What We Are Not Being Told About Suicide And Depression

Shouldn’t researchers examine societal and cultural variables that are making us depressed and suicidal?

By Bruce E. Levine / AlterNet

February 15, 2015

For nearly two decades, Big Pharma commercials have falsely told Americans that mental illness is associated with a chemical brain imbalance, but the truth is that mental illness and suicidality are associated with poverty, unemployment, and mass incarceration. And the truth is that American society has now become so especially oppressive for young people that an embarrassingly large number of American teenagers and young adults are suicidal and depressed.

In November of 2014, the U.S. government’s Substance Abuse and Mental Health Services Administration (SAMHSA) issued a press release titled “Nearly One in Five Adult Americans Experienced Mental Illness in 2013.” This brief press release provides a snapshot of the number of Americans who are suicidal, depressed, and mentally ill, and it bemoans how many Americans are not in treatment. However, excluded from SAMHSA’s press release—yet included in the lengthy results of SAMHSA’s national survey—are economic, age, gender, and other demographic correlates of serious mental illness, depression, and suicidality (serious suicidal thoughts, plans, or attempts). It is these demographic correlates that have political implications.

These lengthy results, for example, include extensive evidence that involvement in the criminal justice system (such as being on parole or probation) is highly correlated with suicidality, depression, and serious mental illness. Yet Americans are not told that preventing unnecessary involvement with the criminal justice system—for example, marijuana legalization and drug use decriminalization—could well prove to be a more powerful antidote to suicidality, depression, and serious mental illness than medical treatment.

Also, the survey results provide extensive evidence that unemployment and poverty are highly associated with suicidality, depression, and serious mental illness. While correlation is not the equivalent of causation, it makes more sense to be further examining variables that actually are associated with suicidality, depression, and serious mental illness rather than focusing on variables such as chemical imbalances which are not even correlates (see AlterNet January 2015). These results beg questions such as: Does unemployment and poverty cause depression, or does depression make it more likely for unemployment and poverty, or are both true?

And the survey results also provide extensive evidence that younger Americans are more depressed than older Americans, that women are more likely to be depressed than men, and that Native Americans and biracial Americans are more likely to be depressed than other ethnic/racial groups. Again, while correlation is not the equivalent of causation, depression obviously cannot cause one to become young, female, or Native American. More rationally, researchers should be asking what is it about American society that is so depressing, especially for young people, women, and Native Americans?

These recent SAMHSA survey results provide a golden opportunity for a scientific and societal shift to reconsider what about American society and culture is resulting in emotional suffering and self-destructive behaviors, especially for certain groups. Below is a summary of some of the key statistics in these buried SAMHSA survey results.

Summary of Buried SAMHSA Survey Results
Involvement with the Criminal Justice System: In 2013, the percentage of American adults with serious suicidal thoughts: 10.7 percent for those on parole or a supervised release from jail in the past 12 months, 9.2 percent among those who were on probation, and 3.9 percent for those not involved in the criminal justice system. The percentage for adults with any mental illness: if on probation was 32.3 percent, if on parole or supervised release, 36.5 percent, double the percentage of adults not involved in the criminal justice system (18.3 percent). The percentage of adults with serious mental illness: if on probation was 9.4 percent, if on parole or supervised release was 13.9 percent, more than triple for those not involved in the criminal justice system (4.1 percent).

Unemployment: Among American adults in 2013, the unemployed were more likely than those who were employed full time: to have serious thoughts of suicide (7.0 vs. 3.0 percent), make suicide plans (2.3 vs. 0.7 percent), or attempt suicide (1.4 vs. 0.3 percent). The percentage of adults with any mental illness: for the unemployed was 22.8 percent, for part-time employed was 20.3 percent, and for full-time employed was 15.4 percent. Among adults with serious mental illness: the percentage for the unemployed was 6.6 percent, for part-time employed was 4.8 percent, and for those full-time employed was 2.7 percent. Among those adults having a major depression episode: the percentage for the unemployed was 9.5 percent, for part-time employed was 7.8 percent, and for full-time employed was 5.3 percent.

Family Income: Among American adults in 2013, serious suicidal thoughts occurred in: 6.6 percent of those from family incomes below the Federal poverty level, 4.7 percent of those with family incomes between 100 and 199 percent of the Federal poverty level, and 3.1 percent of those with annual family incomes at 200 percent or more of the Federal poverty level. Among American adults, the percentage with serious mental illness: for those with a family income that was below the Federal poverty level was 7.7 percent, for those with a family income at 100 to 199 percent of the Federal poverty level was 5.1 percent, and for those with a family income at 200 percent or more of the Federal poverty level was 3.2 percent.

Age: No suicidality results were reported for Americans under 18, however, among American adults having serious suicidal thoughts, the percentage: for those aged 18 to 25 was 7.4 percent, for those aged 26 to 49 was 4.0 percent, and for those aged 50 or older was 2.7 percent. And among adults who made suicide plans in the past year: the percentage for those aged 18 to 25 was 2.5 percent, for those aged 26 to 49 was 1.3 percent, and for those aged 50 or older was 0.6 percent. The percentage of Americans having a major depressive episode in 2013: for those aged 12 to 17 was 10.7 percent, for those aged 18 to 25 was 8.7 percent, for those aged 26 to 49 was 7.6 percent, and for those aged 50 or older was 5.1 percent.

Gender: In 2013, adult women were more likely than adult men to have: any mental illness (22.3 vs. 14.4 percent), a serious mental illness (4.9 vs. 3.5 percent), a major depressive episode (8.1 vs. 5.1 percent), and suicidal thoughts (4.0 vs. 3.8 percent). Among American ages 12 to 17, females were more likely than males to have a major depressive episode (16.2 vs. 5.3 percent) and a major depressive episode with severe impairment (12.0 vs. 3.5 percent).

Ethnicity/Race: In 2013, the percentages of adults aged 18 or older having serious thoughts of suicide in the past year were: 2.9 percent among blacks, 3.3 percent among Asians, 3.6 percent among Hispanics, 4.1 percent among whites, 4.6 percent among Native Hawaiians or Other Pacific Islanders, 4.8 percent among American Indians or Alaska Natives, and 7.9 percent among adults reporting two or more races. The percentages of adults with a major depressive episode: were 1.6 percent among Native Hawaiians or Other Pacific Islanders, 4.0 percent among Asians, 4.6 percent among blacks, 5.8 percent among Hispanics, 7.3 percent among whites, 8.9 percent among American Indians or Alaska Natives, and 11.4 percent among adults reporting two or more races.

Conclusions
The SAMHSA press release states that among American adults in 2013: 10 million American adults (4.2 percent) experienced a serious mental illness, 15.7 million adults (6.7 percent) experienced a major depressive episode, and states that “major depressive episodes affected approximately one in ten (2.6 million) youth between the ages of 12 to 17.” The press release then laments how many Americans with mental illnesses are not receiving treatment.

