Customer Reviews

Manufacturing Depression: The Secret History of a Modern Disease

5 star:		(21)
4 star:		(15)
3 star:		(5)
2 star:		(4)
1 star:		(2)

 

 

Finally, a critical history of depression that illuminates the conditions and origins of the malady while advocating humanely on behalf of its sufferers. I loved this book! Combining narratives about his own experiences as both a depressed person and a professional therapist treating the depressed, along with a fascinating history of depression from the time of the ancients (including a wonderful reading of the Book of Job as an early record of depression) through modern melancholia all the way to the present biochemical understanding of the disease, Greenberg brings remarkable erudition, insight, and humanity into this deeply personal and problematic subject. In addition, he provides the most acute and detailed analysis of the nexus between the pharmaceutical industry and diagnostic trends that I've read so far. If its effect on me is any indication, reading this book will help anyone who has experienced depression (and the people who love them) to understand more fully the nature of their suffering and the limitations of current trends in treatment. While it is certainly critical of many aspects of the industry that's grown up around depression, and provides no pat answers or magic bullets for how to overcome it, the main message to me is deeply positive: that anti-depressants are clearly valuable tools in the battle against depression but we shouldn't shortchange ourselves by letting our identities or our suffering be defined by the pharmaceutical industry. Greenberg is one of the sharpest, most compassionate, and most entertaining minds currently exploring the intersection of psychology, science writing, and cultural studies--think Foucault with a great sense of humor and a big heart--and this intervention into the national conversation about depression and anti-depressants is long overdue.

I first read Gary Greenberg's thoughts on depression in a Harper's essay that was passed from friend to friend always with the same insistence: "You've got to read this!" I'm pleased to say that the book is also a must read. It is a devilishly hard thing to see how one's culture informs one's sense of self. Some writers try to manage the trick by becoming vociferous critics of the psychological trends of their time, endlessly pointing out the mistakes of all the people not as smart as they are. Greenberg's approach is much more interesting. His approach is empathic, deeply personal and at many times filled with wonder and humor. Highly recommended.

Gary Greenberg has stepped into the 'treacherous waters of anti-depressant
research' and challenged the old-guard establishment, calling into question the
integrity of the entire healthcare industry - but he doesn't necessarily outline
a concrete remedy for the frustrating mess. And as we all know, the American
people don't mind if you enlighten them on the problem, but you'd better
follow that up with the ANSWER.

And Greenberg doesn't do that. He nudges, he suggests, he makes inroads, takes
detours, and will occassionally outright opine, but a sure-fire ANSWER - not
Greenberg's style.

But asking the questions, pointing out the gaps in reason and logic, exposing
falsehoods....that's just as important, isn't it? That at least gets us
somewhere more meaningful and substantial than the complacency spoon-fed us by
those ominous depression doctors (forget the spoon, these days it's a
multi-colored cocktail).

Of course, Greenberg has a powerful opponent, a Goliath to his David. Just ask
those Uconn guys who did all that placebo research and ruffled many a lab coat
feather. His may not be a popular message, but it is an important one. Like a powerful movie or a rousing speech, Manufacturing Depression challenges us to reconsider long-held beliefs and erroneous thinking - because the depression doctors sure as heck aren't going to do it for us...

Dr. Gary Greenberg is both a psychoanalyst and a person who has lived through several depressive episodes in his life, so he brings some unique insights (or axes to grind) to "Manufacturing Depression." As is evident from the introduction, Dr. Greenberg is highly critical of our current Prozac/Paxil/Zoloft culture but rather than focus exclusively on the marketing of antidepressant drugs, Dr. Greenberg takes a long-term historical approach which takes us from the origins of professional medicine and psychiatry in the 19th century up until the present day and cognitive-behavioral therapy. It's an unusual approach for the sort of general interest audience Dr. Greenberg is writing for, and as a result the book is often tiring to read for long periods of time. It's best to break it down chapter by chapter and - given that Dr. Greenberg does have a certain agenda to push - perhaps explore "Manufacturing Depression" within a weekly book club. This is definitely a book that generates discussion!

There's a lot of information in this book. Dr. Greenberg gets the historical details admirably right and makes the past as vivid as he can but misrepresents (or misunderstands) the purpose of statistical significance testing. This wouldn't be so bad if Dr. Greenberg were attempting to describe statistics and research methods in a neutral fashion; he is not a specialist. Unfortunately, this isn't the case. Most of his discussion about this topic is embedded in excerpts from an article he wrote a few years ago about his experiences as a patient in a clinical drug trial and it's here that his tone veers from approachable and interesting to snarky and smarmy. It's also uncomfortably narcissistic.

