How Americans Relate to Depression in "Comfortably Numb" by Charles Barber

Charles Barber begins his narrative, or rather, investigation into mental illnesses by discussing his time working with the mentally ill at homeless shelters and New York-Presbyterian Hospital. Not only does Mr. Barber discuss the cases of some of those he aided, readers quickly notice how much he focuses on what outsiders thought of the issue. For instance, Barber says that socialites at parties in his native Connecticut never knew an air about his work and did not regard it in the same respects of the doctors and lawyers as many of them were. Then, Barber notes, a significant change happened, where him and his work was the center of attention. Many stigmas were alleviated, as people were no longer ashamed, defects in personality became disorders, this therapy work foreign to many became national news. Barber explains the phenomena of medications, the absence of stigma, and aggressive marketing campaigns to explain for the sudden change in Americans. Barber clearly makes his central claim that so many people turn to medication hoping it will improve their lives, while those with true, clinical mental illnesses are not receiving their proper treatment.

Barber is completely thorough in his investigation of this matter. He cites scientific findings, testaments from doctors and researchers, medical articles and journals, first-person statements of the mentally ill, and all of this is nicely paired with his own personal experience. Barber utilizes primary sources, such as looking at research and people’s statements while also providing with us with secondary sources evaluating many of the topics he introduces such as critiques and analyses of studies and methods in both psychology and psychiatry. Barber nicely organizes the information he presents to us. He starts with his own experience then moves into discussing the impact big pharm companies have had. After this, Barber writes of the true cases of mental illness that are not brought to light by the media and discusses approaches to psychiatry that do not involve medications. His writing style is also an important element to discuss in his book. He writes very colloquially to ensure everyone understands and this also has a very conversational feeling with the reader, which is always a great strategy. That being said, Barber also writes citing relevant scientific data and facts which more than adequately supports his main claim. The only detraction, perhaps, is the inclusion of so much of the scientific that people without a fairly good grasp of biology and medicine may not receive the full effect of everything Barber is trying to tell. Yet also, this a great read for anyone interested in both the science and business of modern medicine.

Patients put so much power in the hands of doctors and trust them wholly, why should they not? The answer, as Barber bluntly and shockingly admits, is that modern science has ultimately failed us. As I think of it, we are truly in the dark ages of medicine. This is because it is impossible at this moment to design drugs for a specific purpose, rather drugs are more or less discovered accidentally. Even new drugs supposedly treating mental illness are simple recreations of preexisting medications. Scientists are just beginning to look at the brain and nervous systems comprehensibly, there are 100 trillion connections in the brain, and we still do not understand the function of entire regions of the brain. For example, while drugs in the United States seem to focus on increasing the amount of Serotonin in the brain, drugs derived in Europe decrease the amount of Serotonin, and both classes of drugs have the same results. This is surprisingly not accounted for in our knowledge of the brain.

This begs to offer then, if we really do not understand these drugs or their long time effects, while also showing little data to always improve someone, then why are they so aggressively advertised? Well, to no one’s surprise, it is because of corruption, bribery, and the cutthroat business. The corruption and bribery charges are accounted for by the fact that Pharmaceutical companies are actually footing the funding for both their drugs to be inspected and these companies are paying for the Food and Drug Administration’s new headquarters. Drugs are getting passes in the manner of innocent until proven guilty, an entirely preposterous idea. Barber includes a quote from Michael F. Jacobson, executive director of the Center for Science in the Public Interest, “Roosevelt would be sick to his stomach if he could see how Harvey Wiley’s [first FDA commissioner] hard-charging tiger of an agency became such a pliant pussycat” (Barber 36). And for the corporate business deals, Barber reports that the top ten pharmaceutical companies earned more than the other 490 companies in the Forbes 500 (Barber 22). This is an astounding fact. These companies’ products, such as Prozac, are prescribed to millions, it is no wonder they are pushing them so hardly on the general population. As Berber puts it frankly, what better way to make more money than creating a bigger perspective customer pool by targeting people that are perfectly healthy?

One such in-class topic that this book analyzes is the debate between mental illness and problem behavior. Thomas Szasz asserts that mental illnesses are not, in actuality illness, but, rather, a great myth passed on the public. Barber would partially agree with this idea. For many people, especially those who can afford care and prescription medicine, they do not medically need medicine to treat them, but seek care for something wrong in their lives. Barber says that many people with social anxiety are just shy, and people with depression are really just not happy. In both these cases, the great majority of people do not reach the threshold to be clinically diagnosed with illnesses. Since many mental illnesses are not concretely defined enough to be 100% accurately identified, it may very well be the case that these conditions are nonexistent for many people. As Barber says, “there is the catchall term depression” meaning there is a difference between depression and clinical (actual and diagnosable) Depression. And Szasz may be on to something, as Pharmaceutical companies make great profits from “treating” these people.

For the most part, I do indeed agree with Barber’s claims. For instance, he says the stigma of mental illness is not nearly as great anymore. People are free to discuss their lives and contact trained physicians. Case in point, myself. I have, or at least believe to, have social anxiety and obsessive-compulsive disorder. Now for myself, these are minor hindrances in my life; it is just a struggle to overcome just as everything else in life is. I would never feel the need to actively pursue medication. My father, an executive at Pfizer (a company Barber attacks numerously), even does not advocate for medication. He does not even care for the use of Advil. There was a time not too long ago, when people simply moved on with their lives and did not feel the need to be “cured”. Furthermore, I agree with Barber’s assertion that too many people are prescribed too many medications that are completely unnecessary. From this reading, I have also learned the power of therapeutic approaches to treating mental illnesses. This was an approach that I do not feel is marketed enough to people. Medication should always be treated as a last resort, and I find it tremendously irresponsible of doctors to not point patients in the right direction and simply give them a prescription if they ask for it. After general surgeries, patients are expected to rehabilitate with therapists and look after themselves. So why, then, does it makes sense to give someone a pill and send them on their way?

In conclusion, Barber’s publication, Comfortably Numb: How Psychiatry Medicated a Nation, is a book that I would recommend to any person, be it layman or scientist, as it truly breaks down all the factors involved in America’s current relationship with mental illnesses and psychiatry. Barber includes the best and worst parts of diagnosing these illnesses, the involvement and perchance corruption of Big Pharma, and alternative approaches that can be adopted to aid the suffering. This book truly opened up my eyes to the inner workings of such a tremendous field. It is surprising how much our daily lives are affected by the topics he explored and how much the general public is blind to.