This is not my story. This is the story of my friend, who will remain anonymous. Let's call him "Lucas."

Lucas was feeling very down. Very down, very lonely, very alone. Very afraid. So, under the encouragement of his friends, he went to the doctor. That's a smart move, because doctors can often tell you if there's dietary or medical reasons for your depression. This, in fact, is what happened to me in late April of 1999; I was feeling depressed, went to the doctor, and was diagnosed with hypoglycemia. Took care of myself, felt better.

But in Lucas's case, the doctor couldn't find any physiological reasons for his sorrow. As they spoke, Lucas broke down and cried, and they spoke for a long time.

In the end, the doctor put Lucas on a perscription mood-altering drug called "Paxil." Paxil works by keeping serotonin levels high. Sounds harmless enough, right?

I know the stories of five people who went to talk to their doctors (all in PEI) about their depression, myself included. In my case, it turned out that it could be diet-controlled, and was detected in a routine blood-test. Lucas is another. That leaves three unaccounted for.

One, let's call "Joseph." Lucas knows Joseph. Joseph is, to put it mildly, very fucking strange. He was put on Paxil a few years ago. Joseph writes, "All it did for me was kill my libido and make it so that I could never recall any dreams. It just plain sucked." Joseph doesn't take Paxil anymore, and though he can hardly be called "normal" (being a recluse, a hermit, extremely antisocial, and "moody" is an understatement), he doesn't feel that prescription drugs have anything to offer him. Maybe, just maybe, doctors are hasty in prescribing Paxil to some people, rather than looking for another cause of their depression.

The next, let's call "Sandra." Sandra is fifteen years old, and suicidal. She's attempted to slit her wrists on several occasions. Since she started taking Paxil, she's again attempted to commit suicide. She tells me that the most important thing in her life is vodka. Nothing in her life has changed at all since she started taking Paxil. Maybe, just maybe, Paxil doesn't do a goddamn thing for some people – because the problem isn't their mood, it's their attitude.

The final one was actually my first encounter with the demons of institutional psychiatry on Prince Edward Island. Let's call her "Laura." I've always had a soft spot in my heart for Laura, but she's another "moody" one. Her temper and ferocity and weirdness are part of what I love so much about her. Which is why it disturbed me so much when she started taking this "medication" prescribed by her doctor. I'm not sure if Laura was on Paxil or some other related drug, but the principle is the same.

Laura's disposition changed completely, for the worse. She became emotionally numb, and slurred her speech and looked dopey as if she were perpetually drunk. In effect, it had dulled her instincts, and instincts are one of the most important aspects of a person's identity. I talked to her for hours about these things; she told me that she was only going to continue taking the drugs for a while, and only because it was important to her mother, who was paying a lot of money for this "medicine."

Laura no longer takes her medicine. Instead, she lives a relatively stable and generally happy life. It has its ups and downs, like anybody else, and she gets angry sometimes, but she doesn't dwell on it all. She doesn't want to kill herself, and doesn't hurt anyone. In effect, she solved her problems with the support of her friends and with initiative. So maybe, just maybe, it's possible to take charge and address your problems instead of going on some hackbone's prescription.

I have the utmost respect for medical doctors, who know more about your body than you do yourself. But when a family doctor prescribes a mood-altering substance, my suspicions raise. The doctors on Prince Edward Island are too quick to prescribe drugs to fix their patients' problems, and that makes them (in my eyes) little more than glorified pushers. What's more, they make their patients feel like they need the drugs, which is, in my experience, quite false. I think this is a horrible thing to do to a depressed person's self-esteem. But I also have serious philosophical problems with it; they have a metaphysical agenda, if you will, that Lucas can't see. Of course they're going to tell you you need the drugs; they're the "experts," and they wouldn't have us believe that they spent eight or more years getting a "degree" that means nothing in a "discipline" that is so riddled with methodological, epistemological, and ethical holes that it is little more than a farce.

Maybe I would trust a humanist psychologist or a trained counsellor as someone I could talk to. But your average family doctor has no grasp of the philosophical problems assoiciated with his "One Pill Fits All" quick-fix and the demon of the "chemical imbalance," a myth I feel whose time has come.

Lucas hasn't always been as sad as he is now. I remember happy times, and although circumstances were a little different then, Lucas knows as well as I do that things haven't always been so depressing. So any "chemical imbalance" must be a new development. If it's a new thing, then something must have caused it to manifest only now. He hasn't had any sort of head-beating, so actual brain damage is out; he hasn't been taking copious narcotics, so an outside chemical influence is out. The doctor found nothing wrong with him physiologically, so if the problem were viral or bacterial we'd expect to see other symptoms, of which there are none. Therefore, the "chemical imbalance" (a cold term which means, for all I can tell, what those of us with little faith in the institution call "emotion," regardless of how strong it may be) most likely has a circumstantial cause – a bad attitude on Lucas's part. Treating the "imbalance" with drugs is only addressing a symptom, not the cause. Unless Lucas wants to rely on Paxil his whole life, which I think he obviously doesn't have to do, then he's going to have to address whatever's causing his depression; and as long as he quells those emotions, he's going to have very few clues as to what the real problem is.

Now, Lucas and I have had a falling out, because I expressed these opinions out of concern. Apparently, though, he misunderstood what I was saying. He thought that I was judging him as weak because he needed the drug. My point was that I didn't think he really "needed" the drug at all; I didn't mean to make him feel like he had no options, I meant to make him see that he did have many options, and that he didn't have to buy the shrink's bullshit about "chemical imbalances." That crap should've gone out with leeches and humour theory. He's my friend, and I think he's making a mistake; I didn't want to let him get away with kicking his own ass. He seems quite determined to do it, though, and I can't hang around with him to watch that. I've seen it before, with Laura, and it really disturbed me. I'm not going to go through that again.

So, Lucas, I'm sorry. I'm not sorry for saying these things; – I'm sorry for not making it clear that I wasn't judging you, but that I was concerned you were making a bad choice. I stand by this, and this is the most of an apology I can make; if you can't accept this, and think that this issue is worth throwing away thirteen years of friendship, then all that's left to say is:

• You owe me $42.50.
• I need my set of pictures back so that I can scan them.
• It's been a good thirteen years.
• I don't like the drugs.

Noder's Note (December 7, 2000): We worked it out. Just as he had misunderstood my original concerns, I had misunderstood his anger. He's still taking Paxil, and he says it does help.

THE POINT OF THIS NODE:

Taking any mood-altering substance is your own choice. Many of these substances can have therapeutic effects when used properly. However, it is your prerogative and responsibility to determine what is proper; doctors can only ever advise. Not all doctors know what they're talking about, even if they're otherwise smart fellas, and even if they mean well.

THE MORAL OF THIS STORY:

Open, frank communication is the key to lasting friendship. When you disagree with something a friend does, you seriously have to give some consideration to why they did it, and just how stubborn and normative/judgmental you're going to act about it. Sometimes you have to trust other people to figure out what's best for them, even if it's not what you would have done.