Thanks to Chris' and Andy's previous posts, I have the luxury of entering into this dialog with the majority of our premises already defined. We believe that modern society has now reached the point where neuroscience is on the cusp of understanding the brain in previously unimaginable detail. Future discoveries in drug design and neurobiology will allow us a fine grained control over the mind itself. The time for pubic policy debate is now, while we are at this frontier of possibilities.
Unfortunately, contemporary society has a rather large problem with mind altering substances – by this I refer not only to the cornucopia of scheduled drugs of which possession alone is often a federal offense, but also to the state and corporate sanctioned GDP-boosting kind. Depression, for instance, has now been targeted by big pharma, and thanks in part to many advertisements it is now rightly looked upon as a disease rather than an indication of “weak will or character”. Pfizer's Zoloft alone generated over $3 billion in US sales in 2004. Yet there is a large divergence between these advertisements and current scientific literature.
It has never been shown that depression is a result a serotonin deficiency, as is now commonly believed. This is in part due to the fact that there is no easy way to even measure serotonin levels in living humans.
“I spent the first several years of my career doing full-time research on brain serotonin metabolism, but I never saw any convincing evidence that any psychiatric disorder, including depression, results from a deficiency of brain serotonin. In fact, we cannot measure brain serotonin levels in living human beings so there is no way to test this theory.”
-David Burns, MD, Stanford University
“A serotonin deficiency for depression has not been found.”
-Joseph Glenmullen, MD, Harvard University
To blame mental illnesses such as depression on chemical imbalances is to sidestep important problems – both philosophical and biological. Ignoring these questions leave us personally and societally at a disadvantage. Being depressed at times and even committing suicide is part of being human. This is what it means to live in a world which was created by selfish replication molecules, copying themselves for the sake of copying themselves. Individual happiness does not come into play; it has never been, nor will it ever be, a goal of natural selection. Our feelings and cognitive abilities are evolutionary byproducts, built upon selfish genes.
As such, we can postulate possible causes for depression actually being an adaptive evolutionary condition – “...rank theory proposes that depression is an adaptive response to losing rank and conceiving of oneself as a loser. The adaptive function of the depression...is to facilitate losing and to promote accommodation to the fact that one has lost. In other words, the depressive state evolved to promote the acceptance of the subordinate role and the loss of resources which can only be secured by holding higher rank in the dominance hierarchy. The function of this depressive adaptation is to prevent the loser in a status conflict from suffering further injury....” (Evolutionary Psychology, Stevens and Price) Mother nature does not care how you feel, as long as you manage to reproduce.
This line of thought brings us closer to the root of the problem. We must recognize that these diseases are not based on the individual level, but stem from the very nature of our existence. Through this, we can then understand the rational need for cosmetic pharmacology. Humanity was not created perfect, and society has spent many thousands of years bringing us to our current point. There was a time in history when humans had not even developed written language. It is now time to open our eyes and realize what human engineered chemicals can do for us, both emotionally and cognitively. The science and technologies are coming, we need only make the decision of how to use them.
It is possibly for this reason that depression is currently disguised as a chemical imbalance. People have an easier time imagining “chemical imbalances” than the idea that prehistoric history influences the way in which their minds work. SSRIs are not so much curing their depression as relieving them from worry. (http://psychiatrictimes.com/p990423.html) This would also explain the great successes SSRIs have in treating other mental disorders, ranging from Post-Traumatic Stress Disorder to Obsessive-Compulsive Disorder. One secret of anti-depressive drugs is the fact the selective serotonin reptake *accelerators* are just as effective at treating depression as selective serotonin reuptake *inhibitors*, despite the two having completely opposite effects. This is not widely discussed, as there is only one SSRA on the market, Tianeptine, and it is not currently marketed in the United States.
Tianeptine (brand names: Stablon, Coaxil, Tatinol) is as efficacious in treating depression as Prozac, with fewer side effects. For instance, sexual dysfunction or anorgasmia, is a frequently reported side-effect of SSRIs, yet it has been shown to occur with much less frequency during Tianeptine usage. (Switching to tianeptine in patients with antidepressant-induced sexual dysfunction. Human Psychopharmacology, 2003 Jun;18(4):277-80) Tianeptine also has a mood-brightening effect, in contrast to the emotion flattening caused by SSRIs. Later posts will detail tianeptine in more depth, but pubmed currently contains a wealth of information.
The general human condition itself can be much improved upon, without even entering into the realm of diseases currently standardized in the DSM-IV. Mental diseases when defined in this manner seem to often be an essentialist attempt by society to categorize and classify different behaviors which are rooted in the human condition itself and are quite often unrelated to any one chemical disorder or imbalance. (ie. Rosenhan - “If sanity and insanity exist, how shall we know them?”) Society does this not only for financial gain, but also because it does not know any better. The ontological framework which is evolutionary biology is only currently being deployed, often to vigorous debate and violence by the current Luddite or bioconservative class. It is our goal to help usher in a era where all individuals are free to safely modify their neurochemical makeup to allow them happier and more productive lives.