I have a soft spot for writer Johann Hari. We’ve often quoted a key section of a Guardian piece many years ago, Protest works. Just look at the proof.
Below we’ve posted an interview with Hari on his new book, Lost Connections, which is an investigation of the depression industry, although he doesn’t call it that. His work started with his own experience, of being medicated for depression starting as a teenager and only having at best short-term relief. He found it striking that his experience of rising doses with what amounted to relapses was common and was also taking place when the number of people taking anti-depressants and other psychoactive medications was exploding.
As you will see, Hari makes a strong-form argument that the causes of the big increase in reported cases of depression are social, that the modern work environment is particularly hostile to people having a sense of control and purpose that is important to well being. He also contends that the “brain chemistry imbalance” theory of depression was not proven when selective serotonin uptake inhibitors like Prozac were becoming popular and even as of today does not have a solid scientific foundation.
Another angle Hari discusses is the way that advertising induces people to make unhealthy social choices. I wont’t give away the anecdote in his video. But more broadly, advertising is designed to create needs and wants, which means preying on insecurities and desires. Moreover, a great deal of advertising presents people who are “happy” as the result of consuming the product or service on offer. That happiness is seldom contentment or relaxation; instead it is usually giddy or euphoric. Those aren’t sustainable states. They are brief highs. But the message to consumers on a large scale basis is that that is what your life should look like, and if it doesn’t, you must be doing something wrong.
By contrast, a major focus of religions is how to reconcile individuals to the inevitability of suffering and death.
Some medical professionals have objected strenuously to Hari’s book. They content that he’s incorrect in depicting anti-depressants as generally not beneficial and claiming that psychiatrists don’t give much/any weight to life experiences when prescribing anti-depressants.
The wee problem is that there is a big gap between the theory of how psychiatry ought to be done and what is actually taking place. My large sample (relatives who’ve suffered from depression, and way too many people I know personally who are taking anti-depressants) is that at least in the US, the pattern conforms to what Hari describes: doctors, including GPs, all too eager to hand out drugs like Prozac and Adderal, with no psychological evaluation whatsoever. From what I can tell, in major US cities, they are seen as productivity enhancers and thus perfectly fine to prescribe casually.
By contrast, one of my former lawyers who is also a biomedical engineer is FDA specialist, and many of the partners in her boutique intellectual property firm are former FDA commissioners with serious medical and/or science backgrounds. She has mentioned repeatedly that while they take Valium casually, to a person they’ve made clear that they would never take an SSRI and have advised her to steer people away from them. So it isn’t just members of the great unwashed public who have reservations.
As Hari points out in an excerpt from his book, one of the problems with talking about SSRIs is that the drug companies have been cherry-picking studies for decades. Not only is the efficacy of SSRIs not so hot (around 50%), it’s not much higher than the placebo rate (30%).