"One recent study of trials submitted to the FDA for the six most widely prescribed antidepressants—Prozac, Paxil, Zoloft, Effexor, Serzone, and Celexa—showed that the drugs were only significantly more effective than placebos less than half the time."

Given that this is in the article you link to (involving Lincoln's supposed mental illness), I am surpised that you use Prozac in your title at all. The overuse of medications for so-called mental illness is not about science-- it's about our culture and our myths, and our faux-scientific, positivistic ways of dealing with anything that might be uncomfortable. In no other scientific milieu would someone seriously even write about a medication that has this kind of success rate, seriously.

The fact that people call Linclon mentally ill is ridiculous. In the common sense use of this term, which I consider the right one, mental illness makes you unable to function, and out of touch with common, pragmatic markers of reality. Depression, or sadness, is suffering. But it's not illness. You can't cure the human condition. The reason sadness has become an "illness" is because of our culture, which alienates people from each other. This has been commonly noted since at least the 19th century. Arguably, society has always alienated some people. But it became a mass phenomenon at that point. There is no way to cure it, so the establishment came up with faux cures, that conveniently cost a lot of money to your average Joe and make someone else a lot of money.

Lincoln suffered; probably women suffer more than men. You can call them ill, or you can call them in the first case heroic, which Linclon was, and in the second, second class citizens who bear pains that most men don't, and are conditioned to express those pains differently.

Come out with a medication that has a 90% efficacy rate, and come out with diagnostic criteria that aren't set by a bunch of men in a room with no concrete data, and I'll take you seriously. Until then, our culture needs to undestand that deep suffering is often part of the human condition. What we don't have now that people had for much of history is support networks, and patience and understanding that life is often painful. Life is not a self-cleaning oven. That doesn't mean you should ignore suffering people. Indeed, our current system of telling suffering people they are crazy, is the worst form of ignoring possible. It scapegoats people and steals their subjectivity.

Our culture has really no idea what being human really is, despite luxury vehicles. And I'll take Lincoln or suicidal but brilliant aunt Martha over Stepford Prozac people any day.

Depression kills. People die of it every day.

People who are truly depressed are paralysed. Everything is an ordeal. Work, school, eating habits, sleep patterns, are all abnormal. Decision making is compromised, relationships are virtually impossible, outbursts of anger or even rage are typical of depression. Many sufferers drop out of school, self-medicate with alcohol or illegal drugs and withdraw from anything that anyone else would consider normal.

Pretending that something doesn't exist is foolishness. It's a pretty fiction you tell yourself so that you can keep your safe, closed little world view. It makes you feel better because facing reality would mean that you have to deal with contradiction, and you don't want to do that. It's easier for you to dismiss people who aren't like you than it is to ignore them.

The best treatments for certain cancers have an efficacy rate far less than 90%, or even 50%. Would you argue, billapiacere, against treating those cancers, especially since suffering from cancer must be surely be part of "what being human really is"?

In practice it's not beyond the ability of clients and psychotherapists together to distinguish between debilitating clinical depression and forms of sadness, even suffering, such as melancholy that many people may experience as part of their personalities and creativity.

There's a false dilemma here. People can get help for serious illness, or even moderate illness. And they can have their identies intact. Sure, many people get Rx for SSRI from the G.P. at the first sign of sadness or drifting, and true, our society pushes us toward conformity in mood. But I don't see that pressure being applied in the psychologist's office, or the psychiatrist's office either.

(ADHD may be an execption, as another poster mentioned.)

who merrily toss samples at doctors who may or may not have the time or the inclination to find out what they really do and if they're really indicated for that particular patient.

I've found that the people who do the most reading and have the most knowlege aren't the doctors, but the pharmacists. If you want to know anything, ask them. They know all the side effects, up sides and down sides cold.

Cancer is an actual disease that kills people. Both of my parents and my guardians also died of cancer, as well as my grandfather and great uncle. That's six people directly related to me. Cancer should be treated.

As long as you bring it up, cancer is riddled with faux science claims about the causes.I no longer tell people that my mother died of cancer, because the common reply is, "She must have been a very angry woman." Interestingly, my father gets no such commentary. This is just another example of our pathological culture in regards to mental states and disease.

