the nyt on new thoughts about antidepressants : do they make us act better and then we feel better?

“But the most profound implications have to do with how to understand the link between the growth of neurons, the changes in mood and the alteration of behavior. Perhaps antidepressants like Prozac and Paxil primarily alter behavioral circuits in the brain — particularly the circuits deep in the hippocampus where memories and learned behaviors are stored and organized — and consequently change mood. If Prozac helped Dorothy sleep better and stopped her from assaulting her own skin, might her mood eventually have healed as a response to her own alterations of behavior? Might Dorothy, in short, have created her own placebo effect? How much of mood is behavior anyway? Maybe your brain makes you “act” depressed, and then you “feel” depressed. Or you feel depressed in part because your brain is making you act depressed. Thoughts like these quickly transcend psychiatry and move into more unexpected and unsettling realms. They might begin with mood disorders, but they quickly turn to questions about the organizational order of the brain.”