05/08/2013 - 1:17am
Wait, we cured depression?
by Benjamin Wachs

Charles Barber writes in Salon that we now live in the Age of Trauma.

Every era has a particular mental disorder, you see, and for 21st century America that disorder is PTSD.  He writes:

"(T)he appropriate diagnosis of the last decade — since Sept. 11, 2001, to be exact — may be PTSD: post-traumatic stress disorder. Of course legions of American soldiers have received the diagnosis, and enormous resources, appropriately, have gone into its treatment. The Department of Veterans Affairs estimates that nearly 30 percent of the more than 800,000 Iraq and Afghanistan War veterans treated in veterans’ hospitals and clinics are diagnosed with PTSD.

But in the past 10 years, even non-veterans have been engaged in an ongoing narrative of American trauma. After 9/11 came Katrina, then the economic meltdown and the recession that never seems to end. This past year saw Sandy followed by Newtown. Along the way there’s been the mass killings at Virginia Tech, at Northern Illinois University, and in a Colorado movie theater. There also seems to be a deepening sense that one can never fully escape from potential catastrophe, not on a Boston street on a promising spring day or in a Connecticut elementary school a few weeks before Christmas.

In the popular perception, the locus, both psychologically and geographically, of the tragedies has shifted. They’ve gone from being “out there” — in, say, the remote parts of the South or West, or the inner cities — to “right here,” in respectable, suburban America. The latest chapter is the bombing in Boston, with its indelible images — the 70-year-old runner laid out on the ground; the impossibly innocent smiling face of the 8-year-old boy who was killed. And it further cements post-traumatic stress in the popular psyche and lexicon in a similar way in which depression, bipolar disorder and ADD — and the drugs to treat them — were popularized in earlier eras."

I'm quite sympathetic to the idea that every era can be known by its particular form of mental disorder - althrough for my money we're still in the "Age of Anxiety."  While Barber is right to say that trauma is being "normalized" in America, I still see far, far, more people experiencing existential anxiety than I do even mild forms of PTSD.  We want to know if we're doing the right thing, and how we'd know that.  We want to know if we'll hold on to our economic life and our social capital far more than we want to know we'll live to see next year.  The question America wants answered isn't "Am I safe," but "Am I okay?"  That's anxiety.

But the thing that really astonishes me is what comes next, where Barber writes:  "Yes, PTSD is the reigning diagnosis of the day. But unlike other diagnoses in other eras, there is no clear drug and no definitive way of treating PTSD."

Wait ... we had a definitive cure for depression?  And nobody told me?

What Barber means is, we had drugs for it.  And while we have drugs for PTSD too, those drugs (unlike the ones for anxiety or depression) don't work.  "Starting in the Prozac-fueled late 1980s and 1990s," he says, "the omnipresent diagnosis was depression."

Yes it was - but did Prozac work?  Have we beaten depression?  Is that problem solved? 

Hardly.  A 2011 study sponsored by the World Health Organization showed that America is one of the two most depressed countries in the world.  (The other was France, but deep down you knew that).  According to news reports, depression rates in America have tripled over the last two decades.

Is that what happens with a successful drug treatment?  By any objective measure, Prozac (and like compounds) were a dismal failure.  Perhaps that's why multiple studies have since suggested that antidepressants are no better than placebos (except for some cases of severe depression) - only with harmful side-effects.

No, we haven't drugged our way out of depression anymore than we have anxiety.  I can take the argument that we're in the "Age of Trauma" - though I disagree - but it's absurd to say that what distinguishes trauma is that we can't cure it by taking a little pill. 

Come on.

As for the idea that every era has an era defining drug, I think the definitive word on that came from Margaret Talbot in the Guardian of London, in an amazing 2009 piece on the off-label use of "neuro-enhancers."  The whole thing's incredible and well worth the read, but here's the kicker: 

"(I)t's not the mind-expanding 1960s any more. Every era, it seems, has its own defining drug. Neuroenhancers are perfectly suited to the anxiety of white-collar competition in a floundering economy. And they have a synergistic relationship with our multiplying digital technologies: the more gadgets we own, the more distracted we become and the more we need help in order to focus. The experience that neuroenhancement offers is not, for the most part, about opening the doors of perception, or about breaking the bonds of the self, or about experiencing a surge of genius. It's about squeezing out an extra few hours to finish those sales figures when you'd really rather collapse into bed; getting a B instead of a B-minus on the final exam in a lecture class where you spent half your time texting; cramming for the GREs (postgraduate entrance exams) at night, because the information-industry job you got after college turned out to be deadening. Neuroenhancers don't offer freedom. Rather, they facilitate a pinched, unromantic, grindingly efficient form of productivity."

Be honest: doesn't that sound way more like us than any drug for PTSD?


Benjamin Wachs is a Partner at Omnibucket.  He founded Fiction365.com, and archives his work at www.TheWachsGallery.com