Decades ago, antidepressants were only in their nascent stages but today, they flood the pharmaceutical market while an unprecedented number of prescriptions fly from underneath the fingertips of doctors. With their emergence arrived an entirely new philosophy on the origins of mental illness and what it took to treat it. The idea that chemical imbalances accounted for one’s inner distress was a significant departure from the Freudian perspective that had hitherto dominated the psychological field. This new “scientific” view proliferated in the 90s, following the splashy debuts of ambitious new SSRIs such as Prozac.
Antidepressants are surely useful, particularly in severe cases. But in mild to moderate scenarios, there is evidence to suggest that they are grossly overprescribed. Given that American society is swimming in medication to begin with, perhaps this is a development we ought to question.
The supposed virtues of these clever scientific remedies have been extolled for years now. And yet, is there not something alarming about the flagrant mismatch between present rates of mental illness and present rates of antidepressant usage? Both have skyrocketed — which begs the question — is there something we’re not seeing? Is it really correct, or even sufficient, to slap a biological explanation onto mental afflictions such as depression? Why — if we have ostensibly acquired the technical means by which to patch up mood deficiencies — do even more people exhibit signs of unraveling? In short, what did we get wrong?
Science vs. Psychology
The narrative of “chemical imbalances” abounds, not necessarily because of its empirical merit (of which there actually isn’t much) but because such an explanation is so appealingly comprehensive and satisfies the quick-fix impulse so sneakily rampant in our culture.
Psychology is naturally messy, you see. It is hopelessly aligned in a gray area and is not categorized by the mechanical efficiency of science with its crisp black-and-white lines of demarcation. What the modern approach to mental illness has done is attempt to subtract all the messiness, subjectivity and shades of gradation from the equation by swapping it with one medical panacea that handily disregards all that “messiness”.
It is easy to see why the theory ungirding the entire medical approach to mental illness is so pounced upon. The promise of ‘the certain cure’ makes it so enthralling. And we do so love our scientific explanations for things. The drug cure for depression, for example, is popular less because of its proven success but largely because it is financially lucrative, time-efficient and allows practitioners to wash their hands clean after making quick, detached work of medicating human distress.
By structuring a person’s depression, for example, as a neurological glitch that is justified by levels of brain chemicals strips the complexity from the situation and robs any kind of meaningful uniqueness from characterizing a person’s state of affairs. As the theory goes, a depressed person happened to acquire an insufficient level of serotonin and now haplessly finds themselves depleted of appropriate resolve to thrive in life. Apparently, the intricacies of their life story and concealed pain are of little consequence.
And yet, it’s a sloppy scientific explanation because the research on the causes of depression is frankly, nonexistent. Though antidepressants can boost serotonin levels, in actuality, it cannot be said that depression is caused by low serotonin levels as no such proof is available. And yet, the stubborn myth of chemical imbalances still persists.
Why then, we should ask, do we see such startlingly high rates of depression and anxiety currently as opposed to earlier periods in history? Why would chemical imbalances en masse become popular? There’s something illogical about that, no? There’s something disconcerting about that, right? After all, wouldn’t this be a strange phenomenon if you subscribed to the idea that culture, individual histories, personal trauma, and internal conflict were irrelevant and/or insufficient in the face of brain molecules and their apparently obvious clout?
The rise of antidepressants is no surprise then, set against the backdrop of cultural enthrallment with scientific solutions. But the stature of the psychotherapeutic approach is dwindling, and only to our detriment.
External vs. Internal
This belief that mental illness is some sort of neurological error — little but an unfortunately incorrect cocktail of brain chemicals — grips the public, but grievously so. Sure, some individuals may be more susceptible than others to mental illness, as functions of genetics or personality, for example. But as I have earlier mentioned, this does not mean that such ailments should be — or even can be — hastily chalked up to the physicality of the brain. Actually, what such a widespread belief does is solidify in people an idea that their inner conflict is not actually their’s — that it exists as something falsely imposed, as something outside-of-them, as something externally inflicted.
Following this line of reason, one’s ensuing feelings of hopelessness, existential despair, and crippling lack of motivation are technically speaking, meaningless. Meaningless in the sense that they are indicative of nothing profound within the person because all is apparently the consequence of a dearth of serotonin, and can be cured by swallowing some pills, the psychological mess swiftly swept away.
