Tuesday, June 25, 2019

The Dangers of SSRIs

This ought to be well enough known by now, but apparently it isn’t. Every time a high profile individual commits suicide the media issues some well intended advice, to the effect that we need to have a national conversation about depression. And it always adds, wistfully, that if only the victim could have received proper treatment.

And yet, many of these suicide victims were receiving mental health treatment. As I noted in my post about Lauren Slater, psychiatric treatment seems to be doled out haphazardly. It produces some very unpleasant side effects. And besides, we ought to emphasize, yet again, a simple fact, known to all physicians and psychopharmacologists: namely, that antidepressant medication, especially SSRIs, comport a suicide risk.

The Daily Mail has the story:

Taking antidepressants raises the risk of suicide, a study suggests.

Experts last night warned that patients should be told of the dangers before they start taking the pills.

The research found depressed people on the drugs were more than twice as likely to attempt suicide as similar patients who were not taking them.

Study leader Dr Michael Hengartner, of Zurich University in Switzerland, said: ‘We can be confident that these drugs are producing an excess rate of suicides, beyond the depression itself.

‘There is no doubt that this must be a response to the pharmacological effect of the drugs themselves.’ 

Although the increased risk appears stark, in real terms the researchers calculated only 77 extra suicides per 100,000 patients taking the pills.

Scientists acknowledge that for many people, antidepressants are a lifeline.

Given that the Daily Mail is a British publication, it emphasizes how these medications are being prescribed in Great Britain:

But with more patients in Britain taking them than those in almost every other Western country, many doctors believe millions are being put at risk. 

Some seven million adults in England took the drugs in 2016/17. The researchers believe that for some, the chemicals in the pills can trigger severe agitation, restlessness and even psychotic episodes.

Dr Hengartner added: ‘I’m not saying no one should be given antidepressants, but doctors should be much more conservative about how they use them. One in six adults being given antidepressants like in the UK – that is alarming.

How bad is the risk?

The study found that people prescribed antidepressants were 2.5 times more likely to attempt suicide than depressed people taking placebo pills.

The research, published in the journal Psychotherapy and Psychosomatics, combined the results of 14 studies involving nearly 32,000 people taking a variety of antidepressants.

The authors stressed that the real-terms rise in risk was small, calculating that for every 100,000 taking the pills, there would be an extra 413 suicide attempts and an extra 77 suicides. But in England, this could add up to thousands of extra suicides.
The highest risk was found to occur in the first four weeks after the treatment begins.

And yet, the data for the study comes from the United States, of all places:

Professor Wendy Burn, president of the Royal College of Psychiatrists, pointed out that the study was based on US data, and four of the 14 drugs assessed are not available in the UK.

But she added: ‘This is an important issue, which we need to understand better. As with all medications, we need to balance the potential benefits and risks of harm from starting, continuing and stopping their use.

‘It is vital that people prescribed antidepressants are monitored closely, made aware of possible side effects and know how to seek help if they experience them.’

This ought not to be news. Strange to say, it is. And suicide is not the only risk factor, to being on or coming off the drugs:

Last month, the Royal College of Psychiatrists acknowledged for the first time that coming off the pills can cause severe side effects lasting months – with the worst-hit suffering nausea, anxiety and insomnia.

And two weeks ago, the European Medicines Agency issued guidance suggesting the most common pills – selective serotonin reuptake inhibitors or SSRIs – can cause long-term loss of sexual function.

Aside from teaching us that these pills are not a panacea, we all need to be far more aware of the potential bad side effects. Let’s accept that they are beneficial on balance. But, it is strange to see, thirty years after SSRIs were introduced, people coming to a belated awareness that those who take them need to be monitored and warned.

Hijab Wars in Iran

Calling Jacinda Ardern. You recall that the dimwitted virtue signalling prime minister of New Zealand was widely praised for donning a hijab after a terrorist opened fire in a Christchurch mosque, killing 51 and injuring dozens more.

But then, Iranian feminists rejected Ardern’s virtue signalling. After all, they have no right to remove their hijab, lest they be arrested, imprisoned and tortured. They see the hijab as an instrument of female oppression. They are having none of it.

