Antidepressant medication and evidence-based psychotherapy have largely equivalent efficacy in the management of the common, less severe grades of depression. As a result, several national guidelines recommend that either can be used in the treatment of this disorder. Psychotherapy, however, differs in that it assists insight into how the depressed person appraises and manages the stressors that frequently trigger depressive episodes. I argue that the self-knowledge achieved through psychotherapy has moral value in that it promotes the autonomy of stressor-related decisions. (...) I further argue that such an effect comprises a compelling moral reason for doctors to see evidence-based psychotherapy not as merely optional, but as a necessary treatment for their patients with depression. (shrink)

The author raises the ethical problem of the widespread use of drugs such as Prozac, among individuals with normal mental disorders, such as nostalgia or discomfort. Referring to the work of practitioner P. Kramer, the author shows that Prozac is a psychiatric tool allowing individuals to better integrate into a society increasingly medicalized.

Too little attention has been paid by philosophers to the cognitive and epistemic dimensions of emotional disturbances such as depression, grief, and anxiety and to the possibility of justification or warrant for such conditions. The chief aim of the present paper is to help to remedy that deficiency with respect to depression. Taxonomy of depression reveals two distinct forms: depression (1) with intentionality and (2) without intentionality. Depression with intentionality can be justified or unjustified, warranted or unwarranted. I argue that (...) the effort of Aaron Beck to show that depressive reasoning is necessarily illogical and distorted is flawed. I identify an essential characteristic of that depression which is a mental illness. Finally, I describe the potential of depression to provide credal contact with important truths. (shrink)

Since the publication of Listening to Prozac there have been many debates about how and why Prozac and other similar drugs are prescribed. The articles that follow take up debates about what conditions such drugs can and should address, questions about authenticity in using drugs for psychic well‐being, and concerns about what means we morally endorse in projects of self‐creation. The contributions from Carl Elliott, Peter Kramer, James Edwards, and David Healy derive from a project supported by the Social Sciences (...) and Humanities Research Council of Canada, “Enhancement Technologies and Human Identity.” Psychiatry, like the Prozac it prescribes, aims to enhance the patient's internal psychic well‐being. Yet what ails many may be not an internal state like depression or anxiety, but alienation. And the experts of the self to whom we turn cannot “cure” our collective form of life in which alienation takes root. (shrink)