While these statistics in the SAMHSA press release are troubling, the devil is in the details of the actual lengthy SAMHSA survey results. These results make clear that suicidality, depression, and mental illness are highly correlated with involvement in the criminal justice system, unemployment, and poverty, and occur in greater frequency among young people, women, and Native Americans.

Shouldn’t researchers be examining American societal and cultural variables that are making so many of us depressed and suicidal? At the very least, don’t we as a society want to know what exactly is making physically healthier teenagers and young adults more depressed than senior citizens?

Depression Chemical Imbalance Doesn’t Exist

Depression Chemical Imbalance Doesn’t Exist, Experts Say
by Elizabeth Renter
04/18/2013

What if you went to a crime ridden street corner, suffering from depression, and were told that a certain drug could change how you felt about things? What if you went to your doctor and were told the same thing? While the corner drug dealer and your physician might have different drugs in mind, they are essentially offering a similar solution—putting you in a “drug-induced” state to minimize your negative symptoms. Doctors, the media, and society say there is a chemical imbalance which causes depression, but a depression chemical imbalance doesn’t exist, experts say.

Dr. Joanna Moncrieff, a mental health expert from the department of mental health services at University College in London is taking a quite non-politically-correct approach in characterizing anti-depressants and other mental health drugs as just another dependency.

She says that although doctors, the media, and society in general has latched on to the idea that depression and anxiety, for example, are just evidence of a “chemical imbalance” in the brain, there is no hard evidence to support this.

“Scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed.”

While many people are convinced this is indeed their problem and therefore are okay with being offered a drug to solve the “problem”, she says the problem is that we are minimizing the seriousness of taking drugs to solve a “mental disorder.”

It is frequently overlooked that drugs used in psychiatry are psychoactive drugs, like alcohol and cannabis. Psychoactive drugs make people feel different; they put people into an altered mental and physical state. They affect everyone, regardless of whether they have a mental disorder or not. Therefore, an alternative way of understanding how psychiatric drugs affect people is to look at the psychoactive effects they produce

She says that these drugs, like anti-depressants, often produce symptoms of other, illegal drugs. The difference—these are prescribed by medical professionals and marketed to the masses in a more acceptable way.

In decades past, there was a stigma associated with mental health drugs. While it’s debatable whether this stigma was justified, there’s little doubt that it did make people think twice about taking medication for depression.

Now, however, we are convinced that these drugs are correcting a defect in the brain. The drugs are correcting an “imbalance.” But the problem is, that imbalance has never been proven.

Sure, you can argue that your medication makes you feel better, but wouldn’t other psychoactive drugs make you feel better too?

Dr. Moncrieff isn’t suggesting that people take cheaper illegal drugs, since they may have similar effects, but instead wants people to really get real about their anti-depression or anti-anxiety medications– what are they really doing to themselves when they rise each morning and pop the same pill, occasionally having to up their dosage because their body has developed a tolerance.

And with the number of Americans on antidepressant medication estimated to be 1 in 10, perhaps a critical look at this drug trade is warranted.

When terrible, abusive parents come crawling back, what do their grown children owe them?

The Debt 
By Emily Yoffe|Posted Monday, Feb. 18, 2013 | Slate


What do we owe our tormentors? It’s a question that haunts those who had childhoods marked by years of neglect and deprivation, or of psychological, physical, and sexual abuse at the hands of one or both parents. Despite this terrible beginning, many people make it out successfully and go on to build satisfying lives. Now their mother or father is old, maybe ailing, possibly broke. With a sense of guilt and dread, these adults are grappling with whether and how to care for those who didn’t care for them.

Rochelle, 37, wrote to me in my role as Slate’s Dear Prudence because of the pressure she was getting from friends to reach out to her mother. Rochelle is a banquet waitress in the Midwest. She has a boyfriend but lives alone and has no children. She and her younger brother grew up with an angry, alcoholic mother who was on welfare but cleaned houses off the books to supplement the check. Rochelle’s parents were never married and split when she was young. Her mother always told her not to have children. “We were the reason her life turned out as it did,” Rochelle says. She told Rochelle she was so stupid that she’d need to find a rich husband to support her. She said she couldn’t wait for Rochelle to turn 18 and get out of her house. Rochelle’s younger brother had difficulties from the start—she looks back and thinks he might have been autistic. Her mother used to take a belt to him and call him the devil and say she wished he’d never been born.

Rochelle started waitressing when she was 15. By 18, she was indeed out of the house and into an abusive relationship with an older man. She broke up with him, got her own apartment, a decent boyfriend, and started working to put herself through college. Then her brother was killed at age 18, shot in the heart during a silly fight over a girl. Rochelle stepped up and took care of all the funeral arrangements. Her father came and, when he left, hugged her goodbye. “That was the first time he ever hugged me,” she recalls. Her mother called later that night, drunk, and said that, by hugging her, Rochelle’s father was trying to molest Rochelle. Rochelle wrote her mother a letter saying she had a drinking problem and needed help. In response she got a letter saying that she was a horrible daughter and she would get what she deserved and that her brother was defective and needed to die.

That was Rochelle’s breaking point—after that, she didn’t see her mother for the next 13 years. Even though Rochelle was barely scraping by, she would sometimes send her mother money for rent, knowing she probably used it for booze. Occasionally, a friend would check on her mother and give her a report. Then last year a tornado struck the town where Rochelle’s mother lived, and Rochelle went to make sure she was all right. That began a sort of rapprochement. Rochelle started taking her mother out to lunch every other Sunday. She did it not because she felt she owed her mother anything: “Absolutely not.” Instead it was for her own sense of self. “To me being a good person means helping people when you can.”

The visits took a toll. Rochelle describes a physical response that sounds a lot like post-traumatic stress disorder. “All the stuff I tried to let go of seeps in. One little thing—the scent of her cigarettes, a mannerism, a word—floods back all these memories.” Rochelle started chewing gum on the drive to see her mother, she says, “because I’m clenching my jaw, white-knuckling the steering wheel.”

Rochelle found that being a good person to her mother was so draining that it left her sleepless and snapping at the people she did love. Her mother’s verbal abuse resumed and her demands started escalating—she wanted more attention, more money. Rochelle got a therapist, and with her help, has again cut ties with her mother. Rochelle says, “I can’t sacrifice my life and sanity in order to try to save her.”

In an essay in the New York Times, psychiatrist Richard Friedman writes that the relationship of adults to their abusive parents “gets little, if any, attention in standard textbooks or in the psychiatric literature.” But Rochelle is not alone. I have been hearing from people in her position for years, adult children weighing whether to reconnect with parents who nearly ruined their lives. Sometimes it’s a letter writer such as “Comfortably Numb” who has cut off contact with a parent but is now being pressured by family members, and even a spouse, to reconcile and forgive. Sometimes a correspondent, like “Her Son,” has hung on to a thread of a relationship, but is now fearful of being further yoked emotionally or financially to a declining parent.

