Shelley fights back the tears as she utters in a voice barely audible to her family physician, “Things have just gotten to be too much. At first I didn’t want to get up for work, and now I don’t want to get up at all.” Shelley feels hopeless, desperate, and fragile. In times gone by, she rallied during the tough times and met obstacles head on. But this time is different: no lastminute heroics or rising to the occasion, no platitudes or pep talks that have always worked for her in the past. The doctor looks at the ten-item questionnaire Shelley completed in the waiting room; it accurately reflects her poor appetite and loss of pleasure in sex or anything else for that matter. Her physician explains that such “neurovegetative symptoms” are a sign of “clinical depression,” a medical illness resulting from a chemical imbalance in the brain. She also tells Shelley that though the problem is serious, there is no need to despair because the illness is now treatable. The doctor gives Shelley a brochure that says treating depression is just like using insulin for diabetes. By taking an antidepressant, Shelley will in crease a critical chemical that is in short supply in the brain. As the examination nears completion, the physician suggests that Shelley seek out the support of a “talk therapist” inasmuch as combining medication with psychotherapy can sometimes enhance the chances of recovery. She nods her agreement. Prescription in hand and samples in her purse, Shelley leaves the office feeling comforted: her problem has a name, a cause, and a known cure. The practice of attributing emotional suffering to chemical imbalances in the brain is now commonplace and embraced by the public and mental
health professionals alike. So popular is it, in fact, that since the antidepressant Prozac-the first SSRI, or selective serotonin reuptake inhibitor-was introduced in 1988, over 300 million prescriptions have been written for the drug and its two chemical cousins, Paxil and Zoloft. Pharmacological treatment is not only popular for adults but also the fastest-growing form of intervention for children. In 1996, 600,000 prescriptions for Prozac alone were written for kids under the age of 18 and 203,000 for children between the ages of 6 and 12. Three thousand perscriptions were written for infants under the age of 1!