Many mental health professionals are now questioning the effectiveness of anti-depressant medications. Their skepticism is warranted by a good bit of evidence.
The evidence I have in mind concludes that mildly to moderately depressed people do about as well on placebos (pills that look like medications but are not) as they do on the real thing. Only the most severely depressed are being helped much by anti-depressants.
I am hopeful that this discovery will lead medical practitioners to work differently with their less severely depressed patients, in specific, by talking with them more and medicating them less. I am not hopeful that insurance companies will allow them to do it.
One thing I do think the research cries out for, whether by intention or not, is a re-thinking of “placebo effects” and what they imply for understanding the psyche.
Here’s why. As is well known, establishing the effectiveness of any new medication requires creating two kinds of groups among persons suffering a particular disorder. Members of one group are given the medication being tested, and members of the other group are given a placebo. No one in either group is supposed to know which he or she has received.
If all goes well, a definitive explanation can be given for why people “on” the medication do not improve: the medication does not work. But left unanswered is the question of why many people receiving the placebo improve.
One answer to this question is common sense-oriented: People get over depression best by working it out rather than taking medication for it.
How do they “work it out?” By eating well, getting enough exercise, reaching out to caring family members and friends, and allowing enough time for sleep. That’s hard to do when you are depressed, but staying depressed is even harder.
Another answer to the question about placebo effect is unembarrassedly faith-oriented. People who take anything for their depression, and get better, get better because they believe that what they take works. Pill + belief = recovery.
Might the belief be curative in itself? Many people think so. I am not so sure. It looks to me as if our culture has made of taking pills something very much like earlier cultures made of seeing and touching sacred objects, the bones of a saint, for example.
Perhaps we are still in an Age of Belief after all.