Main Side Effect of Some Drugs: Identity Confusion

It’s astonishing how effective pharmaceuticals are today with only very minor side effects.

But there’s one side effect yet solved and I suspect it’s the most potent for some drugs: the identity confusion of whether the you on drugs is really “you.”

For drugs that deal with personality issues or depression, I imagine even a successful patient must grapple with whether their newly improved state is artificial. (Artificial in a more serious way than the effect of myriad everyday things like coffee.) Am I really happy or is it just the drug that’s tricking me into thinking so?

If the goal is to have people take medication that can help them while also minimizing in their own minds the fact that they’re on medication, maybe these drugs could induce temporary amnesia immediately after swallowing the pill? The problem is that you need to know you’ve actually taken it!

Bottom Line: We’ve made remarkable progress in eliminating the biological side effects of anti-depressants and other mind-altering drugs, but still have to figure out how to deal with the assorted identity and self-understanding issues that can bedevil medicated patients.

(Note: I have never been on any these drugs so I’m speaking from observation not experience.)

10 comments on “Main Side Effect of Some Drugs: Identity Confusion
  • Dan Gilbert has some interesting ideas on synthetic happiness. Read some of his books, or look for his TED talk. He makes a strong case that synthetic happiness is just as real as “real” happiness.

  • I believe that worrying, “Is it me, or is it the drugs?” is silly self-indulgence.

    You can alter your mood by exercising…do you wonder, “Is it me, or Gold’s Gym?”

    You can alter your mood by having regular sex…do you wonder, “Is it me, or the orgasms?”

    You can alter your mood by sleeping more…do you wonder, “Is it me, or the siesta?”

    In fact, it’s simply yet another way to avoid responsibility. If Prozac cancels out your responsibility for your own happiness, then logically, Johnny Walker should cancel our your responsibility for getting behind the wheel and wiping out the local Cub Scout troop.

  • You might want to read Listening to Prozac. He talks at lengths about patients whose lives were transformed by Prozac and what that means in terms of definition of the self. In many of the patients’ cases, they saw themselves on Prozac as the “real me” vs. the hollow, pre-Prozac personality.

    Note that this is a distinct minority of Prozac users. Most users report benefits from taking the drug, but 20% or so say it changed their lives dramatically.

  • Ben, I have been on medication for many years for both OCD and crippling depression. At times I have struggled with issues of feeling “not like myself” as well as feeling that if the drugs were making me “happy,” then it was an artificial happiness.

    Now that I’ve finally found a combination of drugs that works well for me (and admitted that medication is, for me at least, a lifesaver), I prefer to look at it like this: The drug does not make me happy. The drug evens out the chemicals in my brain so that I’m better capable to make life choices that will make me happy.

    I’ve found that the feelings of “not being myself” are really feelings of fear of change, and fear of success. And though I do still sometimes struggle with the idea that this simply is not the real me, it’s a small price to pay for being a functional human being.

  • I can’t think of a less rewarding subject for contemplation than this so-called “identity confusion of whether the you on drugs is really ‘you’.”

    We should be suspicious of unjustified and exaggerated claims made for the efficacy of such profitable drugs as Prozac or Zoloft. Drug treatment may have its place in treating emotional disorders, but those ultimate purveyors of materialism, the pharmaceutical industry, spend hundreds of millions of dollars to aggressively market their products.

    The truth is that selective serotonin reuptake inhibitors like Prozac do not perform that much better than placebos in controlled clinical trials, except in the most severe depressions.

    We would never know from industry advertising that there is no scientific evidence for the “serotonin-biochemistry imbalance” theory of depression.

    Even much of the current scientific literature is corrupted by publication bias and ghost writing commissioned by the
    pharmaceutical industry.

    Absurd utopian fantasies of better living through chemistry are promoted relentlessly by profit-hungry drug companies, to the point their customers are persuaded they can’t reach their full human potential without them.

    Regarding your rhetorical question, “Am I really happy or is it just the drug that’s tricking me into thinking so?”:

    It is a time-honored practice of wise men and women everywhere to put on a front of happiness when none is felt, and thus to find that depressive moods disappear, and the happy feeling becomes genuine.

    People would do better to cultivate the experience of joy in their daily lives than to try to create it artificially through drugs in a futile effort to restore some elusive and unscientific ‘balance’ of brain chemicals.

    I believe this is where David Foster Wallace went wrong. His writing revealed that he habitually took the most negative view of events. This constant reinforcement of the downside has devastating effects on mental health, and I think his life was a witness to that truth.

  • Vince,
    I welcome you to come watch me pacing back and forth in a doorway while organizing my thoughts into complete sentences and repeating them over and over to myself until I get it “right”–at work, in the middle of the day–and then watch me a week later, on the right combination of medications, and tell me to my face that I’m taking the equivalent of a placebo. Please. There are drugs for all sorts of diseases that work without us knowing the exact chemistry of how or why they work.

    It’s not about creating an artificial joy. It’s about being able to leave my bed and my apartment, and being able to function as a human being.

    Yes, antidepressants are over-marketed and over-prescribed, but that doesn’t mean they’re useless little sugar pills.

  • Thanks for your reply, Carli.

    You should know that I never said antidepressants are “useless little sugar pills”.

    You might notice what I did say: “SSRI’s like Prozac do not perform that much better than placebos in controlled clinical trials, except in the most severe depressions.”

    I know what it is to be clinically depressed, but I’m more familiar with the exaltation of a manic high.

    I’ve been diagnosed with bipolar disorder, but I never took the prescribed Lithium. Instead, I invested abundant energy in building a personal philosophy to deal with unanswered questions.

    But as you say, “There are drugs for all sorts of diseases that work without us knowing the exact chemistry of how or why they work.”


    I used hallucinogenic drugs as a tool to explore the interior landscape, and after a while the extraordinary depth of field you gain that way became ordinary.

    In other words, I never came down from the last trip, and I still have tea with John Lennon every day.;-)

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