In fact, the article's excerpted inclusion highlights the most serious problem this book faces - exceptionally poor editing. Unless you already possess a certain degree of knowledge about medical history, psychology, and psychiatry you will have a very hard time seeing exactly where Dr. Greenberg is going with his book until it's nearly over. As it is now, this is a mélange of somewhat interesting memoir about coping with depression, an expanded version of a mean-spirited article, some very interesting professional insights, and a well-researched historical exploration of modern medicine, the rise of big pharmaceutical companies, and modern psychiatry's attempts to stay relevant in the face of some serious chemical competition. At times it pursues digressions with a passion. This book would have been much better (and perhaps Dr. Greenberg would be far less depressed) if only a strong editor imposed a real structure upon it and pruned out the tangential aspects. As it is now, the last couple of chapters almost completely collapse into a disorganized harangue in which Dr. Greenberg's points are almost totally lost amid some increasingly emotional language. The attacks on cognitive therapy seem almost tacked-on as an afterthought.

Dr. Greenberg raises a lot of interesting questions throughout, and also reveals a lot of interesting paradoxes. It's strange that a man so critical of our prescription drug culture writes so glowingly about his LSD and Ecstasy experiences in the same book, for instance. It's equally unusual that a champion of psychoanalysis - which does not have an inspiring track record - would relish pointing out (correctly) how poorly anti-depressant drugs actually perform when the research is closely examined. Despite what might appear to be a negative review, this is a book that I have shared with several of my colleagues and we've had some great discussions about it. There are very few books of this nature that seem to encourage their readers to interact with each other as a result of reading - and this book is one of them. For that reason - and in spite of unfortunate lapses into neurotic snarkiness, Dr. Greenberg emerges as one of the more engaging storytellers I've read in a while - I recommend this book to anyone interested in the topic. I've rounded it up to 4 stars based upon its strongest aspects.

I recommend this book for anyone who suffers from depression, especially those who are taking any kind of depression medication.

By laying out the history of the treatment of mental disorders through the years, the author makes a pretty convincing case that folks are buying just as much snake oil today as they did back in the nineteenth century.

Only now, the FDA and the AMA seem to be endorsing it.

The author dissects most of the so-called facts behind the claimed efficacy of these drugs, and boy, have we been sold a bill of goods. Or bads.

It seems that most of the pills have little more effect than placebos like sugar pills. But sugar pills don't have horrendous side effects like suppressing your libido or making you commit suicide.

As for the various talking cures, no one is really more effective than another. But -- there is some therapy in the simple act of seeking therapy -- finding an empathetic professional to talk to.

Folks, as someone who has made a living -- or in recent years, tried to -- in the field of advertising, believe me when I say what it took me many years to admit to myself: the more they try to sell you something, the less you actually need it!

I will also confirm what any review of the help wanted ads will prove: the one area of advertising that has grown in leaps and bounds in recent years is health care, including pharmaceuticals. Deduce what you will!

The author includes some of his own experiences with mental health professionals in this book, which are equally enlightening. He also has a ready wit, a kind heart, and more clear-headed wisdom than most of the so-called professionals in his field, all of which he displays here, even in passages dense with chemical formulas.

I did deduct one star, because it felt as if there was a bit of redundancy in the book -- the author repeats many of the same arguments throughout.

Still I would strongly encourage anyone who is thinking of taking an anti-depressant to read this book first.

You may conclude that it is far more safe and effective to get on board Willie Nelson's bus than take prescription meds, especially if you use a vaporizer to eliminate dangerous tars when inhaling...

And for heaven's sake -- even if you have a spiffy new flat-screen TV that continues to work for longer than a year or two -- TURN IT OFF OCCASIONALLY! Read a book -- like this one...

Greenberg's writing style is easy to read, easy to understand. The book is a bit of a "slow starter." His premise so far seems to be that feeling sad used to be acceptable; now it's a reason to take a pill. For those with chronic mental illness, namely clinical depressive disorder, his writing will not be helpful, and may even cause more guilt and self-doubt, but for those who have cause/effect depressive symptoms, it may lead to some worthwhile self-examination and even validation of the experience of being sad for good reason.

