Stronger Than The Pills: Dependence and Identity

I was talking the other day with a friend about how people can act completely differently around their significant others. Some people are super bothered by that. “They’re not being themselves!” these hypothetical people whine. “They’re changing!” There are a lot of people who argue that you shouldn’t allow other people to change who you are, that you should “be yourself”.

My friend and I went back and forth for a while about what this meant for your “real” self, but by the end of the conversation we had mostly agreed that everything we do and everyone we interact with affects our brain. Brains are malleable things, and there’s evidence that (especially when we’re young) even single interactions can have impacts for years to come. Relatedly, we all adjust our behavior and self based on context. We change our clothes when we go to work, our language changes based on who we’re around. When there are different inputs and contexts, our “self” has to adapt. This is part of being a successful and functional human being.

Brains tend less to be like a static identity and more like a processor: we have ways that our brains like to interpret things or respond to things, but there is always something there to interpret, there’s always stimuli coming in that will make slight adjustments to our processors. So it doesn’t seem to be that big of a deal if you choose to be around someone who affects your processor.

What does this have to do with pills you might ask?

Well some of those things that people say about relationships that affect your personality are things that people say about pills. I’ve been listening almost nonstop to Neon Trees for a few weeks and one of their lyrics says “I’m stronger than the pills”. I’m so done with phrases like this. They imply that anything that affects your brain chemistry is a crutch, a cheat, a way out of being you.

The biggest problem with this is that just like a relationship that affects the way you act, there is no integral self to interrupt. “Self” is choosing which inputs you would like. There’s really no way we can figure out what we’re like without the influence of our environment and the food we eat and the sleep we get and the people we talk to and the job we have (see: Judith Butler). We’ve got influences from the moment we’re conceived. This is not to say that there aren’t some elements of personality and self that stay consistent across time, just that it’s silly to imagine that you can have a pristine, untouched self that would be horribly tainted forever by the introduction of meds.

Strength is knowing what allows you to behave positively and functionally and choosing to put yourself under that influence: because you will never be without influence. “Being true to yourself” is about what you choose to surround yourself with. Changing our inputs is part of how we remain independent. Unless you cannot choose to change your inputs, you are always stronger than they are.

Another issue some people have with meds or serious relationships is dependence. They don’t want to have to rely on something external to themselves. I hate to break it to you all but we’re all dependent on things that are external to us. we’re dependent on food and on sleep for god’s sake, and those things affect our brain chemistry and biology. There are things we need each and every day, whether that is a medication or 20 minutes of alone time or running or food or a book or your Facebook. We’re dependent on the world around us. And all of these things affect your brain in ways similar to your relationship or your drugs.

It doesn’t feel nice to realize how dependent you are on external things, how fragile you are. And when you’re dependent on things that others aren’t dependent on (like pills), it’s a reminder over and over that we have to choose our inputs but that we don’t get to choose whether or not there are inputs. That can be scary. It can feel like you have no control over your Self. But you do. You get to choose (to some extent) what things affect your Self. You get to choose whether to sleep enough or work a shitty, stressful job, or eat healthy, or be around validating people, or whatever it might be that turns you into a processing machine or a bumbling Windows ’95.

That’s all the power you get. So yes, your identity will be dependent on your pills. It might change who you are a bit. But that’s ok. Because everything and everyone you encounter does. If you don’t like how you change then you get a choice: you can continue to depend on it or you can move away from it. But if you want to stop being influenced, if you want your identity to be pure and unadulterated you, then you’re pretty much just going to have to die because that’s the only way you stop being influenced.

Making choices to change yourself so you don’t act like a dick is not selling out: it’s being an adult.

 

Happiness Pills: Yay or Nay?

Over the weekend I was hanging out listening to one of my old professors play music (because that’s how I roll). He introduced one of his songs with the question “if I could get happiness with a pill, would I do it?” Instantly my “grrrr, mental illness stigma” detectors went off, but I have great respect for this particular individual and challenged myself to think a bit further about it. I realized that in general, the question “if I could be happy with a pill” is a. unclear and b. misleading, as well as c. totally unrelated to the antidepressants that actually exist today.

The biggest problem I have with the question is what we mean by “happy”. Is it the actual presence of a positive emotion? Or is it simply a lack of negative emotion? Does it mean you can’t feel negative emotions, even when they’re appropriate? I suspect that when this question is posed most people mean feeling on the positive side of the emotion spectrum constantly. While this might sound appealing to lots of people, I think there are actually some serious problems with this concept, and that even the idea of a pill that can do this is self-contradictory.

Emotions have appropriate times and places. They come as reactions when they’re functioning healthily. They fit situations or they don’t. If you aren’t happy and you take a pill to be happy, your emotions probably don’t make any sense for the situation that’s happening around you. It seems a bit like taking away physical pain: you no longer have a barometer for when something is wrong or hurting you. You no longer have the emotions that tell you something has violated your boundaries or treated you inappropriately. Just as with a lack of physical pain, this will probably result in doing things that are actually hurting you without realizing it.

Negative emotions give us information. They make us more aware of what’s happening around us because they clearly communicate to us “something bad is happening”. Fear tells us to escape, anger tells us that a boundary has been violated, sadness and grief tell us that we’ve lost something we care about. This makes them appropriate.

We all understood why Ten was crying, and it would have been creepy if he wasn’t.

