right that psychopharmacology is a sign of a major change in the climate, wrong that it is not worth your time to “ask about the virtues” of the new climate. Once you find out how unhappiness has become an illness to be treated with drugs, and once you grasp that there is a history to your depression that has nothing to do with your biochemistry, you have another choice besides “all in your head” and “all in your brain.” If the idea that depression is a disease is as much a matter of history as it is of science, if it is, in short, a story about our suffering, then you are free to look for other stories, or to tell your own. You are free to arm yourself with information that your doctor might not even know about, to seek alternatives, to resist the regime—or to choose, because it makes sense to you and not because a drug-industry-fattened doctor told you so, to subscribe to that story.

I’m not going to tell you that I don’t have a dog in this hunt. I’m writing this book in part because I think that the medical industry, regardless of its intentions, has acquired far too much power over our inner lives—the power to name our pain and then sell us the cure one pill at a time. But even though I am a psychotherapist, I don’t think the only alternative is what I sell in my office one hour at a time—although I will point out that it is probably the only profession built on the idea that changing the story we tell about our suffering can relieve it. And I know, through my own experience as both a therapist and, as I’ll detail later, as an officially depressed person, that drugs—although not necessarily the drugs that Pharma is selling—do work. But that doesn’t mean that depression—yours, mine, or anyone else’s—is the disease the depression doctors say it is.

© 2010 Gary Greenberg

much more of Chapter 1 at Simon and Shuster

  1. 1 Mental Disorders 101

    Manufacturing Depression « Medical Skeptic…

    I found your entry interesting do I’ve added a Trackback to it on my weblog :)…

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