Depressing: The Pharmaceutical Exploitation of Depression in America
Sawyer Batten
ENG 303
14 April 2014
Enthymeme: Depression is being misdiagnosed to fit the masses and treated with pills which do
not work for those masses, which started with the advent of Anti-Depressants in 1988 and
pharmaceutical companies’ advocacy and campaigns since.
Stasis Question: Consequence
Major form of Appeal: Logos
Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
Depression is a condition affecting nearly ten percent of America’s adult population and
one that will affect everyone at some point in their lives (Murray and Fortinberry). Because of
this, it is important to look into the methods being used to treat depression and evaluate their
effectiveness and benefits for patients. Currently, the most prevalent and ever-growing form of
depression treatment is the use of prescription antidepressant drugs (Cohen). The use of these
antidepressant drugs is not only proven to be ineffective on many patients, the drugs also have
associations with many unpredictable negative side effects and are being prescribed, in
increasing frequency, to patients that do not need prescription drug treatment for their symptoms.
The following will explain what depression is, how depression characterization has
altered and its diagnosis rate has skyrocketed within the last three decades, as well as the
corresponding timeline of antidepressant drug development and their rise to becoming the mostprescribed drug in America. It will explain the advocacy of pharmaceutical companies that has
resulted in people who are not depressed being told that they are, and people who do not have
major or manic depression and do not have a “chemical imbalance” being given drugs—drugs
with high dependency and suicide rates—that cannot help them as an initial response to their
mild depression instead of Talk therapies, which are proven to be more effective and harmless.
Depression, as previously stated, is a very common mental illness that will somehow
affect everyone at some point in their lives, whether as a victim or as a witness. Approximately
18.8 million Americans over the age of eighteen suffer from depression annually and nearly
fifteen percent of all populations from developed countries worldwide suffer from depression
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
(Murray and Fortinberry). It is quite probable that most people have already personally
experienced some form of depression or will at some point in the future. In order to tell, one
must be aware of the symptoms of depression. Constant and unrelenting emotions of sadness,
hopelessness, or worthlessness that result in a loss of interest in usual or enjoyable activities are
the basic symptoms of depression (Ayers 15). Other indicators are fatigue and change in sleeping
patters, loss of concentration and performance, change in eating habits, feelings of frustration,
apathy, the development of compulsive behaviors, and violent thoughts of suicide or harming
others (Ayers 16).
The severity and duration of these symptoms determine the type of depression one is
experiencing. There are three main types of depression: minor, major, and manic (also called
bipolar disorder) (“Psychotherapy to Treat Depression”). Minor depression is characterized by
depressive moods that persist and become like a lifestyle. Its symptoms are usually constant but
not severe (“Psychotherapy to Treat Depression”). Major depression consists of three categories;
reactive depression, endogenous depression, and psychotic depression. Reactive depression is
caused as a response to a stressful or tragic event or loss. Endogenous depression is a form of
depression that is hereditary or caused by a gene or chemical imbalance in the brain. Psychotic
depression is a form of depression that usually results from stress or exhaustion and feeling
overwhelmed (Ayer 11-12). Symptoms of major depression are usually more severe and
intrusive that those of minor depression, and even though most cases of depression pass within a
matter of months, it is still important to seek treatment. The final and most severe form of
depression is manic depression or bipolar disorder. This form of depression is characterized by
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
dramatic mood swings from rage to depression that impair a person’s ability to reason or control
their emotions. This form of depression is the least common, but by far the most severe
(“Psychotherapy to Treat Depression”). For all forms of depression, therapy is needed; the type
of treatment, however, varies. The two most common types of treatment are Talk therapy and
prescription drug therapy (Davis). These are often used together, but drug therapy has quickly
become the most prevalent form of treatment which is, for the reasons I am about to share,
unnatural, dangerous, and devised.
Prescription drug therapy is the practice of prescribing prescription antidepressant drugs
to patients. These drugs can alleviate symptoms of depression for some patients, but for a
surprisingly large number of others they are ineffective or have many harmful side effects.
Antidepressants are proven to benefit only about thirty percent of patients who take them (Martin
and Fortinberry). This small percentage is generally composed of only the most severely
depressed patients, as the majority of minor depression cases are treated just as well with
placebos (Braun 121) Peter Breggin states that, “Depression is obviously a psychological and
spiritual condition; therefore, drugs do not do patients any good because they do not address the
real problems or causes of depression” (Braun 119).
In a study done by the Lilly Pharmaceutical Company, makers of the antidepressant
Prozac, results show that out of six tests, only once did Prozac have results better than those of
placebos in patients (Braun 121). For some of the patients who did see improvement when taking
antidepressants, once the medication stopped, their symptoms returned. A majority of
antidepressant users experience a relapse after they stop their treatment, which creates drug
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
dependencies in many patients. This is due to the fact that antidepressant medications do not cure
depression; they simply compensate for a malfunction in the body, in the cases when there is an
actual malfunction (Franklin). In his book, The Science of Happiness, Stephen Braun states that,
“Today, millions of people have tried Prozac, Paxil, Serzone, or Wellbutrin and, after a period of
experimentation, have dropped the drugs because they have found the experience unpleasant of
unhelpful” (159). When this happens, total relapse occurs and patients must start their drug
treatment all over again (Ayer 53).
