The bioethicist Carl Elliott writes that for some people antidepressants do not address an inner psychic state so much as “an incongruity between the self and external structures of meaning—a lack of fit between the way you are and the way you are expected to be.” Elliott wonders if “at least part of the nagging worry about Prozac and its ilk is that for all the good they do, the ills that they treat are part and parcel of the lonely, forgetful, unbearably sad place where we live.”