I state in my objection to this article that very sad or upset people should be paid attention to. People should be restrained from committing suiced for instance. Schizophrenia and manic depression are two very real diseases. But getting up and feeling like you are too overwhelmed to do the dishes is just part of life. Even deep sadness has legitmate causes. And it's part of life. Being scapegoated for having completely natural feelings, especially in the name of "helping", is simply part of American culture, which is positivistic and materialistic and deeply in denial, yes, of what it is to be human. One should not made hack science or riddle people with labels that are pejorative simply to address the fact that society makes some people very sad. And there are legitmate causes for sadness, like grief. Some people are high strug and sensitive, and have great artistic gifts. To call highly functional people like Lincoln, Clinton, and Beethoven insane, is insane and just a marker of how ridiculous this cultural conversation is. The idea that there is a price to be paid for high acheivement is very common. We prefer that people live elevator music lives and have very few swings of emotion. This contrasts, for instance, with 19th century Germany, when the isolated poet artist was a popular figure. Today, the hero of Winterreise would be locked up in an asylum, as well as his organ-grinding friend. The kind of cultural anaylsis doctors do to "decide" what mental illness is is quite different than what people have to do to decide if a person has a cancer. In both case, I'd argue, (and it is interesting you picked this disease) is to blame the person who has it. It's primitive, it's stupid, and it makes certain people a lot of money.

My mother had private in-home nurses when she died, and one of these people, a dishonest hack, was a therapist. She informed everyone that my mother, orphaning two children under 15, was "angry." I don't know how much money she was paid to inform us that our mother was a normal, loving mother who would do anything to avoid leaving her children behind, even if it meant suffering months and months longer to try to be with us.

Here you find noble suffering, love, and commitment, which this witchy woman tried to pathologize. I am surprised she did not accuse my mother of getting the disease because she was angry to start. But others, strangers to me, have done so. And this is just an illustration of how the cultural conversation on "mental illness" is pathological to start, based on the idea that common emotions are pathological and dangerous. It's a medieval mindset. America is primitive. It's only a step to refuse to treat people with legitimate illness because people believe that they are caused by emotions.

Luckily, we have real medical professionals in the world who would stop this. But no one stops the quackery with mental illness because it's not as visible. People have negative emotions... that's life. Instead of labelling and putting away people you think are having unacceptable emotions, support them.

Just to add to my post below, cancer is realized as a physical illness.

It is not self-reported, it is not reported by neighbors, it is not reported by Sam Lufti.

There are clinical markers to these illnesses. And in the case of so-called mental illness, it's all very subjective. I've had many neurotic friends who simply believe they should be a little happier than they are, get on Prozac. And they remain unhappy and neurotic... while others are happy with their neurosis. You can have perspective that life is not perfect. Americans expect perfection. You can't treat the world's imperfections with medication, and that is largely what we have come to expect.

It's very commonly understand that many cancer treatments are effective only sometimes, and people take these risks rather than die without treatment. My mother, suffering from pancreatic cancer that at the time had a survival rate of 12%, partook in a pioneering study at Stanford Hospital. She lived twice as long as most people suffering from this illness. I do not think depression has a survival rate of 12%. I think it's quite a bit higher. So you are playing with apples and oranges here.

I can go in to a doctor's office today and click off a list of symptoms I read on the internet and get medication. No problem. That's not medical science. I cannot claim I have cancer and get treated.

I do not think either the problem is those people who cannot get out of bed or who are completely paralyzed. The problem is that if you express any iota of unacceptable feeling in this culture you are pathologized. There is a wide, wide berth of extreme between these two things, but they are both treated as deadly issues, as polluting as cancer. When we stop being afraid of normal feelings, we will understand how to deal with people who act and feel differently than the so-called norm. Given that talk therapy is as effective or more so than medication for sad people, perhaps people can start just saying "I am mad" or "I am sad" without alarm bells going off that they are suicidal. And this, in turn, will probably prevent a lot of suicide. (This is the same logic in the recent fat article about people costing society money for being fat-- actually, fat people are so persectued that it makes them feel worse. If a tiny sad feeling wasn't so bad, would it eventually turn into suicide? And if we didn't talk to women as if we expect them to be emotional wrecks, would they really have a higher state of reported self-wreckage? The way we look at mental state as completely individual is ludicrous. Human behavior is mimetic. We are interconnected.)

