Another interesting one from The New York Times, Who Are We? Coming of Age on Antidepressants, by Dr. Richard A. Friedman; I found this one really well done, asking more questions than it answers, but thought-provoking.
The introduction to the article lays out the central existential question posed by long-term treatment with anti-depressants, especially for patients who started on their regimens when very young:
“I’ve grown up on medication,” my patient Julie told me recently. “I don’t have a sense of who I really am without it.”
At 31, she had been on one antidepressant or another nearly continuously since she was 14. There was little question that she had very serious depression and had survived several suicide attempts. In fact, she credited the medication with saving her life.
But now she was raising an equally fundamental question: how the drugs might have affected her psychological development and core identity.
As Friedman points out, the medical testing for these pharmaceuticals doesn’t include long-term research anywhere close to the lengths of time that people are actually spending on the drugs: the longest maintenance study — done on Effexor — lasted two years.
But the more subtle issues that Friedman raises, as far as I’m concerned, are the questions of identity that are clouded by long-term anti-depressant use. He discusses one woman who was concerned about her ‘low sex drive’ and pressure from her boyfriend to have sex after eight years on libido-reducing Zoloft: ‘She had understandably mistaken the side effect of the drug for her “normal” sexual desire and was shocked when I explained it: “And I thought it was just me!”’ I can’t tell from the way Friedman writes this how he feels about the idea that an individual has a ‘normal’ sex drive, something that might exist ‘prior to’ or ‘independent of’ any outside influences, whether that influence be an anti-depressant or a particular life event or the effects of interpersonal dynamics with a partner.
The idea that the ‘anti-depressed’ state might become ‘normal,’ both in the medical sense that intervention seeks to create this state and in the sense that a patient spends so much time in the drug-influenced state that it becomes a kind of reference, suggests yet another way that cultural expectations might become biological ‘nature.’
No!!! Anti-depressants reveal the true identity! A healthy state of mind! Depression is a disease which “kills” our true identity. The anti-depressed state is the normal state. The abnormality is the desease:depression.I can’t see how this article is thought provoking…it’s absurd…
About the first patient (Julie) when she says she doesn’t have a sense of who she really is without medication, I would ask her to stop taking her medication, thus leaving her in a depressed state of mind. Depression gives the wrong idea about what’s really happening.
This article is totally ridiculous and absurd
I’m sorry Anya. Even Martin Seligman admits that the sunny, ‘optimistic’ personalities he has studied are not those most in touch with the truth. I’d go further: they’re not the most in touch with themselves. This may be news if you’ve been relieved from suffering by such drugs, or if sitcoms seem funny to you. I myself am on two antidepressants and a mood-stabiliser, and after many years of every such drug in the MIMS, and lots of talking therapy I’m still addicted to misery, because there is a cruel beauty in it that I know too well not to love. And anyway, these things prolong my life so I might turn it to account somehow, maybe like some of those famous depressives of yore, artists, writers, etc — I won’t labor the point. (Robert Lowell claime that the fire went out of his writing when he started on lithium.) On the other hand, if poetry doesn’t turn you on, you need but read the newspapers. Richard Affleck, BA, B. Psych (Hons)
It goes without saying on this blog that personal identity development interacts with culture, but until this is explicitly learned we tend to think that there’s still an essence unfolding. But when you know you’re on an antidepressant that alters your personality and you have the contrastive pre- and post-antidepressant memories to tell you that there’s been a change, it can make one feel, or at least worry about being, inauthentic after a while. It’s still biology and culture interacting in development — just culture more efficiently crossing the BBB.