Now, the Daily Mail reports on what happened to Iranian women who were caught not wearing the hijab:

This is the shocking moment a woman without a hijab is savagely dragged away by security forces in Iran after she and her friends were caught playing with a water pistol.

Footage posted by Iranian journalist Masih Alinejad, which was shot at an unknown location in the country, shows a confrontation between several officers and a group of girls.

In the footage uniformed officers can be seen standing around a police car as they attempt to detain a woman.

And also:

The country's morality police have frequently made headlines for arresting women who decline to wear Islamic headdress. 

Only last month, clashes broke out at Tehran University amid anger over the enforcement of Islamic laws which force female students to wear a headscarf. 

Students claimed that Iran's religious police and security forces had entered the campus to warn female students that they had to obey the hijab laws. 

There’s an ongoing struggle in Iran over the hijab. One would think that Western female leaders would take it into account before they indulged in virtue signalling.

Tehran University students protest Iran’s mandatory hijab law

Mob Rule at Harvard

In today’s New York Times Ronald Sullivan responds to Harvard University. He opens by reminding us of why he was dismissed as faculty dean of Winthrop House:

In May, Harvard College announced that it would not renew the appointment of me and my wife, Stephanie Robinson, as faculty deans of Winthrop House, one of Harvard’s undergraduate residential houses, because I am one of the lawyers who represented the Hollywood producer Harvey Weinstein in advance of his coming sexual assault trial. The administration’s decision followed reports by some students that they felt “unsafe” in an institution led by a lawyer who would take on Mr. Weinstein as a client.

Why did the administration do it? Because they thought that dismissing Sullivan and his wife would be therapeutic.

To which Sullivan responds:

I am willing to believe that some students felt unsafe. But feelings alone should not drive university policy. Administrators must help students distinguish between feelings that have a rational basis and those that do not. In my case, Harvard missed an opportunity to help students do that.

In a culture where therapy rules, students must be protected and coddled. We must suppress any stimulus that might hurt their delicate feelings. We have not been told, because the current cultural climate makes it impossible, that children who are protected from the least triggering stimulus will become hypersensitive. Having no experience processing potentially traumatizing stimuli, they will be prey to almost any stimulus whatever.

Sullivan recommends that hurt feelings be submitted to rational examination:

I would hope that any student who felt unsafe as a result of my representation of Mr. Weinstein might, after a reasoned discussion of the relevant facts, question whether his or her feelings were warranted. But Harvard was not interested in having that discussion. Nor was Harvard interested in facilitating conversations about the appropriate role of its faculty in addressing sexual violence and the tension between protecting the rights of the criminally accused and treating survivors of sexual violence with respect.

Evidently, the administration simply capitulated. The mob is in charge. Academic officials, at Harvard and elsewhere have attained a level of cowardice that speaks ill of their own ability to process emotion:

Instead, the administration capitulated to protesters. Given that universities are supposed to be places of considered and civil discourse, where people are forced to wrestle with difficult, controversial and unfamiliar ideas, this is disappointing.

Sullivan continues:

But I am profoundly troubled by the reaction of university administrators who are in charge of student growth and development. The job of a teacher is to help students think through what constitutes a reasonable argument. It is a dereliction of duty for administrators to allow themselves to be bullied into unprincipled positions.

Unchecked emotion has replaced thoughtful reasoning on campus. Feelings are no longer subjected to evidence, analysis or empirical defense. Angry demands, rather than rigorous arguments, now appear to guide university policy.

It’s not just that universities have redefined their purpose in terms of therapy, not education. More importantly, they are offering up bad therapy, therapy that will make students more, not less likely to suffer emotional distress.

Monday, June 24, 2019

Can HR Solve the Workplace Sexual Harassment Problem?

I for one count myself among the fans of Caitlin Flanagan’s writing. I have hesitated to comment on her most recent piece from The Atlantic because I do not think that it’s up to her standards.

Nonetheless, let’s have a look.