One hallmark of growing up in a frightening home is for the children to think they are the only ones in such circumstances. Even when they reach adulthood and come to understand that many others have had dire childhoods, they might not reveal the details of their abuse to anyone. “The profound isolation that’s imposed on people is a very painful and destructive thing,” says Dr. Vincent Felitti, co-principal investigator of the Adverse Childhood Experiences Study. According to the Centers for Disease Control and Prevention, about 3.3 million cases of abuse or neglect were reported to child protective service agencies in 2010. This vastly undercounts the actual number of horrific and painful childhoods, as most never make it into any official record. The CDC notes that some studies estimate that 20 percent of children will be the victims of such maltreatment. That means a lot of people are wrestling with this legacy.

Loved ones and friends—sometimes even therapists—who urge reconnecting with a parent often speak as if forgiveness will be a psychic aloe vera, a balm that will heal the wounds of the past. They warn of the guilt that will dog the victim if the perpetrator dies estranged. What these people fail to take into account is the potential psychological cost of reconnecting, of dredging up painful memories and reviving destructive patterns.

Eleanor Payson, a marital and family therapist in Michigan and the author of The Wizard of Oz and Other Narcissists, sees some clients who feel it would be immoral to abandon a now-feeble parent, no matter how destructive that person was. Payson says she advises them to find ways to be caring while protecting themselves from further abuse. “One of my missions is helping people not be tyrannized by false guilt or ignore their own pain and needs,” she says. Setting limits is crucial: “You may need to keep yourself in a shark cage with no opportunity to let that person take a bite out of you.” It’s also OK for the conversation to be anodyne. “You can say something respectful, something good-faith-oriented. ‘I wish you well’; ‘I continue to work on my own forgiveness.’ ”

There is no formula for defining one’s obligations to the parents who didn’t fulfill their own. The stories of famous people with abusive parents reveal the wide range of possible responses. Abraham Lincoln couldn't stand his brutish father, Thomas, who hated Abraham’s books and sent him out as a kind of indentured servant. As an adult, Lincoln did occasionally bail out his father financially. But during his father’s final illness, Lincoln ignored letters telling him the end was near. Finally, he wrote not to his father, but his stepbrother to explain his absence: “Say to him that if we could meet now, it is doubtful whether it would not be more painful than pleasant.” Lincoln didn’t attend his father’s funeral.

Warren Buffett remained distantly dutiful to his mother, who had subjected her children to endless, rabid verbal attacks. On the occasions he visited her at the end of her life, he was a “wreck” of anxiety, sitting silently while his female companions made conversation. He was 66 when she died at 92. His tears at her death were not because he was sad or because he missed her, he said in his biography, The Snowball. “It was because of the waste.”

Bruce Springsteen’s frustrated, depressive father took out much of his rage on his son. In a New Yorker profile, David Remnick writes that long after Springsteen’s family had left his unhappy childhood home, he would obsessively drive by the old house. A therapist said to him, “Something went wrong, and you keep going back to see if you can fix it or somehow make it right.” Springsteen finally came to accept he couldn’t. When he became successful he did give his parents the money to buy their dream house. But Springsteen says of this seeming reconciliation, “Of course, all the deeper things go unsaid, that it all could have been a little different.”

We all accept that there is an enduring bond between parent and child. One of the Ten Commandments is to “honor your father and your mother,” though this must have been a difficult admonition for the children of, for example, Abraham, Rebecca, and Jacob. Yet the loyalty of children to even the worst of parents makes perfect biological sense. From an evolutionary perspective, parents, even poor ones, are a child’s best chance for food, shelter, and survival.

Regina Sullivan is a research professor of child and adolescent psychiatry at the NYU Langone School of Medicine who studies emotional attachment in rats. In experiments with rats raised by mothers who neglect or physically hurt their pups, Sullivan has teased out that, when in the presence of the caregiver, the infant brain’s fear and avoidance circuits are suppressed. Attachment “programs the brain,” she says. “The ability of an adult who can say to you, I had a horrible childhood, I don’t like my parents, but then do things to continue to get the parents’ approval, is an example of the strength of human attachment in early life.”

As Springsteen’s experience shows, one doesn’t just leave such childhoods behind, like outgrowing a fear of the dark. Study after study has found that just as an emotionally warm, intellectually stimulating childhood is typically a springboard for a happy, healthy life, an abusive one can cause a litany of problems.

Abuse victims are more likely to suffer from depression, substance abuse, broken relationships, chronic diseases, and even obesity. Many of the high-functioning people I hear from who are wrestling with their debt to their parents have struggled with some of these issues. Rochelle says, “I was a very angry kid, I got into fights in grade school. I’ve worked on it a lot, on not being the spiteful angry person all the time.” She also says she has dealt with food issues her whole life. Her mother brought home groceries once a month and she and her brother would devour the food before unpacking it. “We were starving,” she says. “If I have an addiction, it’s eating.”

Those who refuse to make peace with a failing parent may also find themselves judged harshly. In his memoir Closing Time, Joe Queenan writes of the loathing he and his sisters felt for their alcoholic, physically and psychologically abusive father. When they were grown, Queenan writes: “We talked about him as if he were already dead; such wishful thinking was rooted in the hope that he would kick the bucket before reaching the age when he might expect one of us to take him in,” although they agreed none would. When the father finally died, he wrote, “Clemency was not included in my limited roster of emotions.” In a review of the book in the Wall Street Journal, Alexander Theroux writes, “It is a shameful confession to make in any book.”

In his New York Times essay, Richard Friedman acknowledges that some parent-child relationships are so toxic that they must be severed. But he adds, “Of course, relationships are rarely all good or bad; even the most abusive parents can sometimes be loving, which is why severing a bond should be a tough, and rare decision.” But substitute “husband” for “parents,” and surely Friedman would not advise a woman in such a relationship to carry on because her battering spouse had a few redeeming qualities.

I know from my own inbox that many people are looking for someone, anyone, to tell them they should not feel guilty for declining to care for their abuser. I’m happy to do it. In private correspondence with these letter writers, I sometimes point out that, judging by their accounts, there doesn’t seem to be any acknowledgement of guilt on the part of the parent for neglecting to meet their most basic responsibilities.

A woman I’ll call Beatrice wrote to me as she wrestled with how to respond to a series of emails, calls, and letters from her long-estranged parents. Beatrice, 42, has a doctorate, is a professor of mathematics at a Midwestern university, and lives with her supportive boyfriend. She thinks of herself simultaneously as a “self-made person” and a “damaged” one. She decided long ago not to have children. “I have never felt confident I could trust another person to be the other parent. I’m not sure I could be a competent parent because of what I’ve been through.”

Of her childhood she says, “I don’t remember any happy days at all.” Her father had violent rages; he once knocked her down a flight of stairs. If she couldn’t finish dinner, she would have to sit at the table all night, then get beaten by him if she didn’t clean her plate. Her mother never intervened. Her parents divorced when she was young and her father refused to pay child support. A few years later, her mother became the fifth wife of Beatrice’s new stepfather and life got much worse.

