This is the first book I've read that examines mental health in a sociopolitical context, and it was a breath of fresh air. Last year, I had a video appointment with my new primary care doctor because I was dealing with burnout and depression from severe job stress. Five minutes into the call, the doctor told me she would write me a prescription for antidepressants. I'd never met this doctor before, she didn't know anything about my life or the circumstances that led me to feel depressed and burned out—yet she was happy to give me a prescription for psychiatric drugs within minutes.
The entire appointment was 15 minutes long, and it really rattled me. It implied that there was nothing wrong with my situation, but rather there was something wrong with me. If you're stressed and exhausted by a high stress job during a global pandemic, the doctor seemed to suggest, you should fix yourself with drugs, rather than working to fix the external circumstances. I didn't take the prescription, but that appointment stayed with me.
Mental health doesn't exist in a vacuum, separate from everything else that happens in a person's life. Sometimes people are severely depressed without any clear cause, and they need medication to function. But often, as James Davies argues in this book, people are depressed or anxious for good reasons. They don't need drugs to paper over their problems; they need things like decent housing, a living wage, fulfilling work, strong community ties, rewarding relationships, time to rest and pursue hobbies, or the support of a patient, competent therapist.
As Sedated takes great pains to explain, rather than fixing the social and economic issues that cause people to feel depressed or anxious, the current mental health system hands out psychiatric drugs like candy or rushes people through ineffective, vacuous therapy with the goal of getting people back to work as quickly as possible. Based on my "antidepressants in five minutes" doctors appointment, this is definitely a thing.
The central thesis of this book is that mental health is too "medicalized" and low-grade anxiety and depression are conceptualized as chemical imbalances within an individual's brain, rather than understandable, rational reactions to living in a very stressful world. Why would this be so? In Davies' view, the medical establishment does this because it exists in neoliberal capitalism—which is all about individual responsibility, productivity, and buying products to solve all of your problems.
Because I've never read any psychological or psychiatric literature that actually bothers to situate mental health care within the culture context in which its practice, this book was a thrill to read. Other books I've read on this subject treat mental health as separate and distinct from the socioeconomic context in which it appears. Sedated, on the other hand blends together a compelling critique of the mental health industry, politicians, drug companies, and neoliberalism.
Some readers may find the book's conclusion rather depressing (spoiler: we can't really do anything about the increasing rates of anxiety and depression and the staggering amounts of unnecessary psychiatric drug prescriptions until we get rid of capitalism), but I think that the conclusion, while unfortunate, is very honest. These problems won't go away with a bit more government funding, a new meditation app, or a bunch of academic studies—because they aren't just problems with the mental health industry; they are problems with our entire economic system.
I'm not sure how this book would land with people who aren't some flavor of communist/socialist/anarchist/other leftist, or at least quite progressive. But if you're already sympathetic to the idea that capitalism isn't meeting our needs, this book makes a compelling case that capitalism is atrocious for mental health. Readers may find reassurance in the fact that mental health issues aren't just imbalanced chemicals in your head; they are a product of the precarious, unequal, often grueling society we live in.