Health Secretary Robert F. Kennedy Jr’s questions this week about the scale of antidepressant use in the United States should be welcomed, whatever your politics. Long-stated concerns about psychiatric medication are now being taken seriously, and Kennedy has announced initiatives aimed at reducing the use of SSRIs, the most widely prescribed class of antidepressants. These drugs — which include Prozac, Zoloft, Lexapro, and Paxil — are now taken by roughly one in six American adults.

Introduced a little over 40 years ago, SSRIs were widely embraced because they were seen as safer and easier to prescribe than earlier medications. They quickly became a first-line response for doctors confronted with depression and anxiety. Global studies show that anxiety and depression remain widespread despite decades of increasing antidepressant use. The net effect is more diagnoses, more medication, and less curiosity about why people are struggling.

Despite these trends, antidepressants haven’t received the proper scrutiny, while the medicalisation and pathologisation of human suffering continues unabated. Whenever anyone questions this, they are silenced by accusations of recklessness, of undermining treatment, and of putting others at risk. It is now increasingly difficult even to ask why so many people are on these medications.

Notably, this rise in prescriptions did not follow a major scientific breakthrough or a clear long-term evidence base. It happened gradually, driven in part by overstretched doctors faced with large numbers of those suffering from mental illness who have seen little other success in treatment. Many people arrive in the consulting room hoping there might be some way to improve their low mood. There are few immediate alternatives, and medication is often the reflexive response.

The truth is that life is often difficult, and for many it is extremely difficult. As a result, some turn more quickly toward melancholy and despair. Struggle is part of the human lifecycle, but antidepressants disrupt this rhythm. They can offer hope, but they can also blunt emotional range and alter how people relate to themselves and others.

Many who take medication become less tolerant of sadness, both in themselves and in those around them, and may begin to wonder why others do not simply take medication to reduce their distress. At the same time, as the effects of the drugs inevitably wear off, impatience with our own distress can deepen. This creates a cycle in which patients return to their doctor seeking more help.

The desire for a “quick fix” has helped create a culture in which medication or diagnosis is expected to resolve mental distress. Each pill carries the hope of improvement, of an answer to life’s struggles, sidestepping the harder work of contemplating life without easy answers, developing self-understanding, and strengthening our capacity to cope.

As we increasingly pathologise ordinary human distress, the deeper questions are left untouched. The doctor does not have the time to understand what has happened in the patient’s life or what they might need to feel better. People need to understand what they are taking and what withdrawal involves, and they need proper support to taper. We also need far greater investment in psychological therapies and community-based support that address the roots of distress. At present, those alternatives are limited: waiting lists are long, access is inconsistent, and medication fills the gap.

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Stella O’Malley is a psychotherapist and bestselling author. She is Founder-Director of Genspect, an international organisation that advocates for a healthy approach to sex and gender.

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