He was unemployed and always around. Beatrice was a young teen and when she got home from school he would go into her bedroom, put his fingers up her vagina, and say he was giving her a massage. He made her touch his genitals. He let his friends come over and “have fun” with her, as long as they didn’t take her virginity. When she was 17, she finally stood up to him and he kicked her out of the house. He told her mother she had taken off of her own accord. By that time she was working 40 hours a week at a crafts store in addition to going to school, and a co-worker let her move into her basement. She contacted her mother and asked her to meet her for lunch. Beatrice explained everything that had been going on with her stepfather. “She told me she didn’t believe a word and didn’t want to hear anymore,” Beatrice says. “That was the last time I saw her.” That was 25 years ago.

Beatrice says that during her childhood she would sometimes feel sorry for herself. Her friends would complain about their parents, or about having bad days, and she would think they had no idea what a bad day was. But she says of being on her own at 17, “The day my stepdad kicked me out, my life got better. I could come home and no one was trying to do anything bad to me. I didn’t have to hide. I didn’t worry about getting hit. That meant everything.”

Last year, separately and out of the blue, Beatrice’s mother and father each got in touch. Her biological father sent a small gift and a card with an update: He was in debt, out of work, and was supporting Beatrice’s troubled sister. A few months later, there was a message on her answering machine. “This is your mother,” the voice said. She wanted Beatrice to know her stepfather had only a few days to live. She told Beatrice she was willing to forgive her. “That made me laugh,” Beatrice says. Her mother started sending emails and Beatrice sent her a reply saying she was busy and couldn’t deal with any of this. She hasn’t heard back from her mother since. But she fears that both her parents will contact her again and explicitly ask for help.

“I’m worried about that happening. I’m worried she’ll call and say, ‘I have cancer.’ I don’t know what I’m going to do,” Beatrice says. “If she knows I’m a professor, I’m sure everyone thinks I make a huge salary and I’m going to save them. My salary is enough for me to do what I want.”

Dr. Ronald Rohner, an emeritus professor of family studies and anthropology at the University of Connecticut, has devoted much of his career to studying parental rejection and its effects. He says there’s little research on adult role reversal—that is, what happens when the parent is vulnerable and wants support from the child. But he says the studies that do exist demonstrate that “it really truly is as you sow, so shall you reap. Those parents who raised children less than lovingly are putting their own dependent old age at risk for being well and lovingly cared for themselves.”

In a 2008 essay in the journal In Character, history professor Wilfred McClay writes that as a society we have twisted the meaning of forgiveness into a therapeutic act for the victim: “[F]orgiveness is in danger of being debased into a kind of cheap grace, a waiving of standards of justice without which such transactions have no meaning.” Jean Bethke Elshtain, a professor at the University of Chicago Divinity School writes that, “There is a watered-down but widespread form of ‘forgiveness’ best tagged preemptory or exculpatory forgiveness. That is, without any indication of regret or remorse from perpetrators of even the most heinous crimes, we are enjoined by many not to harden our hearts but rather to ‘forgive.’ ”

I agree with these more bracing views about what forgiveness should entail. Choosing not to forgive does not doom someone to being mired in the past forever. Accepting what happened and moving on is a good general principle. But it can be comforting for those being browbeaten to absolve their parents to recognize that forgiveness works best as a mutual endeavor. After all, many adult children of abusers have never heard a word of regret from their parent or parents. People who have the capacity to ruthlessly maltreat their children tend toward self-justification, not shame.

Even apologies can have their limits, as illustrated by a Dear Prudence letter from a mother who called herself “Sadder but Wiser.” She verbally humiliated her son when he was a boy, realized the damage she had done, changed her ways, and apologized. But her son, who recently became a father, has only a coolly cordial relationship with her, and she complained that she wanted more warmth and caring. I suggested that she should be glad that he did see her, stop whining for more, and tell her son she admires that he is giving his little boy the childhood he deserves and that he didn’t get.

It’s wonderful when there can be true reconciliation and healing, when all parties can feel the past has been somehow redeemed. But I don’t think Rochelle, Beatrice, and others like them should be hammered with lectures about the benefits of—here comes that dread word—closure. Sometimes the best thing to do is just close the door.

Fascinating New Uses For Psychedelics

Scientists are looking into various medical and psychiatric uses for psychedelics.
Could the taboo be ending?

By Sarah Seltzer, AlterNet
Posted on April 26, 2012

On last week's episode of the drama "Mad Men," set in 1966, Roger Sterling, the embodiment of the classic old-boys club figure, accompanies his younger wife to a dinner party where the guests "turned on" to LSD.

After a night of laughing fits, tears, dancing and hallucinations, the couple have a profound conversation about their marriage's failure. Sterling wakes up the next morning feeling that he's been given an entry into "the truth" and in a shockingly sincere tone, declares that it's going "to be a beautiful day."

The sequence represents a surprisingly positive portrayal of acid, staying away from cliches and demonstrating how a stuck-in-the-mud character might actually, at least temporarily, be jolted out of despair and complacency by an experience on drugs.

In some ways, Roger's fictional night embodies the quintessential mid-'60s "long, strange, trip." For a brief period before LSD became synonymous with the youth-led counterculture, hippies and burnout, it was taken seriously among elites--it was even legal. The drug, originally being tested for various physical and psychological institutions, began to be recreationally used by professionals like the therapist who encourages the Sterlings to "turn on" as aiding personal development and enhancing insight.

But when LSD became a street drug and was criminalized, it moved out of laboratories, and the stigma carried over through the end of the century.

Hallucinogens like LSD and psilocybin were added to the 1970 Controlled Substance Act as Schedule I substances, which defines them as having no medicinal value and makes getting federal funding (or the actual drugs necessary) for research nearly impossible. That is why, even now, many studies of pot and hallucinogens are conducted in other countries. Scientists wanted to conduct the research, but they couldn't, and for the most part, it's still very difficult.

It's taken decades for American scientists, doctors and patients to have the chance to take a closer look at the uses of psychedelic drugs, not just recreational but medical, personal and therapeutic. Even now, doctors who do this work are eager to distance themselves from Timothy Leary and his ilk.

And yet the shift has happened. The profession is back to exploring the various positive effects of these drugs, and their work is being covered by the mainstream media. Here are some examples of ways psychedelics are being explored in medicine today.

1. Alcoholism. This year, a group of Norwegian scientists went back into medical archives to reexamine previous LSD studies to help recovering alcoholics. When they crunched the data, what they found was not only evidence that LSD is useful in treating addiction, but also circumstantial evidence that the culture wars may have derailed the progress of this line of inquiry. From HealthDay's story last month:

In a new analysis, Norwegian researchers examined six studies of LSD and alcoholism that were conducted in the United States and Canada between 1966 and 1970. 

