‘Normal human despair’

Marianne Williamson recently observed that Americans are too frequently prescribed antidepressants for what she called “normal human despair”:

“The twenties can be very hard. They’re not a mental illness,” Williamson told BuzzFeed News in an interview Friday. “Divorce can be very difficult, losing a loved one, someone that you know died, someone left in a relationship and you’re heartbroken — that’s very painful, but it’s not a mental illness.”

“You had a professional failure, you lost your job, you went bankrupt,” she continued. “Those things are very difficult, but they’re not a mental illness.”

Williamson, a self-help author, has previously weighed in on the topic of overprescribed antidepressants, tweeting in June 2018 that such medications are being prescribed “many times when people are simply SAD.”

“The answer to depression is more scientific research only if you think of it simply in biomedical terms. The medicalization of depression is a creation of the medical industry,” she tweeted. “For millennia depression was seen as a spiritual disease, and for many of us it still is.”

I think this is true. And I think this also pairs well with Christopher F. Rufo’s City Journal piece on how those who have true addictions, affiliations, and illnesses in San Donato Val di Comino are treated in a humane way:

At six o’clock each morning, the alcoholics, addicts, and mentally ill residents of San Donato Val di Comino, Italy, emerge from their homes and congregate—sometimes together, but mostly alone—in the cafés around the town’s main square. Some of the hardened alcoholics order an espresso with a shot of liquor, then climb into work trucks and head out to farms and construction sites. The mentally ill—who suffer predominantly from depression, bipolar disorder, and schizophrenia—order cups of coffee or sit at the patio tables emptyhanded, an indication that they have run out of cash for the month.

My father was born in this village, where I’ve observed this early-morning ritual during family vacations over the past two decades, but this time it struck me in a new way. For the past 18 months, I’ve reported on homelessness, addiction, and mental illness in American cities and spent many hours with America’s most vulnerable residents, who, on the surface, struggle with the same afflictions as the residents here in San Donato.

In fact, the contrast is profound. In West Coast cities, tens of thousands of addicts and mentally ill people live outdoors in horrific conditions and survive on a combination of panhandling, prostitution, and property crime, which, in turn, creates disorder on urban streets. Not in San Donato, however: here, addicts and the mentally ill are deeply integrated into the community and maintain a dignified standard of living. Their families and relatives look after them and stay involved in their lives. When necessary, the municipal government provides employment sweeping the streets, and local businesses sometimes pay mentally disabled residents to serve as lo spanno, an informal occupation that entails walking through the streets with a loudspeaker announcing products newly available in the town market. The community plays a role in helping the most vulnerable, not through compulsion or formalized social programs but instead through the values of self-help and community responsibility.

In San Donato, a man found sleeping on the streets would suggest a moral scandal. The village would shame the homeless man’s family into taking him in to provide financial, practical, and psychological support. The reason that nobody sleeps on the streets here isn’t medical or technical—it’s cultural. Despite massive economic and social change over the past century, Italians have retained a culture of family and responsibility that strictly limits the expression of pathological behavior and enforces a standard of dignity that encourages addicts and the mentally ill to participate in society despite their condition.