In his piece in this week’s New Yorker on depression, and depression-related research, Louis Menand asks, “Is psychopharmacology evil, or is it useless?” Increasingly, skeptics say it’s the latter, and new tests telling us placebos are as effective as anti-depressants only bolster their view. But whether or not these drugs work, there is another, vastly less statistical, dilemma: if we’re all happy all the time (whatever that means) will we lose something—a feeling, a challenge, an intellectual asset—fundamental to life?
Menand designs a simple, provocative test, an emotional one. He asks the reader to consider giving up grief. Grief, after all, has certain similarities to what physicians term depression. Yet unlike many modes of diagnosable depression—it also has a clear cause: loss. He writes:
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.
Amen. Earlier in the piece, Menand makes this beautiful (his always are) metaphor:
Science, particularly medical science, is not a skyscraper made of Lucite. It is a field strewn with black boxes.
The box labeled “the brain” will be the hardest to recover.