Ethical Human Psychology and Psychiatry, Volume 10, Number 2, 2008
Reviewed by Stuart Shipko, M.D., Diplomate, American Board of Psychiatry and Neurology
This well-referenced book espouses that depression is an uncomfortable human reaction and not a disease. As such, the best approach is to this is a nourishing human experience, meaningful relationships with other people. What we call depression is natural. It need not be feared and it can ultimately be a motivating and positive force.
Surviving America's Depression Epidemic: The humanization of depression starts with the title of the book. One typically survives natural disasters and catastrophes, but the usual terminology regarding mental illness is that one recovers from it, beats it or goes into remission from it. The language of the book follows from the title and depression is continually de-reified.
It is a good book for patients and potential patients to read. With the selling of psychiatric diseases by pharmaceutical companies, people continue to hear the message that unhappiness is a disease, and question whether their negative feelings really do represent a treatable medical condition. Surviving gives the reader a palpable understanding of sadness and emotional pain as uncomfortable but not dangerous feelings.
The book starts out with a chapter entitled "Marketing, Myths, Science and Society," which looks at the history of depression. It debunks the biological model of depression, and takes shots at psychotherapy as well. Levine introduces the role of society and culture in depression illustrating it with historical facts and vignettes and then outlines how the worship of industrialization and technology leaves peoples' expectations and needs unmet. This chapter ends with a section on 'the unhappiness taboo' and the perversion of the pursuit of happiness to mean that it is our duty to be upbeat all of the time.
This sets the stage for the rest of the book, which seeks to more precisely define depression as a normal human reaction. Levine deftly avoids using the word depression whenever possible. He writes, instead about emotional pain and resulting paralysis. He addresses the issue from a variety of contexts, discussing depression as a once successful coping style that becomes a failed strategy, as demoralization, as emotional denial, and as self absorption just to name a few.
Assuring people of their normalcy could well serve to help them avoid unnecessarily entering the mental health system, but does not address their suffering. Surviving emphasizes that negative emotions are not just "weeds on a lawn" to be removed with chemicals so much as an uncomfortable human reaction that can act as a positive motivating force.
In describing and characterizing this uncomfortable human reaction, there are a lot of helpful suggestions and strategies to help readers change and cope. The last chapter, entitled, 'Public Passion and Reclaiming Community' takes change a step further, outlining how our social conditions cause us to feel powerless and disconnected and how the antidote to this lies in forming antiauthoritarian community.
Beyond the factual information, Surviving is a pleasure to read. Interesting historical information and fascinating referenced studies are interspersed with numerous personal vignettes and commentary in an appealing combination.
Personally, as an isolated antiauthoritarian (the sort of patient Levine writes that he most commonly sees) I found that reading Surviving was comforting and provided me with a comforting sense that my own angst is really average and that the local healing community Levine refers to is there for me as well if I reach out for it.
Early in the book Levine cites information that supports the notion that people with depression are probably more realistic in their assessment of the world. For those who have this sort of a realistic depressive assessment of the world around them, Surviving is the antidote.
Book Review- October 15, 2007
Levine is a clinical psychologist whose message, which he first explored in 2003’s Commonsense Rebellion, is that American society is a pathological society, mired in “an extremist consumer culture” that breeds depression as a matter of course (he points to the American Psychological Association’s 1998 statement that the U.S. was suffering “ten to twenty times as much” depression as it was 50 years before). Levine attributes this to three consumerism-driven factors: the failure of the medical profession to account for “societal and cultural sources for despair”; the“psycho-pharmaceutical complex” that pushes health practitioners to prescribe drugs; and therapists’ determination not to stray from the standardized counseling rulebook. The solution Levine uses in his own practice recognizes that periods of depression can be a “natural part of the human condition” and “potential sources for motivation and discovery,” and combines humor and practical advice to instill the self-acceptance and self-release that will help people pull themselves clear and find “life beyond self.” Though the toppling of consumer society advocated in a final section on “Public Passion and Reclaiming Community” may not be entirely realistic (especially for the lone self-helper), Levine’s holistic approach, bolstered by plenty of scholarship and popular literary references, will give depression patients a useful big-picture perspective. (Oct)