Speaking of psychoactive drugs, this article from N+1 (hat tip--I'm afraid I can't remember who) on Adderall is really very good. One of the things that struck me was the language that pharmaceutical companies use to market the drug:
Adderall has been on the market since 1996. It is produced by the British drug maker Shire Pharmaceuticals, and is currently the 125th most popular clinical drug in America. The Shire website offers some vague information about ADHD, the disorder for which Adderall is prescribed, and warns that the consequences of untreated ADHD can include relationship problems, drug abuse, and frequent job changes. There is a link for people who are already taking Adderall. "Congratulations!" it reads. "By taking ADDERALL XR, you're showing your commitment to reaching your potential in all aspects of your life—and to being the person you were meant to be."
This is very similar to the language that people often use to talk about anti-depressants--I'm thinking particularly of Listening to Prozac, but it's a pretty common meme. This strikes me as wrong; any meaningful sense of "meant to be" probably does not rely on a physician prescribing you long-term pharmaceutical treatment. I'm trying to unpack why we have such a deep need to believe that we are accessing our truest self through drugs. Part, I assume, is social stigma; no one wants to think that the personality they came with is something that needs fundamental alteration, so instead we think of our ADD or depression or just suburban ennui as some sort of fallen state from which we have a moral duty to escape. For depressives, too, there's the uncomfortable fact that their depressed self is the more accurate self--depressed people generally see social relations, and their place in them, more accurately than the healthy, so seeking treatment is in some way a conscious decision to blind themselves to reality. Indeed, it's a form of self-murder.
But if you don't like the self you got, surely you're entitled to murder it and replace it with something better. Whether or not your true self is the sick one or the better one, you only have one life and limited scope for action; why should you fritter away your opportunities just because nature destined you to be scattered or sad?
Whether or not your true self is the sick one or the better one, you only have one life and limited scope for action; why should you fritter away your opportunities just because nature destined you to be scattered or sad?
Agreed. Would anyone ever ask the "true self" question of a diabetic?
"Murder" seems too strong a descriptor of the effects of psychopharmacologicals on one's personality.
I've taken one or two, and a better analogy would be a kidney transplant for your mind, or perhaps a face-lift. The changes are subtle, especially those caused by ADD meds.
No, Megan, you're wrong.
Murdering yourself is when your depression has you drive your car directly into a wall in an attempt to die. Taking antidepressants is taking the aspects of your personality that would make you do that and putting them in a cage where the rest of you can control it. They're still there, they're still part of you, they're just no longer in charge of the accelerator pedal of the car.
Derek, I think an analogy to medical issues like diabetes works against your POV, not for it. Pain, sugar crash, seizures, cancer - we think of those as "not our real self" and so we move to fix them. The philosophical issue of whether the real you is the one under stress or the one relieved of stress is interesting, but I doubt anyone argues for either extreme. In everyday language, we say we are not ourselves when we have a headache or medication side effects.
We tend to change the rules how we look at medicine when personality or mood is involved, as many of us have a strong bias toward believing we make our own personality. Fair enough, and I tend to that bias myself. But I have OCD and counted into the thousands, factored large numbers in my head, and readjusted objects for forty years, knowing that this was not my real self but some intrusion I could not shake. Two weeks on medicine - OCD gone. This is my real self.
The previous condition influenced my personality - mostly it influenced how I dealt with distraction - but I don't see it as part of my personality.
I make my living dealing with the severely mentally ill. Schizophrenia is not your real personality. Personality gets murkier as we get into discussing personality disorders, depression, anxiety, ADHD; I am certainly aware of people who try to hide behind a name of a condition to avoid having to take responsibility. But leap not quickly into that definition of the true self.
What AVI said.
Again, as I commented re the earlier post, it's easier to see how foreign behaviors are when they are something like counting, or hand-washing, or ruminating over and over, or exhibiting motor or verbal tics, etc. But depression seems different to a lot of people. To be sure, a lot of what is diagnosed as depression is just a temporary, unavoidable response to a given lousy situation. But there is a depression that can exist independently of normal causes. A person's 'happiness meter' is set much lower than he/she feels appropriate. Because this is clearly a more subjective assessment than the one that states that someone retying his shoes a hundred times is abnormal, people (like Megan) often think that the 'feeling like yourself' meme is inappropriately applied here. Yet they have probably not seen the people who are crying in the waiting room due to no particular stress, or who can't get interested in anything for an extended period of time. Further, decades of pharmacology has located depression on an axis with anxiety, OCD, and Tourette's. Often two or more of these are present in the same person at the same time. All of these are treated with the same drugs, often with parallel, successful results.
While it may seem that depression is just one of many normal states of mind (and sometimes that is all that it is), and those looking for treatment are kidding themselves about being subjected to some malady when what they really want is to artificially be made happier, it is really the foreign nature of the depression that makes people identify it as 'other.' In the same way that you could more easily imagine some OCD-related impulse feeling that way.
Megan,
Your post overgeneralizes, because there are multiple forms and various causes of depression. In many cases, people with depression exhibit remarkably distorted cognition, including false assumptions about others’ thoughts and emotions and a kind of tunnel vision—a lack of proper perspective, memory, and context—in considering themselves and their circumstances, notwithstanding any accurate negative perceptions of self and others that they may offer.
