Pull Yourself Up by Your Pill Bottles
Big Pharma's attack on personal responsibility
Anyone who has recently watched American television has undoubtedly been bombarded by a slew of pharmaceutical advertisements. The simplistic narrative presented in these ads suggests that our society is full of individuals who, thanks to the intervention of miraculous pharmaceutical developments, live lives as blissfully untroubled as the smiling actors in these commercials. Beneath this façade of cheerful faces, however, lies society's incessant desire to find a fix—a quick fix—for any health issue. Personal initiative has been replaced with small, seemingly harmless white capsules. Yes, these pills are sometimes helpful to those with severe or debilitating illnesses. But what about the millions of Americans who do not absolutely require this extra step? Is the antidepressant better understood as a panacea or as a shortcut around necessary habitual change?
Pharmaceutical companies have reduced complex human experiences to mere chemical imbalances. The message of those ubiquitous advertisements is that individuals’ thoughts and emotions stand firmly outside their control; external assistance in the form of medical intervention is necessary and, the ads suggest, sufficient to regulate thoughts and feelings. The solution to depression and anxiety, however, is far more complicated than that, and trivializing the depressive mental state in this way threatens to undermine individual initiative and responsibility. Nonetheless, the pills persist: it is understandably easier to rely on an external solution to our problems than to do the intellectually and emotionally taxing work of working through them ourselves, especially when the pharmaceutical industry does its best to convince us that only it can help us. As a result, Americans have developed a culture dependent on medical intervention to help us when we struggle. Consequently, people come to regard themselves as victims, fundamentally beholden to forces beyond their control, rather than as the authors of their own lives.
Life is meant to be lived, not managed; getting a handle on negative emotion should be a starting point to future growth, not the only goal of mental healthcare.
The perception of these conditions as long-term, seemingly insurmountable disorders further encourages us to offload our agency onto pharmaceuticals. But it is precisely the complex and nuanced nature of these mental conditions that ensures that they cannot be completely addressed by medical treatment. One cannot entirely alleviate the symptoms of depression in a few hours or days through a daily pill. Pharmaceuticals, if used, cannot hope to replace a commitment to personal lifestyle changes.1 In fact, the APA is reluctant to recommend antidepressants in the absence of psychotherapy.2 Yet pharmaceutical companies and advertisements rarely focus on this important fact. What results are consumers who expect too much from their medications and too little from themselves.
This mindset works against the genuine promotion of mental wellbeing. Indeed, as many as two-thirds of antidepressant prescriptions may be “unnecessary.”3 With over 37 million Americans taking antidepressants, their misuse impacts our entire society.4 What’s even more striking is that they are used to treat not only depression and anxiety but also conditions like migraines and ADD; moreover, some of these applications “are... not based in scientific evidence.”5 Americans should be especially concerned about the widespread use of such drugs because antidepressants perform only marginally better than placebos.6 For many individuals, merely the belief that their condition should improve is sufficient to make it improve. In other words, many patients need only to be convinced that they could assume greater responsibility over their own lives to begin doing just that. On the other hand, if non-medicinal solutions are consistently deferred until a medical intervention creates “the right conditions” for change, individuals grow less and less prepared to undertake the challenge of self-improvement and self-healing.
This attitude has also helped blur the line between mental wellbeing and mental health. Promoting mental health usually involves management of mental illnesses and has also expanded to include reducing day-to-day stresses. On the other hand, mental wellbeing focuses on a balanced lifestyle, improved nutrition, and meditative exercises like yoga. Such a connotative distinction begs the question: why do we not promote mental wellbeing, which asks what it would take to flourish, rather than the mere stress avoidance of mental health? Even at their best, drugs and pharmaceuticals only address the latter. The opportunity to take control of our lives, though, is a great gift and pleasure, not to mention ultimately more impactful than relying on third parties. Life is meant to be lived, not managed; getting a handle on negative emotion should be a starting point to future growth, not the only goal of mental healthcare.
Medication should not be the first step in addressing mental struggles, especially when habit and self-improvement have the power to create much more stable improvements in one’s quality of life. Instead, medication should be reserved for cases where individual initiative is not sufficient and external intervention is clearly necessary. America’s diminishing attachment to self-reliance is worrisome; pharmaceuticals, when used, should be a supplement to other efforts, not a replacement for them. This does not mean nothing can be done. Thankfully, we have far more power over our surroundings—and our minds—than the pharmaceutical industry would have us believe.
A version of this article originally appeared in Heal Thyself, the February 2023 print issue of the Salient.
As this Harvard Health Publishing article points out, “self-care” is at least as important in treating depression as medication and therapy. Dr. Monique Tello, “Diet and Depression,” Harvard Health Publishing, Jan. 29, 2020.
Kirsten Weir, “APA Offers New Guidance for Treating Depression,” American Psychological Association, Sep. 1, 2019.
“Antidepressant Abuse and Addiction,” Cycles of Change Recovery Services, 2020.
Alexandra Sifferlin, “Half of the People Taking Antidepressants Aren’t Depressed: Study,” Time, May 24, 2016.
Clare Wilson, “Nobody can Agree About Antidepressants. Here’s what you Need to Know,” New Scientist, Oct. 2, 2018.