08 May, 2012

Mental Health Month: Drugs

A recent article in the Boston Globe states "The drug's(antidepressants) effectiveness inspired an elegant theory, known as the chemical hypothesis: Sadness is simply a lack of chemical happiness. The little blue pills cheer us up because they give the brain what it has been missing.There's only one problem with this theory of depression: it's almost certainly wrong, or at the very least woefully incomplete. "

The article talks about the possibility of Prozac and similar drugs being neuroprotective agents. But cocaine, amphetamine and to a lesser extent cannabis are also neuroprotective and neuroregenerative. Given that antidepressants are now closely linked with dependence, long term brain changes and tardive dysphoria, the line between "safe" medications and "unsafe" street drugs seems blurrier than ever.

It is also, I find, very hypocritical to put someone in treatment or insist they stop their cannabis, their alcohol, even their coffee usage while at the same time insisting they take powerful antidepressants or antipsychotics.

I've known successful businessmen who used cocaine everyday to no ill effect, and others totally annhilated by seemingly safe prescription psychotropics. I've seen the ravaging effects of a few drinks on good friends, while others seem to be able to drink and suffer no ill effects.

Our society has such black and white thinking about drugs. A drug is either addictive and should be avoided or a drug is a miracle. The murky area in-between makes many uncomfortable. That area where drugs can be helpful, but also addictive and there is no clear line between a street drug and a prescription is tricky territory. Add to that the fact that amphetamines are still routinely used as anitdepressants and serotonergic antidepressants often have dopaminergic and norepinephrinergic effects, making them eerily similar to cocaine makes things even more complicated.

But more than that,  the fact that we are looking at primarily biological and behavioral aspects of depression says more about us than about those suffering. Very often it is assumed, with depression and similar ailments that the problem lies with the person who is suffering, not in society. It also assumes that having such a temperament is really a disease as well.

It is certainly unwanted and I certainly understand why some choose to medicate away their pain. But personally, I see no difference between smoking a joint, having a drink or popping a Prozac.

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