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24 June, 2007

Selling My Soul

How fascinating that a thread discussing Faust should go this direction.

The claim was made that "messing with brain chemistry is a bad thing", in a context of the discussion of antidepressants. (Also comparing Prozac to heroin and ecstasy, and making an analogy to defacing written texts.) And was baffled and hurt that this offended people.

There are all kinds of places I can go with this, but I want to go into the mythology of depression. Many of which struck me as being in play in that discussion.

Like:

- Mental illness is fundamentally different from physical illness, and should be treated with different rules. Never mind, of course, that most "mental illness" is organic in some way, whether it's my depression as rooted in digestive and thyroid disorders as much as a propensity to the specific chemical glitch-set, which is just as much a part of my fucked-up body as my other weirdly functioning bits anyway; never mind, similarly, that some physical illnesses are in fact psychosomatic, something that any child who has induced a fever by failing to finish their math homework is well aware of. Never mind that the brain is another body part.

- Mental illness is intrinsic to a person and a personality. Sometimes this takes the form of "What an excellent example to others you are!", which is a sort of patronisation that I've seen directed at physically disabled people as well. Sometimes this takes the form of the romanticisation of the tortured artist; how many artistic heroes committed suicide or died young, and we hear, "Yes, so tragic, but would the art have been as good without it?" Sometimes this is in the form of, "If you treat the illness, you are changing who that person is!" whether it's calling Prozac Ecstasy or suggesting that Ritalin treatments for ADHD children are producing 'zombies'.

- Mental illness is not a real concern worthy of treatment; the moral question of whether it is acceptable to alter brain chemistry is significant enough to call medication into question. That medication is the equivalent of illegal drugs or puritanically disapproved euphorics, not the equivalent of insulin treatment for diabetics.

And then the fascinating:

- Mental illness is a special case because brain chemistry is more bound to "self" than other body parts. Modifying other body parts will not change sense of self; modifying brain chemistry will axiomatically change sense of self.


The argument against antidepressants and other treatments seemed to boil down to (I say "seemed to" because the person making the argument seemed to me to be increasingly incoherent; the unawareness that the position was mind-body dualism was a fascinating bit of "Aren't you paying attention to what you're saying?"):

Axiom 1: The personality ought to be immutable and sacrosanct.

Which is bloody nonsense, honestly, in denial of the functions of the real world: personalities shift over time and circumstance all the time. I note, for a dramatic example, that I never used to swear before the assault; it wasn't an inhibition, it just didn't occur to me to do so. Other changes, those Trousers of Time moments where one knows that one's life has forked (but perhaps not what the different ways might have led to, other than "Something different"), the gradual accumulation of experience -- like the post over on SM-feminist Trinity made about gender supremacism and being embarassed by old thoughts while still understanding how the person she had been had had them -- all of these change who we are, how we respond.

Axiom 2: Any modification of brain chemistry is morally questionable.

Setting aside, for the moment, that in practical terms this means that one should not eat, sleep, have sex, fall in love, experience any other emotion, record memories ....

The notion here was that changing the brain chemistry changes who one is, and because of the axiom encoded in (1), that's bad. Of course, for at least some depressives and other people familiar with similar issues, the concept of identifying with the disease is about as appealing as binding one's identity to a pus-filled abcess: that is not the self, that is a lesion on the self.

This notion is one that I have a hard time understanding at all, really. But, mind, I have at times made studies of my mental reactions to various substances so that I know what cognitive shifts they induce -- so that I feel better able to handle the workings of my mind in a variety of states, so that I am familiar with what tools I might want to use in order to get my cognition into functional order. Some of these I maintain long-term (such as B vitamins and various fatty oils, which induce the cognitive shift of 'not suffering from persistent severe depression with anxiety attacks'); others are more situational (such as, say, my awareness of my responses to various forms of alcohol). This does not leave me with much sympathy for the "OMGitchangesthebrainchem" position; I am systemically inclined to want to know how to captain my brain through a variety of waters, not least because I can't count on it remaining smooth sailing on the biochemical sea in the first place.

Axiom 3: A person taking antidepressants or other medications is not the same person as the same body not taking them.

Given my sense of piloting through the Straits of Serotonin I ... don't get this one. Not how it meaningfully differs from any of the other changes in the self over time or circumstance, especially.

Even if I believed that this particular use of medication crossed a line into being a qualitatively different way of readjusting oneself than any of the other ways that people change, consent to activities, or otherwise deliberately do things that have a risk of rearranging their perspectives, I'm not sure I'm capable of seeing the problem. When the meds work, this philosophically-defined suicide and transformation into a new person produces a happier, more productive, more capable individual in the body of someone who was suffering. Considering this morally questionable strikes me as the old suffering-is-virtue trope, which I've never much cared for.



Mostly I'm left with a weird impression of what-gets-called-privilege -- that this level of lack of understanding can only be maintained by someone who has no intimate personal experience of what it's like living in a mind that doesn't work right. Probably someone who has no intimate personal experience of what it's like living in a body that doesn't work right, either.

I'll just continue selling my soul to those demon vitamins.

2 comments:

cube said...

The problem also is that everyone else's hangups with medication are preventing those for whom it might actually make sense from doing so - and that's a giant giant barrier there.

How many of these people who are talking about antidepressants have needed to take them? I start feeling like it's the abortion debate - most people just blithely judging.

I will say, having been through the whole rigamarole, that one of the odd things about taking antidepressants is that your line of mental continuity never breaks - you never really see yourself as different than what you were, as far as I can tell. Not unless you actually have benchmarks or people helping you do you realize that anything has changed at all.

...and we're not even talking about the hangups and the cycles and the habits that get formed under the inability to cope the same way other people do. I'm still dealing with the aftereffects of that, and probably will for the rest of my life.

Dw3t-Hthr said...

The people who are talking about how horrible and weird and personality-disrupting it is to change one's brain chemistry are, as far as I know, the ones with no intimate experience of depression or other similar fuckedupednesses.

The people who are telling these people they are crazed and offensive all have experience with the issues, though not all of us have personally taken them. (I haven't.)

The fact that the mind-body dualism discussion is also breaking down mostly to atheists for, theists against is a coincidence, but it's one that I find awfully funny.