Marcia Angell wrote an article a couple of months ago, titled "The epidemic of mental illness", in which she discusses psychoactive drugs as a cure for mental illness. Angell believes that drug cures, while becoming increasingly used in place of talk therapy, is an effective form of treatment, and almost always detrimental instead, to a person's health. However, there are also others who believe in the opposite, that we are able to cure mental illnesses more effectively with drugs. The reason for the controversial nature of this issue can be found in the limitations of the four ways of knowing: reason, emotion, sense perception and language.
Psychoactive drugs are considered an effective form of treatment because they appear to treat the symptoms of mental illnesses in a seemingly logical and scientific manner. For example, depression, a mental illness, causes a drop in serotonin levels. So-and-so drug increases serotonin levels. So-and-so drug is a cure for depression. However, this line of reasoning becomes flawed, because any type of reasoning is based on premises which we have to first accept. The drop in serotonin levels might not be a direct result of depression and merely the side effect of a change in another aspect. We are assuming that the drop in serotonin levels is either a result of or the cause for depression and by altering it, we can effectively cure depression.
Another limiting for the effectiveness of psychoactive drugs lies in emotion. When a drug is administered to a person, and the person reports that the mental illness or symptoms of it are going away, it might in fact be a result of emotion and not the drugs themselves. By believing that the drugs will effectively cure them might in fact be the more effective cure. When individuals are presented with the selective data and results of studies that 'show' how a certain drug can do this or that, they are more inclined to believe it, which is why drugs are advertised in that manner. Mental illnesses such as depression can be altered by changing one's thought process and the drugs merely give them the confidence, or the empathetic ability from the previous success stories, to actively change their thought process. Thus, this is more of a cognitive treatment than a biological (drug) treatment.
Sense perception plays an important role in this argument, because unlike physical injuries or illnesses, a mental illness takes root in the mind and cannot be observed for what it is, if it is in fact what it is. Drug treatments is seen as a magic fix to these internal problems, and is taken because of this. However, because we cannot observe mental illnesses, this also means that we cannot assess the level of effective drug therapy has on them.
Lastly, I believe that language is the main knowledge issue that suggests that drug treatment is not administered properly, if not simply ineffective. The DSM, a catalogue of mental illnesses have been steadily growing in size over the pat few years. Are more people getting mentally ill every year or are we just changing the definitions of mental illnesses to include more people? We need to make sure the focus is always to see the implications symptoms have for people and treat them in the most beneficial way. By labeling people with this or that illness, and then giving them a bunch of drugs to take according to how we stigmatize them is not going to be effective in the long run.
Although the psychoactive drug may offer the patient a boost in physiological performance, consider the concept that this would be stemming from the temporary conviction of their mind on the asserted effect of the drug. Although the drug itself may offer an amazing solution to some forms of mental illnesses, the human psyche should be factored into the overall results of the drug. Just like any other subtle drug taken to boost some form of activity whether physical or psychological, it would not last forever. Take for example the consumption of coffee for the “waking up” affect which is mainly created by our minds. Although caffeine stimulates brain processes, studies have shown that the chemical itself, encouraging synaptic connection in our brain does not actually make us more alert and once the effect wears off, the person sinks into a crash (extremely subtle). However, to make this a much more analogous example, caffeine is completely valid in comparison to nicotine and ecstasy which do the exact same things chemically but are much more dangerous. The psychoactive drug may offer the patient some form of mental belief which contributes to his health, but it will eventually wear off. This gives way for addiction or the eventual disbelief in the effectiveness of the drug as has been questioned in the article. The danger posed by the addiction to the drug would result in a hope to remain within a pleasant state of mind by using the drugs. The inference which can be made from this would be the endangerment of surrounding people and their willingness to do anything for the drug. Since a drug can also be defined linguistically as a dependence, the individuals labeled as having a mental illness would only accumulate another mental illness by relying on the drug.
ReplyDeleteThanks for your comment Terry; this is essentially my argument except I focused more on how how the ways of knowing related to drug therapies. I liked how you used coffee as an analogy; drugs may alleviate symptoms by changing the levels of neurotransmitters in our brain, but this does not effectively deal with how the person has reached that mental state of mind.
ReplyDeleteI remember reading this at the beginning of the year for Psychology class. I think the main issue here would be related to ethics. Is it ethical for psychiatrists to simply prescribe patients with drugs instead of other options such as talk therapy? Are psychiatrists and their patients taking the easy way out instead of taking time to help people who really need it? In regards to emotion, are the statistics Angell provides us with in her article an increase in the number of people with mental illnesses or are they simply a statistic showing us how comfortable people are with admitting they have mental illnesses? Because as history shows, mental illnesses have always been around. However, people may not have been comfortable admitting to experience such symptoms. Additionally, I think language plays a large role in diagnosing mental illnesses. In part 2 of her article, she informs us that children as young as two years old take drugs for mental disorders. However, such symptoms, for lack of a better word, should be found as a characteristic for a child. Isn't a healthy, normal, baby supposed to be somewhat irritable and easily distracted? Are drugs really necessary for these children? Overall, I think Angell provides an interesting outlook on this new "epidemic", and that drugs as treatment should be use wisely, as Jerald points out how drug therapies are related to the ways of knowing.
ReplyDeleteI agree that emotions do play a big role in limiting our understanding to how effective a drug is. The placebo effect, confirmation, bias, and power of suggestion will all influence how a person reacts to a drug. If the person is skeptical of the effects of the drug to begin with, he or she will most likely not find an improvement in his or her mental state. On the contrary, a person who believes that the drug will work will be more likely to find his or her mental state improving after taking the drugs. Emotions give the drug a pre-assumed level of effectiveness, making it hard to isolate how effective the drug is by itself. This is the same as trying to determine if the emotional and behavioral symptoms of PMS is actually real or not. We learned about a psychology experiment in IBSL Psychology that suggests that PMS is a myth. In that experiment, women were asked to graph their moods over a long period of time. Half of the participants were told that this was to measure the effects of PMS, while half of the participants were not told of what the graphs were for. The results showed more drastic mood swings in correlation with their menstrual cycles in the women who were told that the graphs were to measure the effect of PMS, while the graphs of the women who were not told of the aim of the graphs gave a much more consistent mood chart throughout each month. The fact that the psychologists told the women that they were looking for symptoms of PMS suggests that there are really symptoms of PMS, and this simple suggestion makes them more prone to experiencing the symptoms. This could be the same as drug users, as the suggestion of the effectiveness of a drug will influence how effective the drug will be on a person. To better understand the effect of a drug, people should try slipping the drugs into the meals of depressed people and secretly observe the effects (if visible). This would be like the group of participants in the PMS experiment who were not told of what they were graphing for. By doing it this way, the drug users will not be expecting an effect from drugs, so emotions will not influence how effective the drugs are perceived. This however cannot take away other factors that could influence a mood of a person, but is a better way to observe how effective a drug really is.
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