Dean, this article is so full of inaccuracies and bias that I am not going to write much about it. I was tempted to, but I realized it would take up most of my morning to do so.

Suffice it to say, anyone who asks this question- "How are Paxil, Zoloft, and Xanax any different from Miltown, Librium, and Valium, the pills many critics now denounce as addictive drugs used to keep women of the ’50s and ’60s passive and complacent?" has a lot of learning to do, and a suspicion of The Medical Establishment that does not mesh with reality. Of course, I'm biased, too.

I also noted that she quoted three or four books, but no original research, and we all know that the writers of these books have huge agendas of their own and the more controversial their stand, the more books they will sell.

I keep thinking of David Nash, who also refused to medicate his mental illness. I think that certainly is up to the individual to choose which model of mental illness they wish to follow, but a lot of them are dragging their families and colleagues through hell. In the end, I get the very strong feeling that the author has made her mental illness into her life's work, her career, even her religion. It wuld be interesting to hear what those around her think about that.

In my own experience so far, since it is on-going, I despise the fact that therapists do not listen to me . They would rather send me for medication FIRST, listening may or may not come at all. The few times I got a listener, one of them had a "diagnosis of the week" for me. Another one had me perfectly pegged as an abused child. I want someone to listen when the demons in my head get to be too much. I want someone to just plain realize that it isn't "all in my head". I don't want to be drugged up with only the heavy duty, addictive drugs that Medicare will pay for. In short, it's highly frustrating to get the help I need.

Etherian, one of the reasons why you are not being given the help you need may lie with the fact that you are on Medicare. It's sad, but true. Psychiatrists are often in short supply because of chronic underpayment by insurance companies, and Medicare is the worst in that regard.

My advice would be to see someone who doesn't accept Medicare and pay cash. It's pretty pathetic that you would have to do that, but you might want to think about it.

I have not had time to read the article, but i will and comment, but here is an immediate comment regarding anti-depressants and addiction. Take Paxil, an SSRI - most people will take Paxil for a bit, get used to it, let it build up in their system, but if they miss getting the scrip filled, and have to skip dosage for 2-3-4 days, for example, many people will start to shake, have wild thoughts, fee flu like symptoms, dizziness and disorientation.

I did a course of it through my GP and forgot to get my scrip filled over a weekend. Come Monday I was swaeting, shaking and felt like I had a really bad flu. Called the doc and he says, "oh yeah, you can't stop suddenly, your body needs it."

It may not be addictive in a food or booze craving way, but shouldn't that qualify as addictive?

People who write so dismissively of depression and medication simply haven't suffered enough. Note that the author is a professor of communication: highly motivated to communicate, but without much to say on the subject; all talk and, it seems to me, rather self-indulgent talk at that.

For serious, even gripping, accounts of depression and drinking/addiction read Darkness Visible by William Styron (short, personal) and The Noonday Demon by Andrew Solomon (broad in scope but also personal). For people like that, drinking may be A problem, but it's not THE problem.

The term "depression" is unfortunately broad. It takes in normal mood states, leading many to be skeptical of the real thing. It may not be a disease in the sense that malaria and cancer are diseases, but it is undeniably a disorder. The brain and nervous system are complex beyond our understanding. Is it any wonder that so complex a system has many and subtle ways of malfunctioning?

It's impossible to convey the raging intensity of a major depressive episode, one that has the body fully engaged, one that is most definitely not "all in your mind." Styron and Solomon come close.

PS - I don't mean in any way to minimize the suffering of those who manage to carry on with life under the relentless burden of chronic depression. For them, self-medication with alcohol may be unwise, but it answers a deep need. Idle talk of cosmetic psychopharmacology in this context is a cruel insult.

I have so much experience with this subject and so do all of you.

Those suffering with different kind of illness all have something in common. We felt inside us there was something wrong, something not quite right in our psyche, our hearts our lives.

It has gone on since life began and each era has a different way of defining the *problem*.

Had none of these people been around to do something about it, well my my my what a different kind of world would it have been.

Each of these people had a problem and it is amazing to me just how very thankful I am to have known them and you have too.

Time is a teacher in itself, and I love the different ways we have evolved and called sickness, illness, and disease different things as the era's of our past, present and future have and will teach us.

