Living the neurochemical self? Experiences after the success of the SSRIs

ABSTRACT

This is an exploration, in dialogue with Nikolas Rose’s conceptualization of the neurochemical self, of how people taking antidepressants through in-depth interviews make sense of their experiences of using selective serotonin reuptake inhibitors. The neurochemical self, according to Rose, is a self understood as regulated by neurochemical processes, where how we feel is mapped onto the body, more precisely the brain. The findings suggest that one of Rose’s points – that the deep inner self informed by psychoanalysis is gone – has some bearing. However, the plasticity of the biological that Rose argues accompanies a neurochemical understanding that cannot be traced; rather, the understanding of depression is gravitating towards it being a biological, constitutional malfunctioning. Adding to this, even though the users experienced that the pills worked, their understandings bore no relation to the wider neurochemical framework and were riddled with uncertainty. As a conclusion it is suggested that depression is delinked from explanation, and exists in a void abandoned to containment by medicine, although not that effectively treated. In this, the only way to become a functioning subject once again seems to be to go on pills.

KEYWORDS:

• Antidepressant use
• experiences
• neurochemical self
• depression
• Nikolas Rose
• SSRI

Acknowledgements

The author wants to thank her informants for generously sharing their experiences. I also want to thank my colleagues in this research project – Shai Mulinari, Anna Bredström and Marianne Wither Jørgensen – as well as the editor and the reviewers for comments on earlier versions of the manuscript. The manuscript is composed of original material not under review elsewhere.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Kerstin Sandell, Associate Professor, Department of Gender Studies Lund University, Sweden, is a scholar within the field of feminist technoscience studies. Her work mainly focuses on medical practice and the boundaries drawn between the normal and the pathological.

Notes

1. Prozac is the most famous brand name in USA for SSRIs.

2. For an example of the expression of this fear/hope, see Kramer (1997).

3. Data on antidepressant sales were obtained from Apoteket Service AB. http://www.apotekensservice.se/lakemedelsstatistik/ (accessed March 16, 2012).

4. A related group, the SNRIs, account for a little more than 10% of antidepressant prescriptions.

5. The Swedish National Board of Health and Welfare (Socialstyrelsen) has published results showing that for depression and antidepressant prescription, diagnoses are not always given and/or are unclear in medical records (2006).

6. I have in another publication, with Hanna Bornäs explored how experiences of depression and antidepressant use can be both gendered and not (Sandell and Bornäs, 2015).

7. The diabetes/insulin analogy is also identified by, for example, Martin (2010).

8. I have elsewhere, with Hanna Bornäs, argued within a phenomenological theoretical framework, see [Sandell and Bornäs, 2015].

Additional information

Funding

This work was supported by Riksbankens Jubileumsfond [grant number P09-0281:1-E].