Wrote this for a second year philosophy course (contemporary ethical issues). Probably like the most interesting paper I ever wrote. Check out the works cited for interesting sources. Also, plagiarism is bad.
Medicating our Personalities: A Reflection on Antidepressants
With advancements in the pharmaceutical field, medically prescribed drugs now exist which can alter a person’s personality towards societal ideals. The availability of such drugs raises numerous moral tensions, primarily, if personalities can be biologically manufactured, is it moral for patients and psychiatrists to manufacture them? In order to agree upon the ethical use of these drugs a definition of the human personality is required. To what extent, for example, can certain behaviours be labelled as illness and therefore medically correctable? At the very root of the issue is whether the human personality is defined as a product of nature or nurture, or more complexly as a combination of the two. Should personalities be protected in their raw form because they have deep and undiscoverable meaning or are they a biological concoction which medicine can perfect? Where is the line between medically treating an illness such as depression or a character flaw such as social anxiety? Should it be permissible for entire societies to take drugs which seemingly increase personal happiness and ability to function in a culturally-perceived normalcy? The debate ultimately hangs on the question of who we are as human personalities and where we plot ourselves on the line between creatures of biology and creatures of deeper meaning. This paper, acknowledging the firm evidence that we are indeed creatures of biology, argues that we are foremost creatures of meaning that is intrinsic and invisible within biology. The following offers a discussion of relating viewpoints on the issue and suggests means of practicing the viewpoint of deeper meaning both socially and personally. Nevertheless, recognizing the limitless variety of personal opinions on the topic, the most basic purpose of this paper is to inform and empower readers with both knowledge and hope so that they may critically develop their own opinion and then choose to live according to their moral belief.
The Conversation on Personality-Altering Drugs
The conversation on personality-altering drugs in this paper will be limited to those which are currently in use for both depression and manic-depressive illness. The most infamous of these is Prozac, a drug which in some patients causes a very dramatic transformation of personality from depressive to extremely confident. Antidepressants are now a common household drug within Western society and had been comfortably received until the advent of Prozac and its like. The questions which need to be asked address the past, present and future: have we already begun altering personalities with antidepressants, have we already medicated past the point of knowing what is illness and what is not, and will we continue to develop and use medications that are not strictly for illness?
At this point it is necessary to introduce the most extreme opposing opinions in this debate. The first, being primarily held within the medical field (psychiatrists, doctors) supports and encourages the prescription of any drug which increases the quality of life. Science proves, after all, that we are biological beings. One study of a depressive patient on Prozac reports that “if her self-destructiveness with men and her fragility at work disappeared in response to a biological treatment, they must have been biologically encoded” (Kramer, 2002, p. 650). Since all distinct character traits, positive or negative, are a product of biology than humans themselves are simply biology that can be altered. This reasoning, of course, leads to serious philosophical concerns on the uniqueness, purpose and value of the individual human life. Consequently, at the other extreme of the issue are those who condemn the use of any mentally-related drug. They do so on the conviction that the human personality is made up of meanings and experiences, more than simply biological, and is therefore too complex and sacred to be biologically tampered with:
“When I became ill, my sister was adamant that I should not take lithium and was disgusted that I did... she made it clear that she thought I should “weather it through” my depressions and manias, and that my soul would wither if I chose to dampen the intensity and pain of my experiences using medication...my personality, she said, had dried up, the fire was going out, and I was but a shell of my former self” (Jamison, 1995, p. 99).
Opinions similar to this are particularly rampant within naturalist and religious circles. Yet, in reality, most people accept the use of antidepressants as a moral treatment of an otherwise fatal mental illness. The debate over these drugs cannot be made as simple as the two-opposing sides.
The tensions between these two arguments are best illustrated within the lives of those who must decide, in their own life, whether or not to take the medically prescribed drugs. The moral dilemmas begin at the most basic level of differentiating between personality and illness. Kay Redfield Jamison, a woman of substantial knowledge and experience as both a psychiatrist and a victim of manic-depressive disorder, has seen through experience that “like so many people who get depressed, we felt our depressions were more complicated and existentially based than they actually were” (Jamison, 1995, p. 54). At one point she “genuinely believed that I ought to be able to handle whatever difficulties came my way without having to rely upon crutches of medication” (Jamison, 1995, p. 99). However the life-threatening highs and lows of manic-depressive disorder convinced her that it was necessary for her to take her medication: “At this point in my existence, I cannot imagine leading a normal life without both taking lithium and having had the benefits of psychotherapy” (Jamison, 1995, p. 88). She seems to be a clear example that, although medication does alter personality, “losing... energy, vivacity, and originality by taking medication” is preferable to “how costly, damaging and life threatening” her manic-depressive illness was (Jamison, 1995, p. 88). Her medication is how she survives. However, in her book Touched with Fire (1993) she seems to argue that manic-depressive illness is an indispensable element of uniquely artistic personalities. She highlights the link between artistic and creative genius in individuals like Emily Dickinson, Victor Hugo, Charles Dickens, Vincent van Gogh and Hugo Wolf - individuals whose personalities were defined by their manic-depressive disorders and whose accomplishments would not have been possible on medication.
