I have been living with depression since a teenager and after so many years, I recently finally started receiving psychotherapy (CBT). While I’m already seeing some modest changes in my thinking patterns, my therapist noted that in the last few weeks the severity of the condition is worsening and it might be a good time to talk with my primary care provider about antidepressants as a combination therapy.
This got a reaction out of me, specifically that I don’t like the idea of chemically altering my mental state and losing access to what “I really feel” (as I perceive it).
I know that the logic behind this sentiment is not very solid, but we can’t reason ourselves out of our feelings that easily. For me this is also challenging because I don’t take any recreational substances that affect my mental state, so I can’t tell to myself that it’s like e.g. smoking weed only more targeted and supervised.
I’m curious if this sentiment is familiar to anyone else, and how you dealt with it (whether you decided for or against medication).
I didn’t give a shit about real any more. I wanted more comfortable and did not cate at all whether my new state would be “real”.
I was an eager user of recreational drugs, and I never saw any of my drug experiences as “not real”. Doing psychedelics and uppers and muscle relaxants and all sorts of “research chemicals” gave me a view of my own consciousness as a little tiny sliver of reality modulated by neurotransmitters.
So for example the crazy world of interconnection and possibility that I saw during a trip was just part of reality that I normally wasn’t able to see. And the dark hell that I’d find myself in when coming down from MDMA was just another aspect of reality that I only saw in a certain brain state.
So a better way to put it is that I didn’t really think of there being a reality that I could see while “sober”. I just saw “sober” as a particular state point on the map of states of consciousness.
If I was going to take a drug that got me “high” by making me on average happier and more effective, I was fine with that. I didn’t want to run to win medals I wanted to run to explore the world. Give me steroids, robot legs, rocket skates, I don’t care if it’s my own “accomplishment” or not I just want the mobility.
Now I see it slightly differently. I still believe “sobriety” is but point in a vast landscape of equally legitimate/valid states of consciousness. But I also understand that what antidepressants do isn’t just get you “high” like any other paychoactive drug. They don’t change your mental state directly like that. Instead they alter neurogenesis patterns, and these grow certain parts of your brain, and the expansion of processing power in certain parts of your brain alleviates the depression. The extra capacity tends to lower the threat level perceived by your brain and it enables exploratory, spontaneous engagement with life and that’s the end of your depression.
They like to say “it takes a couple weeks to build up in your blood”.
Naw. MDMA and all other psychoactive oral drugs take a quite uniform 30 - 90 minutes to “build up in your blood”.
What takes two weeks is the effects of neurogenesis — the growth and differentiation of neurons — to have a discernible effect in mood. It’s physical brain changes that take two weeks, not blood concentrations of various orally ingested drugs.
I definitely think that some of my hesitations have to do with not having any experience of using chemicals that affect the mood before, so I don’t have a mental model that I can re-use for antidepressants. I definitely drink caffeine though, so it’s probably valid to say that I have constructed a fiction of me never having done anything like this, but it’s a convincing fiction.
I think of it like a sci for scenario where Earth is destroyed. There’s a new planet and some people might be thinking “but it’s not the same”, but I say it’s better than death.
Without the antidepressants, my emotional world was a charred landscape of pain and misery. No place for a life, even if it is more “natural”.
There’s nothing natural about a helicopter airlifting you out of the water, but the loss of natural is made up for by no longer drowning in a roiling sea.
Just try it for a month. If you decide there’s something too valuable missing with the loss of your “natural” state of mind, you can go back.