The power of Prozac

0 Comments | Insight on the News, Sept 14, 1998 | by Michael Rust

The children provide a special cautionary note. Most recent neuropsychological research points to the impact of environmental factors, such as families and schools, on behavior as well as brain chemistry. If antidepressants take on the persona of a "quick fix" used by adults eager to absolve themselves of responsibility for their children's behavior, they ultimately will be a destructive force. Michael Strober, a clinical psychologist at the University of California at Los Angeles' medical school, said earlier this year that antidepressants often are provided too quickly. At the same time, he cautioned that "we've also seen the reverse problem --teenagers with severe and persisting depression who received surprisingly minimal treatment."

And this is the rub. Doubtless, many physicians are quickly prescribing antidepressants for people of all ages. But at the same time, the relief that the drugs have provided for people remains real; what many critics object to may be the disquieting fact that emotions and moods can be paralyzingly destructive. "It's odd," says Wallace. "We ask people who are suffering from depression to live without their `medication' but we don't ask the same of diabetics. And the same pharmaceutical companies are making these medications, but it only becomes an issue in relation to antidepressant medication."

The reason, she says, is an "underlying bias. Not so much so that the medication itself is bad or that pharmaceutical-company practices are difficult to reconcile with patient interests, but that there's a deep-seated stigma surrounding mental illness -- that it's not a medical condition, it's a moral issue."

The relationship between environment and depression is well-established. (In one of the least surprising developments in the field, several studies have shown that poverty tends to make people more depressed.) However, prolonged exposure to these environmental factors, it is argued, can alter the brain chemistry to the point where serotonin boosts can have a real, positive effect. Contrary to easy and cheap stereotypes, those who have found antidepressants useful are neither giddy nor constantly cheerful. Instead, those for whom the drugs work have achieved normality.

Why this is so continues to be a point of contention as scientists, philosophers, healers and patients delve deeper into the confounding mystery that is the human mind. Just as there is nothing simple about that most complex of organisms, the human brain, there is nothing simple about depression, an unfortunate byproduct of the brain's intricate internal system. Both those who would enthrone the antidepressants and those who quickly would discard them must remember this.