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In print | Published November 6, 2008

To the Editor:

As some of you may be aware, last week marked the observance of Speak to Swatties’ first “We’re All Mad Here” mental health awareness week, and the apparently coincidental publication of C.A. Chase’s “The Problematic Placebo” article. It is moments like these that my withered, blackened heart is opened to the possibility of the existence of an interventionist god. Presumably one with a bastard sense of humor. As an associate of Speak to Swatties, I had a number of problems with Chase’s column, which in classic Swarthmore fashion I shall now comprehensively and humorlessly elucidate.

First off, Chase significantly misrepresents the October 23rd New York Times article “Half of Doctors Routinely Prescribe Placebos.” The statement that the “effect [is] on patients’ psyches, not their bodies,” for example, specifically refers to placebo pain medications and not to psychiatric drugs as Chase implies. Although the article does mention that placebos may effectively treat depression in “controlled clinical trials,” it remains frustratingly vague, and fails to mention any other (potentially significant) forms of treatment offered to the subjects.

More so than its inaccuracies, however, I was troubled by the article’s trivialization of mental illness. Chase begins by referring to psychiatric treatment as “self-medication,” (apparently “self-medication” actually refers to “physician-prescribed medication”) and proceeds to equate psychopharmaceutical treatment with college binge drinking and huffing Windex. Although I generally enjoy Chase’s music references, her suggestion that the “awful female yowling or pseudo-rock grimaces that populate the airwaves” may in some way correlate to modern mental illness seems slightly unfair; I’m not wildly enthusiastic about Katy Perry or Nickelback, but even at my most indie-elitist their music does not inspire in me soul-crushing existential despair. Chase accuses psychiatry of enabling a “bland sugarized version of depression,” a “watered-down version of the teenage angst,” an “adolescent emo-ish attempt at control.” “[W]e aren’t really depressed,” she claims, “we’re just so boring we can’t realize that we’re bored with ourselves.” Such language betrays at best a careless and deeply flawed understanding of mental illness, and at worst outright contempt for the mentally ill.

Troublingly, Chase also equates mental illness with creativity and individuality. She praises the “creative despair” and “authenticity”, “ that offer the tortured but poetic soul the chance of “actually saying something real about the world”. This is a common misconception, but a dangerous one. “[G]lamorizing depression”, as Chase freely admits that she does, is at best condescending, and at worst callous and misanthropic. Depression is not the result of “relentless analysis” but of maladaptive cognitive mechanisms. It is not “reading into things” and it offers no “creative or analytical benefits.” Depression makes people suffer meaninglessly for long periods of time, and then it very often kills them. The human creative impulse is completely unrelated to “the sort of unhappiness that can be cured by sedatives,” and to claim otherwise is to belittle those who manage to express themselves through such overwhelming pain. Insanity does not enable art, but only hinders its expression. To claim that the genius of a troubled artist such as (to use two pertinent examples) David Foster Wallace or Heath Ledger is born not of talent and effort, but of a debilitating psychological condition, is to demean their achievements.

The most perplexing thing about Chase’s piece is her depiction of life on medication, one she groundlessly assumes is “teeth-gnashingly mundane…The weather outside is neither bright nor stormy; instead it’s dull and drizzly and everyday.” Taken out of context this quote serves as a beautiful encapsulation of life with clinical depression, at least as I understand it. Everything is poisoned, everything is corrupted; the mind pathologically seeks its own misery. Every day, as it were, is like Sunday. “Constant picking at the world and at yourself is a distortion,” Chase claims, “but within that distortion is a mechanism for seeing things as they are that healthy people have learned to put aside in their personal lives in order to function.” Since when are functionality and mental health things to be ashamed of? Since when is meaningless, ceaseless, unproductive suffering a virtue?

Chase seems concerned that, as psychiatric medicine becomes more widely practiced, poor diagnoses are being made and people are using drugs to escape from their problems instead of facing them. This isn’t unreasonable. Hell, I’d be surprised if it didn’t happen frequently. But consider all of those suffering with undiagnosed mental illness; the tremendous financial, emotional and psychological burdens placed on the mentally ill and their families; the cruel social stigma that discriminates against survivors. As a society, we have a lot of work to do on the perception and treatment of mental disorders before we start worrying about over-diagnosis. How is it possible for us to have gone too far, when we haven’t even come close to doing enough?

I don’t necessarily blame Chase for her arguments, as I think such misconceptions are (distressingly) quite common. The tone of the article strikes me as thoughtless rather than genuinely malevolent. Yet the fact that depression and psychiatric treatment were deemed acceptable subjects for such an inadequately researched and poorly constructed argument suggests that neither Chase nor the Phoenix editorial truly understand the severity of this issue. I urge Chase or anyone on this campus who harbors such views on mental health to please re-evaluate them, and consider a more nuanced and compassionate perspective. If Chase is willing, I’d like to talk to her about her article and her opinions on mental health; generally, however, I believe that Swarthmore students would be better served by contacting a Speak to Swatties counselor, as I am a horrible person and I enthusiastically embrace many of the misanthropic, life-denying philosophies that Chase’s article inadvertently espouses.

A final note to Phoenix editorial: This is the second time in two years that the paper has published a misinformed, inflammatory article about mental health. I believe that in engaging such a delicate subject, one assumes the responsibility to put forth a consistent, respectful, and carefully researched argument, and while I admire the Phoenix’s opposition to censorship, it is inexcusable that such articles are not subjected to a more rigorous editorial process. That Chase’s article was deemed publishable in its current state, factual errors and all, is not a testament to freedom of speech but to lazy editing and production. There is no doubt in my mind that if a columnist submitted a similar article that suggested that homosexuality could be ‘cured,’ or that argued in favor of racial eugenics, the Phoenix would at the very least demand exhaustive editorial revision.

Chase’s column offers a similarly confused understanding of biological and psychological issues; the only difference is that her arguments are directed at a less visible minority. The fact that mental illness is considered an appropriate topic for such cavalier writing speaks poorly not only of the author and the Phoenix, but of our supposedly enlightened campus as a whole.

Fletcher Wortmann ’09

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