Book review: ‘Cracked: Why Psychiatry Is Doing More Harm Than Good’, by James Davies

Do you know someone who has ‘depression’? Do you know if that same person (or those same people) have been prescribed and have consumed ‘anti-depressants’? Chances are you do. In 2011 there were nearly 47 million prescriptions for ‘anti-depressants’ in the UK alone.

I put ‘depression’ and ‘anti-depressants’ in quotation marks to indicate the high level of scepticism with which I now regard them after reading James Davies’ excellent book Cracked. What is ‘depression’? Can it be objectively diagnosed like, say, tuberculosis? If not, why do psychiatrists prescribe pills to combat it? Are these pills effective? And, perhaps more importantly, do they have any negative side effects?

Davies attempts to answer these questions through numerous interviews with important figures in psychiatry and his own experiences working in the NHS. The results are startling: depression is hugely subjective; and anti-depressants are usually no better than placebos, sometimes have very nasty side effects, and have become more common as the pharmaceutical industry has bought the influence of ever more psychiatrists.

A qualified psychotherapist with a PhD in medical and social anthropology, Davies argues that the cavalier diagnosis of ‘depression’ is part of a worrying trend, which is the attempt to categorise as ‘disorders’ what were hitherto regarded as normal human emotions and physiological states. Grief makes everyone sad. Accumulated failures in love, life and the workplace would weigh heavily on anyone, especially when combined with repeated gorging on drink and drugs. It’s largely thanks to some clever and relentless marketing from various pharmaceutical giants that people in the west and beyond have begun to regard such states as neurological shortcomings that can be cured with a course of medication.

Take another, perhaps less insidious but no less disturbing, example, female sexual dysfunction (FSD). With the rampant sexualisation of everyday life and the creation of Viagra, pharmaceutical marketing teams had little trouble convincing the western public that women who showed little desire for heterosexual intercourse were sexually dysfunctional. The good news here is that the resulting pill (pink, naturally) has barely sold, despite billions of dollars of research, investment and marketing.

While the detailed analysis of depression in adults is fascinating and urgent, I would dearly have liked Davies to explore the mass drugging of adolescents and even children that is now common in Britain and the USA to combat ‘disorders’ such as ‘ADHD’ and its even flimsier off-shoot ‘Oppositional Defiance Disorder’. Like depression, these ‘disorders’ are almost wholly subjective and combatted with dubious pills that may have very damaging side effects.

Then again, I suppose it’s the mark of a good book and a good writer that one ends with a desire for more, not less.