The United States is in a state of decline—a reality decades in the making. At the thin end of the wedge sits Appalachia, one of the nation’s most deprived regions, mythologized by outsiders and misunderstood the world over. Embedded as a therapist within this community, Rayelle Davis frames the addiction, suicide, and “diseases of despair” that plague the region as a consequence of cultural trauma, exploitation, and systemic neglect. Her work is a searing exploration of generational adversity and a powerful indictment of the psychological abuse of the American Dream. Davis reveals a profound truth: Appalachian trauma is colonial trauma. As in exploited nations abroad, everything of value—from wealth and health to life itself—is extracted by a distant elite. This courageous book exposes the predatory systems of power and challenges everything we think we know about identity, sovereignty, and the actual cost of inequality in America. In a time of extreme political polarization, Money in the Mountains is not a requiem for Appalachia, but a manifesto for collective healing.