In her piece Flanagan addresses sexual harassment, thus, the #MeToo movement. And she remarks that within corporations those who are supposed to be dealing with rampant sexual harassment are human resources workers, thus the ladies of HR. She notes that most HR workers are female. And yet, most female victims of sexual harassment avoid taking their complaints to HR. They know that HR is working for the Man, not for the sisterhood.

HR does not have the power or even the inclination to deal with the problem. It provides training seminars and earnest proposals, but can do very little. You see, Flanagan reports, HR is designed to protect the company from lawsuits, by making the problems go away.

On the other side, if the problem is as pervasive as we believe it to be, HR will need to ask the value, to the company, of destroying the careers of senior male executives. How well will the company function under such circumstances? It is a difficult balance. If you are about to launch a major military invasion or to defend a major military installation and you discover that your commanding officers have committed acts of sexual harassment, do you dismiss them and risk losing the battle or keep them on, while holding your nose?

If you think that it’s an easy question, you are wrong.

Flanagan does not mention one obvious corollary of her analysis. If HR is devoting its time to protecting against lawsuits, that must mean that we as a nation have chosen to deal with the sexual harassment issue by way of lawsuits and indictments. Evidently, this has not worked. Yet, Flanagan has no further insights in how we might deal with the problem, or even of why we are having the problem.

For one, she has a blindspot. She sees the origin of the problem in Anita Hill’s accusations against Clarence Thomas. In the world of Harvey Weinstein and Co., Thomas’s supposed offenses, involving foul language and vulgar references, seem less than malign.

And yet, Flanagan utters not a word about America’s first couple of sexual harassment: Bill and Hillary Clinton. People were appalled at the Anita Hill allegations, but many of those who should have defended harassed and assaulted women turned a blind eye to the accusations against Bill Clinton. Need we repeat that Hillary Clinton, in whose name the #MeToo movement has purportedly been launched, was the nation’s leading enabler of sexual harassment.

The problem is cultural more than personal. We agree with Flanagan that senior executives should take the lead in fighting against sexual harassment, but how about casting a cold eye on the godparents of harassment, Bill and Hillary Clinton.

Furthermore, for better or for worse, the nation has suffered a sexual revolution. People have been encouraged to be more open and honest and shameless about their sexual feelings. They have been told to let it all hang out, to express it all, not to bottle it up and get cancer. Isn’t this what some sexual harassers are doing: following the new cultural script.

Moreover, business is now more casual. People are less formal. And yet, casual dress suggests, however subtly, that people are not just there to do business. Naturally, the titans of industry have responded to this overly casual atmosphere by making it more casual indeed. Clearly, this is not going to help.

And then, another issue that Flanagan manages to ignore completely, many young women have taken complete possession of their sexuality. They are unashamed and unabashed about seeking out their own hookups, about putting up Tinder profiles, of partying hard and long.

One hates to have to say it, but many young women do not act as though they respect themselves. If they want to be respected they should take off the Pussy Hats, shut down their Tinder profiles and project a more professional tone and demeanor. It is wrong to tell people that they can behave any which way, can advertise it in public, and expect that no one is going to draw the wrong conclusion.

All of this is not going to stamp out the problem altogether, but it will clearly make a difference… by changing the larger cultural climate. Isolating the issue within the walls of corporate America is shortsighted. Flanagan’s focus is far too narrow to be helpful.

Anyway, for the record, examine her ideas, in her words:

For 30 years, ever since Anita Hill testified at Clarence Thomas’s Supreme Court confirmation hearings, HR has been almost universally accepted as the mechanism by which employers attempt to prevent, police, and investigate sexual harassment. Even the Equal Employment Opportunity Commission directs Americans to their HR offices if they experience harassment. That the #MeToo movement kept turning up so many shocking stories at so many respected places of employment seemed to me to reflect a massive failure of human resources to do the job we have expected it to perform. Even Harvey Weinstein’s company, after all, had an HR department.

And Harvey Weinstein was a close friend of the Clintons. He knew well that they would let him get away with anything as long as he continued to support their political ambitions. If HRC had been elected in 2016 Weinstein would not be facing jail time. Flanagan should have noted the point.

