"Mr. Brunswick, you look troubled. How have you been feeling? Let's see here, you were in good shape when you had your last physical."

"Well, to tell you the truth, doc, I just haven't been feeling myself lately. You know, like everybody, I've always had the blues once in a while, but now it seems like I'm uptight more often, and then other times I just don't have any energy.

"At first I thought I was just anxious about the impending war and the economy and my plummeting 401(k). You know, money can be depressing and my work can get pretty intense. But still, I started thinking that maybe there's something wrong with me.

"Then I saw this ad for Paxil on television. It said it was approved for the treatment of depression, obsessive-compulsive disorder, panic disorder, social anxiety disorder, post-traumatic stress disorder and generalized anxiety disorder. And the people on the ad looked so calm and happy after taking it.

"So I figured maybe I just have one of those disorders."

"Depression is serious business, Mr. Brunswick," the doc replied. "Many people suffer from its various forms and for them it's not just a case of having a bad day. Medications developed in recent decades have made it possible for many suffering from depression to get on with their lives.

"So don't take that talk of disorders lightly. I was reading about a study in my AMA journal that found the percentage of Americans being treated for depression more than doubled from 1987 to 1997. And the total number of people receiving treatment rose from 1.7 million to 6.3 million.

"The use of Paxil and other new antidepressants - such as Prozac, Zoloft, Celexa, Luvox, Serzone, Remeron and Effexor — has been a godsend for many people. The problem is that since the government let companies start advertising in the mid-'90s, too many people like you see the ads and say, `hey, why not?' and too many doctors are willing to prescribe them."

"Yeah, but come on, doc. If so many people are taking these medications there must be a reason for it. I mean, it's not like advertising laundry soap or something."

"Oh, there's a reason for it, Mr. Brunswick. Mental health these days is dominated by the idea that emotional problems are rooted in the biology of our brains and that psychiatric drugs can correct the alleged biological defects.

"The question is why are patients almost five times more likely to be treated with antidepressants than they were 15 years ago. Does it mean we've suddenly become a society full of people suffering from depression, or that these medications are being prescribed too often to people like yourself who don't really need them?

"And there's big money in it. Take Paxil, since you mentioned it. GlaxoSmithKline, which makes it, took in nearly $3 billion last year from Paxil alone. I read that it has been prescribed 70 million times in the past decade. You saw the ad, Mr. Brunswick. Well, about 60 percent of doctors say it's the advertisements that often influence patients to ask about the drugs."

"But I'm not imagining the way I've been feeling lately, doc, — any more than all those millions of other people. We're all just ordinary people trying to do our best with our jobs and families. Are our lives so much more stressed out nowadays that we need these pills to get by? We're even getting our children hooked on prescriptions."

"Certainly there are a lot of added pressures these days, Mr. Brunswick. The question is how people should deal with them, and, of course, their lifestyles also are a big factor — you know the line — obesity, not enough exercise, too much television, not knowing how or making the time to relax.

"Depression is one of our major health problems, but we can't blame it all on our brains because we're not living in a vacuum. We've obviously evolved into a society in which too many people have trouble adapting. That doesn't necessarily mean there's something wrong with all those people. It may be that the world we've created is unhealthy."

"But, doc, short of some major social and economic changes, what are we supposed to do then? Why can't I have my Paxil, if that will help me feel better?"

"Like I said, Mr. Brunswick, for some people suffering from depression, that is the answer. But don't you think the government would like nothing more than to have a nation full of your so-called happy and calm citizens — even if they have to be drugged?

"So, it sounds like you're not going to write me a prescription, doc."

"Yes, I am. Try this, Mr. Brunswick."

"`Take a walk in the woods one hour a week.' What kind of prescription is that? Are you serious, doc?"

"The Japanese have a word for `walking aimlessly through the forest with no thought of return.' Our language could use such a word. Try it, it might help, Mr. Brunswick. And it's a lot better than taking pills."

Cary Brunswick is managing editor of The Daily Star. He can be reached at (607) 441-7217 or cary@thedailystar.com.