The Psychopharmacology of everyday life.
Everyone is on drugs. I don’t mean the old-fashioned, illegal kind, but the kind made by pharmaceutical companies that come in the form of pills. As a psychoanalyst, I’ve listened to people through the screen of their daily doses; and I’ve listened to them without it. Their natural rhythms certainly change, sometimes very dramatically—I guess that’s the point, isn’t it? I have a great many questions about what happens when a mind—a mind that uniquely structures emotion, interest, excitement, defense, association, memory, and rest—is undercut by medication. In this Faustian bargain, what are we gaining? And what are we sacrificing?
There is new resistance to the easy solution of medicating away psychological problems, because of revelations about addiction and abuse, a better understanding of placebo effects, or, for example, the startling realization that antidepressants, far from saving some teenagers from committing suicide, can sometimes push them to do it, which means that these pills should not be a first line of defense. Perhaps the time is right to return to the conundrum of mind and medicine.
The story of psychopharmacology stretches from the advent of barbiturates at the turn of the century to the discovery in the early 1950s of the first antipsychotic, based on a powerful sedative used for surgical purposes that was described as a “non-permanent pharmacological lobotomy.” This drug, Chlorpromazine, led to the development of most of the drugs used today for psychiatric management. The proliferation of psychiatric medications, ones with supposedly less overt dangers, began in the late 1980s—at the same time, a watershed lawsuit was filed in the UK against the makers of benzodiazepines, a class of drugs used for treating anxiety and other disorders, for knowingly downplaying knowledge of their potential for causing harm. Today, psychopharmacology is a multibillion-dollar industry and an estimated one in six adults in America is on some form of psychiatric medication (a statistic that doesn’t even include the use of sleeping pills, or pain pills, or the off-label use of other medications for psychological purposes).