So, she raises the question:

If HR is such a vital component of American business, its tentacles reaching deeply into many spheres of employees’ work lives, how did it miss the kind of sexual harassment at the center of the #MeToo movement? And given that it did, why are companies still putting so much faith in HR? I returned to these questions many times over the course of the following year, interviewing workplace experts, lawyers, management consultants, and workers in the field.

The problem is that HR is part of the company. It is concerned with what is good for the company, not necessarily for what is good for individuals within the company. This means that HR professionals are professionals. They are doing their jobs.

Fairly or not, HR is seen as the division of the company that slows things down, generates endless memos, meddles in employees’ personal business, holds compulsory “trainings,” and ruins any fun and spirit-lifting thing employees come up with.

And, especially:

And when it comes to sexual harassment, women understand that Jane reports to upper management, not some neutral body that stands in allegiance with right moral action. If employers judged HR departments by their ability to prevent sexual harassment, most would have gotten a failing grade long ago. What HR is actually responsible for—one of the central ways the department “adds value” to a company—is serving as the first line of defense against a sexual-harassment lawsuit. These two goals are clearly aligned, but if the past year has taught us anything, it’s that you can achieve the latter without doing much of anything at all about the former.

Through Flanagan’s lens the women of HR are oppressed by the patriarchy.

Ellen’s joke depended on our common understanding that in the decades since Anita Hill’s testimony, HR has created a huge body of instructional films, computer training modules, seminar scripts, and written policies on sexual harassment. That a subject as urgent and—in its own, lurid way—bound with eros, fear, and guilt created an oeuvre known primarily for its stupefying dullness should have been a clue that the serious issue of harassment was being funneled through a bureaucracy whose aim was not (at least not purely) protecting women workers.

And:

At solving the problem, HR is not great. At creating protocols of “compliance” to defend a company against lawsuits? By that criterion, it has been a smashing success. How do we know? Partly because employers are so devoted to it; the first thing many an executive will do when a company is under scrutiny for sexual harassment is heap praise on its crackerjack HR team, and describe the accused men as outliers.

How bad is the problem? Or better, how much has our effort to have a national conversation about harassment, to bring it into the light of day, to gnash our teeth about it solved the problem. Or has the enhanced awareness and raised consciousness made the problem worse, by making it seem more like a norm than an aberration.

Flanagan continues:

In fact, the movement could have begun a full year earlier, in 2016, when a special task force from the EEOC released its findings on sexual harassment. The occasion was the anniversary of the Meritor case. The task force had been charged with determining how much progress the country had made since that historic decision. Its finding: very little. “Much of the training done over the last 30 years has not worked as a prevention tool,” the task force found. That’s an incredible statement—three decades of failure.

The EEOC report is a government white paper for the ages: sprawling, maddeningly unfocused, almost willfully opaque. But wade through it with pen in hand, and you realize it is also a startling document. It reveals that sexual harassment is “widespread” and “persistent,” and that 85 percent of workers who are harassed never report it. It found that employees are much more likely to come up with their own solution—such as avoiding the harasser, downplaying the harassment, or simply enduring it—than to seek help from HR. They are far more likely to ask a family member or co-worker for advice than to file a complaint, because they fear that they will face repercussions if they do.

So, we can overthrow the patriarchy and destroy companies and careers and families. And yet, as we all know by now making punishment especially harsh induces women not to report harassment. How bad does it have to be before you put a man out of a job, and destroy a reputation the is shared by his wife and children? As everyone knows, the victims of sexual harassment are often shunned in the workplace.

Like everyone else who understands the problem, including the EEOC, the HR workers I met at the conference reported that there is only one way to eradicate harassment from a workplace: by creating a climate and culture that starts at the very top of the company and establishes that harassment is not tolerated and will be punished severely. Middle managers can’t change the culture of a company; only the most senior people can do that. And expecting an HR worker—with a car loan, a mortgage, college tuition around the corner—to risk her job in a fight against management on behalf of an employee she barely knows is unrealistic.

HR is no match for sexual harassment. It pits male sexual aggression against a system of paperwork and broken promises, and women don’t trust it. For 30 years, we’ve invested responsibility in HR, and it hasn’t worked out. We have to find a better way.

