After over 20 years of mostly unsuccessful treatment for depression from both psychiatrists and psychotherapists, I have seen a bias in treatment toward internal causes of depression like brain chemistry, thoughts/cognitions, emotions, behaviors, and very little attention paid to external causes of depression like trauma, child abuse, conflict, and social and economic injustice. As a depression patient I feel I've been led to see my suffering as essentially "all my fault". This cultural bias is probably a major reason why the majority of depression sufferers avoid treatment altogether or don't stick with it if they do try it. In essence, the "cure" can feel worse than the illness.
Bruce Levine, PhD in his 2007 book "Surviving America's Depression Epidemic— How to Find Morale, Energy, and Community in a World Gone Crazy" asserts that the consumer culture that dominates American society is a source of a depression epidemic, and that conventional treatments for people who feel alienated from such a culture can actually increase their alienation and contribute to their despair. Levine points out that the rate of depression in America is now between ten and twenty times as much as it was fifty years ago and that depression has increasingly become a young person's problem in which the average age of the first onset of depression in now fourteen or fifteen years old.
Like Dr. Peter Breggin, a well-known New York psychiatrist critical of the proliferation of psychiatric drugs in the last twenty five years, Bruce Levine asserts that "there is no scientific evidence that depression is a consequence of any chemical imbalance we can measure," and further, that "rather than correcting a specific chemical imbalance, there is much more evidence that psychotropic drugs work by dampening one's emotional experiences."
For years I felt a certain smugness around using psychiatric drugs in that I was using "medicine" and not "getting wasted" with alcohol or illegal drugs. But after reading Peter Breggin and now Bruce Levine it's clear my use of psychiatric medication was most likely accomplishing the same task of alcohol and illegal drugs in anesthetizing myself.
In an article from alternet.org on his website (brucelevine.net), Bruce Levine talks of how in 2012 NPR reporter Alex Spiegel was surprised to discover that "the psychiatric establishment now claims it has always known that the biochemical imbalance theory of depression was not true." In 2011, Ronald Pies, editor-in-chief of the "Psychiatric Times" stated, "In truth, the 'chemical imbalance' notion was always a kind of urban legend — never a theory seriously propounded by well-informed psychiatrists." In 2007 Thomas Insel, director of the National Institute of Mental Health and the highest U.S. governmental mental health official, told Newsweek that "depression is not caused by low levels of neurotransmitters such as serotonin." Levine states that "psychiatry made no serious attempt to publicize the fact that the research had rejected this chemical imbalance theory, a theory effectively used in commercials to sell antidepressants as correcting this chemical imbalance — an imbalance psychiatry knew did not exist."
Levine states in "Surviving America's Depression Epidemic" that the "pharmaceutical companies ... have been so effective at marketing the neurotransmitter deficiency theory of depression that even though the NIMH has now retreated from this view, the general public and many doctors continue to believe it." Depression is profitable for Big Pharma and the mental health treatment industry, and when anything, including mental illness, becomes extremely profitable, we are likely to see more of it. Consequently, the rates of depression and mental illness in the U.S. have steadily increased.
Levine asserts that there is a certain phenomenon contributing to the increased rates of depression. In a culture pushing productivity and efficiency unrelentingly on its members, a strategy some Americans use to withdraw and be contemplative without regard for productivity and efficiency is to become ill. Illness has become "one of our few socially acceptable routes to meet our needs for contemplative withdrawal."
Levine argues that one possible reason for the increasing rate of depression among Americans is that this culture *demands* happiness. Since the ascent of advertising in the early 1900's and especially the consumer boom following World War II the U.S. has become a nation primarily of consumers rather than citizens and an "unhappiness taboo" has dominated here. In a consumer culture "people are forever trying to buy happiness and sellers are expected to appear happy so as to inspire confidence in what they are offering." Most businesses are in some sense selling happiness or relief from unhappiness, and thus there is enormous pressure to maintain the appearance of happiness.
Levine also asserts that over the last several decades there has been a transformation in the United States in which "corporations and other bureaucracies have increasingly taken over American society and required a more conformist personality." Americans have acquiesced to something Levine calls "institutionalization: the domination by gigantic, impersonal, bureaucratic, standardized entities" that have attempted to have everyone fit into increasingly standardized environments. This has contributed to increasing numbers of Americans feeling alienated, inadequate, and depressed.
I earlier mentioned my experience of psychiatric medication numbing me from pain, and Levine argues that this is a sign of the consumer culture which urges us to numb and divert us from emotional pain. He says that "increasingly the US economy is based on diversions and anesthetizations." He makes the somewhat radical (for this culture) assertion that "nature does not want us to permanently anesthetize emotional pain."
In "Surviving America's Depression Epidemic," Bruce Levine focuses on several potential solutions to the depression epidemic including the topics of morale, healing, wholeness, self-acceptance, life beyond self, but for brevity's sake I will highlight the area he covers that I feel is most significant in relieving the depression epidemic, and that is "Public Passion and Reclaiming Community."
Levine begins his chapter on reclaiming community by highlighting a popular book by sociologist Robert Putnam called "Bowling Alone" (2000) which states that "while American society has been an unparalleled success in producing financial and material capital, Putnam makes it painfully clear that it has ravaged *social capital*, his term for social connectedness." Putnam links low levels of social support to depression and states that half a century of research indicates that "happiness is best predicted by the breadth and depth of one's social connections." Putnam details a social collapse in the U.S. on every level: work, informal social connections, family, and progressive religious institutions.
Levine writes of a "It's-nobody's-fault" attitude toward depression which asserts that it's neither the individual's nor his parent's fault for being depressed, a seductive exoneration of responsibility "blaming brain chemistry rather than confronting society and human relationships." Levine argues that the "It's-nobody's-fault" belief is used as a marketing tactic that benefits mental health professionals by making parents feel less threatened about taking their children to treatment as well as benefitting Big Pharma by leading to drugs and profits. If our society had an abundance of healthy families and communities that encouraged human relationships, the mental health profession would probably be out of business.
Levine asserts that "our extreme industrial society values other things more than human connectedness," specifically efficiency, production, and consumption. In an "extremist industrial-consumer society" that worships production and consumption above all else, healthy families, intimacy, and friendships are a threat: "Maintaining families and groups requires attention and energy, and time spent on human relationships is time taken away from production and consumption." Levine states that time and mindfulness are required for human relationships which cannot be done without a rebellion against the worship of industrialization and consumerism.
Levine references the work of psychiatrist Viktor Frankl ("Man's Search for Meaning," 1959), who believed that "emotional pain can have meaning, and meaning can provide direction and energy" and that "the striving to find a meaning in one's life is the primary motivational force in man."
Bruce Levine "wrote this book for people whose gut tells them that depression is neither a character defect nor a biochemical defect but rather a normal, albeit painful, human reaction." A depression sufferer is facing an oppressive force in a consumer culture adhering to an "unhappiness taboo" and an economy which merely encourages us to divert and anesthetize ourselves with consumer products and services including those sold by the pharmaceutical and mental health treatment industries. Levine asserts that there are healthier, more satisfying and dignified options than having one's "normal, albeit painful" depression be pathologized and exploited for profit by an industrial-consumer culture that is a large source of the pain to begin with.