So I was about eight years old when I developed my first serious amphetamine habit. I guess it began when my grades started to slip. Now, if your parents are poor or uneducated or otherwise naïve enough to believe that your grades are actually a reflection of merit, they might just let you fail. But I was lucky. See, if you have middle class parents like I do, bad grades are considered the symptom of a medical problem, at least when they happen to your child. So they took me to a psychiatrist who prescribed Adderall, a drug whose effects turn out not to be significantly different than high-quality crystal meth.

Now, I took this drug for no more than two weeks. The problem was, once that shit started to wear off, I’d sink into just a pit of fury and despair, which I had no way of coping with at the time. See, the thing about uppers is you feel great when you’re on them, but when you come down, you come down hard. And that is a heavy load to lay on the back of an eight-year-old with no experience taking mind-altering chemicals.

So by middle school, the adults in my life had all forgotten about my ADD diagnosis. But once I hit puberty, I started exhibiting some strange behaviors. I became very concerned about my appearance. I was known to style my hair for longer than the appropriate amount of time. And I would sometimes spend half an hour in the bathroom, doing they dared not speculate what. 

This evidence was laid out before the psychiatric authorities, who diagnosed me at age 15 with Obsessive Compulsive Disorder, for which I was prescribed Zoloft, and a regimen of Cognitive Behavioral Therapy, which, needless to say, did not eliminate my effeminate compulsions.

Well, pretty soon I started dating, and dating led to love, and love led to heartbreak, or at least the teenage facsimile thereof. New diagnoses were in order. First depression, and then bipolar disorder. And I’m not making this up, licensed psychiatrists have diagnosed and treated me for all of these disorders. My teenage years were the most intense. I was given SSRIs, NDRIs, mood stabilizers; the whole pharmacopeia. I was seeing a psychiatrist and a psychologist every week, so often that insanity became part of my identity. Because when you’re 15 years old there’s something kind of romantic about madness, especially when it’s 2005.

Mnemosyne, my muse. Wake me up inside.

When I went off to college I discovered this (booze), and it helped me kick my psychiatry habit. But it was only a matter of time before I was back in the office of another shrink, this time with some kind of vague anxiety diagnosis, taking Seroquel and Lamictal. Later on I ended up seeing another psychiatrist to help get off of those drugs, which led to a Klonopin habit that I kicked on my own a couple years ago.

So after nearly two decades of prescription pills, I’m happy to say I’ve been off all psychiatric drugs for about a year and a half now, and I gotta say, I feel just fine, just fuckin fine…

So when I look back at the majority of my life that I was seeing psychiatrists, what I see is five different diagnoses, at least eight different drugs, many hours of therapy, and thousands of dollars spent by my parents and their insurance, and I have to ask myself: was this really necessary?

I suppose I don’t have the medical qualification to say. But as someone who spends a lot of time around me, I have to say that there’s at least a chance, that, in my case, all of this is just nonsense.

And I’m not saying that psychiatry is bullshit, or that it doesn’t help people. I know people who will tell you that psychiatry saved their lives. For all I know, it may have saved my life. I just don’t know. 

What I’m saying, is that there’s reason to be a little bit skeptical, especially when you consider that most of the research on these drugs is funded by pharmaceutical companies with billions of dollars at stake, and that many of the most prescribed psychiatric drugs barely do better than placebo in a lot of studies.

I guess part of me worries that psychiatry medicalizes ordinary human emotions and treats them as disease symptoms. And at the heart of that worry is a fundamental question about what is or isn’t a medical condition. How do we even go about answering that question?

Well, one way would be to take a pragmatic approach. A medical condition is a problem that we go to the doctor to fix. So, for instance, the question to ask is, are drugs the best way to manage eight-year-old boys who don’t like sitting still for eight consecutive hours, or is the problem that schools place unrealistic demands on them? Does a moody teenager have bipolar disorder, or is he just moody? These are the kinds of distinctions that diagnostic criteria are supposed to make, but psychiatric diagnosis is based almost entirely on the subjective self-reports of patients, or, in the case of children and teenagers, of the reports of their parents. Meaning that, if you know what words to say, you can kind of get the diagnosis you’re looking for, or that your parents are looking for.

Now you might think, “Well, we can improve this with more advanced neuro-imaging, or with genetic testing.”

But even if that were possible, it wouldn’t entirely eliminate some fundamental doubts. The decision to treat a pattern of thoughts and feelings as a disease can never be an entirely scientific one. Even if my emotions are statistically abnormal, to call them “diseased” is inevitably to pass a kind of value judgment on them, and value judgments lie beyond the scope of science.

I think there are clearly cases of depression and anxiety so debilitating that treating them like diseases is the best approach. And I don’t want to discredit the experience of anyone who experiences their depression or anxiety as a disease. However, when I look at the current state of psychiatry, what I see is a bunch of drugs that make you fat, impotent and possibly suicidal, only to alleviate your depression to a degree only slightly more clinically significant than inundating your colon with homeopathic crystals and intoning a sincere prayer to Moloch. 

And that, along with the fact that I couldn’t afford a psychiatrist even if I wanted to, is the reason I prefer not to think of my sadness and anxiety as a disease. Instead I think of it as just the perpetual dusk that shrouds my life in a little mild, harmless despair. So, Hail Darkness, Hail Moloch. Let’s whip out the crystals. *sniff*

Ich sehe deinen Geist.

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