In the vein of Prozac Nation, author Greenberg takes on and challenges some of the well-entrenched notions of clinical depression and similar now-routine diagnoses. Armed with medical and historical research, the author illustrates how certain afflictions, once commonly labeled as simple melancholy and treated with "medicinal" tonics dispensed by traveling barkers, later gained definitions as neurological disorders that required extensive psychiatric and pharmaceutical remedies.
While there are obviously people with real psychological issues that require treatment involving advanced care, Greenberg sustains that many are over-diagnosed as victims of depression, and have created a huge multi-billion dollar industry around the pharmacological and psychiatric treatment of patients who might be better treated by extended rest or other obvious - and far less costly - remedies.

I hardly know where to start with this review. Manufacturing Depression is a dense book which covers a lot of ground. The reading is historical, anecdotal, scientific, and opinionated. If you have ever wrestled with the notion that what used to be described as "nervous" or "delicate" is now a mental illness, this book will in many ways answer that question.

It should be noted that Gary Greenberg has a VERY clear point of view on this issue. He is a psychiatrist who has treated patients with depression, and also wrestled with the condition himself. He resolutely believes that were it not for pharmaceutical and insurance companies, depression would not be considered a disease. Let me be clear, here, though, that he is not denying the existence of real depression. On the contrary, he argues that depression is real, and for some it can be a debilitating state. His argument is more that a condition that was once considered to be part of being human is now considered to be unnatural. He argues that in the U.S. where our mission is life, liberty, and the pursuit of happiness, we have been set up to deny the natural valleys of life.

He fleshes out this argument meticulously. He writes about the history of mental illness, the history of psychiatry, the history of treating mental illness, and the history of mental illness treatments. He details the backstage of drug advertising campaigns, and insurance company payment requirements. His writing style is intelligent, but accessible. He writes openly about his own experiences with depression and his treatments (both legal and otherwise).

This is not a self-help book. It is a history book. This book will not tell you how to live with depression, but it will make some convincing arguments that periods of sadness are just as important to the human experience as periods of joy--which may help some gain perspective.

I HIGHLY recommend this book.

Not only will this book help you to weigh the pros and cons of antidepressants, it will also help you look deeper into all kinds of advertising and media.

This book goes way beyond revelations about the pharmaceutical industry and the nature of sadness, depression, and disease. With a nervous chuckle, it digs into that dark, foggy, philosophical place where psychology gropes ontology and gets smacked.

I can think of no way to explain what this book is about. It's as if the issue of depression and Big Pharma is merely a context in which something deeper and more disturbing can be brought into focus. Maybe you shouldn't look there. But then again, maybe you'd better.

This is a very confused and confusing book, and I kept on reading it not so much because I liked it, but because I wanted to figure out why anyone else would like it (all those great reviews) and because I became intrigued with the workings of the author's mind. What, I wondered was the source of all his confusion and anger?

As a history of the modern concept of depression and the development of antidepressants, I found that it meandered here and there, dipped into this and that, and did not keep up a coherent story line or argument. There were anecdotes that seemed beside the point. After a while, I became so frustrated that I decided to skip the middle chapters of the book. (Chapter 13 on CBT was an exception; it was lucid and informative.)

The development of the author's own ideas on depression is even more disordered. This is a person, a therapist, who cured his own depression by taking an illegal drug, but who is vehemently opposed to seeing depression as a biochemical illness. This is a person who seeks treatment for his own depression (and treats others) --so he must understand how destructive and degrading depression can be, but he treats those who would cure it by physical means as enemies of humanity. (Easy enough to do when you're talking about pharmaceutical companies--isn't the phrase "shooting fish in a barrel"?)

Finally, toward the end of the book, I began to see (I think) the source of the author's inconsistencies and anger. He seems to be one of these "Either/Or" thinkers. So either depression is a psychological/existential condition that results from the tragedies and indignities of life, or it's a biological/chemical illness. This kind of thinking dooms the book from the start. If you think you have to make a choice, you're always going to choose meaning over chemicals and be angry at anyone who suggests otherwise.

But of course, there is no either/or. It is both the case that depression is biological and that it is psychological. There is room for both psychotherapists and neuroscientists. Depression is caused by both physical events in the brain and by psychological events, thoughts, and meanings in one's life. And depression is cured both by physical means (drugs, shock, exercise) and by psychological means (therapy, improved relationships, new interpretations.)

By the end of the book, the author seemed to be figuring this out. I hope so. But I also hope that those who want to understand depression go elsewhere. The most insightful and helpful book on depression I have found is "The Mindful Way Through Depression."