Megan's general point is backed up by cognitive psych.
Normal, non-depressed people have overly optimistic, unrealistic beliefs about themselves and others.
The normal healthy human mind believes many, many demonstrably false things -- most of which are designed to make the person feel good about themselves.
Healthy people believe they are smarter, better looking, kinder, more loved, etc, etc, than they really are. Healthy people believe they deserve the good things in their life, and that bad things are due to unfair outside influences.
Good Lord. Maybe nature destined you to be nearsighted; are you going to murder your true self by wearing glasses for the rest of your life? For that matter, maybe nature destined you to be illiterate; are you going to murder your true self by learning to read?
Why do we have such a deep need to believe that we are accessing our truest self through education and personal development?
"For depressives, too, there's the uncomfortable fact that their depressed self is the more accurate self--depressed people generally see social relations, and their place in them, more accurately than the healthy"
Maybe the causality is reversed. Some people can realistically see how they relate to others, therefore they are depressed.
I think you misunderstand me. I don't think there is a true self beyond whatever entity chooses to take (or not) mind-altering drugs; I don't recognize the claim that either the happy or sad self is the one with rights to your body.
Indeed . . . but depressives are not always isolated. Being very, very finely attuned to social cues is useful.
"you only have one life and limited scope for action; why should you fritter away your opportunities just because nature destined you to be..."
A perfect rationale for anything from TM to tattoos.
Lasik, implants, piercings... all good.
But if psychologically disturbed people (depressed, manic, obsessive, whatever) are cured by drugs (or whatever), then who will produce the great literature (paintings, symphonies, whatever) of the future?
Somebody's got to entertain me.
Seriously, I heard this arguement when Prozac was first introduced (in ... 1988).
"Somebody's got to entertain me."
There's always that cat flushing the toilet on Youtube.
I remember a poem or a song or a story that analogized the ability to be too finely attuned to the emotions and thoughts of others to being able to hear too well and to hear the deafening noise on the other side of silence. (I wish I could remember it.) It is sense overload. Being finely attuned to sounds could prevent you from harm, or you could just go nuts being able to hear every ticking watch and bird twitter.
Being finely attuned to social cues can indeed be useful -- as can an accurate assessment of one's place in the world. But it can also cause one to have too much to process and to sink into a place where life is not worth living and getting out of bed is a feat beyond the imagination.
Be careful about what you define as "normal." You probably mean optimal, but optimal for what? For the individual? That's one definition, and quite popular, but it's not the definition used by some people, and more importantly not the definition used by Mother Nature and Father Evolution. For them, the proper definition of the optimal functioning of the individual is what is best for the tribe.
Clearly people who are more optimistic about social relationships than is justified by experience are better for the survival of the group than people who more "realistically" assess those relationships. Why that is, is probably complicated, but we wouldn't be that way if there weren't real evolutionary advantages to it. So, arguably, being slightly delusional is being our "real" and "optimized" selves according to the only long-term definition that counts.
Sucks to realize you're just a gamete's way of making another gamete, eh? But the normal delusions take care of that for you.
The DSMIV criteria for ADHD includes the phrase: the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level. You have talked about wanting 'good teachers;' sometimes education also involves helping the student to be a student. I think sometimes the difference is that most people can't quite imagine the problem. Sort of like the person who thought 'headache' was just an excuse; he didn't think they existed until in middle age he had one.
Before I ever had any mental health problems I felt similar. It took me awhile to realize I was wrong.
At 20 a mix of PTSD and insomnia led to a manic episode. My natural personality is not someone who curses out his Dad, rambles economic theories to strangers, thinks the Internet has special messages intended just for me, cries over Simpsons episodes, or thinks that my thoughts are connected to higher realities. I also don't think the beliefs or outlooks of that period are supported by reality. In fact even when I was feeling them I knew on some level that I wasn't behaving "like myself" and that's part of why I sought treatment.
I've gone off medication at times and I take very low amounts of medication now, but I think the personality I have on them is more consistent with my general personality. I'm trying to avoid a personality change, not create one. It's like a man who takes medicine to avoid another heart attack. Do I feel bad about "murdering" that altered version of me, about not embracing my new self as a delusional philosopher? In a weird way I did, a little, at times. My manic episode was intense, ecstatic, and creative. I felt like I understood everything and for about the only time in my life I believed I was attractive to women. However it was a delusion. The reality is that I'm a small deformed man whose IQ is above average, but not genius. And I've always been happy with that. I decided I'd rather be happy, if occasionally insecure, as me than be ecstatic as an arrogant caricature of myself.
Granted when you're talking about things like depression you might be meaning things that are in a person throughout their life. Still I don't think the depression is all that the person is and I don't agree that the impressions of depressed people are true. They might be less likely to be outright lies than that of happy people, but they're often exaggerated and extreme. "Most people don't like me" might be true, but that having to be an earth-shattering fact that ruins all joy is probably unreal. Ideally I think the idea is that you "cut away" the depression, but most of who you are remains. If it really does just create new people I would generally object to it.
