That said, for those of us who take SSRIs and other psychiatric drugs, there is a more nebulous issue that also deserves attention—namely, the forces of confusion, fear, and inertia that keep us gobbling these pills for decades.

Patients start taking medication because they are suffering. In that state, even a slim shot at relief seems like a smart bet. But that’s when the confusion starts. “Are the drugs helping?” isn’t necessarily an easy question to answer. Some patients know that their lives have improved. They feel lighter, sharper, more capable day to day. But for many others, perhaps the majority, improvement is devilishly hard to measure. Moods shift. Anxiety fluctuates. Sadness waxes and wanes. Circumstances change.

To understand what the medication is doing, for good and for bad, often requires a deep dive into the murk of subjective experience, where everything is in flux and the variables seem infinite. “Are you feeling better?” the psychiatrist asks. “I think so,” you answer. “I’m not entirely sure. It feels like maybe I am.” And if you do feel notably better, is the medication the cause? Or is it a placebo effect? Is it the work you’re doing in psychotherapy? Is it the fact that you’re eating better and exercising more? Who could say for sure?

The answer is that no one can. Not the academic researchers, not the psychiatrists, not the federal regulators, and certainly not the pharmaceutical companies. Yet once you get it into your mind that you may need your pills to feel all right, it can seem almost impossible to stop taking them. Why run the risk? Why open yourself up to the withdrawal symptoms, to the resurgence of your anxiety, to another depressive episode? What’s the big deal? It’s just a pill. Just take it and move on.

In this way, years can pass, years in which you wonder what your life would be like without the drugs—whether you would feel more brightly; whether you would have more creative thoughts and more intense sensations; whether your orgasms would be stronger; whether you would know better who and what you are; whether you would have a more intimate, unadulterated sense of your own capabilities, your own resilience, your unique consciousness. The damage here is harder to measure even than the long-term efficacy of SSRIs, for it isn’t an empirical question; it’s a moral one. And it gnaws at many of us, even as, for the umpteenth time, we trudge to the pharmacy to refill our prescriptions.