Emotional Choices: What Story You Choose to Believe about Antidepressants Reveals a Deeper Truth about Who You Are

By Jensen, Joli | Reason, April 2004 | Go to article overview

Emotional Choices: What Story You Choose to Believe about Antidepressants Reveals a Deeper Truth about Who You Are


Jensen, Joli, Reason


IN MODERN LIFE, we each get to choose how to act and whom to be. This freedom can also be a curse, because we must make our choices based on approaches to doing and being that may be persuasive but are often in conflict. Our choices are centered on the stories we tell ourselves and the stories we are told; our challenge is to find good ways to choose among contradictory stories.

Such decisions are among the most basic challenges we face, because they become the foundation for a succession of other choices we make throughout our lives, often with no clearly right answers yet with long-term consequences. When we want to make the "right" decision about education, child rearing, or medicine, we must first sort out conflicting claims about what is true.

But while modern life offers us an abundance of compelling stories about what is best for us to do, it offers little guidance for finding our way through a thicket of equally plausible but often mutually contradictory points of view.

There are as many compelling illustrations of this issue as there are choices to make. The example I will use centers on a personal medical decision, but it involves far broader issues: social norms, approaches to choice, even identity. It is about mood medication.

Mother's Little Helper

I'm a prime candidate for such medication--female, entering menopause, with a full-time job and two active children. I've long been prone to bouts of sadness and lethargy. I usually answer yes to most of the depression screening questions found in women's magazines and drug company pamphlets. On top of my symptoms of depression, I have lots of anxiety; I'm definitely a worry-wart, imagining disasters of many kinds befalling me, my loved ones, and the world.

Plenty of experts have tried to convince me that I need mood medication. In the last 10 years my primary care physician, my gynecologist, and even my allergist's assistant have offered to get me prescriptions. I'm also being targeted by pharmaceutical companies with magazine and TV ads that describe me exactly and tell me that I can greet the dawn with gusto, romp with my children, smile at myself in the mirror, and be productive, cheerful, and optimistic ("like myself again") if I take their drugs. Why am I resisting taking mood medications, an option that millions of my fellow citizens have already chosen?

One reason I'm hesitant to take Prozac, Zoloft, Xanax, Celexa, Wellbutrin, or their like involves a related but complicating issue: alcoholism. Years ago, I quit drinking because I believed I was an alcoholic, and if this is true it makes taking even doctor-prescribed drugs problematic. When I was first struggling to control my alcohol use, I strongly resisted the alcoholic label. But my resistance was interpreted by a counselor as denial, which is a key element in the diagnosis of alcoholism. And as with those depression screening questions, I could answer yes to well over the minimum number of questions required for an official diagnosis of alcoholism.

Since even with my best efforts I was unable to control my drinking, I finally adopted the language and beliefs--what we in academic life call the discourse--of alcoholism recovery, including the conviction that the only way to control my addiction was to abstain completely from alcohol and other mood-altering substances. I've successfully abstained from these, one day at a time for more than 20 years.

Many in 12-step recovery circles believe that mood medication--20 years ago it was Librium, Valium, and tricyclic antidepressants--is just alcohol in pill firm. In the 1980s, lots of recovering alcoholics (more women than men) considered themselves dual addicts because they both drank and took pills. Recovering addicts were therefore considered to be one drink or drug away from active addiction. So if these beliefs are true, antidepressants are (for me, if I am indeed an addict) not useful medicine but dangerous drugs.

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