Manufacturing Depression: The Secret History of a Modern Disease
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Am I depressed or just unhappy? In the last two decades, antidepressants have become staples of our medicine cabinets—doctors now write 120 million prescriptions annually, at a cost of more than 10 billion dollars. At the same time, depression rates have skyrocketed; twenty percent of Americans are now expected to suffer from it during their lives. Doctors, and drug companies, claim that this convergence is a public health triumph: the recognition and treatment of an under-diagnosed illness. Gary Greenberg, a practicing therapist and longtime depressive, raises a more disturbing possibility: that the disease has been manufactured to suit (and sell) the cure. Greenberg draws on sources ranging from the Bible to current medical journals to show how the idea that unhappiness is an illness has been packaged and sold by brilliant scientists and shrewd marketing experts—and why it has been so successful. Part memoir, part intellectual history, part exposé—including a vivid chronicle of his participation in a clinical antidepressant trial—Manufacturing Depression is an incisive look at an epidemic that has changed the way we have come to think of ourselves. Kirkus Reviews Mother Jones contributing editor and self-described "old-fashioned psychotherapist" Greenberg (The Noble Lie: When Scientists Give the Right Answers for the Wrong Reasons, 2008, etc.) ponders depression and its treatment through the ages. Thirty million Americans now take antidepressant medications. Is this sudden epidemic of depression "not so much the discovery of a long-unrecognized disease but a reconstitution of a broad swath of human experience as illness?" Life is tough, the world is an insecure and often merciless place, and there are bewilderments of loss, stresses and frustrations, not to mention the "melancholy cultivated through fifty years of absorbing life's quotidian blows." Call it the human condition, and Greenberg is the first to say the condition can be crippling; he has suffered bouts of deep depressions for years, smartly conveyed here, including participation in a clinical trial for an antidepressant. However, the author is suspicious that the drug came first and then a vast market was created for them through the interplay of pharmacological and insurance companies, doctors and the FDA. He is also distressed about the drugs' exaggerated claims and sleight-of-hand efficacy statistics. Greenberg focuses heavily on the human element lurking behind the symptoms of depression and their context and meaning. During this tour of depression, the author engages in extended, illuminating discussions of a host of therapeutic techniques, the confounding power of the placebo effect, the evolution of psychopharmacology and the ways in which expectations shape response. A humanistic, witty exploration of the human response to depression.
1 Mollusks 12 Job Versus His Therapists 253 Mauve Measles 384 The Dangers of Empathy 615 Making Depression Safe for Democracy 806 What Your Mum and Dad Will Do to You 1027 The Shock Doctors 1278 The Acid and the Ecstasy 1539 Getting High and Making Money 16910 Double Blind 20111 Diagnosing for Dollars 22512 Mad Men on Drugs 25313 Embracing the Model: Cognitive Therapy 28614 The New Phrenologists 31515 The Magnificence of Normal 338Notes 369Bibliography 397Acknowledgments 417Index 419
