Louis Menandís New Yorker article earlier this year that reviewed a couple of new books on psychiatry in the context of the confusing state of psychiatric literature posed the compelling question that is the title of this post:

You go see a doctor. The doctor hears your story and prescribes an antidepressant. Do you take it?

However you go about making this decision, do not read the psychiatric literature. Everything in it, from the science (do the meds really work?) to the metaphysics (is depression really a disease?), will confuse you. There is little agreement about what causes depression and no consensus about what cures it. Virtually no scientist subscribes to the man-in-the-waiting-room theory, which is that depression is caused by a lack of serotonin, but many people report that they feel better when they take drugs that affect serotonin and other brain chemicals. [.  .  .]

.  .  . As a branch of medicine, depression seems to be a mess. Business, however, is extremely good. Between 1988, the year after Prozac was approved by the F.D.A., and 2000, adult use of antidepressants almost tripled. By 2005, one out of every ten Americans had a prescription for an antidepressant. IMS Health, a company that gathers data on health care, reports that in the United States in 2008 a hundred and sixty-four million prescriptions were written for antidepressants, and sales totalled $9.6 billion.

As a depressed person might ask, What does it all mean?

Following on that provocative article, Russ Roberts’ essential EconTalk series this week presents this fascinating interview of Menand on the state of psychiatric knowledge and the scientific basis for making conclusions about current therapeutic approaches of battling it.

Although hard and fast conclusions are few, Menand is asking the right questions about a subject that desperately needs better societal understanding. His article and interview are valuable contributions to improving that understanding.