When did the word addiction come about? When did the word mental illness, alcoholic or emotional problems come into being? When did others look at another person and say, "He is kinda touched", ya know? Gee, I never know how this person or that person is going to be from one day to the next. He or she was said in a whisper, "He eats or drinks too much."

Can you imagine being around St. Francis or St. Theresa? Yes, those saints had their *problems*. The aposotle Paul? How about President Abraham Lincoln? You can only imagine what words and terms were used.

Edgar Allan Poe, Buzz Aldrin? You've got to be kidding! You mean that man that threw me into deep emotional highs and lows and got me spooked, as I read his books. And an astronaut that thrilled me beyond this earth... and gave me inspiration and hope for the future

Well how about Winston Churchill, Hans Christian Anderson, Art Bushwald, Emily Dickinson, Agatha Christie, T.S. Elliot, Francis Ford Capolla. Oh and these people too? Gary Grant (hubba, hubba, won't say where he got me going in my emotions and feelings :), Marilyn Monroe, Liz Taylor, Victor Hugo, Jim Carey, Robin Williams, Napoleon. Did I say, Napoleon? Yep! President John Kennedy ( let's name a few Kennedys). Brian Wilson, a Beach Boy with a *problem*!?! My gosh, how loud did I play his music and dance my fanny off!

Each and every era has produced inspiration, beauty and I am still learning today.

That article you linked Dean, touched on the era of the 50's and 60's and how some drugs were used to treat problems. Good grief, they helped people. What in the world could that have meant if you were ill in that era and needed some assistance to feel better. They were good drugs for that time and still are. Dah...

Oh and how about J.C. Penny. What was in his closet? I know I have had many things in my closet because of him. And another guy that is still with us in thought and when I feel down I think of him and his *problem*, non other than W.C. Fields. How many comics have tried to immitate him.

Time is a great teacher and so is experience. Medication, support, understanding and love all are here to help.

As with any illness and problem, seek help and you just might find some remedies and some you may not. Those famous people I listed tried with their problems and I believe they were successful. Why? They helped me along the way...maybe even you too.

Dean--try taking Paxil for 3-4 months and then quitting cold turkey. You'll develop a craving for that little pill pretty quickly.

Anything that produces withrawal symptoms is addictive to some degree. That runs the gamut from heroin through alcohol and down to caffeine. For some people, Paxil and other SSRIs are right up there with opiates: they can't stop taking them because the psychological and physical symptoms of withdrawal are too severe, sometimes worse than the symptoms they took the drugs for in the first place. Ms. Jensen is correct when she writes about the "gradual weaning process much like other addictive drugs." That's how I got myself off Paxil. (It should be noted, though, that most of her ideas about SSRIs and identity aren't really original--they're cribbed from Dr. Peter Breggin's work).

Glaxo Smith-Klein had to be sued before they admitted that their product caused these problems, and even now they downplay it (of course--it's counter to the brand message).

With that in mind: consider that human neurochemistry was essentially "finished" many thousands of years before we decided to settle down, plant things, and eat them. This being the case, it stands to reason that all of the various conditions "diagnosed" by the psychiatric profession and enumerated in the DSM-IV were part of the range of human personality and experience.

Why, now, in the late 20th and early 21st centuries, are these conditions so much of a problem? What's changed?

Not human neurochemistry, that's for certain--H. sapiens' brain size and structure were finalized 200,000 years ago.

The demands placed upon that neurochemistry, however, have changed radically. How does a brain that evolved for tens of thousands of years within small hominid social groups react when it's placed in a city of nine million, surrounded on all sides by other apartment dwellers? What happens to hormonal balance under 40 hours-plus a week of artificial lighting? What happens to mood when the body is chronically sleep-deprived, as the majority of modern Americans are? How do emotions react to a constant intake of high-glycemic foods that alter serotonin levels?

People haven't changed, but their society has.

The typical course of human social evolution has been driven by the needs of individuals: when enough people got fed up with a social situation, desired change expressed itself, either abruptly or gradually.

We are entering an age where this is no longer true. Today, it is the people who find themselves laboring under intolerable social demands who are changed. The great mass of the medicated in this country might very well be those who, in former times, would have become a force for social evolution.

Not anymore. Now, they’re the problem, and the remedy is to fix them.