If lawsuits and summary justice have not done the job until now, why imagine that they are going to do it now? If anything, we need to understand the larger climate producing the epidemic of sexual harassment if we are going to solve the problem.

Sunday, June 23, 2019

Jared's Conference in Bahrain

By now you know that Jared Kushner’s peace plan is doomed to failure. The Kushner plan, which will be officially unveiled Tuesday at a conference in Bahrain, has been denounced by every Middle East hand the media has been able to find.

Naturally, the Palestinian Authority, never missing a chance to miss a chance, has rejected the plan out of hand. Their representatives will not be present in Bahrain. Nor will, presumably, Israeli officials. This does not mean that no Israelis or Palestinians will be present. Business leaders from both sides might still show up.

We must note that all the world’s diplomats have been working on producing peace between Israel and the Palestinians for decades now. They have all failed. This means that they have a stake in Kushner’s failure. If a rank amateur can solve a problem that has eluded the great minds of world diplomacy, the shame will almost be too much to bear.

In two ways the Trump administration approach deviates from past diplomacy. First, the Trump administration has rejected the position of honest broker and has sided with Israel. This has, as you might expect, infuriated the Palestinians, who never miss a chance to hate America, to hate Israel and to hate American Jews like Kushner. Second, the Kushner plan emphasizes economic exchange and economic reform in the Palestinian territories. It sidesteps the political issues and goes straight for the economic.

We should also note that the Trump administration has strongly sided with Saudi Arabia in its conflict with Iran. Naturally, Congresspeople from both parties think that this is very bad. One does not see how anything can be solved in the region without direct Saudi participation.

By the Kushner plan regional economic development is the path to peace. Like it or not, it is not a dumb idea. And yet, how many others have taken the same route... thus sidestepping the grievance narrative that seems baked into all discussions?

Having sacrificed three generations of their children for a phantom cause, and having gained international support by committing acts of terrorism against Israelis, the Palestinians refuse to come away with very little for their efforts. Right now they are being supported by Iran and they are hoping against hope, as are the Iranians, that the Trump presidency will end in 2021. Thus, they think that a Democrat will give them a better deal.

Hanan Ashrawi, a senior Palestinian official, tweeted this:

First lift the siege of Gaza, stop the Israeli theft of our land, resources & funds, give us our freedom of movement & control over our borders, airspace, territorial waters etc. Then watch us build a vibrant prosperous economy as a free & sovereign people.

Of course, this is idiocy. It’s a blame-the-Jews attitude that has worn thin. If the Palestinians call off their war against Israel, if they had accepted the peace plan offered by Bill Clinton, they could have had all of the above-- with the obvious excepting of a right to return. They have consistently rejected all such proposals.

As for the conference attendees, the list is impressive. The Wall Street Journal reports:

Officials from Qatar, Saudi Arabia, Egypt, United Arab Emirates, Jordan and Morocco will be part of the gathering, as well as representatives from the United Nations, the International Monetary Fund and businesspeople from Israel, the Palestinian territories, the Middle East and Europe.

According to the White House, Colony Capital Chief Executive Thomas Barrack Jr., Blackstone Group CEO Stephen Schwarzman, International Monetary Fund Managing Director Christine Lagarde and AT&T CEO Randall Stephenson will be among those appearing on panels at the event. The White House said 328 people will attend the workshop.

The U.S. would place funds raised for the effort into a fund administered by a multinational development bank, according to the plan. The blueprint calls for funds for 179 economic development projects, mostly in the West Bank and Gaza but also in Egypt, Jordan and Lebanon. They include water, power, tourism, medical facilities and telecommunications projects.

Among the more interesting and pertinent commentaries comes this one from a Saudi diplomat, in the Jerusalem Post:

“History and Allah brought a real opportunity,” a top-ranking Saudi diplomat told Israelis via an interview in Globes on Friday, “the blood conflict had lasted too long, us Saudis and all Gulf States plus Egypt and Jordan realize that the age of going to war with Israel is over.”

