By Amy Benfer

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I agree with Mr. Levine that modern American society has evolved into something unlivable for a good segment of the population. The "canary in a coal mine" analolgy comes to mind. Those more fragile psychically give a warning sign to the rest that all is not well.

But it is wrong and very irresponsible to attack psychiatry this way. I am someone who has experienced the horror of living inside a mind gone out of control with bipolar disorder, and have felt the blessed relief of treatment with the right combinations of medications. I don't see how returning to an agrarian village society would have prevented or cured a condition like mine, or like the one suffered by that poor woman in Texas.

-- Lisa Majersky

I don't know why Salon's editors considered Bruce Levine's hissy fit about antidepressants to be news. To me, it read like scraps from the tables of Thomas Szasz and Peter Breggin, both of whom have been peddling much the same line of crap for decades.

The only novelty is Levine's fuzzy invocation of some lost, pre-industrial Arcadia in which everything was made right through marathon group hugging or some such thing. He can spare us the auld lang syne. "Melancholy," as it used to be called, has been common as weeds, and just as hard to kill, since time immemorial.

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As someone currently taking -- and benefitting from -- three of Levine's devil drugs, let me assure your readers that they render one anything but numb. He is right only in describing what these drugs do chemically. They are neurotransmitter enhancers. In most people with "depression," consumption of one or another of these drugs is highly correlated with relief of the intractable blues. Perhaps "depression" is not a simple matter of low neurotransmitter levels, but jacking them up seems to help a lot of people and that is certainly nothing to sneer at. An elegant and "true" cure for depression may be out there somewhere, but palliation in the meantime is no small achievement. It sure beats sitting around the campfire singing "Kumbayah."

In my own case, I was not depressed, per se. I was cranky and easily frustrated or angered. I was also having increasing difficulty remembering things. My "mellowness," for lack of a better word, as well as my long- and short-term memory and my ability to concentrate have all improved markedly on my demon cocktail. Sexual side effects sometimes manifest themselves, but I use my brain many more hours a week than my gonads. Good enough, until something better comes along.

As for postpartum depression, I don't know what it is or whether it is similar to garden-variety depression and neither does Levine. The one thing I'm sure of is that it doesn't come from suddenly noticing that child care is a lot of work. If this were so, it would hit hardest with a first child. Andrea Yates had five.

What triggered her psychotic break, neither Levine nor anyone else knows. Even assuming it was her meds, though, an effect like this is obviously very rare. A woman killing her five children is such a big story, precisely because it is so singular. There are many more deaths per year from allergies to antibiotics, yet no one seriously suggests that antibiotics are frivolous and unneeded.

Bottom line: the body is a hugely complicated chemical plant. Why is it so odd to suppose chemical causes for its ills or to find chemical palliatives and cures for same? If boosting one or more neurotransmitters will fix depression and it takes a pill to make this happen, what's wrong with taking the pill? We don't tell diabetics or hemophiliacs to "just cheer up" or to "walk it off." What makes depression so special?

-- Dick Eagleson

While I agree in general with Bruce E. Levine's assertion that Americans have pathologized many ordinary states of mind in recent years, I have also personally benefitted from the SSRI Zoloft. In my case, the drug was almost instantly effective in eliminating a lifetime of panic attacks and obsessive thinking. I am a 50-year-old male writer and was concerned that taking this drug would make me feel numb, but I have not experienced this side effect. Zoloft has affected my sleep cycles -- though it sometimes takes me longer to get to sleep than it used to, now I actually sleep through the night and wake rested. I have experienced no ticks or sexual dysfunction.

I don't think the debate about depression and related psychological states is much advanced by the shrill-sounding accusations made by Levine any more than it is by the bland assurances of the pharmaceutical industry and its fellow travelers in the medical profession. Clearly, states such as depression and episodes of irrational panic are produced by a mixture of somatic, mental and environmental factors. Psychoactive drugs like SSRIs are not a panacea, but they can be effective in restoring a person's sense of balance and well-being.

But far from being "numbed," the use of an SSRI literally returned me to myself. No doubt others will have had different experiences and reactions; no doubt these drugs are over-prescribed. It seems obvious, however, that when carefully prescribed and consciously chosen, this class of drugs can be extremely useful.

-- Joseph Duemer

Bruce Levine's jeremiad against the use of psychotropic drugs is a ludicrous overreaction. Is it just possible, do you suppose, that some psychotropic drugs, used under some circumstances, might promote and enhance the welfare and autonomy of patients instead of always being worse than the alternatives? I can think of several reasons why we should be suspicious of Mr. Levine's claims.

1) In my experience, untreated depression often leads people to self-medicate with blunderbuss legal and illegal psychotropic drugs like marijuana or alcohol, such that the realistic choice they present us with is one of which drugs they will take, not whether they will take drugs at all. If the choice is between Prozac dependency or alcoholism, then I think we have plenty of reason to prefer Prozac.

2) Why is this presented as a "gender issue"? Plenty of adult men are treated with psychotropic drugs. Are the rich white men conspiring to medicate themselves as well? If differentially and systematically overmedicating women is a distinctive problem, then at the very least the reader is entitled to some comparative statistics on how much more likely it is that women rather than men will be medicated.

3) Levine's suggestion that overmedicating is a capitalist conspiracy intended to keep the ladies working and shopping is a classic case of what social scientists call a "functionalist" argument. In showing how some phenomenon fulfills a function or satisfies some powerful interest we are relieved of the duty of providing actual evidence to prove that the function or the interest is the CAUSE of the phenomenon.

4) Why is Levine so convinced that psychotropic drugs violate the autonomy of the user? As far as I can tell, people are not forcibly medicated with Prozac and Wellbutrin. In fact, these drugs increase the scope for autonomy and choice.

5) Although I have never used one of the class of drugs Levine discusses, I have spent a great deal of time with people who do, and by and large they don't seem to be uniform or zombified or changed in any fundamental way. In my experience, people are just a little less depressed, a little less anxious, a little happier: just enough to make it possible for them to live a flourishing life.

-- Matthew Kocher

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