Thursday, May 5, 2011

Rockin' the medical high

I don't believe in free will. Recently, this belief has been reinforced by my experiences with medicine. I'm gonna explain what I mean about that.

Some of my earliest memories were of incredibly fury and frustration. As a child of single digit years, I would literally be writhing on my bed in silent fury so intense it was a kind of agony. Other times, I felt a mind-numbing ennui that robbed me of all strength. I told no one of these feelings . . . except my mother, who helpfully told me to hide it. After all, said she, everyone feels angry and frustrated sometimes.

That's what I did. For years, decades. I assumed everyone else felt the same way I did. That they felt the same curious, intense and unspecified angers and frustration. That they felt the same crushing helplessness and hopelessness. I just assumed that they had more determination or willpower than I had.

It wasn't until I lived with Adrienne that I realized that, no, that wasn't normal. Not even a little bit. During this time, I was able to structure my life (or our lives) in such a way as to more or less remove all external sources of meaningful anxiety or frustration. By this time, I could give voice to the specific forms of the malady -- depression and anxiety. Still, despite a long standing belief that willpower is a sham primarily used to manipulate people, I was captured by the old belief that my problem was my will. If only I were stronger!

Several years ago, I started taking St. John's wort for depression. It worked pretty well, not completely, but it took the edge off. I noticed about this time, however, a worsening of my creativity and drive. Still, the respite from depression made SJW worth it. This January, I talked to my doctor about my depression and anxiety. She gave me citalopram which dismantled my depression in the middle of winter, where I have my darkest moods.

However, my creativity and my sense of language failed me. So I talked to a psychiatrist about that. My psychiatrist gave me Adderall.

Again, my life changed. I realized that the happiness I felt under St. John's wort and citalopram was merely the absence of depression. Which is an amazing feeling after being depressed my life long. I also realized that I was suffering a side effect common to both SJW and citalopram: emotional flattening. The absence of pain is not the presence of joy. Adderall, a combination of different flavors of medical speed, reintroduced (introduced?) me to that. Suddenly, women were prettier, music sounded sweeter and I was occasionally struck by the remarkable beauty that surrounds me here in Santa Cruz.*

Additionally, under citalopram, I was able to lose weight. Forty pounds since late January. This is unprecedented in my life. It appears that eating food was a kind of crude self-medication for depression -- fatty and sugary foods increase serotonin, which regulates mood. Adderall has the side-effect of making me not hungry, which is a different pathway . . .

Where is willpower through all of this? All I can find is a bunch of messed up neurochemistry. It just seems like, during my various development phases, or perhaps genetically, I got some damaged neurological pathways. My body doesn't regulate serotonin very well. My body has a damaged dopamine pathway. So taking one drug helps one, another drug helps the other. It gives me clarity of mind, calmness of spirit and . . . I can feel my command of language and creativity returning. I can focus.

At the same time, my problem with weight seems to be diminishing. I don't eat to feel better because I already feel better. And I'm just hungry less often. I have never had such a command over my diet! But I didn't "do" anything to get this command except take a couple of pills.

Wither will? I can't see it. I just see myself as a big ol' chemical reaction, doing things because the interplay of atoms and energy that I call "me" interacts with the environment in particular ways, determined by no one, going nowhere. My life has all metaphysical intentionality as ripples in a pond. What I feel to be intentionality is a chimera, a fantasy created by a heavily negentropic system that evolved in terrestial environment.**

Plus, as a nifty side-effect of all of this, I feel great. Even if I can't sleep as much or as well as I might want. It is a tiny, tiny price to pay!

* Medically, the current theory of what was going on in my brain runs like this: my depression was caused by too little serotonin. The citalopram increased the amount of serotonin in my body, removing the depression. However, I likely also have a short circuit in my dopamine pathways, which are important in the regulation of "rewards" for successfully completing tasks and even simple things like appreciation of beauty. The Adderall stimulates those pathways, making me happier, which allows me to focus better and take pleasure from the exercise of creativity.

** Which isn't as nihilistic as it sounds. Even if there is no spiritual component to human existence, no dualistic "mind", the existentialist truth still abides: we invest value into all components of our existence. How splendid! How . . . liberating! But, Chris, you might ask, how about me deciding if I want to get Cheetos or Doritos at 7-11? Clearly, you might say, I have some free will, if I can choose between those two tasty snacks? I believe that it is simply that we don't have the sense or intellectual ability to process all the factors going into our decisions. This creates a very powerful illusion of free will, but it is no more than the die not understanding the forces acting upon it as it is rolled. And, of course, we are going to react to that sensation, but insofar as no one, anywhere, can understand the factors acting upon us, ideas of will remain a useful fiction for purposes legal, moral and so forth and so on. But we shouldn't kid ourselves, I feel. We are controlled by forces we cannot understand, both internal and external. As we understand these internal and external forces, we will be able to act upon them -- we are acting upon them, which is basically the point of this entire post! My fallacy of free will was getting in the way of my mental health, and because lovely scientists were able to figure out some of the mechanisms of depression and reward, I am subsequently much healthier. And, of course, medical science isn't the only field interested in controlling you. There's always advertising . . .

1 comment:

  1. I mostly stopped by here to say it's AWESOME you're feeling better! Really! I remember the first time I had absence of depression. Dude… *shakes head* It's amazing. You get used to it fast, though ;-)

    As for free will… Well, I'm agnostic on this point too ;-) As in, I'm not sure how far I believe in it, or if I do/don't. (But for example I sure as fuck don't believe that "willpower" can fix moods.)

    But the main thing is it's SO GREAT TO HEAR YOU'RE FEELING BETTER!!!