He further stated that despite the understanding among Saudi people that the age of war with Israel needs to end, the kingdom has a deep commitment to the Palestinians.

“Maybe it is hard to them to part with the character of the ever-suffering victim and they don’t believe they could survive without it,” he said, noting that if they accept the American peace plan they will be given “sums they never dreamed of.”

The official slammed Palestinian leadership as “irresponsible” for not even considering the Deal of the Century, which will bring 60 billion USD to their people, he said.

The diplomat argued that one of the reasons for this refusal is the Palestinian perspective that Prime Minister Benjamin Netanyahu may not be able to sell a peace-deal to the Israelis and so they can wait until a leader who is more suitable to their needs might appear.

While too many people are in it for the drama, the work of diplomacy is reflected in the Saudi official’s rather more constructive statement.

Foodie Calls

A man invites a woman out on a date. He invites her to dinner at the hot new restaurant. We are assuming, for the sake of argument and to fulfill the terms of the scientific research, that such events still occur.

When she accepts his invitation, he thinks that she cares about him. To be fair, if he believes that he must dangle the possibility of a great meal, he must sense that his charm alone will not quite do the trick.

Anyway, he imagines that she is interested in him. And not just in the food. In many cases, this is true. In a significant number of cases, it is not. She has accepted the invitation because she likes the prospect of eating well for free. Serious researchers now call this: a foodie call.

Research done by the Society for Personality and Social Psychology has set us all straight:

When it comes to getting a date, there’s any number of ways people can present themselves and their interests. One of the newer phenomena is a “foodie call” where a person sets up a date with someone they are not romantically interested in, for the purpose of getting a free meal.  New research finds that 23 - 33% of women in an online study say they’ve engaged in a “foodie call.”

Does this tell us what women really want? Does it offer an answer to Freud’s question: What do women want? Could it be that the answer is: free food? It takes a cold and cynical heart to believe such a thing, but still….

I can think of more than a few men who have been tricked by such women. And yet, before you start pitying them, keep this in mind: if you want to play the game, you should leave your naivete at the door.

It feels somewhat cynical to think such thoughts, but apparently, women are not all saints. In fact, some are conniving schemers, possessed of the “dark triad” of negative personality traits. Worse yet, the women of the dark triad tend to believe in more traditional gender roles. One assumes that they were more comfortable having men pick up the check.

The researchers observed:

Upon further analysis, the social and personality psychology researchers found that women who scored high on the “dark triad” of personality traits (i.e., psychopathy, Machiavellianism, narcissism), as well as expressed traditional gender role beliefs, were most likely to engage in a foodie call and find it acceptable.

Researcher Brian Collison elaborated:

Several dark traits have been linked to deceptive and exploitative behavior in romantic relationships, such as one-night stands, faking an orgasm, or sending unsolicited sexual pictures.

It is hard to believe that women deceive and exploit men, but perhaps it’s one of the few ways they have of defending themselves.

You may be shocked at the statistics, but if you are looking to restore your faith in women, move onto the next paragraph. There we learn that a majority of women do not approve of foodie calls. Whew:

23% of women in this first group revealed they’d engaged in a foodie call. Most did so occasionally or rarely. Although women who had engaged in a foodie call believed it was more acceptable, most women believed foodie calls were extremely to moderately unacceptable.

Lest we become too cynical, keep in mind that a man whose date has accepted a foodie call still has the opportunity to persuade her to see him in a more favorable light. She is offering him an opportunity. If he fails to capitalize it isn't her fault.

One must add that having dinner with someone who genuinely repulses you is probably going to do damage to your appetite, to say nothing of your digestion.

Saturday, June 22, 2019

How to Produce Depression

Given our cultural deformities, we should not be surprised to see columnists offering a bunch of tired bromides on the anniversary of Anthony Bourdain’s suicide.

Yesterday, Tim Carman, a food reporter at the Washington Post explained to us that Bourdain’s suicide should provoke a national conversation about depression. And that we must destigmatize depression. So people can openly share their misery-- which is likely to deter others from socializing with them. It's a solution creating a problem.

