Medicated Identity: The Philosophical Psychology of Drugs

(Hello! My schedule’s a little hectic at the moment, so I’m using a couple of Sundays to feature updated reposts from another site I used to run. This week’s post was originally published on July 27th, 2015.)

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How do the substances we put in our bodies fit with our self-perception of who we are?

It’s a big question, and it raises a number of smaller questions. What do I mean by “substances?” What do I mean by “who we are?” What on earth am I talking about in general?

Maybe I’m jumping into things too quickly. I’ll start with some basic setup and then we can tackle these questions as they arise. Let’s begin by considering one incredibly succinct (if somewhat unsettling) definition, which states that human beings are just “sacks of chemicals which stay alive by finding other chemicals and putting them inside us.”

And while we may hesitate to use the word “chemical” in this way because of the “synthetic” and “potentially harmful” connotations the word carries, it’s entirely accurate. Digestion is, after all, a chemical process, and food is just a bunch of chemicals by a different name. An illustrative example may be useful here: if you prepared a solution of some manganese and a variety of polyphenols (including epigallocatechin gallate) in boiling dihydrogen monoxide before adding an emulsion of triglycerides, carbohydrates, and protein aggregates and maybe some particulate steviol glycosides, you’d be ready to enjoy a nice cup of tea with some milk and sweetener.

As for humans, we’re made up of all kinds of chemicals, from proteins and fats to amino acids and nucleotides. I’m not a biology student and have little desire to become one (no offense to any biology students out there) so I don’t have in-depth knowledge of the specifics, but my psychology background has at least given me a rudimentary understanding of the many hormones and neurotransmitters in the body, like dopamine and serotonin. Keep those in mind, by the way, since we’ll be revisiting them later.

For now, let’s consider all those substances floating around in our hypothetical cup of tea. If you were to drink that tea, would it be a part of you? SciShow made a really effective video on this subject, but for our purposes, the short answer is “yes and no.” The useful chemicals in the tea will get broken down and absorbed by the body, while much of the mass will end up being expelled later. As Hank Green comments in the above video, however, some of the atoms from that cup of tea will quite possibly stay in your body for the rest of your life.

I’m more concerned with how that tea affects you, though. Specifically, some of those chemicals will directly influence your neurological processes. The big one here is caffeine, which is admittedly less prevalent in tea than in coffee, but it certainly still plays a part. There’s another interesting SciShow episode dedicated purely to exploring and explaining how caffeine works, but in this case, you probably already know everything you have to: caffeine makes you feel alert and awake when you may otherwise feel subdued, sleepy, and unfocused.

As someone who has consumed a lot of caffeine in the past and recently decided to cut down dramatically, I’m all too familiar with this. Now, when I have the occasional cup of tea, I distinctly feel the improvement it has on my mental faculties. My thought processes seem to move faster and more effectively, I feel more creative, and I have more motivation than I would otherwise have. Even if some of this is simply a placebo effect, it’s a really tantalizing feeling, and it’s hard to give it up.

Most of us have probably seen the converse of this too, be it in our schools, our workplaces, or simply in pop culture. We know people who claim that they “don’t feel like themselves” if they haven’t had any caffeine, and we’ve heard someone angrily snap, “Don’t talk to me until I’ve had my morning coffee!” If you know someone who has, say, three or more cups of coffee in a day, ask them which “version” of themselves they believe is more indicative of who they are: before they drink coffee, or after. They’ll probably think about it, but I would guess that most of them would go with the latter.

Just think about that for a moment. This is a substance that fundamentally and incontrovertibly alters your brain chemistry from its natural state (albeit without any significantly harmful effects), and people say that it makes them feel more like themselves.

Why, you might ask, is this interesting? Well,  consider another commonly consumed substance: alcohol. I’m sure no one will argue against the fact that alcohol alters the way your brain functions while it’s in your system (just in case, here’s the third and final SciShow episode I’ll link to today). I also think most people, even heavy drinkers, would agree that our drunken states don’t represent who we truly believe ourselves to be.

To shift to another perspective, let’s talk about prescription drugs. There’s a widespread cultural stigma surrounding medications for psychological disorders on the grounds that they change our personality by way of tinkering with our neurochemistry and should thus be avoided. Obviously, there can be some merit to this argument in specific instances (there is some evidence suggesting that ADHD is overdiagnosed and drugs like Ritalin too readily prescribed) and there’s definitely a discussion to be had, but a lot of these drugs can also be incredibly helpful for those suffering from mental illnesses.

For example, selective serotonin reuptake inhibitors (SSRIs) are one of the most common and effective types of antidepressants, found under such well-known brand names as Prozac and Zoloft. A deficit of the neurotransmitter serotonin in the brain has been regularly linked to such disorders as depression and OCD, and SSRIs work to counter this deficit by reducing the amount of serotonin that is reabsorbed into nerve cells.

Interestingly, a number of studies have been conducted to examine the effects of SSRIs on an individual’s personality. One study found that those participants who had been given SSRIs showed increased extraversion and decreased neuroticism (a personality trait broadly associated with anxiety and mood instability). Another study, conducted on psychologically healthy participants — that is, people without the mental disorders that such drugs are typically used to treat — reported greater levels of happiness and lower levels of hostility when they had taken SSRIs.

Some psychologists theorize that these effects are a result of serotonin promoting a certain psychological and emotional stability, wherein negative events and emotions aren’t as devastating as they would be without the drug. Thus, people who take SSRIs often feel better equipped to cope with the stresses of life, so everything feels generally more positive.

Let me reiterate the results of that last study for a second. The participants were normal, everyday people. The SSRIs they took were not simply mitigating or controlling the effects of a psychological disorder. But the drug still made normal people feel happier and more like themselves — or, perhaps, like a better version of themselves — by altering their neurochemistry.

So what’s the takeaway here? Do we prescribe SSRIs to everyone? That second study noted that some participants reported side effects like drowsiness and mild sexual dysfunction, but most asserted that the benefits were worth the cost (plus for most SSRIs, these side effects disappear after several weeks). And if prescription drugs are the most effective way to “feel like ourselves,” what does that mean for our laws? Should controlled substances like cocaine or methamphetamine be legalized if they make people feel better, or is the change to the chemistry of our brain too dramatic for us to bear while still calling ourselves the same people? Where do we draw the line?

I’m not going to present an “answer” here because I don’t think there really is one. There’s no absolute definition of how much we can ethically alter our neurochemistry; this is an issue where you should think about it and decide on your own opinion. It might not make too much of a difference for the big picture, at least not in the immediate future. After all, you’ll still need a prescription to purchase SSRIs, and drugs like ecstasy will still be illegal. While there is no question that medication can be very effective for managing psychological disorders, self-medication (even with something relatively innocuous like caffeine) still needs a lot of examination, both on personal and societal levels.

This isn’t to say that you need to rigorously analyze everything you put in your body and the effect it might have on your self-concept. Like many philosophical ideas, this isn’t meant for such precise real-world application. Still, it just might give you pause when you reach for that next cup of coffee.

 

Author: Mitchell

I'm 22 and currently pursuing my MA in Creative Writing at the University of Toronto.

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