Stronger Medicine


Anti-Depressants Haven't Made Therapy Obsolete


IT WAS MID-MORNING ON THE FIRST DAY OF THE LARGE Psychotherapy conference when I first began noticing the small white buttons with their pithy little saying sprouting on the lapels of conference attendees: "DEPRESSION: IT'S AN ILLNESS, NOT A WEAKNESS." By late afternoon, the buttons, dispensed at an exhibit booth for a large pharmaceutical company, were everywhere. I glimpsed them affixed to collars, pockets, belt loops, purses, backpacks, folders, any spare inch of apparel or appurtenance. It was startling to see how quickly a slogan could capture the allegiance of so many of my colleagues, especially when so many of them shared a common preference for brief, solution-oriented psychotherapies. Why were they so willing to make a public endorsement of the saying? For one thing, the slogan is catchy. It seems to suggest that we've moved beyond an era of superstitious belief and finally uncovered depression's "true" nature. The idea that depression is a clear-cut illness, caused by a "chemical imbalance" that can be cleared up with a daily dose of Prozac or Zoloft, now threatens to become a widely accepted clinical mantra and a popular shibboleth, repeated in best-selling books, mass-circulation periodicals and morning TV talk shows.

Currently, the most common mental health disorder in America and one of the most costly depression racks up a staggering $54 billion a year in costs from work absenteeism, reduced productivity, lost earnings and treatment expenses,…

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