Once fixed, the impetus for action is removed.

And, so, here we are.

I think this wants to be a blog entry…

I have to agree with the commenters that this article doesn't have much useful to say.

She mocks the concept of "feeling like me again". It may not make sense to her, but that's EXACTLY how it feels. No, I didn't suddenly become perky. I didn't lose my ability to feel sadness or anger when appropriate. I just stopped being at the mercy of emotions.

Once, before I was medicated, I went into a compulsive search of the whole house because I couldn't find a box of herbal tea I remembered buying at the grocery store. How is the "me" that would spend hours searching for tea more authentic than the "me" that would have decided to either do without or go back to the store? Is the "me" that went into tears over an banking error more real than the "me" who can calmly call the bank and clear things up?

Maybe she likes to have cranky friends. But I don't like being a crank.

BTW, Paxil doesn't have to make huge problems when you quit. It stopped working for me, so my doctor switched me directly from Paxil to Lexapro. No withdrawal effects at all. Occasionally I forget to take a Lexapro, but I've never noticed any withdrawals then too.

Ask yourself one question about social change and its demand on us today.

Then go do a google search and look at the social changes of the 1800's or 1900's. Each of those eras had tremendous social problems. Were morals declining and health problems at all time highs? Oh my God, this world is going to hell. I can't believe those teens! Apathy has hit an all time high! New medical cure for mental illness. Too much beer can cause flushing in the liver and that is why our face turns a brighter pink and may cause you to blush? Those old articles slay me.

Science has done tremendously in each and every era. These new drugs have side effects and so did those of the past. We are in a time where ads in newspapers, the internet and the television are informing us of this pill or that pill to help this or that.

I wonder too about the physical body becoming addicted to pills or alcohol or even food. If you are under the care of a good doctor that describes anti depressants and you are smart about it you will personally record on paper how you are doing each day and what you ate or drank.

The *pill* is not the end all to any disease, any pill, birth control pill as well. That birth control pill better be in your system or ahh.., and your emotions on that alone, run a huge gambit because of hormonal changes. Personal responsibility is up to you. The doctor can only do so much. If you are coming off a pill of any kind your body chemistry has become used to it and the cells will run around searching out the help it needs. A doctor will help you understand that if he or she is any good and of course warn you of things such as addictive properties in the drug that your body has become accustomed to. Come off medication with the help of your doctor. Don't tell people this drug or that drug is addictive unless you know the chemical compound and you are a doctor, or well qualified pharmacist that can assist you in your questions. (Not talking to you Dean because you have done research on anti-depressants and have personal experience due to yourself or family members on your side as well as Rosemary's) and if you did not, DANI, our wise doc., would chew you out fast!

Addictions have a lot more behind them than our physical bodies needing them. Craving something can be a signal that your body is out of wack and when you over do a food or drink then there is far more behind the problem than simply saying it is an addiction. There is a root cause behind it somewhere.

There is no epedimic as Dean said. Have fun and look at the newspaper headlines of era's gone by.

Ian, make that a blog entry, I want to link it.

I took Paxil for months, and never missed it when I quit cold turkey. I've never heard any of the SSRIs causing withdrawal cravings.

I don't know that there's any evidence that depression, anxiety, etc. are more prevalent today than they've ever been.

Arguments from evolution don't persuade. There are plenty of well-documented genetic diseases. They are carried along because they are not fatal to the survival of the species. Nature does not strive toward perfection, it settles for what is good enough under the circumstaces.

It's a funny sort of addiction where you have to set a timer to remind you to take the stuff on schedule.

I have no idea about whether depression is more rife now than before, but I wager that if there's an epidemic, it's of prescriptions. I've been really surprised at how many of my friends are on antidepressants. Granted, many seem to be a lot better off for it.

I suffered from depression throughout my late teens and early 20's, but I didn't realise that's what it was so I never got help. Fortunately I grew out of it, as I imagine a lot of teens/20-somethings will eventually.

The issue I have is that I think a lot of people who suffer from *mild* depression would be better off just seeing a counsellor regularly. Antidepressants are great for helping people to function normally - to get out of bed, go to work, eat their lunch, talk to their spouse - when they couldn't otherwise; but I think there are a lot of people who are still capable of living their lives without them.

