The 1990s, of course, were the age of Prozac, a decade when a class of antidepressants called SSRIs (selective serotonin reuptake inhibitors) came to dominate both psychological treatment and public discussion about why life in America had become such a downer. After Prozac’s approval by the U.S. Food and Drug Administration in 1987, some 80 million new prescriptions for antidepressants were written in the next 10 years. It was as if America had suddenly caught a bad case of the superpower blues: Office visits to doctors for treatment of depression tripled.With the pills came books. Along with volumes about the new psychopharmacology like Peter Kramer’s best-seller, Listening to Prozac (1993), there were Martin Seligman’s Learned Optimism (1992) and Authentic Happiness (2002), which helped launch “positive psychology,” a broader attempt to understand not illness but happiness.But soon enough the good feelings gave way to a backlash: Where there was once Listening to Prozac, now there is David Healy’s Let Them Eat Prozac. Authentic Happiness has been countered by the newly published Artificial Happiness: The Dark Side of the New Happy Class by Ronald Dworkin. In 2005, it was Kramer’s Against Depression; now it’s Eric Wilson’s Against Happiness.Yet the recent volley of books represents more than an attack on our current overreliance on drug therapy to treat depression. They rip into the massive sales of the drug companies, dispute the medical thinking behind doping the populace and question whether the antidepressant advocates understand depression, happiness or the human mind.What happened in the ’90s wasn’t an epidemic of the blues or just a new biomedical discovery taking hold. In Charles Barber’s compelling new book, Comfortably Numb:How Psychiatry is Medicating a Nation, the author contends that we underwent a major shift in attitudes toward mentalillness and medications. Depression was redefined and popularized; the use of psychotropic drugs was greatly expanded to include what might be termed “personality repair.”And psychiatry became Big Science. Because of the speed and effectiveness of the new drugs in treating conditions that traditional therapies struggled with for years, psychotherapists lost their leadership in mental health care. Amazing advances in brain imagery and neurosurgery only heightened therapists’ poky obsolescence. The bioengineers took over.They weren’t the only ones. The advent of managed care gave primary caregivers the power to green-light treatments. This means that therapists are often dependent on the family doctor for patient referrals– at least when the family doc isn’t the one dispensing the pills. Of those 80 million new antidepressant prescriptions in the ’90s, non-psychiatrists wrote 60 million. And if studies of primary caregivers are any indication, most of those diagnoses of depression were made in less than three minutes.Once we add the multibillion-dollar weight of the pharmaceutical corporations behind some of these changes, we have what Barber calls the “Serotonin Empire” — a “formidable testament to the ease and rapidity with which massive sociological change can occasionally be realized.”
Tags: decade, family, Family Doctor, neurosurgery, referrals, three minutes
Copyright © 2008 Family News Home. All Rights Reserved.