The analysis of data from the 536 patients in the studies showed that a single dose of LSD helped heavy alcoholics quit and reduced their risk of resuming drinking, according to the meta-analysis appearing online March 8 in the Journal of Psychopharmacology. 

Patients who received a full dose of the controversial drug did the best. On average, 59 percent of those patients showed a clear improvement, compared with 38 percent of patients in other groups, the Norwegian University of Science and Technology researchers said.

Kristen Gwynne has pointed out on AlterNet that this study is particularly promising as there are currently very limited options for those who suffer from alcoholism, and 12-step programs, which rely on a loosely religious framework, can be discriminatory and leave people out.

The implications of these studies are huge. As the authors said, "Given the evidence for a beneficial effect of LSD on alcoholism, it is puzzling why this treatment approach has been largely overlooked." In fact, the kind of radical new perspective portrayed on "Mad Men" is the kind of jolt that could help break the hold of the disease. 

2. End-of-life issues. That change in perspective may also help those who are dying or at risk of dying, and in the throes of psychological crisis. The New York Times Magazine recently ran a comprehensive cover story by Lauren Slater describing new trials for patients suffering from terminal or severe disease, and the attendant anxieties.

One patient profiled in the story had a profound emotional catharsis during her controlled use of psilocybin, and described it for posterity on video:

“I felt this lump of emotions welling up...almost like an entity,” Sakuda said, as she spoke straight into the camera. “I started to cry....Everything was concentrated and came welling up and then...it started to dissipate, and I started to look at it differently....I began to realize that all of this negative fear and guilt was such a hindrance...to making the most of and enjoying the healthy time that I’m having.” Sakuda went on to explain that, under the influence of the psilocybin, she came to a very visceral understanding that there was a present, a now, and that it was hers to have.

Slater's piece contains other compelling personal anecdotes from deeply ill patients, taking part in similar or parallel studies. After the directed, controlled administration of psychedelics, their fear of death decreased, their feeling of transcendence increased. Most importantly their anxiety was lessened, an alteration which positively affected their health and well-being.

3. Depression and anxiety. Slater's Times story also begins to dig into the physical reasons that psychedelics might have this effect--they may shut down over-active regions of the brain that are associated with depression:

The researchers found that the states of “unrestrained consciousness” that accompany the ingestion of psilocybin are associated with a deactivation of regions of the brain that integrate our senses and our perception of self. In depressed people, Nutt explains, one of those regions, the anterior cingulate cortex, is overactive, and psilocybin may work to shut it down. Nutt is planning a study in which he will give psilocybin to individuals with treatment resistant depression and see whether the drug can ease some of depression’s most recalcitrant symptoms.

That such an experiment would take place is logical; it seems evident that given the indications for these drugs' interaction with the depression and anxiety faced by terminal patients, they might also help those suffering from anxiety at other phases of life.


4. Cluster headaches. One interesting, more physical indication for these drugs--which arises from their non-hallucinogenic properties--is for the treatment of cluster headaches, which some call "suicide headaches" due to their extremely painful, frequent nature.

In 2009, the Daily Beast wrote about Bob Wold, a cluster headache sufferer, and the first time he took magic mushrooms (psilocybin):

The psychedelics arrived in a brown box at his doorstep from a long-distance dealer. He took one dose: about 1.5 grams. "In 15 minutes I could feel the difference,” he says. “My head was clearer than it had probably been in the past 20 years. Other medications felt like they were just covering it up.” But on acid, “All the pressure was gone."

Wold decided to help fund research into the uses of psychedelics on headaches like his:

Cluster Busters, a nonprofit advocacy group co-founded by Wold, is funding research by Harvard’s Dr. John Halpern, who recently administered a modified LSD molecule to a handful of cluster patients, successfully ending most of their headache cycles for weeks or months. Halpern thinks they may have finally found the cure for an ailment that has mystified physicians for years, and hopes to run a larger clinical trial soon.

Harvard’s Dr. John Halpern recently administered a modified LSD molecule to patients, successfully ending most of their headache cycles.

5. Post-traumatic stress disorder (PTSD). MDMA, the psychedelic ingredient in the drug Ecstasy has been studied recently to treat a specific form of depression and anxiety: that associated with past trauma. Oprah Magazine profiled several women who had been abused or raped and underwent experimental MDMA therapy. Their reactions were varied, but mostly positive. Here's one:

"I used to think, I'm a broken person. I'll never be able to do this simple thing. But after my first session, I thought, Well, it's okay not to stand in line. It's okay to go early. I stopped judging myself, and I didn't avoid my life anymore. Which was wonderful." A quarter-century after taking MDMA, Ot'alora still gets triggered from time to time, particularly in crowded places. "But it's much more short-lived now," she says. "Sometimes it's a matter of a second before I bring my body back to a safe zone."

Here's another:

In 2008 Emily did a single session of MDMA with the guidance of an underground therapist. "I took myself through the rape and I felt the trauma deeply, but I also stepped outside of it," she says. "I had what they call the 'God view' in a computer game. I saw it objectively, and with compassion. I wasn't thinking, I shouldn't have been there or I'm a piece of crap or This is all my fault."

The LA Times reported on a study being run by clinical investigator and psychiatrist Michael Mithoefer of South Carolina, the man who conducted the most recent round of MDMA therapy experiments:

Mithoefer has received FDA permission to test whether Ecstasy can help Iraq and Afghanistan veterans overcome their PTSD when used during psychotherapy sessions; six veterans have enrolled in the study. In an earlier clinical trial, Ecstasy helped 10 of 12 women recover from PTSD stemming from child sexual trauma. Only 2 out of 8 women who took a placebo had similar results, Mithoefer reported last year in the Journal of Psychopharmacology.

With MDMA as well as with mushrooms and LSD, the commonly known effects of the drug for recreational use can be seen in the way it's used to target particular psychological conditions.

Ecstasy's reputation for enhancing trust has clear roots in its biological effect. Using brain scans, Columbia University psychologist Gillinder Bedi found that subjects who took MDMA showed heightened activity in a brain region associated with processing rewards and depressed activity in the amygdala — a source of fear reactions. In animals, MDMA boosts the hormone oxytocin, which promotes trust, sociability and interpersonal attachment.

The politics of testing and studying the positive medical effects of psychedelics are marked by the politics of the drug war, the culture war, the pharmaceutical industries and academia.There may be no interest from Big Pharma to lobby the government for these studies because of the lack of profit potential; these drugs are something you take once or twice, not daily, and they are not patented.

But as all these stories in the mainstream media show, the therapeutic uses of these substances may finally be getting the kind of measured, rational attention they deserve--without the handwringing that comes from past negative associations. At least we can hope.

Here's a  National Geographic video about the return of LSD to the lab:

'Shy' children at risk of being diagnosed with mental disorder

(Good fucking grief! The psychiatric industry has gone nuts itself. They are out of their minds turning every little childhood issue or dilemma into a psychiatric disorder. OK, see, when people think I go off on rants too much, this is one of the reasons why. This is insane!--jef)

++++

Children who are merely shy or sad are at risk of being diagnosed with mental disorders and given powerful drugs, experts warn.

