Manufacturing depression Read Online Free PDF Page A

four or more days per week—are a symptom of depression. (There’s no explicit exception for countries, such as Spain, that have siesta schedules, but one imagines that therapists in those places adjustthe criteria accordingly.) I did nap more after my first marriage collapsed, although I never kept track. One day during that period, I was awakened from a particularly lovely nap by a phone call from my father. I immediately forgot everything about the conversation other than the way I felt as I fought through my grogginess: anxious to the point of nausea.
    “Dread,” I said to my therapist, whom I happened to be seeing later that day. “Just a feeling of dread and self-loathing. Like there he was working hard, being productive,
functioning
”—he was calling me from his office, where he spent ten-hour days until he was well into his seventies—“and here I was wasting time, crashed out on the couch in the middle of the day.”
    “Well, what do you think this means?” she asked. I had, I knew, lobbed her a huge hanging curve—all that Oedipal drama captured in a single scene.
    “Maybe nothing. I have to say, it felt, I don’t know,
biological.
”
    “Biological? You mean, like there are little bugs swimming in your blood or something, making you feel dread?”
    She said this as if it were the most preposterous idea in the world, as if anyone who believed it was either evading the truth or just plain deluded.
    It’s not preposterous anymore. There are many ways to distinguish various depressive states from one another. You could, for instance, listen to the stories I’m telling here and conclude that there are three sorts of depression—the temperamental kind that seems to sum up a considered view of the world as a not-so-happy place, the kind that seems always to have been there and has no particular reason behind it, and the kind that comes on after a setback. Evelyn’s depression is a good example of the first, Ann’s of the second, and, if I have to place myself in a category, mine belongs in the last. And then there are formal distinctions. For example, in the old days, which is to say before the DSM-III, doctors talked about manic-depressive illness , in which patients alternated between those two poles; involutional psychotic reaction , a condition of delusionalguilt and self-loathing that came on in middle age; and depressive neurosis , the garden-variety unhappiness that psychoanalysts treated in the Freudian heyday. Whether these distinctions were valuable or not or based on anything other than current fashion is hard to say. But what is clear is that they no longer exist. Sometime in the twenty years since my therapist made fun of me, the “bugs” have gnawed them into so much powder.
    In
Against Depression,
his sequel to
Listening to Prozac,
Peter Kramer wrote “ Depression is neither more nor less than illness, but illness merely.” Being depressed is not simply a response to circumstance, he argued, although it can be kindled by events in our lives. Neither is it a sign of sensitivity or intelligence or insight, nor a branch of suffering with roots in the social or political world—a despairing apprehension, say, of the world we have made. Nor is it a response to the tragedies inherent to human life—mortality, for instance, and the inevitability of loss. Indeed, he claimed, the failure to grasp the fact that depression is just another disease, just another way our bodies have of betraying us, as purposeless and meaningless as tuberculosis (which, he points out, was once seen as a mark of refinement), is itself a symptom of a widespread and longstanding, but deeply wrongheaded, view: that melancholy signals a profound grasp of the true nature of existence.
     
    Kramer likened depression to “ an occupying government ,” one that has apparently colonized our collective consciousness, propagandized us, as it were, into believing that it is more than illness. Under this regime, we don’t