Johann Hari

Today is our fifth anniversary, and all the classic
anniversary questions are rattling through my mind. Is
it really five years since I walked from my local
branch of Boots, squeezing her tightly in my hand,
knowing that my life was about to be changed
completely? Is it really five years since first I felt
her on my tongue? Is it really five years since she
made me able to walk steadily and think clearly and
live again? Is it really five years since I started
taking Seroxat?

You may have heard of my beloved. She is part of the
SSRI (selective serotonin re-uptake inhibitors) family
of anti-depressants - Prozac is her somewhat more
famous big sister - and she is a bit of a slag, since
over 100 million people worldwide also have her in
their bloodstream.

What better anniversary gift could we have than Robbie
Williams's acknowledgement that Seroxat is beautiful?
Speaking on Sarah Cox's radio show last week, he
revealed that SSRIs have pulled him back from
depression. "I took too much ecstasy, to tell you the
truth," he said. "When you take E, your brain releases
an awful amount of serotonin the chemical in the brain
that broadly correlates with happiness and it makes
you go, Great.' Use it all up and your brain's got
nothing to bathe in." SSRIs have restored his
serotonin to normal levels (or as normal as it gets
for a billionaire rock-god).

This problem is going to be one of the biggest health
challenges facing developed economies over the next
few decades. The first ecstasy generation (hundreds of
thousands of them) are now sagging into middle age,
and there is a small mountain of research indicating
that heavy ecstasy use can, in the long term, cause
depression. This is, very soon, going to be a country
with a massive constituency of the anti-depressed. I
doubt that my own ecstasy use was a factor in my
depression, since I can remember being seriously
depressed long before I ever saw a tab of ecstasy; but
Britain has, we must admit, already waded pretty far
into a sea of artificially induced serotonin. Last
year, the NHS issued 20 million prescriptions for
SSRIs.

Please, please don't take this column as a trite
Reefer Madness-style warning against ecstasy. It
cannot be repeated enough that most ecstasy users will
be perfectly safe and have some terrific,
life-enhancing experiences. Alcohol claims more
victims than a vicious invading army, with its liver
diseases, its car wrecks and its violence; by
comparison, ecstasy is a stray bomb. If the limited
dangers of ecstasy enthuse you for its ongoing
prohibition, then I look forward to your campaign to
criminalise alcohol.

The problems caused by extreme ecstasy use (and the
widespread problem of depression caused by other,
unknown factors) can, thankfully, be largely rectified
by SSRIs. But there is at the moment an irresponsible
scare campaign - orchestrated by sections of the media
that should know better - that is stigmatising SSRIs.

A tiny number of suicides have been tenuously linked
to anti-depressants, and on the basis of these
unproven accusations, an entire demonising bandwagon
has been put on the road.

It is never mentioned that for every one of these
supposedly linked suicides, there are hundreds of
thousands of people such as Robbie and myself who have
been saved. Journalists rarely understand what they
are dealing with when they write about this subject.
It takes very little to scare depressives away from
anti-depressants, because it is far easier to wallow
in the howling pain you know than to venture into the
frightening anti-depressed world that you have
retreated from. One scare-mongering article is often
all it takes to keep you in a darkened room.

Of course, SSRIs are not perfect, and there are
side-effects. Like many users, I have put on a hideous
amount of weight since I started taking Seroxat
(although I guess my diet of Big Macs and KFC buckets
might be a factor). I get hot flushes once or twice a
week, where I sweat rather unpleasantly for about 20
minutes or so. But this is a pathetically small price
for the freedom to live a normal life.

Many people do have problems coming off the drug, but
since I never intend to come off (and I think any
depressive who tries is crazy), why should that bother
me? Dependency in itself is not a problem. I am
dependent on food and water and oxygen and the
maintenance of the social fabric around me. Diabetics
are dependent on insulin, and I don't hear anybody
lecturing them to wean themselves off.

Nor do SSRIs turn people into zombies, or make them
incapable of thought; these are stereotypes left over
from the old, terrible antidepressants such as
lithium. I feel things just as keenly as I ever did;
the difference is that Seroxat prevents one dark
feeling - of emptiness and self-loathing - from
overwhelming all the other, more subtle and
interesting feelings.

I often wonder why the impact of SSRIs is not more
widely appreciated. One of the great, lingering curses
of the human condition - depression - is now, in all
but a small number of cases, treatable. This is a
breakthrough - I mean this seriously - as substantial
as a cure for cancer. Robbie Williams could easily
have gone the way of Sylvia Plath or Virginia Woolf;
there are whole stadiums full of people walking our
streets who would have cut their wrists or drowned
themselves without SSRIs.

The new generation of anti-depressants has even
created a wholly new human condition: I think of it as
"anti-depression". Those of us taking SSRIs are not
depressed, but we are not quite like normal,
undepressed people either. We are anti-depressed, and
we should be proud of it. Most people - the
undepressed - live by default; they live because death
hasn't come along yet. But if you have flirted with
suicide but then discovered life through Seroxat, you
emerge with a purpose and an impatience that the
never-depressed often lack. The anti-depressed are
very often driven people, aware of the presence of
utter misery and death and the knowledge that without
a packet of chemicals, it would all flood back. Death
is an almost tangible presence to us; we hurry.

There is even a theory, explained by Oliver James in
his book Britain on the Couch, that SSRIs are a
helpful prop for people in advanced capitalist
societies. Market economies require people to be able
to deal with failure without becoming depressed. You
should be able to launch a company, fail, launch
another company, fail and keep on going until
eventually you crack the market before the market
cracks you up. We may even be developing a form of
Seroxat capitalism - if human beings cannot change
harsh market processes to make them liveable (through
shorter working hours, say, or reduced levels of
stress) then we will have to alter our own brains
chemically.

I think there is something in that: of my friends from
university, it is the SSRI users who have had, if you
like, an unfair head-start. The anti-depressed are
racing ahead of my undepressed friends. So, yes, there
will be many drawbacks to tomorrow's Britain as it
copes with its ecstasy hangover; but it will, I
suspect, have some unexpected advantages, too.