Showing how far the mental health hysteria has gone into the mainstream, which I find truly unscientific and frightening, I was recently hospitalized for appendicitis. I had the operation, and was doing fine, when i was suddenly given an anti-nausea medication that prevented my eyes from focusing. I momentarily panicked, as I was basically unable to see, and told the nurse what the problem was. Instead of CHECKING MY CHART TO SEE MY MEDICATIONS, she called mental health therapists. They helpfully asked questions like "What emotional state caused your appendicitis?" I told them my understanding was that it was caused by bacteria or virus infecting the organ. After a totally fruitless conversation, the nurse LOOKED AT MY CHART, and noticed that I had been given a medication with a common side effect on the eyes.

Don't let's let cultural hysteria replace science. I will listen to articles like this one when it gives me good science.

This kind of behavior is more of symptom than a disease. There is no defining line for when something crosses over into "disease". This is a description of behaviors you outline, all occurring in social contexts. Because these contexts are so complicated, we prefer to tell ourselves a story about people in them as having a disease. OK, but where is the biological marker of this disease? We pathologize behavior because we cannot deal with the social complexities causing the behavior. Human behavior is mimetic, meaning that we mirror one another. When a person acts like this, they have been shut out from healthy social relations in their society. And the likelihood is that they are not sick at all, but responding to being scapegoated. Of course we cannot and will not deal with the social reasons for this. So we create an illness, and scapegoat the person further.

The boxing in occurs because the person so described most likely cannot even express basic emotions in his or her context because they are so pathologized. So who is really closed in, the person or the society? The longer you separate the "ill" from the "normal", the more ill people there will be. This is not being cold hearted, this is the opposite. Describing a person who drops out of school, and does these other things, as mentally ill, is ridiculous. They are responding to some intolerable situation and that should be understood. But call them ill if you want.

I have many friends classified as mentally ill, and I find the main thing wrong with them is that they have been told they are mentally ill.

I of course distinguish what people call depression from situations where people hallucinate or speak to themselves. I do not know if there is biological change noted in these conditions, but I believe they must be biological in nature and thus true illness.

Depression as you call it is simply what society has decided to call very sad people in intolerable situations. Instead of give them sympathy and understanding, give them a lable and an illness.

I don't dispute that many psychologist and psychiatrists have come to have a nuanced view of behavior and can reverse the pathological hysteria about mental illness that the common folk have. If only these healthy individuals were more common.

To Billapiacere: While I disagree with your viewpoint, I can see where your "I don't believe it if I can't see it" logic comes from. However, I think part of it is an unstated bias against anything that's described as a mental illness. Many people who have no experience with it say they don't believe it exists, and well, the nice thing is that you don't need to accept any mental health treatment. Live and let live. Just don't interfere with my ability to access MH services. BTW, regarding your discounting of illness that can't be physically shown- would I be correct in assuming that that extends to most forms of back and neck pain? Lupus, Fibromyalgia? Science just isn't there yet as far as providing specific 'tests' for a lot of things, and for disorders of the brain, well, its the most complicated and least understood organ in our body. You state that you could go into a doctors office and lie to get anti-depressants. Well, that's probably true, at least for a while, because it's primarily diagnosed based upon reported symptoms. But you could say the same thing about some other conditions that we accept as 'more legitamate' because they don't involve the mind - like the aforementioned back pain. You mention society being afraid of normal feelings - well, normal feelings don't qualify as psychiatric disorders. That's what the word 'disorder' means. It is an admittedly fine line at times, but properly diagnosed mental illness should exceed normal bounds. Also people certainly can say 'I am mad or sad" without being considered suicidal. Virtually everyone in therapy says they are mad or sad. Only a very small number are considered at high risk for suicide. In fact, in our current insurance cliamate, even stating "I am suicidal" is sometimes not enough to get you admitted to a hospital. Finally, your example of the nurse giving you improper treatment, is exactly that. It's an unfortunate incident, but I don't think that's indicative of a greater trend in physical medicine to ascribe psychiatric causes to things.

"This kind of behavior is more of symptom than a disease. There is no defining line for when something crosses over into "disease"."

