Dear Ethan Watters: Depression Is Not “Normal”

Journalist Ethan Watters was on The Daily Show last week, talking about this new book “Crazy Like Us: the Globalization of the American Psyche.”  In it he questions the usefulness of the American biomedical model of mental illness when its applied to the rest of the world.  John Stewart jokes that this might be a good thing — since we’re not exporting cars, exporting depression has to be worth something.  Watters responded:

“… It is worth something.  It’s a tremendous seller.  When we get another culture, like Japan, to buy into our notion of depression, to move that line between where the pathological and the normal is, we can score a huge profit.”

Huh.  Depression is “normal”.  I guess all those years that I struggled to get out of bed, to leave the house, to keep myself from slitting my wrists — I wasn’t “pathological” at all!  I was “normal”.  I guess the only thing wrong with me is that I was an unwitting dupe of Big Pharma.  Silly me!

Mr Watters, depression is not “normal”.  It’s not the same as “sad”.  People who are “sad” feel sad for awhile, maybe they cry, maybe they go running, but pretty soon they feel better and move on.  People who are “depressed” sleep for 16 hours a day.  They fight the urge to crawl under their beds and stay there.  They expend massive amounts of energy just to deal with the routine tasks of everyday life.

It’s too bad, because his book sounds like it’s based on an interesting idea with some validity.  It makes sense that  mental illness can’t be readily divorced from its social context, because humans are social animals.  The way we other humans interact with us  affects the way our neural circuits behave.  That in turn determines our emotions, our thoughts, and our grip on reality.

I do believe that imposing Western understanding on other cultures can be incredibly problematic.  I believe that the biomedical model of mental illness is incomplete.  I also believe that Big Pharma can be incredibly problematic, and while I love some of what it’s done for me, I nonetheless engage with it reluctantly and with caution.

But Watters goes a bit far in this interview when he implies that the biomedical model of depression robs Japanese culture of its traditions, in which (he states) that “sadness” has been an important “spiritual state”. As a commenter on The Daily Show’s web feed points out, Japan has very high rates of suicide.  Is this related to the “sadness” that Watters speaks of?  Does this really reflect a “spiritual state”?  If it does, does that make suicide any less tragic for the victims and their families?

As Stewart asks, might the fact that the country has embraced the biomedical model of depression, along with biomedical treatments for it, imply that at least some Japanese people consider this to be a problem?

I certainly have my critique of Western cultural imperialism.  On the other hand, I think at times it’s used as a facile explanation for issues that are actually very complex.  Furthermore, it robs non-Westerners of individual and cultural agency.  Japan, the example that Watters keeps returning to in this interview, is an industrialized country with a sophisticated advertising culture.  Are we really to believe that the Japanese are just so naive that they’re incapable of coming to an informed decision about mental illness and how to treat it?