Thank you for your willingness to engage and voice your discomfort with some of my presentation.

I think that the real problem here is thinking that “understanding” is an all or nothing issue. The physicists would tell us that we don’t fully understand gravity — but we use and rely on the force of gravity for all sorts of human projects.

Lacking a detailed and complete understanding of the mechanism by which something works does not address whether or not something is working. And the judgment on whether antidepressants work is not based solely on the professionals, it is actually trusting the experience of millions of consumers who have experienced them working.