Let's take something like antidepressant medications. There's decent science saying it has an effect, but it's shockingly small after you control for penetration of the blind, people knowing that they're getting the active pills versus sugar pills, if you use an active control. It's probably only a few points. But it's a multi, multibillion-dollar industry. And by the way, has huge side effects. 40 percent of the people taking them have significant sexual side effects. And that's just one. A single antidepressant medication can be worth a billion dollars to a company.

I want good science, and I want it to be realistically marketed. I wouldn't like only two countries on the planet that allow pharmaceutical companies to market directly to people, New Zealand and the United States. It ought to be better regulated. And when it's presented to people, it ought to be presented in a way that's realistic. For example, often people will prescribe antidepressant medications, and we'll say, you have a brain disease; you'll have to be on these medications permanently. There is no biological marker for depression. It's not true that we know that it's a brain disease.

The government ought to help out, because the average citizen can't go out and be doing reviews of the scientific literature. And focus on the processes that have low side effects and good long-term outcomes. Right now you're going to find those in the psychosocial area, in the therapy area, in the empirically supported treatments such as ACT or cognitive behavior therapy, behavior therapy. And go there first rather than going to the pill bottle as if it's going to be the end of your journey. Very often it's only going to help, and even only to a minor degree, and more is going to be needed.

The prescribers very often overstate, oversell, and the detail people are only too happy to tell them to do that. This idea that there's something wrong with your brain, and by the way, almost never are these antidepressant medications evaluated with what will happen if you're on them for three, four, five, 10, 15 years. Sometimes some of the side effects that come up come up only later, and sometimes they're very severe, even irreversible side effects.

I kind of look at what's on the T-shirts and I see another solution, which also worries me. I see "Just do it." "No fear." - this kind of suppressive response to the treacle that the culture tries to define for us as a meaningful life also blows up on you. "No fear" is not something that you should put on your shirt. How about "I can hold my fear and still connect with you"? Put that on your shirt. "It's okay to be me, with all of my history." Put that on your shirt.

There is a middle path between indulgence and suppression, but the culture has overwhelmed that in the cacophony that has been created in the modern world and the commercial encouragement of avoidance and indulgence on the one hand, or suppression and "just do it," treating yourself as an object on the other. We've got to find a way that's more compassionate, softer, that allows us to move forward towards the kind of lives that we really want to live.

Almost all people suffer some form of intense inner pain at some times in their lives. The suffering might be depression, anxiety, substance abuse, or suicidal thoughts and it results from the battles we wage against our thoughts as we futilely try to get rid of our historie.