Elizabeth Gilbert, you suck.

From that book that I finally got around to reading for research purposes (research question: "Why is this book such a huge bestseller?") and which everyone but me loves to bits, Elizabeth Gilbert's Eat Pray Love. Context: During a harrowing divorce, Gilbert becomes depressed. She tries endless "natural remedies," but seeks the care of a psychiatrist after she attempts suicide.

I do know these drugs made my misery feel less catastrophic. So I'm grateful for that. But I'm still deeply ambivalent about mood-altering medication. I'm awed by their power, but concerned by their prevalence. I think they need to be prescribed and used with much more restraint in this country, and never without the parallel treatment of psychological counseling. Medicating the symptom of any illness without exploring its root cause is just a classically Western hare-brained way to think that anyone could ever truly get better. Those pills might have saved my life, but they did so only in conjunction with about twenty other efforts I was making simultaneously during the same period to rescue myself, and I hope to never take such drugs again.

There are so many selfish, condescending, and hare-brained statements in that one little paragraph that I need to pull it apart to address each one.

But I'm still deeply ambivalent about mood-altering medication. I'm awed by their power, but concerned by their prevalence. I think they need to be prescribed and used with much more restraint in this country

In the year 2020, approximately 1.53 million people will die from suicide based on current trends and according to WHO estimates. Ten to 20 times more people will attempt suicide worldwide (2). This represents on average one death every 20 seconds and one attempt every 1-2 seconds.

It is, of course, possible for a medication to be over-prescribed in some cases and under-prescribed in others. But considering that, according to WHO, "Suicide is among the 10 leading causes of death for all ages in most of the countries for which information is available. In some countries, it is among the top three causes of death for people aged 15-34 years," I'm going to say that under-prescription is the bigger problem-- a problem which attitudes like Gilbert's foster.

I think they need to be prescribed and used with much more restraint in this country

How callous, priveleged, arrogant, selfish, and smug can you get?! So meds are okay for her, because she had a real problem and didn't take them until she was at the point of suicide and has moral qualms about their use, but all those other ignorant peons who gobble them like candy need to have their access restricted?!

That is one of the most despicable statements and sentiments I've come across in quite some time.

and never without the parallel treatment of psychological counseling.

I agree with that, actually.

ETA: Oops, missed the "never;" I think counseling should always be offered, but should not be mandatory. If nothing else, the experience of having a mental illness for a long period of time will usually give you dysfunctional thinking patterns and ways of relating to people that counseling will help address. But if your problem is being completely addressed by meds and you're doing fine, no, you probably don't need counseling if you don't want it.

Medicating the symptom of any illness without exploring its root cause is just a classically Western hare-brained way to think that anyone could ever truly get better.

1. In many cases of mental illness, the "root cause" is either known as a biological and/or genetic problem and so doesn't really need to be "explored" in the sense of discovering its root cause (like schizophrenia or bipolar disorder) or the patient is so ill that she will not benefit from such exploration until medication has kicked her into a higher-functioning mode.

Also, some forms of talk therapy are specifically about the present and not root causes -- and those forms are statistically more effective for some disorders than classic "root cause" therapy. (ie, cognitive-behavioral therapy vs. psychoanalysis for depression.)

2. What a stupid statement!

"Medicating the symptom of a broken leg by setting it without exploring its root cause is just a classically Western hare-brained way to think that anyone could ever truly get better."

"Medicating the symptom of the bubonic plague with antibiotics without exploring its root cause is just a classically Western hare-brained way to think that anyone could ever truly get better."

"Medicating the symptom of a cataract with surgery without exploring its root cause is just a classically Western hare-brained way to think that anyone could ever truly get better."

3. Gilbert's Asia-philia blinds her to the reality of actual Asian medicine, which is not necessarily as holistic as she thinks. She should read Atul Gawande's Better for an excellent portrayal of actual doctors in India doing brilliant work under extremely difficult conditions.

Those pills might have saved my life, but they did so only in conjunction with about twenty other efforts I was making simultaneously during the same period to rescue myself,

I am absolutely not against doing whatever might help. All the same, the plural of anecdote is not data.

and I hope to never take such drugs again.

Well, I hope you DO!

I can't believe I'm wishing such ill on anyone, whatever sort of scumbag they are... but this book was a huge bestseller, people are influenced by what they read, and so Gilbert's screed may be indirectly responsible for someone committing suicide because they were trying to make sure they waited to use them as long as she did -- and she waited till it was down to her, a knife, and a worried friend. What if some reader doesn't have a worried friend?

What a loathesome and damaging thing to write.

Here is a three-part essay on my experience with depression.

Here is a three-part essay on my experience with post-traumatic stress disorder.