Along with ineffectiveness are the prevalent harmful side effects that can create
symptoms worse and more uncomfortable than those being treated initially. The side effects and
severity of them are highly unpredictable. The effectiveness of the drug as well as the conditions
it creates vary from person to person; the tolerance for dosage and length of use varies as well
(Franklin) Common side effects are dry mouth, sleep disruption, weight gain, headache, nausea,
urinary retention, gastrointestinal problems, abdominal pain, loss of libido, and agitation (“Side
Effects of Antidepressants”). More serious side effects of the drugs are abnormal bleeding, the
formation of brain tumors, suicide, and various sorts of violent acts (Murray and Fortinberry). In
2004, the drug Serzone was taken off the market after causing liver failure and twenty patient
deaths (Prater). The varied response to these drugs is due largely to the fact that we do not yet
fully understand the effects that the drugs have on the brain. Even pharmaceutical companies
have stated that they do not fully understand how the drugs work (“Side Effects of
Antidepressants”). Why, and how, really, are these drugs the go-to form of depression treatment
in America?
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
In Britian, the use of any antidepressant on children, other than Prozac, is prohibited due
to the fact that there is “no scientific evidence proving that SSRI’s work for any patient under
18” (Murray and Fortinberry). There is an established link between antidepressants and suicidal
tendencies, which is magnified in young patients. All antidepressants available in the United
States are proven to increase suicidal tendencies in patients under the age of twenty four (Prater).
Ironically, preschoolers are the fastest growing market for antidepressant drugs. Four percent of
American preschoolers have been diagnosed as clinically depressed and over a million of them
are taking prescription drugs (Murray and Fortinberry). This indicates that prescription drugs are
being over-prescribed and that this treatment method is being carelessly used.
There is an interesting correlation between the increasing number of new “depression”
patients needing prescription drugs and the profits of the pharmaceutical companies distributing
these medications. Since the introduction of the first prescription antidepressant, Prozac, in 1988,
the numbers of patients needing this drug have increased drastically and, by 2005,
antidepressants were the most-prescribed drug in the United States with more than 118 million
prescriptions. The use of antidepressants from 1995 to 2002 increased forty-eight percent
(Cohen). Now, eighty percent of depression sufferers use antidepressants and only one quarter of
those patients benefit (Davis). There is something wrong with that picture. We must ask
ourselves why drugs are being prescribed so profusely—can it truly be the case that suddenly,
corresponding with the advent of prescription antidepressants, that depression decided to ramp
up its virulence to scourge status? Why are the drugs being prescribed en masse while,
simultaneously, evidence of harmful effects and ineffectiveness mounts? Why did doctors
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
become more likely to write a prescription than first recommending a safer, more effective
treatment? It is due to the massive profits being made by pharmaceutical companies, and thus,
doctors, who distribute antidepressants.
To illustrate this point, I will relate to you the 1985 case of the drug Protropin. Protropin
was a revolutionary new drug for the treatment of Pituitary Dwarfism, however, there were only
around 7,000 patients that actually suffered from that condition and that could benefit from the
drug. This small patient pool could not return the profits needed to fund the development of the
drug, so the drugs did not go on sale until the pool had been expanded to a size from which a
profit could be made. So how did they increase the size of this pool? The company marketed the
drug to children who fell under a certain height percentile, but who, in no way, suffered from
Pituitary Dwarfism. By making shortness a diagnosable condition, the pool of 7,000 was
expanded to 90,000 (Braun 113). It seems that much of the same is happening in the present
antidepressant market. The difference between suffering from dwarfism and being short is a
substantial one, yet a single pharmaceutical company decided to redefine the term dwarfism to
include a condition that is not, and will never be, dwarfism. Similarly, pharmaceutical companies
in America have campaigned, with much success, to define depression in a lax manner which
maximizes their profits.
