While one often comes across articulate and well-argued articles criticising anti-depressants from a medical or efficacy point of view, one seldom comes across the philosophical argument against anti-depressants. It was, in fact, the philosophical case against anti-depressants that convinced me as a teenager that I would never, ever take them for myself, a decision that has been beneficial to me ever since.
I am against their usage both on medical grounds and on philosophical grounds, but I accept that anti-depressants are likely here to stay. Indeed, I would argue we have always had anti-depressants, for what else should we call caffeine, nicotine, alcohol, and opium but traditional remedies for our emotional ailments? People who are feeling low in motivation often indulge in coffee for the caffeine hit. People who lack courage often indulge in alcohol to shore up their nerves. People who are miserable will often indulge in excessive amounts of sugar to give themselves a rush. Everywhere, we have people self-medicating on different substances in attempts to battle their moods and unwanted feelings. Anti-depressants are not anything new, they’ve been with us all along.
In this piece, I am going to ignore all the medical and efficacy arguments, not because I do not think these discussions are not important, but because I believe the philosophical argument is the strongest of the three. For the sake of argument, I will assume that anti-depressants actually work precisely as intended: that they alleviate sadness, depression, grief, and malaise effectively and without significant side effects. I make this assumption not just for the sake of simplicity, but to better illustrate why we should be wary of them. I believe the better anti-depressants work, the stronger the philosophical case against them.
Let’s start with an example of a typical situation where a person might be advised to take anti-depressants.
Jake works for a large tobacco corporation in the marketing department. He is very good at what he does and he gets paid a large commission for any increases in sales that takes place after each new round of marketing opens up. Recently, Jake has been finding it difficult to come to work. He finds himself waking up on time, but instead of jumping out of bed, he lies awake staring at the ceiling until he has to rush to make it to the bus stop. People at work notice that his performance has dropped because he often zones out or gets easily frustrated and snappy. Jake goes to see a doctor and is prescribed anti-depressants.
As a philosophical therapist, I believe in free will and personal responsibility. I encourage my clients to make their own decision as to whether or not they should take them. In this case here, Jake has a decision to make: to take anti-depressants or not to. What Jake decides to do will have a significant impact on the rest of his life. Let us explore two likely scenarios that might unfold depending on which direction Jake might take:
Option 1: Jake takes the anti-depressants
Jake starts taking the anti-depressants and they happen to work exactly as described. He wakes up feeling refreshed in the morning and goes to work cheerily and on time. He is no longer distracted by unwanted thoughts and is thus able to focus effectively on this work: developing a new marketing strategy aimed at women. Jake has come up with a way to subliminally tell women that cigarettes will make them slim, even though he knows this is not true and that the cigarettes will harm them. He is happy nonetheless and proceeds to have a successful career in marketing earning a large salary for his family.
Option 2: Jakes doesn’t take the anti-depressants
Jakes decides not to take the anti-depressants and he finds himself constantly distracted, unable to focus on coming up with a clever marketing plan to get more women hooked on cigarettes. Jake has a young daughter and he is concerned about the impact this marketing scheme may have on her, but he is also concerned about how he would support his family if he quit his job. He tells himself that if he doesn’t run this marketing campaign then someone else will, so he can not actually stop this from happening. One morning, he wakes up so miserable about this that he does not go into work. He starts calling in sick almost every day. He finally loses his job and is fearful for the future of his family. After a couple of months of looking for work, he finds a job working for the marketing department of a health insurance company that promotes healthy lifestyle choices for their customers. Jake really enjoys his new job and, although he is not paid as much as his last job, he never feels miserable or unmotivated in the morning. He concludes that although it was difficult for him to adjust at the time, in the end it was a good thing for him that he felt so miserable, otherwise he never would have felt motivated to find a new job and would not now have a job that he can take pride in.
Keeping in mind that we are assuming anti-depressants work as advertised, so in both situations Jake ends up feeling happy. In fact, if he takes the first option, Jake will be happier sooner than he would be if he took the second option. If the sole goal in life is be happy, by eliminating negative emotions such as grief and sadness, then choosing option one and taking the anti-depressants is the wisest choice. However, despite the obvious prolonged pain and suffering that Jake experiences, many people would prefer option two over option one. This is because there is a serious moral issue in this example.
Some people at this point may argue that I am deliberately choosing an example that is unnecessarily complicated by a moral problem, when it could have been just a case of a person feeling unhappy. This doesn’t compute, though, because people do not feel miserable for no reason. There is always a reason for our feelings, even if it might be hard to uncover initially. To understand this, one needs to understand why negative emotions exist and I highly suggest reading my article on that to better understand what I am about to say here.
Here is the philosophical case for anti-depressants: by suppressing negative emotions, anti-depressants are not actually fixing any problems; they are merely making the user blind to the existence of their problems. Once a person is blinded to the existence of their problems, they lose the motivation to fix their problems. Negative emotions allow us to be aware of consequences, which gives us sufficient awareness to make choices. Thus, anti-depressants also rob us of free will leading us into a form of slavery where we will happily carry out immoral actions without any awareness of what they are doing. If anti-depressants worked exactly as advertised, they still wouldn’t solve any problems, they would create the illusion that no problems existed and the problems would continue to get worse until they eventually reached a catastrophe.
One of the few good things about anti-depressants is that they actually do not work as advertised. If they actually did work, the moral hazard that Jake walked into would end civilisation, given the number of people who take these drugs (Australian stats, American stats). Effective anti-depressants would eliminate awareness of moral consequences for decision making and lead to a bleak and dark future for humanity because unresolved problems would just keep piling up until we reach the tipping point where civilisation starts to unravel. Let us hope we all grow to be far more enlightened before the drug companies ever figure out how to make anti-depressants that are actually effective.
Now, most users of anti-depressants will say they need to take them for their anxiety or their depression when these ailments are symptoms of something else being wrong in their lives. I do appreciate that there are perhaps genuine genetic factors or conditions that will make some people more susceptible than others to these conditions; however, I think it is important to consider the advice of Galen on this issue: look for a non-pharmacological solution to your problem first. Try philosophy, diet, lifestyle, and exercise first, and only when these have been tried exhaustively and failed to bring about any improvement should one consider medication and surgery. If you jump to medication and surgery first, then you are risking permanent damage to your body that could be worse than the original condition.
I encourage my clients to think about the pros and cons with taking any drug, legal or illegal, and freely admit that if I have slept badly, I will go and have some caffeine myself so that I can get through my work day efficiently. So I do sometimes decide to take a drug to improve my quality of life in the short term, under specific circumstances. It would be hypocritical of me to condemn drug takers or drug makers. The point is to be responsible about your usage and limit yourself to drugs that will not have permanent or long term negative effects on your health. I might frown when I find out a client is taking streets drugs, but I frown because of the harm and danger they are exposing themselves to, not because they have broken any laws.
Philosophically speaking, anti-depressants are bad for you because they inhibit your ability to listen to your emotions and act accordingly. It can be tempting to want a quick fix to feeling down, but you’re only cheating yourself. True solutions and a pathway to happiness are only found through being sufficiently in touch with reality, understanding what your emotions are trying to tell you, and having the fortitude to act accordingly. Anti-depressants won’t help you get on the right path towards happiness, they will merely help you walk farther down the wrong one, making it take longer in the end to retrace your steps and get back on the right path. No drug will ever fix a bad job, a bad marriage, a bad childhood, or any other negative life circumstance. Only self knowledge and self improvement can do that.