Psychiatrist Peter Kramer is very tired of one objection raised to his notorious 1993 book, Listening to Prozac. Kramer had raised concerns that Prozac and the other SSRIs would usher in an era of ‘cosmetic psychopharmacology’, modifying personality traits in people who had never experienced a frank mood disorder. The book considered the ethical and policy implications and wondered how physicians should prescribe such drugs. (I have always agreed with Kramer’s concerns and both of have practiced long enough to see his worst fears come to pass, IMHO.) Kramer reflects on the question one variant of which was almost invariably asked when he gave talks on the themes of Listening to Prozac. “What if Prozac had been available in van Gogh’s time?” Especially in light of the compelling evidence of the last decade that depression is a progressive disorder and a neurodegenerative one which destroys nerve pathways as well as damaging the cardiovascular and endocrine systems, Kramer is compelled to remind us that the tortured artist’s genius must be envisioned to be despite rather than because of his/her mental illness. “Beset by great evil, a person can be wise, observant and disillusioned and yet not depressed. Resilience confers its own measure of insight. We should have no trouble admiring what we do admire — depth, complexity, aesthetic brilliance — and standing foursquare against depression.” (New York Times Magazine)