Steven Braun states in, The Science of Happiness that, “Drug companies try to block
publications unfavorable to their interests. Many materials distort the reality of mental illness to
broaden the pool of patients, unjustly tout the efficiency of the drug and promulgate outright
falsehoods” (111). Pharmaceutical companies like Lilly, Zeneca, Abbot, Pfizer, Glaxo, and
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
Wyeth-Ayerst have all sponsored and funded organizations which campaign and advertise that
depression is caused by a chemical imbalance in the brain that can only be corrected by
prescription drugs. While this may be fact in some cases, i.e. some degrees of major or manic
depression that make up only thirty percent of users, Stephen Braun states in his book that,
“Depression is simply not caused by depleted Seratonin levels” (126). Other researchers
acknowledge that the chemical imbalance notion is outdated and used to sell more prescriptions
(Prater). Currently Harvard Medical School’s website reads that, “It’s often said that depression
results from a chemical imbalance, but that figure of speech doesn’t capture how complex the
disease is. Research suggests that depression doesn’t spring from simply having too much or too
little of certain brain chemicals”, followed by “Researchers understanding of the biology of
depression is far from complete… their understanding of the neurological underpinnings of
mood is incomplete” ( “What Causes Depression”). A Dr. Dworkin stated that, “Doctors are now
medicating unhappiness. Too many people take drugs when they need to be making changes in
their lives” (Cohen). As evidenced by the Protropin case, and also by the staggering statistic that
only thirty percent of depression patients taking drugs are benefiting from them—which means
that seventy percent of users are not—it is undeniable that American pharmaceutical companies
have artificially expanded their patient pool by marketing a faux depression.
These practices are aided by the allowance of pharmaceutical companies to perform their
own testing on drugs to present to the FDA. An example of the way these get skewed involves a
previously-mentioned Prozac study. Out of six tests performed, only one provided positive
results. Only this test was presented to the FDA, however, with no record of the five failures, and
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
the drug became one of the top-selling prescriptions in the country. Had the FDA or some other
third-party agency been in charge of testing, Prozac would likely have failed. The current liberty
of pharmaceutical companies to do their own testing, free of oversight, is the equivalent of
giving a student a take home test and a textbook. So why have this privilege? In his book,
Stephen Braun acknowledges that “the monumental profit to be made creates pressure on all
aspects of development, testing, marketing and regulation.” He discusses how the pressure can
lead to false or misleading claims about a drug’s safety, effectiveness, or unbalanced descriptions
of the conditions the drug is intended to treat (136).
With the following knowledge—what depression is, how depression characterization has
altered and its diagnosis rate has skyrocketed within the last three decades, as well as the
corresponding timeline of antidepressant drug development and their rise to becoming the mostprescribed drug in America—one cannot maintain that the advent of the drugs and resulting
marketing by pharmaceutical companies has not manipulated the characterization and treatment
of depression. People who are not depressed are being told that they are, and people who do not
have major or manic depression and do not have a “chemical imbalance” are being given
drugs—drugs with high dependency and suicide rates—that cannot help them as an initial
response to their mild (or non) depression instead of Talk therapies, which are proven to be more
effective and harmless. This paper argues not to demonize anti-depressant drugs, but only to
articulate that because of the substantial profiteering, power, and relationships between doctors
and pharmaceuticals, that, like the Protropin case in which short people—not patients with
dwarfism—were exploited and misled into receiving the drug, that depression has been
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
characterized in a way that makes everyone a candidate if they claim it. Further, doctors who
make such (willfully) misinformed diagnoses should also know that for non-major or non-manic
depression, for which Talk therapy should be the first step, yet they prescribe anti-depressants at
a hat’s drop. Case studies, the evolution of how depression is characterized, and the
synchronized rise of diagnosis rates and prescriptions prove that this practice is occurring in a
most concrete way. This paper urges you to be aware, and if convinced, to share your new
knowledge with a friend.
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
Works Cited
Braun, Stephen. The Science of Happiness: Unlocking the Mysteries of Mood. New York: Wiley,
2000. Print.
Cohen, Elizabeth. “CDC: Antidepressants most prescribed drugs in U.S.” CNN.com. Cable
News Network, Inc. 9 July 2007. http://www.cnn.com/2007/HEALTH/07/09
antidepressants/index.html?_s=PM%253AHEALTH
Davis, Jeanie. “Drug Therapy vs. Talk Therapy for Depression”. WebMD.com. WebMD, LLC.
7 September 2004. http://www.webmd.com/depression/news/20040907/drug-vs-talk
therapy-for-depression
Franklin, Donald. "Antidepressant Medications." Psychologyinfo.com. Forks Publishing
Company, n.d.Web. 22 Mar. 2014. http://psychologyinfo.com/depression/medication.htm
Murray, B. & Fortinberry, A. “Depression Facts and Stats”. Upliftprogram.com. The Uplift
Program. 15 Jan. 2005. Web. 18 Mar 2014. http://www.upliftprogram.com/depression
_stats.html#2
“Psychotherapy to Treat Depression”. Medicinenet.com. MedicineNet, Inc. 24 July 2012.
http://www.medicinenet.com/psychotherapy/article.htm
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Sawyer Batten
Dr. Bushman
ENG 303
Essay 3
14 April 2014
Prater, Alicia. "Selective Serotonin Reuptake Inhibitors." Sciences360.com. Helium, Inc., 22
Mar. 2010. Web. 22 Mar. 2014. http://www.sciences360.com/index.php/selective
serotonin-reuptake-inhibitors-10976/
"What Causes Depression?" Health.harvard.edu. Harvard University, n.d. Web. 27 Mar. 2014.
http://www.health.harvard.edu/newsweek/what-causes-depression.htm.
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