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And you rec'd your MD where?
Well you got me there don't you.
Just because in certain studies the effect was the same, does not mean that these were valid studies and applicable to everyone - there are many ways to set these studies up. To jump to such conclusions, regardless of how it is reported, is irresponsible. Since we are dealing with brain chemistry, there may be significant differences between those who get better on the drug versus those in the control group getting better with a placebo.

You almost have it. The fact is we know precious little about how changes in our low level brain chemistry affect moods and higher thoughts. All these tools are extremely blunt and imprecise especially the stronger ones used for severe brain illness. What clinical psychiatrists essentially do is supress (or sometimes enhance) certain brain activity in the hope that it changes certain thought patterns. Effectiveness is usually enhanced when the treatment is combined with a psychologist who helps the patient through the thought process changes. I believe that therapy should never be left out even with relatively weak drugs like Prozac.

But the most important fact of all is that many placebo patients undergo the same or similar low level brain chemistry changes that the drugs cause.

If belief is so important, why didn't I get better with Prozac? God knows I thought I would. But I didn't. Perhaps I should have tried harder?!?

Faith in medicine is intrinsic, you have it or you don't. If you don't, you can't "force" yourself to have it. However, you can develop faith in your own healing abilities, with medicine and without. That faith can only develop very slowly with substantial changes in lifestyle, work habits, etc. Diet is also very important but very slow to affect brain chemistry. There are no short cuts; Prozac is not a one step program.

You are right there - brain chemistry can be changed in many ways. It's almost a chicken or the egg question. I would venture that there are many people who have a chemical imbalance that is so strong that getting the imbalanced fixed is the way to go.

Or, there may be some brains that are not as responsive to non-chemical intervention. There is the thought that children who have undergone trauma or serious long term stress when young have their brains almost hardwired along certain pathways.

I believe that there are also cases where giving up the drugs is not an option. Regardless, I agree that therapy is a necessary part of recovery. (Gosh that sounds so touhy-feely!)