I revel in the fact that I'm an emotional person. I like that I feel very passionately about stuff. I'd hate to sacrifice the good feelings (and I include anger or hurt in the "good" category) just to eliminate the days I woke up feeling uptight, muddy and lethargic.

Obviously I'm only talking about people with quite mild cases of depression, but all in all I think a lot of people would ultimately be better and stronger for just skipping the drugs and finding other ways to fight their depression (particularly learning their triggers and how to pre-empt them, learning to distract themselves, adjusting diet, exercising, seeking counselling for the external problems in their lives, etc), as well as realising - sometimes you're allowed to feel like crap.

I just think there's too much pressure on people to feel good Now At All Costs, and I think we sell ourselves short if we believe that. While suffering isn't a virtue in itself, it's certainly part of living. Without sacrificing the opportunities to make life nicer for ourselves and our loved ones, I think we should still learn to embrace the crap as much as the kitsch.

Any resemblance to any perspective, living or dead, of Milan Kundera is purely intentional.

For me, the difference between 'moody' and 'crippling' is when the symptoms and the results of those symptoms become a way of life and not transient or a sometimes thing.

Either way, either/both can and should be acknowledged and addressed, supported in the best way possible for each person depending on their needs and situation. Sometimes, medication is a temporary solution, other times, it needs to be a life helper. We don't question the need for antibiotics, we should not question the need for medication to treat any other illnesses.

The biochemical workings of the brain need not be a moral issue. Perhaps we continue to think of depression and its results on the brain as a moral issue because we still know so very little about how the brain truly works.

I think the way we support the illness of depression and the mere fact that we question support of it for either sex (male or female) with drug therapy, psychotherapy, group support, time off work, life changes, etc. will one day be seen as barbaric.

The sooner we see depression as an illness like cancer, or a bacterial infection brought on by an irritant virus (whatever that cause might be), the sooner we will find treatments that work.

Some of the difficulty with deciding how to handle depression is that there are at least two forms of it. There's endogenous depression, which seems to appear without any explanation, and reactive depression, which has a cause. Grief from the loss of a spouse would be an example of that.

Endogenous depression needs to be treated with medicine more often than not. Reactive depression may depend on changing whatever is in the environment that is triggering it, and that's where couseling and therapy help. The problem is telling the difference.

In some ways, I think we've gotten ourselves in such a pressure cooker so much of the time that it's impossible to even see what's wrong. So the temptation is to think it's endogenous depression and the root causes go unaddressed. How many times have each one of us left an unhappy, stressful situation, and, looking back, not even realized how truly awful things were at the time? It sure has happened to me, with a job situation. It's happened with my son, at school. Only by leaving the situation did we finally realize what was going on. What makes these scenarios so hard is that everyone around you seems to be fine, and you may even be told that you're the problem. Certainly, that happens in troubled marriages all the time. So reactive depression can easily be mistaken for endogenous depression, and only treated with medications, which is inadequate.

Janelle pointed out many famous people who battled depression. Many of these suffered from endogenous depression- a lifelong affliction. I am reminded about Dostoevsky's "Man of Thought" versus "Man of Action." He clearly envied the Man of Action, since, being the Man of Thought, he was constantly thinking about everything. The fact that I am posting in the early a.m. (along with many others here, I notice) means many of us are like him, too. (or, there are a lot of Australians on this blog!). We think too much, and that gets us in all kinds of trouble. It may even cause reactive depression if you don't fit in with your colleagues or family.

A third type of depression is secondary to organic or physical processes, such as postpartum depression. My own brother's depression was so profound, rapid in onset, and refractory to treatment , that he had a CT scan done to look for a brain tumor. Alcoholism often causes depression, since it is a powerful sedative and very destructive socially, but sometimes people use it to "self-medicate" when they're depressed. B-blockers for the heart or blood pressure can cause depression, too.

The bottom line is, anyone with depression needs to take a long, hard look at their life as well as consider taking medication. Seldom are the answers crystal clear.

"I took Paxil for months, and never missed it when I quit cold turkey. I've never heard any of the SSRIs causing withdrawal cravings."

That'll learn me.

Similarly: I quit cigarettes with no problem at all.

Different people have different reactions, depending on individual neurochemistry, dosage, and length of treatment.

