The Decision Tree

Decision-making from all perspectives

Why Taking Mental Health Pills Isn't All That Bad

I trust psychiatrists more than magazine columnists.

A recent article in Slate points out that 1 in 4 women take mental health pills, and make the obvious (to its author) point that this is a bad thing. I am not so sure I agree. If people (men or women) are sick, and pills make them better, why is it so bad to take them?

I would guess that about 90% of people take medicine at some point in their lives. Bodies are complicated things and they need tuneups like cars. The brain is the most complicated part of the body. Pills are a very efficient way of tuning them up. 

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The author (KJ Dell'Antonia) rejects this idea. The title of the article is "1 in 4 women cannot possibly need mental health drugs." This forceful declaration makes sense, but wait, what is the basal rate of mental illness in the natural environment? Actually, science doesn't have any idea. It could well be over 1 in 4. It's quite possible that it's a lot higher. If so, maybe 1 in 4 is about right, or even too low.

Some mental illness is deadly. A lot of mental illness is the mind equivalent of getting a cold: it's unpleasant, but doesn't really hurt you. There's probably not much evolutionary selective pressure against it. Maybe we have reached a point in human evolution where we can get rid of this stuff, and mental health pills are like Tylenol. It's tidying up what natural selection failed to do.

I think the idea behind this article's sentiment is that drugs are unnatural and thus dangerous. My motto is 'natural is probably more dangerous'. Human life expectancy is much much higher than it has ever been in human history. I take blood pressure medicine every day and, according to my doctors, they increase my life expectancy. I prefer this unnatural situation to the natural one. (Like 80% of people with high blood pressure, my disease is not caused by any identifiable environmental variable). And high blood pressure is probably underdiagnosed. I want more people to take medicine for blood pressure. The side effects are minimal!

My opinion: I trust psychiatrists to prescribe the right drugs more than magazine columnists. Of course, when it comes to depression at least, therapy is often as effective if not more effective than pills, and the combination is generally the most effective. But that's also a decision that can be guided by a good mental health professional.

It's possible that men don't take enough mental health pills. Given that depression in men is linked to domestic violence, alcoholism, neglect of family, and is (according to some) transmitted to children in the form of depressogenic thought and behavior patterns, let's get more men onto mental health pills too.



Ben Hayden, Ph.D., is an Assistant Professor of Brain and Cognitive Sciences at the University of Rochester.


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