An Ignorant Argument

In his recent book, “Comfortably Numb: How Psychiatry is Medicating a Nation,” Yale psychiatrist Charles Barber argues that Americans have come to rely on psychiatric medications to solve even the most benign and normal of emotional ills. He isn’t the first to make this claim. Since the 1993 publication of Peter Kramer’s “Listening to Prozac”—which stated, deceptively, that Prozac could not only make depressed people feel better, but that it could make people feel “better than well!”—dozens of writers, doctor and layperson alike, have jumped on the “overmedication” bandwagon. Americans, they declare, have been duped by pharmaceutical companies and doctors into believing that the everyday downs and disappointments that come with being human are not only undesirable, but unhealthy and altogether avoidable. They seem to imagine that doctors across the country encourage even the healthiest of patients to pop a pill to cure all ills and become perpetually euphoric.

People who subscribe to this belief fail to understand several fundamental facts about psychiatric disorders and medications. Antidepressants—that is, serotonin and serotonin-norepenephrine reuptake inhibitors, or SSRIs and SNRIs—relieve symptoms of clinical depression by balancing levels of certain chemicals in the brain. Psychiatrists believe that if a person who does not suffer from clinical depression—that is, who has healthy brain chemistry—were to take an antidepressant, he would experience any number of negative side effects while not getting any benefit from the medication.

Simply put, these medications won’t do any good unless your brain is unhealthy in very specific ways. Moreover, the notion of “better than well” is an optimistic myth: medications for psychiatric disorders enable people to feel normal, not better than normal. Antidepressants bring people from the hell of severe depression to a sense of being able to function normally; they aren’t magic happy pills. Similarly, they don’t make normal and appropriate feelings of sadness (or anxiety or anger) go away; a person whose brain chemistry is balanced (with or without the aid of medication) feels sad, even miserable—just not hopeless or suicidal for months or years on end. (Thus, the argument that antidepressants eliminate great art is not only incredibly selfish—let others suffer so that I may look at paintings!— it is misinformed: even if suffering does enable the production of profound literature or heartrending symphonies, antidepressants do not by any means eliminate suffering.)

So not only would people who don’t suffer from depression (which is the disorder most discussed in the context of these debates) not experience any benefit from taking this type of medication, but they might experience any number of these medications’ undesirable side effects, which include insomnia, constipation, diarrhea, muscle pain, increased sweatiness, nausea, constant fatigue, extreme weight gain, memory loss, decreased sexual desire, and inability to orgasm. (Let people who question the reality of depression note that people who take antidepressants decide that living with these pretty awful side effects is better than living with depression.) No one would choose to take these medications just for kicks.

The problem is not that too many people are taking antidepressants and other psychiatric medications, but that too few are. At Harvard, we are a constant audience for mental health publicity campaigns (both on campus and in the media we consume daily), but we must not forget that in many parts of the country, mental illness remains highly stigmatized and its symptomology and treatments are not well known or understood.

According to a recent column by Judith Warner in the New York Times, while psychiatrists are hard pressed to think of a patient who has asked without reason for an antidepressant, they can think of many patients who exhibit depressive symptoms who aren’t aware that there are treatments for depression—or even that it is an illness. As much as drug companies have been criticized for advertising their medications to the general public, we must acknowledge that the increased awareness of mental illness these ads have generated have had the positive effect of getting information about treatments to those who may suffer from mental illness. All of this misinformed and ignorant talk of drug companies turning Americans into unthinking pill-popping drones runs the very serious risk of discouraging those same people from seeking the help they so desperately need.

Besides, people have been attempting to seek relief from their psychic suffering with less safe—and less legal—methods since time immemorial. And while one can’t become addicted to antidepressants, it is very possible indeed to become addicted to engaging in alcohol, cigarettes, drugs, and self-injurious behaviors in order to alleviate the suffering caused by mental illness.

In the end, misconception may prove to be the bitterest pill to swallow. Though proponents of the “overmedication” argument may believe that they have their countrymen’s best interests in mind, their ignorant and often plainly false pronouncements may only serve to dissuade an already under-reached population from seeking the treatment they need. After all, while there’s no such thing as a happy pill, there is such thing as a loud and uninformed one.

Emily R. Kaplan ’08-’09 is an anthropology concentrator in Pforzheimer House. She is co-chair of the Mental Health Awareness and Advocacy Group.