The whore-ish nature of antidepressants
At risk of becoming one of Brave New World's soma-snorters, it might still be one way to solve a problem
A perverse kind of mindfuck arises when you considering going back on antidepressants, in order to be able to function at a job, so that you can have health insurance in order to pay for therapy and antidepressants. It makes you feel like a bit of a whore.1
At the end of Brave New World, John the Savage hangs himself because he can’t reconcile the closest thing that he’s ever known to love with the wretched depravity of the so-called “civilization” that Lenina comes from. Soma far surpasses any antidepressant that we currently know in real life, and it’s also handed out like candy. It has the atrocious property of making everything feel ok, no matter what the circumstances: in other words, it makes circumstances meaningless. Most people in Huxley’s brave new world rely on it to survive. John realizes how messed up this is, and chooses to opt out of the game entirely.
Anybody who has thought about getting (back) onto antidepressants has probably struggled with this dilemma. On the one hand, it is the inability to stand daily existence that usually prompts a person to look into meds. On the other hand, you do have to question whether it makes sense to drug yourself up in order to stand a set of circumstances that your body and your brain are declaring, on a daily basis, to be unsustainable. You, as a system, interact with the environment around you and your serotonin levels get shot to hell daily. Is it obvious that simply doping them back up is an unfettered good?2
To use a dumb example, imagine that you hate eating chocolate ice cream, even though it is a perfectly good flavour, and live in a country where the vast majority of economic activity is in chocolate ice-cream making. (A small number of people are making vanilla, and you honestly think it’s so much better than chocolate, but it just doesn’t sell for very much - for arbitrary historical and cultural reasons3). You could dope yourself up on drugs and keep peddling chocolate. Heck, you might even get good at it. You might even get married and buy a house and have some kids and do the life things. Is that a life well lived? Who is to say? It’s probably better than a life spent not making any ice cream at all.
You could not dope yourself up on drugs, and scream at the top of your lungs about how insane it is that we only make chocolate ice cream. When your daily serotonin levels are shot to hell, it’s hard to this in a non-angry way, and it usually just makes all the chocolate-loving people wonder “geez, what is your fucking problem”? This generally does not go well. It also has a tendency to lead to the same sort of face-raking insanity that made John go crazy and hang himself.
Here is the real holy grail that I think most responsible4 healthcare professionals and depressed people are hoping for: that the meds will help you get out of your serotonin-starved doom-loop for just long enough to take a bloody shower, put some nice clothes on, and think about how to do things differently - in a way that isn’t just utterly antisocial. Hanging yourself is a way of doing things differently - it’s just not the brand of different that your therapist and friends are hoping for.
My cat got scratched up by a neighbour’s cat once, and he got so upset that he stopped eating. By the end the week he had stopped drinking water and was simply hiding and sleeping in a corner of the house. We brought him to the vet, who told us that he was severely dehydrated and probably feeling extremely weak. The poor little guy got an IV drip and an appetite stimulant pill - and when he got home he finally started eating his kibble. Everything was uphill after that.
Non-dystopian use of antidepressants is probably something similar. You get yourself into a shitty local minimum somehow5, and there’s a good chance it was your own fault. Now you’ve been there for too long and you’re too messed up to get yourself out. A temporary suspension of disbelief about how awful things are is probably necessary in order find the activation energy to do things differently.6 The key part is doing things differently. Suppose my cat had gone right back to sitting in a corner of the house. Suppose we kept shooting him up with an IV nutrient goop every day just to keep him alive. Much like the soma-snorting citizens of Huxley’s Brave New World, we would be missing the point.
#153
This passage from Mademoiselle Fifi by Guy de Maupassant comes to mind. (Oxford World Classics edition, translation by David Coward):
'France is ours, and all the French people, and the woods, the fields and all the houses in France!'
The other officers, all quite drunk, carried away in a sudden burst of bullish, martial hysteria, grabbed their glasses yelling 'Long live Prussia! and downed them in one.
The women, reduced to silence and very scared, did not say a word in protest. Even Rachel said nothing, for there was nothing she could say.
Then the little Marquis, balancing his glass, which had been recharged with champagne, on the head of the Jewess, added: 'Not forgetting all the women in France!'
She stood up so quickly that the glass overturned, spilled the wine on to her black hair like holy water at a christening, and fell to the floor where it shattered. Her lip trembled and with a look of fury she defied the officer who was still laughing. In a voice choking with anger, she stammered: 'It's a lie a dirty lie... for a start, you can't have the women of France!"
He sat down so that he could laugh in comfort and, affecting a Paris drawl, said: "That's rich, it really is. So what are you doing here then, sweetie?"
Disconcerted, she said nothing for a moment, her wine-dulled wits too sluggish to take in what he had said. But when she grasped his meaning, she grew even more indignant and retorted impetuously: 'Me? I'm not a woman. I'm a whore. Whores are all Prussians deserve!'
Note that there isn’t much of a point in passing judgement on how “bad” a situation really is, or whether it “warrants” emotional distress. (Otherwise super rich beautiful celebrities would have no reason to kill themselves.)
like diamond vs moissanite
And when I say responsible, I am not referring to the gentleman on Maple (the Canadian healthcare app) who whored out his MD by promptly dropping a sertraline prescription after literally one intro text message - but maybe he had a quota to get through. We all gotta eat, right?
Was my cat stupid for not eating? Did it make him a culpable piece of shit in his own suffering? Is this even a useful line of questioning?
Easier said than done though. Doing things differently is predicated on the idea that there is some better future outcome to be had, and it is worth doing things differently for. A complete paucity of any positive neurotransmitters tends to skewer that idea straight through the heart and beat it into a bloody pulp.