Popular Drugs May Help Only Severe Depression

A headline from two years ago in Nature:

SSRIs show efficacy over placebo only in the most severely depressed patients

Drug companies exaggerate and even fictionalize their drugs’ benefits. This is not news.

I’m not against the use of these drugs, but their reckless promotion leaves a sour taste. Who are these drugs made for, exactly? When I take one of these pills, who stands to gain? These are always good questions to ask. Pills can work, and in the severest cases they’re necessary despite risks. But in the battle for peace of mind, no drug is an easy answer. Adam Phillips says it best: “Havoc is always wreaked in fast cures for confusion.”

[Update: As usual, Jonah Lehrer has a clever take from a year ago. -Ed.]

I pride myself in keeping an open mind about mental illness, but I have to admit that it’s tough to watch this video without feeling a pang of conservative rage. Where are we going with all of this? Are we so desperate and starry-eyed that we’re willing to experiment on our own children?? Don’t they deserve a more cautious approach?!??!?!

I’m not quick to judge any of the parents. My heart goes out to them. I’ve never had a kid, let alone one with mental illness. But I do know something of the helplessness that surrounds families in the midst of these crises. It’s a God-awful experience – and a dangerous one, too. Feelings of abject helplessness lead to extreme vulnerability. And that’s exactly what you see in this video: vulnerable families being pressured into troubling treatment, all at the behest of powerful institutions with their own interests to weigh. I’m not skeptical of doctors or “experts” (that’s a strain of American fundamentalism I could live without), but at the same time we have to recognize our respective roles. A child’s care is the sole responsibility of his or her parents. The educational system and the health care industry, despite what they advertise, were not designed to care for any particular child. Those institutions have competing priorities (the profit initiative, organizational flow, etc.), including millions of other kids. What is good for a school or a doctor’s office might be at odds with what is good for a child. When it comes to medicating our youth, we should be especially vigilant about these conflicts of interest, and wise to how good people’s judgment can go bad.

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“If you just sit on your couch, then steroids aren’t going to be very effective,” he says. “Antidepressants are the same way: if you want the drug to work for you, then you have to work for the drug.”

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