C'mon Get Happy

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What's driving this trend? Part of the appeal of pill-popping is rooted in the increasingly popular view that mental illness is biologically based, writes critics Seymour Fisher and Roger P. Greenberg in Psychology Today (Sept./Oct. 1995). The two veteran psych profs complain that some biological psychiatry fans are so convinced that unhappiness results from physical malfunctions of the brain that they're urging young shrinks to skip psychotherapy training and learn 'scrip-writing instead.

Yet when the two authors examined the evidence, they found that the bottom-line question -- do the drugs work? -- must often be answered 'no.' Their overall research showed that overall, one-third of patients did not improve with antidepressant treatment; one-third improved with placebos, and one-third responded favorably. The placebo research was revealing -- some takers reported significant side-effects, even addiction, to the inert sugar pills. This placebo effect along with the low efficacy rates for drugs argues strongly against the biological basis for mental illness.

So should drugs be avoided? Fisher and Greenberg say no, but they do recommend avoiding antidepressant use at the first sign of depressive distress. 'Depressed feelings have complex origins and functions. In numerous contexts -- for example, chronic conflict with a spouse -- depression may indicate a realistic appraisal of a troubling problem and motivate a serious effort to devise a solution,' they say. Quickly popping a pill 'could interfere with the potentially constructive signaling value' of unhappy feelings.

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