Precisely how a food writer comes to be an authority on depression… I leave that to your imagination. And yet, Carman has consulted experts and we all believe in experts, don’t we?

In his words:

But another of Bourdain’s legacies is one we don’t care to talk about: his suicide and the mental state that led him to that awful moment. Yet evidence suggests the more we ignore the problems that beset us and/or our loved ones — the fears, the shame, the fevered thoughts in the night — the more we contribute to the growing suicide rates. Talk, experts tell us, can help save lives.

Dare we mention that experts have a vested interest in accumulating clientele. Theirs is not the most disinterested perspective.

But then, Carman continues, sometimes talk does not work. Uh oh!

A place to talk is not, by itself, always enough. A friend of mine, a man I had once sought out as a mentor, committed suicide several years ago. He committed suicide even though he had countless friends who would listen, without judgment, to anything he had to say. He committed suicide even though he was a gifted therapist. He committed suicide after the last of his beloved Siberian huskies had died and he was alone with his worst thoughts.

Of course, there is not just one kind of depression. And the quality of treatment-- see yesterday’s post about "Lauren Slater’s Pharmacopoeia"-- varies considerably from therapist to therapist.

In his effort to read between the lines of Bourdain’s script, Carman lights on the fact that Argentina has more mental health professionals per capita than anywhere else in the world. If he had dug into the statistics he would have discovered that many of these professionals are Freudian psychoanalysts. Which means, for the uninitiated, that they are more in the business of producing depression than in healing it. I hope that this does not come as a surprise.

In truth, Argentina, for having a well-educated and well-therapied population is perennially a political, social and economic basket case. Do you really want to emulate Argentina?

Carman does not know enough to know about this, but then, why is he making pronouncements about treating depression?

Carman continues, about Bourdain:

Still, amid the tongue-in-cheek disclosures that bad airport hamburgers send him into a “spiral of depression that can last for days,” Bourdain did, in fact, reveal something important about himself. Outside the psychiatrist’s office, he told the shrink, over a drink, that “I’m not going to get a lot of sympathy from people, frankly. I have the best job in the world.”

“Let’s face it,” Bourdain continued. “I go anywhere I want. I do what I want. Look, that guy over there loading sausages onto the grill? That’s work. This is not so bad. It’s all right. I’ll make it.”

By the standards of today’s therapy culture, doing what you want, when you want, with whom you want stands as a beacon toward which we are all supposed to aspire. And yet, a life of perpetual vagabondage, of disconnection, of social uprootedness… is not the best thing that can ever happen to your mental health. It produces good feelings, but they are accompanied by anomie… an anomie that can only be treated by a structured routinized life… one where you fulfill your responsibilities to other people, not where you evade others to travel the globe in search of the perfect taco.

After explaining that he too suffers from depression, Carman indulges yet another foray into pure banality, suggesting that the best way to overcome depression is to destigmatize it… and to find a good therapist.

I’m telling you this because not telling you this is a sure road to destruction. I’m telling you this because I want to help destigmatize a condition that’s literally killing off people who make our world a better place. I’m telling you this because, if you’re a fellow sufferer, I hope you will find your way to a good therapist, as I have. I’m telling you this because I have so much left to give.

We do not know whether or not Bourdain had been treated for depression. If he is like most of today’s citizens he would have been given a prescription or two or twenty for different psychiatric medications. As we saw in the case of Lauren Slater yesterday, the effectiveness of these medications has been seriously called into scientific question.

And, as we all know, suicide is a risk factor for anti-depressant medication.

Beyond that, the call to destigmatize depression is not original. But it is still a bad idea. Since Prozac burst on the scene a few decades ago, the psycho world has been talking about nothing but depression. And since Prozac was such a magic pill, all the talk might well have induced people to develop the symptoms of depression… the better to test out the miracle drug. And to redesign their personalities.

As Ethan Watters argued at length in his book Crazy Like Us, efforts to destigmatize mental illness tend to produce more, not less, mental illness. We saw it with hysteria in Europe the late 19th and early 20th centuries. We saw it with anorexia in Hong Kong in the 1990s. And it is likely that we are seeing it today in America with depression.