Some researchers are arguing that often when someone’s antidepressant stops working, it’s because they were only getting a placebo effect off of it. They quote one of the researchers, Dr. Mark Zimmerman, as saying:
a message can be conveyed to patients who have repeatedly improved on medication and then lost its benefit that perhaps they are more capable than they think in bringing their own resources to bear to improve their depression
That edges awfully close to victim-blaming. (I hope they were misquoting him.) If you’ve been on several medications that pooped out on you, it was your own ability all along! So if you decide to stay depressed now, then it’s your fault for not getting it together. It’s a slightly sciencified version of “pull yourself up for your bootstraps”.
We don’t know a lot about the placebo effect, but it’s unlikely to be the same as bringing your resources to bear. For example, the placebo effect in pain reduction is associated with greater expectation of a reward, but this has only been shown to be an individual-difference thing, that is, we don’t know whether trying to get people to expect a reward will lead to greater pain relief. And it seems unlikely that trying to get people to expect a reward when they have no external reason to (i.e., medication or something similar) is going to make a difference.
(Imagine that you’re about to get your wisdom teeth pulled and your dentist says: “We’re not going to give you medication to reduce pain. Instead, we want you to expect that you’ll get a reward. Now, open your mouth.”)
If it’s accurate that most people who have antidepressants poop out are actually having a placebo effect poop out, that raises some interesting questions. The most important might be “how can we replicate the placebo effect’s effects without having a placebo for peoples’ psyches to use?” and the second most important might be “why does the placebo effect keep pooping out and how can we make it last?”