Key Concepts

• In the past three generations, increasing numbers of Americans have been prescribed antidepressants. In many cases, such prescriptions are the only mental health care the patients receive.
• One cause of the rise in antidepressant use is that many doctors conflate conventional sadness—as from the loss of a loved one or a life-changing event such as a divorce—with the more serious and life-quashing condition of clinical depression.
• A second contributing factor, the author argues, is a change in the standard diagnostic guide, which caused many milder mental ailments to fall under the seemingly neutral label of “disorder.”

I am thinking of the Medicated Americans, those 11 percent of women and 5 percent of men who are taking antidepressants.

It is Sunday night. The Medicated American—let’s call her Julie, and let’s place her in Winterset, Iowa—is getting ready for bed. Monday morning and its attendant pressures—the rush to get out of the house, the long commute, the bustle of the office—loom. She opens the cabinet of the bathroom vanity, removes a medicine bottle and taps a pill into her palm. She fills a glass of water, places the colorful pill in her mouth and swallows. The little pill could be any one of 30 available drugs used as antidepressants—such as Prozac or Zoloft or Paxil or Celexa or Lexapro or Luvox or Buspar or Nardil or Elavil or Sinequan or Pamelor or Serzone or Desyrel or Norpramin or Tofranil or Adapin or Vivactil or Ludiomil or Endep or Parnate or Remeron. The pill makes a slight flutter as it passes down her throat.

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