Moving Beyond Psychotropics & “Patch-Up Therapy”

This article is not intended to provide medical advice.

Please consult your prescriber before beginning or discontinuing the use of any medication.

A recent opinion article published in Bloomberg (1) reviews some of the latest research on SSRIs in light of the claims made by pharmaceutical companies that these drugs fix “a chemical imbalance in the brain” which supposedly causes depression. Unsurprisingly, the research shows that the vast majority of the positive effects that come about when people take these drugs boil down to the placebo effect. It could be said that in about 15% of patients the actual drug is having a therapeutic effect, but there’s bound to be some sort of changes—good and bad—when you mess with the brain’s chemistry in this way.

I say “unsurprisingly” because critics have long observed that these drugs have been developed through shoddy corporate science, with little data backing up their claims of having developed “miracle cures” (2). The fact is we still don’t really know exactly what impacts are being had on people’s brains when they take SSRIs and other psychotropics. We do know, however, that the potential for addiction and negative mental health outcomes—including suicide—are very real. People are sold on the idea that these expensive, harmful drugs are going to cure them of their mental distress. Perhaps people feel some stability in the short term, but what usually ends up happening in the long term is that they develop a host of negative side effects yet see very little improvement in their condition.

Rollo May, one of the founders of the existential-humanistic movement in psychotherapy, frequently warned against psychotherapists turning towards “gimmicks” (3) and becoming “patch-up artists” (4). It would be hard to argue that medications and modalities like CBT (the “gold standard” of psychotherapy) don’t fit into the description of gimmicks being peddled by patch-up artists. Again, these interventions may help stabilize people in the short term, but they don’t address the underlying causes of depression and other mental health concerns.

In order to address the actual causes, someone suffering from mental health concerns should be given the space to explore their existential situation. Factors such as racism, sexism, heterosexism, and capitalist exploitation need to be on the forefront of a therapist’s mind. Rather being plied with pills or told to simply not think a certain way, a client should be given the freedom to work out how they would like to respond to their existential situation. How would they like to and/or how are they able to take control of their life? How can they make a meaningful life in the face of what existentialists call the “facticity” (5)—the conditions beyond their control—of their human experience? It is through engaging in this deeper work that people have the opportunity to find true healing and peace.

Notes:

(1)   Flam, F. (2022, August 8). Pharma overpromised on antidepressants. Bloomberg. https://www.bloomberg.com/opinion/articles/2022-08-08/what-causes-depression-it-s-more-complicated-than-low-serotonin?srnd=opinion-technology-and-ideas&sref=r4AzvICB&utm_campaign=socialflow-organic&utm_content=view&cmpid%3D=socialflow-twitter-view&utm_source=twitter&utm_medium=social

(2)   Whitaker, R. (2010). Anatomy of an epidemic: Magic bullets, psychiatric drugs, and the astonishing rise of mental illness in America. Broadway Books.

(3)   Schneider, K. J., Galvin, J., & Serlin, I. (2009). Rollo May on existential therapy. Journal of Humanistic Psychology, 49, 419-434.

(4)   May, R. (1983). The discovery of being. Norton.

(5)   Sartre, J. (1943). Being and nothingness. Washington Square Press.