By Martin Beckford, Health Correspondent

14 Sep 2011

Psychologists say that new guidelines being developed in America will lead more young people seeing their common problems regarded as illnesses that must be treated, rather than just being given support.

They fear that pupils who are quiet at school could be diagnosed with “social anxiety disorder” while those who become withdrawn after suffering a bereavement are classified as having a “depressive disorder”.

Children who just talk back to adults or lose their temper regularly could be diagnosed with “oppositional defiant disorder”.

As a result, those found to have these increasingly broad mental disorders could be prescribed powerful medication such as Prozac or Ritalin to control or alter their behaviour.

Now the pressure is increasing for a national review of the use of such drugs on schoolchildren as well as more research into their long-term effects, following a vote at the TUC Congress on Wednesday.

Kate Fallon, general secretary of the Association of Educational Psychologists, told delegates: “Behaviours develop over a long period of time, often with a range of complex causes; we can’t ‘cure’ the behaviours we don’t like with a quick fix of medicine. They usually require careful management by all the adults around the child.

“In 2013 we’re expecting new criteria for the definition of mental illness to be adopted here in the UK. These criteria will lead to many more children being diagnosed as mentally ill, based on reports of their behaviours.

“A shy child could be diagnosed with social anxiety; a sad or temporarily withdrawn child could be diagnosed with depression.

“These are conditions which are also likely to be treated with medication – and under these circumstances, Congress, we will be putting potent drugs into children with little or no understanding of what it will lead to.

“In a society that wants quick results using drugs to improve behaviour is very tempting. But there can be other ways of improving children’s behaviour which typically involve time and energy from people.”

Research has found that children under the age of six are being prescribed the drug Ritalin for attention deficit hyperactivity disorder, prompting calls for the Department of Health to investigate the scale of the problem and the potential long-term damage it may be causing.
Recent figures show 650,000 children aged between eight and 13 are on the pscyhotropic drug, up from just 9,000 two decades ago, while others are taking Prozac for depression or anxiety.

Fears are growing that the number of children diagnosed with mental disorders and prescribed drugs will increase still further after 2013, when a new “bible” of the psychiatric profession is published.

Known as DSM-5, the book widens the diagnostic criteria for many supposed conditions including social anxiety disorder, better known as shyness, and will likely be adopted by the health authorities in Britain after appearing first in the US.

The proposed new definition for social anxiety disorder states that it is marked by “fear or anxiety about one or more social situations in which the person is exposed to possible scrutiny by others. Examples include social interactions (e.g., having a conversation), being observed (e.g., eating or drinking), or performing in front of others (e.g., giving a speech)”.

In children this fear could be expressed by “crying, tantrums, freezing, clinging, shrinking or refusal to speak in social situations”.

Young people will be deemed as having oppositional defiant disorder if they display symptoms including losing their temper, arguing with adults, deliberately annoying people or being “spiteful or vindictive at least twice within the past six months” to people other than their brothers or sisters.

The British Psychological Society has also raised concerns about the proposed revisions to the DSM.

It does not dispute that some children have emotional and behavioural problems but says that patients and the public are “negatively affected” by the continued “medicalisation” of natural and normal responses to their experiences, and that classifying such problems as “illnesses” ignores their wider causes.

Prof Peter Kinderman, chairman of the society’s Division of Clinical Psychology, said: “We’re not certain that a diagnosis and a medical response is the best way to help these kids.
“Absolutely understand and help, not necessarily diagnose and treat.”

Selling Clinical Depression

Adding New Spin and Urgency to Depression Drug Sales
By MARTHA ROSENBERG

The discovery that many people with life problem or occasional bad moods would willingly dose themselves with antidepressants sailed the drug industry through the 2000s. A good chunk of the $4.5 billion a year direct-to-consumer advertising has been devoted to convincing people they don't have problems with their job, the economy and their family, they have depression. Especially because depression can't be diagnosed from a blood test.

Unfortunately, three things dried up the depression gravy train for the drug industry. Blockbusters went off patent and generics took off, antidepressants were linked with gory and unpredictable violence, especially in young users and -- they didn't even work, according to medical articles!

That's when the drug industry began debuting the concept of "treatment resistant depression." It wasn't that their drugs didn't work (or you didn't have depression in the first place), you had "treatment resistant depression." Your first expensive and dangerous drug needed to be coupled with more expensive and dangerous drugs because monotherapy, one drug alone, wasn't doing the trick!

You've got to admire the drug industry's audacity with this upsell strategy. Adding drugs to your treatment resistant depression triples its take, patients don't know which drug is working so they'll take all of them and the defective drugs are exonerated! (Because the problem is you.)

Now the drug industry has a new whisper campaign to keep the antidepressant boat afloat. Your depression is "progressive."

Once upon a time, when depression was neither seasonal, atypical, bipolar or treatment resistant, it was considered to be a self-limiting disease. In fact, just about the only good thing you could say about depression was it wouldn't last forever.

But now, the drug industry is giving depression the don't-wait scare treatment like coronary events (statins), asthma attacks ("controller" drugs) and thinning bones (Sally Field). If you don't hurry and take medication, your depression will get worse!

"Depressive episodes become more easily triggered over time," floats an article on the physician Web site Medscape (flanked by ads for the antidepressant Pristiq.) "As the number of major depressive episodes increase, the risk for subsequent episodes is predicted more from the number of prior episodes and less from the occurrence of a recent life stress." The article, unabashedly titled "Neurobiology of Depression: Major Depressive Disorder as a Progressive Illness," is written by Vladimir Maletic who happens to have served on Eli Lilly's Speaker's Bureau, says the disclosure information, and whose co-authors are each employees and/or Lilly shareholders.

On WebMD, a sister site to Medscape, the depression sell is even less subtle. An article called Recognizing the Symptoms of Depression, smothered with five ads for the Eli Lilly antidepressant, Cymbalta, submits, "Most of us know about the emotional symptoms of depression. But you may not know that depression can be associated with many physical symptoms, too."

Depression may masquerade as headaches, insomnia, fatigue, backache, dizziness, lightheadedness or appetite problems mongers the article. "You might feel queasy or nauseous. You might have diarrhea or become chronically constipated." And here, you thought it was something you ate!

The danger with these symptoms says the article is that you would fail to diagnose yourself as suffering from a psychiatric problem and buy an over-the-counter drug like a normal person. "Because these symptoms occur with many conditions, many depressed people never get help, because they don't know that their physical symptoms might be caused by depression. A lot of doctors miss the symptoms, too."

But when head and backaches aren't labeled as depression, the drug industry make no money and insurance rates could stop climbing from over-treatment with unnecessary, expensive and dangerous psychoactive drugs!

