An account of the way misery has been pathologised in the interests of drug companies is vital reading
Across the world, 450 million people suffer from mental health problems. In the next 20 years, according to the World Health Organisation, depression will become the single biggest health burden on society. Given these numbers, perhaps it is no surprise that experts have begun to challenge both the definition of the problem and the notion that medication is its best solution.
Oliver James, in 2007’s Affluenza, argued that the depression “epidemic” was induced by a culture that obliges us to compete and consume. There was a media furore in 2008 when a major review appeared to show that Prozac worked little better than a placebo. Now US psychotherapist Gary Greenberg has stepped in with Manufacturing Depression, a thorough, often shocking history of how the pharmaceutical industry has pathologised misery in order to sell us the cure.
Greenberg includes frank and funny accounts of his own battle with depression, and deals principally with the US healthcare system. However, his argument and detailed evidence make it vital reading for anyone who has ever been squeezed through the machinery of depression treatments, or who simply has a healthy scepticism about the influence of Big Pharma.
“It could be that the depression epidemic is not so much the discovery of a long-unrecognised disease,” he writes, “but a reconstitution of a broad swathe of human experience as illness.” While he isn’t the first to advance this argument, his account of the origins of psychiatric medicine is a revelation. The history of mental health research is one of guesswork, wild extrapolations and hit-and-miss efforts to impose a taxonomy on the aberrations of the mind. The conclusion that depression is the result of serotonin deficiency – the basis for a generation of treatments – was reached, Greenberg says, by scientists observing the effects of LSD.
Greenberg isn’t afraid to stand against orthodoxy. If science claims depression is the result of neurochemical imbalance, and that this can be cured by restoring balance, then this is an optimistic view. In western society, to suggest that depression is part of our psychic landscape, and that in trying to eliminate it we risk losing something crucial to our humanity, is a heresy. But this engaging and necessary book is a rallying cry to resist the pathologising of emotion for profit. Greenberg is asking us to step back from neuroscience and take a more philosophical look at what it means to live now.
Pessimism, he suggests, may be a correct response to times of crisis, and a spur to action. “Regardless of whether or not the drugs work, to call pessimism the symptom of an illness and then turn our discontents over to the medical industry is to surrender perhaps the most important portion of our autonomy: the ability to look around and say… ‘This is outrageous. Something must be done.'”