Saturday, June 22, 2019

How to Produce Depression

Given our cultural deformities, we should not be surprised to see columnists offering a bunch of tired bromides on the anniversary of Anthony Bourdain’s suicide.

Yesterday, Tim Carman, a food reporter at the Washington Post explained to us that Bourdain’s suicide should provoke a national conversation about depression. And that we must destigmatize depression. So people can openly share their misery-- which is likely to deter others from socializing with them. It's a solution creating a problem.

Precisely how a food writer comes to be an authority on depression… I leave that to your imagination. And yet, Carman has consulted experts and we all believe in experts, don’t we?

In his words:

But another of Bourdain’s legacies is one we don’t care to talk about: his suicide and the mental state that led him to that awful moment. Yet evidence suggests the more we ignore the problems that beset us and/or our loved ones — the fears, the shame, the fevered thoughts in the night — the more we contribute to the growing suicide rates. Talk, experts tell us, can help save lives.

Dare we mention that experts have a vested interest in accumulating clientele. Theirs is not the most disinterested perspective.

But then, Carman continues, sometimes talk does not work. Uh oh!

A place to talk is not, by itself, always enough. A friend of mine, a man I had once sought out as a mentor, committed suicide several years ago. He committed suicide even though he had countless friends who would listen, without judgment, to anything he had to say. He committed suicide even though he was a gifted therapist. He committed suicide after the last of his beloved Siberian huskies had died and he was alone with his worst thoughts.

Of course, there is not just one kind of depression. And the quality of treatment-- see yesterday’s post about "Lauren Slater’s Pharmacopoeia"-- varies considerably from therapist to therapist.

In his effort to read between the lines of Bourdain’s script, Carman lights on the fact that Argentina has more mental health professionals per capita than anywhere else in the world. If he had dug into the statistics he would have discovered that many of these professionals are Freudian psychoanalysts. Which means, for the uninitiated, that they are more in the business of producing depression than in healing it. I hope that this does not come as a surprise.

In truth, Argentina, for having a well-educated and well-therapied population is perennially a political, social and economic basket case. Do you really want to emulate Argentina?

Carman does not know enough to know about this, but then, why is he making pronouncements about treating depression?

Carman continues, about Bourdain:

Still, amid the tongue-in-cheek disclosures that bad airport hamburgers send him into a “spiral of depression that can last for days,” Bourdain did, in fact, reveal something important about himself. Outside the psychiatrist’s office, he told the shrink, over a drink, that “I’m not going to get a lot of sympathy from people, frankly. I have the best job in the world.”

“Let’s face it,” Bourdain continued. “I go anywhere I want. I do what I want. Look, that guy over there loading sausages onto the grill? That’s work. This is not so bad. It’s all right. I’ll make it.”

By the standards of today’s therapy culture, doing what you want, when you want, with whom you want stands as a beacon toward which we are all supposed to aspire. And yet, a life of perpetual vagabondage, of disconnection, of social uprootedness… is not the best thing that can ever happen to your mental health. It produces good feelings, but they are accompanied by anomie… an anomie that can only be treated by a structured routinized life… one where you fulfill your responsibilities to other people, not where you evade others to travel the globe in search of the perfect taco.

After explaining that he too suffers from depression, Carman indulges yet another foray into pure banality, suggesting that the best way to overcome depression is to destigmatize it… and to find a good therapist.

I’m telling you this because not telling you this is a sure road to destruction. I’m telling you this because I want to help destigmatize a condition that’s literally killing off people who make our world a better place. I’m telling you this because, if you’re a fellow sufferer, I hope you will find your way to a good therapist, as I have. I’m telling you this because I have so much left to give.

We do not know whether or not Bourdain had been treated for depression. If he is like most of today’s citizens he would have been given a prescription or two or twenty for different psychiatric medications. As we saw in the case of Lauren Slater yesterday, the effectiveness of these medications has been seriously called into scientific question.

And, as we all know, suicide is a risk factor for anti-depressant medication.

Beyond that, the call to destigmatize depression is not original. But it is still a bad idea. Since Prozac burst on the scene a few decades ago, the psycho world has been talking about nothing but depression. And since Prozac was such a magic pill, all the talk might well have induced people to develop the symptoms of depression… the better to test out the miracle drug. And to redesign their personalities.

As Ethan Watters argued at length in his book Crazy Like Us, efforts to destigmatize mental illness tend to produce more, not less, mental illness. We saw it with hysteria in Europe the late 19th and early 20th centuries. We saw it with anorexia in Hong Kong in the 1990s. And it is likely that we are seeing it today in America with depression.


Sam L. said...

I only depress the buttons on my keyboard, nowadays. Well, OK, on/off buttons, too

B. said...

Work cures melancholy. Maybe we need more opportunities for people to get off their computers, go outside, pick up trash, plants flowers, etc..WPA for mental health.

DocVinny said...

Frequently the best way for me to treat your depression is to get you off medication. I get patients in that have been put on four medications while being treated for their depression, and they have no idea what planet they're on. Their hands shake from the antipsychotic they've been put on. They can't stay awake because the medications are all sedating.. They're still depressed but any ability to cope they had is gone, thanks to the medication.