Oftentimes this awareness does more than simply tell an individual about situations that are harmful to them. We have empathy, so our negative emotions often inform us about things that are morally inappropriate and then give us an impetus to act. If I didn’t have anger or sadness, I think I would be hard pressed to care about something like anti-gay hate crimes, or oppression of women. I could come to an intellectual conclusion about why those things were wrong, but without any feelings of sadness it doesn’t have the same impact. Without our emotions we are less aware of the world around us, particularly the things that need to be improved.

I’m less worried about the concept of an identity or an essential self that many people find themselves wondering about when they think of pharmaceuticals. Every time we make choices we affect our brains and through our brains our emotions, thoughts, and selves. When we try to change a habit, when we go somewhere new for the first time, when we learn a new fact or skill, we are training our brains to operate differently. Therapy is all about changing the patterns that your brain uses and finding more effective ones. Perhaps there is some core that holds steady through all of that, but every human being in the world encounters so much change and adjustment to their personality, from within and without, that it seems a bit silly to be worried about losing yourself, especially if what you’re changing will improve things.

But that’s the question here: will being constantly happy improve your life and the world?

Will this make me a better, healthier, more functional person who is more capable of improving the world around me and contributing something? I don’t think depression or sadness are necessary to be productive or creative or any of those other silly myths that depression tells, but I do think having the full spectrum of human emotion is deeply important for having empathy, for understanding why certain things are morally inappropriate and others are morally praiseworthy, and for gaining motivations to make changes.

There are some ways in which always being positive will improve the world around you (for example you’ll probably be a much nicer person to be around), but as I mentioned above, it also makes you less aware of what’s wrong with the world, and in the end I think the balance would point towards no, it would not improve the world unless everyone in the world were fed happy pills at the same time so that we didn’t need to empathize with people who were in pain. As long as there are injustices and other unhappy people in the world, it’s important for our understanding of those people to be able to empathize and feel anger or sadness on their behalf. But what about improving your life?

I have a hard time imagining how a pill that consistently makes you happy would actually do anything to improve your life, because as I mentioned before, negative emotions tell us when a situation is bad for us. If we don’t have that information, we’re likely to stay in situations that will hurt us. Additionally, we’re less likely to develop healthy coping strategies. Pain gives us a reason to find a better way of doing things. This is why antidepressants are almost always accompanied by talk therapy so that the patient can find effective ways of managing their lives and emotions.

As an example, let’s say you were in a relationship where your significant other was emotionally abusive. They berated you constantly, expected you to do all the work, and never did anything for you. But despite all that you were constantly feeling just fine. It seems unlikely to me that you would be willing to work towards better relationship strategies, leave the relationship, or confront your partner about their inappropriate behavior if it never made you feel sad or unhappy. You would never learn that the things they said were inappropriate because they didn’t hurt you. You would never spend time trying to understand why they did what they did because it never had any impact on you.

What about appropriate emotions? How would we feel grief for things ending if we took a pill that made us always happy? Doesn’t it seem deeply wrong to not grieve things, unhealthy even? I suspect that not grieving (which leads to not processing and not effectively storing those memories and relationship in a way that you can cope with them and they’re not consistently popping into your mind) would make it harder and harder to be happy and we’d have to increase our happy pill dose again and again and again.

Unless happy pills came with effective coping techniques, appropriately living on conjunction with your values, healthy relationships, and other positive ways of living, they would stop working. And if everything feels ok all the time, why would you have any motivation to do all these other things? Most often the ways we understand what our values are is by feeling guilt or shame when we violate them. If you don’t have these emotions, it would be nearly impossible to live in tune with your values. People who don’t have these emotions get labeled sociopaths and psychopaths. We understand there’s something wrong with that.

The problem is that if you were made this way by a pill, you wouldn’t set up your life in such a way to create happiness, which means that you would keep yourself in bad situations, living antithetically to your values, in shitty relationships. And so the happy pills would have to do more and more work. And then you’d have to up the dosage, and you’d make your life even worse. And then the pills would have to do more so you’d have to up the dose…

We actually already do have these hypothetical happy pills that cut us off from appropriate emotions and make us feel good. They’re called drugs and most people agree that they’re a bad way of dealing with your emotions. They don’t provide a stable foundation for happiness and good living, because they mean if you stop taking them your happiness can flit away. They mean that you lose the fear of being homeless or starving because you’re stuck in the happy of this exact moment. They are deeply unhelpful.

The other thing I’d worry about is whether this stunted way of feeling would leave me with less happiness overall. Would you still get those melancholy/bittersweet moments that are so flipping good because of the fact that they hurt? Would I still get to watch Romeo and Juliet and love it? Would I still understand culture and relationships and other people? Would I turn into an annoying asshole because I never have to work on myself? What about the high of coming up from a bad day? The adrenaline of fear and anxiety heightens everything…what do we do without that?

If I could find a pill that made me content (which is what an antidepressant is supposed to help with: give you the emotional space to be able to tolerate things and find some contentment), that I would take. I would take the possibility of reacting accurately and effectively to the stimuli that surround me, of being able to reach my goals without my emotions getting in my way. What I wouldn’t take is a pill that disturbs the relationship between stimulus and appropriate response. Many people get these two things mixed up, and so when this question comes up in the context of antidepressants, I think it’s important that we remember to distinguish.

Sure it might be nice to feel good no matter what you’re doing, but what’s the point? It’s easy to be oblivious. It’s hard to be aware and truly work on yourself and your world.