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Antidepressants as Spiritual Practice

Disclaimer: In this article, SNS writer Eric Steinhart shares his perspectives on antidepressants and his personal practice. SNS is a diverse community under the large umbrella of naturalistic spiritual ideas and practices, and members or writers may have different ideas and approaches on these matters. Therefore, articles like this can be helpful starting points for dialogue. Please note that the views expressed here are those of the author’s and do not necessarily imply any official position of SNS. This website is not a medical source and none of these materials are meant to serve as medical advice for you or other individuals…

I take mirtazapine at night for depression and low dose escitalopram in the morning for migraines. I’m lucky that these drugs work for me with minimal side-effects. Since I take these molecules every day, taking them is certainly a discipline or practice. But I say that taking them is a spiritual practice. Why say it is spiritual? The term “spiritual” is often criticized for its vagueness. It needs to be clarified.

I think spiritual practices are devoted to the ethical improvement of the self. And if they aim at that kind of improvement, then they are acting, not on some vague self; they are acting on your will or character. They are changing your dispositions, the typical or habitual ways you respond to stimuli. A practice is spiritual if doing it leads to the ethical improvement of your character – it makes you a better person, where better means more virtuous. Spiritual practices are means to the ends defined by virtue ethics. The virtues are the ethically positive features of agents acting in the world together, and these agents are always living bodies. To say that a practice is spiritual means that it aims at the perfection of agency. It aims at changing your character into an ethical ideal, such as a Stoic or Buddhist ideal.

Taking mirtazapine certainly makes me a better person. It relieves my depression. So I am not consumed by negative emotions; I’m less anxious and less angry. And escitalopram reduces my migraines and arthritis pain; less pain makes me more joyful and optimistic. Better emotions make me behave better towards others. I’m kinder. I’m no longer stuck in my ruts. Doors that seemed closed now swing wide open. I am more aware of the possibilities of life. I’m no longer trapped in a defensive posture, responding with automatic hostility towards other people. It’s easier for me to appreciate the alternative perspectives of other people. I’m more sympathetic and compassionate. I feel closer to Buddhist and Stoic ideals, though of course I’ve still got a very long way to get to them. I’m sure there many other ways these drugs make me better. But anybody who’s ever taken anti-depressants knows that this is not an easy road. Like other spiritual journeys, this one is fraught with danger. It takes time to figure out the right drugs and dosages. These molecules have side-effects which can be worse than the disease. Sometimes they don’t work. And it can be ethically disturbing to depend on medications.

I see taking medications as part of a much larger type of spirituality. This spirituality goes hand in hand with lifehacking. It is closely connected with self-tracking and the quantified self. It was, in fact, through careful self-quantification that I was able to link my apparently benign visual auras to some unusual migraine symptoms. The Stoics were perhaps the first self-trackers: they urged daily journaling as a spiritual practice. To be human is to be clothed with techniques and with tools. All spiritual practices involve techniques of self-revision. But techniques expand to become technologies. Spiritual practices become ethical enhancement technologies, they become technologies of enlightenment. Anti-depressants are one kind of ethical technology. But there are many others. Of course, there are virtuous and vicious uses of technology. It would be obviously wrong to use ethical technologies in unethical ways.

There are, for me, many spiritual benefits to taking anti-depressants. One benefit is gratitude: I am grateful to those who discovered these molecules, who advanced our understanding of mental illness by turning it into a purely material science of the brain. This materiality leads to philosophical benefits. Anti-depressants are molecules that act on specific receptors on nerve cells. They change my brain. They remind me that my character emerges from my body.   They remind me that I am an entirely material thing. My mind is not some immaterial substance that floats free from the body. As a purely physical thing, I am like all the other living things on this planet. I am a human animal, one of the great apes, bound up with other animals and plants in the ecology of this earth. The biosphere is a network of interacting molecules. All molecules encode information – they are all signs, pointing towards differing ways of living.

Another benefit to taking anti-depressants is greater self-knowledge. I am, in my nakedness, spiritually disabled or handicapped. My depression and migraine almost certainly emerge from genetic disorders. My genetic code contains internal grammatical conflicts which make it dissonant or inarticulate. My genes mumble and cannot clearly express the meaning of being human. Although I am not fallen, and I do not suffer from any original sin, my genetic code ethically requires revision. It points beyond itself to more articulate genetic codes, codes which are more virtuous, and ultimately to codes which ideally express the meaning of human agency. To remedy my nakedness, I eat mirtazapine and escitalopram; they fill my bloodstream, so that my receptors are baptized with neurological grace. The existence of these salvific molecules suggests that evolution is providential. Any molecule whose consumption facilitates ethical elevation is a natural eucharist. Evolution blesses us with these molecules.

