Most of my patients, who are adults, developed their psychiatric problems after they had a pretty clear idea of who they were as individuals. During treatment, most of them could tell me whether they were back to their normal baseline.
Julie could certainly remember what depression felt like, but she could not recall feeling well except during her long treatment of antidepressant medications. And since she had not grown up before getting depressed, she could not gauge the hypothetical effects of antidepressants on her emotional and psychological development.
Dr. Richard A. Friedman has written for today's Science Times about a generation who has built their character and their knowledge of themselves while always on psychotropic medication. We would not think twice if Julie grew up with congenital high blood pressure, that was untreatable through diet and exercise, about medicating her. I think it unlikely that she or anyone would say what a loss it was that she didn't know her heart without that medication if it was protecting her internal organs from irreparable damage. With the brain, however, with the psyche, questions of self arise. We see the self as arising from the brain. However, a medication that slows the heart, regulates the diameter of the blood vessels or otherwise controls blood pressure would control our entire body's rhythm, with it our ability to be aroused in the general sense of the word, and no doubt our character would be affected by that too. I am being provocative with this example but using most medication requires serious risk assessment and there certainly there are risks when it comes to the different classes of antidepressants. Would you feel more latitude to not medicate someone in the case of garden-variety upper middle class neurosis or average teenage angst that you would with serious suicidal depression? I would say I would and yet how confident could I be that I can tell the difference? The use of psychotropic medication and understanding the usual short and long term risks of any medication is already a serious one, but adding this component of a drug being a component of ones formative experience complicates the issue. That is treated thoughtfully in today's article.