This is a severely detrimental way of looking at things, and I would describe it as this focus on “external imposition”, or the idea that the invisible forces of brain chemicals enact mood changes that are severed from psychology and that are wholly in the domain of neurological circuitry. This top-down conception is, in all honesty, a radical departure from the older, psychodynamic perspective that had a bottom-up orientation, holding that inner strife was the consequence of personal unrest on the level of the soul.
There’s something dehumanizing about this top-down theory — that our inner experience is inauthentic, that the way we think or feel (in essence, consciousness) is mostly illusory, and that our human experience is principally the product of the chemical substances sloshing around in our brains that we are hopelessly enslaved to.
Distraction vs. Consciousness
The medical approach so popular to the psychiatric community is so tellingly scraped thin of making any hard inquiries into the state of our souls. It promises to smooth over the wrinkles that are upsetting our daily lives, and it pledges to chemically normalize those peskily fluctuating moods, but it cannot induce us to face our own existential unrest.
We pride ourselves on finding remedies that chemically induce positive moods and we call this ‘progress’. But in the larger scheme of things, is it? We cannot transcend the human soul and so we can never hope to actually “fix” the inner self via a powdery drug. Why did we ever think we could? It’s almost naïve.
Furthermore, why did we ever think we could ever reduce psychological turmoil to the form of brain chemicals? As if they contain the full explanation for human suffering? And even more, would it even be remotely possible to prove that depression originated from them? My hunch is that that is an impossible endeavor and it can’t be done. Not everything lends itself to scientific corroboration and that’s a terrifically difficult thing for those of us in the Western world to swallow. I’d even add, it’s hard to comprehend.
Psychology may be tangled up with biology to some degree, but it’s tangled up with spirituality, also. It’s interwoven with what we know for sure and also what we don’t know for sure, and never will. Where it ventures into the objective human condition it also ventures into the complexity of individual human experience. This duality is not adequately expressed in the current psychiatric model.
Popping some pills may help someone return to the folds of even-keeled society and resume their business, but it’s at best a temporary fix. If you think about it, it solves nothing, merely neutralizes something, by virtue of an external agent, no less. Such a route will not address the lingering unrest at the soul-level that needs attending to. Talk therapy, admittedly, is a time-consuming and protracted process. It is not as simple as penciling out a prescription and sending you on your merry way. But it assuredly does not promise distraction, but rather, frontal engagement with one’s complicated emotions and anxieties. It does carry with it the bright potential of solving, however — the redemptive side of consciousness.
Psychotherapy is a method that drives through the mental struggle. Increasingly popular pharmaceutical “solutions” cover over the mental struggle.
Maybe you’re unfulfilled but you don’t know precisely how or why. Maybe you’re irrationally angry at someone and you don’t know where the rage comes from. Maybe you are restless and can’t bear the passage of time coinciding with your own mounting anxiety.
All of these situations and more will not be rendered solved with the introduction of a chemical substance. Instead, that chemical substance will distract from it — conveniently removing oneself from the specter of existential consciousness and all that it painfully, glaringly exposes.
People assume that a spate of depression has nothing to teach us, but in most cases it materialized as a result of something, didn’t it? The medical approach would have the symptoms for mental illness scrubbed away with prompt precision, but wait, didn’t they have something to show us? The symptoms, after all, are the threads we must follow to the source of our unrest.
Sit with your pain and figure it out; that’s what I would counsel. Antidepressants, while undoubtedly useful in severe cases, will in most cases, superficially flatten over the pain and thus, will never remove it. It does not evaporate, you see. You must dig up the roots, after all, and fight the urge to merely smooth over the soil.
The proliferation of psychiatric drugs is some indication of our prevailing cultural philosophy which popularizes the quick-fix mentality and wishes to eschew the pain of consciousness.
That said, the equal proliferation of mental illness itself in our society can be seen as striking evidence of wholesale soul-sickness. Clearly the former, in all its scientific vigor, proves weak and insufficient for the task of “healing the human soul”.
That emotions and our inner experience were toppled by the strange supremacy of brain chemicals is a trend that deserves some analysis. We’d do well to wake up to the fact that the thorny question of human suffering and fulfillment cannot be adequately conquered by science and instead, demands a far deeper and more holistic perspective.