I forgot to add that my manic period also came with periods of intense anger, fear, and shame. It wasn't all "positive" emotions. Also in the last six years the times I was off my medication I did not relapse. I started taking medicine again because I was feeling things that made me believe I could relapse. It's preventive to an extent.
Ms. McArdle, I see I need to be a bit more explicit. Please do not take offense, but I would suggest that, when discussing a treatment for a condition that induces people to attempt suicide, calling the treatment "self-murder" is a rather unfortunate choice of words, and should, upon reflection, be revised. It is a striking metaphor for the act of personality alteration, but gauche given the close topical connection to rather more literal self-murder.
Megan, you are being quite offensive with this post. You say, “why should you fritter away your opportunities just because nature destined you to be scattered or sad?” What if nature intended you to be a big, strong retarded man (like my son) with a 30-second attention span and uncontrolled, angry obsessions? I guess you should be taken from your family and made to live in a cage. It would be wrong in your view to take medication that allows you to function in society and live a more-or-less productive life, since that is “murdering” your real personality.
Perhaps the tone of the marketing is somewhat inappropriate but your commentary is even more so. I’m sure your real targets were the lazy parents who turn their active boy into a passive zombie, or the self-obsessed woman who just wants to be able to enjoy herself at parties, but these are anecdotal examples which just don’t exist that frequently in the real world. For most who use these drugs they are a lifeline to a semi-normal existence.
Omaha1--
"It would be wrong in your view to take medication that allows you to function in society and live a more-or-less productive life, since that is “murdering” your real personality."
Ummm, the quote that you gave in the second sentence of your post (why should you fritter away...) means that MS McArdle thinks that it's entirely appropriate to take medication to treat a disorder.
Sorry, that should, of course, be Ms. McArdle for civilians. I got stuck in Army writing mode.
Clearly people who are more optimistic about social relationships than is justified by experience are better for the survival of the group than people who more "realistically" assess those relationships. Why that is, is probably complicated, but we wouldn't be that way if there weren't real evolutionary advantages to it. So, arguably, being slightly delusional is being our "real" and "optimized" selves according to the only long-term definition that counts.
On the contrary, we probably have non-negligible numbers of depressed people because the mix is optimal. Optimistic, slightly delusional people, probably work harder. Depressed, hyper-rational people probably direct efforts more sensibly. "Hey, while you're piling up all those rocks to show your gratitude to the gods for the droughts they will surely be preventing, why don't you make a hollow spot inside to store some grain, y'know, in case it doesn't work."
I've had a rather downbeat and pessimistic personality throughout most of my life. Up until a couple of years ago, I would have described myself as "depressed." Then after some personal conflicts, I got to experience the real thing. The difference between my usual pessimistic state and the real thing was like the difference between being slightly sniffly and pneumonia. I absolutely did *not* experience my major depressive episode as "my true self." Thank god for medication--if I hadn't been able to make that feeling go away so that I could begin to deal with my situation, I don't know what would have happened to me.
Njorl, your theory about the value of depression is an interesting one, however the main problem I see with it is that, at least based on my own experience and taking off from your example, I would not have been capable of telling *anyone* to store some grain--in fact, I was so trapped in my own misery I probably wouldn't even have noticed the rock pile in the first place. I have read some theories on the evolutionary value of depression which hold that it is actually a signalling trait designed to alert the members of one's social circle to one's own distress in a way that is so costly it's unfalsifiable. It's plausible, though I'm not entirely sure I believe it.
"For depressives, too, there's the uncomfortable fact that their depressed self is the more accurate self--depressed people generally see social relations, and their place in them, more accurately than the healthy"
This is just flat-out wrong. People with clinical depression have no special access to the truth of social relations. This romanticization of depression is as inaccurate as it is timeless. If you had read Kramer's 'Against Depression' (he also wrote 'Listening to Prozac,' which you cited), you would know this.
I don't think ADD medicine causes anything approaching self-murder, at least not at the dosage I take. It provides more focus and energy for a certain number of hours and then it wears off, leaving me a bit tired. In fact, it's like the effect of drinking 6 cups of coffee, but with less side effects (no shaking, heartburn, etc). Although, to be honest, it does seem to have a negative impact on creativity. It's a strange subjective sort of thing. I mean, when I'm on the medicine I'd probably score slightly higher on tests or whatever, but I think I'd be less likely to come up with a novel metaphor or something like that (perhaps because the process of coming up with such a thing requires a degree of tangential thinking). The problem is that most of the time modern life is more about taking tests, showing up on time, and being organized than it is about coming up with a novel metaphor. So I really am better off on the medicine. It's nice that it does wear off after a number of hours and then maybe I can come up with some metaphors, but I do wonder what the long-term effect of taking stimulants might be. I'm pretty sure that medical science has absolutely no idea what 20+ years of having that stuff in your system can do, and that is scary. But, it's also scary that I'm so distractable that I might get fired if I weren't on medicine, and that could hurt me a lot sooner than 20 years from now. So I drink the KoolAid.
thats for sure, man