The complexity of drugs which affect the mind and personality is becoming increasingly more difficult as the effects of drugs are unpredictable and can actually transform people from one personality to another. Since drugs are more readily available, they also seem to be becoming more easily prescribed. Psychiatrist Peter Kramer’s study on his patient Tess and her transformation due to Prozac is perhaps frightening evidence of this. Past the point of healing Tess from depression, Kramer continues to provide Prozac to free Tess from hindrances that seem to be obviously an element of personality rather than mental illness:
“Here was the dilemma for me. Ought I to provide medication for someone who was not depressed... I assumed I would be medicating Tess’ chronic condition, call it what you will: heightened awareness to the needs of others, sensitivity to conflict, residual damage to self-esteem – all odd indications for medication... Who was I to withhold the bounties of science” (Kramer, 2002, p. 646).
Kramer has documented the transformation of Tess’ personality by Prozac from low to high self-esteem, from shy to outgoing, from fearful to confident (Kramer, 2002, p. 644). He also notes that “she was not longer drawn to tragedy, nor did she feel heightened responsibility for the injured” (Kramer, 2002, p. 645). On Prozac Tess’ life became one of social success and personal happiness that is society’s advertised ideal. As a result of the drug, Tess regarded her character flaws as separate from her identity and defined her real identity as the high gained by Prozac (Kramer, 2002, p. 651). As Kramer witnesses the new lightness of Tess’ personality he recognizes what Jamison did in her study of manic-depressive disorder: as a result of personality-altering drugs “might we not, in a culture where over seriousness is a medically correctable flaw, lose our taste for the many melancholic or brooding artists (Kramer, 2002, p. 651). He realizes, as well, that our very concept of self is at stake if we can biologically define and alter ourselves.
It is essential that antidepressants are studied and criticised as a moral issue because they threaten humanity’s definition and value of self. Simply on a philosophical level, they present an extremely burdensome challenge to solidify an understanding of self in the range of biological to existential meanings. As if resolving this were not impossible enough, there are also the practical implications of personality-altering antidepressants that need to be taken into account. Is it moral for society to create personalities that match its culturally-perceived ideals, and if so might this be the end of society, with individuality and diversity lost? Surely a division between those who can and cannot afford personality-altering drugs will develop, and then will we create a segregation of society too far of the moral path to ever repair? At the most basic level, will human life lose its meaning, lose love and selflessness, as we all strive for the ideal self?
A Socio-Political Response to Personality-Altering Drugs
Idealistically, if society were able to recognize a true definition of personality and its source, then a set of criteria and laws could be agreed upon which ethically regulate the prescription and use of personality-altering drugs. The nature of the human personality is, however, so disagreed upon and intangible that a true consensus is impossible. Therefore, for those whose morals disagree with the developing usage of personality-altering drugs, counter-pressures within the political domain will be difficult to apply. Since the issue of personality is very opinion-based, one cannot enforce their opinion on others in the form of a law or regulation. It seems, rather, that the best action to be had within the political domain is a continuing protection of the freedom of opinion and choice so that one may still express their moral beliefs personally and communally. Moreover, individuals may have the freedom to investigate and test the effects of personality-altering drugs and therefore to develop or change their opinions. Protecting freedom of choice in this area – to take or not take the drugs, to disagree or agree with someone else taking the drugs – can be accomplished through awareness-raising. Social media and formal organizations are effective means of upholding these rights of citizens.
Having protected the freedom of choice within the political domain, social action can then be made to inform society of the moral issue that antidepressants present and encourage serious analysis of their impact on the value of humanity. This is not a moral issue which can be legalistically enforced but must rather be upheld by firm belief in protecting the sacredness of the human personality. The choice to use or not use personality-altering drugs is a personal one. The bias of this paper, as mentioned earlier, is towards a human personality that is primarily sacred and then biological. This belief is rooted in the truth claims of Christianity. From within this framework of the Christian faith - a framework that is not at all black and white - the use of antidepressants is not a matter of law but a matter of heart. That is to say, it is not beneficial for Christians to host legalistic campaigns pinpointing the perfect moral position between total abstinence and total acceptance of personality-altering drugs. Rather, the complexity and confusion of this moral issue requires individuals to seriously examine their desires and purposes in using their respective drugs. The issue to be handled is not the drugs themselves, but the selfish desires or lack of trust in God which causes people to use antidepressants wrongfully.