Well, actually there kind of is. It's different for each disorder, but there are pretty specific criteria for each. Many behaviors that are included in a psychiatric diagnosis are indeed, normal, i.e. sadness, but they become a disorder when they are taken to a pathological extent. A key criterion in most psychiatric disorders is that it "interferes with major life activities". So being sad is not a disorder. Being very sad, plus having at least 7 other symptoms, for more than two weeks, without any physical or substance related cause, and not better accounted for as grief or bereavement, and interfereing with work or school, that is clinical depression. Washing your hands? Normal. Washing your hands over 100 times a day and experiencing extreme anxiety when not able to wash your hands for any length of time? OCD.

Being diagnosed as having a mental illness should be the first step to getting treatment and overcoming the problem. That people (patients and their families and friends) resist the diagnosis is because of the negative connotation, stereotype, and discrimination people such as yourself apply to what should be as neutral a label as being told you have a physical illness. And to the comment about people who are eccentric and just fine to be so? Some of those people might fit some of the criteria of a mild disorder, but the fact that they're not bothered by it, in most cases means they wouldn't be diagnosed with one, since most (not all) disorders require that the individual be experiencing distress. And again, (unless they're not threatening themselves or others), they need not recieve treatment. People talk about psychiatric treatment being 'forced' upon them. While that does happed, more often the scenario is someone who wants and needs treatment and can't get it (usually because of cost).

"The fact that people call Linclon mentally ill is ridiculous.

Sorry - one last comment. Re: Lincoln - 'Rediculous." Really? Why? Because you are so prejudiced that you can't accept that someone could suffer from a psychiatric disorder and still rise to greatness? Because Lincoln doesn't fit your viewpoint of persons with mental illness as useless, dangerous, and incoherent? Because it mixes someone you admire with a label that you view with disdain and discomfort? And because accepting it would reduce his stature in your mind, when instead it should increase it to realize that he did what he did while having to overcome great personal adversity? Myself, I am not entirely comfortable with diagnosing someone who is so long ago deceased, as it's based on limited information. However, based on his numerous writings, it does look as though he was depressed. The more I learn about Lincoln, the more impressed and inspired I become. I prefer not to judge people unfairly based upon whether the illness they may have suffered was physical or mental. BTW, I don't think anything less of FDR just because he was in a wheelchair.

"In the common sense use of this term, which I consider the right one, mental illness makes you unable to function, and out of touch with common, pragmatic markers of reality."

Wow, this is a big one - A.) "In the common sense use of this term" - common sense for who? Archie Bunker? Ignorant people? People who are stuck in a 1950's era of thought? I would prefer to define common sense differently. Sadly, a lot of people in this country view things the way you do, and that's a big part of why people who are mentally ill, shun help, avoid treatment, face anxiety about disclosing their condition, and deal with predjudice and stigma when they try to get a job, go to school, or do other things, and why insurance coverage for mental illness lags behind coverage for physical illness.

B.) "which I consider the right one" - Ok, so you not only get to define what is "common sense", but you get to pick what is the "right one", or proper definition. Never mind what the medical community has to say about the definition of what is, after all, a medical term. That would smack of 'book smarts'. Better to poll the man on the sidwalk.

C.) "mental illness makes you unable to function, and out of touch with common, pragmatic markers of reality" - SOME mental illnesses do this, not all (or even most), and even then, they can usually be treated. That statement is the equivalent of saying that "The common sense definition of physical illness, the right one, btw, is a person lying in a hospital bed, on machines, and an IV." Well, it COULD be, or it could mean that you have an ear infection. Both are illnesses, both should be treated in some fashion. Neither should cause you to be looked down upon. I've already detailed the numerous problems with your definition of mental illness. It is exactly the problem.

D.) "Depression, or sadness, is suffering. But it's not illness". Ok, first off, depression is not the same thing as sadness. Both states do entail suffering however. "But it's not an illness" - ok, once again I forgot that your opinion trumps that of medical experts, university researchers, the people who write the dictionary, etc. But if you want to get technical, depression would be classified as a disorder. So you sort of win on that one. It's a disorder with several variants, degress of severity, and it's very treatable. Disorders collectively fall under the umbrella of Mental Illness, i.e. mental= of the mind, and ilness= something wrong. The fact that you have your own, prejudiced view of the world doesn't mean you get to define terms for anyone other than yourself.