Not to be overly semantic, but the cold-turkey craving isn't for the pill per se, it's for the results of the pill, i.e. "Make it stop!" For some people abrupt cessation of treatment causes a severe "bottoming out" of mood, sometimes coupled with physical symptoms; this can be worse than the initial symptoms that prompted treatment.

For more info on the whole SSRI-withdrawal thing, see the link to Dr. Breggin's site that I included in my first comment (or just Google "Paxil SSRI withdrawal" for other evidence of varying quality). IMAO, it's not a marginal issue. It certainly wasn't for me.

"I don't know that there's any evidence that depression, anxiety, etc. are more prevalent today than they've ever been."

It's not really the historical prevalence or non-prevalence of the conditions that I'm concerned with.

On an individual level, I view depression, freeform anxiety, and the rest of the popular diagnostic grab-bag as a sort of "soul barometer." In the absence of serious underlying physical first causes (which includes substance abuse), or the obvious "reactive" causes Dani mentioned, these conditions indicate that something, somewhere, just isn't right in a person's life. I believe that truly "endogenous" depression actually quite rare, and more often than not is a reaction to a cause or group of causes that may be hidden, or long-suppressed.

As Dani mentioned, suitable introspection (by whatever method) can help locate such problems. This doesn't mean that solutions will be easy, or even possible. For example, if you discover that your depression and anxiety is caused by living in a crowded city and working in a mindless corporate job and convincing yourself that you're content by hitting the bars, you basically have to change your entire life to resolve the problem.

Or...you could keep your miserable life, and take a pill.

Which is my point. SSRIs short-circuit the soul-barometer mechanism by providing relief without requiring problem-solving. The pharmaceutical companies pay lip-service to the necessity of counselling along with the use of their product...but how many of the 20 million Americans who take SSRIs are actually in regular therapy, dedicated to uncovering and resolving their internal conflicts?

For some people, SSRIs are absolute life-savers, vital medications that allow them to function, pick up the pieces, and move on.

But I suspect that, for most people, SSRIs are a way to tolerate what is, or should be, intolerable.

I don't think that's a good thing at all--for individuals, or for society at large.

There's much to be said for examining life situations. However, as one of my favorite sayings goes, it's easier to get into things than to get out of them. Sometimes people have to try to make the best of a bad situation. Sometimes people have promises to keep.

The one piece of advice I've ever dared to give my daughters is to keep their options open as long as they can.

Ian, I think you have nicely summarized quite a few things I've thought , myself.

Although my brother's slide into despair was seemingly rapid, his entire life read (to me) like a handbook on what not to do. And I paid attention, because he was 20 years older than me.

Only thing is, on the outside, he looked like the Great American Success story- even went to Bush's inagural ball. Pretty good for a kid from the sticks; but in the end it wasn't enough, or maybe it was too much.

So I absolutely applaud you, Bill. Your daughters will actually think about where their choices will lead them. I'm quite sure that kind of thinking saved my life.

Some of the difficulty with deciding how to handle depression is that there are at least two forms of it.

Dani, thanks so much for the clarification. That distinction between endogenous and reactive depression is just what I needed to better understand my own and my friends' experiences.

In retrospect it seems such an obvious difference, with massive ramifications for drug prescription, but I've just never seen it before.

Addiction isself medication for medically unrecognised pain. PTSD etc.

If you look at addiction as self medication for pain then it all starts to make sense.

What we have now is the voodoo theory of drugs. Drugs will sneak up on you and capture your soul making you a slave to the drug demon for life.

And we have whole government agencies dedicated to combatting the demons.

What we are doing in fact is persecuting people in pain. How terribly Christian.

The people we are persecuting are victims of child abuse, victims of sexual abuse, combat soldiers with PTSD etc.

As the truth of all this comes out from our studies of the brain we are going to be ashamed for what we have done. The so called moral guardians will be shown for the moral frauds they are.

BTW people here are confusing habituation with addiction.

Habituation is a body tolerance thing.

Addiction is what is left when you have solved habituation.

In my opinion addiction is just another name for long term chronic pain treatment.

Since food, and sex, and other stuff can cause the body to produce its own natural heroin overindulgence in these is also a sign of chronic pain.

In my view it is the pain that is crippling not the drugs.