To prevent such goring of marketshare, the article (whose content was "selected and controlled by WebMD's editorial staff and is funded by Lilly USA," an original WebMD financial partner according to the Washington Post) counsels worry about physical symptoms. "Don't assume they'll go away on their own." Symptoms may "need additional treatment" and "some antidepressants, such as Cymbalta and Effexor, may help with chronic pain, too."

Before direct-to-consumer advertising, the health care system was devoted to preventing over-treatment and assuring patients they were probably okay. Who remembers "Take two aspirin and call me in the morning"? Now patients are assured they probably aren't okay but probably have a progressive disease. Luckily their disease can be treated with progressive prescriptions from pharma.

Study: Depression Hits Losers Hardest

THE ONION | MARCH 5, 1997 | ISSUE 31•08

PALO ALTO, CA—According to a report released Monday by Stanford's Institute For Psychotherapeutic Study, depression, America's leading mental illness, hits losers worse than any other segment of society.

Losers, sad excuses for human beings who have no reason to feel good about themselves or their failed, miserable lives, are approximately 25 times as likely to suffer the emotionally crippling effects of depression as any other group researched, the study claims.

Worse yet, the prospects for successful treatment of depression among the loser populace are "poor at best," the study found. The reason: Most losers are such hopeless lost causes that they can never get a life, no matter how hard they try, and are "doomed to repeat their mistakes forever, living out their pathetic existence as little more than human garbage."

"People who are depressed are gripped by painful feelings of shame, hopelessness and low self-esteem," said Dr. Anne Wyler-Hustad, head of the Stanford team. "Losers are much more likely to internalize these emotions, as they are miserable little nothings, devoid of any value as people."

Noted therapist Eli Wasserbaum agreed. "Because they are so inherently inferior to regular people, many losers feel—quite correctly—that their lives are not worth living," Wasserbaum said. "Nobody cares about them, they are alone, they can't hold down a job, they have no money. Even their own families hate them. Life has passed them by. What's the point in their even going on?"

According to the Stanford study, losers are five times more likely to suffer from negative sexual self-images than non-losers, usually because they are fat and ugly, and nobody in their right mind would ever want to date them. Further, negative feelings such as despair, self-loathing and hopelessness are three times as common among go-nowhere lowlife losers than among normal people who are not worthless as human beings.

A depressed loser cowers in a corner. According to a new Stanford University study, there is no hope for such people.

The study also indicates that, because nobody would miss them if they died, losers are nine times as likely to attempt suicide as worthwhile people. "From the true loser's point of view, the compulsion to inflict self-harm seems to be 'the only way out.' This is true," Wyler-Hustad said. "Lord knows why they don't just do us all a favor and blow their heads off once and for all. I know I would if I were a loser like that."

But is there any hope for these losers? Can they get better? According to Stanford researchers, the answer is a resounding no.

"The depressed patient suffers from severe, delusional feelings of worthlessness," the study read. "But through therapy, the majority of those people are able to overcome their depression by slowly discovering that these negative beliefs are not true. In the case of losers, however, such negative self-images are not delusional, but instead reflect the truth about their lack of worth. This makes the loser's chances of suffering depression far more likely, and their prognosis for recovery slim to none."

With over one million Americans on Prozac, depression remains America's leading mental illness. But while most patients can expect to benefit from the drug, mental health experts agree that losers will not be helped by prescription drug therapy or, for that matter, anything at all.

"Losers, despite their profound, constant state of despair, are hated by others as much as they hate themselves," said Theodore Foti, director of the famed Rochester Institute For Mental Health. "They have no friends because they are, quite simply, too pathetic and useless for anyone to care about. How could anyone possibly expect a little pill to cure a problem like that? Give me a break."

Because of their severe, profound "loserdom," realistic treatment options for depressed losers are almost nil, the Stanford report concludes.

"The only treatment that makes any sense is loathing and rejection," Wyler-Hustad noted. "It is only logical that stupid, fat, ugly, bed-wetting, crybaby losers be shunned as outcasts and be treated with the hatred and disrespect they so richly deserve."

Manufacturing Depression

The answer is YES!

Manufacturing Depression':
Are Doctors Overprescribing Antidepressants to the Tune of $10 Billion a Year for Drug Companies?
By Amy Goodman, Democracy Now!
March 3, 2010

Is depression manufactured? Two decades after the introduction of antidepressants, it’s become commonplace to assume that our sadness can be explained in terms of a disease called depression. The National Institute of Mental Health estimates more than 14 million Americans suffer from major depression every year and more than three million suffer from minor depression. Some 30 million Americans take antidepressants at a cost of over $10 billion a year.

My next guest argues while depression can be debilitating, it’s also been largely manufactured by doctors and drug companies as a medical condition with a biological cause that can be treated with prescription medication. Psychotherapist and writer Gary Greenberg participated in a clinical trial for antidepressant medication and found that more often than not the drugs failed to outperform placebos. His latest book is a scientific, medical, historical and cultural exploration of the antidepressant revolution here in the United States. It’s called Manufacturing Depression: The Secret History of a Modern Disease.

AMY GOODMAN: Tell us about the trial you went through.

Gary Greenberg: I enrolled in a trial at Mass General Hospital, intending, actually, to enroll in a trial for minor depression. But the tests that I took showed that I had major depression. And the trial was a trial of fish oil versus placebo, which meant that I was taking omega-3 fatty acids or a placebo, I didn’t know which.

AG: And what happened?

GG: What happened was that I returned to Mass General every other week for two months, and I was given the same battery of tests over and over again. And as the time went on, I appeared to be getting better on the tests that were being used to measure my depression. At the end of the trial, I asked if I could be told if I was on the placebo or the drug, and they told me no, but since it was the next to the last day of the trial, I still had some pills left. I sent them off to a lab, and it turned out I was on the placebo.

AG: What did you think?

GG: I thought that was really interesting. And I thought that it was more interesting that the doctors really assumed that I was on the drug. The way I know that is because after the trial was over, they offered me what’s called an open label trial, where I would get what I knew to be, in this case, fish oil, which is standard for clinical trials. If they think the subject was on the drug, they offer them the drug after the trial is over, even if they have no way of knowing.

AG: So, talk about your overall thesis in this book, Manufacturing Depression, two decades after exactly what?

GG: It’s two decades after Prozac was introduced, which saw an explosion of two things: one of them is sales of antidepressants in the Prozac generation, and the other is the rates of diagnosis of depression. And in the book, what I’m trying to do is to show how these two things go together and how, in many respects, the drugs came first, and how this was something that has grown historically. For at least 150 years we’ve been heading in this direction.

And basically what the book is about is why it even makes sense at this point for people who are unhappy to even think about the possibility that they have a mental illness. And in the book, I’m mostly interested to say that our concern probably shouldn’t be so much with the drugs themselves as the meaning that we have for why we’re taking the drugs, which I believe shapes our response to the drugs, and that what really we should be paying attention to is how easily people are diagnosed with mental illnesses, as opposed to given other explanations or opportunities for themselves to explain why they might be suffering.

AG: Go on with that.