If atoms are letters, then molecules are words. When two or more molecules come together, like an agonist and its receptor, like a noun and a verb, they form a sentence. They express meanings in a chemical language. As entirely material things, we are first spoken in this language.   Our bodies are self-writing molecular texts. We are spoken into being.   The speech which emerges from the molecular networks of our bodies has the power to make value appear in our behaviors. When the molecular text in my body speaks well, when it is eloquent, then its meaning signifies virtue, it points toward the good, its meaning is luminous. But when it speaks poorly, when it curses itself and desecrates the world with its condemnations, then its meaning signifies viciousness, and points towards evil. Its light works against itself, its meaning becomes shadow.

Molecules call to molecules in voices shaped by atomic forces. Molecules speak to each other, they listen to each other, and they hear each other. Receptors call to their ligands; they pray for their agonists; proteins call to genes. But in me, these genes are garbled and weak – my genetic voices fail to answer their calls. The calls to my disordered genes are met with silence, and in that silence, shadow thrives. Fortunately, when my receptors pray for their ligands, their prayers are answered by mirtazapine and escitalopram. Their prayers are answered by good words, that is, by benedictions. When these drugs bind to their receptors in my brain, their sentences are formed in the grammar of light. Brighter meanings shine out through their syntactic conjunctions.

If molecules can talk to molecules, and if I am just a gigantic molecular complex, then it makes sense for me to talk to molecules. I can, without any absurdity, literally talk to escitalopram: I can ask it to bless me; I can thank it for easing my migraines. It answers my request by bonding to molecules in my body. When these molecules bond in my body, they form sentences. These sentences are spoken within my body, which is a great molecular symphony, a chorus of molecular voices. These sentences contribute to the beauty of my visceral symphony. This beauty corresponds to my virtue, so that, through my body, the goodness of human animality is spoken more clearly. This goodness is spoken to other human bodies – but why stop there? It is spoken to every other living molecular complex on the earth, in the entire universe. Our telescopes search the skies for the biosignatures of alien worlds. Life on earth, in turn, sings to the cosmos, broadcasts its molecular symphony, filling space with beauty.

 

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One Comment

  1. Thank you Eric for sharing and for the opportunity to converse on this. I would never presume to know about other people’s conditions, requirements, or experiences. But I think it would be good for me to add some caveats and other takes on antidepressants.

    It is wonderful that you haven’t experienced severe side effects. Thank you for mentioning that finding the right prescription for any individual can be dangerous. I would agree that it’s a good idea to be extremely cautious about beginning any antidepressants. Even with a Doctor’s prescription or advice, it may be good to be careful, as opinions vary among healthcare providers and there may be profit-based issues clouding these matters in some cases.

    And, if one does decide to use them, many recommend doing so for as short a period of time as possible, as negative effects can become lasting. To make matters even more opaque, there have been some studies that suggest the efficacy of antidepressants to placebo are suprisingly similar. And, even when their effects are positive, other studies have found the efficacy of Cognitive Behavioral Therapy (CBT) to be just as effective. This suggests to me that trying every possible alternative is advisable.

    CBT is much like the spiritual practices we promote (Stoicism even influenced its development), but it takes time and patience for these practices to transform. I realize some people’s situation may not allow for that and perhaps something more drastic may open the door to even begin such a process. But what I think a lot of people don’t realize is just how incredibly powerful and transformative Stoic and Buddhist meditation and character development practices can be in one’s life. The ‘Stoic ideal’ can be read about, but no amount of reading will ever get one to it without the practices being employed on a regular basis.

    Here are some links people may find interesting:

    Harvard Health Publishing
    “What are the risks of antidepressants?”
    https://www.health.harvard.edu/newsletter_article/what-are-the-real-risks-of-antidepressants

    Frontiers in Psychology
    “An evolutionary analysis of whether antidepressants do more harm than good”
    https://www.frontiersin.org/articles/10.3389/fpsyg.2012.00117/full

    National Center for Biotechnology Information
    Study: “Antidepressants and the Placebo Effect”
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

    Sunnybrook Health Sciences Centre
    “Comparing antidepressants and behaviour therapy”
    http://sunnybrook.ca/media/item.asp?c=1&i=1362&f=antidepressants-and-CBT-compared

    Anecdotal, but one person’s experience getting caught in a cycle of medications and side effects, and getting out:
    https://www.madinamerica.com/2013/10/story-fight-antidepressants/

    Some evidential issues with Mirtazapine:
    http://psychotropical.info/mirtazapine-a-paradigm-of-mediocre-science

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