There’s a reason antidepressants are referred to as happy pills. While some may find it a gross oversimplification of mental illness, the primary reason we take them is so we can feel happier.
But how happy is too happy?
There’s a puritan vein running through our society that begrudgingly allows us to take consciousness-altering substances for medical reasons, but if we’re simply wanting a buzz, the jaws of temperance clamp down tighter than an elastic burkha.
In some cases, the collateral damage caused by the banning of substances has been the closing off of avenues for potential treatment – take the history of MDMA, for example, one of the active compounds in the street drug Ecstasy.
First discovered in 1912 and patented by the drug company Merck, it was legal in the US until the mid-1980s, by which time authorities had cottoned on to its recreational usage.
It was recreational usage that caught the attention of psychotherapists, who saw the potential benefits of MDMA for lifting mood in the severely depressed. It is only recently that the combination of MDMA and psychotherapy has begun to be studied seriously again.
Dr Michael Mithoefer was part of a team that conducted a study into the use of MDMA with a group of 20 patients with “chronic, treatment-resistent PTSD [post-traumatic stress disorder]”.
MDMA appeared to lower fear levels while increasing access to emotions in general—including painful emotions. This created an opportunity for patients to process painful, traumatic experiences while avoiding the extremes of either being overwhelmed by emotions or experiencing emotional numbing (both common features of PTSD). One of our study participants said:
“Without the study I don’t think I could have ever dug down deep, I was so afraid of the fear. In the sessions there was just no fear; that builds your confidence. When I tried in therapy before, it would send me into a tailspin.”
After an MDMA-assisted session, another participant told us:
“It’s like night and day for me compared to other methods of therapy. Without MDMA, I didn’t even know where I needed to go. Maybe one of the things the drug does is let your mind relax and get out of the way because the mind is so protective about the injury.”
One potential reaction to this might be to ask the question: what’s the difference between giving someone like this MDMA and handing out a hip flask of whisky when they enter the clinic?
We’re so conditioned to the idea that taking drugs is outrageous at best and damaging at worst that we don’t ask the more important question: does it work?
Studies are also underway currently to assess the value of ketamine – also used recreationally – as a treatment for depression.
The limited amount of research conducted to date (all in a hospital setting) has established that ketamine has a rapid antidepressant effect, particularly in those experiencing major depressive episodes that have resisted other forms of treatment, including electro-convulsive therapy.
Again, this may sound amusing, like the cartoon drunk in a bar who orders you another beer to cheer you up after losing your job.
These extremities of reaction to drug use – to condemn it like a fire-and-brimstone preacher or indulge in it giggling like naughty children – is preventing us from having serious discussions about the place drug use has in our society.
As neuroscientist and author Sam Harris points out in his thought provoking essay “Drugs And The Meaning Of Life”:
One of the great responsibilities we have as a society is to educate ourselves, along with the next generation, about which substances are worth ingesting, and for what purpose, and which are not. The problem, however, is that we refer to all biologically active compounds by a single term—“drugs”—and this makes it nearly impossible to have an intelligent discussion about the psychological, medical, ethical, and legal issues surrounding their use…
Many people wonder about the difference between meditation (and other contemplative practices) and psychedelics. Are these drugs a form of cheating, or are they the one, indispensable vehicle for authentic awakening? They are neither. Many people don’t realize that all psychoactive drugs modulate the existing neurochemistry of the brain—either by mimicking specific neurotransmitters or by causing the neurotransmitters themselves to be more active. There is nothing that one can experience on a drug that is not, at some level, an expression of the brain’s potential. Hence, whatever one has experienced after ingesting a drug like LSD is likely to have been experienced, by someone, somewhere, without it.
Is exploring the brain’s potential to help us lead better lives through chemistry such a bad thing? Why should one need a clinical diagnosis of a mental disorder to ingest ‘happy pills’? Should we need an excuse to be happy?