Saturday, December 27, 2008

To the Max--- Life With a Little Help


I'm back from my White Christmas, back to muddy Maryland. I'm trying to find something stimulating to blog about with my brain on psychiatric vacation. Judith Warner of the New York Times has been kind enough to help with her op-ed piece "Living the Off-Label Life." She talks about a Shrink Rap favorite topic: the line between distress and illness, the use of medication (or in this case, non-meds such as coffee ...Clink....diet, etc) to help people reach some idealized potential. Ms. Warner writes:

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What if you could just take a pill and all of a sudden remember to pay your bills on time? What if, thanks to modern neuroscience, you could, simultaneously, make New Year’s Eve plans, pay the mortgage, call the pediatrician, consolidate credit card debt and do your job — well — without forgetting dentist appointments or neglecting to pick up your children at school?

She goes on to discuss an article in Nature:

That’s why when Henry Greely, director of Stanford Law School’s Center for Law and the Biosciences, published an article, with a host of co-authors, in the science journal Nature earlier this month suggesting that we ought to rethink our gut reactions and “accept the benefits of enhancement,” he was deluged with irate responses from readers.

“There were three kinds of e-mail reactions,” he told me in a phone interview last week. “ ‘How much crack are you smoking? How much money did your friends in pharma give you? How much crack did you get from your friends in pharma?’

But Greely and his Nature co-authors suggest that such arguments are outdated and intellectually dishonest. We enhance our brain function all the time, they say — by drinking coffee, by eating nutritious food, by getting an education, even by getting a good night’s sleep. Taking brain-enhancing drugs should be viewed as just another step along that continuum, one that’s “morally equivalent” to such “other, more familiar, enhancements,” they write.
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Seems like something we struggle with over and over....

4 comments:

Rach said...

Almost like self-actualization, no?
As much as I've come to terms with the fact that meds (ie: chemicals) help me live my life safely and in a stable manner, I don't believe that I need them to live a maximally successful life. Big difference.

Motivation needs to come from both internal and external sources...

Oh nature vs. nurture...

Therapy Patient said...

"We enhance our brain function all the time, they say — by drinking coffee, by eating nutritious food, by getting an education, even by getting a good night’s sleep. Taking brain-enhancing drugs should be viewed as just another step along that continuum, one that’s “morally equivalent” to such “other, more familiar, enhancements,” they write."

A big difference is that a good night's sleep, quality food and a good education don't have negative side-effects. Caffeine may be more debatable and seems more like a drug.

Mr Ian said...

Defining a drug is not so easy. Some chemical that alters the function of the body? Like air?

I note pharma's latest move is to actually announce we'd all be better off if we took drug enhancements - regardless of any pre-conditional need.

There is something horribly yet intangibly repulsive about legally pushing drugs onto people.
I prefer the current state of illegality that prevents pharma from marketing to anyone - and leaves the individual to choose to enhance their social/functional life with supplements.

And it's clear that pharma don't like the idea that 'natural' remedies that are not bound by the same FDA restrictions can peddle their wares to all and sundry.

We've socially tries to manage the enhancement/drug culture for several generations with arguable levels of success and failure. But at least the pendulum is somewhere near the middle. If it gets kocked off kilter - it's going to have to go to one extreme or another.

a psychiatrist who learned from veterans said...

What was it Sherlock Holmes said? 'It seems like a 2 pipe problem?' The caveat as someone suggested is to know/think about the side effects. The issues here are I think what contribute to 'Why doctors don't like Xanax' being one of Roy's favorite posts. I don't think 'Big Pharma' is the problem here; I'd say it is our drug abuse subculture.