Manufacturing Depression
the Secret History of a Modern Disease

This is a book in which author Greenberg tells us in the most long-winded way possible that "Depression" has been cast as a disease so drug companies can sell us treatments and psychiatrists can prescribe those treatments and get paid by insurance companies.

Concepts of Mental Illness

In this rambling and frequently personal indictment of the whole mental health industry, Greenberg traces the history of the concept of depression and "mental disease" from the days of Hippocrates through its introduction as an incurable illness, with sufferers being relegated to the insane asylums; through the Freudian idea of roots in childhood, to be treated with psychotherapy; to its current status as a "real disease" for which there are drugs that will make the depressed person feel better.

I was quite a long way through the book before I realized that the author is not a Psychiatrist, but rather a Psychologist, which may account for some of his antipathy toward the strictly medical approach taken by his brethren with MD degrees. Or, it may be that he disdains Psychiatrists because medicalizing "feeling depressed" gives them a lucrative new market and, in collusion with the drug companies, they can sell customers expensive drugs, to be taken forever.

Inventing Diseases to Sell Cures

I was attracted to this book because I am personally disgusted with the whole health care industry which has been busy inventing new diseases for many years now and trying to sell all of us on taking loads of expensive drugs. When I was growing up back in the stone ages, no one had "restless leg syndrome" or "osteoporosis" or "acid reflux disease" and few people were on expensive maintenance drugs like Lipitor, which their doctors insisted they take for the rest of their lives. Nor was the TV full of ads from law firms trolling for people who had taken drugs which later proved to cause some condition worse than the thing they were supposed to help, all in hopes of cashing in on class action lawsuits.

Of all the things we spend money on, nothing delivers LESS bang for the buck than health care, and its growing price is bankrupting our nation. God save us from the Depression Doctors who want to give Prozac to everyone who "feels sad." That ought to add a few more billion dollars to our collective health care bill.

The Depressed Therapist

So, I am somewhat in tune with Gary Greenberg's discontent with all the proselytizing of "Depression is a Real Illness" for which sufferers should receive treatment, but I wonder how this works when treating depressed and unhappy people is also your profession? Greenberg the Therapist makes no bones about the fact that he himself has been depressed, even severely depressed, and that these black feelings may come back. He tells us all about his experiences with a clinical study for a treatment for depression, mentions being in analysis and tells us about some of his blacker moments. At times, his narrative reminds me of a bad Woody Allen movie, where self loathing abounds. How does a depressed person provide therapy to another depressed person?

Just Body Parts, or Something More?

But Greenberg does more than just whine. He takes us into heavy territory and asks us whether we think we are just the sum of our body parts, or is it possible that we are more? Is my consciousness, the essential "me," just switches in my brain or is there something else in there? Do I have an existence separate from my body? These are important questions that bear on what exactly it means when we are "feeling sad." Could there be actual reasons for feeling sad? Even the DSM, the handbook of mental illnesses used by therapists, gives a dispensation for the bereaved. Apparently, it's ok to feel sad if someone you loved has just died. But it's less ok to feel sad if you merely lost your job or you had a fight with your spouse or your child flunked math.

Gary Greenberg takes way too many pages to tell us what's wrong with the mental health industry, but I learned a lot I didn't know about the history, the drugs, the people and the concepts that have shaped the idea that there is such a thing as mental illness. I give him credit for letting it all hang out with his personal story of mental anguish. Most of us have had periods when we may have seemed disturbed to those around us, when events in our lives overwhelmed us.

My husband insists I was once a bit manic-depressive, but now that I have joined the Medicare crowd, I regard myself as a happy person on a daily basis... not that growing older is fun, but I have come to terms with my own mortality as part of the way the universe operates and I don't waste any time wishing I was someone else. I am grateful for the life I've had, the life I have, the life I have left and for whatever comes after that. Yes, I think human beings (and probably ALL biological life) has an immortal spiritual component.

What Exactly Does it Mean to be "Happy?"

My own take is that happiness has something to do with external conditions (it's hard to be really happy if you are enslaved, homeless or hungry) but has most to do with inner life and how you approach each day. In the last chapter, the author writes of building a house during a blue period in his life, and says pounding nails and creating something (the house) gave him the satisfaction he needed to get by other disappointments. It also showed that temporary unhappiness may have something to teach us. Maybe it is not "just another illness cured by a drug." Maybe discovering and working on activities and causes that matter to you is a better choice than Prozac.

A Nation of Zombies?

Apparently, people who have accepted the clinical label "depressed" are yearning to be "normal." But being "normal" does not mean you can't get angry about social injustice or hold viewpoints outside the mainstream or sometimes fail to conform to "respectable" behavior. Are the drugs served up by the Depression Doctors turning us into a nation of conformists, like the soma-induced contentment of Brave New World?

The prospect is frightening, and I for one intend to continue resisting the "magic bullets" served up by the money-grubbing, predatory health care industry and continue listening to what I think is my authentic self instead. This powerful industry, with its chemical solutions to life's difficulties, has no claim on credibility, as the author makes clear in this book.

Perhaps, for those who feel they need help coping, the "talk therapy" offered by psychologists may be helpful, and it doesn't involve turning yourself into a zombie on drugs. For some, as even the author admits, the zombie effect may make them feel better and be "worth it" in terms of not spending each day in a blue funk, but it is truly frightening to think of a money-driven inustry working to convince large numbers of people to take that route.

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Manufacturing Depression: The Secret History of a Modern Disease

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