GG: Well, people get diagnosed largely by their family doctors, and sometimes only implicitly. In other words, you go to your doctor and you have some complaints about sleeplessness or nervousness or unhappiness or demoralization, and the doctor will give you a prescription often for Prozac, after asking some intelligent questions, or some other antidepressant besides Prozac. And he may not say, you know, “You are depressed.” He may just give you the drug. But you’ve seen enough on TV in ads and heard enough to know what the deal is. You don’t need the weatherman to know which way that wind blows. Or he does tell you that you’re depressed and explains to you that it’s a biochemical imbalance. And so, when you take the drug, if you feel better, then indeed you—that confirms that you were sick in the first place. And I’m not sure that it’s necessary to do that in order to take—get whatever benefits there are of these drugs.

AG: Today we’re seeing a major recession—jobs, unemployment. People can get very depressed. What happens? What do you think should happen? How should this be dealt with?

GG: Well, I don’t know that we’re that far off. I mean, there’s no reason people shouldn’t confide in their doctors or their therapists about how unhappy they are, but to be told that you have a biochemical illness is automatically to distract your attention from those kinds of conditions that you just mentioned. In fact, I think that the American Psychiatric Association is going to move even farther away from any kind of consideration of causes that come from the outside. In their next edition of the DSM, they’re eliminating—at least they’re planning—

AG: Explain the DSM.

GG: The DSM is the Diagnostic and Statistical Manual of diagnosis. It lists the diagnoses of official mental illnesses. Right now, if you’re simply suffering from bereavement—somebody dies—you can’t be diagnosed as depressed, unless your unhappiness lasts for more than two months. In the next edition, they may remove even that as an exception to the diagnosis of depression. And so—

AG: And remove what?

GG: The bereavement exception. So, in other words, if you’re bereaved now, you meet all the criteria for depression, but you can’t be diagnosed, because you were bereaved. Research shows that bereavement isn’t any different from other psychosocial stressors, like unemployment, like divorce. So, rather than grapple with that, the American Psychiatric Association seems to be moving in the direction of simply eliminating the exception. So what I’m getting at is that it’s very difficult in the context of a doctor’s visit, because doctors aren’t trained to do this, to talk with people about how their world might be at least part of why they’re demoralized.

AG: And then, take that a step further.

GG: If people then are encouraged to think of external circumstances, then they may be more empowered to take action. They may be more ready to consider the possibility that what they need to do is engage somewhere in the politics of their world. They may be ready to tell their own story about what depression is about, rather than the biomedical story.

The definition of depression has been changing since it was first introduced as a medical concept, which was about a little more than a hundred years ago. But the most radical changes have occurred after 1973, when the American Psychiatric Association had suffered a series of embarrassments, including, particularly, the discovery suddenly that homosexuality really wasn’t a disease. And they were forced to grapple with the fact that they—not only were there questions about whether their diseases really were diseases, but doctors couldn’t agree on the same patient what disease that patient had. And so they went to a system of diagnosis that’s purely a checklist. If you meet the criteria, then, regardless of your circumstances, you have the disease. And that’s how depression works.

And so, over time what’s happened is that the diagnosis has gotten increasingly detached from any sense of where it might come from, either within the psyche, as Freud would talk about, or from external circumstances, as more politically minded psychologists would talk about. And that, of course, goes hand in hand with the idea that it’s a biochemical illness, because if it’s not being caused by your external circumstances and it’s not being caused by some, you know, childhood trauma, then what’s left? In must be being caused by something inside your brain. And it’s become a brain disease.

AG: What role do pharmaceutical companies play in this?

GG: Pharmaceutical companies have been very eager to jump on that bandwagon. In fact, in many respects, they’ve originated that idea, or at least spread it through the culture like a virus. Since about 1960, the drug industry has been actively engaged in trying to help first doctors and now patients —believe that demoralization is really a mental illness.

They’ve done it through very clever marketing. For instance, they distributed 50,000 copies of a book called Recognizing the Depressed Patient to prominent doctors back in the early 1960s, in which the biochemical argument was made for the first time, in the almost entire absence of any findings that supported it. It was like a myth that was being given to the doctors to pass along to their patients, like viral marketing. Now with TV direct to consumer ads, every time there’s an advertisement for Prozac, it’s also an advertisement for the idea that depression is a disease. And I think that’s obviously very beneficial to the drug companies.

AG: At the end of your book, your final chapter is 'The Magnificence of Normal.' What does that mean?

GG: In my book I try to grapple with the possibility that there might be something redemptive about large groups of people thinking of themselves as sick, as is what’s happening right now, if 20 percent of the population is depressed. And I visited with some people who take that line. Unfortunately, what they do with their collective action is they decide to treat themselves as chronically ill people and to demand better drugs and to demand nothing but the restoration of normalcy in what they consider to be their brain illness.

Now, I don’t mean to criticize people who are really struggling to just get by every day, but for most of us, the idea that the normal is what’s magnificent is a problem, because it gives very little room for challenging or questioning the status quo. So, in the end, we can see that this idea that depression is a biochemical illness, no matter how the intentions or what the intentions were, which were probably good intentions, it doesn’t matter, because that idea is going to favor the status quo no matter what we do, if there’s not built into it some understanding of the way our engagements with the world contribute to the way that we’re unhappy.

AG: What about antidepressants in children?

GG: don’t know much about antidepressants in children, except I know that it’s a science experiment that everybody’s involved in right now that nobody has actually been asked to consent to. We don’t really understand how Prozac works in grownups. We know that if you put it into the system, you get a better mood out of the system after—in many cases. But with children, we have no idea what constantly tweaking their brain metabolism—we don’t know what the effects of that are going to be on a brain that’s still developing. So, while there may be situations in which it can be valuable, I think that we’re moving very, very fast, considering we know very little about how the drugs work in the brain and we know very little about the developing brain. So you put those two things together, that’s a lot of ignorance.

AG: Gary Greenberg, you’re a psychotherapist. You have been through trials yourself. But when you were researching Manufacturing Depression: The Secret History of a Modern Disease, what most surprised you?

GG: The thing that most surprised me was to discover just how easily ferreted out this history is. I mean, if you sit down and you look at the way medicine has developed for the last 150 years, while you probably couldn’t have predicted it from 1850, looking back, it’s a complex history, but it’s a very clear line from the first discovery of magic-bullet drugs in the late 19th century and the idea that our diseases—our suffering can be understood as medical diseases, to the idea that this kind of suffering can be understood as a biomedical disease. The book was really hard to write, don’t get me wrong. I earned my money. But it was really also a surprisingly straight line. It was how easily or quickly things fell into place to show that history.

I think that that’s important for people who might read the book, because when you read it, you see how you’ve really arrived on a wave that’s been building for 150 years. When you get to your doctor’s office and he starts to talk to you about your depression, you’re really at the end of a long line of events, that if you know about them, they really change the way that whole experience goes and the way you understand what your demoralization is about and the way you understand being told that you’re depressed.