An extremely honest and very well-researched work, by a Christian theologian who suffers from manic-depressive disorder, asserts that “mental illnesses are understood these days as biologically and socially based, not spiritually. But they do have a spiritual fallout” (Greene-McCreight, 2006, p. 107). If the ultimate source of the human personality is God Himself, then “religious language covers all and every aspect of being” (Greene-McCreight, 2006, p. 114). Although mental illness and medications are certainly not well-understood within Christian doctrine, the character of God and the relation of God to mankind are steadfast. The Christian response, therefore, to these dilemmas should not be to find a human and temporal answer but to find an eternal one. The Christian can have hope that when sin and confusion seem rampant, specifically with the new power of humanity in the biological field, all things are created and understood by God. The human personality finds its root in Him and is controlled by Him. Those struggling with mental illness can trust that “the Strong Man who will bind this spiritual fallout is Jesus” (Greene-McCreight, 2006, p. 107). Surely moral failure and sin are beyond human ability to control and understand, including the presence and impact of personality-altering medications. Likewise the God of the Universe remains that only One who can free us from the moral failure of them. He frees us from moral failure by a personal relationship with Him that is not of legalism or laws but of personal trust, forgiveness and love. As we try to decide to what extent personality-altering drugs are permissible it is necessary to depend on Him to be our source of goodness and truth because we, as sinful creatures, cannot make moral and good decisions.
A Personal Response to Personality-Altering Drugs
The moral issue of when or when not to use potentially personality-altering drugs is specifically related to a whether or not a person needs to make these choices in their life. The need for drugs to treat mental illness cannot be truly understood until it is experienced, and the importance of one’s moral stance on personality-altering drugs is not critical until a real decision must be made. The relevance of personality-altering drugs in most people’s lives will simply be staying informed on the reality of the drugs and their impact. A real moral opinion is not necessarily required, or put to the test, until one has the option to use the drugs themselves. My interest in the effects of personality-altering drugs is their increasing prevalence in the treatment of mood disorders and my suspicions that I may be victim to them. Having lived the textbook symptoms of depression for periods of three to four months at a time, but somewhat fearing a diagnosis, I have avoided professional opinions and also the certain offer of antidepressants. I am currently of the opinion that my moods are a part of personality which, though I may be unable to control them, are essential to my identity and do not require drugs to change them. I do not think that I need to be medicated because I have had suicidal thoughts; rather I think that my moods and thoughts have been out workings of my growing and changing relationship with God. As in the Books of Job, Psalms and Ecclesiastes, I find the deep and painful aspects of life and personality to be the most real and revealing of our nature in contrast to God’s.
The course reading on Prozac, as well as the personal research I have done in the works of Greene-McCreight and Jamison, have informed me greatly and caused me to re-analyze and test my opinions numerous times over. I am certainly still in the process of testing and developing my opinions, therefore my most practical means of responding to the issues of antidepressants has been to inform myself with a variety of opinions. I am thankful that my experiences of depression have not yet been all-consuming and also thankful that I have not experienced symptoms of mania. I realize, though, that there may come a time when I have to more seriously consider the possibility of taking antidepressant drugs. I also realize that I am still very naive to the real pressures of mental illness on daily life (I have always been able to re-surface on my own). The Prozac article concerned me because the dissolution of personality by medication seems horrifyingly destructive to the meaning of our lives. I am admittedly at a point of fearing the effects of medication on the brain, and I am attempting to deal with this moral issue by reading and questioning my own beliefs against the beliefs of others.
Works Cited
Greene-McCreight, K. (2006). Darkness Is My Only Companion: A Christian Response to Mental Illness. Grand Rapids, MI: Brazos Press.
Jamison, K.R. (1995). An Unquiet Mind: A Memoir of Moods and Madness. New York, NY: Random House, Inc.
Jamison, K.R. (1993). Touched with Fire: Manic-Depressive Illness and the Artistic Temperament. New York, NY: Free Press Paperbacks.
Kramer, P.D. (2002). “Listening to Prozac: A Psychiatrist Explores Antidepressant Drugs and the Remaking of the Self.” In L. May, S. Collins-Chobanian & K. Wong (Eds.), Applied Ethics: A Multicultural Approach. 3rd ed. (640-652). Upper Saddle River, NJ: Prentice Hall.
Works Consulted
Styron, W. (1990). Darkness Visible. New York, NY: Random House, Inc.
Dossey, L. (1993). Healing Words: The Power of Prayer and the Practice of Medicine. New York, NY: HarperCollins Publishers.
