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A Question of Degree

March 8, 2010

In Vanilla Sky, that says the sweet isn’t as sweet without the sour. I read it on somebody’s Facebook wall – I haven’t actually seen the movie – but two recent articles about the science and medical practices relating to depression as a psychological condition/disorder brought it to mind. The first, a review of two recent books on the subject by Louis Menand in The New Yorker, exposes the ambiguities of the research that forms the basis of treatments for depression while the second, an article by Jonah Lehrer in the NYT Magazine, parsed recent claims of depression’s evolutionary value. The question they both get at is one of degree: where do we draw the line between sadness, the intense and powerful emotion, and depression, a medical condition that deserves treatment? It’s a significant question that relates to our fundamental values and what we view as the purpose of our lives. The final paragraphs of Menand’s article that lays out the questions most clearly:

What if your sadness was grief, though? And what if there were a pill that relieved you of the physical pain of bereavement—sleeplessness, weeping, loss of appetite—without diluting your love for or memory of the dead? Assuming that bereavement “naturally” remits after six months, would you take a pill today that will allow you to feel the way you will be feeling six months from now anyway? Probably most people would say no.

Is this because of what the psychiatrist Gerald Klerman once called “pharmacological Calvinism”? Klerman was describing the view, which he thought many Americans hold, that shortcuts to happiness are sinful, that happiness is not worth anything unless you have worked for it. (Klerman misunderstood Calvinist theology, but never mind.) We are proud of our children when they learn to manage their fears and perform in public, and we feel that we would not be so proud of them if they took a pill instead, even though the desired outcome is the same. We think that sucking it up, mastering our fears, is a sign of character. But do we think that people who are naturally fearless lack character? We usually think the opposite. Yet those people are just born lucky. Why should the rest of us have to pay a price in dread, shame, and stomach aches to achieve a state of being that they enjoy for nothing?

Or do we resist the grief pill because we believe that bereavement is doing some work for us? Maybe we think that since we appear to have been naturally selected as creatures that mourn, we shouldn’t short-circuit the process. Or is it that we don’t want to be the kind of person who does not experience profound sorrow when someone we love dies? Questions like these are the reason we have literature and philosophy. No science will ever answer them.

Both articles are worth reading.

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