Post-Prozac Nation: The Science and History of Treating Depression


The Sunday New York Times Magazine traces the history and controversy around serotonin, “imbalance theory,” deep-brain stimulation and more; including references to Irving Kirsch and placebos, and David Healy.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. Very disappointing article. Dr. Mukherjee has bought the primacy of serotonin, antidepressant-induced neurogenesis, and other psychiatric vaporware.

    Kirsch’s conclusions have been replicated by independent researchers several times.

    I hope David Healy responds to the NYTimes.

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  2. This strikes me as faux science. It’s not critical enough, in my opinion of its own assertions. I appreciate that at times the author appears to offer caution, but at other times he pretends we know far more than we do.

    For example, the fascination with Serotonin. Because we believe we’ve found a way to influence this neurotransmitter through the introduction of various drugs, we now feel it has to play a key role? I can’t help but think of the “streetlight effect”

    A police officer sees a drunk man searching for something under a streetlight and asks what the drunk has lost. He says he lost his keys and they both look under the streetlight together. After a few minutes the policeman asks if he is sure he lost them here, and the drunk replies, no, that he lost them somewhere over there (in an unlighted area). The police officer asks why then is he searching here, to which the drunk replies, “the light is better here”

    Why no acknowledgement by the author that we’ve identified around 100 neurotransmitters? Yet, how often do we just hear about 1 or 2 (Serotonin and Dopamine)? Bob Whitaker has been traveling the world talking about his book and he has rightly said, the easiest way to discredit him and the evidence described in his book, is produce actual evidence to the contrary. Bob is still waiting.

    I fear the love affair some physicians have with the chemical imbalance theory of so-called mental illnesses will go on for some time. She’s an attractive partner for those drawn to what she offers.

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  3. Proponents of the now admitted fabrication of the “chemical imbalance” construct will still, incredulously, attempt to foist their snake oil. They’ve a childs understanding of how real scientific observation and investigation is conducted. Their level of scientific savvy is tantamount to one concluding that when many people carry umbrellas on ominous, overcast days, it “causes” it to rain.

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  4. Weird how he cites Kirsh’s research that shows antidepressants to be essentially ineffective except in fairly extreme cases of depression, then goes on to explain how Prozac somehow improves depressive states by altering cell growth in the hippocampus. I thought Prozac didn’t work very well – why is he explaining how it works? He also says that it seems unlikely that talking to someone could create brain cell growth – why on earth not? If negative relationship experiences can cause changes in the brain, why can’t positive ones as well?

    The author also neglects to mention the budding science of epigenetics, where the genes’ expression is modified chemically based on the experiences of the organism. He also fails to cite research on the ability of meditation to actually cause growth in certain areas of the brain associated with calmness and happiness.

    In the end, it sounds like he’s trying to rescue the SSRIs from their appropriate demise. Theories are great, but when the stuff simply doesn’t do what it’s supposed to do, it’s time to stop theorizing and admit you got it wrong.

    —- Steve

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