Manufacturing Depression: The Secret History of a Modern Disease (2010)
by Gary Greenberg. Published by Simon and Schuster.
This book presents a combination of research and Dr. Greenberg’s personal experience with depression. He takes a position critical of today’s prevailing view that depression is a brain disorder caused by a neurochemical imbalance and effectively treated by antidepressant medications. He looks at the history of depression as a disorder, the history of antidepressant medication, and considers what we lose when we look at our sadness as a brain disease.
Dr. Greenberg’s writing is fluid and unforced, making serious material an easy read (He has written for publications such as the New Yorker, Harper’s and Discover — just to name a few). He is able to combine humor (sometimes pointed at his own foibles and sometimes at the foibles of the health-care professions and pharmaceutical industry), with serious scholarship. And his points are well taken!
The book follows two tracks: The major theme focuses on the history of psychiatric thinking about and treatment of the thing we now all too easily call depression, and leads to an analysis of the current mainstream medical view of depression and its treatment. The second thread in the book is about Dr. Greenberg’s own experience of depression and his participation in a clinical trial at Massachusetts General Hospital. He includes his own doubts about whether depression is the kind of illness we currently see it as, and his experiences as a psychotherapist with severely, mildly and moderately depressed patients. His own experience of sadness and angst as described in the book would be seen by most mental health professionals as moderate to (at times) severe depression.
Dr. Greenberg is able to see both sides of issues. He does not merely rail at the pharmaceutical industry for being greedy (although he is critical of them vis-a-vis antidepressant medication), but understands that part of their mission, as well as to provide helpful products, is to make money and sell things. And perhaps the making money has become too prominent and perhaps some of those running such corporations have lost sight of the being helpful part. At the very least they often appear to spend little time in critical analysis of the true human value of each of their products.
Although it is not totally comprehensive (what is?) or the final analysis (again, what is?) it raises some very important questions and is very thoughtful and well documented in the process. Its 48 pages of notes and bibliography lead to other interesting works on the topic.
The book’s messages:
- How we look at sadness or depression or whether these things are illnesses worthy of diagnosis and treatment depends on the culture (both in terms of time and place) we are living in.
- We have theories about what causes depression, but no one has proven that the cause is an imbalance of neurotransmitters in the brain, even though pharmaceutical advertising may lead us to believe that the cause has been clearly described and proven.
- The current view of depression as a biological illness that can be cured with pharmaceutical is not adequate to Dr. Greenberg because it leaves out the possibility that suffering may be an opportunity for growth, and because it prevents us from coming to our own interpretation about what the sadness and suffering in our lives is about.
- Antidepressant drugs may be somewhat helpful to people who are depressed, especially people with severe depression, however, the way these drugs are currently advertised and prescribed leads people to believe that they are much more effective than they really are.
- People have a huge capacity for healing themselves which is largely ignored by the current western medical view of depression and its treatment.
- It may be valuable to people to be able to choose how they look at their own sadness and suffering rather than to be indoctrinated with the idea that sadness and suffering are related to a brain disorder.
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Dr. Gary Greenberg obtained a Ph.D. in Psychology (concentration in Clinical Studies) from the Saybrook Institute in 1992 with distinction. He also holds a M.S. in Counseling Psychology from Southern Connecticut State University and a B.A. from Swarthmore College. He is a Licensed Professional Counselor in Connecticut, and has written numerous articles on Clinical issues in Psychology for the popular press as well as for peer reviewed journals such as Review of General Psychology and the Journal of Narrative and Life History. In addition, Dr. Greenberg has authored chapters for academic books and is the author of three books in addition to this one (The Self on the Shelf: Recovery Books and the Good Life, State University of New York Press, The Noble Lie: When Scientists Give the Right Answers for the Wrong Reasons, John Wiley, and the forthcoming The Book of Woe: DSM-5 and the Unmaking of American Psychiatry, Blue Rider Press). Dr. Greenberg also has a private psychotherapy practice in New London, Connecticut.