It’s been a Prozac world for 20 years now, yet an international team of researchers has just concluded that Prozac is no more effective than placebos or sugar pills. This is big news, considering all the lives in which antidepressants are lodged.

It’s not an inherently negative finding. It doesn’t mean Prozac doesn’t work. Lots of people “improve” when they take it. But they feel about as good when they take placebos, which they think are Prozac.

This is complicated. Could you just take placebos, if your doc prescribed them, and get relief? No. Because placebos work when you think they’re Prozac, which you think works. And if people stopped taking either, they’d stay depressed, whereas they now feel better.

It’s a bit like organized religion. Almost any version seems to lighten people’s load. So why can’t they just tolerate other religions, letting them work for other people? Because often, it seems, if you aren’t sure your faith is the “true” one, and others are false, then it won’t work for you either.

Of course drug companies are defiant and say the study ignores clinical experience. But no one denies the experience. It’s just that it isn’t the ingredients in the antidepressants that produce the results, it’s something else. What might that be? How about — hope? The doc says, “Take this, it should help.” People yearn to get better — and SHAZAM! What does it prove? People want change, they need hope. It’s the Obama effect!

Stop the presses: Emotional states have physical effects; physical states have emotional effects. Hope can relieve depression. It works on private misery. It works on political despair.

So this week, the U.K. government, right after the study’s release, said it plans to train 3,600 more psychotherapists. A body called NICE, the National Institute for Health and Clinical Excellence (I kid you not) says talk therapy should always be tried before drugs but most GPs find there’s a shortage of therapists for patients to talk to, so they’re often forced to prescribe. Now this sounds odd to me.

“Talking cures” have been frequently badmouthed for, come to think of it, roughly the time that Prozac has been on the market. Could it be the badmouthing was nudged along by the companies selling antidepressants? Perish the thought. But I digress.

And there’s a similar dilemma about talk therapy: Many types seem to work comparably. A British GP said, “It might just mean seeing the patient regularly. That itself can be therapeutic.” So the point is to have attention paid. It’s the equivalent of sugar pills. Any interest helps. What works in this case is not so much hope as care, being shown concern. It’s like the emotional benefits of exercise. Maybe the effective ingredient is not physical activity; it’s doing something, overcoming passivity, feeling you can act.

As for the restorative effect of Barack Obama, it may be “working” because expectations of actual change in the world have been ratcheted down so far that people are ready to settle for a strong feeling of hope for change, a feeling that change is merely possible, full stop.

This seems to be an era of feelings and mood swings in politics, rather than action. What I’ve never got about fervid right-wingers is why they care so much who’s in power. It doesn’t affect their real lives — even if it’s a Clinton or Chrétien. Yet they need to feel their side has won and that the dark side hasn’t.

This kind of internalized politics may be just as well for Barack Obama, if he gets to be president, since there are vast limits on what any president can do.

Profound social change tends to be based on mass movements, such as civil rights, anti-war or labour movements — with vast numbers of ordinary people beavering away. I know the term is used for the Obama campaign, but it looks a lot like a sugar pill to me.

rick_salutin_small_24_1_1_1_1_0

Rick Salutin

Rick Salutin is a Canadian novelist, playwright and critic. He is a strong advocate of left wing causes and writes a regular column in the Toronto Star.