Manufacturing Depression

Democracy Now! 1 March 2010

There are several stories in this hour long program, one about earthquakes, one about race in a Californian university, and one about depression. The last one tells me what I know as a psychotherapy to be true. Not that antidepressants don’t always work, but that why they work is a big muddle, it could be the placebo effect or just time. And the price for this dubious result is to pathologise millions of people, to get them thinking about the psyche in a medical & unhelpful way.

All for huge profit.

The DSM 5 is a scandal and will make the problem worse!

All part of a 150 year trend… that bit was new to me.

Video of the Depression story on Democracy Now

Every health professional should watch this video, listen to this last story in this episode of Democracy Now, or read the book by Gary Greenberg, Amazon:

Manufacturing Depression: The Secret History of a Modern Disease

Manufacturing Depression?:

The primary point that Greenberg expressed in the interview is that we are taking a normal human experience and turning it into a disease. He makes it clear that he has no problem with relieving the suffering of depression with drugs, but he questions whether we have turned normal blue moods into a disease in order to justify medicating away sadness.

A satisfying read online is where Greenberg is interviewed on the Well. Quote follows.

The WELL: Gary Greenberg, Manufacturing Depression:

So all of this adds up, at least in common sense, to the possibility that this form of depression is a classic disease.

But there are two problems with this. One is that common sense has been known to be wrong. In 1850 in England, for instance, common sense told doctors that cholera was caused by bad air. The places in the London with the worst cholera, after all, were the places with the worst stink. As we know now, the stink was only an indication of the problem, which lay elsewhere–in the shit-infested water. Waht was missing at that time, in addition to the open-mindedness that John Snow possessed and which allowed him to look at the water supply, was any knowledge of microbes. Obviously, we can’t yet know what is missing from our account of the chemical origins of depression, although we can say that if they exist, they’re mighty difficult to pin down. The evidence remains largely circumstantial, and there may be no way of finally knowing if the chemical findings are the cause or the effect of the condition. So we need to be very careful about connecting the dots here.

The second problem is worse. It is that people with this kind of depression are a very small percentage of the people who can be diagnosed with depression. My book is largely about how these categories came to be conflated, so that we’ve come to think of demoralization as a disease. The result is a diagnostic scheme that effectively pathologizes something like twenty percent of us. But if you stick with that strain of depression that seems to be a disease in the classic sense, the numbers are much lower, probably lower than ten percent. Which is not an insubstantial number, but hardly the epidemic that various interests would like you to think it is.

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